CLINICAL PARASITOLOGY

POST LAB DISCUSSION: FECAL OCCULT BLOOD (Laboratory)

Prelims | January 27, 2023

OCCULT BLOOD Causes of FALSE (+)

Presence of blood in stool not seen by the naked o Meat
eye o Vegetables
“occult” – hidden  Turnip
Blood is broken down when passing the colon  Horse radish
>2 ml = (+)  Mushroom
PATHOPHYSIOLOGY  Broccoli
 Bean sprouts
Upper GIT  Orange
Bleeding heme derived
porphyrin o Anticoagulants (aspirin)
Proximal o White cells (neutrophils have peroxidase)
RBC Black o Boric acid
Rectosigmoid
tarry
stool
o Other drugs
bleeding (50 to 75 Causes of FALSE (-)
Hgb
ml)
o Vitamin C >250 mg – inhibits peroxidase
o Oxidant
Hgb

Heme

Globin

Hgb – gives color to RBC, responsible for O2

transport
Heme – acted upon by bacteria in colon
Globin – acted upon by bacteria & goes back to
liver (normal flora)
Heme derived porphyrin – detected in occult
blood
RECTOSIGMOID BLEEDING
Cannot be detected by fecal occult blood test
Rupture in rectum
Can be caused by anal sex
Specific test: Fecal immunochemical test (FIT)
FECAL IMMUNOCHEMICAL TEST
o Ab is used against Hgb (Anti Hgb)
HEMA SCREEN
Peroxidase-containing reagent reacts with heme
derived porphyrin
Only detects heme
50-75ml of heme derived porphyrin = black tarry
stool
Indication:
o Tumor growth
o Colorectal cancer
o Ulcerative/neoplastic
o Swallowed blood
o Kaposi sarcoma, Amyloidosis, Gastritis,
Diverticulitis
 Gastritis & diverticulitis = inflammation
Other tests:
o Guaiac’s
o Benedict’s
1+ Faint blue
2+ Distinct blue
3+ Dark blue
4+ Prussian blue

CPARST1 VERA RAÑESES