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Iatrogenic
pertaining to a condition caused by treatment, meds, or diagnostic procedures
What "environmental" factors allow for crystals to form/dissolve?
- temp (more at low temp)
- solute conc.
- pH
uric acid crystals
Found in acid urine
Pleomorphic; red-brown
May find with gout or chemotherapy
In what pH would you see uric acid crystals?
< 5.5
What is the significance of uric acid crystals?
- chemo
- Gout
- Lesch-Nyhan syndrome
Calcium oxalate crystals
Found in acid urine
Colorless, refractile 'envelopes'
pH for calcium oxalate crystals
acidic to neutral
Monohydrate calcium oxalate crystals cause:
anti-freeze poisoning
Calcium oxalate crystals are a major component of what?
renal calculi
amorphous urate crystals
Found in acid urine that's been in the fridge
Pink macroscopic precipitate
Can be dissolved by warming
In wat specimens would you expect to fine amorphous urate crystals?
refrigerated urines
pH for amorphous urate crystals
acidic pH down to 5.5
What, macroscopically, can be seen with amorphous urate crystals?
pink sediment (uroerythrin)
Amorphous Phosphate Crystals
Where would you find amorphous phosphate crystals?
- refrigerated urine (doesn't dissolve after warming)
- alkaline urine
Triple Phosphate Crystals
Found in alkaline urine
'Coffin lids' or feathery, fern-leaf
Calcium Phosphate Crystals
Found in alkaline urine
Prisms, tapered at one end
Calcium Carbonate Crystals
dumbell shaped, alkaline urine
Ammonium Biurate Crystals
-Yellow brown "thorny apples"
-will convert to uric acid when acetic acid is added
-Alkaline pH
-Old specimen
Cystine Crystals
Abnormal, found in rare amino acid disorder (Cystinuria)
Colorless hexagonal plates
How can you confirm cystine crystals?
cyanide nitroprusside
Cholesterol Crystals
Abnormal, found in nephrotic syndrome, lipiduria
Flat plates with notched corners
What are the crystals of liver disease?
Leucine, Tyrosine, and Bilirubin
Leucine Crystal
- yellow/brown spheres w. radial striations
- seen with tyrosine crystals
- acidic
Tyrosine crystals
- needles in clumps/rosettes
- seen w/ pos. bilirubin
- acidic
Bilirubin Crystals
- made of conjugated bilirubin
- liver disease, tubular damage, viral hep
Sulfonamide Crystals
What is the clinical significance of Sulfonamide crystals?
- UTI treatment
- if in fresh, tubular damage
Radiographic Dye Crystals
- similar to cholesterol crystals, polarize
- patient history
- very high SG with refractometer
Ampicillin Crystals
Ampicillin crystals appear as colorless needles that tend to form bundles following refrigeration (massive dose check history)
