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AUBF > Fecal Analysis > Flashcards

Fecal Analysis Flashcards

1
Q

a specimen that contains bacteria, cellulose, undigested foodstuffs, GI secretions, bile pigments, cells from the intestinal walls, electrolytes, and water

A

Fecal Specimen

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2
Q

how much feal specimen is excreted in a 24-hour period

A

100 to 200 g

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3
Q

resistant to digestion pass through the upper intestine unchanged but are metabolized by bacteria in the lower intestine, producing large amounts of flatus

A

Oligosaccharides

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4
Q

site where digestion of ingested proteins, carbohydrates, and fats takes place

A
  • Alimentary Tract
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5
Q

primary site for the final breakdown and reabsorption of compounds

A

Small Intestine

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6
Q

aid in the digestion of fats

A

Bile salts

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7
Q

how much fluid is excreted in the feces

A

150 mL

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8
Q

When the amount of water reaching the large intestine exceeds this amount, it is excreted with the solid fecal material, producing

A

diarrhea

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9
Q
  • provides time for additional water to be reabsorbed from the fecal material, producing small, hard stools
A

Constipation

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10
Q

it is increase in daily stool weight above 200 g, increased liquidity of stools, and frequency of more than three times per day

A

Diarrhea

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11
Q

diarrhea lasting less than 4 weeks

A

Acute Diarrhea

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12
Q

diarrhea persisting for more than 4 weeks

A

Chronic Diarrhea

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13
Q

major mechanisms of diarrhea

A

secretory, osmotic, and intestinal hypermotility

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14
Q

laboratory test use to differentiate major mechanism of diarrhea

A

fecal electrolytes (fecal sodium, fecal potassium), fecal osmolality, and stool pH

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15
Q

Normal Total Fecal Osmolarity

A

290 mOsm/kg

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16
Q

Normal Fecal Sodium

A

30 mmol/L

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17
Q

Normal Fecal Potassium

A

75 mmol/L

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18
Q

formula on how to calculate fecal osmotic gap

A

osmotic gap = 290 - [2 (fecal Na + K)]

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19
Q

A fecal fluid pH of less than 5.6 indicates a

A

malabsorption of sugars

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20
Q

A fecal fluid pH of less than 5.6 indicates a malabsorption of sugars, causing an

A

osmotic diarrhea

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21
Q

caused by increased secretion of water

A

Secretory Diarrhea

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22
Q

what leads to secretory diarrhea

A

Bacterial, viral, and protozoan infections –> increased secretion of water and electrolytes –> override the reabsorptive ability of the large intestine –> leading to secretory diarrhea

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23
Q

osmotic gap of osmotic diarrhea vs secretory diarrhea

A

osmotic diarrhea = greater than 50 mOsm/kg
secretory diarrhea = less than 50 mOsm/kg

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24
Q

caused by poor absorption that exerts osmotic pressure across the intestinal mucosa – results in excessive watery stool

A

Osmotic diarrhea

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25
Q

impaired food digestion

A

Maldigestion

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26
Q

impaired nutrient absorption by the intestine

A

Malabsorption

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27
Q

it is when an unabsorbable solute increases the stool osmolality and the concentration of electrolytes is lower

A

Osmotic gap

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28
Q

when the specimen is stored for hours, there is markedly increased osmolality. why?

A

there is increased degradation of carbohydrates

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29
Q

describes conditions of enhanced motility (hypermotility) or slow motility (constipation)

A

Altered Motility

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30
Q

functional disorder in which the nerves and muscles of the bowel are extra sensitive, causing cramping, bloating, flatus, diarrhea, and constipation

A

Irritable Bowel Syndrome (IBS)

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31
Q

excessive movement of intestinal contents through the GI tract that can cause diarrhea

A

Intestinal hypermotility

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32
Q

describes hyper motility of the stomach and the shortened gastric emptying half-time, which causes the small intestine to fill too quickly with undigested food from the stomach

A

Rapid Gastric Emptying (RGE) dumping syndrome

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33
Q

hallmark of early dumping syndrome (EDS)

A

Rapid Gastric Emptying (RGE) dumping syndrome

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34
Q

gastric emptying time of Rapid Gastric Emptying (RGE) dumping syndrome

A

< 35 mins

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35
Q

Symptoms begin 10 to 30 minutes following meal ingestion

A

Early Dumping Syndrome (EDS)

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36
Q

occurs 2 to 3 hours after a meal and is characterized by weakness, sweating, and dizziness

A

Late Dumping Syndrome (LDS)

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37
Q

useful in diagnosing pancreatic insufficiency and small-bowel disorders that cause malabsorption

A

Steatorrhea (fecal fat)

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38
Q

when there Absence of bile salts that assist pancreatic lipase in the breakdown and subsequent reabsorption of dietary fat (primarily triglycerides)

