Duke PA Stool Studies
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| how does a FOBT work | based on oxidation of guaiac by hydrogen peroxide, resulting in development of a blue color on card when exposed to heme found in stool
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| 3 days prior to FOBT avoid | red meats, >250mg vitamin C
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| 7 days prior to FOBT avoid | NSAIDS/Aspirin (>325)
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| FOBT specimens are ideally innoculated onto card at least __ days prior to developing test | 3
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| If immediate results are required for FOBT, wait at least __ minutes prior to development | 3-5
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| causes FOBT false positives | red meats, aspirin, NSAIDS, alcohol, steroids, anticoagulants, chemotherapeutics, iodine preps
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| causes FOBT false positives | vitamin C >250mg/day
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| __ detects presence of leukocytes | methylene blue
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| __ indicative of invasive infective organisms or other inflammatory bowel disorders | fecal leukocytes
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| stool cultures are not routinely __ | gram stained
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| fecal leukocytes will be absent in | norovirus, rotavirus, CMV, ETEC and EHEC, giardia lamblia, Entamoeba histolytica, Cryptosporidium, S. aureus, B. cereus, C. perfringens
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| infectious causes of present fecal leukocytes | shigella, campylobacter, EIEC, Entero, Ivasive E. coli
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| an inflammatory protozoal infection. intact fecal leukocytes may not be seen | Entamoeba hisotlytica
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| an inflammatory viral agent (usually in immunocompromised patients) causes ulceration with viral inclusion bodies within cells on intestinal biopsy | CMV
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| predominant causative enterotoxin for Pseudomembranous colitis | C. difficile toxin A
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| when assessing a patient for C. diff it is the __ that you are looking for | toxin
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| three most commonly screened pathogens in stool cultures | salmonella, shigella, and campylobacter
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| when doing a stool culture a fresh or unpreserved stool should be delivered to the lab in <__ hours | 2
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| IFA indirect immunofluorescence assay utilizes monoclonal antibodies to identify __ | giardia cysts
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| __ is extrememly sensitive and specific for H. pylori | urea breath test
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| when looking for __ don't send for culture, you look for indirect evidence for the organism | giardia cysts
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| for detection of malabsorption disorders which result in steatorrhea (celiac/tropical sprue, Whipples dz, ZE, Crohn's) used more as a screening tool due to more specific testing for each disorder | fecal fat studies
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| flock of seagulls on gram stain | campylobacter
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| diarrhea acute in onset and persisting for less than 2 weeks is most commonly caused by __ | infectious agents, bacterial toxins, or drugs
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| community outbreaks of diarrhea suggest __ | viral etiology or shared food source
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| day care attendance or exposure to unpurified water may result in infection with | giardia, or cryptosporidium
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| watery, nonbloody diarrhea associated with periumbilical cramps, bloating, nausea, or vomiting suggests __. because tissue invasion does not occur there will be no fecal leukocytes | small bowel source that disrupts normal absorption and secretory processes
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| prominent vomiting suggests __ | viral enteritis or S. aureus food poisoning
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| the presence of fever and bloody diarrhea indicates __ | colonic tissue damage caused by invasion or a toxin
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| diarrhea that originates in the __ is high volume | small intestine
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| diarrhea that originates in the __ is low volume | large intestine
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| organisms that may cause fever and bloody diarrhea from invasion of colon tissue | shigella, salmonella, campylobacter, yersinia or toxins (C. difficile, E. coli O157:H7)
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| organisms that may cause watery non-bloody diarrhea from disruption of small bowel activity | enterotoxigenic E. coli, S. aureus, B. cereus, C. perfringens, giardia
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| a shiga-toxin producing non-invasive organism most commonly acquired from contaminated meat | E. coli O157:H7
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| watery, nonbloody diarrhea associated with periumbilical cramps, bloating, nausea, or vomiting. fecal leukocytes often not present | noninflammatory diarrhea
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| fever and small volume bloody diarrhea, associated with LLQ cramps, urgency, and tenesmus. fecal leukocytes often present | inflammatory diarrhea
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| if diarrhea worsens or persists for more than 7 days, stool should be sent for __ | fecal leukocytes or lactoferrin determination, ovum and parasite evaluation, and bacterial culture
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