URINALYSIS 1

UA Crystals

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Brown or colorless granules Na or K Sediment in spin down tube may have brick red color Amorphous Urates 7

• Ca or Mg • Found in Basic urine • Dissolves in Acetic Acid Amorphous Phosphates 8

Acid urine Yellowish Brown Ovals with pointed Ends Uric Acid 9

Yellowish Brown Ovals with pointed Ends Uric Acid 10

Birefringence under polarized light Uric Acid 11

Sometimes associated with gout Uric Acid 12

Uric Acid Polarized 13

Many Forms “Great Imposters” Uric Acid Rosette Form 14

• Common • pH acid or neutral • Envelope or dumb bell shaped • Oval May be mistaken for RBC • Ca Ox soluble in HCl Insoluble in acetic acid • RBC lyse in acetic acid Calcium Oxalate 15

Calcium Oxalate and Epi 16

Calcium Oxalate 17

Calcium oxalate dihydrate and monohydrate (dumbbell and ring forms) - x400 magnification.

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Calcium oxalate dihydrate, various octahedral forms...

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Calcium Oxalate 20

Coffin Lid Triple Phosphate 21

AKA Ammonium Magnesium Phosphate Found in Basic or Neutral urine Soluble in Acetic Acid Triple Phosphate 22

Alkaline urine Irregular plates “Sheets of Ice” Rosetts Associated with Cystitis and Urine retention Calcium Phosphate Crystals 23

Alkaline urine Irregular plates “Sheets of Ice” Rosettes Associated with Cystitis and Urine retention Calcium Phosphate Crystals 24

Alkaline urine Irregular plates “Sheets of Ice” Rosettes Associated with Cystitis and Urine retention Calcium Phosphate Crystals 25

Alkaline urine Spheres or Dumb bell forms Birefringent Calcium Carbonate Crystals 26

• Rhombohedral form Calcium Carbonate 27

• Dumbbell form Calcium Carbonate 28

Alkaline urine Only urate found in alkaline urine Yellow brown spheres with horns Thorn apple Soluble in Acetic Acid Ammonium Biurate Crystals 29

Ammonium Biurate 30

• pH alkaline • Thorn apple Ammonium Biurate 31

• All are found in acidic urine • Indicate pathologic condition Abnormal Crystals 32

Acid pH Needle shaped fine and silky appearance Liver disease due to hepatitis, hepatocellular poisons Leukemia's Typhoid fever and smallpox Tyrosine 33

Acid pH Needle shaped fine and silky appearance Liver disease due to hepatitis, hepatocellular poisons Leukemia's Typhoid fever and smallpox Tyrosine 34

Acid pH Spheres, Yellow brown concentric rings Birefringence Pseudo Maltese Cross Maple syrup disease Liver Disease Leucine 35

Acid pH Spheres, Yellow brown concentric rings Birefringence Pseudo Maltese Cross Maple syrup disease Liver Disease Leucine 36

Acid pH Thin colorless hexagonal plates Birefringent in polarized light Hereditary metabolic disorders involving renal transport of various amino acieds Cystine 37

Acid pH Thin colorless hexagonal plates Birefringent in polarized light Hereditary metabolic disorders involving renal transport of various amino acieds Cystine 38

Acid pH Thin colorless hexagonal plates Birefringent in polarized light Hereditary metabolic disorders involving renal transport of various amino acids Cystine 39

Cystine 40

• Acid Urine Cystine 41

Acid Urine Regular or irregular plate with Notched corner Birefringent under polarized light Various renal diseases Nephrotic Syndrome or other condition where there is a deposition of lipids in Kidney Cholesterol 42

Acid Urine Regular or irregular plate with Notched corner Birefringent under polarized light Various renal diseases Nephrotic Syndrome or other condition where there is a deposition of lipids in Kidney Cholesterol 43

Cholesterol 44

Oval Fat Bodies 45

Oval Fat Bodies Polarized 46

Fiber 47

Fatty Cast Polarized 48

Corpora amylacea 49

• Sterheimer Malbin Stain Crystalline Artifact 50

• Acidic Urine • Pigmented yellowish Brown Granules • Pathologic appear in a wide variety of hepatobiliary and hematopoietic diseases Bilirubin Crystals 51

• Acidic Urine • Pigmented yellowish Brown Granules • Pathologic appear in a wide variety of hepatobiliary and hematopoietic diseases Bilirubin Crystals 52