Question

In acidic urine, we may observe the following type of crystals during microscopic examination
A. Uric Acid
B. Triple phosphate
C. Calcium oxalate
D. Hippuric acid
E. Amorphous phosphate
Choose the correct answer from the options given below:

• A. B and E only
• B. B, C and E only
• C. D and E only
• D. A, C and D only

Hint:

Urine Crystal pH Rules:
Acidic Urine ($pH < 6.5$) = Uric Acid, Calcium Oxalate, Hippuric acid, Cystine.
Alkaline Urine ($pH > 7.0$) = Triple Phosphate (Struvite), Amorphous Phosphate, Calcium Carbonate.

Answer 1

The Correct Option is D

Step 1: Understanding the Concept:
Urinary sediment crystalluria is strictly pH-dependent: acidic urine precipitates uric acid, calcium oxalate, and cystine; alkaline urine precipitates struvite (triple phosphate) and calcium carbonate.

Step 2: Detailed Explanation:
Urinary crystal precipitation by urinary pH:
1. Acidic Urine Crystals ($pH < 7.0$):
- A. Uric Acid: Rhomboid/diamond-shaped plates in acidic urine.
- C. Calcium Oxalate: Envelope (dihydrate) or dumbbell (monohydrate) crystals.
- D. Hippuric Acid: Hexagonal prisms/needle clusters in acidic urine.
- Cystine and Tyrosine.
2. Alkaline Urine Crystals ($pH > 7.0$):
- B. Triple Phosphate (Struvite Magnesium Ammonium Phosphate): 'Coffin-lid' prisms in alkaline urine.
- E. Amorphous Phosphates Calcium Carbonate.
Therefore, crystals found in acidic urine are A, C and D only.

Step 3: Final Answer:
Therefore, the acidic urine crystals are A, C and D only, corresponding to option (D).