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MLS 415 Urinalysis & B.F. > Microscopic Examination of Urine - Crystals > Flashcards

Microscopic Examination of Urine - Crystals Flashcards

1
Q

How long is the centrifuge spun for?

A

5 minutes at 400-450Gs

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2
Q

When viewing the sample under a microscope, what is the process?

A

Exam along the edges on 10X to find casts. Flip to 40X to get a better view. Once on 40X have a minimum of 10 fields and take average of all structures present.

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3
Q

What stains do you want for Supravital staining for intracellular components?

A
  • Sternheimer-Malbin.

- 0.5% Toluidine blue.

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4
Q

What is used to differentiate renal tubular epithelial cells and white blood cells?

A

0.5% Toluidine blue.

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5
Q

What is used to differentiate red blood cells, yeast cells, and crystals?

A

Acetic acid.

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6
Q

What is used to differentiate triglycerides and cholesterol?

A

Fat stains.

Triglycerides will stain while the cholesterol won’t.

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7
Q

What stains are used for fat or lipid staining?

A
  • Sudal III.

- Oil Red O.

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8
Q

What is Prussian Blue stain used for?

A

Presence of hemosiderin in urine.

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9
Q

What stain is used to differentiate Neutrophils and eosinophils?

A

Hansel stain.

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10
Q

Which crystals are made from salts of Na+, K+, Mg++, and Ca++?

A

Amorphous Urates.

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11
Q

What is the morphology of Amorphous Urates?

A

Sand-like.

Either yellow-brown or a pink (“Brick dust”).

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12
Q

Amorphous rates form uric acid crystals when exposed to:

A

HCL-

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13
Q

Amorphous urates are soluble with?

A

Alkali and heat.

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14
Q

What is the significance for amorphous urate crystals?

A

There are none.

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15
Q

What is the significance for uric acid crystals?

A

Seen in patients with gout, kidney stones, and chemotherapy.

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16
Q

What is the morphology for uric acid crystals?

A
  • Diamond/ football (most common).
  • Cube-shaped in clusters.
  • Rhombic plates, prisms, large barrel, and lemon- shaped.
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17
Q

Uric acid crystals are soluble with?

A

Alkali

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18
Q

Uric acid crystals are birefringent when seen with what microscope?

A

Polarized microscope.

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19
Q

What is the morphology and color of monosodium urate crystals?

A

Light yellow slender prisms.

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20
Q

What is the morphology of acid urates?

A

Larger granules that may have spicules.

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21
Q

What are the pathologic conditions of calcium oxalate?

A
  • Ethylene glycol poisoning.
  • Sever renal disease.
  • 75% of urinary calculi contain.
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22
Q

What is the morphology of calcium oxalate dehydrate?

A

Envelope form.

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23
Q

What is the morphology of calcium oxalate monohydrate?

A

Small dumb-bell or oval.

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24
Q

Calcium oxalate crystals are soluble with?

A

Alkali

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25
Q

What is the cause of 2/3 cases of kidney stones?

A

Calcium oxalate.

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26
Q

Calcium oxalate can be increased with which types of food?

A

high-oxalic acid foods.

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27
Q

Which crystal found in acid urine is described as “brick dust”?

A

Amorphous urates.

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28
Q

Which crystal found in acidic urine is described as “envelopes”?

A

Calcium oxalates.

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29
Q

Which crystals are salts of Mg++ and Ca++?

A

Amorphous phosphates.

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30
Q

What is the microscopically morphology of amorphous phosphates?

A
  • Sand-like.

- Yellow- brown

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31
Q

What is the macroscopically morphology of amorphous phosphates?

A

White to beige precipitants.

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32
Q

Amorphous phosphates are soluble with?

A

Acid

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33
Q

What is the significance of amorphous phosphate crystals?

A

The are none.

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34
Q

Which crystals are salts of NH3 and Mg phosphates?

A

Triple phosphates.

35
Q

3-6 sided prisms “coffin lids” are associated with which alkaline crystals?

A

Triple phosphates.

36
Q

Feathery or fern forms, and long prism forms are associated with which alkaline crystals?

A

Triple phosphates.

37
Q

Triple phosphates appear what color under the microscope?

A

Colorless.

38
Q

Triple phosphates are soluble with?

A

Acid

39
Q

What is the significance of triple phosphates.

