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135 Cards in this Set
- Front
- Back
Mechanism of ketone body formation?
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Depletion of oxaloacetate stalling TCA cycle: starvation and diabetes shunt oxaloacetate to gluconeogenesis, in alcoholism excess NADH shunts oxaloacetate to malate
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Rate-limiting step of cholesterol synthesis? Inhibitor?
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HNG-CoA Reductase (inhibited by statins)
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Essential fatty acids?
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Linoleic and linolenic acids (if linoleic acid is absent, arachidonic acid become essential)
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Function of pancreatic lipase?
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Degrades dietary TG in small intestine
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Function of lipoprotein lipase?
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Degrades TG circulating in chylomicrons and VLDLs
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Function of hepatic TG lipase?
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Degrades TG in IDL
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Function of hormone-sensitive lipase?
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Degrades TG stored in adipocytes
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Function of LCAT (lecithin-cholesterol acetyltransferase)?
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Esterifies cholesterol (2/3 of plasma cholesterol undergoes this process)
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Function of CETP (cholesterol ester transfer protein)?
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Transfers cholesterol esters to other lipoprotein particles
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Function of apolipoprotein A-1?
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Activate LCAT
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Function of apolipoprotein B-100?
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Binds LDL receptor and mediates VLDL secretion
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Function of apolipoprotein C-II?
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Cofactor for lipoprotein lipase
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Function of apolipoprotein B-48?
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Mediates chylomicron secretion
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Function of apolipoprotein E?
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Mediates uptake of remnants
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Chylomicron function? Source?
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Delivers dietary TGs to periphery; Secreted by intestinal epithelial cells
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Signs of excess chylomicrons?
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Pancreatitis, lipemia retinalis, eruptive xanthomas
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Apolipoproteins of chylomicrons?
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B-48, A-IV, C-II, E
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VLDL function? Source?
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Deliver hepatic TGs to periphery; Secreted by liver
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Sign of excess VLDL?
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Pancreatitis
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Apolipoproteins of VLDL?
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B-100, C-II, E
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IDL function? Source?
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Deliver TGs and cholesterol to liver; Formed from VLDL degradation
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Apolipoproteins of IDL?
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B-100, E
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LDL function? Source?
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Delivers hepatic cholesterol to periphery; Formed by lipoprotein lipase metabolism of VLDL in periphery
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Signs of LDL excess?
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Atherosclerosis, xanthomas, arcus cornae
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HDL function? Source?
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Reverse cholesterol transport (periphery to liver) and storage for apoC and apoE necessary for chylomicron and VLDL metabolism; Secreted from liver and intestine
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Familial dyslipidemia type I: Pathophys? Increased lipoprotein? Lab blood findings?
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Deficiency of lipoprotein lipase; Increased chylomicron; Elevated TG and cholesterol
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Familial dyslipidemia type II: Pathophys? Increased lipoprotein? Lab blood findings?
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Deficient LDL receptors; Increased LDL, Elevated cholesterol
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Familial dyslipidemia type IV: Pathophys? Increased lipoprotein? Lab blood findings?
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Hepatic overproduction of VLDL; Increased VLDL; Elevated TG
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Fetal development within week 1
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Implantation as blastocyst
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When would you see embryonic bilaminar disk formation (epiblast and hypoblast)?
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Before end of week 2
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Fetal development within week 3
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Gastrulation; formation of primitive streak, notochord, neural plate
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Fetal development during weeks 3-8
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Neural tube completes; Organogenesis, Period of extreme teratogen susceptibility
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When would you expect to first see a fetal heart beat and formation of limb buds?
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Week 4
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Fetal development during week 8
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Fetal movement, begins to resemble baby
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When do fetal genitalia assume gender differentiation?
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Week 10
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Which portion of nervous system arises from alar plate?
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Sensory (alar is dorsal)
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Which portion of nervous system arises from basal plate?
