1. A physician’s office laboratory is experiencing inconsistencies in the results of patient-collected specimens for FOBT. Patients are instructed to submit samples from two areas of three different stools. Positive and negative controls are producing satisfactory results. Patient #1 is a 30- year-old woman taking over-the-counter medications for gastric reflux who has reported passing frequent, black stools. The results of all three specimens are negative for occult blood. Patient #2 is a 70-year-old woman suffering from arthritis. She is taking the test as part of a routine physical. The results of all three specimens are positive for occult blood. Patient #3 is a 50-year-old man advised by the doctor to lose 30 lb. He has been doing well on a high-protein, low-carbohydrate diet. Two of his three specimens are positive for occult blood.
a. What is the possible nonpathologic cause of the unexpected results for Patient #1? Patient #2? Patient #3?
b. How could the physician’s office staff avoid these discrepancies?
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