A
  • None really.
  • Can been seen with kidney stones.
  • UTI’s with urea splitting bacteria.
40
Q

What is the morphology of dicalcium phosphates?

A
  • Thin prisms in rosette shape.

- One tapered end and one pointed end.

41
Q

What is the morphology of calcium phosphate?

A
  • Irregular granular sheets.

- Float on top of the specimen.

42
Q

What color are calcium phosphates?

A

Colorless

43
Q

Calcium phosphates are soluble with?

A
  • Dilute acetic acid and dilute HCL.
44
Q

What is the significance of calcium phosphates?

A

None

45
Q

Which alkaline crystal is confused with sulfonamide crystals?

A

Calcium phosphates.

46
Q

What is the morphology of ammonium biurate?

A
  • Spheres with striations.
  • Spicules “thorny apples”.
  • “Starfish”.
47
Q

What color are ammonium biurate?

A

Yellow/brown.

48
Q

Ammonium biurate are soluble with?

A

Heat

49
Q

Ammonium biurate can be converted with uric acid by using:

A

Acid

50
Q

What is the significance of ammonium biurate?

A

None

51
Q

Ammonium biurate can be confused with:

A

Sulfonamine crystals.

52
Q

What is the morphology of calcium carbonate?

A
  • Small granular crystals.

- Seen in pairs that resemble dumbbells.

53
Q

What color is calcium carbonate?

A

Colorless.

54
Q

What is the significance of calcium carbonate?

A

None

55
Q

Which crystals found in alkaline urine is described as “Coffin lids”?

A

Triple phosphates.

56
Q

Which crystals found in alkaline urine is described as dumbbells?

A

Calcium carbonates.

57
Q

What is the morphology of bilirubin crystals?

A

Fine needles in clusters, granules, or plantes.

58
Q

What color are bilirubin crystals?

A

Yellow-brown.

59
Q

Bilirubin crystals are dissolved in?

A

Alkali or strong acids.

60
Q

What is the significance of bilirubin crystals?

A

Liver disease resulting in renal damage.

61
Q

What is the morphology of Tyrosine crystals?

A

Fine delicate needles.

62
Q

What is the morphology of Leucine crystals?

A

Highly refractive concentric circles with radial striations.

63
Q

What color is tyrosine?

A

Colorless, or yellow, black when focusing.

64
Q

What color is leucine?

A

Yellow to brown.

65
Q

Tyrosine can be dissolved in:

A

Alkali

66
Q

Leucine can be dissolved in:

A

Alkali

67
Q

What is the significance of tyrosine AND leucine?

A
  • Metabolic disorders of amino acid metabolism.
  • Severe liver disease.
  • If seen together it usually means the patient doesn’t have long to live.
68
Q

What is the significance of tyrosine?

A
  • Oast-house disease.

- Hereditary tyrosinosis.

69
Q

What is the morphology of cystine?

A
  • Hexagonal plates.

- Clear refractive.

70
Q

Using cyanide-nitroprusside on will cause cystine crystals to turn what color?

A

Purple

71
Q

What is the significance of cystine crystals?

A

Cystinuria

72
Q

What is the morphology of cholesterol crystals?

A

Large, flat, rectangular plates with notched corners.

73
Q

What color are cholesterol crystals?

A

Colorless

74
Q

What is the significance of cholesterol crystals?

A
  • Nephrotic syndrome.

- Chuluria.

75
Q

What is the morphology of ampicillin crystals?

A
  • Thin needles or prisms.

- Aggregate into sheaves after refrigeration.

76
Q

What color are ampicillin crystals?

A

Colorless

77
Q

How are ampicillin crystals confirmed?

A

Patients history.

78
Q

What are the significance of ampicillin crystals?

A

None

79
Q

What is the morphology of sulfonamide?

A
  • Bundles of sheaves with constricted area.

- Brown rosettes.

80
Q

What color are sulfonamide crystals?

A

Yellow/brown.

81
Q

How are sulfonamide crystals confirmed?

A
  • Diazo reaction gives magenta color.

- Patient history.

82
Q

What is the significance of sulfonamide crystals?

A
  • Adequate hydration.

- Maintain alkaline pH.

83
Q

What is the morphology of Idinavir?

A

Clear star like crystal.

MLS 415 Urinalysis & B.F. (37 decks)

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