Stool Studies
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| blue indicates | heme found in stool
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| blood testing is specific for human “globin” & fewer false positives from interfering factors (ie. red meat or drug ingestion) no prep, less # of spec. needed (eg. Hemoccult-ICT) | Immunochemical fecal occult blood (iFOBT)
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| requirement for hemoccult accuracy | Hemoccult requires 3 serial stools: avoid red meats & >250mg vitamin C x 3 days Avoid NSAIDs or *Aspirin (>325mg) x 7 days prior to & during specimen collection. Iodine preps should be out of system
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| green results may be due to | bile
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| WBCs are associated | with a fast, acute process. You may not see WBCs in deep tissue or if problem is localized. Negative WBC does not mean that you don't have an inflammatory diarrhea
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| ___ of stool is bacteria | 98%. NEVER GRAM STAIN
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| Presence of Fecal leukocytes | Shigella, Campylo, EIEC, entero, Invasive, E.coli
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| Variable Fecal Leukocytes | salmonella, yersinia, vibrio, p
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| abset | come back to
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| non | com back to
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| C. difficile test | is a toxin assay, not a stool culture. One positive means they have it, but if it is negative, you may need to send serial specimens. C diff is an anaerobe.
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| HIV patient with watery, heme pos diarrhea. Stool cultures are reported as no growth and fecal leukocytes are absent. The most likely etiology of infection is: | CMV
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| A stool guaic is positive in a 79 yo pt receiving tx for severe OA. Which of the following meds is most likely responsible if this is a "false" positive result? | Naproxen 500mg BID (not acetominophen 500mg BID, Aspirin 81 mg QD)
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| Fecal leukocytes is indicative of | inflammatory diarrhea
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| fecal leukocytes are not generally found in entamoeba histolytical | surface toxins rupture WBCs
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| A nursing home pt is treated with cephalosporin for pneumonia. One week later, pt develops green, watery diarrhea with fever. | C. Difficile
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| The enterotoxin associated with C. diff diarrhea that is most common | Toxin A (may need to request toxin B if A comes back negative)
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| The three most common bacterial pathogens tested on a routine stool culture are | salonella, shigella, campylobacter
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| what is not an idication for parasitic testing | bloody diarrhea for 2 days (indicated: travel to endemic area and subsequent diarrhea, HIV pt with diarrhea, Persistent diarrhea >10days)
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| two most common parasite infections | crypto and cyclospora
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| The most sensitive diagnostic test for detecting Giardia | IFA
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| two parasites seen with acid-fast stain | cryptosporidium and cyclospora
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| What bacterial pathogen is limited to humans and primates as hosts and transmitted via fecal-oral transmission | Shigella
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| What months of the year do you get Vibrio | The months that lack an R. May, June, July, August
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| Peanut butter has been pulled for | Salmonella
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| small curved gram negative rods resembling "flock of seagulls" | Campylobacter
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