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Motor (basal is ventral)
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Rule of 2's for 2nd week
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2 germ layers (bilaminar disk), 2 cavities (amniotic and yolk sac), 2 placenta components (cytotrophoblast and syncytiotrophoblast)
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Rule of 3's for 3rd week
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3 germ layers (gastrula)
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Rule of 4's for 4th week
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4 heart chambers, 4 limb buds
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From what layer does the primitive streak emerge? And what does it give rise to?
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Forms from invagination of epiblast; Gives rise to mesoderm and endoderm
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Derivatives of surface ectoderm?
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Adenohypophysis; eye lens; epithelium of skin, ear, eye, nose; dermis
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Derivatives of neuroectoderm?
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Neurohypophysis, CNS neurons, oligodendroglia, astroglia, ependymal cells, pineal gland
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Derivatives of neural crest?
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ANS, DRG, melanocytes, adrenal medulla chromaffin cells, enterochromaffin cells, pia and arachnoid, celiac ganglion, Schwann cells, odontoblasts, thyroid C cells, laryngeal cartilage, skull bones
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Derivatives of endoderm?
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Gut tube epithelium and derivatives (lungs, liver, pancreas, thymus, parathyroid, thyroid follicular cells)
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Derivatives of mesoderm?
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Dura mater, connective tissue, muscle, bone, CV structures, lymphatics, blood, urogenital structures, serous body cavity linings, spleen, adrenal cortex, kidneys
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What is the function of the notochord? What is its postnatal derivative?
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Induces ectoderm to form neuroectoderm (neural plate); gives rise to nucleus pulposus of IV disks
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Mesodermal defects = VACTERL (name 'em)
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Vertebral defect, Anal atresia, Cardiac defects, Tracheo-Esophageal fistula, Renal defects, Limb defects (bone and muscle)
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Postnatally, the umbilical vein becomes what structure?
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Ligamentum teres hepatis
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Postnatally, the umbilLical arteries become what structures?
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MediaL umbilical ligaments
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Postnatally, the allaNtois/urachus become what structure?
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MediaN umbilical ligament
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Postnatally, the notochord becomes what structure?
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Nucleus pulposis of the intervertebral disks
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What structure(s) is derived from the 1st aortic arch?
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Part of the maxillary artery
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What structure(s) is derived from the 2nd aortic arch?
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Stapedial artery and hyoid artery
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What structure(s) is derived from the 3rd aortic arch?
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Common carotid artery and proximal part of internal carotid artery
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What structure(s) is derived from the 4th aortic arch?
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Aortic arch and proximal part of the right subclavian artery
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What structure(s) is derived from the 5th aortic arch?
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None
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What structure(s) is derived from the 6th aortic arch?
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Proximal part of pulmonary arteries and ductus arteriosus
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From which germ layer are branchial clefts derived?
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Ectoderm
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From which germ layer are branchial arches derived?
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Mesoderm and neural crest
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From which germ layer are branchial pouches derived?
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Endoderm
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The following are from which branchial arch: Mandible, Malleus, incus, sphenoMandicular ligament, Muscles of Mastication, Myelohyoid, anterior belly of the digastric?
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1
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The following are from which branchial arch: Stapes, Styloid process, lesser horn of hyoid, Stylohyoid and posterior belly of digastric?
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2
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The following are from which branchial arch: Greater horn of the hyoid and stylopharyngeus?
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3
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Which two branchial arches form the posterior 1/3 of the tongue?
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3 and 4
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All intrinsic muscles of the larynx are derived from the 6th branchial arch except for which muscle?
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cricothyroid muscle
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CN V2 and V3 are derived from which branchial arch?
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1
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CN VII is derived from which branchial arch?
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2
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CN IX is derived from which branchial arch?
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3
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The superior larygeal branch of CN X is derived from which branchial arch?
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4
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The recurrent laryngeal branch of CN X is drived from which branchial arch?
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6
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Which branchial arch makes no major developmental contributions?
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5
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Which branchial cleft develops into the external auditory meatus?
