CHAPTER 5 Flashcards

Genes, Environment-Lifestyle, and Common Diseases

1
Q

_____

  • is the incident rate of a disease among individuals exposed to a risk factor divided by the incidence rate of the disease among individuals not exposed to the risk factor
  • many factors including _____, _____, _____, _____, and _____ of the disease can influence the risk
  • -complex interactions occur among _____ and _____ factors; each factor can be quantified in terms of _____
A
relative risk
age
gender
diet
exercise
family history
genetic
nongenetic
relative risks
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2
Q

_____:
-traits caused by the combined effects of multiple genes
-focus is on the _____- usually many (poly) _____
_____:
-genetic and environmental or lifestyle factors cause the variations in traits
-additive effects of many _____ and _____ factors cause _____ traits
_____:
-are measured on a continuous numeric scale
-follow a normal bell curve for distribution

A
polygenic traits
genes
genes
multifactorial traits
genetic
environmental 
multifactorial
quantitative traits
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3
Q

_____

  • is hard to determine in _____ diseases
  • -number of _____ contributing to the disease is usually not known, precise _____ of parents is also not known, and the extent of environmental effects can vary substantially
  • _____: is based on direct observation of data; is specific for each multifactorial disease
  • recurrence risks of multifactorial diseases can substantially change because the _____, _____, and _____ factors can differ among population
  • recurrence risk become _____ if more than one family member is affected
  • if the expression of the disease in the proband is more severe, then the recurrence risk is _____
  • if the proband is of the less commonly affected sex, then the recurrence risk is _____
  • recurrence risk for the disease usually _____ rapidly in remotely related relatives
A
recurrence risks
multifactorial
genes
allelic constitution 
empirical risks
gene frequencies 
environment
lifestyle 
higher
higher
higher
decreases
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4
Q

QUESTION 1
recurrence risk in multifactorial diseases is:
1. rapidly increased when more distant relatives are affected
2. lower if the disease is more severe in the proband
3. higher if the proband is the more commonly affected sex
4. higher if more than one family member is affected

A

4

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5
Q

nature and nurture: disentangling the effects of genes and environment

  • adoption studies
  • -children born to parents who have a disease but are then subsequently adopted by parents lacking the disease are studied for _____
  • -a preliminary indication of the extent to which _____ may cause a multifactorial disease is provided
  • _____
  • -a genetic predisposition may interact with an environmental factor to _____ the risk for a disease to be a much higher level than either factor would alone
A

disease recurrence
genetic factors
gene-environment interaction
increase

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6
Q

genetics of common diseases
_____:
-congenital diseases are present at _____
-most congenital diseases are _____
-_____ can cause congenital malformations
-having other disorders along with congenital disease is _____

A
congenital malformations
birth
multifactorial
environmental factors
common
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7
Q

Name the 9 multifactorial diseases in adults

A
CHD
hypertension
breast cancer
colon cancer 
diabetes mellitus
obesity
Alzheimer disease 
alcoholism
schizophrenia and bipolar affective disorder
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8
Q

MULTIFACTORIAL DISORDERS IN THE ADULT POP
Coronary heart disease
-potential _____ caused by _____ in the _____ supplying blood to the heart
-potential _____ caused by _____ in the arteries supplying blood to the brain
-risk increases if:
-more _____ exist
-affected relatives are _____ rather than _____
-age of onset is younger than _____ years
-_____, _____, _____, _____, _____, increase risk

A
myocardial infarction
atherosclerosis 
arteries 
cerebrovascular accident (stroke)
atherosclerosis 
affected relatives
female
male
55
autosomal dominant familial hypercholesterolemia
high-fat diet
lack of exercise
smoking
obesity increase risk
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9
Q

MULTIFACTORIAL DISORDERS IN THE ADULT POP
hypertension
-is a risk factor for _____, _____, and _____
-between _____ and _____ of blood pressure variations are genetic, which means that _____ are important
-important environmental factors include _____ intake, lack of _____, _____ and _____
-blood pressure regulation is complex
–research that focuses on individual components for gene involvement include _____, _____ and _____

A
heart disease
stroke
kidney disease
20%
40%
environmental factors
sodium
exercise
stress
obesity
renin-angiotensin system
nitric oxide 
kallikrein-kinin system
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10
Q

MULTIFACTORIAL DISORDERS IN THE ADULT POP
cancer
-is the _____ leading cause of death in the US
-many major cancers occur in _____
-_____ and _____ choices increase the risk for cancer
–_____ use accounts for _____ of all cancers

