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AUBF > MIDTERM - FECAL ANALYSIS > Flashcards

MIDTERM - FECAL ANALYSIS Flashcards

1
Q

In the minds of most laboratory personnel, fecal specimen analysis
fits into the category of a “___.”

A

necessary evil

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2
Q

Routine fecal examination includes ___

A

macroscopic,
microscopic, and chemical analyses

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3
Q

the fecal routine analysis such as macroscopic, microscopic, and chemical analysis, it will provide an early detection for what diseases and conditions?

A

gastrointestinal bleeding, liver and biliary duct disorders, maldigestion and malabsorption disorders, pancreatic diseases, inflammation, and causes of diarrhea and steatorrhea

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4
Q

The normal fecal specimen contains _

A

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

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5
Q

. Approximately ___ g of feces
is excreted in a 24-hour period

A

100 to 200

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6
Q

___ produces
the strong odor associated with feces and intestinal gas (flatus)

A

Bacterial metabolism

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7
Q

It is the waste residue of indigestible materials of an
animal’s digestive tract expelled through the anus during
defecation

A

feces or stool

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8
Q

Lactose intolerance leads to __

A

excessive gas production

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9
Q

Produces strong odor and flatus

A

bacterial metabolism

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10
Q

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

A

Carbohydrates

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11
Q

Excessive gas production also occurs in ___ people when the intestinal bacteria metabolize the
lactose from consumed milk or lactose-containing substances.

A

lactose-intolerant

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12
Q

Although digestion of ingested proteins, carbohydrates, and fats takes place throughout the alimentary tract, the ____ is the primary site for the final breakdown and reabsorption of these compounds

A

small intestine

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13
Q

Digestive enzymes secreted into the
small intestine by the pancreas include ___,___, ____ , and __

A

trypsin, chymotrypsin,
amino peptidase, and lipase

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14
Q

__ provided by the liver aid
in the digestion of fats

A

Bile salts

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15
Q

Excess undigested or unreabsorbed materials then appear
in the feces, and the patient exhibits symptoms of __.

A

maldigestion
and malabsorption

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16
Q

9000 ml of fluid including saliva, gastric, liver, pancreatic secretions enter the digestive tract each day but only ___ ml are excreted

A

150 ml

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17
Q

how many ml of water from 9000 ml intake reaches the small and large intestine

A

500 to 1500 ml

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18
Q

up to how many ml of water do colon can reabsorbed?

A

3000 ml of water

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19
Q

pancreas secreted up to how many ml of secrtions?

A

1000 ml

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20
Q

intestinal secretions composed of water and electrolytes is about how many ml

A

2000 ml

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21
Q

bile from liver is about how many ml?

A

1000 ml

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22
Q

saliva is about how many ml?

A

1500 ml

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23
Q

how many ml of water do food and intake water contributes in 9000 ml

A

2000 ml

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24
Q

gastric secretions is about how many ml ?

A

1500 ml

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25
Q

mucous secretions in the GI tract is about?

A

200 ml

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26
Q

The large intestine is capable of absorbing approximately ___mL of water

A

3000

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27
Q

When the amount of water reaching the large intestine exceeds this amount (3000 ml), it is excreted with the solid fecal material, producing ____

A

diarrhea

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28
Q

____, on the other hand, provides time for additional water to be reabsorbed from the fecal material, producing small,
hard stools.

A

Constipation

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29
Q

____ is defined as an 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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30
Q

Diarrhea classification can be based on four
factors what are they?

A

illness duration,
mechanism,
severity,
stool characteristics

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31
Q

Diarrhea lasting less than 4 weeks is defined as ___

A

acute

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32
Q

Diarrhea lasting more than 4 weeks is defined as ___

A

chronic

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33
Q

The major mechanisms of diarrhea are ___, ___, and ___

A

secretory, osmotic, and intestinal hypermotility

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34
Q

The major mechanisms of diarrhea are secretory, osmotic, and intestinal hypermotility.

The laboratory tests used to
differentiate these mechanisms are ___

A

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

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35
Q

The normal total fecal osmolarity is close to the serum osmolality

_____mOsm/kg

A

290 mOsm/kg

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36
Q

normal fecal sodium is ___ mmol/L

A

30 mmol/L

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37
Q

normal fecal potassium is ___ mmol/L.

A

75 mmol/L

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38
Q

The fecal sodium and fecal potassium
results are used to calculate the ____

A

fecal osmotic gap.

