Partial Chromosomal Deletions And Duplications ✅ Flashcards

1
Q

What does the phenotypic effect of a deletion or duplication depend on?

A

The genes it encompasses

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2
Q

In general, is a deletion or a duplication more likely to have a phenotypic effect?

A

Deletion

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3
Q

Why can partial chromosomal deletions and duplications be hard to diagnose?

A

With conventional karyotype, many of the common pathogenic deletions and duplications are too small to be visible on conventional karyotyping

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4
Q

What was historically required to diagnose many chromosomal deletions and duplications?

A

The clinician to recognise the disorder and request the correct FISH test

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5
Q

What has made the diagnosis of partial chromosomal deletions and duplications much easier?

A

Array CGH

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6
Q

Why has array CGH made the diagnosis of partial chromosome deletions and duplications much easier?

A
  • Much higher resolution than karyotyping

- Tests across the whole genome for microdeletions and duplications in a single test

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7
Q

What is the result of array CGH being better at detecting partial chromosomal deletions and duplications?

A

It has replaced karyotyping as the first line test for suspected chromosomal abnormalities in paediatrics

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8
Q

Give 2 microdeletion syndromes

A
  • 22q11 deletion syndrome

- Williams syndrome

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9
Q

What is 22q11 deletion syndrome also known as?

A
  • DiGeorge syndrome

- Velocardiofacial syndrome

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10
Q

What causes DiGeorge syndrome?

A

Deletion of 22q11 region of one copy of chromosome 22

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11
Q

What is the inheritence pattern of DiGeorge syndrome?

A

Autosomal dominant

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12
Q

Who else may be tested when a child is diagnosed with DiGeorge syndrome?

A

The parents

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13
Q

Why may it be helpful to test the parents when a child is diagnosed with DiGeorge syndrome?

A

The parents may have a milder phenotype and not be aware of it

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14
Q

Are more cases of DiGeorge syndrome inherited or de novo?

A

The majority are de novo

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15
Q

What are the characteristic facial features of patients with DiGeorge syndrome?

A
  • Long face
  • Narrow palpebral fissures
  • Over-folded ear helices
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16
Q

What is the limitation of the identification of DiGeorge syndrome based on facial features?

A

The facial phenotype is often subtle

17
Q

What medical complications might patients with DiGeorge syndrome experience?

A
  • Cardiac defects
  • Palatal abnormalities
  • Immune deficiency
  • Hypocalcaemia
  • Renal tract abnormalities
  • Mild to moderate learning difficulties/developmental delay
18
Q

What cardiac defects might be present in DiGeorge syndrome?

A
  • Tetralogy of Fallot
  • Interrupted aortic arch
  • Ventricular septal defect
  • Truncus arteriosus
19
Q

Give an example of a palatal abnormality that may be present in DiGeorge syndrome

A

Cleft palate

20
Q

What immune deficiencies may be present in DiGeorge syndrome?

A
  • Impaired T-cell production and function

- Thymic hypoplasia

21
Q

Who is at particularly high risk of hypocalcaemia in DiGeorge syndrome?

22
Q

What causes hypocalcaemia in DiGeorge syndrome?

A

Parathyroid dysfunction

23
Q

What is the chromosomal abnormality in Williams syndrome?

A

Deletion of a region of chromosome 7q11.23

24
Q

What gene is contained within chromosome 7q11.23?

A

Elastin gene

25
Is Williams disease inherited or de novo?
Usually de novo
26
How does Williams disease often present?
Poor feeding and hypocalcaemia as a neonate
27
What is the result of elastin deletion in Williams syndrome?
Arteriopathy
28
What arteries are affected in Williams syndrome?
Can affect any artery
29
What is the characteristic arteriopathic lesion in Williams syndrome?
Supra-valvular aortic stenosis
30
What are the characteristic facial features of Williams syndrome?
- Puffy etes - Long philtrum - Stellate iris
31
How does Williams syndrome present cognitively?
- Moderate learning difficulties | - Chatty demeanour and overfriendliness