GI Labs

Question 1

Microscopic

+ rbc =

+ epithelial cells =

+ wbc =

Answer 1

+ rbc = Cancer, infection, IBS

+ epithelial cells = Irritated GI tract (gastroenteritis)

+ wbc = Infection, IBS

Question 2

Fecal fat detection

Answer 2

Sudan Stain

Increased fat => malabsorption of pancreatitis (no lipase produced)

Question 3

Charcot-Leyden crystals in stool

Answer 3

Sometimes found w/ parasitic infections

Especially amoebas

Question 4

Stool Colors

Normal

Clay

Tarry

Red

Black

Answer 4

Normal = brown

Clay = biliary obstruction

Tarry = >100 ml blood from upper GI

Red = blood in large intestine, beets or tomatoes

Black = blood

Question 5

Occult blood and wbc indicate

Answer 5

Bacterial etiology

Usually also have signs of fever

Question 6

C. difficile colitis test

Answer 6

Test for toxins A&B using ELISA

Treatment: Flagyl and oral vancomycin (IV doesn’t work)

Question 7

CBC

Answer 7

anemia (rbc) => multifactorial, liver dx (ETOH) causing GI bleed/deficiency

Neutropenia (wbc) and thrombocytopenia (platelets) => liver cirrhosis -> portal HTN -> sequestered in spleen

Question 8

Macrocytic anemia causes

Answer 8

B12/folate deficiency

Myelodysplastic syndrome

Question 9

Microcytic anemia causes

Answer 9

TAILS

Thalassemia

Anemia of chronic disease

Iron deficiency anemia

Lead poisoning

Sideroblastic disease

Question 10

ALT/AST

Answer 10

Indicate hepatocyte injury - more so ALT

Highest with viral/ischemic hepatitis, toxicity

Rapid decline indicates recovery or massive acute liver failure

Question 11

Alkaline Phosphatase (AP)

Answer 11

Indicates cholestasis (liver block) if 5-nucleotidase or GGT also elevated

Question 12

Ammonia

Answer 12

Indicates advanced liver disease - not cleared

Ammonia build up causes reversible neuropsych impairment

easier to follow neuropsych sx instead of ammonia levels for treatment efficacy

Question 13

Albumin and PT relating to liver function

Answer 13

Indicate the severity of chronic liver disease

Both synthesized in liver (clotting factors)

As liver function declines, PT goes up and Albumin goes down => blood is getting thinner

Question 14

Amylase and Lipase

Answer 14

Pancreatic enzymes

Amylase cleaves starch to polysaccharides

Lipase cleaves triglycerides into glycerol and fatty acids

Rise in both indicates pancreas damage, but not severity

Lipase will remain elevated longer, Amylase elevates early

Determine improvement via sx

Question 15

Imaging Test of Choice for:

RUQ

RLQ

LLQ

LUQ

Suprapubic pain

Answer 15

RUQ = US

RLQ = CT w/ IV contrast

LLQ = CT w/ oral and IV contrast

LUQ = endoscopy, US, or CT

Suprapubic pain = US