FECALYSIS

Yves Laure Pimentel · 70問 · 2年前

通報

問題一覧

Quantitative: timed specimen;

(3-day collection)

scarping of stool from diapers

CAMMIDGE

Pancreatic Disorders, Bile-duct Obstruction

BULKY/ FROTHY

insertion of thick walled glass in rectum

JALIFE

Intestinal constriction, Spastic bowel, Rectal Narrowing/ Structure

RIBBON LIKE

From intestinal oxidation of Stercobilinogen fo Stercobiin by intestinal bacteria

BROWN

Colitis, Dysentery, Malignancy, Constipation

MUCUS OR BLOOD STREAKED

Mushy, Foul, Smelling gray stool that floats on water

STEATORRHEA

Bleeding form UPPER GIT (Esophagus, Stomach, Duodenum) > 3 days for blood to stool Bismuth (Antacids), Iron Therapy, Charcoal

Black

LOWER GIT Bleeding; Beets, Food coloring, Rifampin

RED

seen in feces in cases of Ulcerative Colitis and Bacterial Dysentery

Leukocytes (Neutrophil)

FECAL ASSOCIATED PARASITES

Salmonella, Shigella, Campylobacter, Yersinia, EIEC:

Bile-duct Obstruction, Barium Sulfate

GRAY/ PALE YELLOW

Biliverdin/ Oral Antibiotics, Green Vegetables, Calomel

Green

Wet preparations stained with

Methylene Blue

Dried Smears:

Wrights/ Giemsa Stain

Indicative of an invasive condition

NEUTROPHILS

Detects Lactoferrin (Secondary Granule)

Lactoferrin LATEX AGGLUTINATION

MUSCLE FIBERS

Creatorrhea

MUSCLE FIBERS

Helpful in diagnosis of pancretic sufficiecy

MUSCLE FIBERS (Creatorrhea)

MUSCLE FIBERS (Creatorrhea) Helpful in diagnosis of

pancretic sufficiecy

Partially Digested Muscle Fibers:

striation in one direction

Fully Digested Muscle Fibers:

no striations

microscopically screening for the presence of Excess Fecal Fat & Differentiate MALABSORPTION AND MALDIGESTION

QUALITATIVE FECAL FATS

QUALITATIVE FECAL FATS microscopically screening for the presence of Excess Fecal Fat & Differentiate

MALABSORPTION AND MALDIGESTION

QUALITATIVE FECAL FATS Stain Used:

SUDAN III, IV, OIL RED O

are readily stained by Sudan lll & appear as Large Orange Red Droplets

Neutral Fats

Neutral Fats are readily stained by Sudan lll & appear as

Large Orange Red Droplets

Neutral Fats Stain are readily stained by ? & appear as Large Orange Red Droplets

Sudan lll

>60 Orange Droplets/ HPF =

Steatorrhea

Soaps and fatty acids do not stain directly w/ Sudan lll

split Fat Stain

Stool + 36% Acetic Acid + Sudan + Heat =

ORANGE DROPLETS

FECAL FATS : 100 small droplets with <4um in dm

NORMAL

FECAL FATS : 100 droplets w/ 1-8 um

SLIGHTLY INCREASED

FECAL FATS : 100 droplets with 6-75 um in diameter

STEATORRHEA

Steatorrhea can occur with Diarrhea and can result from

Malabsorption Vs. Maldigestion

Impaired Nutrient Absorption that result from Intestinal mucosa damage (Celiac Dse, Tropical Sprue)

Malabsorption

Impaired Food digestion that result from DECREASED level of pancreatic enzymes (Pancreatitis, Pancreatic Cancer, Obstructive jaundice)

Maldigestion

Maldigestion DISEASES

(Pancreatitis, Pancreatic Cancer, Obstructive jaundice)

DISEASES Malabsorption

(Celiac Dse, Tropical Sprue)

First Slide (Neutral Fat Stain) Malabsorption

NORMAL

First Slide (Neutral Fat Stain) Maldigestion

INCREASED

Second Slide (Free Fatty Acids) Malabsorption

INCREASED

Second Slide (Free Fatty Acids) Maldigestion

NORMAL

First Slide (Neutral Fat Stain) NORMAL, Second Slide (Free Fatty Acids) INCREASED CAUSES?

