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Crystals in Urine Sediment

by Carlo Raj, MD
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    00:00 Now we'll take a look at crystals.

    00:02 The crystals, well we have in the urine, you find calcium oxalate, and with calcium oxalate, it might be a square that you're finding or you might have heard of a "coffin" type of appearance in your urine You know what a coffin looks like? which you basically place your well, excuse me... my apologies If a family wishes to bury their loved one, you put your loved one in a coffin, that cofffin shape that you might find as a crystal in your urine will then be associated with calcium oxalate I'll show you pictures upcoming Pure vegan diet, ethylene glycol is a big one and then calcium oxalate stones are what we're looking at what's the most common type of renal stone? a calcium stone.

    00:50 Calcium oxalate being right up there Crystal; uric acid will give you crystals, hyperuricemia Two big ones here, maybe gout , and who's your patient with gout? most likely a male who's been drinking quite a bit and maybe perhaps is not drinking enough water may result in uric acid crystals.

    01:11 massive destruction of your cells, what is happening here? Well you tell me about cancer, and chemotherapy.

    01:18 Is cancer made up of DNA, the cancer cells? of course they are.

    01:22 what does DNA mean to you? purine, pyrimidine, purine, pyrimidine, purine, pyrimidine.

    01:26 Now this patient has cancer receiving chemotherapy, are we together now? That chemotherpay is causing what? massive destruction of your cancer cells.

    01:36 what's it doing? Oh, this is uric acid.

    01:40 Where is uric acid coming from? purine isn't it? So therefore this is called tumor lysis syndrome, may result in excess uric acid in your urine you may have decreased pH and uric acid crystals Triple phosphate may be a sign of urinary tract infection due to urease produced in your pathogens. Give me an example.

    02:00 Something like? Good, Proteus mirabilis, urease Cystine Our discussion earlier, we have talked about different types of malabsorption especially in the proximal convoluted tubule and at some point in our discussion, we talked about Hartnup disease we talked about Fanconi syndrome and we talked about cystine stones, and at that time, I gave you a mnemonic called COLA C- cystine, O-ornithine, L-lysine, A-arginine, didn't I? I sure did.

    02:37 and during that time, this patient is unable to properly reabsorb cystine result in these beautiful, clear, amazingly hexagonal crystals Welcome to cystinuria.


    About the Lecture

    The lecture Crystals in Urine Sediment by Carlo Raj, MD is from the course Urinalysis.


    Included Quiz Questions

    1. Tamm-Horsfall proteins
    2. Lipid
    3. Neutrophils
    4. Hyaline
    5. Red blood cells
    1. Pure vegan diet
    2. Ethylene glycol poisoning
    3. Sterile pyuria
    4. Proteus urinary tract infection
    5. Hypercalcemia
    1. Uric acid crystals
    2. Hexagonal crystals
    3. Cystine crystals
    4. Calcium oxalate crystals
    5. Triple phosphate crystals
    1. Ornithine
    2. Tryptophan
    3. Phenylalanine
    4. Leucine
    5. Valine

    Author of lecture Crystals in Urine Sediment

     Carlo Raj, MD

    Carlo Raj, MD


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