MICROSCOPIC EXAMINATION (CRYSTALS)

AUBF
BALIUAG UNIVERSITY
2ND SEMESTER A.Y. 2023 – 2024
I. NORMAL ACID CRYSTALS (ACU CHAM)
NOTE: ACU are commonly encountered in lab
Crystal pH Color Solubility Appearance Other info
Amorphous urates Acid Brick dust or Alkali and Yellow brown granules +Acetic acid = uric acid
yellow brown Heat +Ammonium
hydroxide =
ammonium biurate
Increased in gout,
chemotherapy
Calcium Oxalate Acid Colorless Dilute HCl envelopes, oval, dumbbell Dihydrate (Weddelite)
(Whewhellite and oval – envelope/
Weddelite) bipyrimidal/
octohedron
Monohydrate
(Whewelite) –
oval/dumbbell
Uric Acid Acid Yellow-brown Alkali soluble Rhombic (Diamond), 4-sided flat plate Lesch-Nyhan
(Whetstone), lemon shaped, wedges, barrel, Syndrome,
rosettes, irregular shaped plates, laminated chemotherapy, gout
forms, hexagonal

Calcium Sulfate Acid Acetic acid Cigarette butt

Hippuric Acid Acid Yellow Water and Elongated prism
brown/colorless Ether
Acid Urates Acid Brown Heat and Brown spheres or cluster Rare form of UA
Alkaline
Monosodium or Acid Colorless Tiny,slender colorless needles; spherulite or Inc. in acute and
sodium Urates beach ball chronic gout
Rare form of UA
II. NORMAL ALKALINE CRYSTALS (CAM TAC)
Calcium Phosphate Alkaline Colorless Dilute acetic Flat plate, thin prism in rosette
(Apatite) Neutral acid
Amorphous Alkaline White-colorless Dilute acetic Granular; fine lacywhite precipitate Mc cause of turbidity
Phosphate Neutral acid in alkaline urine
Magnesium Alkaline Colorless Acetic acid Elongated rectangular, rhomboid plates
Phosphate
Triple Phosphate Alkaline Colorless Dilute acetic Coffin lid, fern leaf, feathery Increase in presence
(Struvite) acid of urea
Ammonium biurate Alkaline Yellow-brown Acetic acid Thorny apples Seen in old specimen
with heat
(60C)
Calcium Carbonate Alkaline Colorless Gas from Dumbbells Misidentified as
acetic acid bacteria
III. ABNORMAL ACID CRYSTALS (2CBTLS RA)
Cystine Acid Colorless Ammonia Refractile hexagonal plates, often laminated Increased in cystinuria
Mistaken as Uric Acid
Cholesterol Acid Chlorform Staircase pattern, resemble radiographic dye Increased in lipiduria
Bilirubin Acid Bright yellow acetic acid, Needles cluster in clumps or sphere Increased in liver
(Stratsinger) HCl, NaOH, disease
Reddish brown acetone, and
(Turgeon) chloroform
Tyrosine Acid Fine colorlessto Alkali or heat Needles in clump or rosettes Increased in liver
yellow disease
Leucine Acid Yellow brown Hot alkali or Oily looking spheres wih concentric circle and Increased in liver dse
alcohol radial striation Resemble fat globule

GONZALES, R.L. | Page 1 of 1

MICROSCOPIC EXAMINATION (CRYSTALS)
AUBF
BALIUAG UNIVERSITY
2ND SEMESTER A.Y. 2023 – 2024
Sulfonamide Acid Acetone Fan shaped needles,shape of wheat, rosette, Mistaken as calcium
arrowhead, petals, round shaped, phosphate.
whetstones (+) Lignin & Diazo
Possible tubular
damage
Ampicillin Acid Colorless Needles tend to form bundles Increased in massive
dose of penicillin
Radiographic dye Acid 10% NaOH Flat, four sided plates with notched corner Resembles cholesterol
Long thin prism or rectangle crystals. To
differentiate:
- Check patient
history
- Correlate with UA SG
IV. OTHER ABNORMAL CRYSTALS (HAI)
Hemosiderin Yellow-brown Course granules (+) Rous test
Resemble amorphous
urates
Acyclovir Colorless Slender needles Birefringent with
polarized light
Seen in alkaline urine
Indianavir sulfate Colorless Sleder needle or slender rectangular plate Associated with renal
Feather like blockage and stone
Fan shaped, starburst forms, bundles or formation in HIV
sheaves individuals
URINARY SEDIMENT ARTIFACT
1. Oildroplets
2. Airbubbles
3. Pollengrains – Spheres w/ cell wall and concentric circles
4. Hair and fibers – Mistaken for cast
5. Fecal contamination
6. Starch granules
• Spheres with Dimpled center
• Maltes cross formation on polarizing microscope
o Maltese Cross Formation: (OFFS)
▪ O - Oval Fat Bodies
▪ F - Fatty Acids
▪ F - Fat droplets
▪ S - Starch granules

GONZALES, R.L. | Page 1 of 1