American Board of Internal Medicine (ABIM) Certification Practice Exam

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Which type of stone is commonly associated with uric acid?

Hexagonal
Rhomboid/Rosette
Envelope
Dumbbell

The correct answer is: Rhomboid/Rosette

The correct answer highlights that uric acid stones are commonly associated with a rhomboid or rosette appearance when viewed under a polarized light microscope. These stones form in conditions where uric acid levels in the urine are elevated, such as in certain metabolic disorders, dehydration, or certain dietary practices. Uric acid stones are typically yellowish-brown and can vary in size. They do not crystallize in the same manner as calcium stones, which commonly appear as envelope-shaped stones (calcium oxalate) or dumbbell-shaped (also calcium oxalate but in a different crystallization form). Rhomboid or rosette formations, characteristic of uric acid stones, reflect their unique chemical structure and solubility properties. Understanding the crystallization patterns can help in identifying and managing patients with kidney stones effectively, as each type has different treatment implications and dietary recommendations. This detail is vital in the clinical context of nephrolithiasis management.