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Sediment Constituents (Normal Crystals) Flashcards

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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
What is the most frequently observed urinary crystal?
Calcium oxalate
26
What is another name for dihydrate calcium oxalate?
Weddellite (double D letter - Di)
27
What shapes do weddellite calcium oxalate crystals have?
Envelope, bipyramidal/emerald-cut diamond
28
What is another name for monohydrate calcium oxalate?
Whewellite
29
What is the shape of Whewellite?
Oval, dumbbell
30
In which conditions is calcium oxalate (CaOx) increased?
Foods rich in oxalic acid (tomato, asparagus), ascorbic acid, ethylene glycol or methoxyflurane poisoning (MH)
31
In what solution is calcium oxalate (CaOx) soluble?
Dilute HCl
32
What crystal has a 'cigarette butt' appearance?
Calcium sulfate
33
In what solution is calcium sulfate soluble?
Acetic acid
34
What crystal is yellow-brown or colorless, elongated, and prism-shaped?
Hippuric acid
35
In what solutions is hippuric acid soluble?
Water and ether
36
What is acid urate composed of?
Sodium, potassium, ammonia
37
What is the rare form of uric acid that appears as brown spheres or clusters?
Acid urates
38
What does acid urates resemble?
Ammonium biurate, leucine, sulfamethoxazole crystal
39
What does acid urates turn into when acetic acid is added?
Uric acid
40
In what solutions is acid urates soluble?
Heat and alkali
41
What is the rare form of uric acid that appears as tiny slender, colorless needles, spherulite or beach ball?
Monosodium or sodium urates
42
In which conditions are monosodium urates increased?
Acute gout (intracellular crystals), chronic gout (extracellular crystals)
43
What are the normal alkaline crystals in urine?
Amorphous phosphates
44
What is the composition of amorphous phosphates?
Calcium and magnesium
45
What is the most common cause of turbidity in alkaline urine?
Amorphous phosphates
46
What does amorphous phosphates look like macroscopically?
Fine or lacy white precipitate
47
What is the microscopic appearance of amorphous phosphates?
Granular
48
In what solution are amorphous phosphates soluble?
Dilute acetic acid
49
What is the alkaline counterpart of uric acid and amorphous urates?
Ammonium biurate
50
What is the appearance of ammonium biurate?
Yellow-brown thorny apple appearance, seen in old specimens
51
In which conditions is ammonium biurate increased?
Presence of urea splitting bacteria (urea → ammonia)
52
What does ammonium biurate turn into when HCl or acetic acid is added?
Uric acid
53
In what solution is ammonium biurate soluble?
Acetic acid with heat
54
What is the appearance of triple phosphate (struvite)?
Colorless, prism-shaped, coffin lid, fern leaf
55
What happens to the appearance of triple phosphate after disintegration?
Becomes feathery
56
In which conditions is triple phosphate increased?
Presence of urea splitting bacteria (urea → ammonia)
57
In what solution is triple phosphate soluble?
Dilute acetic acid
58
What is the appearance of magnesium phosphate?
Colorless, elongated, rectangular or rhomboid plates
59
What unique features are seen in magnesium phosphate?
Notched end or corner; edges can be irregular or eroded
60
In what solution is magnesium phosphate soluble?
Acetic acid
61
What does dibasic calcium phosphate (stellar phosphate) look like?
Colorless, flat plates, thin prisms in rosette form
62
What is the appearance of apatite?
Irregular, granular, appearing sheets or plates
63
What is less common than dibasic calcium phosphate?
Monobasic calcium phosphate
64
What is another name for basic calcium phosphate?
Hydroxyapatite
65
What is the appearance of calcium hydrogen phosphate (brushite)?
Sheets resembling large degenerating squamous cells
66
In what solution is apatite soluble?
Dilute acetic acid
67
What does calcium carbonate look like?
Small, colorless dumbbell, tetrads, or spherical-shaped crystals
68
What crystal is misidentified as a bacteria crystal?
Calcium carbonate

AUBF (26 decks)

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