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Step 1 3.1.13 (2)
Genetics/Nutrition
Question | Answer |
---|---|
What is codominance what what is an example? | neitehr of 2 alleles is dominant= Blood groups A, B,AB |
What is variable expression and what is an example? | pheontype and severity vary from personm to person. ex. 2 people with neurofibromatosis type I can can different presentations |
What is incomplete penetrance? | not all people with mutant genotype show the mutant phenotype |
What is pleiotropy? What is an example | 1 gene>1 effect on a persons phenotype. Ex. PKU has many sx from retardation to hair and skin changes |
What is imprinting and what is example? | differences in phenotype depend whether the mutation is maternal or paternal in origin. ex. Prader-Willi and Angelman's syndrome |
What is anticipation and what is an example? | severity of disease is worse or age of onset is earlier in succeeding generations. Ex. huntington's |
What is loss of heterozygosity? What is an example? | patient inherits a mutation in a tumor surpressor gene. the complimentary allele also has to be deleted or mutated before disease develops. (not true for oncogenes). Ex. retinoblastoma |
What is a dominant negative mutation. What is an example? | heterozygote produces a nonfunctional altered protein that prevents the normal from working. Ex. TF is mutated in allosteric site. nonfunctiong mutant binds DNA preventing wild type bidning |
What is linkage disequilibrium? | tendency for certain alleles at 2 linked loci to occur together more often than by change. measured in populations |
What is mosaicism? | cells in body differ in genetic makeup due to postfertilization loss of genetic material, can be germline and produce disease not found in parental cells |
What are the 2 Hardy Weinberg equations? | p2 + 2pq+ q2=1, p+q=1 |
What might cause a hematologic mosaic individual? | mutation in the embryonic precursor of bone marrow stem cell |
What is the origin of a chimeric individual? | 2 zygotes that subsequently fuse |
What is locus heterogeneity and what are some examples? | mutation at different loci can produce same phenotype. Ex. Marfan's, MEN2B, and homocystinuria all cause marfanoid habitus. |
What is heteroplasmy? | presence of both normal and mutated mtDNA resulting in variable expression in mitochondrial inherited disease |
What is uniparental disomy? | offspring receives 2 copies of a chromosome from one parent and none from the other |
How do you calculate the frequency of homozygosity for a given allele in Hardy-Weinberg equilibrium? | p2 for p, q2 for q. |
how do you calculate the frequency of heterozygosity for a given allele ( carrier frequency) in Hardy Weinberg equilibrium? | 2pq |
What is the freqiuency of an X linked recessive disease in males vs females in Hardy Weingberg equilibrium? | males=q, females=q2 |
What are the 4 major assumptions in Hardy Weingberg equilibrium? | 1. no mutation at locus 2. no selection for genotypes at locus 3. random mating 4. no migration |
What is imprinting? | at a given loci, only 1 allele is active other is inactivated. If you delete the active allele it results in disease |
What chromosome is affected in both Prader Willi and Angelman syndromes? What other mech could they happen from? | both invovled Chr 15. Can also result from uniparental disomy |
Patient has mental retardation, hyperphagia, obesity, hypogonadism, and hypotonia. Dx and Mech? | Prader-Willi Syndrome. individual has normally inactivated maternal allele, paternal allele should be active but is deleted |
Patient has mental reatrdation, seizures, ataxia, and inappropriate laughter. Dx and mech? | Angelman's syndrome. individual has a normally inactivated paternal allele. The maternal allel should be active but it's deleted |
What types of things tend to be autoD? Who is affected in a pedigree? | often due to defect in structural genes. many generations both male and female are affected |
When do AutoD disease tend to present? | often pleiomorphic and present after puberty |
What types of things tend to be autoR? What is seen on pedigree? | 25% of offspring from 2 carrier parents are affected. often seen in enzyme deficiencies. usually seen in only 1 generation |
