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Stool Information and Courses from MediaLab, Inc.

These are the MediaLab courses that cover Stool and links to relevant pages within the course.

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Laboratories Individuals

CLIA Microbiology / Serology Review
This suspicious form, shown below at both low (10X) and high dry (40X) power, measures 90 micro meters by 42 micro meters. It was seen in a stool sample.View Page
This suspicious form, found in a stool sample, measures 15 micro meters.View Page
This intestinal parasite, found in stool, measures 170 micro meters by 63 micro meters.View Page
This suspicious form was found in stool.View Page
I measure 15 micro meters and am found in stool.View Page
I measure 12 micro meters and am found in stool.View Page
I may be found in stool.View Page
Which one of the following statement about Campylobactor jejunisp. jejuni is false:View Page
A 20 year-old female was admitted into the hospital complaining of 10 to 15 bloody mucous stools per day, fever, gastrointestinal disturbances, abdominal pain, and nausea. The preliminary O & P report went out as "Probable Entamoeba histolytica trophozoites and cysts, confirmation pending." This patient is most likely suffering from:View Page
Which of the following specimens is the most sensitive for detecting active CMV infection:View Page
Which one of the following statements about E.coli O157:H7 is false:View Page

Current Topics in Clinical Microbiology
Review 1

Garbutt JM. Littenberg B. Evanoff BA. Sahm D. Mundy LM. Enteric carriage of vancomycin-resistant Enterococcus faecium in patients tested for Clostridium difficile. Infection Control & Hospital Epidemiology. 20(10):664-70, 1999OBJECTIVE: To identify independent risk factors for enteric carriage of vancomycin-resistant Enterococcus faecium (VREF) in hospitalized patients tested for Clostridium difficile toxin.PATIENTS: Convenience sample of 215 adult inpatients who had stool tested for C. difficile between January 29 and February 25, 1996.RESULTS: 41 (19%) of 215 patients had enteric carriage of VREF. Five independent risk factors for enteric VREF were identified: (1) history of prior C. difficile infection, (2) parenteral treatment with vancomycin for > or = 5 days, (3) treatment with antimicrobials effective against gram-negative organisms, (4) admission from another institution, and (5) age > 60 years. These risk factors for enteric VREF were independent of the patient's current C. difficile status.CONCLUSIONS: Antimicrobial exposures are the most important modifiable independent risk factors for enteric carriage of VREF in hospitalized patients tested for C. difficile.

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Case History

A 63 year old man was seen in the emergency room with the complaints of sudden onset of fever, chills, and abdominal pain, accompanied by mild diarrhea. The blood pressure was 140/84, the pulse rate 82/minute, and the body temperature 39.8C. A blood sample was drawn for a complete blood count, and a blood culture.A second blood culture was drawn from the opposite arm, with 10 ml of blood being placed into each an aerobic and an anaerobic bottle, following customary practice.The complete blood count revealed a hemoglobin of 15.8 mg/dl, a hematocrit of 45%, and a white blood count of 4.2/L. The neutrophils were 39%, lymphocytes 45%, monocytes 10%, eosinophils 4% and basophils 2%. The platelet count was 255/L. The patient was admitted to the hospital for further work-up and empiric antibiotic therapy.Within 24 hours after admission, the body temperature had decreased to 38.2C, although the mild diarrhea persisted.A stool toxin test for Clostridium difficile was negative and neither enteric pathogens nor Campylobacter species were recovered in stool culture after 24 hours incubation. Fecal neutrophils were not seen on direct examination. The anaerobic blood culture became positive 36 hours after inoculation.

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Laboratory Ergonomics
Scenario #3Jim spends most of his workday sitting on a stool at the technical workbench. The image on this page illustrates how he routinely sits. Lately, he has been experiencing lower back and leg discomfort that continues to bother him when he leaves work. He has been having trouble sleeping because of the pain in his legs. Eventually, the pain progresses to the point where he cannot work an entire day. What may have caused the problem and what could have been done to prevent the MSD from developing? Consider what could be the problem based on your observation of Jim's normal sitting position. Then click on the blue text below to see the ergonomic evaluation and possible solutions.View Page
Body Position