Malabsorption

First Slide (Neutral Fat Stain) INCREASED, Second Slide (Free Fatty Acids) NORMAL CAUSES?

Maldigestion

QUANTITATIVE FECAL FATS Specimen:

3 DAYS/ 72 HOURS STOOL SPECIMEN

GOLD STANDARD FOR QUANTITATIVE FECAL TESTING & the Method routinely Used for Fecal Fat Measurement

VAN DE KAMER TITRATION

Reference Values based on 100 g/d intake are 1-6 g/d or coefficient of fat retention of at least

95%

Rapid test to estimate amount of fat excretion, screen steatorrhea in pediatric populations

ACID STEATOCRIT

Most Frequently Performed in Fecal Analyses

FECAL OCCULT BLOOD TEST

grams of stool > Pathologically significant

>2.5mL/150g

Most Frequently Used Screening Test Principle: Pseudoperoxidase Activity of Hemoglobin =» Positive Result: blue

GUIAC BASED FECAL OCCULT BLOOD TEST

GUIAC BASED FECAL OCCULT BLOOD TEST Principle: Pseudoperoxidase Activity of Hemoglobin =» Positive Result:

blue

False-POSITIVE/ NEGATIVE FOBT Aspirin and other inflammatory medications

False-POSITIVE FOBT

False-POSITIVE/ NEGATIVE FOBT Red Meat

False-POSITIVE FOBT

False-POSITIVE/ NEGATIVE FOBT Vitamin C >250 mg/dl

False NEGATIVE FOBT

False-POSITIVE/ NEGATIVE FOBT Horseraddish. Raw Brocolli, Caulifiower, Radish, Turnips

False-POSITIVE FOBT

False-POSITIVE/ NEGATIVE FOBT Iron Supplements containing Vit

False NEGATIVE FOBT

False-POSITIVE/ NEGATIVE FOBT Melon, Menstrual & Hemorrhoid Contamination

False-POSITIVE FOBT

False-POSITIVE/ NEGATIVE FOBT Failure to wait after sample is applied 1to add the developer reagent (3-5 minutes)

False NEGATIVE FOBT

Specific for the Globin Portion of Human Hemoglobin and uses Polyclonal Anti- Human Hgb Antibodies

Immunochemical Fecal Occult Blood Test

More sensitive to lower GIT bleeding

Immunochemical Fecal Occult Blood Test

Based on the conversion of Heme (Degrade by Intestinal bacteria) to fluorescent porphyrins More sensitive to Upper GIT Bleeding

Porphyrin-Based Fecal Occult Blood Test

Distinguish between the presence of fetal blood or maternal blood in infants stool or vomitus

APT Test (Fetal Hemoglobin)

APT Test (Fetal Hemoglobin) WHAT IS USED

1% NAOH

Solution remains pink

HBF- FETAL HEMOGLOBIN

Yellow-Brown supematant after standing for 2 minutes

MATERNAL HALO

FECAL ENZYMES

(Trypsin, Chymotrypsin, Elastase 1)

Decreased Production of Pancreatic Enzymes (Pancreatic insufficiency) is associated with

Chronic Pancreatitis & CF

Screening test for Fecal Trypsin

GELATIN TEST

Maybe Present in stool as a result of intestinal inabili : ty to reabsorb CHO (Celiac Disease); or lack of digestive enzyme (Lactase: Lactose Intolerance)

CARBOHYDRATES

CARBOHYDRATES Normal pH:

Between 7 & 8

Copper Reduction Test: Indicative of CHO Intolerance

0.5 g/dl

Most Common Cause of Malabsorption in developed countries

CELIAC DISEASE

CELIAC DISEASE Immunologic Test:

Anti-Glidialin & Anti-Endomysial Antibodies

CELIAC DISEASE TEST

CELLOBIOSE MANNITOL PERMEABILITY TESTS

a sugar that doesn't need to be digested but absorbed in order to be present in urine

D-xylose

because pancreatic enzymes are not required for absorption of D-Xylose

<3 G Enterogenous Malabsorption

other names parasitology

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