Genetics Flashcards

(93 cards)

1
Q

List the 7 types of congenital abnormalities and birth defects.

A
Malformation
Disruption
Dysplasia
Sequence
Association
Deformation
Syndrome
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2
Q

Define dysplasia.

A

Abnormal organisation of cells into tissue

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3
Q

What is the most common cause of Sequence e.g. Potter Sequence?

A

Oligohydramnios – reduced supply of amniotic fluid

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4
Q

What are the 3 types of chromosome?

A

Metacentric
Submetacentric
Acrocentric

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5
Q

Describe how chromosome banding works.

A

Starts at 11 at the centromere – different banding for different stains

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6
Q

What are the three different types of chromosomal abnormality?

A

Aneuploidy
Structural
Mosaicism

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7
Q

What is mosaicism?

A

The cells of an individual do not all contain identical chromosomes. There may be two or more genetically different populations of cells. E.g. one cell lineage will be Down Syndrome

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8
Q

What is the difference between a balanced and unbalanced translocation?

A

Unbalanced – there is a loss of genetic material

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9
Q

What could be the potential future issues for someone who has a balanced translocation?

A

Balanced translocations lead to the formation of quadravalents (rather than bivalents) during meiosis which can lead to strange exchanges in genetic material which can cause disease

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10
Q

List some clinical features of Down Syndrome.

A
Excess nuchal skin, sleepy, severe hypotonia 
Single palmar crease, sandal gap
Upwards slanting eye folds, macroglossia
Short stature
Cardiac abnormalities – ASD and VSD
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11
Q

List three possible causes of Down syndrome.

A

Non-disjunction during meiosis I or meiosis II
Robertsonian translocation – 2 acrocentric chromosomes break at the centromere and fuses to form a new chromosome
Mosaicism

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12
Q

What is monosomy X in females and what are the clinical features?

A

Turner Syndrome – webbed neck, infertile, normal intelligence, low posterior hairline

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13
Q

What is polysomy X in males and what are the clinical features?

A

Kleinfelter’s syndrome – tall, gynaecomastia, infertile, learning disability

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14
Q

How can someone who has sex chromosomes XX be male?

A

Due to a translocation in which the sex determining region on the Y (SRY) has been translocated onto the X chromosome.

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15
Q

What are genomic disorders?

A

Disorders in which there is a gain or loss of DNA

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16
Q

Give an examples of two genomic disorders.

A

Deletion – Di George syndrome

Duplication – Charcot-Marie-Tooth Disease Type 1A

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17
Q

State the differences between monogenic and complex diseases.

A

Monogenic diseases are rare, have a clear inheritance pattern and are not affected by environmental factors
Complex diseases are the opposite

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18
Q

State the difference between mutations and polymorphisms.

A

Mutations are any changes in genetic material that are hereditary
Polymorphisms are mutations which occur at >1% frequency in the population

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19
Q

State two different types of point mutations.

A

Non-sense and mis-sense

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20
Q

State two types of frame shift mutations.

A

insertion and deletion (InDel)

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21
Q

Give an example of an autosomal dominant disease and the mechanism of action.

A

Huntingdon’s Disease – mutations in the HTT gene on Chr 4, which codes for huntingtin. Mutation leads to production of a toxic protein that accumulates and forms clumps in organs. Causes cell death in the basal ganglia in the brain. It is caused by an unstable CAG repeat – the more repeats you have the more likely you are to get HD. Severity increases with time and age of onset decreases.

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22
Q

Give an example of an autosomal recessive disease and the mechanism of action.

A

Cystic Fibrosis – caused by a mutation in the CFTR gene on Chr 7, which affects chloride ion function in epithelial cells. Gives rise to thick mucus.

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23
Q

Give an example of a mutation in the same gene causing two different conditions.

A

Congenital absence of the vas deferens – caused by mutations in CFTR

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24
Q

Give an example of a X-linked recessive condition.

A

Haemophilia A and B – A is caused by a mutation in the F8 gene on Chr X which encodes factor VIII.
B – caused by mutation in F9 gene which encodes factor IX

