Fecal Analysis

Question 1

Of the 9000 mL of fluid ingested daily, how much is excreted in feces?

Answer 1

150 mL

Question 2

Diarrhea is defined as?

Answer 2

>200 mg with increased liquid more than 3x per day

Question 3

What four factors classify diarrhea?

Answer 3

• duration
• mechanism
• severity
• stool characteristics

Question 4

What are the major mechanisms of diarrhea? (3)

Answer 4

• Secretory
• Osmotic
• Altered motility

Question 5

Bacterial, viral and protozoan infections produce increased secretion of water, which override reabsorbtivity of large intestine.

What type of diarrhea?

What are other causese of this type?

Answer 5

• Secretory
• drugs
• laxatives
• IBS (Chrons, ulcerative colitis, lymp. coltis, divert colitis)
• endocrine disorders
• noeplasms
• collagen vascular disease

Question 6

Incomplete breakdown or reabsorbtion of food presents increases fecal material to the large intestine resulting in water retention and electrolytes in large intestine.

What type is this?

Answer 6

Osmotic

Question 7

What are the two kinds of Altered motility?

Answer 7

Enhanced moltility (hyper motility) or slow Motility (constipation)

Question 8

Rapid Gastric emptying (RGE) dumping syndrome describes? RGE time?

What is Healthy gatric emptying time?

What is late dumping?

Answer 8

• Shortened gastric emtying half time <30 mins
• small instetine fills too quick with undigested food and a hall mark of early dumping syndrome.

35 - 100 mins

2 - 3 hours after meal

Question 9

What is Steatorrhea?

Answer 9

Increase in stool fat >6g per day

Question 10

Steatorrhea in malabsorbtion and maldigestion can be distinguished by what test?

What does low and normal results on this test indicate

Answer 10

D-xylose test

Low urine d-xylose = malabsorbtion

Normal d-xylose indicates pancreatitis

Question 11

What causes green stool?

Answer 11

oxidation of fecal bilirubin to biliverdin

Question 12

Fecal leukocytes primarily netrophils are seen in the fecesin conditions that affect?

Answer 12

intestinal mucosa

Question 13

These do not usually cause the appearance of fecal leukocytes?

Answer 13

Viruses and parasites

Question 14

3 neutros per hpf is indicative of?

Answer 14

invasion w/ 70% sensitivity

Question 15

The presence of undigested muscle fibres are helpful in diagnosis of?

Answer 15

pancreatuic insufficiency

Also seen in biliary obstruction

Question 16

Slides for mucles fiber detection use stooly emulsified with?

How long is the slide examined for?

What fibers are counted?

Answer 16

• 10% alcoholic eosin which enhances striations
• 5 minutes
• red strained well-preserved striations

Question 17

Striations of muscle fibers:

Undigested =

Partially digested =

Digested =

Answer 17

• verticle and horizontal striations
• striations in 1 direction only
• no visible striations

Question 18

Sudan II readily stains?

how many droplets per hpf indicate steatorrhea?

Answer 18

• Neutral fats orange-red
• >60

Question 19

What is the most freq. performed fecal analysis?

Bleeding in ecess of what is significant?

Guiaic reagent produces what color?

Answer 19

• Occult blood
• >2.5 mL/150g poop
• blue

Question 20

What Occult blood test does not require diet . drug restrictions and why?

Answer 20

Hemooccult ICT

Specific for human blood (specific to globin portion of hgb)

*** more sensitive to lower GI bleeding

Question 21

Quantitative fecal Fat Testing:

What must the patient maintain?

What test is the gold standard?

What is a rapid test for the etimated amount of fat secretion?

Answer 21

regulated fat intake of 100g/pd prior to and during collection.

Van de Kamer titration

Acid steatocrit