Honors Urinalysis Home Middle Aged Woman Case Study Teenage Boy Case Study |
Teenage Boy with Severe Side Pain |
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4. Sometimes the crystals at the end of the arrow below form 6-sided crystals and get confused with the ones present in this patient's urine. How can they be differentiated? ![]() The crystal at the end of the arrow is uric acid. When uric acid is thin and hexagonal, it can resemble cystine. To make sure the crystals are really cystine and not uric acid, add sodium cyanide to the sample, which reduces cystine to cysteine. Free sulfhydryl groups react with nitroprusside to form a purple color. This is called the sodium-nitroprusside reaction. If the sample just has uric acid, then the purple color will not be present. In this photomicrograph, there are multiple forms of uric acid, none of which have the hexagonal shape of cystine. A 14 year old boy went to his doctor complaining of severe side and back pain, which got worse while he slept. His family history showed males on both his mother's side and his father's side with chronic kidney stones. Urinalysis results are:
Microscopic 10-20 RBCs/hpf Few Calcium Oxalate crystals Many crystals which look like this: |