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OBSTETRICS > 1M - Genetics > Flashcards

1M - Genetics Flashcards

1
Q

study of genes, heredity, and the variation of the inherited characteristics

A

Genetics

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2
Q

deals with the etiology and pathogenesis of human diseases that are at least partially genetic in origin, along with their prediction and prevention

A

medical genetics

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3
Q

study of gene function and interaction

A

genomics

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4
Q

how many percent of individuals is diagnosed with a genetic defect by age 15?

A

3%

2-3% newborns

8-10% by age 18, have one or more functional or developmental characteristics

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5
Q

biochemical gene marker for breast cancer?

A

BRCA 1 and 2

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6
Q

Which project identified more than 25,000 human genes which led to a rapid expansion of genomic research to better understand disease biology

A

Human Genome Project 2003

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7
Q

Genetic code varies every 200-500 base pairs usually as?

A

SNP (single nucleotide polymorphism)

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8
Q

How many single nucleotide polymorphism does the human genome have?

A

more than 80

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9
Q

Aneuploidy accounts for how many percent of 2nd trimester miscarriages?

A

20%

> 50% of 1st trimester miscarriages
6-8% of stillbirths and early childhood deaths

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10
Q

Trisomy 21`

A

Down Syndrome - 50% of aneuploidy cases

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11
Q

Trisomy 18

A

Edward - 15% of aneuploidy cases

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12
Q

Trisomy 12

A

Patau - 5% of aneuploidy cases

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13
Q

p in chromosome nomenclature stands for?

A

Short arm

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14
Q

q in chromosome nomenclature stands for?

A

long arm

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15
Q

nomenclature for trisomy 21 in a genetic male

A

47, XY, +21

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16
Q

Nomenclature for Klinefelter syndrome

A

47, XXY

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17
Q

Nomenclature for Turner Syndrome

A

45, X or 45, XO

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18
Q

How many chromosomes are there in a euploid?

A

46

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19
Q

how many chromosomes are there in a aneuploid?

A

gain or loss from 46

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20
Q

a polyploid chromosome has?

A

a multiple of haploid 23 e.g. 69

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21
Q

half of all chromosomal abnormalities?

A

Autosomal trisomy

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22
Q

Trisomy most commonly results from?

A

Non disjunction

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23
Q

How does non disjunction happen?

A

Failure to pair up
pairs up but separates prematurely
fail to separate

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24
Q

risk for any autosomal trisomy is greatly increased after reaching what maternal age?

A

35

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25
Q

From birth tilll ovulation the oocytes are suspended in what phase of meiosis?

A

Mid prophase of meiosis I

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26
Q

If non disjunction happens, the gamete which receives the affected chromosome when fertilized, results in?

A

Trisomy

the gamete that receives no copy, when fertilized results in monosomy

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27
Q

Aneuploidy is higher in sperm or oocytes?

A

oocytes

Oocyte vs sperm (10-20% vs 3-4 %)

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28
Q

after pregnancy with a trisomy, what is the risk of having another trisomy in future pregnancy?

A

1%

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29
Q

What procedures are ordered during pregnancies with history of trisomy?

A

Chorionic Villus sampling and amniocentesis

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30
Q

If there is history of pregnancy with unbalanced translocation or structural rearrangement. what procedure may be ordered for the parents?

A

parenteral chromosomal studies

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31
Q

most common non lethal trisomy

A

Down Syndrome

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32
Q

how many percent of fetal death rate beyond 20 weeks of gestation is caused by down syndrome

A

5%

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33
Q

Most common cause of trisomy 21? non disjunction, robertsonian translocation or Mosaicism?

A

Non disjunction - 75%

Robertsonian Translocation - 3-4 %

Mosaicisim - 1-2%

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34
Q

75% of cases of non disjunction happens during meiosis I or meiosis II?

A

Meiosis I

25% during meiosis II

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35
Q

Adult women with Down Syndrome are fertile or sterile?