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39
Q

describe the difference between the osmotic gap and electrolytes of osmotic diarrhea and secretory diarrhea

A

osmotic diarrhea > 50 mOsm/kg
electrolytes negligible

secretory diarrhea <50 mOsm/kg
electrolytes increased

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40
Q

A fecal fluid pH of less than ___ indicates a malabsorption of sugars, causing
an osmotic diarrhea

A

5.6

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41
Q

___ diarrhea is caused by increased secretion of water.

A

Secretory

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42
Q

what are the causes of increase production or secretion of water and electrolytes in secretory diarrhea

A

Bacterial, viral, and protozoan infections

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43
Q

what is the mechanism of secretory diarrhea

A

Usually caused by an organism that produces a toxin that
stimulates adenylase cyclase enzyme that leads to crampy
diarrhea & secretion of intestinal fluid

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44
Q

the mechanism of secretory diarrhea Usually caused by an organism that produces a toxin that
stimulates ___ that leads to crampy
diarrhea & secretion of intestinal fluid

A

adenylase cyclase enzyme

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45
Q

secretory diarrhea stools are characterized as

A

watery and voluminous with no RBC,
WBC, and mucus

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46
Q

causative agents of secretory diarrhea

A

o Vibrio Cholerae
o ETEC (Travelers’s bacterial Diarrhea)
o Giardia lamblia

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47
Q

Other causes of secretory diarrhea are

A

drugs, stimulant laxatives,
hormones, inflammatory bowel disease (Crohn disease, ulcerative colitis, lymphocytic colitis, diverticulitis), endocrine disorders (hyperthyroidism, Zollinger-Ellison syndrome, VIPoma),
neoplasms, and collagen vascular disease.

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48
Q

increase production of water caused by bacterial, viral, and protozoan infections, will override the __ of large intestine resulting to secretory diarrhea

A

reabsorptive ability of the large intestine,

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49
Q

Process specimens for osmolality testing
immediately. Specimens that are stored for hours may
have a markedly increased osmolality due to the increased
degradation of carbohydrates.

true or false

A

true

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50
Q

is caused by poor absorption that exerts osmotic pressure across the intestinal mucosa.

A

osmotic diarrhea

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51
Q

Incomplete break
down or reabsorption of food presents increased fecal material to
the large intestine, resulting in water and electrolyte retention in
the large intestine

A

osmotic diarrhea

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52
Q

what is the mechanism of osmotic diarrhea

A

Usually caused by inefficient reabsorption of an osmotic substance due to an enzyme deficiency

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53
Q

___(impaired food digestion) and
___(impaired nutrient absorption by the intestine) contribute to osmotic diarrhea

A

Maldigestion ; malabsorption

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54
Q

explain the relationship of the osmolality and the concentration of the electrolyte in terms of the unabsorbable solutes

A

increases the stool osmolality
concentration of electrolytes is lower

resulting in an increased osmotic gap

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55
Q

osmotic diarrhea stools are characterized by

A

Stool samples are watery and Gaseous with no WBC, RBC, and
mucus

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56
Q

causes of osmotic diarrhea based on the ppt

A

o Lactose intolerance
o Pancreatic insufficiency

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57
Q

Differential features for Diarrhea

osmotic diarrhea has _____ in terms of osmotic gap

A

> 50 Osm/kh

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58
Q

Differential features for Diarrhea

osmotic diarrhea has ____ in terms of stool Na

A

<60 mmol/L

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59
Q

Differential features for Diarrhea

osmotic diarrhea has __ in terms of stool output

A

<200 g

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60
Q

Differential features for Diarrhea

osmotic diarrhea has ___ in terms of pH

A

<5.3

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61
Q

Differential features for Diarrhea

osmotic diarrhea is ___ in terms of reducing substance

A

positive

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62
Q

Differential features for Diarrhea

secretory diarrhea has __ in terms of osmotic gap

A

<50 Osm/Kg

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63
Q

Differential features for Diarrhea

secretory diarrhea has __ in terms of stool Na

A

> 90 mmol/L

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64
Q

Differential features for Diarrhea

secretory diarrhea has ____ in terms of stool output in 24 hr

A

> 200 g

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65
Q

Differential features for Diarrhea

secretory diarrhea is ___ in terms of reducing substance

A

negative

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66
Q

Causes of osmotic diarrhea include ___

A

disaccharidase deficiency (lactose intolerance),
malabsorption (celiac sprue),
poorly absorbed sugars (lactose, sorbitol, mannitol), laxatives, magnesium-containing
antacids, amebiasis, and antibiotic administration