Take frequent posture breaks; if standing, sit periodically. If sitting, stand about every 20 minutes and walk around. Shoulders and Arms Keep the shoulders relaxed, not shrugged-up or slumped-down. Keep your elbows close to your body Keep work at elbow height and directly in front of you as shown in the image below. Head and Neck Avoid situations that require prolonged or repetitive twisting, forward-bending, or backward-bending of the neck.Hands and Wrists Keep the hand in line with the forearm. Avoid repetitive twisting of the wrists. Avoid working with wrists pressed against hard surfaces or edges as shown in the image below. Feet and Legs Place a foot on a footrest for comfort Provide a toe space to allow work closer to counters and reduce reaching. Use mats on hard floors to reduce fatigue as shown in the image below.Back Stand straight. Avoid situations that require bending forward, backward, leaning side-to-side, or twisting. Use a stool to provide an occasional change in posture. If working seated, use a back rest/support to maintain proper posture. The chair that is shown in the image below offers neck, back, and lumbar support.

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Parasitology Review
Match each parasite listed here with its corresponding diagnostic stage:View Page
Which of the following specimen types is/are suitable for the recovery of Entamoeba histolytica?View Page
The specimen of choice for the recovery of Entamoeba hartmanni is:View Page
Match each organism listed here with the most likely specimen type where it may be recovered. Each answer may only be used once.View Page
Which of the following characteristics should be observed for and noted in the macroscopic examination of a stool sample for parasites?View Page
Match each parasite listed here with the appropriate laboratory technique that may be used for its identification: Each answer may only be used once.View Page
Which of the following is the recommended protocol for collecting stool samples in order to rule out a parasitic infection?View Page
Which of the these substances, when present in a sample, may mask parasites?View Page
The ideal stool sample for parasitic examination is one that is freshly collected and submitted to the laboratory at:View Page
Suppose that a stool sample was submitted to the laboratory for O & P examination. Macroscopic examination revealed a chalky-clay colored sample. If you were the alert clinical laboratory scientist on duty, which of the following would be the proper protocol would you follow in handling this sample?View Page
Suppose that a stool specimen was received in the laboratory for an O & P examination. The clinical laboratory scientist on duty performed direct wet preparations and found suspicious forms. An ethyl acetate concentration procedure was done, the top layer was examined, and no suspicious forms were seen. A slide of the sample was stained with Trichrome and again suspicious forms were noted. Which of the following is the most likely explanation for these discrepant results?View Page
This suspicious form, recovered from a stool sample, measures 30 µm in diameter.View Page
This suspicious form measures 12 µm by 7 µm and was found in a stool sample.View Page
Recovered from a stool sample, this suspicious form measures 6 µm by 8 µm.View Page
This suspicious form, seen in a stool sample, measures 10 µm in diameter.View Page
This suspicious form measures 13 µm and was recovered from a stool sample.View Page
This suspicious form, shown here at both low (10X) and high dry (40X) power, measures 90 µm by 42 µm. It was seen in a stool sample.View Page
This suspicious form, found in a stool sample, measures 15 µm.View Page
This parasite may inhabit the small intestine or take up residence in the bile ducts. It typically measures 145 µm by 75 µm.View Page
This intestinal parasite, found in stool, measures 170 µm by 63 µm.View Page
This suspicious form was seen in a stool specimen and measures 33 µm by 28 µm.View Page
Recovered in a stool sample, this suspicious form measures 7 µm.View Page
This suspicious form, found in stool, measures 55 µm.View Page
This suspicious form, found in stool, measures 25 µm.View Page
This suspicious form was found in stool.View Page
This suspicious form, shown here under both low and high power, was found in a stool sample and measures 50 µm.View Page
This suspicious form, found in stool, measures 54 µm by 32 µm.View Page
This suspicious form was recovered in stool.View Page
This suspicious form, found in stool, measure 10 µm.View Page
A 20 year-old female was admitted into the hospital complaining of 10 to 15 bloody mucous stools per day, fever, gastrointestinal disturbances, abdominal pain, and nausea. The preliminary O & P report went out as "Probable Entamoeba histolytica trophozoites and cysts, confirmation pending." This patient is most likely suffering from:View Page
This suspicious form, which was recovered in stool specimen and measures 32 µm, is responsible for which of the following diseases?View Page
This stool parasite measures 135 µm by 50 µm and is the causative agent of:View Page
This suspicious form, found in stool, which measures 15 µm by 10 µm, is responsible for which of the following diseases?View Page
