Crystals in Urine Sediment

by Carlo Raj, MD

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    00:01 Now, we take a look at crystals.

    00:03 The crystals, well, we have in the urine, you find calcium oxalate and with calcium oxalate, while it might be a square that you're finding, pure vegan diet, ethylene glycol is a big one, and then calcium oxide stones as we're looking at.

    00:19 What's the most common type of renal stone? A calcium stone, calcium oxalate being right up there.

    00:25 Crystal: Uric acid will give you crystals hyperuricemia.

    00:29 Two big ones here, maybe gout and who's your patient with a gout, most likely a male, who's been drinking quite a bit, and maybe perhaps is not drinking enough water.

    00:40 May result in uric acid crystals, massive destruction of your cells, what's happening here? Well, you tell me about cancer and chemotherapy, is cancer made up of DNA the cancer cells? Of-course they are.

    00:54 What's the DNA mean to you? Purine-pyrimidine, purine-pyrimidine, purine-pyrimidine.

    00:59 Now, this patient has cancer, receiving chemotherapy, Are we together now? That chemotherapy is causing what? Massive destruction of your cancer cells.

    01:09 What's it doing? This is uric acid, where is uric acid coming? Purine isn't it, so therefore, this is called tumour lysis syndrome, may result in excess uric acid in your urine, you may have decreased pH and uric acid crystals.

    01:26 Triple phosphate, may be a sign of urinary tract infection due to urease, producing your pathogens.

    01:31 Give me an example.

    01:32 Something like, proteus mirabilis, urease, cysteine.

    01:40 Our discussion earlier, we had talked about different types of malabsorption, especially in the proximal convoluted tubule and at some point, in our discussion we talked about heart knob disease, we talked about Fanconi syndrome and we talked about cysteine stones, and at that time i gave you a mnemonic called “Cola.” C - Cysteine, O – Ornithine, L – Lysine, A – Arginine.

    02:07 Didn't I. I sure did.

    02:09 And during that time, this patient is unable to properly reabsorb cysteine, results 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. Calcium oxalate crystals
    2. Cystine crystals
    3. Uric acid crystals
    4. Triple phosphate crystals
    5. Magnesium ammonium phosphate crystals
    1. Pure vegan diet
    2. Ethylene glycol poisoning
    3. Sterile pyuria
    4. Urinary tract infection
    5. Gout
    1. Uric acid crystals
    2. Hexagonal crystals
    3. Cystine crystals
    4. Calcium oxalate crystals
    5. Triple phosphate crystals
    1. Triple phosphate crystal
    2. Calcium oxalate crystal
    3. Uric acid crystal
    4. Cystine crystal
    5. Hexagonal crystal

    Author of lecture Crystals in Urine Sediment

     Carlo Raj, MD

    Carlo Raj, MD

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