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Sunday, January 06, 2008

development events are dependent on the production of maternal or fetal glucocorticoid,

017. All of the following development events are dependent on the production of maternal or fetal glucocorticoid, except

1. Induction of thymic involution

2. Production of surfactant by type II alveolar cells

3. Functional thyroid

4. Functional hypothalamopituitary axis

Answer

3. Functional thyroid

Reference

Ganong 22nd Edtion Page 370

Guyton 11th Edition Page 954

KDTripathi 5th Edition Page 258

Nelson 15th Edition Chapter 87.3 and Chapter 518

OP Ghai 6th Edition Page 482

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Discussion

Glucocorticoids have a major role in the synthesis of Surfactant by type II cells and also in the induction of thymic involution (Ganong) and functional hypothalamo pituitary axis (Ganong)

Explanation

The fetal hypothalamic-pituitary-thyroid system develops independently of maternal influence. (Nelson Chapter 518). It starts functioning by the 20th week and is generally independent of the maternal endocrine status (OP Ghai)

Comments

Approximately one third of maternal T4 crosses the placenta to the fetus. Maternal T4 may play a role in fetal development, especially that of the brain, before the synthesis of fetal thyroid hormones begins. The fetus of a hypothyroid mother may be at risk for neurologic damage, and a hypothyroid fetus may be partially protected by maternal T4 until delivery.

Tips

Etiocholanonlone, one of the metabolites of the adrenal androgens and testosterone can cause fever when it is unconjugated. Certain individuals have episodic bouts of fever due to periodic accumulation in the blood of unconjugated etiocholanone termed as “etiocholanone fever”

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