Clinical Genetics 2022

Question 1

The use of a whole chromosome painting probe in FISH test does not allow to detect a:

A. trisomy
B. microdeletion
C. insertion
D. monosomy

Answer 1

Anki:
not sure: either microdeletion or insertion –> probably micro??

(bc often of insufficient complexity to detect subtle chromosomal changes)

Question 2

The following are the most typical anomalies seen in Patau syndrome:

A. hypertelorism, cleft palate, polydacyly
B. macrocephaly, cleft lip and palate, microphthalmia
C. cutis aplasia, cleft lip and palate, microphthalmia
D. polydactyly, cleft lip, macrocephaly

Answer 2

Anki:
cutis aplasia, cleft lip and palate, microphthalmia

(bc microcephaly)

Question 3

The 7q11.23 imbalance containing the ELN gene, presented in the picture, can be interpreted as:

A. DiGeorge syndrome
B. Williams syndrome
C. Smith-Magenis syndrome
D. Angelman syndrome

Answer 3

Williams syndrome

Extra:
DiGeorge Chr. 22
Smith-Magenis Chr. 17
Angelman Chr. 15

Question 4

Spinal muscular atrophy is characterized by the occurrence of:

A. subtypes classified by the age of onset and the severity of clinical symptoms
B. simultaneous mutations in SMV1 and SMN2 genes
C. intellectual disability
D. mutations in SMN2 gene

Answer 4

subtypes classified by the age of onset and the severity of clinical symptoms

Question 5

Cardinal features of Marfan syndrome include:

A. cataract and scoliosis
B. ectopia lentis and coarctation of aorta
C. aortic root enlargement and myopia
D. glaucoma and joint laxity

Answer 5

Anki:
Most likely C

old question says ectopia lentis and aortic root enlargement…
myopia is also present

Question 6

Generalised hypotonia with feeding difficulties that present in the first weeks of life are suggestive of:

A. Turner syndrome
B. Williams syndrome
C. Beckwith-Wiedmann syndrome
D. Prader-Willi syndrome

Answer 6

Anki:

Prader-Willi syndrome

Question 7

You are asked to consult a newborn baby on the Neonatal Ward. She was born at 38 weeks of gestation via caesarean section because of prenatally diagnosed
omphalocele. Her birth weight is 1800 g. An ultrasound of the heart revealed VSD. As for dysmorphic features you note: a small chin, prominent occiput and low set, abnormally shaped ears, club feet. What is the likely karyotype?

A. 47,XX,+13
B. 47,XX,+18
C. 45,X
D. 69,XXY

Answer 7

Anki:
probably 47,XX,+18

VSD is common in Edwards (Chr. 18)

Question 8

Regarding Down syndrome:

A. The palpebral fissures slope downwards
B. Brushfield spots are found in the mouth
C. Macroglossia may cause speech delay
D. AVSD is pathognomonic of the syndrome

Answer 8

Asli:
C. macroglossia may cause speech delay

(Anki:
I originally thought the palpebral fissures slope downwards but Asli checked with the teacher)

Extra:

• palpebral fissure is “the elliptic space between the medial and lateral canthi of the two open eyelids” –> abnormal (downwards) slanting of the eye most common in Down syndrome
• Brushfield spots are in Down but in the EYES
• (generalised macroglossia is uncommon, rather in Beckwith-Wiedemann syndrome, Hunter syndrome and hypothyroidism, but “Relative macroglossia can be seen normally on occasion but is most common in Down syndrome”)
• AVSD can also frequently be found in Downies

Question 9

What cancers, other than colon, belong to HNPCC spectrum of cancers?

A. skin cancer and endometrial cancer
B. ovarian and thyroid cancer
C. breast and ovarian cancer
D. endometrial and ovarian cancer

Answer 9

Asli:

endometrial and ovarian cancer

Question 10

Look closely at the pedigree, and then find an incorrect statement:

A. I2 is it woman
B. III3 is adopted
C. Ill6 is the proband
D. Il1 is affected with the disorder

Answer 10

Ill6 is the proband

bc arrow was pointing to III4

Question 11

A 4-year old girl was referred to clinical genetics unit due to lack of speech and psychomotor delay. Her parents are healthy. For the first two years her development was normal, she learned to walk and talk but in a few weeks’ time she lost both abilities. She also stopped playing with toys and continues to make movements with her hands that resemble washing. What is the most likely diagnosis for this child?

