________ can be divided into early dumping and late dumping depending upon how soon after a meal the symptoms occur.
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Pseudoperoxidase activity
________ is present from hemoglobin and myoglobin in ingested meat and fish, certain vegetables and fruits, and some intestinal bacteria, so the sensitivity of the test must be decreased.
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Stool chromatography
________ to identify the malabsorbed carbohydrate is available but rarely necessary for the diagnosis of sugar intolerance.
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Hypoglycemia
________ is often a complication of dumping syndrome.
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Lipids
________ included in the microscopic examination of feces are neutral fats (triglycerides), fatty acid salts (soaps), fatty acids, and cholesterol.
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Oral antibiotics
________ (oxidation of fecal bilirubin to biliverdin), green vegetables or food coloring.
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Wrights
Dried preparations stained with either ________ or Gram stains provide permanent slides for evaluation.
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Sucrose
________ is not detected by the Clinitest method because it is not a reducing sugar.
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abnormal excretion
The Clinitest on stools can distinguish between diarrhea caused by ________ of reducing sugars and those caused by various viruses and parasites.
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premature infants
In ________ there is correlation between a positive Clinitest and inflammatory necrotizing entercolitis.
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Elastase I
________ is present in high concentrations in pancreatic secretions and is strongly resistant to degradation.
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Specimens
________ can be examined as wet preparations stained with methylene blue or as dried smears stained with Wrights or Gram stain.
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neutrophils
Leukocytes, primarily ________, are seen if the intestinal mucosa is affected.
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Soaps
________ and fatty acids do not stain directly with Sudan III; therefore, a second slide must be examined after the specimen has been mixed with acetic acid and heated.
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motility disorders
It is not affected by ________ or mucosal defects.
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Cholesterol
________ is stained by Sudan III after heating and as the specimen cools forms crystals that can be identified microscopically.
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length
The ________ of the fat and solid layers are measured using a magnifying lens.
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capillary tube
The ________ is centrifuged horizontally at 13, 000 rpm for 15 minutes in a microhematocrit centrifuge.
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Staphylococcus aureus
________ and Vibrio spp., viruses, and parasites usually do not cause the appearance of fecal leukocytes.
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Chymotrypsin
________ is capable of gelatin hydrolysis but is most frequently measured by spectrophotometric methods.
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acid steatocrit
A(n) ________ of
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Steatorrhea
________ may be present in both maldigestion and malabsorption conditions and can be distinguished by the D- xylose test.
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large intestines
Water and electrolytes are readily absorbed in both the small and ________, resulting in a fecal electrolyte content that is similar to that of plasma.
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Hemoglobin
________ from upper GI bleeding is degraded by bacterial and digestive enzymes before reaching the large intestine and is immunochemically nonreactive.
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Random
________ specimens suitable for qualitative testing are usually collected in plastic or glass containers with screw- capped tops similar to those used for urine specimens.
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Healthy individuals
________ have a gastric emptying half- time range of 35 to 100 minutes, which varies with age and gender; in this case, the time is less than 35 minutes.
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oil immersion
Using ________, the finding of any neutrophils has approximately 70 % sensitivity for the presence of invasive bacteria.
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bacterial degradation
Refrigerating the specimen prevents any ________.
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active solids
Alterations in the motor functions of the stomach result in the accumulation of large amounts of osmotically ________ and liquids to be transported into the small intestine.
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Fecal elastase I
________ is pancreas specific and its concentration is about five times higher than in pancreatic juice.
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Carbohydrates
________ resistant to digestion and lactose (for those with intolerance) passes through the upper intestine and are metabolized by bacteria in the lower intestine, producing large amounts of flatus.
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false positives
It does not detect bleeding from other sources such as a bleeding ulcer, decreasing the chance for ________.
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ELISA test
The ________ uses monoclonal antibodies against human pancreatic elastase- 1; therefore, the result is specific for human enzyme and not affected by pancreatic enzyme replacement therapy.
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proteolytic activity of bacteria enzymes
The ________ may produce false- positive results in old specimens.
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Digestive enzymes
________ secreted into the small intestine by the include trypsin, chymotrypsin, amino peptidase and lipase by the pancreas, and bile salts by the liver.
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Diarrhea
________ is defined as an increase in daily stool weight above 200 g with increased liquidity and frequency of more than three times per day.
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Slides
________ for muscle fiber detection are prepared by emulsifying a small amount of stool in 10 % alcoholic eosin, which enhances the muscle fiber striations.
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Analysis of the feces
________ focuses primarily on the proteolytic enzymes trypsin, chymotrypsin, and elastase I.
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Carbohydrate malabsorption
________ or intolerance (maldigestion) is primarily analyzed by serum and urine tests; however, an increased concentration of carbohydrate can be detected by performing a copper reduction test on the fecal specimen.
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Fecal lipids
________ are converted to fatty acids and titrated to a neutral endpoint with sodium hydroxide.
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GI
It is more sensitive to lower ________ bleeding that could be an indicator of colon cancer or other gastrointestinal disease and can be used for patients who are taking aspirin and other anti- inflammatory medications.
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Fecal chymotrypsin
________ is more resistant to intestinal degradation and is a more sensitive indicator of less severe cases of pancreatic insufficiency.
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copper reduction test
The ________ is performed using a Clinitest tablet and one part stool emulsified in two parts water.
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lactoferrin latex agglutination test
A(n) ________ is available for the detection of fecal leukocytes and remains sensitive in refrigerated and frozen specimens.
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immunochemical fecal occult blood test
The ________ (iFOBT), is specific for the globin portion of human hemoglobin and uses anti- human hemoglobin antibodies, so it does not require dietary or drug restrictions.
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fecal reducing
Testing for ________ substances detects congenital disaccharidase deficiencies as well as enzyme deficiencies due to nonspecific mucosal injury.
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D xylose
________ is a sugar that does not need to be digested but does need to be absorbed to be present in the urine.
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absence of bile
It is an an increase in stool fat> (6 g per day) caused by the ________ salts that assist pancreatic lipase in the breakdown and subsequent reabsorption of triglycerides.
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visible striations
Digested fibers have no ________.
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Rapid gastric emptying
________ (RGE) dumping syndrome 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.
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Diarrhea classification can be based on four factors
duration of the illness, mechanism, severity, and stool characteristics
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Osmotic gap = 290
[2 (fecal sodium + fecal potassium)]
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fecal fat for adults in grams per 24 hours = [0.45 x (acid steatocrit in percent as a whole number)]
0.43
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fecal fat for children up to the age of 15 years in grams per 24 hours = [0.1939 x (acid steatocrit in percent as a whole number)]
0 .2174
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bacteria metabolizing food
What causes flatus?
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in plastic or glass containers with screw-capped tops
What specimens are needed for qualitative testing?
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3-day specimen, collected in paint cans
What specimens are needed for quantitive testing?
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blockage of the bile duct, barium sulfate
What causes pale yellow, white or gray stool?
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damage to the intestinal walls, possibly caused by bacterial or amebic dysentery or malignancy
What causes blood-streaked mucus-coated stool?
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biliary obstruction and gastrocolic fistulas
What do the presence of increased striated muscle fibers indicative of?
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60 droplets/HPF and 100 droplets/HPF, respectively
How many neutral fats and fatty acids indicate steatorrhea?
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occult blood
If colorectal cancer is suspected, what test is recommended?
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quantitative fat testing
What is the confirmatory test for steatorhhea?
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it digests the gelatin, leaving a clear area
What does trypsin do to x-ray paper?
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it becomes 5.5 due to increased lactic acid prod from bacteria
How does stool pH change in cases of intestinal disorders, and why?
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