A

fertile

Male with down syndrome are sterile

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36
Q

How many percent of the offspring of women with down syndrome will also have down syndrome?

A

33%

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37
Q

What particular cardiac defects may affect 50% of liveborn neonates with Down syndrome?

A

Ventricular septal defects and endocardial cushion defect

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38
Q

Those with down syndrome are more at risk of what GI defects?

A

Esophageal atresia
hisrschsprung disease
duodenal atresia

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39
Q

What are the characteristic features of those with Down Syndrome?

A

brachycephaly
Epicanthal folds with upslanting palpebral fissure
brushfield spots (grayish spots on the periphery of the iris), flat nasal bridge and hypotonia
infants with loose skin along the nape
single palmar crease
sandal toe sign
hypoplasia of the middle phalanx of the 5th finger

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40
Q

Prognostic health problems for those with Down Syndrome?

A 
Hearing loss
Severe optical refractive errors
cataracts
Obstructive sleep apnea
thyroid diseases
leukemia
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41
Q

Degree of mental impairment?

A

Mild to moderate

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42
Q

Average IQ of those with down syndrome

A

35-70

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43
Q

Social skills of those affected with down syndrome are higher than predicted by their IQ scores. True of False?

A

True

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44
Q

What is the 10 year survival rate of those with Down Syndrome?

A

at least 90%

99% for those without major malformations

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45
Q

What is the 1 year survival rate of Edward Syndrome?

A

2%

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46
Q

Edward syndrome is recognized 1 in 2000 pregnancies while only 1 in 6600 liveborn neonates. The reason for being less recognized in liveborn neonates is caused by?

A

High in utero lethality and termination of affected pregnancies

more than half die within the first week

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47
Q

what organ system is affected by Edward Syndrome?

A

Virtually every organ system

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48
Q

Common major anomalies found among those with Edward Syndrome

A 
VSD
cerebellar vermian agenesis
myelomeningocele
diaphragmatic hernia, omphalocele, imperforated anus
horseshoe kidney
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49
Q

Cranial and extremity abnormalities among those with Edward syndrome

A 
Prominent occiput
posteriorly rotated and malformed ears
micrognathia
clenched hands with overlapping digits 
radial aplasia with hyperflexion of the wrist 
rocker bottom feet with clubbing
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50
Q

A strawberry shaped cranium is noted among 40% of cases of Edward Syndrome. What causes this?

A

Abnormally wide cavum septum pellucidum and choroid plexus cyst

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51
Q

If pregnancy with Edward Syndrome progresses until the third trimester? What is the common fetal complication

A

Fetal growth restriction with mean birth weight of less than 2,500g

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52
Q

Trisomy 13 or Patau Syndrome can be mostly caused by autosomal non disjunction or robertsonian translocation?

A

autosomal non disjunction

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53
Q

Organs affected in trisomy 13 or Patau syndrome?

A

virtually all organs

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54
Q

characteristic findings on those with Patau syndrome?

A 
holoprosencephaly (no division of brain into hemispheres)
microcephaly
hypotelorism
single nostril or proboscis
VSD
cephalocele
microphthalmia
omphalocele
Cystic renal aplasia
polydactyl
rocker bottom feet
areas of skin aplasia
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55
Q

1 week survival rate Patau Syndrome

A

3%

1 week survival rate of 40%

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56
Q

Trisomy 13 also poses risk to the mother. True or false?

A

True

Other aneuploids dont

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57
Q

What risk does trisomy 13 pose to the mother?

A

Preeclampsia and hyperplacentosis

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58
Q

What does the chromosome 13 carry which predisposes the mother to preeclampsia when bearing pregnancy with Trisomy 13 (patau syndrome)

A

gene for SFLT-1

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59
Q

Most common trisomy found in 1st trimester loss

A

trisomy 16

60
Q

polyploid is rare in later gestations. T or F

A

True

61
Q

Counseling, prenatal diagnosis and delivery options for polyploidy is similar to what trisomies?

A

Trisomy 13 and 18

62
Q

recurrence risk for triploidy?

