Sediment Constituents (Abnormal Crystals)

Question 1

What is the appearance of cystine crystals?

Answer 1

Colorless refractile hexagonal plates, often laminated. Sides are not always even resembling a six sided stop sign

Question 2

What is cystine often mistaken for?

Answer 2

Hexagonal uric acid crystals

Question 3

In which conditions is cystine increased?

Answer 3

Cystinuria and cytinosis

Question 4

What is the color of cystine in urine?

Answer 4

Colorless

Question 5

What is the solubility of uric acid and cystine in ammonia?

Answer 5

Soluble

Question 6

What is the solubility of uric acid and cystine in dilute HCl?

Answer 6

Uric acid: Insoluble, Cystine: Soluble

Question 7

Which test is positive for cystine?

Answer 7

Cyanide-nitropruside reaction

Question 8

What is the appearance of cholesterol crystals?

Answer 8

Rectangular plate with notch in one or more corners (staircase pattern)

Question 9

What type of crystals are seen in refrigeration?

Answer 9

Cholesterol

Question 10

Cholesterol crystals resemble which other crystals?

Answer 10

Crystals of radiographic dye

Question 11

In which condition is cholesterol increased?

Answer 11

Nephrotic syndrome

Question 12

What is the solubility of cholesterol crystals?

Answer 12

Chloroform

Question 13

What are some other names for radiographic dye?

Answer 13

Meglumine diatrizoate, Renograffin, Hypaque

Question 14

What is the appearance of radiographic dye crystals?

Answer 14

Flat, four-sided plates, often with a notched corner; other forms include long, thin, prisms, or rectangles

Question 15

How to differentiate between radiographic dye and cholesterol crystals?

Answer 15

Check patient history, correlate with other UA results (S.G > 1.040 using refractometer)

Question 16

What is the solubility of radiographic dye in 10% NaOH?

Answer 16

Soluble

Question 17

What type of urine crystals appear as hay-like and fine, colorless to yellow needles in clumps or rosettes?

Answer 17

Tyrosine

Question 18

In which condition is tyrosine increased?

Answer 18

Liver disease (more commonly found than leucine)

Question 19

What is the solubility of tyrosine crystals?

Answer 19

Alkali or heat

Question 20

What is the appearance of leucine crystals?

Answer 20

Yellow-brown oily-looking spheres with concentric circles and radial striations

Question 21

What do leucine crystals resemble?

Answer 21

Wagon wheels, tree growth pattern or striations of tree

Question 22

What can leucine crystals resemble besides tree patterns?

Answer 22

Fat globules

Question 23

What pattern is seen under polarization with leucine crystals?

Answer 23

Pseudo-maltese cross pattern

Question 24

In which condition is leucine increased?

Answer 24

Liver disease

Question 25

What is the solubility of leucine crystals?

Answer 25

Hot alkali or alcohol

Question 26

What do bilirubin crystals look like?

Answer 26

Clumped granules or needles with bright yellow color

Question 27

What other form can bilirubin crystals take?

Answer 27

Reddish brown needles that cluster in clumps or spheres

Question 28

In which condition is bilirubin increased in urine?

Answer 28

Liver disease

Question 29

What is the solubility of bilirubin crystals?

Answer 29

Acetic acid, HCl, NaOH, acetone, and chloroform

Question 30

What is the appearance of sulfonamide crystals?

Answer 30

Fan shaped needles, sheaves of wheat, rosettes, arrowheads, petals, round-shaped, whetstones

Question 31

What can sulfonamide crystals be mistaken for?

Answer 31

Calcium phosphate crystals

Question 32

How to differentiate between sulfonamide and calcium phosphate crystals?

Answer 32

Calcium phosphate is soluble in acetic acid, Sulfonamide is positive in lignin test and diazo reaction

Question 33

What can sulfonamide deposits cause in nephrons?

Answer 33

Possible tubular damage

Question 34

What is the solubility of sulfonamide crystals?

Answer 34

Acetone

Question 35

What are the forms of sulfonamide crystals?

Answer 35

Brown rosettes or spheres, with irregular radial striations (sulfomethoxazole), yellow-brown sheaves of wheat with eccentric binding (Acetylsulfadiazine and Sulfadiazine)

Question 36

What is the appearance of ampicillin crystals?

Answer 36

Colorless needles that tend to form bundles following refrigeration

Question 37

When are ampicillin crystals typically present?

Answer 37

Massive dosage of penicillin

Question 38

What do hemosiderin crystals look like?

Answer 38

Coarse, yellow-brown granules resembling amorphous urates

Question 39

What test is positive for hemosiderin crystals?

Answer 39

Rous test (prussian blue stain)

Question 40

What do acyclovir crystals look like?

Answer 40

Colorless slender needles that are strongly birefringent with polarized light

Question 41

What is the appearance of indinavir sulfate crystals?

Answer 41

Slender colorless needles or slender rectangular plates, featherlike crystals that aggregate into wing-like bundles

Question 42

How is indinavir sulfate arranged in urine?

Answer 42

Fan-shaped or starburst forms, bundles, or sheaves

Question 43

What is indinavir sulfate associated with?

Answer 43

Renal blockage, stone formation in HIV positive individuals

Question 44

What type of formation is seen in oval fat bodies, fatty casts, fat droplets, starch granules, and cholesterol?

Answer 44

Maltese cross formation

Question 45

What is the appearance of starch granules?

Answer 45

Spheres with dimpled center (y indentation)

Question 46

What pattern is seen under polarization with starch granules?

Answer 46

Maltese cross

Question 47

What is an artifact mistaken as RBCs?

Answer 47

Oil droplets, air bubbles

Question 48

What is the appearance of pollen grain in urine?

Answer 48

Spheres with cell wall and concentric circles

Question 49

What is an artifact mistaken for Ascaris lumbricoides?

Answer 49

Pollen grain

Question 50

What are artifacts mistaken for casts?

Answer 50

Hairs and fibers

Question 51

What is the fecal contamination artifact in urine?

Answer 51

Vegetable fiber