A

Steatorrhea (fecal fat)

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39
Q

what decrease the production of pancreatic enzymes

A

cystic fibrosis, chronic pancreatitis, and carcinoma

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40
Q

a sugar that does not need to be digested but does need to be absorbed to be present in the urine

A

D-xylose

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41
Q

what happens if D-xylose is low

A

resulting steatorrhea indicates a malabsorption condition

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42
Q

what indicates a normal D-xylose test

A

pancreatitis

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43
Q

increase results seen in steatorrhea

A

1 to 8 µm is considered slightly increased, and 100 droplets measuring 6 to 75 µm

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44
Q

normal results in steatorrhea

A

100 small droplets, less than 4 µm in diameter, per high-power field

45
Q

what specimen may signify a blockage of the bile duct

A

pale (acholic stools)

46
Q

what specimen indicates intestinal oxidation of stercobilinogen to urobilin

A

Brown Feces

47
Q

specimen color with - Upper GI

A

black, dark red, tarry stool

48
Q

what produces the black, tarry stool

A

when there is degradation of hemoglobin during the time when - Blood that originates from the esophagus, stomach, or duodenum takes approximately 3 days to appear in the stool

49
Q

stool color with lower GI

A

red stool

50
Q

what makes the stool red

A

blood has less time to be reabsorbed

51
Q

stool of patients taking oral antibiotics, because of the oxidation of fecal bilirubin to biliverdin

A
  • Green stools
52
Q

primary neutrophil that affect the intestinal mucosa

A

Leukocytes

53
Q

stains use for fecal leukocytes

A
  1. wet preparations stained with methylene blue
  2. dried smears stained with Wright’s or Gram stain
54
Q

faster procedure for feal leukocytes but may be more difficult to interpret

A
  • Methylene Blue
55
Q

provide permanent slides for evaluation

A
  • Dried Preparations
56
Q

finding of any neutrophils has ap proximately 70% sensitivity for the presence of invasive bacteria

A

oil immersion

57
Q

detects fecal leukocytes and remains sensitive in refrigerated and frozen specimens

A
  • Lactoferrin Latex Agglutination Test
58
Q

what indicates an invasive bacterial pathogen

A
  • presence of lactoferrin
59
Q
  • frequently ordered in conjunction with microscopic examinations for fecal fats
A
  • Pancreatic Insufficiency
60
Q

what enhances the muscle fiber striations

A
  • emulsifying a small amount of stool in 10% alcoholic eosin
61
Q

muscle striations in only one direction

A
  • Partially Digested Fibers
62
Q

no visible striations of muscle fibers

A

Digested Fibers

63
Q

the only muscle fiber that are counted

A

undigested fibers

64
Q

stains used for neutral fats (triglycerides), fatty acid salts (soaps), fatty acids, and cholesterol.

A

Sudan III, Sudan IV, or oil red O

65
Q

most frequently used stain in fecal fats

A

Sudan III

66
Q

appearance of neutral fats when stained by Sudan III

A

Orange - red droplets

66
Q

what does not directly stain with sudan III

A
  • Soaps and fatty acids
67
Q
  • most frequently performed fecal analysis
A

Occult blood

67
Q

necessary when there is no visible bleeding present despite the excess bleeding of 2.5mL/150g of stool

A
  • fecal occult blood testing (FOBT)
68
Q
  • has a high positive predictive value for detecting colorectal cancer in the early stages
A

occult blood

68
Q
  • most frequently used screening test for occult blood
A

Guaiac-Based Fecal Occult Blood Tests

69
Q
  • reaction uses the pseudoperoxidase activity of hemoglobin reacting with hydrogen peroxide to oxidize a colorless compound to a colored compound
A

Guaiac-Based Fecal Occult Blood Tests

70
Q

it is based on detecting the pseudoperoxidase activity of hemoglobin

A

Guaiac-Based Fecal Occult Blood Tests

71
Q
  • Prevent False-positive reaction
A
  1. test sensitivity must be decreased, which can be accomplished by varying the amount and purity of the guaiac reagent used in the test
  2. Obtaining samples from the center of the stool avoids false-positive reactions
  3. specimens mailed to the laboratory should not be rehydrated before adding the hydrogen peroxide unless specifically instructed by the kit manufacturer
  4. Specimens applied to the paper in the laboratory should be allowed to dry before testing.
  5. specimens should be tested within 6 days of collection
  6. Two samples from three different stools should be tested before a negative result is confirmed
71
Q

what do you instuct to the patient instructTo prevent the presence of dietary pseudoperoxidases in the stool,

A

patients should be in structed to avoid eating red meats, horseradish, melons, raw broccoli, cauliflower, radishes, and turnips for 3 days before specimen collection.

