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USMLE > Endocrine - Embryology and Anatomy > Flashcards

Endocrine - Embryology and Anatomy Flashcards

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USMLE® Step 1 flashcards
1
Q

Describe thyroid development

A

Thyroid diverticulum arises from floor of primitive pharynx, descends into the neck.

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2
Q

How is thyroid diverticulum connected to the tongue?

A

Thyroglossal duct

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3
Q

What is the pyramidal lobe of thyroid?

A

Persistent thyroglossal duct

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4
Q

What is the foramen cecum of thyroid?

A

Normal remnant of thyroglossal duct

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5
Q

Most common ectopic thyroid tissue site

A

Tongue

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6
Q

Describe thyroglossal duct cyst

A

Anterior midline neck mass that moves with swallowing or pertrusion of the tongue

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7
Q

How is thyroglossal duct cyst different from a brachial cleft cyst?

A 
Brachial cleft cyst - persistent cervical sinus
Lateral neck (vs midline for thyroglossal duct cyst)
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8
Q

Describe fetal adrenal gland

A

Consists of an outer adult zone and inner active fetal zone.

Adult zone is dormant during early fetal life but begins to secrete cortisol late in gestation.

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9
Q

What controls cortisol secretion in the fetus?

A

ACTH and CRH from fetal pituitary and placenta

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10
Q

Role of cortisol in the fetus

A

Fetal lung maturation and surfactant production

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11
Q

What are the embryologic derivatives of the adrenal cortex and medulla?

A

Cortex - mesoderm

Medulla - neural crest

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12
Q

What are the layers of adrenal gland?

A 
Capsule
Zona glomerulosa
Zona fasciculata
Zona reticularis
Medulla (Chromaffin cells)
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13
Q

Primary regulatory control and secretory products of: Zona glomerulosa

A

Regulation: Renin-Angiotensin-Aldosterone System

Secretion: Aldosterone

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14
Q

Primary regulatory control and secretory products of: Zona fasciculata

A

Regulation: ACTH and CRH

Secretion: glucocorticoids (cortisol)

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15
Q

Primary regulatory control and secretory products of: Zona reticularis

A

Regulation: ACTH and CRH

Secretion: sex steroids (androgens)

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16
Q

Primary regulatory control and secretory products of: Adrenal medulla (Chromaffin cells)

A

Regulation: Pre-ganglionic sympathetic fibers (acetylcholine)

Secretion: Catecholamines (Epi, NE)

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17
Q

What is the most common tumor of adrenal medulla in adults? And in children?

How are they different?

A

Adult: pheochromocytoma
Children: neuroblastoma

Pheochromocytoma causes episodic hypertension; Neuroblastoma does not

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18
Q

Describe adrenal gland drainage

A

Left adrenal -> Left adrenal vein -> Left renal -> IVC

Right adrenal -> Right adrenal vein -> IVC

Same as left and right gonadal veins

19
Q

What are the embryologic derivatives of anterior and posterior pituitary?

A

Anterior pituitary (Adenohypophysis): oral ectoderm (Rathke’s pouch)

Posterior pituitary (neurohypophysis): neuroectoderm

20
Q

Function of posterior pituitary gland

A

Secretes vasopressin and oxytocin made in hypothalamus and shipped to posterior pituitary through neurophysins (carrier proteins)

21
Q

Function of anterior pituitary gland

A

Secretes FSH, LH, ACTH TSH, prolactin, GH, melanotropin (MSH)

22
Q

Describe structure of TSH, LH, FSH, hCG

A

Alpha and Beta subunit
Alpha: common to all
Beta: determines hormone specificity

23
Q

How do pituitary acidophils appear on histology and what do they make?

A

Pink

Prolactin, GH

24
Q

How do pituitary basophils appear on histology and what do they make?

A

Blue

FSH, LH, ACTH, TSH

25
Q

Describe organization of islets of langerhans

A

Alpha cells in periphery
Beta cells central
Delta cells interspersed

26
Q

What are the different cell types of islets of langerhans and what do they secrete?

A

Alpha: glucagon
Beta: insulin
Delta: somatostatin

27
Q

What does the islets of langerhans arise from?

A

Pancreatic buds

28
Q

Structure of insulin

A

Alpha and Beta chains connected by sulfur bonds

29
Q

Describe insulin secretion in the pancreatic beta-cell

A
  1. Glucose enter cell
  2. Glycolysis increases ATP/ADP ratio
  3. ATP closes ATP-sensitive K+ channels
  4. Depolarization of cell
  5. Influx of Ca2+ through voltage-gated Ca2+ channels
  6. Exocytosis of insulin granules into blood vessel
30
Q

Does insulin cross the placenta?

A

No

31
Q

What organs have insulin-independent glucose uptake? (6)

A 
Brain
RBC
Intestine
Cornea
Kidney
Liver
32
Q

What organs use: GLUT-1

A

RBCs, Brain

Insulin independent

33
Q

What organs use: GLUT-2

A

Beta islet cells, liver, kidney, intestines

34
Q

What organs use: GLUT-4

A

Adipose tissue, skeletal muscle

Insulin dependent

35
Q

Major functions of insulin (7)

A
  1. Increase glucose transport into skeletal muscle/adipose
  2. increase glycogen synthesis/storage
  3. increase TG synthesis/storage
  4. increase Na+ retention in kidneys
  5. increase protein synthesis (muscles)
  6. increase cellular uptake of K+ and AA
  7. decrease glucagon release
36
Q

What upregulates insulin secretion? (3)

A

hyperglycemia
GH
Beta-2 antagonists

37
Q

What inhibits insulin secretion? (3)

A

hypoglycemia
somatostatin
alpha-2 agonists

38
Q

What pathway does insulin acts in cells?

A

RAS/MAP kinase -> cell growth/DNA synthesis

Phosphoinositide-3 kinase -> glycogen, lipid, protein synthesis; GLUT4 vesicles

39
Q

What does brain use in starvation?

A

Ketone bodies

40
Q

What does RBC use in starvation?

A

Always depend on glucose - no mitochondria for aerobic metabolism

41
Q

Major functions of glucagon

A

Catabolic effects
Glycogenolysis, gluconeogenesis
Lipolysis, ketone production

42
Q

What promotes (1) or inhibits (3) glucagon production?

A

Promoted by hypoglycemia

Inhibited by insulin, hyperglycemia, somatostatin

43
Q

What is a lingual thyroid?

A

Persistence of thyroid tissue at base of tongue

Base of tongue mass

USMLE (13 decks)

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