Professional Documents
Culture Documents
http://www.imhotepvirtualmedsch.com/
Resources:
University of South Carolina - Microbiology,
Virology, Immunology, Bacteriology, Parasitology,
Mycology Online
University of Utah - WebPath
University of Pennsylvania - Gram Stain Atlas
Streptococcus pneumoniae
(A) (B)
(C)
(A) (B)
Syphilis. (A) Chancre associated with (B) Primary syphilis. A dense infiltrate of plasma
primary syphilis. These ulcerative lesions cells and dilated blood vessels can be seen.
are painless. There is epidermal ulceration with crust;
neutrophils are present within the
predominantly plasmacytic infiltrate.
IVMS USMLE Step 1 Prep. 14
Syphilis
(A) (B)
(A) Sickle cell peripheral blood smear. Note the sickled cells as well as anisocytosis,
poikilocytosis, and nucleated RBCs.
(B) Splenic infarction. The splenic artery lacks collateral supply, making the spleen
particularly susceptible to ischemic damage. Coagulative necrosis has occurred in a wedge
shape along the pattern of vascular supply. Individual sickle cells cause generalized splenic
infarcts that result in autosplenectomy by adolescence.
IVMS USMLE Step 1 Prep. 24
Leukemia
(A) (B)
(B) Acute myelocytic leukemia with Auer rods (arrows), peripheral blood
smear. Affects adolescents to young adults.
(C) (D)
(C) Chronic lymphocytic leukemia, peripheral blood smear. In CLL, the lymphocytes are
excessively fragile. These lymphocytes are easily destroyed during slide preparation, forming
“smudge cells.” Affects individuals older than 60 years of age.
(D) Chronic myeloid leukemia, peripheral blood smear. Promyelocytes and myelocytes are
seen adjacent to a vascular structure. Affects individuals from 30 to 60 years of age.
IVMS USMLE Step 1 Prep. 26
Multiple myeloma
(A) X-ray shows numerous punched-out lytic lesions (lucent areas) typical
of multiple myeloma. Note the generalized osteopenia
and multiple compression fractures (arrow).
(B) Classic bone lytic lesions seen in multiple myeloma.
IVMS USMLE Step 1 Prep. 27
Multiple myeloma
(A) (B)
(A) Micronodular cirrhosis of the liver, gross, from an alcoholic patient. The liver
is approximately normal in size with a fine, granular appearance. Later stages
of disease result in an irregularly shrunken liver with larger nodules, giving it a
“hobnail” appearance.
(B) Cirrhosis, microscopic. Regenerative lesions are surrounded by fibrotic
bands of collagen (“bridging fibrosis”), forming the characteristic nodularity.
IVMS USMLE Step 1 Prep. 34
Cirrhosis
(C)
(D)
(A) (B)
(A) Pulmonary thromboembolus (arrow), gross. Most often arises from deep
venous thrombosis.
(B) Pulmonary thromboembolus in a small muscular pulmonary artery.
The interdigitating areas of pale pink and red within the organizing embolus form
the “lines of Zahn” (arrow) characteristic of a thrombus. These
lines represent layers of red cells, platelets, and fibrin that are
laid down in the vessel as the thrombus forms.
IVMS USMLE Step 1 Prep. 41
Squamous cell carcinoma
Small (oat) cell carcinoma in a pulmonary hilar lymph node. Almost all
of these tumors are related to tobacco smoking. They can arise
anywhere in the lung, most often near the hilum, and quickly spread
along the bronchi.
B C
(C) are also associated with Alzheimer’s disease, the most common
cause of dementia in older persons.
IVMS USMLE Step 1 Prep. 47
Asbestosis
(A) (B)
The histologic section (B) at the origin of the aneurysm shows lack
of internal elastic lamina.
IVMS USMLE Step 1 Prep. 52
Multiple sclerosis
(A) Lumbar spinal cord with mostly random and asymmetric white-matter lesions.
(B) Brain with periventricular white-matter plaques of demyelination, gross.
Demyelination occurs in a bilateral asymmetric distribution.
Classic clinical findings are nystagmus, scanning speech, and intention tremor.
(B) Tophi affect the proximal interphalangeal (PIP) joints, knees, and elbows,
growing like tubers from the bones.
