Genetics Flashcards

1
Q

What is personalised medicine?

A

The idea to use some form of testing to identify a subgroup of patients who respond to treatmet involving genetic testing and understanding molceular pathways

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2
Q

What does personlaised medicine allow you to do?

A

Separate patients into subgroups of those who will benefit frmo a treatment and exclude those who won’t or will have severe side effects

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3
Q

What clinical signs can be seen in the nails in tuberous sclerosis?

A

Periungual fibromata

Longitudinal ridging

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4
Q

What is a genodermatoses?

A

A skin condition caused by a genetic cause

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5
Q

How can tuberous sclerosis present in infants?

A

Infantile seizures

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6
Q

What is the earlisest cutaenous sign of tuberous sclerosis?

A

Ash-lead macule

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7
Q

What are all the clinical signs of tuberous sclerosis?

A
Periungual fibromas 
Facial angiofibromas 
Seizures due to tumours in the cortical brain 
Hamaromas - angiomyolipomas 
Bone cysts 
Shagreen patches
Enamel pitting
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8
Q

What are angiofibromas often misdiagnosed as?

A

Acne (erythematous papules) but the defining difference as angiofibromas don’t have comedones

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9
Q

What type of inheritance does tuberous sclerosis show?

A

Autosomal dominant - denovo mutations are common

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10
Q

What chromosomes are affected in tuberous sclerosis?

A

Chromosome 9 and 16

TSC1 and TSC2 which code for tuberin and hamartin

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11
Q

What is the chance of passing on a mutation to offspring in classical autosomal dominance?

A

50-50 chance

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12
Q

What are the different mutation types?

A
Missence
Deletion (in frame) 
Nonsense (premature stop codon) 
Deletion (frameshift) 
Altered splice site
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13
Q

For what conditions is using genetics the most useful in treatment of diseases?

A

In high penetrance disorders due to the fact that they tend to have one pathway and therefore one drug which can control it

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14
Q

What is genetic heterogeneity?

A

Mutations at two or more genetic loci that produce the same or similar phenotypes

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15
Q

What is disease expression variability?

A

Different people are affeced differently - even within the same family

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16
Q

What is epidermolysis bullosa (EB)?

A

A group of genetic skin fragility conditions that can range for very mild blistering to extensive skin loss with any movement or touching of the skin

17
Q

What are the three types of EB?

A

Simplex
Junctional
Dystrophic

18
Q

What is simplex epipdermolysis bullosa?

A

Split occurs within the epidermis - mildest form

19
Q

What is junctional epidermolysis bullosa?

A

Split occurs within the DEJ

20
Q

What is dystrophic epidermolysis bullosa?

A

Split occurs within the dermis of the skin - complicatd by scarring

21
Q

How many genes are involved in epidermolysis bullosa?

22
Q

How many different types of keratin are there?

A

2 types - type 1 and type 2

Both are needed for proper structure of the skin

23
Q

What is haploinsufficiency?

A

Only one working copy of the gene - therefore there is reduced protein production

24
Q

What is dominant negative?

A

Expression of abnormal protein interferes with normal protein function

25
What is gain of function?
Mutant protein gains a new function, affecting cell processes
26
What is complete loss of protein?
Autosomal recessive - 2 faulty copies of gene produces no protein at all
27
What is the risk of passing a mutation to an offspring if the gene is recessive?
1 in 4 risk of an affected child if the parents are both carriers
28
How many cafe au lait patches are required on the skin to suggest a genetic disease?
More than 5
29
What are the clinical signs of neurofibromatosis type 1?
``` Cafe-au lait macules Neurofibromas Plexiform neuroma Axillary or ingunal freckling Optic glioma Lisch nodules Distinctive bony lesion ```
30
What is the neurofibromine pathway involved in?
Controls transcription factors for cell growth, specifically Raf, MEK and ERK
31
What are the genetic factors involved in skin barrier function failure in eczema?
Filaggrin
32
What are the genetic factors involved in immunology in eczema?
IL-4 and IL-13
33
What condition will filaggrin mutations cause?
Ichthyosis vulgaris
34
Histologically what is absent in ichthyosis vulgaris?
Keratihyaline granules containing pro-filaggrin granules