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67
Q

what are the 4 common test for secretory diarrhea

A

Stool cultures
Ova and parasite
examinations
Rotavirus immunoassay
Fecal leukocytes

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68
Q

osmotic diarrhea common fecal test

A

Microscopic fecal fats
Muscle fiber detection
Qualitative fecal fats
Trypsin screening
Microscopic fecal fats
Muscle fiber detection
Quantitative fecal fats
Clinitest
D-xylose tolerance test
Lactose tolerance test
Fecal electrolytes
Stool pH
Fecal osmolality

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69
Q

higher pH will cause __ (osmotic or secretory?)

A

secretory

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70
Q

presence of reducing substance in secretory

A

negative

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71
Q

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

A

Altered motility

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72
Q

hypermotility and slow motility are both can be seen in ___

A

irritable bowel syndrome

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73
Q

a 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

74
Q

IBS can be triggered by___

A

food, chemicals, emotional stress, and
exercise.

75
Q

is the excessive movement of in
testinal contents through the GI tract that can cause diarrhea
because normal absorption of intestinal contents and nutrients
cannot occur.

A

intestinal hypermotility

76
Q

___ describes hypermotility 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

77
Q

Healthy people have a gastric emptying half-time range of ___minutes

A

35 to 100

78
Q

A gastric emptying time of less than
35 minutes is considered ___

A

RGE or rapid gastric emptying dumping syndrome

79
Q

Normal gastric emptying is controlled by ___

A

fundic tone, duodenal feedback,
and GI hormones

80
Q

RGE can be divided into early dumping and late dumping
depending upon how soon after a meal the symptoms occur.

___symptoms begin 10 to 30 minutes following meal ingestion.

A

early dumping syndrome

81
Q

a classification of RGE which occurs ___after a meal and is characterized by weakness, sweating, and dizziness

A

2 to 3 hrs

82
Q

___ is often a complication of
dumping syndrome

A

Hypoglycemia

83
Q

The main causes of dumping syndrome
include ___.

A

gastrectomy, gastric bypass surgery, post vagotomy status, Zollinger-Ellison syndrome, duodenal ulcer disease, and
diabetes mellitus

84
Q

Detection of ___ is useful in diagnosing pancreatic insufficiency and small-bowel disorders that cause malabsorption

A

steatorrhea (fecal fat)

85
Q

it is the Absence of bile salts that assist pancreatic lipase in the breakdown and subsequent reabsorption of dietary fat (primarily triglycerides) produces an increase in stool fat that exceeds 6 g per day.

A

steatorrhea

86
Q

steatorrhea has an increase of stool fat amounting __ g more per day

A

exceeds 6g per day

87
Q

pancreatic disorders, including
- cystic fibrosis,
-chronic pancreatitis, and
- carcinoma,

that DECREASE THE PRODUCTION OF PANCREATIC ENZYME, are the conditions associated with steatorrhea

true or false

A

true

88
Q

Steatorrhea may be present in both
maldigestion and malabsorption conditions and can be distinguished by the what test?

A

D-xylose test

89
Q

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

A

D-Xylose

90
Q

If urine D-xylose is low, the resulting steatorrhea indicates a ___

A

malabsorption condition

91
Q

A normal D-xylose test indicates __

A

pancreatitis

92
Q

Faeces / feces is the plural of latin term “faex”
meaning ___.

A

residue

93
Q

__ is the newborn’s first feces.

A

Meconium

94
Q

___ or ___ is the study of feces.

A

Scatology or Coprology

95
Q

Usually caused by an organism that produces a toxin that stimulates adenylate cyclase enzyme
that leads to crampy diarrhea & secretion of
intestinal fluid

A

Secretory Diarrhea

96
Q

secretory diarrhea stools are characterized as watery and voluminous with no rbc, wbc & mucus

true or false

A

true

97
Q

Causative agent of secretory diarrhea

A

○ Vibrio cholerae
○ ETEC (traveler’s bacterial diarrhea)
○ Giardia lamblia

98
Q

Invasive Diarrhea is mostly caused by

A

bacteria

99
Q

Invasive organisms destroys the mucosal lining of the intestines producing pus, blood and mucus in stool.

A

invasive diarrhea

100
Q

Stool may contain wbc, rbc, & specks of mucus; and sometimes the organism.