Irregular purple patches and plaques are seen on the neck and
chest of the mother, and pink patches are seen on the cheek, lip,
chin, neck, and chest of the daughter.
Both lesions were present at birth.
A B
(A) Lesion just beneath the epidermis with pigmented and nonpigmented cells.
The tumor cells are usually polyhedral but may be spindle shaped, dendritic, or
ballooned or may resemble oat cells. Many but by no means all melanomas make
melanin. Large nucleoli are common.
(B) A multicolored tan, red, and dark brown irregular plaque on the abdomen. The
depth of the lesion is a prognostic indicator.
IVMS USMLE Step 1 Prep. 67
Basal cell carcinoma
A B
A B
(A) Pancreatic acinar cell (EM). A condensing vacuole (C) is receiving secretory product (arrow)
from the Golgi complex (G).
M––mitochondrion; RER––rough endoplasmic reticulum; S––mature condensed secretory
zymogen granules.
(B) Pancreatic islet cells in diabetes mellitus type 1. In patients with diabetes mellitus type 1,
autoantibodies against β cells cause a chronic inflammation until, over time, islet cells are
entirely replaced by amyloid. IVMS USMLE Step 1 Prep. 73
Adrenocortical adenoma, gross
A B
Graves’ disease. (A) Exophthalmos in a patient with proptosis and periorbital edema.
C
(C) Stimulation of follicular cells by TSH causes the normal uniform
architecture to be replaced by hyperplastic papillary, involuted borders,
and decreased colloid.
Typical medical therapy is propylthiouracil, which inhibits the production
of thyroid hormone as well as peripheral conversion of T4 to T3.
(A) (B)
(C) (D)
By three to seven days, neutrophils have Within weeks, granulation and
been replaced by macrophages, and scarring occur (D).
clearing of myocyte debris has begun (C).
Note the path of the internal carotid artery through the neck and its
major branches (ophthalmic artery, anterior cerebral artery, middle
cerebral artery). The aneurysm is inferior to the terminal branches in
this angiogram.
(A) is characterized by neutrophilic infiltration (B) has a lymphocytic invasion with fibrosis.
and abscess formation within the renal
interstitium. Abscesses may rupture,
introducing collections of white cells to the
tubular lumen. In contrast, chronic
pyelonephritis
IVMS USMLE Step 1 Prep. 97
Transitional cell carcinoma
Enlarged, very pale kidneys with “flea bite” or ectasia from a patient
with nephrotic syndrome or subacute glomerulonephritis as a result
of lupus erythematosus.
B
A
(A) Gross. The kidney has been bivalved, revealing a nodular, golden-yellow tumor in the
midkidney with areas of hemorrhage and necrosis.
(B) Histology shows polygonal cells with small nuclei and abundant
clear cytoplasm with a rich, delicate branching vasculature.
(A) Blue sclera caused by translucency of connective tissue over the choroid.
The optic nerve is on the right side of the image.
(B) Abnormal collagen synthesis results from a variety of gene mutations and causes brittle
bones and connective tissue malformations.
The first four toes and adjacent skin are dry, shrunken, and
blackened with superficial necrosis and peeling of the skin. A well-
defined line of demarcation separates the black region
from the viable skin.
The left hand exhibits a distal cyanosis compared to the right hand;
it is seen especially well in the nail beds. Unilateral episodes such as
this one may occur after contact with a cold object.
Patients are tall with very long extremities. The joints are
hyperextensible, with slim bone structure and wiry
muscles.
Signet ring cell. Mucin expands the cytoplasm and pushes the
nucleus to the periphery, creating the appearance of a signet
ring. The diffuse type of gastric carcinoma is composed of
widely infiltrative signet ring cells.
A B
A B
(A) Gross. Note the large area of (B) Bronchopneumonia with neutrophils in
consolidation at the base plus multiple small alveolar spaces, microscopic.
areas of consolidation (pale) involving
bronchioles and surrounding alveolar sacs
throughout the lung.
IVMS USMLE Step 1 Prep. 130
Small bowel obstruction
(A) (B)
Teratoma (benign) of the ovary containing teeth and hair––an incidental finding
during abdominal surgery. In females, teratomas are generally benign, whereas in
males they account for roughly 30% of testicular tumors.
A B
CT scan with contrast reveals blood in the subarachnoid space at the base of
the brain.