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ANURBF FINALS > FECALYSIS > Flashcards

FECALYSIS Flashcards

1
Q

•An end product of body metabolism

A

Feces

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2
Q

•Produced by the intestines after reabsorption of necessary substances

A

Feces

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3
Q

Clinical Significance of Fecal Analysis
•Early detection of [?]
•[?] disorders
•[?] syndromes
•Inflammation
•Causes of[?]

A

GIT bleeding
Liver and biliary duct
Maldigestion and malabsorption
diarrhea and steatorrhea

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4
Q

•Increase in daily stool weight above 200 g

A

DIARRHEA

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5
Q

: less than 4 weeks

A

•Acute DIARRHEA

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6
Q

: >4 weeks

A

•Chronic DIARRHEA

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7
Q

↑liquidity; frequency > 3x/day

A

DIARRHEA

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8
Q

Incompletebreakdown or reabsorption of food

A

Osmotic Diarrhea

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9
Q

> Lactose intolerance

A

Osmotic Diarrhea

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10
Q

> Celiac sprue

A

Osmotic Diarrhea

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11
Q

> Malabsorptionof sugar

A

Osmotic Diarrhea

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12
Q

> Amebiasis

A

Osmotic Diarrhea

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13
Q

> Antibiotic administration

A

Osmotic Diarrhea

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14
Q

> 50 mOsm/kg

A

Osmotic Diarrhea

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15
Q

<60 mmol/L

A

Osmotic Diarrhea

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16
Q

<5.3

A

Osmotic Diarrhea

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17
Q

Increased secretion of water and electrolytes

A

Secretory Diarrhea

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18
Q

> Enterotoxinproducing bacteria

A

Secretory Diarrhea

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19
Q

> Drugs,laxatives

A

Secretory Diarrhea

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20
Q

> Inflammatory bowel disease

A

Secretory Diarrhea

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21
Q

> Endocrine disorders

A

Secretory Diarrhea

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22
Q

<50 mOsm/kg

A

Secretory Diarrhea

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23
Q

> 90 mmol/L

A

Secretory Diarrhea

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24
Q

> 5.6

A

Secretory Diarrhea

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25
Q

•Increase in stool fat (>6g/day)

A

STEATORRHEA

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26
Q

•Useful for the diagnosis of pancreatic insufficiency and small bowel disorders that cause malabsorption

A

STEATORRHEA

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27
Q

•Stool appears pale, greasy, bulky, spongy or pasty

A

STEATORRHEA

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28
Q

: used to differentiate malabsorptionfrom maldigestion

A

•D-xylose Test

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29
Q

Low D-xylose:

A

malabsorption

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30
Q

Normal D-xylose:

A

maldigestion(pancreatitis)

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31
Q

: suitable for qualitative testing for blood, and microscopic examination of leukocytes, muscle fibers and fecal fats

A

Random

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32
Q

: for quantitative testing

A

3-Day Collection

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33
Q

•Specimen Containers

A
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34
Q

•Type and Amount Collected

A
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35
Q

•Contaminants to Avoid

A
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36
Q

•Gas Formation

A
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37
Q

Upper gastrointestinal bleeding

A

Black

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38
Q

Ingestion of iron,charcoal,bismuth

A

Black

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39
Q

Lower gastrointestinal bleeding

A

Red

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40
Q

Beets and foodcoloring

A

Red

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41
Q

Rifampin

A

Red

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42
Q

Bile duct obstruction

A

Pale yellow,white, gray

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43
Q

Diagnostic procedures that use barium sulfate

A

Pale yellow,white, gray

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44
Q

Biliverdin/oral antibiotics

A

Green

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45
Q

Green vegetables

A

Green

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46
Q

Separate hard lumps, like nuts (hard to pass)

A

Type 1

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47
Q

Sausage-shaped, but lumpy

A

Type 2

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48
Q

Sausage-shaped, but with cracks on surface

A

Type 3

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49
Q

Sausage or snake like, smooth and soft

A

Type 4

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50
Q

Soft blobs with clear-cut edges (easy to pass)

A

Type 5

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51
Q

Fluffy pieces with ragged edges, mushy

A

Type 6

52
Q

Watery, no solid pieces (entirely liquid)

A

Type 7

53
Q

Fecal smears are examined for the presence of leukocytes (?), undigested muscle fibers and fats (?)