This stool parasite measures 55 µm by 50 µm and is the causative agent of:View Page
This suspicious form, recovered in stool, measures 165 µm by 65 µm. It is responsible for causing:View Page
This suspicious form measures 15 µm and was recovered in stool. Which of the following conditions is/are associated with the presence of this form?View Page
This suspicious form, recovered in stool, measures 12 µm in length. Which of the following conditions is this form responsible for causing when present?View Page
Which of the following conditions may be associated with the presence of this stool parasite?View Page
The class of protozoa with no apparent organelles for locomotion is known as:View Page
Arrange the basic steps in the intestinal ameba life cycle in order starting with transmission to a human host:View Page
Match each parasite listed here with its corresponding optimal specimen type from which it may be recovered: (Answers may be used more than once.)View Page
Match each parasite listed here with its corresponding optimal specimen type from which it may be recovered: (Answers may be used more than once.)View Page
Stool is the specimen of choice for the recovery of which of the following parasites?View Page
Which of the following parasites is/are known to contain cytoplasmic ingested red blood cells in the trophozoite morphologic form?View Page
A 35 year old male presented to the local clinic complaining of abdominal cramps, severe diarrhea, and intestinal gas discomfort. A stool was collected for parasite examination. It was foul-smelling and light colored in nature. This suspicious form was recovered and measured 10 µm by 12 µm. The patient is infected with:View Page
A 55 year old female, who recently returned from an extensive trip to China, presented to her physician complaining of diarrhea and abdominal cramps. The doctor ordered a complete blood count (CBC), chem 21 panel, and stool for culture and parasite examination (O & P). The CBC revealed pronounced eosinophilia. The chem 21 and stool culture were unremarkable. The O & P revealed suspicious forms like the one below that each measured approximately 140 µm by 80 µm. This patient is most likely infected with:View Page
A 43 year old female presented to her doctor for a routine check-up. Her only complaint was that she had been experiencing watery stools that occasionally contained pus and blood. Examination revealed tenderness in her abdomen. A stool for parasite study was sent to the lab. Two suspicious forms were seen. The oblong form on measured 53 µm by 60 µm whereas the rounder form measured 45 µm by 37 µm. Use the pulldown boxes to identify each picture:View Page
A 27 year old male was seen in the emergency room complaining of diarrhea. He had no other symptoms and was in very good health. The doctor ordered a stool for culture and parasite study. The culture revealed no enteric pathogens. This suspicious form was seen on the wet preparations and the permanent stain. It measured 16 µm. With which of the following parasites is this patient most likely infected?View Page
A 31 year old male missionary worker recently returned from Africa where he helped a small rural community update their sanitation practices. He presented to his physician weak and complained of recent weight loss, abdominal pain, and diarrhea that was often bloody. The doctor ordered a battery of tests including a complete blood count (CBC) and stool for parasite examination. The CBC revealed eosinophilia and anemia. This suspicious form was seen on the wet preparations. It measured 52 µm by 27 µm. What parasite is mostly likely present?View Page
A 50 year old male domestic airline pilot was rushed to the hospital after complaining of tremendous fluid loss due to severe diarrhea. History revealed that the patient was diagnosed with AIDS 6 months ago. The doctor ordered a battery of tests including a stool for parasite examination. Since the sample was properly labeled indicating that the patient was immunocompromised, the lab performed both the standard processing procedures and a modified acid-fast (mod AFB) stain. The mod AFB stain revealed this suspicious form which measured a mere 4 µm. This patient is most likely infected with:View Page
An 18 year old female athlete, who recently competed in a barefoot run for charity in Southern Georgia, presented to her doctor for a routine check-up. Other than complaining of being exhausted and having occasional diarrhea, she was in good health. The doctor ordered a stool for culture and parasite examination. The culture was negative. Numerous suspicious forms, as that shown here, were seen upon microscopic examination of the stool. The name of this suspicious form is:View Page
A 12 year old female went to her doctor for her yearly back-to-school check-up. She was in good health and was asymptomatic at the time of the examination. Due to the increased incidence of parasites in the area, the doctor ordered a stool for parasite examination as part of the routine physical testing. Multiple suspicious forms, measuring approximately 9 µm each were seen. Which of the following is most likely the identification of these forms?View Page