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25
What are the general molecular mechanisms of the different types of genetic disease (autosomal dominant, autosomal recessive, co-dominant)?
Dominant – toxic product produced (treatment aims to neutralise toxic product) Recessive – absence of functional protein (treatment aims to regain function
26
What happens if the full genome of an embryo derives from one parent and what is the significance of this finding?
Paternal – hydatidiform mole Maternal – ovarian teratoma Shows that the origin of the parental DNA is important
27
What is the mechanism of imprinting?
DNA Methylation
28
Which base gets methylated?
5’ position on the pyrimidine ring of the cytosine
29
What is the general effect of methylation on the gene promoter?
Repressed gene transcription
30
The loss of function of a gene on which chromosome causes Prader-Willi and Angelman Syndrome?
Chromosome 15
31
State some symptoms of Prader-Willi Syndrome.
``` Hyperphagia Obesity Mental Retardedness Short Stature Hypotonia Infertility ```
32
State some symptoms of Angelman Syndrome.
Microcephaly Poor or absent speech Gait ataxia Severe developmental delay
33
What are the three possible causes of Prader-Willi and Angelman Syndrome?
Deletion of the PWS/AS critical region on chromosome 15 Uniparental isodisomy Other mechanisms e.g. translocations
34
Describe how uniparental isodisomy can lead to Prader-Willi and Angelman Syndrome.
Non-disjunction in meiosis 2 makes a gamete that has two copies of chromosome 15 resulting in a zygote with three copies of chromosome 15. Failure to remove the duplicated chromosome results in the zygote having two copies of chromosome 15 from the same parent.
35
How is PWS and AS diagnosed? Which genes near/in the PWS/AS critical region are used?
FISH – fluorescence in situ hybridisation PML (promyelocytic leukaemia) gene is just outside the PWS/AS critical region snRNP (small nuclear ribonucleoprotein) gene is inside the PWS/AS critical region
36
What phenomenon determines the severity of mitochondrial disease?
Heteroplasmy
37
State two examples of mitochondrial disease.
MELAS and LHON
38
State some symptoms of MELAS.
Mitochondrial encephalomyopathy (muscle weakness) Lactic Acidosis (vomiting, diarrhoea) Stroke Episodic seizures, headache, hemiparesis
39
What mutations cause MELAS?
MTTL1 – tRNA translated codon as Phenylalanine instead of leucine MTND1 and MTND5 – NADH Dehydrogenase subunits 1 and 5
40
State some symptoms of LHON.
Painless bilateral loss of central vision leading to blindness
41
Mutations in what genes cause LHON?
MTND1, 4,5 and 6 – NADH Dehydrogenase subunits 1, 4, 5 and 6 | MTCYB – cytochrome B
42
Give two examples of inborn errors of metabolism.
Phenylketonuria and MCAD deficiency
43
State some symptoms of Phenylketonuria.
Mental retardation Blonde hair/blue eyes Eczema
44
How is phenylketonuria detected? | What is the treatment for PKU?
Elevated levels of phenylalanine in the blood | Remove phenylalanine from the diet
45
What is a common feature of MCAD Deficiency?
Episodic Hypoketotic Hypoglycaemia
46
What is the treatment for MCAD Deficiency?
Maintain adequate calorie intake to prevent the body from switching to beta-oxidation.
47
What are the normal functions of tumour suppressor genes?
``` Regulate cell division Regulates apoptosis Regulates DNA Repair Monitors DNA damage checkpoint TSG is recessive ```
48
Describe the two hit hypothesis.
It takes two hits (both TSG must be mutated) for a cancer to start The first hit is usually a mutation The second hit is usually a larger deletion that removes the other allele and hence the function of the gene completely
49
What is 'haploinsufficiency'?
The idea that it only takes one hit to give the cell a selective advantage – a 50% decrease in protein is sufficient to give the cell a selective advantage
50
What is a common manifestation of the second hit?
Loss of heterozygosity – the deletion could remove other genes that are part of a heterozygous pair This means that that gene then appears homozygous as one of the alleles has been lost
51
What genes predispose to breast and ovarian cancer and what is the lifetime risk?
BRCA1 and BRCA2 | 60%
52
Describe the patho-genetic mechanism of BRCA genes.
BRCA genes are DNA repair genes (specifically, a process called homologous recombination) When these DNA repair genes are mutated the DNA repair proteins are impaired leading to dysfunctional DNA repair proteins which causes many further mutations
53
What are two diseases that predispose to colorectal cancer and what are the relative risks?
Familial Adenomatous Polyposis – nearly 100% | Hereditary Non-Polyposis Colorectal Cancer (HNPCC) – 80%
54
What are 'cytogenic changes'?
Visible changes in chromosome structure or number
55
Describe, broadly speaking, how translocations can cause cancer.
The translocation could lead to the formation of a new fusion gene that encodes a protein that has oncogenic properties
56
Explain the cause of Chronic Myeloid Leukaemia.
Translocation between chromosome 9 and 22 BCR gene from chromosome 22 and ABL gene from chromosome 9 fuse in the newly formed Philadelphia chromosome. The BCR-ABL fusion gene encodes BCR-ABL1 tyrosine kinase, which promotes CML
57
What protein does the fusion gene in CML produce?
BCR-ABL1 Tyrosine Kinase
58
Describe, using an example, a targeted therapy for CML.
Imatinib – inhibits the BCR-ABL1 tyrosine kinase
59
What are the three techniques of quantifying the level of CML in order of sensitivity?
