DNA mutations and genetic testing Flashcards

1
Q

What is a polymorphism

A

the presence of 2 or more variant forms of specific DNA sequence that occur among different individuals or populations - most common type is single nucleotide polymorphism (SNP) but they can be larger involving longer stretches of DNA. Usually benign and helps to maintain variation in a population

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2
Q

what are the stop codons

A

UAA, UGA, UAG

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3
Q

what is a mis-sense variant

A

A single base substitution which changes the type of amino acid in the protein, can be both pathogenic and non-pathogenic. It could also be a polymorphism of no functional significance

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4
Q

what are the different types of variation

A
  • Duplications (of whole or parts of a gene)
  • ## Deletions (of whole genes or some exons)
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5
Q

what is an out of frame mutation

A

the removal or addition of one or more nucleotide which severely disrupts the production of the protein as the shift of bases causes different amino acids to be coded for e.g. duchenne muscular dystrophy

ATC GT(C) TTA CGC
to
ATC GTT TAC GCG

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6
Q

what is an in-frame mutation

A

A deletion where the reading frame of the gene is preserved - 3 nucleotides (1 codon) are removed - only 1 amino acid is no longer made and the other codons are unaffected

ATC (GTC) TTA CGC
to
ATC TTA CGC TGC

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7
Q

what is an exon

A

Segment of a DNA or RNA molecule containing information coding for a protein or peptide sequene

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8
Q

What is an intron

A

A segment of a DNA or RNA molecule which doesn’t code for proteins and interrupts the sequence of genes

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9
Q

what is a splice-site variant

A

It affects the accurate removal of an intron to make mature RNA containing only exons, so instead the intron is translated into the protein rather than being removed. This can also cause the loss of exons (or part of an exon) so they aren’t incorporated into the protein

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10
Q

where is a splice site

A

at the boundary of an exon and an intron

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11
Q

what is a non-sense variation

A

An out of frame deletion produces a stop codon at a deletion site or further along - causes the protein construction to be stopped prematurely - non-sense mediated decay

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12
Q

how do you tell between a pathogenic variant or a polymorphism

A
  • changes an amino acid which had been conserved through evolution (pathogenic)
  • Disrupts the active site or splice site (pathogenic)
  • Not seen in a large number of normal individuals
    seen previously in individuals with the same condition and shown to segregate with the disease (pathogenic)
  • functional studies showing an effect on protein function (Pathogenic)
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13
Q

Whats is a tri-nucleotide repeat (TNR) expansion

A

tri-nucleotide repeat (TNR) expansion is when the number of triplets (e.g. huntingtons = CAG) present in a mutated gene is greater than the number found in a normal gene, the number of repeats in the diseased gene increases as it is inherited so in the next generation the symptoms develop earlier and are more severe (anticipation)

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14
Q

what is anticipation

A

repeat gets bigger when transmitted to the next generation and so symptoms develop earlier and are more severe

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15
Q

what is allelic heterogeneity

A

lots of different variants in one gene e.g. cystic fibrosis

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16
Q

what is locus heterogeneity

A

variants in different genes give the same clinical condition e.g. hypertrophic cardiomyopathy

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17
Q

In which state does the dominant variant manifest the disease phenotype

A

heterozygous state - i.e. the condition occurs if there is one variant and one normal gene

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18
Q

In which state does the recessive variant manifest the disease phenotype

A

homozygous state - i.e. there has to be variants in both alleles for it to be expressed, the majority of pathogenic variants are recessive

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19
Q

what is a loss-of-function variant

A

Only 1 allele is functioning - most loss-of-function variants are recessive. If a pathway in the body is sensitive to the amount of gene product produced and only half is produced then it will not be able to function and this will cause a problem

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20
Q

what is haplo-insufficiency

A

The situation that occurs when one copy of a gene is inactivated or deleted and the remaining functional copy of the gene is not adequate to produce the needed gene product to preserve normal function.

