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USMLE Embryo

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Answer 50 questions in 15 minutes.
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1. What causes persistent Truncus Arteriosus? What does it result in?
Mullerian inhibitory factor from Sertoli cells; increased androgen from Leydig cells
From the the lung; blood from SVC that went into RV gets shunted from pulm artery to aorta; ligamentum arteriosum
Decreased pulmonary resistance in the pulmonary vasculature
Partial AP septum development; one large vessel leaves the heart - Right to left shunt

2. Which branchial apparatus develops into the superior parathyroids?
Epispadias
Glans penis and corpus cavernosum and spongiosum; glans clitoris and vestibular bulbs
4th pouch
Week 10-12; end of 1st trimester

3. What embryological structures give rise to the SVC?
Right common cardinal vein and right anterior cardinal vein
Found in lateral neck; from no obliteration of 2-4th clefts
Mesdoerm
Branchial arch 2

4. What causes the transposition of the great vessels? What does it result in?
Lacunae in between the chorionic villi
Ring of pancreatic tissue can cause duodenal narrowing; ventral pancreatic bud abnormally encircles 2nd part of duodenum
Failure to spiral (aorta coming out of RV and PA coming out of left ventricle)- two completely separate systems
Glans penis and corpus cavernosum and spongiosum; glans clitoris and vestibular bulbs

5. what structures are the derivatives of the neural crest cells in branchial arches?
Endoderm - floor of primitive pharynx
Bone/cartilage and nerves
...
Persistence of 3rd cleft (groove) and pouch causes fistula between tonsillar area and cleft in lateral neck

6. How do AV canals form?
Diencephalon
Transposition of great vessels (failure to spiral)- right to left shunt; tetralogy of Fallout (right to left shunt caused by skewed development of septum); persistent TA (partial septum development - also right to left shunt)
Mesoderm
From endocardial cushions (ventral and dorsal meet each other)

7. What is a teratogen that causes Ebsteins anomaly? What is ebsteins anomaly?

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8. What embryological structure gives rise to the smooth part of the right atrium?
Failure to recanalize; 21
Failure of the urachus to obliterate; outpouching of the bladder
Found in lateral neck; from no obliteration of 2-4th clefts
Right horn of the SV

9. What does the first branchial pouch create?
Bulbos Cordis; right ventricle entirely
Germinal matrix hemorrhage
Endoderm lined structures of ear: middle ear cavity - eustacian tube - mastoid air cells
Apical ectodermal ridge; limb lengthening; stimulates mitosis of underlying mesoderm

10. What is the Eisenmeger complex?
Polyhydramnios - Down syndrome - Esophageal/duodenal atresia - Imperforate anus - Meckel diverticulum
When left to right shunting switching to right to left shunting
hypertrophy
Tongue

11. As a horseshoe kidney ascends during kidney development - What do they get trapped under?
IMA
Lithium
DHT; estrogen
Neuroectoderm

12. What separates the ant 1/3 and post 2/3 of tongue?
Physiologic incomplete muscular ventricular septum
Right horn of the SV
Foramen cecum and terminal sulus
Synctiotrophoblast

13. From what region do the thalami form?
Maternally derived; meconium
Diencephalon
Neural crest development; MEN 2A (pheo - PTH tumor - parafollicular cell tumor)
Apical ectodermal ridge; limb lengthening; stimulates mitosis of underlying mesoderm

14. What is the mcc of renovascular hypertension in children? What does this predispose to?
Scrotum; labia majora
Renal artery stenosis;
Arnold Chiari and Dandy Walker; Arnold Chiari; Dandy Walker; Arnold Chiari
Excessive resorption of septum primum or secondum (or both)

15. From What embryonic layer do the astrocytes arise?
DiGeorge
The caudal end mesonephros; the ureter - pelvis - calyces - collecting ducts
Neuroectoderm
Partial closure of vitelline duct so that the patent portion is attached to ileum; ectopic gastric mucosa; melena and periumbilical pain

16. What is the primitive streak? From what layer does it form?
Bones - cartilage - and nerves
Mesoderm; epiblast
Ventral shaft of penis (penile urethra); labia minora
Pharynx to duodenum; duodenum to transverse colon; distal transverse colon to rectum

17. What does the ductus venosus shunt blood away from? What is its remnant?
Surface ectoderm
Hepatic circulation; ligamentum venosum
Physiologic incomplete muscular ventricular septum
Endoderm

18. When does hCG secretion take place? with what event?
Ectoderm
Neuroectoderm
Day 6; with implantation
Urogenital sinus; wolffian duct; mullerian duct; urogenital sinus; wolffian duct; wolffian duct; mullerian; mullerian

19. In order to survive tricuspid atresia - What do you need?
Epispadias
Cytotrophoblast and synctiotrophoblast
1st arch neural crest fails to migrate --> mandibular hypoplasia - facial abnormalities (cleft palate - decreased slanting of palpebral fissures)
VSD

20. From What embryonic layer do the ANS arise?
Female; paramesonephric; mesonephric
T neuroectoderm
Neural crest cells
OCPS and maternal diabetes

21. Where is the mothers blood located in the placenta?
Week 8
Mesoderm
Lacunae in between the chorionic villi
2; 1

22. What causes a vesicourachal diverticulum? What is it?
Prenatal and perinatal
secondary palate
Week 3-8
Failure of the urachus to obliterate; outpouching of the bladder

