Urinary Crystals Part 1 Flashcards
Acid
Yellow-brown (rosettes, wedges)
Uric acid
Acid
Brick dust or yellow brown
Amorphous urates
Acid
Colorless
Sodium urates
Acid/neutral (alkaline)
Colorless (envelopes, oval, dumbbell)
Calcium oxalate
Alkaline/neutral
White–colorless
Amorphous phosphates
Alkaline/neutral
Colorless
Calcium phosphate
Alkaline
Colorless (“coffin lids”)
Triple phosphate
Alkaline
Yellow-brown (“thorny apples”)
Ammonium biurate
Alkaline
Colorless (dumbbells)
Calcium carbonate
formed by precipitation of urine solutes
Crystalluria
CRYSTALS Reported as
rare, few, moderate, many/ HPF
Components that contribute to CRYSTAL FORMATION: (3)
• Temperature
• Solute concentration
•pH
Components that contribute to CRYSTAL FORMATION:
• Temperature
• Solute concentration
•pH
______ increases precipitation
Refrigeration
Normal and Iatrogenic Crystals in Acidic Urine (3)
Uric acids
Amorphous urates
Calcium oxalate
Yellow-brown/colorless, pleomorphic, highly birefringent
Shapes: rhombic, four-sided flat plates (whetstones), wedges, and rosettes
URIC ACID
URIC ACID is soluble in
Alkali
URIC ACID is increased in
• Gout
• Leukemia (Chemotherapy)
• Lesch-Nyhan syndrome (Orange-Diaper
Rash)
Uric acid is mistaken for
Cystine crystals
Macroscopic: resemble Brick-dust Microscopic: yellow-brown granules
AMORPHOUS URATES
AMORPHOUS URATES is soluble in
Alkali and heat
AMORPHOUS URATES is commonly seen in
refrigerated samples and with pink sediments (uroerythrin)
2 forms of CALCIUM OXALATE
- Dihydrate (Wheddelite)
- Monohydrate (Whewellite)
What calcium oxalate form? most
common; colorless; octahedral envelope or 2 pyramids joined at their bases
Dihydrate (Wheddelite)