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1st cleft
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Which branchial pouch develops into the middle ear cavity, eustachian tube and mastoid air cell?
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1st pouch
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Which branchial pouch develops into the epithelial lining of the palatine tonsil?
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2nd pouch
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Which branchial pouch develops into the inferior parathyroids?
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3rd pouch
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Which branchial pouch develops into the the ventral wings of the thymus?
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3rd pouch
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Which branchial pouch develops into the the superior parathyroids?
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4th pouch
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Which branchial pouch develops into the the dorsal wings of the thymus?
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4th pouch
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DiGeorge Sequence (Syndrome) results from aberrant development of which branchial pouch(es)?
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3rd and 4th pouches
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What deformation results from the failure of the maxillary and medial nasal processes to fuse?
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Cleft lip
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What deformation results from the failure of the lateral palatine processes, the nasal septum and/or the median palatine process to fuse?
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Cleft palate
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Name the 4 embryologic structures from which the diaphram derives.
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Septum transversum, Pleuroperitoneal folds, Body wall and Dorsal mesentery of esophagus
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In embryologic development, what part(s) of the pancreas does the ventral pancreatic bud form?
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Pancreatic head, uncinate process and main pancreatic duct (dorsal bud becomes everything else)
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A neonate presents with narrowing of the 2nd part of the duodenum. What is the likely etiology?
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Annular pancreas (ventral pancreatic bud abnormally encircles the 2nd part of the duodenum)
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Which of the following organs does not arise from endoderm: stomach, lungs, spleen or endocrine glands of the liver/pancreas?
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Spleen (arises from mesoderm)
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A neonate presents with extrusion of abdominal contents through unfused abdominal (lateral body) folds. Dx?
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Gastroschisis
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A neonate presents with herniation of abdominal contents into the umbilical cord. Dx?
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Omphalocele
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When is the fetus most susceptible to teratogens?
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Weeks 3-8
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What is the effect of ACE inhibitors on a fetus?
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Renal damage
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What is the effect of cocaine on a fetus?
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Abnormal development and fetal addiction
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What is the effect of Diethylstilbestrol (DES) on a fetus?
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Vaginal clear cell carcinoma
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What is the effect of Iodide on a fetus?
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Congenital goiter or hypothyroidism
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What is the effect of Vitamin A on a fetus?
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Extremely high risk for birth defects
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What is the effect of Thalidomide on a fetus?
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Limb defects (flipper limbs)
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What is the effect of Tobacco on a fetus?
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Preterm labor, placental problems, ADHD
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What is the effect of Alcohol on a fetus?
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Developmental retardation, microcephaly, facial adnormalities, limb dislocation, heart and lung fistulas. Possibly due to cell migration.
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What are the two ways to make monozygotic twins?
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One zygote splits to develop two amniotic sacs with a common chorion and placenta or one that splits early and develops two placentas, chorions, and amniotic sacs.
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How are dizygotic twins formed?
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Two separate eggs are fertilized and form individual placentas, chorions and amniotic sacs.
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What is the major purpose of the placenta?
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Primary site of nutrient and gas exchange between mother and fetus.
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What is the fetal component of the placenta?
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The inner layer is cytotrophoblast and the syncytiotrophoblast is the outer layer and secretes hCG.
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What is the maternal component of the placenta?
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The decidual basalis which is derived from the endometrium.
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What are the components of the umblical cord?
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2 arteries (deoxygenated blood) and 1 vein (oxygenated blood from placenta) and the urachus removes nitrogenous waste from fetal bladder
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What embryonic structure gives rise to the ascending aorta and pulmonary trunk?
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Truncus arteriosus (TA)
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What embryonic structure gives rise to the smooth parts of left and right ventricle?
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Bulbus cordis
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What embryonic structure gives rise to the trabeculated parts of left and right ventricle?
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Primitive ventricle
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What embryonic structure gives rise to the trabeculated parts of left and right atrium?
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Primitive atria
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What embryonic structure gives rise to the coronary sinus?
