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AUBF Lec > Urinary Crystals Part 1 > Flashcards

Urinary Crystals Part 1 Flashcards

1
Q

Acid

Yellow-brown (rosettes, wedges)

A

Uric acid

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2
Q

Acid

Brick dust or yellow brown

A

Amorphous urates

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3
Q

Acid

Colorless

A

Sodium urates

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4
Q

Acid/neutral (alkaline)

Colorless (envelopes, oval, dumbbell)

A

Calcium oxalate

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5
Q

Alkaline/neutral

White–colorless

A

Amorphous phosphates

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6
Q

Alkaline/neutral

Colorless

A

Calcium phosphate

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7
Q

Alkaline

Colorless (“coffin lids”)

A

Triple phosphate

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8
Q

Alkaline

Yellow-brown (“thorny apples”)

A

Ammonium biurate

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9
Q

Alkaline

Colorless (dumbbells)

A

Calcium carbonate

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10
Q

formed by precipitation of urine solutes

A

Crystalluria

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11
Q

CRYSTALS Reported as

A

rare, few, moderate, many/ HPF

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12
Q

Components that contribute to CRYSTAL FORMATION: (3)

A

• Temperature
• Solute concentration
•pH

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13
Q

Components that contribute to CRYSTAL FORMATION:

A

• Temperature
• Solute concentration
•pH

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14
Q

______ increases precipitation

A

Refrigeration

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15
Q

Normal and Iatrogenic Crystals in Acidic Urine (3)

A

Uric acids
Amorphous urates
Calcium oxalate

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16
Q

Yellow-brown/colorless, pleomorphic, highly birefringent
Shapes: rhombic, four-sided flat plates (whetstones), wedges, and rosettes

A

URIC ACID

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17
Q

URIC ACID is soluble in

A

Alkali

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18
Q

URIC ACID is increased in

A

• Gout
• Leukemia (Chemotherapy)
• Lesch-Nyhan syndrome (Orange-Diaper
Rash)

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19
Q

Uric acid is mistaken for

A

Cystine crystals

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20
Q

Macroscopic: resemble Brick-dust Microscopic: yellow-brown granules

A

AMORPHOUS URATES

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21
Q

AMORPHOUS URATES is soluble in

A

Alkali and heat

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22
Q

AMORPHOUS URATES is commonly seen in

A

refrigerated samples and with pink sediments (uroerythrin)

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23
Q

2 forms of CALCIUM OXALATE

A
  1. Dihydrate (Wheddelite)
  2. Monohydrate (Whewellite)
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24
Q

What calcium oxalate form? most
common; colorless; octahedral envelope or 2 pyramids joined at their bases

A

Dihydrate (Wheddelite)

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25
Q

What calcium oxalate form? least common; oval or dumbbell shaped

A

Monohydrate (Whewellite)

26
Q

Calcium oxalate is soluble in

A

Soluble in dilute HCl

27
Q

Seen in foods high in oxalic acid (tomatoes, asparagus) and ascorbic acid
Pathologic: ethylene glycol (antifreeze) poisoning (children and pets)

A

CALCIUM OXALATE

28
Q

Pathologic: ethylene glycol (antifreeze) poisoning (children and pets)

A

CALCIUM OXALATE

29
Q

Can also be seen in neutral urine and alkaline urine (rarely)

A

CALCIUM OXALATE

30
Q

NORMAL URINARY CRYSTAL (2)

A

CALCIUM SULFATE

HIPPURIC ACID

31
Q

Long, thin colorless needles/prisms Cigarette-butt appearance

Rarely seen, no clinical significance

A

CALCIUM SULFATE

32
Q

CALCIUM SULFATE is soluble in

A

Acetic acid

33
Q

Yellow-brown or colorless, needles, rhombic plates and 4 sided prisms

Rare, associated with foods containing benzoic acid

A

HIPPURIC ACID

34
Q

HIPPURIC ACID is soluble in

A

in hot water and alkali

35
Q

ABNORMAL URINARY CRYSTALS

A

RADIOGRAPHIC DYE
SULFONAMIDE
AMPICILLIN

36
Q

Flat, colorless, notched rhombic plates; highly birefringent

Associated with a markedly elevated SG (>1.040)

A

RADIOGRAPHIC DYE

37
Q

RADIOGRAPHIC DYE is soluble in

38
Q

Colorless to yellow-brown needles, sheaves of wheat, rosette, arrowheads, petals

Possible tubular damage if crystals form in the nephrons

A

SULFONAMIDE

39
Q

SULFONAMIDE is soluble in

40
Q

Colorless needles that tends to form bundles following refrigeration

Massive dosage of penicillin

A

AMPICILLIN

41
Q

White precipitate
Macroscopic: milky white
Microscopic: granular in appearance

Seen in refrigerated specimens

A

AMORPHOUS PHOSPHATES

42
Q

AMORPHOUS PHOSPHATES soluble in

A

dilute acetic acid

43
Q

AKA “Apatite” Colorless, flat rectangular plates or thin prisms often rosette formations

Common constituent of renal calculi

A

CALCIUM PHOSPHATES

44
Q

CALCIUM PHOSPHATES is soluble in

A

dilute acetic acid

45
Q

AKA “Magnesium ammonium phosphate”, “Struvite” Prism shape resembling “coffin lids”, Fern-life

Presence of urea-splitting bacteria (ex. Proteus, Pseudomonas)

A

TRIPLE PHOSPHATE

46
Q

TRIPLE PHOSPHATE is soluble in

A

dilute acetic acid

47
Q

Yellow-brown spicule covered spheres described as “thorny apples”

Presence of urea-splitting bacteria (ex. Proteus, Pseudomonas)

A

AMMONIUM BIURATE

48
Q

AMMONIUM BIURATE is soluble in

A

acetic acid and heat

49
Q

Small, colorless, dumbbell or spherical; may occur in clumps

No clinical significance

A

CALCIUM CARBONATE

50
Q

CALCIUM CARBONATE is soluble in

A

acetic acid with evolution of gas

51
Q

Abnormal Crystals

A

CYSTINE
CHOLESTEROL
LEUCINE
TYROSINE
BILIRUBIN

52
Q

Colorless, hexagonal plates
May be confused with colorless uric acid crystals

Cystinuria, renal calculi formation

53
Q

Rectangular plates with a notch in one or more corners (staircase pattern), highly birefringent

Lipiduria (Nephrotic syndrome)

A

CHOLESTEROL

54
Q

Yellow-brown spheres that demonstrate concentric circles and radial striations

Soluble in hot alkali or alcohol

Severe Liver Disease

55
Q

Fine colorless to yellow needles that frequently form clumps or rosettes

Soluble in alkali or heat

Severe Liver Disease

56
Q

Clumped needles or granules with the characteristic yellow color

Soluble in acetic acid, HCl, NaOH, ether, chloroform

Severe Liver Disease

57
Q

URINARY ARTIFACTS

A

STARCH GRANULES

Oil droplets and Air bubbles

Pollen grains

Hair and Fibers

Fecal contamination

58
Q

What urinary artifact? Spheres with dimpled center
MALTESE CROSS formation

A

STARCH GRANULES

59
Q

What urinary artifact? refractile; resem. RBCs

A

Oil droplets and Air bubbles

60
Q

What urinary artifact? spheres w/ cell wall and occasional concentric circles, may cause out of focus

A

Pollen grains

61
Q

What urinary artifact? mistaken for casts but longer, refractile

A

Hair and Fibers

62
Q

What urinary artifact? improper collection of specimen

A

Fecal contamination

AUBF Lec (8 decks)

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