00:01
Now, we take a look at crystals.
00:03
The crystals, well, we have in the urine,
you find calcium oxalate and with calcium oxalate,
while it might be a square that you're finding,
pure vegan diet, ethylene glycol is a big one,
and then calcium oxide stones as we're looking at.
00:19
What's the most common type of renal stone?
A calcium stone, calcium
oxalate being right up there.
00:25
Crystal: Uric acid will give
you crystals hyperuricemia.
00:29
Two big ones here, maybe gout and
who's your patient with a gout,
most likely a male, who's
been drinking quite a bit,
and maybe perhaps is not drinking enough water.
00:40
May result in uric acid crystals,
massive destruction of your cells,
what's happening here?
Well, you tell me about cancer and chemotherapy,
is cancer made up of DNA the cancer cells?
Of-course they are.
00:54
What's the DNA mean to you?
Purine-pyrimidine,
purine-pyrimidine, purine-pyrimidine.
00:59
Now, this patient has cancer,
receiving chemotherapy,
Are we together now?
That chemotherapy is causing what?
Massive destruction of your cancer cells.
01:09
What's it doing?
This is uric acid, where is uric acid coming?
Purine isn't it, so therefore, this
is called tumour lysis syndrome,
may result in excess uric acid in your urine,
you may have decreased pH and uric acid crystals.
01:26
Triple phosphate, may be a
sign of urinary tract infection
due to urease, producing your pathogens.
01:31
Give me an example.
01:32
Something like, proteus
mirabilis, urease, cysteine.
01:40
Our discussion earlier,
we had talked about different
types of malabsorption,
especially in the proximal convoluted tubule
and at some point, in our discussion
we talked about heart knob disease,
we talked about Fanconi syndrome
and we talked about cysteine stones,
and at that time i gave you
a mnemonic called “Cola.”
C - Cysteine,
O – Ornithine,
L – Lysine,
A – Arginine.
02:07
Didn't I. I sure did.
02:09
And during that time, this patient is
unable to properly reabsorb cysteine,
results in these beautiful clear,
amazingly hexagonal crystals,
welcome to cystinuria.