General Stool Examination and Composition

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Questions and Answers

What are the two stages of protozoa found in stool specimens?

Bacteria and eosinophils

Mycelium and spores

Larvae and eggs

Trophozoites and cysts (correct)

Which precaution should be taken before collecting stool specimens?

Avoiding high-fiber foods

Reducing water intake

Refraining from consuming milk products

Not taking mineral oils and barium swallow examinations (correct)

What is the minimum size required for a satisfactory stool specimen?

Size of a hen's egg

Size of a pigeon's egg (correct)

Size of a walnut

Size of a grape

What does a black color in stool indicate?

Upper gastrointestinal bleeding Signup and view all the answers

How is the normal reaction of stool classified?

Neutral Signup and view all the answers

Which color of stool is indicative of malabsorption of fat?

Pale brown or pale yellow with greasy consistency Signup and view all the answers

What should the stool specimen container clearly indicate?

Patient's name, date, and time of stool passage Signup and view all the answers

Which of the following is NOT a component typically found in fecal specimens?

Glucose Signup and view all the answers

What is the significance of finding blood in the stool?

It suggests possible bleeding piles or other medical conditions. Signup and view all the answers

What type of stool consistency is typically associated with excessive protein ingestion?

Liquid Signup and view all the answers

Which examination is essential for diagnosing intestinal parasitic infections?

Stool examination Signup and view all the answers

How is occult blood in stool best characterized?

Blood not visible macroscopically, but present. Signup and view all the answers

What is the typical color of normal stool?

Brown Signup and view all the answers

Which of the following describes the procedure for preparing Lugol's iodine?

Mix potassium iodide with water before adding iodine. Signup and view all the answers

Which microscopic result indicates a significant presence of RBCs in the stool?

More than 40 Signup and view all the answers

What is the primary purpose of using buffered methylene blue in stool examination?

To specifically stain amoebic trophozoites. Signup and view all the answers

Study Notes

General Stool Examination

Examines stool for presence of protozoa and helminthes larvae or eggs
Protozoa stages found in stools: Trophozoites and cysts
Helminthes stages found in stools: Eggs and larvae

Stool Composition

Composition:
- 75% water
- 25% solid
- Solid components:
  - Undigested and unabsorbed food
  - Intestinal secretions, mucous
  - Bile pigments and salts
  - Decomposed products
  - Bacteria
  - Inorganic material
  - Epithelial cells, leukocytes

Precautions Before Stool Collection

Avoid the following for 48 hours prior to collection:
- Mineral oils
- Bismuth
- Non-absorbable anti-diarrheal drugs
- Antimalarial drugs
- Antibiotics
- Barium swallow examination
Avoid the following for 48 hours prior to stool collection for occult blood:
- Iron-containing drugs
- Meat
- Fish

Stool Collection Procedure

Provide the patient with:
- A plastic cup or box with a light-fitting lid
Instructions for the patient:
- Pass the stool specimens directly into the container
- Label the container with:
  - Patient’s name or number
  - Date of collection
  - Time the patient passed the stool
Minimum quantity needed for examination: The size of a pigeon’s egg

Stool Color

Black color indicates:
- Iron medication for anemia treatment
- Upper gastrointestinal (GIT) bleeding (e.g., peptic ulcer, stomach carcinoma, esophageal varices)
Bright red color (Hematochezia) indicates:
- Lower GIT bleeding (e.g., piles, anal fissure)
Clay color (gray-white) indicates:
- Obstructive jaundice
Pale brown or pale yellow color with greasy consistency indicates:
- Malabsorption of fat (often with offensive odor)
Yellow-green color occurs in:
- Breast-fed infants who lack normal intestinal flora
Red brown color indicates:
- Drugs like Tetracyclines and Rifambicin antibiotics

Stool pH

Normal: Neutral (pH 6.9 to 7.2)
pH dependent on: Bacterial fermentation and putrefaction in the bowel
Alkaline pH indicates: Excess protein ingestion
Acidic pH indicates: Excess carbohydrate ingestion

Stool Consistency

Can be described as:
- Formed
- Soft
- Loose
- Liquid (watery)

Blood & Mucus in Stool

Large amounts of blood in stool suggest:
- Bleeding piles
- Contamination with menstrual blood
- Destruction of a blood vessel by an ulcerative process
Blood may be present in conditions like:
- Colitis
- Schistosomiasis
- Uremia
- Cancer
Occult blood:
- Undetectable macroscopically
- Present in conditions of occult hemorrhage in the gastrointestinal tract

Microscopic Examination

Clinical significance:
- Identifies pathogenic parasites excreted in stool
- Supports diagnosis of intestinal parasitic infection, often accompanied by symptoms like anemia, eosinophilia, diarrhea, and malabsorption
Microscopic tests:
- Normal saline mount:
  - Uses 10X and 40X objective
  - Reports the number seen in the entire preparation:
    - Scanty (rare) n1-3
    - 3-10 (+)
    - 10 to 20 (++)
    - 20 to 40(+++),
    - More than 40(++++).
- Lugol's Iodine:
  - Staining technique for detecting parasites in stool
  - Preparation:
    - Mix 2g potassium iodide with 200 ml water until fully dissolved.
    - Add 1g iodine to the potassium iodide solution.
  - Procedure:
    - Label a slide with patient name or lab number.
    - Place one drop of normal saline on the left half of the slide.
    - Place one drop of Lugol's iodine on the right half of the slide.
    - Mix a small piece of stool with the iodine drop on the right half of the slide.
    - Use 10X and 40X objective for saline preparation.
- Buffered Methylene Blue (BMB) mount:
  - Prepare if amoebic trophozoites are seen in the saline mount
  - Stains amoebic trophozoites only.

General Stool Examination (G.S.E.) Report

Macroscopic examination:
- Color: brown, yellow, green, black, etc.
- Consistency: formed, loose, soft, watery, etc.
- Blood or mucus
- Occult blood
- pH
- Others
Microscopic examination:
- Pus
- RBC
- Parasites
- Yeast.

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Description

This quiz covers the essential aspects of general stool examination, including the identification of protozoa and helminthes, as well as the composition of stool. It also outlines important precautions and the correct procedure for stool collection. Test your knowledge and understanding of these vital concepts in medical diagnostics.