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AUBF > Sediment Constituents (Normal Crystals) > Flashcards

Sediment Constituents (Normal Crystals) Flashcards

1
Q

What is the excretion of crystals in urine called?

A

Crystalluria

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2
Q

What is the most recognizable but most insignificant part of urine sediment?

A

Crystals

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3
Q

What causes the formation of urine crystals?

A

Precipitation of urine solutes (salts, organic compounds, medication)

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4
Q

What is the most common association for the presence of crystals in fresh urine?

A

Concentrated specimen (high specific gravity)

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5
Q

What factors contribute to crystal formation?

A

pH, solute concentration, temperature

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6
Q

How are crystals usually reported?

A

Rare, few, moderate, or many per HPF

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7
Q

How are abnormal crystals quantified?

A

Averaged and reported per LPF

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8
Q

What are the normal acid crystals in urine?

A

Amorphous urates, uric acid, calcium oxalate (dihydrate and monohydrate), calcium sulfate, hippuric acid, acid urates, monosodium or sodium urates

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9
Q

What is the composition of amorphous urates?

A

Calcium, magnesium, sodium, potassium urates

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10
Q

What causes the fluffy orange or pink sediment of amorphous urates?

A

Uroerythrin

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11
Q

What is the appearance of amorphous urates under a microscope?

A

Yellow-brown

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12
Q

What do clumps of amorphous urates resemble?

A

Granular casts (pseudocasts)

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13
Q

What does amorphous urates turn into when acetic acid is added?

A

Uric acid

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14
Q

What does amorphous urates turn into when ammonium hydroxide is added?

A

Ammonium biurate

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15
Q

In what conditions is amorphous urate increased?

A

Gout and chemotherapy

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16
Q

What is amorphous urate soluble in?

A

Heat (60°C) and alkali

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17
Q

What type of crystal is pleomorphic and has many shapes?

A

Uric acid

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18
Q

What is uric acid a product of?

A

Purine metabolism

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19
Q

What shapes can uric acid crystals have?

A

Rhombic, 4-sided flat plate, lemon-shaped, wedges, football, barrel rosettes, irregular plates, laminated forms

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20
Q

What form of uric acid may be mistaken for cystine crystals?

A

Hexagonal form

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21
Q

At what pH is uric acid present?

A

<5.7

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22
Q

What form does uric acid take if the pH is >5.7?

A

Ionized form as urate

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23
Q

In what conditions is uric acid increased?

A

Lesch-Nyhan syndrome, chemotherapy, gout

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24
Q

What is uric acid soluble in?

A

Alkali

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25
Q

What is the most frequently observed urinary crystal?

A

Calcium oxalate

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26
Q

What is another name for dihydrate calcium oxalate?

A

Weddellite (double D letter - Di)

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27
Q

What shapes do weddellite calcium oxalate crystals have?

A

Envelope, bipyramidal/emerald-cut diamond

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28
Q

What is another name for monohydrate calcium oxalate?

A

Whewellite

29
Q

What is the shape of Whewellite?

A

Oval, dumbbell

30
Q

In which conditions is calcium oxalate (CaOx) increased?

A

Foods rich in oxalic acid (tomato, asparagus), ascorbic acid, ethylene glycol or methoxyflurane poisoning (MH)

31
Q

In what solution is calcium oxalate (CaOx) soluble?

A

Dilute HCl

32
Q

What crystal has a ‘cigarette butt’ appearance?

A

Calcium sulfate

33
Q

In what solution is calcium sulfate soluble?

A

Acetic acid

34
Q

What crystal is yellow-brown or colorless, elongated, and prism-shaped?

A

Hippuric acid

35
Q

In what solutions is hippuric acid soluble?

A

Water and ether

36
Q

What is acid urate composed of?

A

Sodium, potassium, ammonia

37
Q

What is the rare form of uric acid that appears as brown spheres or clusters?

A

Acid urates

38
Q

What does acid urates resemble?

A

Ammonium biurate, leucine, sulfamethoxazole crystal

39
Q

What does acid urates turn into when acetic acid is added?

40
Q

In what solutions is acid urates soluble?

A

Heat and alkali

41
Q

What is the rare form of uric acid that appears as tiny slender, colorless needles, spherulite or beach ball?

A

Monosodium or sodium urates

42
Q

In which conditions are monosodium urates increased?

A

Acute gout (intracellular crystals), chronic gout (extracellular crystals)

43
Q

What are the normal alkaline crystals in urine?

A

Amorphous phosphates

44
Q

What is the composition of amorphous phosphates?

A

Calcium and magnesium

45
Q

What is the most common cause of turbidity in alkaline urine?

A

Amorphous phosphates

46
Q

What does amorphous phosphates look like macroscopically?

A

Fine or lacy white precipitate

47
Q

What is the microscopic appearance of amorphous phosphates?

48
Q

In what solution are amorphous phosphates soluble?

A

Dilute acetic acid

49
Q

What is the alkaline counterpart of uric acid and amorphous urates?

A

Ammonium biurate

50
Q

What is the appearance of ammonium biurate?

A

Yellow-brown thorny apple appearance, seen in old specimens

51
Q

In which conditions is ammonium biurate increased?

A

Presence of urea splitting bacteria (urea → ammonia)

52
Q

What does ammonium biurate turn into when HCl or acetic acid is added?

53
Q

In what solution is ammonium biurate soluble?

A

Acetic acid with heat

54
Q

What is the appearance of triple phosphate (struvite)?

A

Colorless, prism-shaped, coffin lid, fern leaf

55
Q

What happens to the appearance of triple phosphate after disintegration?

A

Becomes feathery

56
Q

In which conditions is triple phosphate increased?

A

Presence of urea splitting bacteria (urea → ammonia)

57
Q

In what solution is triple phosphate soluble?

A

Dilute acetic acid

58
Q

What is the appearance of magnesium phosphate?

A

Colorless, elongated, rectangular or rhomboid plates

59
Q

What unique features are seen in magnesium phosphate?

A

Notched end or corner; edges can be irregular or eroded

60
Q

In what solution is magnesium phosphate soluble?

A

Acetic acid

61
Q

What does dibasic calcium phosphate (stellar phosphate) look like?

A

Colorless, flat plates, thin prisms in rosette form

62
Q

What is the appearance of apatite?

A

Irregular, granular, appearing sheets or plates

63
Q

What is less common than dibasic calcium phosphate?

A

Monobasic calcium phosphate

64
Q

What is another name for basic calcium phosphate?

A

Hydroxyapatite

65
Q

What is the appearance of calcium hydrogen phosphate (brushite)?

A

Sheets resembling large degenerating squamous cells

66
Q

In what solution is apatite soluble?

A

Dilute acetic acid

67
Q

What does calcium carbonate look like?

A

Small, colorless dumbbell, tetrads, or spherical-shaped crystals

68
Q

What crystal is misidentified as a bacteria crystal?

A

Calcium carbonate

AUBF (26 decks)

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