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Left horn of sinus venosus (SV)
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What embryonic structure gives rise to the Smooth part of right atrium?
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Right horn of sinus venosus (SV)
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What embryonic structure gives rise to the superior vena cava?
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Right common cardinal vein and right anterior cardinal vein
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What embryonic structure divides the truncus arteriosis into the aortic and pulmonary trunks?
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Aorticopulmonary septum
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What closes the interventricular foramen?
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The fusion of the aorticopulmonary septum meets the muscular ventricular septum to form the membranous interventricular septum.
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What forms the foramen primum?
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The septum primum grows down towards the endocardial cushions.
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What forms the foramen secundum?
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Perforations in the septum primum
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Which septum contains the foramen ovale?
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Septum secundum
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Which septum forms the valve for the foramen ovale?
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Septum primum
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Where is fetal erythropoiesis at weeks 3-8?
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Yolk sac
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Where is fetal erythropoiesis at weeks 6-30?
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Liver
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Where is fetal erythropoiesis at weeks 9-28?
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Spleen
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Where is fetal erythropoiesis after week 28?
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Bone marrow
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What are the three fetal shunts?
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Ductus venosus, Foramen ovale, Ductus arteriosis
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Where does the ductus venosus shunt blood?
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From umbilical vein to IVC
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Where does the foramen ovale shunt blood?
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Oxygenated blood from reaching the heart from right atria to left so it can reach to head and body
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Where does the ductus arteriosus shunt blood?
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Deoxygenated blood from the SVC is expelled into the pulmonary artery and to the lower body of the fetus
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What closes the foramen ovale?
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The decreased resistance in the pulmonary vasculature causes increased left atrial pressure
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What closes the ductus arteriosis?
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Increase in oxygen concentration leads to a decrease in prostaglandin
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What can be used to close a PDA?
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Indomethacin
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What can be used to keep a PDA open?
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Prostaglandins
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Embryology: 3 stages of kidney development? Function? Derived from which germ layers?
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(1) Pronephros: filtration (wk 1-4, degenerates). (2) Mesonephros: interim kidney (wk 4-end of trimester 1). (3) Metanephros: permanent kidney. All derived from the mesoderm.
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Embryology: GU structures derived from the (1) mesonephros and (2) metanephros?
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(1) efferent ductules->epididymis->vas deferens. (2) ureter->collecting system->nephron tubules + Bowman capsule. Glomeruli arterioles just grow into Bowman capsule induced by Bowman nearby.
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Embryology: what does the urogenital sinus form? Gonad formation/origin?
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UG sinus forms urethra, bladder, allaintois (becomes median umbilical lig) (M & F) and vagina (F). Origin: endoderm (transitional epithelium). Gonads=mesoderm + primordial germ cells that migrate in from the Yolk Sac to spawn gametes.
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Explain sex differentiation in embryology: 'default' development?
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Default: mesonephric ducts->paramesonephric (muellerian) ducts (F). SRY gene (Y chrom) produces testis-determining factor (TDF)->testis. Sertoli cells->Muellerian Inhibiting Factor (MIF), which inhibits female devo. Leydig cells-->testosterone-> sustain mesonephric (Wolffian) ducts (epididymis, vas def).
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Structures arising from the: (1) Mesonephric (Wolffian) ducts? (2) Paramesonephric (Muellerian) ducts?
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(1) Epididymis, ejaculatory duct, vas deferns, seminal vesicles (SEED) + trigone (2) Fallopian tubes, uterus, rostral 1/3 of vagina, trigone.
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M/F genital homologues (F/default given, you name M structure): (1) glans clitoris (2) vestibular bulbs (3) Glands of Bartholin.
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(1) Glans penis (2) corpus spongiosum (3) Cowper glands
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M/F genital homologues (F/default given, you name M structure): (1) urethral & paraurethral glands (of Skene) (2) labia minora (3) labia majora.
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(1) Prostate (think: prostate is paraurethral in M) (2) penile urethra (and ventral shaft) (3) scrotum.
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