A 45 year old mother of two went to her physician because her children were recently diagnosed with ascariasis and she was concerned that she had also contracted the disease. Other than complaining of recent sporadic diarrhea, she was in overall good health. The doctor ordered a stool for ova & parasite examination. This suspicious form, measuring 55 µm was seen throughout the sample. This form is most likely:View Page
A 16 year old male champion athlete went to his doctor complaining of a persistent cough, fever, bloody diarrhea and overall weakness. Upon questioning the patient, it was learned that he had recently competed in a freshwater swimming competition in the Caribbean. Examination revealed a dermatitis on the patient's right calf. A battery of tests were ordered including a CBC, chemistry profile, and a stool for culture and parasitic examination. The CBC revealed the presence of eosinophilia. The other hematology and chemistry tests were unremarkable. The culture was negative. This suspicious form was seen on all parasite preparations made from the stool sample submitted. This form measures 165 µm by 68 µm. This patient is most likely suffering from an infection with:View Page
A 65 year old Asian female presented to the emergency room exhibiting severe abdominal pain, fever and diarrhea. Examination revealed an enlarged liver that was tender to the touch. Patient history revealed that the woman worked in a fish processing plant for years prior to moving to the United States. Her diet was heavy in raw fish. Stool and duodenal contents were collected and sent to the laboratory for cultures and parasite examination. The cultures were unremarkable. This suspicious form was seen in both specimen types. It measures 27 µm by 14 µm. This patient is most likely suffering from:View Page
A 7 year old male presented to the local clinic experiencing mild, yet annoying, abdominal pain, diarrhea and nausea. Patient history revealed that the child lives in a shack where sanitation practices are marginal, at best. The dwelling is infested with rats and multiple insects. Stool was collected and submitted for parasitic study. Numerous suspicious forms, measuring 60 µm by 75 µm were seen. This child is most likely infected with:View Page
A 27 year old female graduate student recently returned from South America, where she completed a nature study of the rain forest. She spent months "living off the land." The woman went to her physician seeking treatment for a sinus infection, which she thought was responsible for several recent bouts of diarrhea. Upon questioning the patient, the doctor decided to collect stool for culture and parasitic examination. The stool culture was reported as "no enteric pathogens isolated." This suspicious form was seen on both wet preparations and on permanent stain. It measures 17 µm. The identify of this form is most likely:View Page
A fresh stool sample was submitted to the laboratory for parasitic examination on a 30 year old male who presented to a local clinic complaining of gastrointestinal discomfort and overall weakness. The only patient history available about the patient was that he was here job hunting and that he is originally from rural Mississippi. The sample was immediately processed and this suspicious form was seen. No other suspicious forms resembling eggs were seen. The patient is most likely infected with:View Page
A 31 year old female with a known history of amebiasis, presented to her physician complaining of bloody diarrhea and fever. Previous patient history revealed that she lives in substandard conditions. Parasitic examination of the woman's stool revealed this suspicious form that measures 20 µm. The identification of this form is:View Page
A 10 year old male presented to the local Appalachian Mountain clinic complaining of vomiting, fever and severe abdominal pain. Patient history revealed that the child lives in the area in substandard conditions and receives only one balanced meal per day. A stool was collected and submitted for parasite study. This suspicious form, measuring 50 µm by 35 µm was found. This patient is most likely infected with:View Page
A 40 year old male recently completed a two-week hiking expedition in Russia. Upon his return to the United States, the man presented to his physician complaining of severe foul-smelling diarrhea and abdominal discomfort. The doctor immediately suspected a parasitic infection and ordered stool for examination. The sample was loaded with this suspicious form that averaged 13 µm in length. This patient is most likely suffering from:View Page
A 4 year old female from South Carolina was rushed to the emergency room who was suffering from malaise, bloody diarrhea and abdominal pain. Examination revealed rectal prolapse. Stool was submitted for parasitic examination and this suspicious form was seen. It measures 45 µm by 20 µm. Which of the following is the correct identity of this suspicious form?View Page
