PATHOLOGICAL INVESTIGATIONS IN G.I.T DISORDERS:

By Anonymous -
COMPLETE BLOOD PICTURE (CBP / CBA)
STOOL ANALYSIS
URINALYSIS ( CUE )
CYTOLOGY ( FNAC / FNAB )
HISTOPATHOLOGY ( SURGICAL PATHOLOGY,IHC, EHC etc.)
ELECTRON MICROSCOPY ( SEM / TEM )

COMPLETE BLOOD PICTURE (CBP / CBA):
HAEMOGLOBIN ( Hb g % ) – A, F, S etc
Normal – 14.5 + 2 (M) and 13.5 + 2 (F)
Normochromia ( MCHC – 28 TO 32 %)
Hypo – iron def., thalassemias etc (MCHC - < 28% )
Hyperchromia - Sphero,B12 & fol. def. ( MCHC-36%)
Inc. Hb - spherocytosis, megaloblastic anemias etc.
Dec. Hb – menorrhagia, hookworm,chronic blood loss and infections, MAS, malignancies etc.
Hb Electrophoresis.

2) RBC’s ( 4 to 5 millions / cumm)
Microcytic – dec. Hb conditions, malig., chr. bleeds etc.
Macrocytic – inc. Hb conditions , myxedema, chronic liver diseases etc.
Spherocyte, Sickle , Elliptocyte – Heriditary, megaloblastic an., Myelofibrosis etc.
Aniso/poikilocytosis - Stomatocyte – Heriditary, alcoholism etc.

3) ESR ( upto 20 mm / 1st hour)- depends on viscosity (necrosis)
Low : Hypo/agammaglobulemia.,polycythemia etc.
High : Menstruation , pregnancy, infections, malignancy etc
Importance : Activity of disease, prognosis (TB,RA,RF,HL)


4) WBC’s ( 4 – 11 th/ cumm)
Neutro ( 60 – 70 % ) – Acute inf., infl. of git ( upto 70 th.), leukemias ( above 1 lakh ), leukamoid reaction
Lympho ( 25 – 30 %) - viral inf., Kochs, chr. Inf., MALTomas etc.
Eosino ( 1 – 5 % ) - Parasitic, Trop. Eosino, Eosinophilic gastritis etc.(upto 35% -)
Mono ( 2-3 %) – Leukemia, Inf. Mononucleosis, Lymphomas, storage disorders, mastocytosis in git.disorders
etc

PLATELETS ( 1.5 to 4 lakhs / cumm)
Inc – CHD, Pul.embolism etc.
Dec – purpura and complications, chemo / radiotherapy etc.

BLEEDING & CLOTTING TIME ( 3-11 min)
BT ( 2 - 9 min) – pl. disorder ( BP app.)
CT ( 3 -11 min) - coagulation disorder ( Test tube )


STOOL ANALYSIS:
Pus + blood = Dysentry (RBC clumps – Amoebic, discrete – bacillary )
Bulky = Steatorrhea
Red streaks = F-I-Ano,Fresh – Haemarrhoids/dysent
Black= Malignancy/polyp, Fe, constipation.
Green = children – bacterial infection (pseudomona)
Rice water = Cholera / viral diarrhoea
Ova = Tapeworm, roundworm, threadworm etc
Cysts = Ent. Histo., E.coli, giardiasis, enterobius etc
Benzidine test (occult blood), Benedicts (reducing sugars) and stercobilinogen ( Haemolytic anaemias)

URINALYSIS
Physical – color, transparency, reaction -- --
Protein and sugar - -----
BS,BP – icterus (obstruction- no urobilinogen – uro.+ - obstr.relieved.)
Ketone bodies – diabetic ketoacidosis
Microscopy -------

CYTOPATHOLOGY
Most commonly employed
U/S and CT guided FNAC
Diagnosis accurate 50 – 70 % cases
Preliminary tool for differentiating origin of tumors

HISTOPATHOLOGY
Most confirmatory and ultimate diagnostic tool.
Unambiguous
Staging and prognostication possible. ( TNM class.& grading of tumor)
Retrievable and re-visitable after long periods of time.
Most preferred.

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