Forms of Inherited Disease Flashcards

(52 cards)

1
Q

What are 3 types of genetic diseases that are inherited in different ways?

A

Monogenic (Mendelian)
Polygenic
Chromosomal disorders

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2
Q

What does congenital vs acquired mean?

A
Congenital = present at birth
Acquired = not inherited or present at birth
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3
Q

What is a polymorphism?

A

An allele variant that is present in more than 1% of the population

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4
Q

What is a variant?

A

Any loci that has more than one possible allele within the entire population, even if in less than 1%

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5
Q

What are the features of a gene that undergoes Mendelian inheritance?

A

The gene has two copies (maternal and paternal)
The copies of the gene separate into two gametes
The copies of the gene segregate independently

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6
Q
What are the features of an autosomal dominantly inherited disease gene?
In terms of
-penetrance
-expressivity
-onset
-gain/loss of function
A

Tends to have reduced penetrance
Variable expressivity
Late onset (onset after the affected individual has had children)
Usually ‘gain of function’ - only need one allele to gain function for there to be a problem

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7
Q

Example of an autosomal dominant condition

A

Huntington’s Disease

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8
Q

How can a loss of function mutation ever be dominant?

A

Haploinsufficiency

One correctly functioning allele is not enough to maintain normal function

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9
Q

Features of an autosomal recessively inherited gene
In terms of
-family history
-gain/loss of function

A

Often no family history
Can be homozygous of compound heterozygous
Usually ‘loss of function’ mutations

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10
Q

Example of an autosomal recessive condition

A

Phenylketonuria (PKU)

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11
Q

What does homozygous vs compound heterozygous mean?

A

Homozygous = Same mutation inherited from both parents

Compound heterozygous = Different mutations inherited in each allele, both cause same problem

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12
Q

Features of an X-linked recessive condition

A

No male-to-male transmission

Mainly affects males as they only have one X chromosome, female carriers less affected

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13
Q

Example of an X-linked recessive condition

A

Duchenne Muscular Dystrophy

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14
Q

Features of an X-linked dominant condition

A

Usually only found in females, as it is usually lethal in males so they do not survive

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15
Q

Example of an X-linked dominant condition

A

Rett Syndrome

Causes delayed development, autism, lack of speech, lack of ability to walk

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16
Q

What is X-inactivation?

A

Females have two X chromosomes, so one of them is inactivated, to prevent twice the amount of gene products
Which one is inactivated in random, but all descendants of that cell will have the same one inactivated
This leads to the pattern on female tortoiseshell cats

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17
Q

What does hemizygous mean?

A

One copy of a chromosome

e.g. males are hemizygous for the X chromosome

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18
Q

Name examples of non-mendelian inheritance

A
De novo mutations
Mitochondrial inheritance
Epigenetic inheritance
Mosaicism
Trinucleotide repeat disorders
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19
Q

What is mosaicism?

A

The mutation is not present in every genetically related cell
Can occur if a mutation occurs during early mitosis of a zygote
e.g. If it occurs during the first division, 50% of all cells will be affected

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20
Q

What is germline mosaicism vs somatic mosaicism?

A

Germline mosaicism = a mutation in the germline cells means that some gamtes carry the mutation and some don’t. Disease may occur in child and siblings
Somatic mosaicism = mutation arises post-fertilisation

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21
Q

What is mitochondrial inheritance?

A

Mitochondria come from the ovum, so are inherited maternally

Severity depends on if there is heteroplasmy or not

22
Q

What is heteroplasmy?

A

The presence of more than one type of organelle genome (e.g. mitochondrial genome) in a cell

23
Q

What are trinucleotide repeat disorders?

A

Repeats of a codon
Happens as a result of slippage during mitosis
More repeats = increased severity
Causes diseases that have anticipation

24
Q

What is anticipation?