A
second
families
environmental 
lifestyle 
tobacco 
one third
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11
Q

breast cancer

  • affects _____ of american women who live to _____ years of age
  • if a women has a first-degree relative with breast cancer, then her risk _____
  • recurrence risk _____ if the age of onset in the affected relative is early and if the cancer is _____
  • an _____ form (5%) has been linked to chromosomes _____ and chromosomes _____
  • -this form causes a _____ to _____ lifetime risk of developing breast cancer and increases the risk of _____
  • other genes are implicated
A
12%
85
doubles
increases
bilateral 
autosomal dominant 
13 (BRCA2)
17 (BRCA1)
50%
80%
ovarian cancer
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12
Q

QUESTION 2
which statement made by the nurse indicates an accurate understanding of breast cancer
1. BRCA1 id on chromosome 13
2. if a woman has one affected first-degree relative then her risk of developing breast cancer triples
3. alterations in the kallikrein-kinin system increases the risk for breast cancer
4. women who inherit a mutation in BRCA2 experience a 50% to 80% lifetime risk of developing breast cancer

A

4.

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13
Q

BRCA1 or BRCA2

  • women who inherit a mutation in BRCA1 or BRCA2 experience a _____ to _____ lifetime risk of developing _____
  • genes responsible for this form of breast cancer have been mapped to chromosomes _____ (BRCA1) and _____ (BRCA2)
  • if a woman has one affected first-degree relative, her risk of developing breast cancer _____
A
50%
80%
breast cancer
17
13
doubles
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14
Q

MULTIFACTORIAL DISORDERS IN THE ADULT POPULATION
colorectal cancer
-is _____ only to lung cancer in the number of cases occurring annually in the US
-the risk is _____ to _____ times higher than the general population in those with one affected first degree relative
-clusters in families
-_____ gene mutations play a vital role in familial adenomatous polyposis
-_____ are involved in common colon cancers
-mutations in any of _____ genes cause hereditary _____
-environmental factors include a _____ diet

A
second
two
three
inherited adenomatous polyposis coli (APC)
somatic mutations
six
nonpolyposis colorectal cancer
high-fat, low-fiber
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15
Q

TYPE 1 and 2 DIABETES

  • type 1 diabetes is characterized by destruction of _____ and reduction/absence of _____
  • type 2 diabetes produces _____; cells have difficulty using the _____ thats produced
A

pancreatic beta cells
insulin
insulin resistance
insulin

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16
Q

MULTIFACTORIAL DISORDERS IN THE ADULT POP
diabetes mellitus
-is complex and not fully understood
-is the leading cause of _____, _____, and _____
-two major types
–type 1 (_____)
–type 2 (_____)

A
blindness
heart disease
kidney failure
insulin-dependent diabetes mellitus 
non-insulin-dependent diabetes mellitus
17
Q

MULTIFACTORIAL DISORDERS IN THE ADULT POP
type 1 diabetes
-is caused by the _____ destruction of _____ in the pancreas
–_____ activation and _____ production
-individuals with type 1 diabetes need _____ for life
-siblings of individuals with type 1 diabetes face a substantial _____ in risk
-incidence is higher in the offspring of diabetic _____
-association of specific _____ class _____ alleles is _____
-_____: genetic variation here is associated with a 10% increased risk
-other genes are also implicated

A
autoimmune 
insulin-producing beta cells 
T cell
autoantibody
insulin
elevation
fathers
human leukocyte antigen (HLA) 
II
40%
insulin gene
18
Q

MULTIFACTORIAL DISORDERS IN THE ADULT POP
type 2 diabetes
-more then _____ of all individuals with diabetes have type 2
-neither _____ nor _____ are present
-_____ is present or _____ is diminished
-risk factors include _____ and a positive _____
–_____ has a preventative effect
-recurrence risk
–_____ twins have a 90% risk
–first-degree relatives have a _____ to _____ risk
-genes:
–variant of _____ is associated with a _____ increased risk
–other genes: _____ and _____ are associated with increased risk
-_____ gene is associated with maturity-onset diabetes of the young

A
90%
HLA
autoantibodies
insulin resistance
insulin production
obesity
family history
exercise
MZ
15%
40%
TCF7L2
50% 
PPAR-y 
KCNJ11
glucokinase
19
Q

QUESTION 4
type 2 diabetes:
1. is highly correlated with reduced body mass index (BMI)
2. is caused by an absence of insulin
3. usually involves a gene identified as HLA
4. is often treated with lifestyle modification, including diet and exercise

A

4.

20
Q

Regarding type 2 diabetes, obesity is considered to be what type of risk?

a. genetic
b. empirical
c. relative
d. modifiable

A

d.