When do autoR present? | commonly more severe than autoD, often present in childhood |
What is seen in a pedigree in XLR? | sones of heterozygous mothers have 50% chance of being affected. no male to male transmission |
What are some common presentation of XLR? | disease is more severe in males, females have to be homozygous to be affected |
What is seen in pedigree in an XLD? | transmitted thru both parents. either male or female of an affected mother can be affected. ALL female offspring of an affected father are affected |
Patient has incr phosphate wasting at the proximal tubule. rickets like presentation. DX and inheritance? | Hypophosphatemic rickets. XLD |
What is seen in a pedigree of mitochondrial inheritance? | transmitted only through mom. All offspring of affected females can show disease. often due to failures in oxidative phosphorylation |
On microscopy, ragged red fibers are seen. DDX and inheritance? | loss of central vision: Leber's hereditary optic neuropathy, myoclonic epilepsy, mitochondrial encephalopathy. Mitochondrial myopathies that are mitochondrial inheritence |
Patient has dwarfism, short limbs but head and trunk are normal sized. Dx and mech and inheritance? What could be a causal factor? | Dx: Achondroplasia. Mech: cell signaling defect og fibroblast growth factor receptor 3. Inh: AutoD. Associated with advanced paternal age |
Adult Pt present with flank pain, hematuria, HTN, and progressive renal fialure. bilateral kidney enlargement. Dx and mech and inheritance? What are some key associations? | Dx: AutoD polycystic kidney disese Mech: mutation in PKD1 (90%) Inh: Auto D. Assocaitons: polycystic liver, berry aneurysm, mitral valve prolapse |
Pt present with adenomatous polyps in colon after puberty. Dx and mech and inheritance? | Dx: familial adenomatous polyposis. Mech: mutation of APC gene on Chr 5. Inh: AutoD |
Severe atherosclerotic disease early in life, achilles tendon xanthoma. possible MI before age 20. Dx and mech and inheritance? | Dx: familial hypercholesterolemia (HLD type IIA). Mech: defective or absent LDL receptor. Inh: Auto D. heterozygotes usally have cholesterol around 300 |
Pt has telangiectasia, recurrent epistaxis, skin discoloration, and ateriovenous malformations. Dx and inheritance? | Hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu) |
Pt has a hemolytic anemia and an incr mean corpuscular Hb concentration and FHx of same. Dx and mech and inheritance? Tx? | Hereditary spherocytosis due to spectrin or ankyrin defect. Auto D. Tx: splenectomy |
20-50 y/o pt comes in with depression, progressive dementia, chorea, caudate strophy and decr levels of GABA and Ach in the brain. Dx and mech and inheritance? | Dx: Huntington's disease. MEch: CAG repeat on chr 4. Inh: AutoD |
Pt is tall with long extremities, pectus excavatum, hyperextensive joint and arachnodactyly. Dx and mech and inheritance? Key associations? | Dx: Marfan's syndrome Mech: fibrillin gene mutation affecting skeleton heart, eyes. Inh: autoD. Assoc: cystic medial necrosis of aorta ( dissection), floppy mitral valve and subluxation of lens |
What gene mutation are MEN2A and 2B associated with? | ret gene |
Pt comes in with cafe-au-lait spots, neural tumors, pigmented iris hamartoms (lisch nodules) and possilbe scoliosis or optic gliomas. Dx and mech and inheritance? | Dx: Neurofibromatosis type 1. Mech: mutation on long arm of Chr 17. Inh: AutoD. |
Pt comes in with bilatreral acoustic schwannomas, juvenile cataracts. Dx and mech and inheritance? | Dx: Neurofibromatosis type 2. MecH: NF2 gene on Chr 22. Inh: autoD |
Pt comes in with facial lesions, ash leaf spots on skin, cortical and retinal hamartomas, seizures, retardation, renal cysts and renal angiomyolipoma, cardiac rhabdomyoma or astrocytoma. Dx and inheritance? | Dx: tuberous sclerosis Inh: autoD |
Patient comes in with hemangioblastomas of retina or cerebellum or medulla. possible bilateral renal carcinoma. Dx and mech and inheritance? | Von Hippel-Lindau disease. Mech: deletion of VHL tumor surpressor on Chr 3. results in constuitive expression of HIF transcription factor. Inh: AutoD |
