Chromosomes, abnormalities and birth defects Flashcards
Explain the classification of congenital defects: MALFORMATION
-Primary structural defect (cleft lip)
-Single organ showing multifactorial inheritance
(genetic and environmental)
Explain the classification of congenital defects: DISRUPTION
- Secondary abnormal structure of an organ or tissue (amniotic band causing digital amputation)
- Caused by ischaemia, infection and trauma (NOT genetic, only predispose)
Explain the classification of congenital defects: DEFORMATION
- Abnormal mechanical force causing distortion (club foot)
- Occurs in late pregnancy, good prognosis as underlying structure is normal
Explain the classification of congenital defects: SYNDROME
- Consistent pattern of abnormalities with a specific underlying cause (Down Syndrome)
- Includes chromosomal abnormalities
Explain the classification of congenital defects: DYSPLASIA
-Abnormal organisation of cells into tissues (thanatophoric dysplasia - short flat bones, small thorax, large head)
-Single gene defect
-↑ recurrence risk for siblings and offspring
Explain the classification of congenital defects: SEQUENCE
- Abnormalities initiated by a primary factor (↓ amniotic fluid = Potter sequence)
- Caused by oligohydramnios (↓ fluid due to failure to produce urine0
- Genes can be the initial factor
Explain the classification of congenital defects: ASSOCIATION
- Non-random occurrence of abnormalities NOT explained by syndrome
- Typically unknown cause
- VACTERL association - Vertebral, Anal, Cardiac, Tracheo-Oesophagal, Renal, Limb
What are the different types of chromosomes?
Metacentric = centromere in the middle Submetacentric = centre towards one side Acrocentric = No short arms, only satellites
What is a karyotype?
- Described in terms of both number and structure
- Visualised by staining with giemsa
- 22 pairs of autosomal and 1 pair of sex chromosomes
What does chromosomes binding/standard human banding pattern show?
Start from centromere (11)
- Chromosome number
- P or Q arm
- Band number
What is aneuploidy?
Numerical chromosomal abnormality -loss or gain of chromosomes Monosomy = loss of 1 (almost always lethal) Trisomy = gain of 1 (can be tolerated) Tetrasomy = gain of 2 (can be tolerated)
What are the types of structural chromosomal abnormalities?
- Translocations
- Rings
- Insertions
- Inversions
- Deletions
What is mosaicism (chromosomal abnormalities)?
Different cell lineages do not contain identical chromosomes (more than 1 lineages in tissue)
Outline partial aneuploidy (chromosome translocations)?
NORMAL = no translocation BALANCED = direct switch of DNA (no loss of genes) UNBALANCED = Part of chromosome is lost (non-viable embryo)
What happens when someone with balanced translocations undergo meiosis?
chromosomes form quadrivalent instead of bivalent
can cause disease
What is a derivative?
A chromosome that looks like it has had a translocation
Trisomy 21 - Down Syndrome (Clinical features)
1 in 700 birthe
Strong association between incidence and maternal age (above 35)
-Newborn period = severe hypotonia, excess nuchal skin
-Craniofacial = macroglossia, small ears, epicanthic folds, upward sloping palpebral fissures, brushfield spot
-Limbs = single palmer crease, wide gap between 1st and 2nd toes
Cardiac = Atrial and ventricular septal defects
Other = short statue, duodenal atresia
Trisomy 21 - Down Syndrome (Cause)
95% = non-disjunction during meiosis I (75%) and meiosis II (25%)
4% = Translocations
-Robertsonian translocation
-Mosaicism
What is Robertsonian translocation?
breakage of the.
acrocentric 21st chromosomes and fusion of the long arms
Trisomy 13 - Patau Syndrome
-Heart defects
-Holoprosencephaly (cleft lip/palate, hype
telorism = increased distance between two organs)
-Mental retardation
Trisomy 18 - Edwards Syndrome
- Heart defects
- Kidney malformation
- Digestive Tract defects
- Mental retardation
Monosomy X - Turner Syndrome
- Sex chromosome aneuploidy
- 1 in 3000 live female births
- Generalised oedema and neck swelling ( can be detected in 2nd trimester)
- Low posterior hairline, short 4th metacarpals, webbed neck, aorta defect in 15% of cases
- (ADULTS) short statue, ovarian failure/infertility
- TREATMENT = oestrogen replacement for secondary sexual characteristics and prevention of osteoporosis
Polysomy X - Kleinfelter’s Syndrome (47,XXY)
- 1 in 1000 live male births
- Clumsiness, verbal learning disability
- Taller than average, long lower limbs
- 30% moderately sever gynaecomastia
- Infertility
- ↑ risk of leg ulcers, osteoporosis and breast carcinoma
- X from either mother or father
How can someone with XX be male?
Due to translocation of the sex determining region on the Y (SRY) onto the X chromosome
Define dosage compensation
-Process by which organisms equalise expression of genes between members of different biological sexes
Mechanisms:
-Random inactivation of single X chromosome in females
-Increased (2) expression of X genes in males
-Decreased (0.5) expression of both X genes in hermaphrodites
What is a genomic disorder/copy number variant?
- Caused by a loss or gain of DNA/chromosome
- Most are harmless, natural process
- Harmless = small size. no important gene, inherited
- Harmful = gig, important gene, not inherited
What is an example of a deletion syndrome (genomic disorder)?
Di George Syndrome
- Cardiac abnormalities (tetralogy of Fallot) = a heart defect that features 4 problems
- hole between lower chambers, obstruction from the heart to the lungs, aorta lies over the hole in the lower chambers, muscle of the lower right chamber is overly thickened
- Hypoplastic thymus (underdeveloped)
- Hypocalcaemia (electrolyte imbalance)
Charcot Marie Tooth disease type 1 A
- Muscle weakness
- Hypotonia (floppy baby)
- Missing reflexes
- Foot deformities (high arches/flat feet)
- Lack of sensation in hands and arms
What is the PMP22 gene?
Peripheral Myelin Protein 22 gene = codes for an integral membrane protein in the myelin of the peripheral nervous system
Outline the classification of congenial defects
SINGLE: -Malformation -Disruption -Deformation -Dysplasia MULTIPLE: -Sequence -Syndrome -Association