72
Q

during collection why do you advice patient to not take aspirin and NSAIDs 7 days before the collection

A

to prevent possible GI irritation

72
Q

why vitamine C avoided 3 days before collection

A
  • because ascorbic acid is a strong reducing agent that interferes with the peroxidase reaction, causing a false-negative result
73
Q

true or false:
Failure to allow stool samples to soak into the filter paper slide for 3 to 5 minutes before adding developer may result in a false-negative result

A

true

74
Q
  • is specific for the globin portion of human hemoglobin and uses polyclonal anti-human hemoglobin antibodies
A

Immunochemical Fecal Occult Blood Test

75
Q

a FOBT that is more sensitive to lower GI bleeding that could be an indicator of colon cancer or other GI disease and can be used for patients who are taking aspirin and other anti-inflammatory medications

A

Immunochemical Fecal Occult Blood Test

75
Q
  • offers a porphyrin-based FOBT fluorometric test for hemoglobin based on the conversion of heme to fluorescent porphyrins
A
  • HemoQuant of Porphyrin-Based Fecal Occult Blood Test
75
Q
  • measures both intact hemoglobin and the hemoglobin that has been converted to porphyrins
A

HemoQuant (Porphyrin-Based Fecal Occult Blood Test)

76
Q
  • confirmatory test for steatorrhea
A

Quantitative Fecal Fat Testing

76
Q

what makes HemoQuant (Porphyrin-Based Fecal Occult Blood Test) false - positive

A

non-human sources of blood (red meat) are present such as red meat

77
Q

a Fecal fat test that - requires the collection of at least a 3-day specimen

A

Quantitative Fecal Fat Testing
- - The patient must maintain a regulated intake of fat (100 g/d) before and during the collection period.

78
Q
  • rapid (5 minutes) and safe procedure for analyzing quantitative fecal fat
A
  • Hydrogen Nuclear Magnetic Resonance Spectroscopy (1H NMR)
78
Q

method routinely used and is the gold standard for fecal fat

A
  • Van de Kamer titration
79
Q

what is the reference base of Hydrogen Nuclear Magnetic Resonance Spectroscopy (1H NMR)

A

100 g/d intake are 1 to 6 g/d or a coefficient of fat retention of at least 95%.

80
Q

a rapid test to estimate the amount of fat excretion

A
  • Acid Steatocrit
81
Q
  • distinguish between the presence of fetal blood or maternal blood in an infant’s stool and vomits
A

APT Test (Fetal Hemoglobin)

82
Q
  • distinguishes not only between HbA and HbF but also between maternal hemoglobins AS, CS, and SS
A

APT Test (Fetal Hemoglobin)

83
Q

results of alkali-resistant fetal hemoglobin during APT test

A

solution remains pink (HbF) after standing for 2 minutes

84
Q

is capable of gelatin hydrolysis but is most frequently measured by spectrophotometric methods

A
  • Chymotrypsin
84
Q
  • denaturation of the maternal hemoglobin (HbA) during APT test
A

yellow-brown super natant after standing for 2 minutes

85
Q

is more resistant to intestinal degradation and is a more sensitive indicator of less severe cases of pancreatic insufficiency

A
  • Fecal chymotrypsin
85
Q

what causes high concentration of HbF

A

the presence of maternal thalassemia major producing erroneous results

86
Q

an isoenzyme of the enzyme elastase and is the enzyme form produced by the pancreas
- is pancreas specific and its concentration is about five times higher than in pancreatic juice

A
  • Elastase I
87
Q

Elastase I is measured by

A

ELISA kit

88
Q

ELISA kit for Elastase I provides

A

provides a very sensitive indicator of exocrine pancreatic insufficiency

89
Q

it causes osmotic diarrhea from the osmotic
pressure of the unabsorbed sugar in the intestine drawing in fluid
and electrolytes

A

Increase carbohydrates

90
Q
  • test is specific in differentiating pancreatic from nonpancreatic causes in patients with steatorrhea
A

Elastase I

91
Q

a result of intestinal inability to
reabsorb carbohydrates, as is seen in celiac disease, or lack of
digestive enzymes

A

presence of carbohydrates in CSF

92
Q

detects congenital disaccharidase deficiencies as well as
enzyme deficiencies due to nonspecific mucosal injury

A

Copper Reduction Test

92
Q

normal stool pH

A

7 and 8

93
Q

distinguish between diarrhea caused by abnormal
excretion of reducing sugars and those caused by various
viruses and parasites

A

Clinitest tablet

93
Q

carbohydrate intolerance reference range

A

0.5 g/dL

94
Q

most common test for malabsorption of carbohydrate

A

D-xylose

95
Q

test for maldigestion of carbohydrate

A

lactose intolerance

96
Q
A

AUBF (5 decks)

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