A

1-1.5%

63
Q

Diandric triploidy in which the extra chromosome comes paternally is also called?

A

Type 1 triploidy

64
Q

This results from fertilization of 1 egg by two sperms or single diploid sperm?

A

Diandric triploidy or type 1 triploidy

65
Q

Diandric triploidy results in partial or complete molar pregnancy?

A

Partial

66
Q

What molar pregnancy occurs mostly during the first trimester? partial or complete

A

partial molar pregnancy diandric triploidy

67
Q

Dygynic triploid pregnancy or type 2 triploidy has extra paternal or maternal chromosomal sets?

A

Maternal

68
Q

This triploidy occurs when the egg fails to undergo the first or second meiotic division before fertilization?

A

Dygynic triploidy or type 2 triploidy

69
Q

a fetus with triploidy expresses asymmetrical growth restriction, what type of triploidy is present?

A

Type 2

70
Q

Type of triploidy occuring mostly during the second and third trimester?

A

Dygynic triploidy

71
Q

Post zygotic failure to complete an early cleavage division can result in what kind of polyplopidy?

A

Tetraploidy (92, XXYY or XXXX)

72
Q

only monosomy compatible with life?

A

Turner syndrome (45, XO)

73
Q

most common aneuploidy in first trimester loss?

A

Turner syndrome (20%)

74
Q

Turner syndrome is associated with maternal age. T or F?

A

False

75
Q

how many percent of pregnancies with turner syndrome yield liveborn nenonate?

A

1%

76
Q

A patient grows to have a webbed neck due to cystic hygromas, short stature and impaired cognitive development, what is the most probable genetic abnormality?

A

Turner Syndrome

77
Q

What is administered to patients with Turner syndrome to ameliorate for the short stature?

A

Growth hormone

78
Q

what is the appropriate prenatal screening test for Turner syndrome?

A

Cell free DNA test

79
Q

What form of turner syndrome will need prophylactic gonadectomy for those with y chromosome and streak ovaries?

A

mosaicism

80
Q

The extra X chromosome in triple X syndrome is derived from maternal or paternal chromosome?

A

Maternal

81
Q

children with triple x syndrome are first diagnosed when due to learning disability and attention deficit disorder and low overall cognitive scores?

A

School age

82
Q

For each extra x chromosome in triple X syndrome what happens to the IQ score?

A

IQ score becomes lower

83
Q

this is the most common sex chromosome abnormality?

A

Klinefelter syndrome (47, XXY)

84
Q

In Klinefelter syndrome, there is no normal virilization. This results in?

A

gonadal dysgenesis

85
Q

Due to gonadal dysgenesis, what supplement is needed for those with Klinefelter syndrome?

Growth hormone and estrogen is for Turner syndrome as _____ is to Klinefelter syndrome?

A

Testosterone

86
Q

A tall male patient suddenly develops gynecomastia and upon physical exam, presents with testicular atrophy, female pubic hair. What is the possible genetic abnormality?

A

Klinefelter Syndrome

87
Q

In 47, XXX or XYY, the more Y chromosomes are present, the more the patients are at risk of?

A

Congenital abnormalities, medical problems and intellectual disability

88
Q

Deletions and duplications mostly occur during?

A

Meiosis

89
Q

What test permits the identification of deletions and duplications?

A

Chromosomal microarray analysis

90
Q

Genetic abnormality presenting as happy puppet appearance with mental retardation, ataxia, hypotonia and seizures. This is due to defect in maternal genes at 15q 11.2-q13

A

Angelman Syndrome

91
Q

Genetic abnormality that presents as abnormal laryngeal development which makes a cat like cry together with hypotonia and mental retardation. This is due to defects in 5p 15.2-15.3

A

Cri-du-chat

92
Q

Genetic abnormality presenting as hypogonadotropic hypogonadism and anosmia. Genetic defects at Xp22.3

A

Kallman Syndrome

93
Q

What genetic abnormality is characterized by obesity, hypotonia, mental retardation, hypogonadotropic hypogonadism and small hands and feet. The genetic defect is at 15q. 11.2-q13 within the paternal genes.

