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Questions and Answers
What is the staining procedure used to detect undigested muscle fibers in stool samples?
In fecal fat analysis, what appears as large orange-red droplets when stained with Sudan III?
What condition can be diagnosed and monitored using undigested striated muscle fibers in stool samples?
What is the primary component observed in excess during fecal fat analysis of samples from steatorrhea cases?
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Which dye is most commonly used for microscopic detection of neutral fats in fecal fat analysis?
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What is the significance of detecting more than 10 undigested fibers in muscle fiber analysis?
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What color supernatant is produced when denaturation of maternal hemoglobin (HbA) occurs?
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What is the main cause of steatorrhea associated with disorders like chronic pancreatitis and cystic fibrosis?
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Which enzyme is most frequently measured using spectrophotometric methods in fecal enzyme analysis?
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Which disorder is commonly associated with undigested food appearing in the feces due to pancreatic insufficiency?
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What effect do increased carbohydrates in the stool have on the digestive system?
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Which test can be used to detect the presence of fecal carbohydrates?
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What is the key requirement for a confirmed diagnosis of steatorrhea using quantitative fecal fat analysis?
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What method is routinely used for fecal fat measurement in quantitative fecal fat testing?
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Why might an APT test for fetal hemoglobin be requested for an infant?
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What is added to the emulsified material in the APT test to release hemoglobin?
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Why should one wait for a specified time after applying a sample to add the developer reagent in fecal fat testing?
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What does a high intake of raw broccoli, cauliflower, and turnips contribute to in fecal fat analysis?
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Study Notes
Muscle Fibers
- Undigested striated muscle fibers in stool can help diagnose and monitor pancreatic insufficiency, such as in cystic fibrosis, biliary obstruction, and gastrocolic fistulas.
- Red meat consumption before collecting a stool specimen can aid in diagnosing muscle fiber disorders.
- Slides are prepared by emulsifying a small amount of stool in 10% alcoholic eosin, which enhances muscle fiber striations.
- The entire slide is examined for 5 minutes, and the number of red-stained fibers with well-preserved striations is counted.
Fecal Fats
- Stool specimens can be screened microscopically for excess fecal fat (steatorrhea) using dyes like Sudan III, Sudan IV, or oil red O.
- Neutral fats, fatty acid salts, fatty acids, and cholesterol can be detected microscopically.
- Sudan III stains neutral fats, which appear as large orange-red droplets.
Apt Test
- The Apt test is used to distinguish between fetal and maternal blood in an infant's stool or vomitus.
- The test involves emulsifying the specimen in water, centrifuging, and adding 1% sodium hydroxide to the pink hemoglobin-containing supernatant.
- If the solution remains pink, it indicates the presence of fetal hemoglobin (HbF); if it turns yellow-brown, it indicates maternal hemoglobin (HbA).
Fecal Enzymes
- Decreased production of pancreatic enzymes, such as trypsin, chymotrypsin, and elastase I, is associated with disorders like chronic pancreatitis and cystic fibrosis.
- Chymotrypsin is often measured by spectrophotometric methods, while elastase I is measured by immunoassay using the ELISA kit.
Carbohydrates
- The presence of increased carbohydrates in stool can cause osmotic diarrhea.
- This is seen in conditions like celiac disease or lactose intolerance due to a lack of digestive enzymes.
- The copper reduction test is used to detect fecal carbohydrates.
False Positives and False Negatives
- Certain substances can interfere with fecal tests, causing false positives (e.g., aspirin, red meat, horseradish) or false negatives (e.g., vitamin C, iron supplements).
Quantitative Fecal Fat Testing
- This test is used to confirm steatorrhea and requires a 3-day stool collection with a regulated fat intake of 100g/d.
- The specimen is collected in a reweighed container, weighed, and homogenized before analysis using the Van de Kamer titration method.
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Description
Learn about the process of detecting undigested striated muscle fibers in stool specimens and its significance in diagnosing pancreatic insufficiency, cystic fibrosis, biliary obstruction, and gastrocolic fistulas. Explore the method of preparing slides using 10% alcoholic eosin for muscle fiber detection.
