Atlas Urinalysis

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The document discusses the microscopic examination of urine sediments and identifies various crystals, amorphous sediments, and cells that may be present in urine and their clinical significance.

Common crystals discussed include tyrosine, cystine, leucine, cholesterol, and triple phosphate. Their presence can indicate conditions such as liver disease, cystinuria, and urinary tract infections.

Uncommon crystals mentioned include hippuric acid, calcium sulfate, and ammonium biurate. Their presence is usually not clinically significant.

Atlas of

Microscopic Examination

of
The Urinary Sediment
Dr. Majed Wakid
Dr MAJED WAKID
MICROSCOPIC URINALYSIS

MICROSCOPIC URINALYSIS

MICROSCOPIC URINALYSIS

MICROSCOPIC URINALYSIS

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MICROSCOPIC URINALYSIS

MICROSCOPIC URINALYSIS

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Amorphous urate
Pinkish

granular appearance
They have no clinical significance

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Na-urate
Needles-like

appearance
They have no clinical
significance

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Hippuric acid (*)


Rare

crystal
Thick or thin needles
They have no clinical
significance

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Ca-sulfate
Rare

crystal
Thin needles
They have no
clinical significance

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Abnormal crystals

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Tyrosine
Very

fine, highly refractile needles


occurring in clusters
Clinical significance
- Severe liver disease
- Tyrosinosis

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Cystine
Colorless,

refractile hexagonal
plates, which appear singly, on
top of each other, or in
clusters
Clinical significance:
- Congenital cystinosis
- Congenital cystinuria
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Leucine
Oily,

highly refractile, yellow or


brown spheroids with radial and
concentric striations
Clinical significance
- Maple syrup urine disorders
- Liver disease
Leucine and tyrosine crystals are
often present together in the urine of
patients with liver disease
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Cholesterol
Large,

flat, transparent plates


with notched corners
Clinical significance
- Excessive tissue
breakdown
- Nephritis and nephrotic
condition
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Drugs, X-ray dye, and


others

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Triple phosphate
Prisms

with 3-6 sides, resemble


coffin lids
Some times in atypical feathery or
fern appearance

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Dr MAJED WAKID
MICROSCOPIC URINALYSIS

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Amorphous phosphate

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Ca-carbonate
Small

dumbbell or
spherical shape
When clumped, they
appear dark
No clinical
significance

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Ca-phosphate
Long,

thin, small prisms


with one pointed end.
Also they can form
granular plates form
No clinical significance

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Ammonium biurate (*)


Yellow-brown

spherical bodies with


or without long, irregular spicules

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Dr MAJED WAKID
MICROSCOPIC URINALYSIS

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Dr MAJED WAKID
MICROSCOPIC URINALYSIS

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