A 54 year old Finnish male presented at the local clinic with abdominal pain, weight loss, overall weakness and digestive discomfort. Patient history revealed that the man's diet was rich in raw fish. A complete blood count (CBC) was performed and revealed macrocytic anemia. A stool for parasitic examination was ordered. This suspicious form was seen upon initial screening of the sample. It measures 77 µm by 48 µm. This patient is most likely suffering from an infection with:View Page
A 17 year old female went to her doctor complaining of diarrhea. With the exception of seasonal allergies, she was in relatively good health. Patient history was unremarkable. A stool was submitted for culture and parasite examination. The culture was reported out as "no enteric pathogens isolated." This suspicious form was seen on wet preparation and permanent stain. It measures 27 µm. This patient is most likely suffering from which of the following conditions:View Page
A 40 year old male just returned from a six-month tour of the Far East. He went to his doctor upon his return complaining of weakness, diarrhea, fever and cough. Upon questioning the patient it was learned that he spent many an evening swimming in the various local fresh water ponds. The doctor, suspicious of a parasitic infection, ordered a stool for examination. Two suspicious forms were seen: form 1 is roundish and measures 77 µm by 62 µm. Form 2 is long and ladder-like and lays on the edge of form 1. What are these two structures?View Page
A stool collected at a local doctor's office was received in the laboratory for parasitic examination. The sample was not received in fixative and due to the new courier system did not arrive in the lab within the traditionally acceptable time frame. Due to logistical difficulties of the patient collecting and submitting another sample, the laboratory director authorized the sample to be processed. The comment "specimen delayed in transit, please evaluate results accordingly" was included in the report. These two suspicious forms were seen upon examination of the specimen. Label these two forms:View Page
A 6 year old female presented to the local clinic complaining of intense perianal itching and diarrhea. The doctor ordered a cellophane tape prep and stool for routine culture and parasitic examination. The cellophane tape prep revealed suspicious form on the left. The stool culture was negative. The form on the right was seen upon examination of the stool for parasites, which measures 10 µm. Label these two suspicious forms:View Page
A 29 year old male steak house owner from Arizona presented to his doctor complaining of weight loss, abdominal pain and diarrhea. Patient history revealed that the man eats all of his meals at his restaurant and his favorite meat is rare sirloin steak. The man also noted that he had recently been on anti-parasitic medication. The doctor ordered a stool for parasitic examination. These two suspicious forms were seen. The patient is most likely suffering from an infection with:View Page
A stool was received in the laboratory for parasitic examination on a 49 year old female who just returned from missionary work in numerous third world countries around the world. The patient had been suffering from mild diarrhea over the past two weeks. These two suspicious forms were seen. Form 1 measures a mere 6 µm whereas form 2 measures 35 µm. Label these two forms:View Page
I measure 15 µm and am found in stool.View Page
I measure 12 µm and am found in stool.View Page
I am found in stool and measure 75 µm by 55 µm.View Page
I measure 12 µm and am found in stool.View Page
I am found in stool and may be easily mistaken for "junk." I measure 12 µm.View Page
I am 12 µm in size and reside in stool. I may be easily missed since I tend to "blend-in" with fecal debris.View Page
I measure 45 µm and am found in stool.View Page
I may be found in stool.View Page
I measure 30 µm by 15 µm and am found in stool.View Page
I measure 65 µm in length and am found in stool.View Page
I am found in stool.View Page
I am found in stool and measure 33 µm in diameter.View Page
I am found in stool and measure 45 µm by 25 µm.View Page
I measure 20 µm in length and am found in stool.View Page
I am found in stool and measure 45 µm.View Page
I am found in stool and measure 10 µm by 8 µm.View Page
I am found in stool as well as in duodenal contents. I measure 15 µm in length.View Page
The artifact that when seen is indicative of intestinal inflammation and is characteristic of a number of parasitic infections is known as (a):View Page
This parasite, found in stool, measures 60 µm by 45 µm. Name that parasite!View Page
This parasite was recovered in a veterinary stool sample. Which of the following human parasites does it most closely resemble.View Page
This parasite measures 28 µm by 17 µm. Its common name is:View Page
This suspicious form, recovered in stool, measures 120 µm by 63 µm. Name that parasite!View Page
Which of the following parasites may be identified by being cultured?View Page
This suspicious form, found in stool, measures 50 µm. Who am I?View Page
This suspicious form, which measures 20 µm, was recovered in sigmoidoscopic material. Name that parasite!View Page
This suspicious form measures 18 µm and was seen in stool. Name that parasite!View Page


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