A

microbial diarrhea
steatorrhea

54
Q

indicates irritation of the intestinal mucosa in ulcerative colitis and bacterial dysentery

A

Neutrophils in feces

55
Q

PRESENCE : diarrhea is caused by

A

invasive bacteria

56
Q

ABSENCE: diarrhea is caused by

A

toxin-producing bacteria

57
Q

All smears or slide preparations must be performed on

A

fresh specimens

58
Q

Types of Smears

A

Wet Smears
Dry Smears

59
Q

faster to prepare, but more difficult to interpret; stained with methylene blue

A

Wet Smears

60
Q

provide permanent slides for evaluation; stained with either Wright’s or Gram stain

A

Dry Smears

61
Q

Fecal Leukocytes Positive result:

A

3 neutrophils/HPF or any neutrophil/OIF

62
Q

Used in the diagnosis and monitoring of patients with pancreatic insufficiency, biliary obstruction and gastro colic fistulas

A

Muscle Fiber

63
Q

Patient Preparation: include red meat in their diet prior to collection

A

Muscle Fiber

64
Q

Specimens should be examined within

A

24 hours of collection

65
Q

Procedure:
1.Stool is emulsified in [?] —> examine for [?]
2.Count number of [?] with well-preserved striations

A

10% alcoholic eosin
5 min
red-stained fibers

66
Q

: with visible striations (vertical and horizontal)

A

-Undigested fibers

67
Q

: with striations in one direction

A

-Partially digested fibers

68
Q

: no striations

A

-Digested fibers

69
Q

Muscle Fiber Significant Result:

A

> 10 undigested fibers

70
Q

•Screening test for the presence of excess fecal fat

A

Qualitative Fecal Fat

71
Q

•Monitoring of patients undergoing treatment for malabsorptiondisorders

A

Qualitative Fecal Fat

72
Q

Qualitative Fecal Fat makes use of lipid dyes:

A

(1) Sudan III, (2) Sudan IV and (3) Oil Red O

73
Q

—readily stained by Sudan III and appear as large orange-red droplets

A

Neutral Fats/Triglycerides

74
Q

Neutral Fats/Triglycerides —steatorrhea

A

> 60 droplets/hpf

75
Q

—do not stain directly with Sudan III

A

Fatty Acid Salts and Fatty Acids

76
Q

—stained by Sudan III after heating and crystallizes during cooling

A

Cholesterol

77
Q

-Specimen must be mixed with HAcand heated

A

Fatty Acid Salts and Fatty Acids

78
Q

-Size and number of fat droplets are noted

A

Fatty Acid Salts and Fatty Acids

79
Q

Fatty Acid Salts and Fatty Acids Normal:

A

100 small fat droplets, <4um in size per hpf

80
Q

Fatty Acid Salts and Fatty Acids Slightly Increased:

A

100 droplets, 1 to 8 um in size per hpf

81
Q

Fatty Acid Salts and Fatty Acids Increased:

A

100 droplets, 6 to 75 um in size per hpf

82
Q

CHEMICAL EXAMINATION TESTS

A

1.Fecal Occult Blood Test
2.Quantitative Fecal Fat
3.Alkali Denaturation Test
4.Fecal Enzymes
5.Carbohydrates

83
Q

•Most frequently performed chemical screening test

A

Fecal Occult Blood Test

84
Q

In Fecal Occult Blood Test, bleeding in excess of [?] stool is pathologically significant

A

2.5ml/150g

85
Q

Used as a mass screening procedure for the early detection of colorectal cancer

A

Fecal Occult Blood Test

86
Q

Fecal Occult Blood Test Principle:

A

pseudoperoxidase activity of hemoglobin

87
Q

Fecal Occult Blood Test Indicator Chromogens:

