Health

How should young menstruating women with iron deficiency anemia be evaluated?  The evaluation of iron-deficiency anemia in pregnant or relatively young menstruating females is individualized according to clinical presentation and menstrual and obstetric history. Iron deficiency during pregnancy is common. In a series of 186 menstruating women, 12% had a clinically important lesion detected by …

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How do patients with iron-deficiency anemia present clinically in terms of symptoms, signs, and laboratory abnormalities? Pica Pallor Weakness Palpitations Koilonychia High-output congestive heart failure Dyspnea on exertion Orthostatic symptoms Microcytic, hypochromic indices for erythrocytes Percent iron saturation <16%

How is a patient with a positive fecal occult blood test (FOBT) evaluated?  The evaluation of a positive FOBT depends somewhat on the clinical situation.  Asymptomatic persons with positive FOBT and iron-deficient anemia require colonoscopy. If colonoscopy is negative for a source of FOBT or anemia, then esophagogastroduodenoscopy (EGD) should be performed.

What is the sensitivity and specificity of guaiac testing for fecal blood?  The sensitivity of guaiac testing depends on the specific brand used. Several guaiac reagents are marketed. The most sensitive brand is the Hemoccult II-SENSA test. The sensitivity also depends on the lesion to be detected. It is not a good test for detecting …

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What is fecal genetic testing and can this test be used to replace the standard guaiac test for occult blood to screen for colon cancer?  Passage of stool through the colon leads to shedding of microscopic amounts of colonic cellular DNA that remain viable in stool for many days. Genetic mutations present in microscopic amounts …

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What test for fecal occult blood is superior to guaiac testing but is not commonly used clinically?  In FIT, antibodies to human hemoglobin are collected from venipuncture of rabbits previously exposed to human blood and are coupled to fluorescent proteins for easy detection. These antibodies attach to human blood (hemoglobin) in stool and are detected …

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How should guaiac tests be ideally performed to detect fecal occult blood? Stool specimens should be collected over 3 consecutive days. Guaiac testing should be performed on a fresh specimen (< 7 days). Dry specimens should be rehydrated. Patients should refrain from eating red meat and cabbage, cauliflower, or broccoli. Avoid taking aspirin or NSAIDs …

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