A

Prader willi syndrome

94
Q

What genetic abnormality is characterized by cardiac defects, cleft palate, velopharyngeal incompetence, thymic and parathyroid abnormalities and developmental delay. The affected genes are at 22q 11.2

A

Di George syndrome

95
Q

Form of translocation that begins when breaks occur in two different chromosomes and broken fragments between them exchange so that each affected chromosome contains a fragment of the other and no chromosomal material is gained or lost in the process.

A

Balanced or Reciprocal Translocation

96
Q

What is the risk of major structural or developmental abnormality in apparent balance translocation?

A

6%

97
Q

Robertsonian translocations involve only acrocentric chormosomes. What are the acrocentric chromosomes?

A

13, 14, 15, 21, 22

98
Q

In Robertsonian Translocation, which arms are retained and fuse at one centromere? p or q arms?

A

q arms

99
Q

A child or fetus is found to have a translocation trisomy, what test should be conducted for the parents?

A

karyotyping and preconceptual counselling

100
Q

The most common isochromosome involves what part of the gene?

A

Long arm of the X chromosome (iXq)

101
Q

This is the etiology of 15% of Turner Syndrome cases?

A

IXq isochromosome

102
Q

These abnormal chromosomes are composed of either 2 q arms or 2 p arms of one chromosome fused together. These are also thought to arise when the centromere breaks transversely instead of longitudinally during meiosis II or mitosis

A

isochromosome

103
Q

Results from breaks in both the p and q arms of a chromosome, such that the inverted material includes the centromere.

A

Pericentric Inversion

Abnormal gametes and and abnormal offspring

104
Q

Results from breaks of both p and q arms of a chromosome but the inverted material does not include the centromere.

A

Paracentric inversion

Normal gametes and low risk for abnormal offspring

105
Q

Happens when there is deletion at each end of the same chromosome.

A

Ring Chromosome

106
Q

If telomeres are lost, the gene becomes unbalanced. True or false?

A

False

Even when telomeres are lost, all necessary genetic material are retained and therefore, the gene is still balanced.

107
Q

A ring X chromosome results in what genetic abnormality?

A

Turner Syndrome

108
Q

This happens when an individual has two ore more cytogenetically distinct cell lines that are derived from a single zygote.

A

Mosaicism

109
Q

When considering inheritance. What is either dominant or recessive? Phenotype or genotype?

A

Phenotype

110
Q

This explains how different mechanisms can result in the asme phenotype

A

Genetic heterogeneity

111
Q

indicates that a specific phenotype can be caused by mutations in the different genetic loci

A

Locus Heterogeity

112
Q

Describes how different mutations of the same gene may affect presentation of a particular disease

A

Allelic heterogeneity

113
Q

explains how different disease state can arise from different mutations in the same gene

A

Phenotypic heterogeneity

114
Q

If only one copy of the gene pair determines the phenotype, the gene is said to be dominant or recessive?

A

Dominant

115
Q

What are the factors that affect phenotype of an autosomal dominant condition?

A

Penetrance, expressivity and presence of co dominant genes

116
Q

This characteristic describes whether or not the dominant gene is expressed at all.

A

Penetrance

117
Q

This characteristic determines the degree if manifestation fo the condition that may range from mild to severe

A

Expressivity

118
Q

Diseases that only develop when both gene copies are abnormal

A

Autosomal recessive

119
Q

this is known to be an inborn deficiency of phenylalanine hydroxylase.

A

Phenylketonuria

Patients will have hair, eye and skin (albinism) hypopigmentations

120
Q

What is the treatment for phenylketonuria?

A

Phenylalanine restriction alone.

121
Q

Where does the X chromosome of a male person come from? Maternal or paternal?

A

Maternal

That is why males with X linked diseases cannot have affected sons and most X linked diseases are obtained by males.