Patient comes in with recurrent pulmonary infections with Pseudomonas and S. aureus, chronic bronchitis, bronchiectasis, pancreatic insufficiency, nasal polyps, meconium ileus. and possib;le infertility. Dx and mech and inheritance? | Dx: cystic fibrosis Mech: autoR defect in CFTR on Chr 7 usually DF508 abnormal folding Inh: autoR |
What is the diagnostic test for cystic fibrosis? | sweat test for Cl- ions |
What is the major Tx for CF? | N-acetylcystein to loosen mucus lugs (cleaves disulfide bonds) |
What is a mnemonic for the XLR disorders? | Be Wise Fools GOLD Heeds Silly Hope: (Burton's agammaglovbulinemia, Wiskott-Aldrich, Fabry's, G6PD def, Ocular albinism, Lesch-Nyhan, Duchennes MD, Hunter's Syndrome, Hemophilia A and B |
Why are female carriers rarely affect by XLR? | due to random deactivation of X in each cell |
A 4 yr old pt comes to the office and need its upper extremities to stnad up. cardiac myopathy is seen as well as calf hypertrophy. Dx and mech and inheritance? | Dx: Duchenne's MD Mech: XL frame shift deletion of the dystrophin gene and accelerated muscle breakdown. Starts at pelvic girlde |
What is the best diagnostic test for Duchenne's MD? | incr in CPK and muscle biopsy |
What is the difference b/w Becker's and Duchenne MD? | Becker's is a mutation but no frameshift in the dystrophin gene. Onset is in adolescence or early adulthood as opposed to <5y/o in Duchenne MD |
Pt presents with macroorchidism (big testes), long face with large jaw, large everted ears, autism and mitral valve prolapse. Dx and mech and inheritance? | Dx: Fragile X syndrome Mech: CGG repeat and inappropriate methylation of FMR1 gene. Inh: XLR |
What are 4 trinucleotide repeat disorders? | Huntington's, myotonic dystrophy, Friedrich's ataxia, fragile X |
What disease has a CGG repeat? | Fragile X |
What disease has a GAA repeat? | Friedrich's ataxia |
What disease has a CAG repeat? | Huntington's |
What disease has a CTG repeat? | Myotonic dystrophy |
A pt comes in with mental retardation, flat facies, epicanthal folds, simian crease, a gap b/w 1st 2 toes, duodenal atresia and ASD. Dx and mech and inheritance? | Dx: Down Syndrome Mech: trisomy 21 meiotic nondisjunction associated with advanced maternal age Inh: autosomal |
A U/s with incr nuchal translucency is assoc with? | Down syndrome |
A pregnancy screen test with decr alpha fetoprotein, incr beta HCG, decr estriol and incr inhibin A suggest? | Down Syndrome |
A pt has severe mental retardation, rocker bottom feet, micrognathia, low set ears, clenched hands, CHD. Dx and mech and inheritance? | Dx: Edwardss syndrome Trisomy 18 Mech: nondisjunction |
A pregnancy screen showin decr alpha fetoprotein, decr Beta HCG, decr estriol, and normal inhibin A is suggestive of? | Edwards syndrome: Trisomy 18 |
A child with severe retardation, rocker bottom feet, cleft lip/palate, holoprosencephaly, polydactyly, CHD. Dx and mech and inheritance? | Dx: Patau's syndrome: trisomy 13 |
A pregnancy screen with normal alphja fetoprotein, normal Beta hCG, normal estriol, and normal inhibin in the setting of retardation is? | Pataus syndrome: trisome 13 |
What Chr are most likely to undergo a Robertsonian translocation? | 13,14,15,21,22 |
Pt has microcephaly, moderate retardation, high pitched crying or mewing, epicanthal folds, and VSD. Dx and mech and inheritance? | Dx: Cri-du-chat syndrome (cry of the cat) Mech: congenital microdeletion of short arm of Chr 5 |
Child with elfin facies, mental retardation, hypercalcemia (incr sensitivity to vit D), well developed verbal skills and extreme friendliness with strangers. Dx and mech and inheritance? | Dx: Williams Syndrome Mech: congential microdeletion of long arm of chr 7 (incluses elastin gene) |
Pt with cleft palate or abnormal facies, Thymic aplasia, cardiac defects, hypocalcia secondary to parathyroid aplasas most likely has what chromosomal abnormality? What development is poor? | 22q11 deletion, abberant development of the 3rd and 4th branchial pouches |
A pt with thymic, parathyroid and cardiac congenital defect has? | DiGeorge syndrome: deletion of 22q11 |
A patient with palate, facial and cardiac defect has? | Velocardiofacial syndrome: 22q11 deletion |