21
Q

type II diabetes

  • often treated with lifestyle modification including _____ and _____
  • this type of diabetes is highly associated with increased _____ and _____, thus weight loss is one goal of therapy
  • dietary modifications can aid weight loss and reduce total _____ load
  • type 2 diabetes is highly associated with _____ and increase in _____
A
diet 
exercise
BMI
obesity
glucose 
obesity
BMI
22
Q

MULTIFACTORIAL DISORDERS IN THE ADULT POP
obesity
-is a BMI _____ than _____
-BMI = _____ in kg (W) divided by _____ in meters squared (H^2)
-presents a substantial risk factor for _____, _____, _____, and _____
-gene for _____ and its receptors are related to obesity

A
greater
30
weight
height
heart disease
stroke
hypertension
type 2 diabetes
leptin
23
Q

MULTIFACTORIAL DISORDERS IN THE ADULT POP
alzheimer disease
-results in progressive _____ and loss of _____
-produces _____ plaques and _____ tangles
-risk _____ if first-degree relative has AD
-mutations for early-onset affect _____ deposition
–_____, _____, and _____ which is the primary cause of AD
-mutations for late onset AD
–allelic variation (_____, _____, and _____) in _____
–one copy of the E4 allele: at least _____ to _____ times at greater risk
–two copies of the E4 allele: at least _____ to _____ times more likely to develop AD

A
dementia
memory
amyloid
neurofibrillary
doubles
amyloid beta deposition
presenilin 1 (PS1)
presenilin 2 (PS2)
amyloid beta precursor protein (APP) gene
E2 E3 and E4
apolipoprotien E (APOE)
two
five
five ten
24
Q

MULTIFACTORIAL DISORDERS IN THE ADULT POP
alcoholism
-risk is _____ to _____ times higher in the individual with an alcoholic parent
-adoption studies:
-offspring of an alcoholic parent, even when raised by nonalcoholic parents, have a _____ increased risk
-offspring of nonalcoholic parents, when reared by alcoholic parents did not have an _____ risk
-twin studies: MZ and DZ pairs have a _____ and _____, respectively, increased risk
-genes:
-individuals with _____ allele are much less likely to become alcoholics
-allelic variation of _____ receptors increase the risk

A
three
five
fourfold
increased
>60%
<30% 
ALDH2*2
gamma-aminobutyric acid (GABA)
25
Q

MULTIFACTORIAL DISORDERS IN THE ADULT POPULATION
schizophrenia
-recurrence risk among offspring of one affected parent is _____ times higher than the general population
-if an individual has an affected sibling and an affected parent, then the risk is approximately _____
-if an individual has to affected parents, then the risk is _____
-twin and adoption studies
-MZ and DZ pairs have a risk of _____ and _____ respectively
-if the offspring of a schizophrenic parent are adopted by normal parents, then the risk is approximately _____ as the risk when raised by schizophrenic parents
-brain-expressed genes whose products interact with _____ receptors have been implicated

A
10
17%
46%
47%
12%
the same
glutamate
26
Q

MULTIFACTORIAL DISORDERS IN THE ADULT POP
bipolar affective disorder
-is also called _____ disorder
-risk rises between _____ and _____ if an individual has an affected first-degree relative, as compared with the normal risk of _____
-concordance rates are _____ and _____ for MZ and DZ twins, respectively
-genes that affect _____, _____, and _____ systems have been implicated
-schizophrenia and bipolar disorder:
-both are _____- reflects the influence of numerous genetic and environmental factors, making the _____ hard to identify and genetic analysis complicated

A
manic depressive 
5% 
10%
0.5%
79%
24%
serotonin
dopamine 
noradrenaline
heterogenous
phenotype
27
Q

MULTIFACTORIAL DISORDERS IN THE ADULT POP
other complex diseases:
-many other multifactorial diseases are also being studied
-some susceptibility genes have been identified

general principles of complex diseases

  • the more strongly inherited forms of complex disorders generally have an _____ age of onset
  • -often represent _____ inheritance
  • when _____ is a component, the _____ forms are more likely to cluster strongly in families
  • the sex-specific threshold model fits some of the disorders (_____, _____, _____, _____), but it can also fail to fit other disorders (_____)
A
earlier
single-gene
laterality
bilateral
pyloric stenosis 
CL/P
autism
heart disease
type 1 diabetes
28
Q

MULTIFACTORIAL DISORDERS IN THE ADULT POP
general principles of complex diseases
-the assumption that a genetic component means the course of a disease cannot be altered is _____; most diseases have both _____ and _____ aspects
-lifestyle modification (_____, _____, _____) can often reduce the risk for disease
-identifying a specific _____ can lead to more effective prevention and treatment of disease

A
incorrect
genetic
environmental 
diet
exercise
stress reduction
genetic lesion