Genetically Inherited Diseases Flashcards

(43 cards)

1
Q

What are the three points of the etiology triangle of disease?

A

100% environmental
Single gene
Polygenic

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2
Q

What are some diseases typically associated with genes?

A

Duchenne Muscular Dystrophy
Haemophilia
Osteogenesis imperfecta

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3
Q

What are some diseases typically associated with the environment?

A

Tuberculosis and Scurvy

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4
Q

What are some diseases typically associated with both genes and the environment?

A

Spina bifida

Pyloric stenosis

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5
Q

What are some features of more genetic diseases?

A

Unifactorial
Rare
Mendelian - so high recurrence rate

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6
Q

What are some features of more environmental diseases?

A

Still genes involved but more polygenic
Multifactorial
Common
Low recurrence rate

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7
Q

What does it mean if a disease is multifactorial?

A

Caused by genes and the environment (drugs, infections) - variation in genes causing alteration of function - one organ system affected

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8
Q

What does it mean if a disease is single gene?

A

One mutation - normally loss of function - dominant/recessive pedigree patterns - can affect structural proteins, enzymes, receptors and transcription factors

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9
Q

What does it mean if a disease is chromosomal

A

Whole stretched of genome deleted (thousands of genes involved) (can be seen with cytogenically down a microscope) - chromosomal imbalance which causes alteration in gene dosage - affects multiple organ systems affected at multiple stages in gestation; can be inherited in rare cases

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10
Q

What does it mean if a disease is mitochondrial?

A

Mutation in the mitochondrial DNA

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11
Q

What does it mean if a disease is germline?

A

Still single cell mutations but more infrequent - sporadic mutations in onca and tumour genes

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12
Q

What are some of the impacts of childhood genetic disorders?

A

50% deafness/blindness/sever MR
25% in patient visits
40-50% deaths

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13
Q

What are some of the impacts of adult genetic disorders?

A

5% disorders/diseases

10% common cancers

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14
Q

Describe how metaphase spread works?

A

Stained with giesma
Dark region show dense bunched up DNA
Pale regions show less condensed DNA

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15
Q

What are acrocentric chromosomes?

A

P arm is much smaller than Q arm

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16
Q

What is a syndrome?

A

A disorder with a collection of features

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17
Q

What causes Down’s syndrome?

A

Trisomy of chromosome 21

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18
Q

What are some of the collective features of Down’s syndrome?

A
Round face
Protruding tongue
Up-slanting palpebral fissures
Epicanthic folds of eye
Developmental delay
19
Q

How can Down’s syndrome be diagnosed?

A

Can be diagnosed in utro prenatally so is screened for in pregnancy

20
Q

What features can be seen on the ultrasound?

A
Short femurs
Nuchal translucency
Echogenic bowel
Choroid plexus cyst
Sandal gap, single palmar crease
21
Q

What are the three different patterns of chromosomes that can cause Down’s syndrome?

A
  1. 95% people have three separate copies of chromosome 21
  2. 4% have extra copy of chromosome 21 because of Robertsonian translocation
  3. 1% have mosaicism with normal and trisomy 21 cell lines (and usually have much milder features because of the presence of normal cells) – occurs post zygotically
22
Q

What causes Patau syndrome?

A

Trisomy of chromosome 13

23
Q

Compare Patau syndrome to Down’s syndrome

24
Q

What are some collective features of Patau syndrome?

A
Affects midline structures:
Incomplete lobation of the brain
Cleft palate
Congenital heart disease (arterial septal defect)
Inguinal hernia
Postaxial polydactyly
25
What is the prognosis for Patau syndrome?
Poor prognosis - majority of babies die within first few weeks of life; if baby survives severe mental retardation
26
Why do trisomies occur?
When there is no disjunction (correct segregation) in meiosis, disomic and nullisomic gametes are formed. If a disomic gamete was to fuse with a monosomic gamete (spermatocyte and oocyte) a trisomy would form.
27
What are numerical chromosome abnormalities?
Gain or loss of complete chromosomes
28
What are the results of numerical chromosome abnormalities?
Serious, often lethal consequences (particularly autosomal) - MCA/MR syndromes
29
Name four microdeletion syndromes
DiGeorge syndrome William's syndrome Prader-Willi syndrome Cat Eye Syndrome
30
What causes DiGeorge Syndrome?
22q11.2 microdeletion
31
What are the features of DiGeorge Syndrome?
``` Small mouth Prominent nose Congenital heart defects Abnormal facies Thymic aplasia Cleft palate Hypocalcaemia/Hypoparathyroidism ```
32
What causes William's Syndrome?
7q11.23 microdeletion (about 26 genes from long arm of chromosome 7)
33
What are the features of William's syndrome?
``` Bright eyes Stellate irises Wide mouth Upturned nose Long philtrum Flattened nasal bridge Heart defects Inappropriately sociable ```
34
What causes Prader-Willi syndrome?
15q13 microdeletion
35
What are the features of Prader-Willi syndrome?
Hypotonia and abnormal neurological function Hypogonadism Developmental and cognitive delays Hyperphagia Obesity Short stature Behavioural and psychiatric disturbances Constant, extreme, ravenous insatiable appetite Marked skill in completing jigsaw puzzles
36
What causes Cat eye syndrome?
22 inverted duplication 22q11
37
What are the features of Cat eye syndrome?
``` Iris coloboma Anal atresia Ear tags and/or ear pits Heart defects Kidney malformations Marked variability ```
38
What is a pedigree?
Short hand to record a family tree
39
Why is diagnostic testing?
Part of clinical management. Confirm/refute clinical diagnosis. Assess carrier status
40
Who is diagnostic testing for?
Test an individual with a family history of the illness or other clinical indication. If early diagnosis reduces morbidity or mortality.
41
What is a karyotype?
Represents the cytogenetic characteristics of the individual - stained with giemsa for G banding
42
Which specimen contain spontaneously proliferating cells?
Bone marrow Lymph nodes Solid tumours Chorionic villi (CVS)
43
Which specimens are routinely cultured in the laboratory?
Blood lymphocytes Tissue biopsies (fibroblasts from skin etc) Amniotic fluid samples Long term CVS