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UA > First test examination of crystals > Flashcards

First test examination of crystals Flashcards

1
Q

nephrolithiasis

A

kidney stone disease

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2
Q

stones that are in the ureter

A

ureterolithiasis

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3
Q

urinary bladder stones which form or havepassed into the bladder

A

cystolithiasis

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4
Q

crystals can form before or after micturation

A

micturation=urination

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5
Q

Crystal precipitation after micturition is most commonly dueto:

A
  • changes in urinary temperature, as can occur if theurine is stored at room temperature or ina refrigerator;- changes in urinary pH, as can occur in thepresence of contamination of urea-splittingorganisms.
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6
Q

abnormal crystals are usually seen in ___ urine

A

acidic

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7
Q

Prerequisites for identification of crystals:

A

– pH of urine– morphology of crystals– crystals solubility– crystals polarization

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8
Q

abnormal acidic crystals

A

metabolic origin

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9
Q

abnormal alkaline crystals

A

Iatrogenic orgin

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10
Q

In vitro factors of urinary crystal formation

A

-Temperature (solubilitydecreases withtemperature)- Evaporation (increasessolute concentration)- Urine pH (changes withstanding andbacterial overgrowth)

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11
Q

In vivo (body) factors:

A

Solute concentration- Kidney filtration rate- Urine pH- Diet- Excretion of diagnosticimaging andtherapeutic agents

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12
Q

most crystals are clinically

A

insignificant

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13
Q

Generally, clinically significant crystals are present infreshly voided urine, or in cases of ______

A

metabolic disorders(e.g. gout)

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14
Q
  • Metabolic disorders may produce crystals (4)
A

• Cystine (inherited metabolic disease)• Leucine• Tyrosine• Cholesterol

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15
Q
  • Iatrogenic disorders-high doses of some drugs and supplements may cause formation of crystals:
A

• Salicilates (Aspirin)• Sulfonamides• Ascorbic Acid (vitamin C)

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16
Q

_____ light is used for the identification of crystalsand other anisotropic substances.

A

Polarized

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17
Q

The first lens is referred to as the “_____ filter” and itis nearest the light source, below the condenser

A

polarizing

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18
Q

The second filtering lens is called the “______” and islocated between the objective and the eyepiece lenses

A

analyzer

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19
Q

It is used for differential diagnosis between variouscrystals

A

Birefringence

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20
Q

•Birefringence is a double refraction (or bending) of thelight into ___ rays, one is ____to the light axisand other is at angles to it

A

two, parallel, right

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21
Q

Birefringence demonstrates crystal’s ability to split ____into the spectrum

A

light

22
Q

when examining with a polarizing filter and REDcompensator filter, the crystals are YELLOWwhen aligned parallel to the slow axis ofthe red compensatorbut they turn BLUE when aligned across thedirection of polarization

A

Negative birefringence: (Y-B)

23
Q

hen examining with a polarizing filter and redcompensator filter, the crystals are BLUEwhen aligned parallel to the slow axis ofthe red compensatorbut they turn YELLOW when aligned across thedirection of polarization

A

• Positive birefringence

24
Q

ACIDIC URINE CRYSTALS

A

Uric acid• Calcium Oxalates• Amorphous Urates

25
Q

Are usually formed when urine pH

A

uric acid crystals

26
Q

can look like barrels, rosettes, rhomboids, needlesor hexagonal plates. usually amber in color, irrespective of the sizeor shape of the individual crystal.

A

uric acid crystals

27
Q

Uric acid crystals are only pathogenic when in…

A

freshly voided urine.

28
Q

______ are much more common inpatients with urate urolithiasis or acute uratenephropathy.

A

Urate crystals

29
Q

A high uric acid level in the urine may be due to:

A

gout- high-purine diet- Lesch-Nyhan syndrome (when the body is not able toprocess purine due to lack an enzyme)- cancer metastases- rhabdomyolysis (due to breakdown of muscle fibers)- myeloproliferative disorders (e.g. multiple myeloma,leukemias)

30
Q

Low uric acid levels in the urine may be due to:

A
  • inability of kidney to get rid of uric acid well,which can lead to gout with kidneydamage- chronic glomerulonephritis- lead poisoning- long-term (chronic) alcohol use
31
Q

May exhibit characteristic “lemon or football” shape appearing singly or in clusters, May also form into barrels, needles, rhomboids, and other shapes

A

Uric acid

32
Q

Dissolves in alkali• Insoluble in– alcohol– HCl– acetic acid

A

Uric Acid

33
Q

will re-solubilize when heated at 60° C

A

Amorphous urates

34
Q

often seen in:- acidic urine,- especially after refrigeration

A

Amorphous Urates

35
Q

formed in urine pH 6.8 - 7, Colorless or yellowish, Needles or slender prisms occurring insheaves or clusters.

A

sodium urates

36
Q
  • are formed usually in acidic urine (pH 6)- may also been seen in neutral urine- they may occur as either:
A

• Calcium oxalate crystals:

37
Q

many small ones can be confused as amorphous

A

Calcium oxalate crystals

38
Q

patients with urolithiasis (___ of all urinary tract stonesconsists of oxalates or combination with calciumphosphate)

A

75%

39
Q

patients with acute renal failure due to ethylene glycol(antifreeze) intoxication (______ calcium oxalatecrystals are found)

A

monohydrate

40
Q

Dissolves in:– NaOH– HCl

A

calcium oxalate

41
Q

Insoluble in:– acetic acid

A

calcium oxalate

42
Q

Crystals CommonlyFound in Alkaline Urine

A

Triple PhosphatesCalcium Carbonates Ammonium biurate

43
Q

10-15% urinary calculi

A

Triple Phosphate crystals ( a.k.a. magnesium ammoniumphosphate, struvites)

44
Q

frequently seen in patientswith urinary tract infections, triple stones

A

Triple Phosphate crystals ( a.k.a. magnesium ammoniumphosphate, struvites)

45
Q

Exhibit distinct prism shape often termed “coffin-lid”

A

triple phosphate

46
Q

Polarizes light• Demonstrates birefringence (not all)• Dissolves in– Acetic acid

A

Triple Phosphate (cont.)

47
Q

Calcium carbonate crystals are _____ found in urine, inalkalinic pH

A

normally

48
Q

A unique feature of _____ _____ is that thecrystals bubbling with hydrochloric acid or acetic acid. Thiscan help to confirm the presence of calcium carbonate inthe urine.

A

calcium carbonate

49
Q

Found in alkaline urine pH 9• Common seen in old specimens• Abnormal only if found in freshly voided urine

A

Ammonium Biurate

50
Q

Dissolves in

A

Acetic acid– NaOH– And when heated (60oC)

51
Q

Abnormal Crystals of Metabolic Origin

A

• Cystine• Tyrosine• Leucine• Cholesterol

UA (6 decks)

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