21
Q

what are gain of function variants

A

A type of mutation in which the altered gene product possesses a new molecular function or a new pattern of gene expression. Gain-of-function mutations are almost always Dominant - they can cause a new trait to appear in inappropriate tissues or at inappropriate times in development. A variant may occur at the recognition site for protein degradation leading to an accumulation of undegraded protein within the cell

22
Q

what is a dominant-negative variant

A

where the protein from the variant allele interferes with the protein from the normal allele

23
Q

what are the different clinical contexts for genetic testing

A
  • Diagnostic
  • Predictive (plan for the future if going to be affected)
  • carrier (helps with decisions about bearing children)
  • pre-natal (to check the baby is affected or not - abortion?)
  • Pre-implantation genetic diagnosis (IVF)
  • Screening
  • susceptibility
24
Q

why would a patient get a diagnostic test

A

if they are showing signs and symptoms suggesting a diagnosis and so they have a test to confirm a clinical diagnosis. the issues involved are informed consent as other people may be affected by the results

25
Q

what is predictive testing used for

A

testing at risk family members for a previously identified familial variant - often dominant. The amount of intervention depends on the disease

26
Q

what is carrier testing used for

A

Autosomal recessive and X-linked disorders - usually done for couples as testing individuals in isolation is not that helpful for reproductive decision making

27
Q

what is pre-natal testing used for

A

it is used when there is an increased risk of a specific condition affecting the fetus e.g. a chronic villous test for downs, edwards or patau syndromes. Often they are chromosonal or DNA tests if a specific variant has been identified in the family. Issues with this involve counselling and decision making

28
Q

what is Pre-implantation Genetic Diagnosis (PGD)

A

they take an 8 cell embryo and under gentle suction with a pipette, one cell is removed making it free for analysis

29
Q

when is genetic screening used

A

the target population is for non-high risk families/an asymptomatic population to help identify those who are at high risk early to give them the best prevention and treatment odds or provide reproduction advice and options

30
Q

what is susceptibility testing used for

A

offered to individuals who have a family history of a genetic disorder and to people in certain ethnic groups with an increased risk of specific genetic conditions

31
Q

what are the roles of genetic testing

A
  • to confirm a clinical diagnosis
  • to give info bout prognosis
  • to inform management
  • to allow predictive testing relatives
  • carrier testing
  • give accurate recurrence risks
  • prenatal diagnosis
32
Q

what do you have to think about when undergoing genetic testing

A
  • is the test available
  • what type of test (carrier etc)
  • is consent full and informed, who else will it affect
  • what are the other implications ie employment, insurance etc
33
Q

What is FISH an what does it do

A

Fluorescence In Situ Hybridisation - used to test for abnormalities of chromosome number and chromosome microdeletions/duplications

34
Q

what does targeted mutation analysis test for

A

single nucleotide changes

35
Q

what do multi-gene panels test for

A

single nucleotide changes

36
Q

What does chromosome analysis test for

A

abnormalities of chromosome number and of chromosome structure

37
Q

what does chromosomal microarray analysis test for

A

abnormalities of chromosome number and chromosome microdeletions/duplications

38
Q

what is sanger sequencing

A

uses PCR to amplify regions of interest followed by sequencing of products - useful for single gene testing. Allows for 800 bps to be read - accurate and simple but slow and expensive

39
Q

what is next generation sequencing

A

Allows rapid sequencing of targeted gene panels, has improved speed over sanger (due to parallel analysis - enhances sequencing speed - can sequence whole genome in a day) and reduced man power and cost

40
Q

Sanger vs NGS

A

Sanger -
Single start point (primer)
Single DNA fragment sequenced
High cost per gene
Time consuming
Simple analysis (read the sequence)
Very accurate
The gold standard

NGS -
Library of DNA fragments
Massively parallel sequencing
Low cost per gene
Fast
Huge amounts of raw data to interpret
Moderately accurate

41
Q

Issues with NGS data analysis

A

NGS generates millions of short DNA fragments - need to be filtered for quality and aligned to a reference sequence, then you need to identify and interpret the variants - this all takes time - sifting through the noise of many different variants

42
Q

what does VUS mean

A

Variant of Unknown Significance

43
Q

what are some examples of databases of disease mutations

A

Decipher, OMIM, ClinVar

44
Q

what are incidental/secondary findings

A

findings that could have potential health and clinical significance that are beyond the aims of the original test

45
Q

Advantages and disadvantages of targeted panels

A
  • you select specific genes to sequence
  • less noise
  • fewer variants of uncertain significance
  • the panels need to be updated often
46
Q

how much of the genome gets sequenced by whole genome sequencing

A

95%< at a high cost and lower depth of coverage than whole exome sequencing and targeted sequencing

47
Q

how much of the genome gets sequenced by whole exome sequencing

A

~1.5% (protein coding regions) at a lower cost than whole genome and in more depth

48
Q

how much of the genome gets sequenced by targeted sequencing

A

0.005% - 0.1% (100s - 1000s of genes) at a lower cost and in more depth than whole genome and whole exome sequencing