A

The severity of the disease increases in subsequent generations due to an increase in the number of repeats

25
Example of a disease that shows anticipation
Huntington's Disease
26
What are epigenetics?
A modification of gene expression that is heritable | Caused by DNA methylation, histone modifications, non-coding RNAs
27
What is genomic imprinting?
Type of epigenetic mechanism | The pattern of gene expression depends on which parents pattern you inherit
28
Example of a mitochondrial inherited disease
Maternally inherited diabetes and deafness (MIDD)
29
Example of a disease caused by epigenetics
Prader-Willi Syndrome | Paternal inheritance
30
What is MODY? - stands for - inheritance pattern - monogenic/polygenic? - main symptom
``` Maturity Onset Diabetes of the Young Inherited form of diabetes Autosomal dominant Monogenic Not related to Type 1 or Type 2 No production of insulin OR beta cells don't release their insulin ```
31
What are the symptoms of MODY?
Early onset - usually before age 25 Usually normal body weight (BMI under 25) Causes hyperglycaemia - easily mistaken for Type 1 or Type 2
32
What mutations can be the cause of MODY?
Single mutation in hepatocyte nuclear factor genes (HNF1a/1b/4a) which express GLUT1 and GLUT2 transporters Or NEUROD1, IPF1 Or in glucokinase gene (GCK) that codes for pancreatic glucose sensor
33
What is the most common mutation cause for MODY?
Single base pair insertion in HNF1a Leads to a premature stop codon The RNA produced is subject to nonsense-mediated-decay Leads to haploinsufficiency of HNF1a
34
Why is MODY often mistaken for Type 1 diabetes?
Both have no release of insulin, leading to hyperglycaemia Both insulin-dependent Both have early onset Both not linked to obesity
35
What is the best treatment for MODY?
Sulphonylureas | K+ channel blockers, cause depolarisation of beta cells so they are more easily activated and release insulin
36
Why is it important to diagnose MODY?
Patients can receive treatment more suited to the underlying cause Family members can be screened and/or watch out for symptoms
37
What is the other type of monogenic diabetes, and what is the cause of this?
Neonatal diabetes Occurs in first 6 months of life May be permanent or transient Caused by mutations in the K+ channels on beta cells
38
What are the psychological issues surrounding MODY, and coming off insulin?
Patients that have been taking insulin their whole life may have built up a psychological dependence on it May cause loss of faith in doctors/medicine if they find out their current treatment is wrong
39
What are the two categories of genetic testing?
Molecular genetic test = looks at nucleotide sequence | Biochemical genetic test = looks for protein abundance/activity
40
What are 3 methods of screening foetuses for genetic disorders?
Ultrasound Amniocentesis Testing foetal DNA from cells that have entered the mothers bloodstream
41
What can be a detrimental effect of NMD?
Sometimes, the attenuated, partially functional protein is better than having no protein at all E.g. cystic fibrosis chloride channels
42
What are the 3 RNA surveillance mechanisms?
Nonsense Mediated mRNA decay Non-stop mediated mRNA decay No-go decay
43
What happens during Nonsense Mediated mRNA decay (NMD)?
When a transcript is produced with a premature stop codon in the last 30 nucleotides, it is phosphorylated by UPF1 Degrades incorrect mRNA transcripts to prevent production of harmful proteins
44
What happens during Non-stop mediated mRNA decay?
Detection and decay of mRNA transcripts that lack a stop codon Can be Ski7 mediated or non-Ski7 mediated
45
What happens during No-go decay?
Degradation of mRNA transcripts on which the ribosome has stalled, for example due to formation of a secondary structure
46
What happens when there is high amounts of glucose in the blood?
Glucose uptaken into pancreatic beta cells via GLUT2 transporters Glucose metabolised by glucokinase, producing ATP ATP sensitive potassium channels close, causing depolarisation VOCCs open allowing Calcium influx Vesicles containing insulin exocytose contents
47
What are the effects of insulin?
``` Cell growth Glycogenosis Fatty acid synthesis Protein synthesis Insertion of more GLUT4 transporters into the membrane ```
48
What happens when there is low amounts of glucose in the blood?
Pancreatic alpha cells secrete glucagon Glucagon increases glycogenolysis Hepatocytes release glucose into blood
49
What determines if a premature stop codon will lead to NMD or a truncated protein?
Stop codon in last 30 nucleotides = NMD | Stop codon before last 30 nucleotides = truncated protein
50
What is Huntington's disease? - inheritance - onset - prevalence - cause - symptoms
Autosomal dominant Middle age onset Rare Mutant protein becomes elongated, sticky, doesn't fold correctly, aggregates within cells Causes decline of motor abilities and cognitive abilities
51
What is Duchenne Muscular Dystrophy?
X-linked recessive Mutation in the dystrophin protein Dystrophin connects cytoskeleton of muscle fibre to the extracellular matrix Causes muscle weakness and wasting
52
What is phenylketonuria?
No production of phenylalanine hydroxylase, so build up of phenylalanine, which is toxic Causes learning difficulties and epilepsy