NORMAL URINARY ALKALINE CRYSTALS

MOST COMMON CAUSE OF TURBIDITY IN ALKALINE URINE

AMORPHOUS PHOSPHATES

AMORPHOUS PHOSPHATES (Ca, Mg) appearance

White-colorless or beige; granular (sand-like) appearance

REFRIGERATED URINE White PPT - does not dissolve if warmed

AMORPHOUS PHOSPHATES SOLUBILITY

Dilute Acetic Acid

CALCIUM PHOSPHATE other name?

Apatite

CALCIUM PHOSPHATE 4 form?

• Dibasic (CaHPO4) - more common

• Monobasic [Ca(H2PO4)2]- less common

other forms:

• Hydroxyapatite (Basic Calcium Phosphate),

• Brushite (CaHPO4)

Dibasic (CaHPO4) appearance

• Thin, slat-like prims in rosette or stars arrangement (stellar form)

• Colorless, flat rectangular plates

• ROSETTE FORMS confused with sulfonamide crystals

• Common constituent of renal calculi

Monobasic [Ca(H2PO4)2]

• Large, thin, Irregular, granular-appearing sheets or plates

• tend to float on the surface of urine

CALCIUM PHOSPHATE Solubility

Dilute Acetic Acid (sulfonamides are insoluble)

TRIPLE PHOSPHATE other name?

Struvite/AMMONIUM MAGNESIUM PHOSPHATE; BIREFRINGENT

TRIPLE PHOSPHATE lab significance?

^^^ Urea-Splitting Bacteria

TRIPLE PHOSPHATE appearance?

• Colorless, prism shaped that resemble a "Coffin Lid"; have oblique ends

• they disintegrate: Feathery or "Fern-leaf like" appearance;

TRIPLE PHOSPHATE seen in?

Calculi, Chronic Pyelitis, Enlarged Prostate, Urine Stasis, Cystitis

TRIPLE PHOSPHATE SOLUBILITY?

Dilute Acetic Acid and HCl

AMMONIUM BIURATE indicates?

Old Specimen ( ^^^ Urea-Splitting Bacteria)

AMMONIUM BIURATE appearance?

Yellow-brown, "thorny apples” spicule-covered spheres

Ammonium biurate is Converted to URIC ACID when added by?

glacial acetic is added(or HCI)

Alkaline counterpart of uric acid and amorphous urates

AMMONIUM BIURATE

AMMONIUM BIURATE resembles?

SULFAMETHOXAZOLE and triamterene (considered as pseudo-Maltese cross)

AMMONIUM BIURATE SOLUBILITY

Heat (60C), HCI, Acetic Acid

CALCIUM CARBONATE appearance

• Colorless, dumbbell or spherical shapes

• In clumps, resemble amorphous material or bacteria

CALCIUM CARBONATE how to distinguish them from bacteria?

Birefringent

CALCIUM CARBONATE SOLUBILITY

Gas Formation (effervescence) after adding Acetic Acid