lecture 3/1

• • For both calcium carbonate and calcium oxalate, if you have a calcium rich diet, less likely to form crystals in urine, combine in intestine
• calcium carbonate is found in calcium lacking diets
• calcium carbonate

  
• • Triple phosphate crystals
  • Coffin lid
  • pH of urine important for differentiation between triple phosphate and calcium oxalate
  • Not clinically significant
  • Can form calculi 
• triple phosphate

  
• • Ammonium biurate 
  • “Thorny apples”
  • May not always have spicules
  • Have dark tint
  • Brown in color is very characteristic
• bruh

  A) ammonium biurate crystal

  
• • Amorphous phosphates
  • Settle as white dust, cannot always rely on color to distinct from urates, as other things can be trapped inside
  • Use color and pH to differentiate
• • Mucus strings - thin, strongly, transparent/translucent, Tamm-Horsefall protein
  • Reportable as rare, few, moderate, or many per hpf
  • Lots of _____ will affect viscosity of urine
• you cannot rely solely on the color of the amorphous sediment, as other things can get trapped and change color, look at pH as well
• • Spermatozoa 
  • Not reported in females 
  • Some labs have protocols for report in males 
  • May be worth investigating while training to see what is protocol for urine under age of 18
• • Fiber
  • contaminant 
  • Not reportable
• if you see Enterobius vermicularis, you see the eggs
• • Schistosoma hematobium
  • Three schistosoma species
  • rarely see in US
• two out of three Schistosoma eggs have spikes
• • Trichomonas vaginalis
  • Parasite, not egg
  • “Darting white cell”
  • Looks like its being pushed around 
• To ID Trichomonas vaginalis

  • Must be moving
  • Urine should be fresh
  • When it stops moving, may look round, still will see flagella and undulating membrane
  • Easiest to ID is pear shaped
• T vaginalis is reported as rare, few, moderate, many
• Trichomonas vaginalis

  
• • Yeast
  • About the same size as a red cell
  • Look for budding forms
  • Replicating awhile, get chain or circular
  • Much larger than cocci
• • Acetic acid or lysing solution can be used to lyse red cells for easier differentiation of yeast
• • Starch crystals 
  • Usually not reported
  • Small indentation in the middle