first test examination of crystals 2 Flashcards
found in acidic urine, typically with a urine
pH
cystine
occur in the sediment of patients with Cystinuria, a
genetic defect in renal cystine transport
cystine crystals
most frequent cause of kidney
stones in children
cystine crystals can for staghorn calculi
• Dissolves in – HCl – NaOH – Ammonium hydroxide • Insoluble in – Acetic acid – Alcohol – Ether • Confirmatory test Nitroprusside Reaction (Acetest)
cystine
Is found in severe liver disorders in which amino acid
metabolism is impaired and associated with
tyrosinemia
tyrosine
The presence of ______ is usually
accompanied by a positive biochemical test
for bilirubin and are often accompanied by
the presence of leucine crystals in the sediment.
tyrosine crystals
• Polarizes light • Dissolves in: – HCl – NaOH – And when heated • Insoluble in: – Acetic acid – Alcohol – Ether
tyrosine
Could also indicate Maple Syrup Disease
leucine
The presence of leucine crystals is often accompanied by a
positive biochemical test for bilirubin and is often
accompanied by tyrosine crystals in the same sediment.
Indicates liver disease
leucine
Yellow, oily-looking spheres with striations and a thick outer
boarder.
Can resemble “grapefruit sections”
leucine
Dissolves in: – NaOH – And when heated • Insoluble in: – Acetic acid – HCl – Ether
leucine
• Is formed in acidic pH of urine
• Free fat from degradation of renal tubular epithelial cells
• May be present in cases of glomerulonephritis
the Nephrotic Syndrome.
cholesterol
cholesterol crystals are accompanied by
Cholesterol crystals are accompanied by: a positive biochemical test for protein oval fat bodies, fatty casts, free fat droplets in the sediment
• Weak birefringence • Dissolves in: – Chloroform – Ether – Hot alcohol • Insoluble in: – Dilute acids – Dilute alkali
cholesterol
Bilirubin crystals are seen in several ____ ____
hepatic disorders.
Is formed in acidic urine
• Yellow-brown needles or granules.
• They are frequently attached to the surface of cells
bilirubin
• Dissolve in: – Acetic acid – HCl – NaOH – Acetone – Chloroform – Ether • Insoluble in: – Alcohol
bilirubin
Iatrogenic Origin
Drugs
• Supplements
• Radiologic Contrast Media
Are formed in acidic pH
• Could result in renal damage while precipitating out in the
nephron
Sulfonamide Drugs
Confirmatory test – Lignin test
sulfonamides
Confusing Artifacts
Starch
• Talc
• Glass fragments
Polarize light into Maltese cross but without the outer edge
resembling “crushed diamonds
starch
summary
Urinary crystals may be present in acidic or alkaline
urine.
• Urinary crystals may be of no significance or may
accompany metabolic disorders.
• Microscopic evaluation of urine is important for
detection of crystals, because no chemical test
detects the presence of crystals.
• Solubility studies and the use of polarized and
compensated light help to identify crystals and
differentiate them from artifacts.
