Crystals (Elsevier)

normal crystal — acidic urine

uric acid crystals

normal crystal — acidic urine

amorphous urates

normal crystal — acidic urine

calcium oxalate crystals

normal crystal — alkaline urine

triple phosphate crystals

normal crystal — alkaline urine

amorphous phosphate crystals

normal crystal — alkaline urine

calcium carbonate crystals

normal crystal — alkaline urine

ammonium biurate crystals

abnormal crystal

cystine crystals

abnormal crystal

cholesterol crystals

abnormal crystal

tyrosine crystals

abnormal crystal

leucine crystal

abnormal crystal

bilirubin crystal

abnormal crystal

sulfonamide crystal

abnormal crystal

ampicillin crystals

uric acid crystals

yellow-brown, flat-sides rhombic plates, wedges, rosettes

cystine crystals (uric acid — polarize)

source of error of uric acid crystals

uric acid crystals

seen in patients receiving chemotherapy & in Lesch-Nyhan disease

amorphous urates

small spheres producing brick-dust (uroerythrin) or yellow-brok sediment

calcium oxalate crystals

may also be seen in alkaline urine

calcium oxalate crystal, dihydrate form

envelope shaped calcium oxalate crystal

calcium oxalate crystals, dihydrate form

clumps in fresh urine may indicate renal calculi

calcium oxalate crystals, monohydrate form

oval or dumbbell shaped calcium oxalate crystals

calcium oxalate crystals, monohydrate form

presence indicates ethylene glycol (anti-freeze) ingestion

triple phosphate crystals

coffin-lid shaped ⚰

triple phosphate crystals

assoc. w/ a very high pH & bacteria found in old specimens

amorphous phosphate crystals

produce a white precipitate after refrigeration

calcium carbonate crystals

dumbbell & spherical shapes, produce gas w/ acetic acid

ammonium biurate crystals

yellow-brown thorny apple-shaped crystals

ammonium biurate crystals

assoc. w/ old specimens w/ bacteria

cystine crystals

hexagonal flat plates

cystine crystals

seen in an inherited disorder that inhibits the reabsorption of cystine by the renal tubules (cystinuria)

cystine crystals

seen in renal calculi form at an early age

cholesterol crystals

rectangular plates w/ notched corners, highly birefringent under polarize light

cholesterol crystals

seen in refrigerated urine & accompanied by fatty casts & oval fat bodies

cholesterol crystals

seen in nephrotic syndrome

tyrosine crystals

yellow needle-shaped forms in clusters or rosettes

tyrosine crystals & leucine crystals

seen in pt with severe liver disease

leucine crystals

yellow-brown spheres w/ concentric circles

leucine crystals

seen in conjunction with tyrosine crystals

bilirubin crystals

bright yellow clumped needles & granules

bilirubin crystals

seen in pt w/ liver damage often from viral infections that damage the renal tubules, preventing reabsorption of bilirubin

sulfonamide crystals

needle, rosette, rhombic shaped

sulfonamide crystals

seen in inadequately hydrated patients taking sulfonamide medications

ampicillin crystals

colorless needles that form clumps after refrigeration

ampicillin crystals

seen in inadequately hydrated patients taking ampicillin