A

invasive diarrhea

101
Q

Patient is experiencing tenesmus.

A

invasive diarrhea

102
Q

a frequent urge to go to the bathroom without
being able to defecate

A

tenesmus

103
Q

invasive diarrhea is caused by

A

○ Shigella dysenteriae
○ Entamoeba histolytica
○ ETEC
○ Campylobacter jejuni
○ Yersinia enterolitica

104
Q

Usually caused by inefficient reabsorption of an
osmotic substance due to an enzyme deficiency

A

osmotic diarrhea

105
Q

Stool samples are watery & gaseous with NO wbc, rbc & mucus

A

osmotic diarrhea

106
Q

Technologist must be aware of contaminants such as

A

o Urine
o Water
o Paper

107
Q

MACROSCOPIC EXAMINATION of fecal

A

color
consistency
form

108
Q

Normal color is

A

brownn

109
Q

the one responsible for the color of the stool

A

Urobilinogen is converted to urobilin and
stercobilin

110
Q

Pale color signifies ___ (acholic stool)

A

biliary obstruction

111
Q

Bleeding can turn the stool into what colors

A

red and black

112
Q

upper git infection causes the stool to turn

A

black

113
Q

lower git infection causes the stool to turn

A

red (hematochezia)

114
Q

Black/Tarry colored stool causes

A
  • UGIT
  • Iron therapy
  • Charcoal
    Intake
  • Bismuth
    intake
115
Q

red colored stool causes

A
  • LGIT
  • Beets intake
  • Rifampin
    intake
116
Q

Pale Yellow,
White, Gray colored stool causes

A
  • Bile duct
    obstruction
  • Barium
    intake
117
Q

green colored stool causes

A

Pale Yellow,
White, Gray colored stool causes

118
Q

macroscopic examination: consistency

what are the things we need to take note in terms of it?

A

form, hardness, and watery state

119
Q

normal form of stool

A

cylindrical

120
Q

ribbon like form of a stool signifies __

A

intestinal structure such as tumor blockage

121
Q

small round/scybalous form of a stool signifies __

A

constipation

122
Q

bulky and frothy form of a stool signifies __

A

steatorrhea

123
Q

mucoid form of a stool signifies __

A

coltis, constpation

124
Q

possible causes of stool form bulky frothy

A

bile duct obstruction
pancreatic insufficiency

125
Q

possible causes of stool form ribbon like

A

interstitial constriction due to malignancy (color cancer)

126
Q

possible causes of stool form mucus and blood-streaked stool

A

-amoebic colitis
-dysentery
- malignancy

127
Q

describe the type of stool base on the form
type 1-7

separate hard lumps, like nuts (hard to pass)

A

type 1

128
Q

describe the type of stool base on the form
type 1-7

sausage-shaped but lumpy

A

type 2

129
Q

describe the type of stool base on the form
type 1-7

like a sausage but with cracks on its surface

A

type 3

130
Q

describe the type of stool base on the form
type 1-7

like a sausage or snake, smooth and soft

A

type 4

131
Q

describe the type of stool base on the form
type 1-7

soft blobs with clear-cut edges (passed easily)

A

type 5

132
Q

fluffy pieces with ragged edges, a mushy stool

A

type 6

133
Q

describe the type of stool base on the form
type 1-7

watery, no solid pieces, entirely liquid

A

type 7

134
Q

__- and ___ are the substances that produce normal
odor formed by intestinal bacterial fermentation and
putrefaction.

A

indole and skatole

135
Q

A foul odor is caused by the degradation of ____

A

undigested protein and excessive carbohydrate intake.

136
Q

A sickly sweet odor is produced by ___

A

undigested lactose.

137
Q

a chemical test that is done for Hidden blood, not seen by microscopic examination

A

Fecal Occult Blood

138
Q

a blood that is Normally found in small amount,___ of
stool.

A

2.5ml/ 150 grams

139
Q

Screening test for colorectal cancer & git bleeding

A

Fecal occult blood

140
Q

what is the principle of the fecal occult blood

A

Based on the pseudoperoxidase activity of
hemoglobin molecule reacting with the
chromogen

141
Q

is commonly used because it is not too
sensitive (avoids high false positive)

A

gum guaiac

142
Q

is the most sensitive chromogen

A

benzidine

143
Q

the positive result for O-toluidine

A

blue chromogen

144
Q

Pale stools are also associated with
diagnostic procedures that use ___

A

barium sulfate.

