Fecalysis Flashcards
Composition of Duodenum (4)
- Exocrine pancreatic secretion
- Bile
- Intestinal Secretion mixed with Gastric Secretion
- Possibly, PARTIALLY DIGESTED FOOD
Major Contributor of gastric component
1,500 mL/day passes in duodenum
pH = 8
Exocrine Pancreatic Secretion
1-2% organic: Enzymes
1% inorganic: Sodium & Bicarbonate
Exocrine Pancreatic Secretion
500-1000 mL/day
Yellow to brown or green
pH = 7.0 - 8.5
Bile
Bile is composed of
- Bile Salts (Sodium glycocholate and taurocholate)
- Bilirubin
- Cholesterol
- Phospholipid
- Inorganic salts
Only enzyme present in siginificant amount in bile
Alkaline phosphatase (ALP)
Detection of pathogenic bacteria and parasite
Fecalysis
Fecalysis is for early detection of
- gastrointestinal bleeding
- Liver
- Biliary Duct Obstruction
- Maldigestion Syndrome
- InflammationN
Normal feces produced everyday
100-200 g/day
Specimen for Qualitative testing for blood and microscopic of feces
Random fecal specimen
Plastic or Glass screw-top container
Mushy or foul smelling gray stool
Floats in water
Steatorrhea
Small, firm, spherical masses of stool (Scybala)
Constipation
Narrow, ribbon-like stool
Spastic bowel
Rectal narrowing or stricture
Blood from lower gut
Beets
Red
Bleeding from Upper GIT
Bismuth, Iron, Charcoal
Black
Spinach, green vegetables
calomel
biliverdin
Green
Presence of mucus in stool is
SIGNIFICANT AND MUST BE REPORTED
Translucent gelatinous mucus
Spastic constipation
Mucous Collitis
Blood Mucus
Neoplasm
Mucus associated with PUS AND BLOOD
Ulcerative collitis
Bacillary Dysentery
Ulcerating diverculitis
Intestinal tuberculosis
Copious quantity of mucus (3 or 4 L in 24 hrs)
Villous adenoma of colon
Large quantities of PUS in stool is seen in patient with
Chronic Ulcerative Colitis
Chronic Biliary Dysentery
Pale Yellow, white, gray
Alcoholic Stool
Bile-duct obstruction, BARIUM SULFATE
Bile-duct obstruction
Pancreatic Disorders
Bulky/Frothy
Ribbon-like
Intestinal constriction
Microscopic Examination of Feces is for detection of (3)
- Leukocytes
- Undigested Muscle Fibers
- Fecal Fats
FECAL LEUKOCYTES:
Leukocytes that primarily affects INTESTINAL MUCOSA
Neutrophils
FECAL LEUKOCYTES:
Presence of Fecal WBC is due to
INVASIVE PATHOGEN
FECAL LEUKOCYTES:
Invasive Pathogens
Salmonella
Shigella
Campylobacter
Yersinia
EnteroInvasive E. Coli
FECAL LEUKOCYTES:
Absence of Fecal WBC is due to
Toxin producing Microorganisms
FECAL LEUKOCYTES:
Microorganisms that doesn’t elicit fecal WBC
S. aureus
Vibrio
Viruses
Parasite
Test that is sensitive for leukocytes even if the stool is refrigerated and frozen
Lactoferrin Latex Agglutination Test
Lactoferrin Latex agglutination tested positive for
Invasive pathogens in stool
Wet preparation uses what stain
Methylene blue
Dry smear for fecalysis uses
Wright’s stain
Gram Stain
Under HIGH POWER ATLEAST ___NEUTROPHILS MUST BE SEEN
3 NEUTROPHILS
UNDER OIL IMMERSION ___ NEUTROPHILS SHOULD BE SEEN FOR + INVASIVE PATHOGEN
ANY
Helpful in diagnosing and monitoring patient with PANCREATIC INSUFFICIENCY OR CYSTIC FIBROSIS
Muscle Fiber
MUSCLE FIBER:
Slides for muscle fiber detection must be emulsified in
10% alcoholic eosin
MUSCLE FIBER:
In microscopic examination for muscle fiber the slide must be examined within
exactly 5 minutes
MUSCLE FIBER:
In microscopic examination for muscle fiber the number of ____ is counted
Red-stained fibers
MUSCLE FIBER:
More than 10 undigested fiber is reported as
INCREASED
MUSCLE FIBER:
No striations
Digested fibers
MUSCLE FIBER:
Striations with 2 directions
Undigested fibers
MUSCLE FIBER:
Striations in 1 direction
Partially digested muscle fibers
Specimens from suspected cases of steatorrhea can be screened microscopically
Qualitative Fecal Fats
This procedure can also be used to monitor patients undergoing treatment for malabsorption disorders
Qualitative Fecal Fats
Lipids included in microscopic examination of feces are
- Neutral fats
- Fatty acids salts (soap)
- fatty acids
- cholesterol
QUALITATIVE FECAL FATS:
Dyes
Sudan III
Sudan IV
Oil Red O
QUALITATIVE FECAL FATS
readily stained by Sudan III
Neutral Fat Stain
QUALITATIVE FECAL FATS
Stool suspension + 95% ethanol + Sudan III =
ORANGE RED DROPLETS (Neutral fats/ Tryglycerides)
QUALITATIVE FECAL FATS
Not readily stained by sudan III
Fatty acids and Soaps
QUALITATIVE FECAL FATS
Fatty acids and soaps are tested using
Split Fat Stain
QUALITATIVE FECAL FATS
Split fat stain
Emulsified stool + _____ + _____ + Sudan III
36% Acetic Acid
Heat
QUALITATIVE FECAL FATS
In Split Fat Stain:
1st Slide (NT) - Normal
2nd Slide (FFA) - Increased
Malabsorption
QUALITATIVE FECAL FATS
In Split Fat Stain:
1st Slide (NT) - Increased
2nd Slide (FFA) - Normal
Maldigestion
QUALITATIVE FECAL FATS
disease results from damage intestinal mucosa
Malabsorption
QUALITATIVE FECAL FATS
disease results from decreased levels of pancreatic enzymes
Maldigestion
QUALITATIVE FECAL FATS
Split Fat Stain:
100 small droplets < 4um
Normal
QUALITATIVE FECAL FATS
Split Fat Stain:
100 small droplets 1 - 8 um
Slightly Increased
QUALITATIVE FECAL FATS
Split Fat Stain:
100 small droplets
Increased (Steatorrhea)
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