A

Benzidine
Ortho-toluidine
Gum Guaiac

88
Q

: most sensitive

A

Benzidine

89
Q

: least sensitive

A

Gum Guaiac

90
Q

; preferred for routine testing

A

Gum Guaiac

91
Q

False positive: Guaiac-Based Fecal Occult Blood Tests

A

Turnips, cauliflower, fish, meat, bananas, apples, aspirin

92
Q

False negative: Guaiac-Based Fecal Occult Blood Tests

A

Ascorbic acid

93
Q

•Used as a confirmatory test for steatorrhea

A

Quantitative Fecal Fat

94
Q

Quantitative Fecal Fat

•Patient preparation: regulated intake of fat (?)

A

100g/dl

95
Q

Quantitative Fecal Fat

•Specimen required:

A

refrigerated 3-day specimen

96
Q

Quantitative Fecal Fat

•Normal values: [?] or at least [?] coefficient of fat retention

A

1 to 6 g/dl
85%

97
Q

Methods for Quantitation

A

1.Van De KamerTitration
2.Gravimetric Method

98
Q

—gold standard for fecal fat

A

1.Van De KamerTitration—

99
Q

•Distinguishes between fetal blood or maternal blood

A

APT Test (Fetal Hemoglobin)

100
Q

APT Test (Fetal Hemoglobin) Sample:

A

infant’s stool or vomitus

101
Q

APT Test (Fetal Hemoglobin) Control:

A

cord blood and adult blood

102
Q

APT Test (Fetal Hemoglobin) Procedure
-Sample emulsified in water to [?] —> centrifuge
-[?] is added to the pink Hbcontaining supernatant

A

free hb
1% NaOH

103
Q

APT Test (Fetal Hemoglobin) Result:
—solution remains pink
— yellow-brown

A

Fetal Hb
Maternal Hb

104
Q

—solution remains pink
— yellow-brown

A

Fetal Hb
Maternal Hb

105
Q

Fecal Enzymes Clinical significance

A

•Pancreatic insufficiency: Chronic pancreatitis, cystic fibrosis
•Steatorrhea

106
Q

-X-ray paper is exposed to the stool sample emulsified in water

A
  1. Trypsin/GELATIN TEST
107
Q

-Insensitive procedure and only detects severe cases

A
  1. Trypsin/GELATIN TEST
108
Q

Trypsin/GELATIN TEST

Presence—digestion of gelatin on the x-ray paper =

A

clear area

109
Q

Trypsin/GELATIN TEST

Absence—inability to digest gelatin =

A

no change

110
Q

Fecal Enzymes False (+):

A

proteolyticactivity of bacterial enzymes

111
Q

Fecal Enzymes False (-):

A

intestinal degradation of trypsin; inhibitors in feces

112
Q

-More sensitive indicator of less severe cases of pancreatic insufficiency

A

Chymotrypsin

113
Q

-More resistant to intestinal degradation

A

Chymotrypsin

114
Q

-Remains stable in fecal samples for up to 10 days at room temp

A

Chymotrypsin

115
Q

-Measured spectrophotometrically

A

Chymotrypsin

116
Q

-Pancreas specific and a very sensitive indicator of exocrine pancreatic insufficiency

A

Elastase I

117
Q

-Easy to perform and requires only a single stool sample

A

Elastase I

118
Q

-Measured by immunoassay using the ELISA kit

A

ElastaseI

119
Q

•Valuable assessment of infantile diarrhea

A

Carbohydrates

120
Q

•Accompanied by pH determination

A

Carbohydrates

121
Q

Carbohydrates

-Normal:

A

7-8

122
Q

Carbohydrates

-Increased fermentation:

A

5.5

123
Q

-Detects congenital disaccharidase deficiency

A

Copper reduction Test

124
Q

Copper reduction Test
[?] —> Carbohydrate intolerance

A

-0.5g/dl

125
Q

Serum carbohydrate intolerance test
a. [?]: for malabsorption
b. [?]: for maldigestion

A

D-xylose
Lactose tolerance

ANURBF FINALS (7 decks)

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