Tuesday, November 22, 2016

Neural crest cell / MEN2 mnemonic

Here's a word-picture to help remember the facts.
Two men "A" and "B" are wearing crowns (neural crests) and are both eating melon (melanocytes).

Man B is really tall and skinny (marfanoid) and has big orthodontics, and he chokes on the melon -- it's gone down his trachea! He freaks out! His lips and his eyelids are swollen!

Man "A," Larry, gives him a cricothyrotomy -- right in his larynx.

Now that it's 10AM, man B enters a muffin store in order to RETurn his melon. There are some seriously lumpy muffins inside...

Man "A" goes to the middle of the store. A swan in the middle of a simulated "sea" (C cells) wearing a royal crest is giving birth. The swan wields a para -- an M249 machine gun, and has HUGE thighs, 'cuz it has been using 'roids.

With the help of her dula, who is pounding on a tympani to help the swan count, she gives birth to a baby swan. Baby swan spirals around, covered in a membrane.

MEN2A/B is a gain of function mutation in the RET (tyrosine kinase) proto-oncogene found on chromosome 10. This affects cells derived from the neural crest. Both types are associated with pheochromocytoma and parathyroid hyperplasia (in type 2A) or Marfanoid habitus and mucosal neuromas (type 2B). These cells are derivatives of neural crest cells and are listed in order of appearance:
  • Melanocytes
  • Odontoblasts
  • Tracheal & laryngeal cartilage
  • Enterochromaffin cells
  • Parafollicular thyroid cells
  • Schwann cells
  • Adrenal medulla
  • Spiral membrane / tympanic surface

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