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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
Q

Altered motility: <35 minutes

A

Rapid gastric emptying (RGE; dumping syndrome)

26
Q

Early dumping syndrome

A

10 to 30 minutes

27
Q

Late dumping syndrome

A

2 to 3 hours

28
Q

Causes of altered motility (5)

A

Gastrectomy, gastric bypass, postvagotomy, duodenal ulcer, diabetes mellitus

29
Q

Increased fats in the stool >7 g/day. Pancreatic insufficiency and malabsorption and lack of bile salts (triglyceride digestion)

A

Steatorrhea

30
Q

Causes of steatorrhea (3)

A

Cystic fibrosis, pancreatitis, and malignancy decrease pancreatic enzymes for lipid breakdown

31
Q

Physical appearance of steatorrhea feces

A

Pale, greasy, bulky, foul odor

32
Q

What kind of containers are used for feces collection

A

Ova and parasite containers

33
Q

How long are quantitative collections?

A

72 hours

34
Q

Color and consistency of stool: upper GI bleeding; iron therapy

A

Black tarry stool

35
Q

Color and consistency of stool: lower GI bleeding

A

Red stool

36
Q

Color and consistency of stool: fat malabsorption

A

Steatorrhea (greasy, spongy)

37
Q

Color and consistency of stool: watery fecal material

A

Diarrhea

38
Q

Color and consistency of stool: bowel obstruction

A

Ribbon like stools

39
Q

Color and consistency of stool: inflammation of intestinal wall (colitis)

A

Mucus

40
Q

Color and consistency of stool: bile-duct obstruction, obstructive jaundice

A

Clay-colored; pale

41
Q

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

A

Fecal leukocytes

42
Q

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

A

Fecal fat

43
Q

Name the type of fecal analysis

Significance: look for undigested striated muscle fibers

A

Muscle/meat fibers

44
Q

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

A

Occult blood (GFOBT or IFOBT)

45
Q
A

Sudan III stain for fecal fats

46
Q
A

Occult blood slide

47
Q

APT test for fetal hemoglobin test step 1

A

Checking bloody stools and vomit from neonates who may have swallowed maternal blood during delivery

48
Q

APT test for fetal hemoglobin test step 2

A

Emulsify material in water to release Hgb

49
Q

APT test for fetal hemoglobin test step 3

A

Centrifuge, add 1% NaOH to pink supernatant
Pink color remains = alkali-resistant fetal Hgb
Yellow-brown = maternal Hgb

50
Q

High Hgb =

A

Maternal thalassemia

51
Q

Definitive test for steatorrhea

A

Quantitative fecal fat

52
Q

Patient requirements for quantitative fecal fat test

A

Limit fat intake for 3 days before
Avoid laxatives, fat substitute, oils, creams, lubricants
Collect feces for 2-3 days

53
Q

How does CLS test quantitative fecal fat

A

Weigh, emulsify and aliquot for liquid testing

54
Q

Common fecal testing on infants for disaccharidase deficiencies and lactose intolerance in adults

A

Fecal carbohydrate tests

55
Q

Why is pH tested in fecal carbohydrate tests

A

To detect fermentation of excess carbohydrates by intestinal bacteria

56
Q

What is normal stool pH and what does pH below 5.5 indicate?

A

Normal pH =7 to 8

Below 5.5 indicates increased carbohydrates

57
Q

Describe the Clinitest and an abnormal result

A

One part stool in two parts water; emulsify and perform test

> 250 mg/dL is abnormal

58
Q

Inadequate intestinal absorption can cause

A

Excess carbohydrate in feces

59
Q

Xylose test tests for

A

Malabsorption

60
Q

Low level of D-xylose in urine indicates

A

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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