122
Q

X linked dominant diseases mainly affect males or females?

A

Females because X linked dominant diseases are usually fatal to males

123
Q

How many percent of their daughters will males with X linked dominant disorders have the disease?

A

100%

All of them will have the X gene from their father which will be phenotypically expressed

124
Q

Are all sons affected by the X linked dominant gene?

A

No

their X chromosome will come from their mother. They will only be affected if their mother also has the X linked disease

125
Q

Deletions of genes on the long arm of the Y chromosome results in?

A

Severe spermatogenic defects

126
Q

Homoplasmy and heteroplasmy of the mitochondria can be determined among offsprings? True or false

A

False

127
Q

This is a phenomenon in which the disease symptoms deem to be more severe and to appear at an earlier age in each successive generation

A

Anticipation

128
Q

Fragile X syndrome, an X linked disease is dependent on what to determine the degree of clinical normalcy or impairment?

A

CGG repeats

129
Q

This is the most common cause of autism or autism like behavior?

A

Fragile X syndrome

130
Q

How many repeats of CGG is necessary to affect those with Fragile X syndrome?

A

45

Unaffected - less than 45
Intermediate - 45-54
premutation - 55-200
full mutation - more than 200

131
Q

What test are done at prenatal diagnosis for those with history or risk of fragile X syndrome?

A

Amniocentesis or chorionic villus sampling

132
Q

An individual presents with unexplained intellectual disability, developmental delay and autism. What possible X linked disorder does the person have?

A

Fragile X syndrome

133
Q

This term describes some genes that are inherited but not expressed.

A

Imprinting

134
Q

Examples of disease that may form due to imprinting?

A

Prader Willi syndrome and Angelman Syndrome

135
Q

This disease is characterized by obesity
and hyperphagia; short stature; small hands, feet,
and external genitalia; and mild mental
retardation and may be caused by maternal gene imprinting with paternal gene inactivation

A

Prader Willi Syndrome (microdeletions and disruptions at 15q11.3-q13 of the paternal gene)

136
Q

This disease is characterized by severe intellectual
disability; normal stature and weight; absent
speech; seizure disorder, ataxia and jerky arm
movements; and paroxysms of inappropriate
laughter. This may be caused by paternal gene imprinting with maternal gene inactivation.

A

Angelman Syndrome (microdeletions and disruption at 15q11.2-q13 of the maternal gene)

137
Q

According to ACOG, all pregnant women should have the option of what test for genes?

A

Aneuploidy screening and prenatal genetic diagnosis

138
Q

What test is commonly done to test for chromosomal abnormalities?

A

Karyotyping or cytogenic analysis

139
Q

During karyotyping, the cells are arrested at metaphase, what technique is most commonly done which yields the G-bands?

A

Giemsa staining

140
Q

This technique can be used for rapid identification of
a specific chromosome abnormality and for
verification of suspected microdeletion or duplication
syndromes, such as the 22q11.2 microdeletion. (Di George syndrome)

A

Fluorescence In Situ hybridization (FISH)

Done when diagnosis affects management of pregnancy. Used for rapidness of about 2 days.

141
Q

This test is 100 times more sensitive than standard
karyotyping and detects microduplications nad
microdeletions as small as 50 to 100 kilobases.

A

chromosomal microarray analysis

142
Q

This genetic test is offered as a
first-tier test when fetal structural abnormalities are
identified.

A

CMA

143
Q

In pregnancies at increased risk for autosomal

trisomy based on aneuploidy screening, what is the recommended test?

A

Karyotyping of FISH plus Karyotyping

144
Q

If CMA fails to arrive at a diagnosis, what other test may be done?

A

Whole Genome Sequencing and Whole Exome sequencing

Genome - for genome
Exome - only the DNA coding regions

145
Q

What DNA fragments come from apoptotic trophoblasts which are used in testing for single gene disorder, Trisomy testing, fetal sex determination and RHD genotype?

A

Cell Free DNA

OBSTETRICS (36 decks)

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