Cytogenetic analysis Fluorescence in situ hybridisation RT-qPCR (Reverse Transcriptase Quantitative PCR)
60
What is the point in pharmacogenomics?
Using genetics to determine which patients will respond best to particular treatments
61
Give another example of a translocation causing cancer.
Acute Promyelocytic Leukaemia (APML) | Translocation between chromosome 15 and chromosome 17
62
Which two genes are involved in this translocation?
Chromosome 15 = PML (Promyelocytic Leukaemia) | Chromosome 17 = RARA (Retinoic Acid Receptor Alpha)
63
How does this translocation cause cancer?
RARA is a receptor that binds to Vitamin A and then binds to DNA and regulates transcription The translocation and resulting gene fusion changes RARA so that it binds to DNA too strongly These genes become silenced – the cell proliferates
64
What treatment is available for this cancer and how does it work?
All Trans Retinoic Acid (ATRA) | Binds to the DNA with greater affinity than the mutated RARA thus preventing gene silencing
65
What are the scans offered for a normal pregnancy?
Nuchal scan – 10-14 weeks Mid-trimester anomaly scan All pregnant women should be offered ultrasound scans at 20-22 weeks as well
66
When is a nuchal scan offered and what is it used to determine?
``` 12 weeks Date the pregnancy Multiple pregnancies Major foetal abnormalities Early miscarriage Risk of chromosomal abnormalities ```
67
What is considered an abnormal nuchal translucency and what would such a result suggest?
Greater than 3mm – indicates possibility of: Chromosomal abnormalities Birth defects Skeletal dysplasia
68
What are the three types of prenatal testing and which test fall under each category?
Non-invasive (ultrasound, MRI) Minimally invasive (maternal serum screening, cell free foetal DNA) Invasive (chorionic villus sampling, amniocentesis
69
What can ultrasound tests be used for?
Nuchal translucency Nasal bone Dating
70
When is maternal serum screening done?
11-14 weeks AND 16-20 weeks
71
What does maternal serum screening look for?
11-14 weeks = looks for presence of hCG and PAPP A | 16-20 weeks = looks for presence of hCG, PAPP A, AFP and uE3
72
In what situation is cell-free foetal DNA testing offered?
Offered in particular if the baby has a chance of having an X-linked condition
73
What is cffDNA used to determine?
The sex of the baby (looks for the presence of the SRY gene)
74
What are the limitations of NIPD and NIPT?
Multiple pregnancies – cannot tell which foetus the DNA is from High BMI – relative proportions of cffDNA is reduced in obese women Ethical issues
75
What are the benefits of NIPD and NIPT?
No risk of miscarriage | Reduces the need for more invasive testing
76
What is the problem with invasive prenatal testing?
Small risk of miscarriage
77
What is CVS and when is it done?
Chorionic villus sampling – take a sample from the chorionic villus which has the same genetic material as the foetus 11-14 weeks
78
What is amniocentesis and when is it done?
Taking a sample of amniotic fluid – 16+ weeks
79
What is amniocentesis and when is it done?
Taking a sample of amniotic fluid – 16+ weeks
80
What further tests are done to the DNA obtained via CVS or amniocentesis?
Karyotype | QF-PCR (test for trisomies)
81
Describe pre-implantation genetic diagnosis.
IVF is used to produce a zygote A cell is sampled at the 8-cell stage and tested to identify any genetic defects Only the cells with no genetic defects will be implanted
82
What are the eligibility criteria for PGD?
Female partner is under the age of 40 BMI above 19 and less than 30 No living unaffected children from this relationship Both partners are non-smokers
83
What are the three types of obesity?
Syndromic, Monogenic and Common
84
What is syndromic obesity commonly accompanied by?
Mental Retardation | Dysmorphic features
85
Describe the action of leptin.
Leptin is produced by adipocytes and travels to the brain to let the brain know how much fat is stored in the adipose cells and thus regulates feeding
86
What are some features of leptin deficiency?
Low thyroid function Immune problems Incomplete/lack of puberty
87
What is the treatment for leptin deficiency?
Recombinant leptin
88
Name some genes that cause monogenic obesity.
POMC PCSK1 MC4R MRAP2
89
What are Genome Wide Association Studies used for in relation to obesity?
To identify single nucleotide polymorphisms that are associated with obesity e.g. FTO
90
How many base pairs are there in the complete human genome?
6 billion
91
Give an example of pharmacogenomics being used to get the dosage right.
6-mercaptopurine is used to treat leukaemia, Crohn’s disease and ulcerative colitis People who have two normal copies of the TPMT (thiopurine methyl transferase) gene metabolise the drug fast and so have a high dose Some people are heterozygous for a mutation in TPMT so they metabolise the drug slower and so have more side effects. This means that they get a reduced dose. Very few people are homozygous for a mutation in TPMT – they barely metabolise the drug at all
92
Give an example of pharmacogenomics being used to get the drug right.
Type 1 Diabetes and Mature Onset Diabetes of the Young (MODY) MODY can be treated with oral drugs but is commonly misdiagnosed as T1D and so patients may be getting unnecessary insulin injections.
93
Give two examples of diseases for which DNA sequencing has been used to find the mutations responsible.
Miller Syndrome | Schinzel-Giedeon Syndrome