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CLS 304 > Chapter 10 Fecal Analysis > Flashcards

Chapter 10 Fecal Analysis Flashcards

1
Q

What is fecal analysis used to detect

A

GI bleeding, liver and biliary duct disorders, pancreatic disorders malabsorption syndromes, maldigestion, and infections

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2
Q

Fecal specimen contain what 8 things

A

Bacteria, cellulose, undigested foodstuffs, GI secretions, bile pigments, cells from the intestinal walls, electrolytes, water

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3
Q

How much feces is extracted in a 24-hour period?

A

100 to 200g

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4
Q

What is the primary site for the final breakdown and reabsorption of proteins, carbohydrates, and fats

A

Small intestine

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5
Q

What is the site of water, sodium, and chloride absorption

A

Large intestine

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6
Q

About how much ingested fluid, saliva, gastric, liver, pancreatic, and intestinal secretions enter the digestive tract each day

A

9000 mL

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7
Q

How much excess water causes diarrhea

A

> 3000 mL

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8
Q

What causes constipation?

A

Increased water absorption in large intestine with decreased bowel motility

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9
Q

> 200 g stool weight per day with increased liquid and more than 3 movements per day

A

Diarrhea

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10
Q

Chronic diarrhea duration

A

> 4 weeks

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11
Q

Acute diarrhea duration

A

<4 weeks

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12
Q

Mechanisms of diarrhea

A

Secretory, osmotic, altered motility

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13
Q

Lab tests for diarrhea

A

Fecal electrolytes, osmolality, and pH

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14
Q

Diarrhea pH <5.6 indicates

A

Sugar malabsorption

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15
Q

What is used to calculate fecal osmotic gap for diarrhea

A

Sodium, potassium, osmolality

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16
Q

Increased solute secretions by intestines cause increase secretion of water and electrolytes to large intestines causes

A

Secretory diarrhea

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17
Q

Secretory diarrhea bacterial, viral, and protozoan infections

A

E. coli, clostridium, Vibrio cholerae, salmonella, shigella, staphylococcus, campylobacter, cryptosporidium

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18
Q

Other causes of secretory diarrhea

A

Drugs, laxatives, inflammatory bowel diseases/colitis, endocrine disorders, malignancy, collagen vascular disease

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19
Q

Poor absorption that exerts osmotic pressure across the intestinal mucosa

A

Osmotic diarrhea

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20
Q

What causes osmotic diarrhea

A

Incomplete digestion of reabsorption of food increases water retention in large intestine

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21
Q

Impaired digestion of foods

A

Maldigestion

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22
Q

Impaired reabsorption

A

Malabsorption

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23
Q

What causes osmotic diarrhea (7)

A

Lactose intolerance, celiac sprue (malabsorption), amebiasis, giardiasis, antibiotics, laxatives, antacids

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24
Q

Hypermotility and constipation; food, chemicals, stress, and exercises are causes of

A

Irritable bowel syndrome (IBS)

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25
Altered motility: <35 minutes
Rapid gastric emptying (RGE; dumping syndrome)
26
Early dumping syndrome
10 to 30 minutes
27
Late dumping syndrome
2 to 3 hours
28
Causes of altered motility (5)
Gastrectomy, gastric bypass, postvagotomy, duodenal ulcer, diabetes mellitus
29
Increased fats in the stool >7 g/day. Pancreatic insufficiency and malabsorption and lack of bile salts (triglyceride digestion)
Steatorrhea
30
Causes of steatorrhea (3)
Cystic fibrosis, pancreatitis, and malignancy decrease pancreatic enzymes for lipid breakdown
31
Physical appearance of steatorrhea feces
Pale, greasy, bulky, foul odor
32
What kind of containers are used for feces collection
Ova and parasite containers
33
How long are quantitative collections?
72 hours
34
Color and consistency of stool: upper GI bleeding; iron therapy
Black tarry stool
35
Color and consistency of stool: lower GI bleeding
Red stool
36
Color and consistency of stool: fat malabsorption
Steatorrhea (greasy, spongy)
37
Color and consistency of stool: watery fecal material
Diarrhea
38
Color and consistency of stool: bowel obstruction
Ribbon like stools
39
Color and consistency of stool: inflammation of intestinal wall (colitis)
Mucus
40
Color and consistency of stool: bile-duct obstruction, obstructive jaundice
Clay-colored; pale
41
Name the type of fecal analysis Significance: determine cause of diarrhea Neutrophils: bacterial intestinal wall infections, ulcerative colitis, accesses No neutrophils: toxin producing bacteria, viruses, and parasites
Fecal leukocytes
42
Name the type of fecal analysis Significance: detects fat malabsorption disorders by staining with Sudan III or oil red O. Look for increased fat droplets/hpf. Steatorrhea >60 droplets/hpf
Fecal fat
43
Name the type of fecal analysis | Significance: look for undigested striated muscle fibers
Muscle/meat fibers
44
Name the type of fecal analysis Significance: used in early detection of colorectal cancer. Ortho-toluidine method based on pseudoperoxidase activity of hemoglobin. Immunological methods
Occult blood (GFOBT or IFOBT)
45
Sudan III stain for fecal fats
46
Occult blood slide
47
APT test for fetal hemoglobin test step 1
Checking bloody stools and vomit from neonates who may have swallowed maternal blood during delivery
48
APT test for fetal hemoglobin test step 2
Emulsify material in water to release Hgb
49
APT test for fetal hemoglobin test step 3
Centrifuge, add 1% NaOH to pink supernatant Pink color remains = alkali-resistant fetal Hgb Yellow-brown = maternal Hgb
50
High Hgb =
Maternal thalassemia
51
Definitive test for steatorrhea
Quantitative fecal fat
52
Patient requirements for quantitative fecal fat test
Limit fat intake for 3 days before Avoid laxatives, fat substitute, oils, creams, lubricants Collect feces for 2-3 days
53
How does CLS test quantitative fecal fat
Weigh, emulsify and aliquot for liquid testing
54
Common fecal testing on infants for disaccharidase deficiencies and lactose intolerance in adults
Fecal carbohydrate tests
55
Why is pH tested in fecal carbohydrate tests
To detect fermentation of excess carbohydrates by intestinal bacteria
56
What is normal stool pH and what does pH below 5.5 indicate?
Normal pH =7 to 8 | Below 5.5 indicates increased carbohydrates
57
Describe the Clinitest and an abnormal result
One part stool in two parts water; emulsify and perform test | > 250 mg/dL is abnormal
58
Inadequate intestinal absorption can cause
Excess carbohydrate in feces
59
Xylose test tests for
Malabsorption
60
Low level of D-xylose in urine indicates
Malabsorption | D-xylose does not need to be digested but must be reabsorbed to appear in urine

CLS 304 (8 decks)

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