AUBF Urinary Crystals Flashcards
Crystals commonly seen in acidic urine
Uric acid
Amorphous urates
Calcium oxalate (Neutal)
Normally seen in alkaline urine
Calcium oxalate (any pH)
Calcium phosphate
Triple phosphate (Ammonium magnesium phosphate)
Ammonium biurate
Calcium carbonate
Appearance: Rhombic, Four-sided flat plates (whetstones), wedges, rosettes
Uric acid
Uric acid distinguishing feature from cystine crystals
Highly birefringent
Pink sediment when refrigerated (Ca, Mg, Na, K)
Amorphous urates
Uric acid is Significantly increased in
Gout, Lesch-Nyhan Syndrome
Crystal: colorless to yellow brown granules
Amorphous urates
Macroscopic: orange-pink precipitate (brick-dust)
Amorphous urates
Amorphous urates can be convert uric acid with
concentrated HCl
Most common calcium oxalate
dihydrate - colorless, octahedral envelope, or as two pyramids joined at their base
Oval or dumbbell shaped crystal
seen in ethylene glycol “antifreeze” poisoning
Calcium oxalate: monohydrate
Majority of renal calculi is composed of
Calcium oxalate
Colorless rectangular shape, present in rosette forms
Calcium phosphate
Confused with sulfunamide crystals
Calcium phosphate
Appearance: Coffin-lid shape, Prism shape
TRIPLE PHOSPHATE (AMMONIUM MAGNESIUM PHOSPHATE)
Triple phosphate fern-like form can be induced by addition of
ammonia
Appearance: Thorny apples - spicule covered spheres
Ammonium biurate
Dissolves at 60 deg C
Ammonium biurate
Most often encountered in old specimen
Ammonium biurate
Appearance: Small, colorless, dumbbell or spherical shapes
Calcium carbonate
Resembles amorphous material - distinguised by addition of acetic acid (formation of gas)
Calcium carbonate
Appearance: colorless, hexagonal plates (thick or thin)
Cystine
Confirmation for cystine crystals:
Cyanide Nitroprusside Test
Metabolic disorder that prevents reabsorption of cystein by renal tubules
Cystinuria
Appearance: Rectangular plates with notch on one or more corners
Cholesterol
Abnormal urinary crystals
CHOLESTEROL
RADIOGRAPHIC DYE/ RADIOGRAPHIC CONTRAST MEDIA
SULFONAMIDES
LEUCINE
TYROSINE CRYSTALS
BILIRUBIN
Can be seen in: Nephrotic Syndrome in conjuction with Fatty Casts and Oval fat bodies
Cholesterol
Appearance: Colorless flat plates, similar to cholesterol crystals
RADIOGRAPHIC DYE/ RADIOGRAPHIC CONTRAST MEDIA
SG: markedly elevated in abnormal urine
RADIOGRAPHIC DYE/ RADIOGRAPHIC CONTRAST MEDIA
Appearance: colorless to yellow brown, needles, rhombics, whetstones, SHEAVES of WHEAT and rosette
Sulfonamides
Distinguished from calcium phosphate; Does not dissolved upon addition of dilute acetic acid
sulfonamides;
Appearance: Colorless needles (tend to form bundles following refrigeration)
Ampicillin
Indication: Precipitation of antibiotics following massive dosage of this penicillin compound without adequate hydration
Ampicillin
Appearance: Yellow-brown spheres (concentric circles with radial striations)
LEUCINE
Abnormal crystals indication for liver disorder
LEUCINE
TYROSINE CRYSTALS
BILIRUBIN
Appearance: Fine, colorless, to yellow needles (in clumps or rosettes)
TYROSINE CRYSTALS
Seen in conjunction with leucine crystals and (+) chemical test for bilirubin
Tyrosine crystals
Appearance: Yellow Clump needles, or granules
Bilirubin