23. From What embryonic layer do the ependymal cells arise?
Neural crest cells
Increase in oxygen concentration which decreases prostaglandin concentration
Prevent recurrent UTIs
Neuroectoderm

24. What artery is derived branchial (aortic) arch 3?
Lots - cleft palate/lip
Glans penis and corpus cavernosum and spongiosum; glans clitoris and vestibular bulbs
Common carotid and internal carotid
Deoxygenated blood; fetal internal iliac arteries to placenta

25. Which branchial arch derivative is obliterated?
5th
Primitive atrium
Maxillary and medial nasal processes
Branchial arch 2

26. When does hcG get secreted? What does it do?up until when ?
Day 6; maintains corpus luteum; 1st trimester
Mesoderm
septum primum and/or secundum
Vascular accident intra uterine; apple peel atresia

27. What does the midgut form? hindgut?
After; extrinsic
Duodenum to transverse colon; distal transverse colon to rectum
Yolk sac; 3rd week
Hypertrophy of muscularis externis of pylorus; surgical incision

28. What axis does the basal plate form? what neural system does it become?
Aortic arch and prox part of subclavian
Metencephalon; cerebellum
Ventral ; motor
SRY gene on Y chromosomes; sertoli and leydi; MIF and androgens; suppression of paramesonephric ducts and dev. of mesonephric (all respectively)

29. What can vit A in excess cause in the fetus?
Neuroectoderm
Mesoderm
Lots - cleft palate/lip
1st cleft/groove (Ectoderm)

30. Cleft lip is a failure of fusion of ________ and ______.
Maxillary and medial nasal processes
Lots - cleft palate/lip
Cranio - caudal; segmental
Physiologic incomplete muscular ventricular septum

31. What is an arnold chiari II malformation? through what hole does it herniate?
3rd; proximal part of the internal carotid artery
Neural crest cells
Embryonic period; 1st trimester
Cerebellar tonsillar herniation through foramen magnum

32. What is annular pancreas associated with in infants?
Polyhydramnios - Down syndrome - Esophageal/duodenal atresia - Imperforate anus - Meckel diverticulum
Pataus; fetal alcohol syndrome
Ventral ; motor
Mesoderm

33. What gene is produced in the zone of polarizing activity?
Thyroid - cricoid - arytenoids - corniculate cuneiform
During; instrinsic
Sonic Hedgehog
Tongue

34. From What embryonic layer does the inner arise?
3rd and 4th arches
Diencephalon
Reicherts cartilage: Stapes - Styloid process - Lesser horn of hyloid - Stylohyoid ligament and CN VII
...

35. From What embryonic layer do CNS neurons arise?
Decreased pulmonary resistance in the pulmonary vasculature
Neuroectoderm
IMA
Hemorrhage - bone deformities

36. From where does the pulmonary arteries and the ductus arteriosus arise?
Apical ectodermal ridge
Greater horn of hyoid; CN IX (styloPharyngeus)
6th aortic arch
Incomplete; yes

37. From What embryonic layer are the pia and arachnoid from?
Post. sup wall; luteal phase
Tunica vaginalis not fully fused
Palpable olive mass in epigastric region; nonbilious projectile vomitting @around 2 weeks
Neural crest cells

38. in hypospadias - on which side is the abnormal opening? What causes it?
4th/5th branchial pouches
Ventral; failure of urogenital folds to close
...
5th

39. what invaginates to form the primitive streak?
Epiblast
Synctiotrophoblast
Hepatic circulation; ligamentum venosum
Week 4; week 3

40. From what are the umbilical arteries and veins derived from?
When left to right shunting switching to right to left shunting
Midgut; 10th week
Allantois
Neural crest cells

41. which genital embryology is default? From what duct? what duct degenerates without signal to stay?
2nd; 2nd
Female; paramesonephric; mesonephric
4th/5th branchial pouches
StyloPharyngeus

42. From What embryonic layer does the retina arise?
Maternally derived; meconium
Telencephalon
Midgut; 10th week
Neuroectoderm

43. which tracts are damaged first in syringomelia? What tract is preserved?
Prenatal and perinatal
Vascular accident intra uterine; apple peel atresia
6-30
Spinothalamic first

44. What secretes hCG?
Synctiotrophoblast
Nicotine; preterm labor
Hypertrophy of muscularis externis of pylorus; surgical incision
lumbosacral

45. What is the 'fetal period'- ie When is it?
Week 8
Surface ectoderm
Embryonic period; 1st trimester
From endocardial cushions (ventral and dorsal meet each other)

46. What causes tetralogy of Fallot?
8
Skewed development of AP septum
Amniotic epithelium
Endoderm

47. What is the mnueomonic for the mesodermal defects? What does it stand for?
VACTERL- vertebral defect - anal atresia - cardiac defects - tracheo - esophageal fistula - renal defects - limb defects
mesoderm
DiGeorge
Ventral; failure of urogenital folds to close

48. From where to Where is the foregut derivative? midgut? hindgut?
Week 8
mesoderm
Pharynx to duodenum; duodenum to transverse colon; distal transverse colon to rectum
Aortic arch (from left side); right subclavian (on the right)

49. Septum primum (patent foramen oval) caused by excessive resorption of...
Fallopian tube - uterus - upper 1/3 of vagina
Endoderm
septum primum and/or secundum
Week 3-8

50. Which part of the branchial apparatus makes up membranes?
Arnold chiari; syringomyelia
Neural crest cells
Primitive atrium
All 3

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USMLE Embryo

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