Now we'll take a look at crystals.
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.
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.
massive destruction of your
cells, what is happening here?
Well you tell me about
cancer, and chemotherapy.
Is cancer made up of DNA,
the cancer cells?
of course they are.
what does DNA mean to you?
purine, pyrimidine, purine,
pyrimidine, purine, pyrimidine.
Now this patient has cancer
are we together now?
is causing what?
of your cancer cells.
what's it doing?
Oh, this is uric acid.
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.
Good, Proteus mirabilis, urease
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.
and during that time, this patient is
unable to properly reabsorb cystine
result in these beautiful, clear,
amazingly hexagonal crystals
Welcome to cystinuria.