145
Q

False-positive reaction for fobt

A
  • NSAIDS
  • Contamination of menstrual
    blood
  • Hemorrhoids
  • Non adherence to diet advice
146
Q

false negative for fobt reaction

A

vitamin c and iron intake

147
Q

Substances that may also exhibit pseudoperoxidase
activity/ reaction:

A

○ Hemoglobin
○ Myoglobin
○ Vegetables
○ Fruits

148
Q

Dietary restrictions 3 days before the examination

A

○ Red meat
○ Horseradish
○ Melons
○ Raw broccoli
○ Turnip
○ Vitamin C and iron

149
Q

___ specific for globin portion of
human hemoglobin. uses anti-human hemoglobin
antibodies.

A

Hemoccult ICT (IFOBT)

150
Q

It does not require dietary or drug restrictions.

A

Immunochemical Fecal Occult Blood

151
Q

It 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

152
Q

offers a porphyrin-based fobt
fluorometric test for hemoglobin based on the
conversion of heme to fluorescent porphyrins. the test

A

Hemoquant

153
Q

measures both intact hemoglobin and the hemoglobin
that has been converted to porphyrins.

A

Hemoquant

(Porphyrin-based Fecal Occult Blood)

154
Q

Determines if infant’s stool or vomitus is fetal or
maternal in origin

A

chemical examination: apt test

155
Q

principle of apt test

A

Principle:
○ “Fetal blood resist alkali denaturation (remains
pink) while maternal blood is sensitive to alkali
denaturation (yellow brown).”

156
Q

procedure of apt test

A

Specimen in emulsified with water, centrifuged
then added with 1% NAoH.

157
Q

result of apt test

maternal blood is denature = ___

A

yellowish brown

158
Q

result of apt test

fetal flood is unchange

A

pink

159
Q

Confirmatory test for Steartorrhea

A

Quantitative Fecal Fat Testing

160
Q

Collection of 3 day fecal specimen

A

Quantitative Fecal Fat Testing

161
Q

Methods for quantitative fecal fat testing

A

Van de Kamer Titration (gold standard)

162
Q

Rapid test for quantitative fecal fat testing

A

acid steatocrit

163
Q

MICROSCOPIC EXAMINATION of fecal will check on

A

● WBCS
● Increased fecal fat
● Meat or muscle fibers

164
Q

__ are positive for fecal wbc.

A

Invasive organisms

165
Q

__ organisms are negative for fecal wbc.

A

Toxin producing

166
Q

fecal wbc is assesed using __

A

Wet preparation with methylene blue, gram’s stain or wright’s stain

167
Q

3 wbc/ hpf is significant for fecal wbc

true or false

A

true

168
Q

test for fecal wbc

A

Lactoferrin latex agglutination test

169
Q

Detects fecal wbc even on frozen specimen

A

Lactoferrin latex agglutination test

170
Q

clinical significance of wbc in fecal test

A

▪ Ulcerative Colitis
▪ Dysentery (Bacterial)
▪ Ulcerative diverticulitis
▪ Intestinal TB
▪ Abscess

171
Q

Signifies pancreatic insufficiency (acute and chronic pancreatitis, cystic fibrosis)

A

muscle fiber

172
Q

Usually associated with bulky frothy stool with lots of fecal fat

A

muscle fiber (Signifies pancreatic insufficiency)

173
Q

muscle fibers is predominant in patient’s stool with

A

Gastrocolic fistula (abnormal connection of the
stomach and intestine)

174
Q

describe the striations of digested meat fibers

A

no striations

175
Q

describe the striation of a partially digested meat fibers

A

fibers has 1 stration

176
Q

describe the striation of undigested fibers

A

has 2 striations or more than

177
Q

Fecal WBCs are seen in __ and ___

A

bacterial dysentery and ulcerative colitis

178
Q

Wet preparation for fecal wbc

A

methylene blue
gram stain
wright stain

179
Q

how many wbc per hpf is considered significant in fecal wbc test?

A

3 WBC/HPF is significant

180
Q

a microscopic screening that is Done in cases steatorrhea and Malabsorption syndromes

A

qualitative fecal fat

181
Q

Types of fats:

A

o Neutral Fat (TAG)
o Fatty Acid; Salts or Soaps
o Fatty acid
o Cholesterol

182
Q

Stain used in qualitative fecal fat

A

sudan 3 (Most commonly used),
4 or ORO

AUBF (28 decks)

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