A. Williams syndrome
B. Rett syndrome
C. Angelman syndrome
D. Fragile X syndrome

Answer 11

Asli:

Rett syndrome

Question 12

Which of the following statements is true?

A. the undifferentiated primitive gonad is formed from the Wolff canals in males and Muller canals in females
B. the Wolff and Muller canals (ducts) develop into testes and ovaries, respectively
C. the presence of antimullerian hormone (AMH) causes the regression of the bipotential gonad
D. 5-alpha-reductase is an enzyme that converts testosterone into dihydrotestosterone

Answer 12

Asli:

5-alpha-reductase is an enzyme that converts testosterone into dihydrotestosterone

Question 13

Classical Huntington disease:

A. is a progressive disorder primarily of the muscular system
B. is caused by point mutations in the HTT gene
C. is curable with haloperidol and other neuroleptic drugs
D. leads to an early-onset dementia

Answer 13

Asli:

leads to an early-onset dementia

Question 14

The diagnostic criteria for neurofibromatosis type 1 include:

A. scoliosis and Lisch nodules
B. hypertension and plexiform neurofibroma
C. café-au-lait macules and learning difficulties
D. optic glioma and Crewe sign

Answer 14

Asli:

optic glioma and Crewe sign

Question 15

Name a genetic syndrome that does not present with primary amenorrhoea:

A. Turner syndrome
B. complete androgen insensitivity syndrome
C. FMR1-related premature ovarian failure
D. Rokitansky-Mayer- Kustner syndrome

Answer 15

Asli:

FMR1-related premature ovarian failure

Question 16

Amniocentesis should be recommended in the following clinical situation:

A. a 32-year-old woman in the 15th week of gestation whose sister has a child with simple trisomy 21 (47,XY,+21)
B. a 24-year-old woman in the 18th week of gestation whose husband is a carrier of a balanced robertsonian translocation between chromosomes 14 and 21
C. a 32-year-old woman in the 16th week of gestation with 1:1260 risk of Down syndrome estimated in an integrated non-invasive prenatal testing
D. a 23-year-old woman in the 19th week of gestation with no previous test estimating Down syndrome risk

Answer 16

Anki:
B

Extra:
Downie risk: 1/1,300 for 25-year-old woman; age 35, risk increases to 1/365. At age 45, risk increases to 1/30
- C has “normal risk” and D is young (= lower risk)
- A seems young-ish enough and maybe sister is old?
—> “Robertsonian translocation carriers specially 21-14 are the most common balanced rearrangement among the carrier couples with the history of spontaneous abortion” & “The risk of Down syndrome (trisomy 21) is elevated in the offspring of the rob(14;21) balanced carriers”

Question 17

The result for GTG analysis according to ISCN: 46,XX,del(5)(p15.3) means:

A. abnormal result, structural aberration, terminal deletion
B. abnormal result, numerical aberration, terminal deletion
C. abnormal result, structural aberration, interstitial deletion
D. abnormal result, structural aberration, terminal duplication

Answer 17

Anki:

abnormal result, structural aberration, terminal deletion

Question 18

Prader-Willi syndrome can be caused by:

A. a microdeletion of 15q11-13 in the paternal chromosome 15
B. paternal disomy of chromosome 15
C. a duplication of 15q11-13 in the paternal chromosome 15
D. a point mutation in the UBE3A gene

Answer 18

a microdeletion of 15q11-13 in the paternal chromosome 15

Question 19

Adult polycystic kidney disease is inherited as:

A. autosomal dominant trait
B. autosomal recessive trait
C. X-linked recessive trait
D. X-linked dominant trait

Answer 19

autosomal dominant trait

old question

Question 20

Following the birth of a child with 47,XX,+21 karyotype, the family should be offered:

A. cytogenetic analysis for each parent
B. cytogenetic analysis for siblings of the child
C. invasive prenatal diagnostics for the mother in each subsequent pregnancy
D. cytogenetic analysis for the mother and parents from the mother’s side

Answer 20

Anki:
B or C –> probably B?? (thinking about future siblings)

Extra:

• You can do NIPT (non-invasive) for Down (99% accurate)
• cytogenetic analysis for parents should not work/help because the parents are healthy
• (already born siblings should already have a diagnosis, but if it means future siblings, then yes, they definitely should be tested)

Question 21

In a newborn with large birth weight, hypoglycaemia and hemihypertrophy the most probable clinical diagnosis is:

A. Smith-Lemli-Opitz syndrome
B. Prader-Willi syndrome
C. Wolf-Hirschhorn syndrome
D. Beckwith-Wiedemann syndrome

Answer 21

Beckwith-Wiedemann syndrome

old question

Question 22

It is a well-known fact that an American actress, a carrier of a BRCA1 mutation, underwent prophylactic mastectomy. The most probable reason for her to do so
was:

A. as she approached the age of 40 and she wanted breast implants to look better
B. she wanted to lower her risk of developing ovarian cancer
C. she wanted to get rid of her BRCA1 mutation
D. she wanted to lower her risk of developing breast cancer

Answer 22

she wanted to lower her risk of developing breast cancer

Question 23

Which statement about Tay-Sachs disease is false?

A. it is common in the Finnish population
B. it is caused by hexosaminidase A deficiency
C. it affects the nervous system
D. it is usually lethal in infancy

Answer 23

Anki:
it is common in the Finnish population

(B & C correct for sure, life expectancy usually 3-4 or 5 years, doesn’t say anything about Finnish)

Question 24

A newborn with a coarctation of aorta, short neck, low neck hairline and high palate is likely to be diagnosed with:

A. Down syndrome
B. Patau syndrome
C. Klinefelter syndrome
D. Turner syndrome

Answer 24

Asli:

Turner syndrome

Question 25

Soft-tissue sarcomas, adrenal carcinoma and brain tumours constitute the spectrum of which cancer predisposition syndrome? A. von Hippel-Lindau syndrome B. multiple endocrine neoplasia C. Li-Fraumeni syndrome D. Lynch syndrome

Answer 25

Asli: | Li-Fraumeni syndrome

Question 26

What dysmorphic feature of the fingers is shown on the following picture? A. arachnodactyly B. polydactyly C. brachydactyly D. oligodactyly

Answer 26

polydactyly

Question 27

Molecular analysis of the BRCA1 gene is indicated in the following situations: (1) a woman with breast cancer diagnosed at the age of 35 with a negative family history for malignancy (2) a woman with endometrial cancer and a family history for the same malignancy (3) a female with bilateral breast cancer diagnosed at the age of 38 and 45 with a negative family history for malignancy (4) a woman with ovarian cancer diagnosed at the age of 56 with a history of mastectomy for cancer at the age 44 and a negative family history for malignancy A. (3), (4) B. (1), (3), (4) C. (1), (2), (3) D. (1), (2), (3), (4)

Answer 27

Asli: | 1), (3), (4

Question 28

The result for QF-PCR analysis: rsa(X)x1, (13,18,21)x2 means: A. normal result, female foetus B. abnormal result, female foetus, monosomy of X C. abnormal result, male foetus, monosomy of X D. abnormal result, female foetus, trisomy of X

Answer 28

abnormal result, female foetus, monosomy of X

Question 29

A woman has given birth to a child with trisomy 13. What is the most likely outcome? A. survival to early adulthood B. normal life expectancy C. death in under one week D. death between 1 and 2 years of age

Answer 29

Asli: | death in under one week

Question 30

Ambiguous genitalia may be a manifestation of the following, apart from: A. partial androgen insensitivity syndrome B. 5alpha-reductase deficiency C. congenital adrenal hyperplasia D. complete androgen insensitivity syndrome

Answer 30

Asli: | complete androgen insensitivity syndrome

Question 31

Which of the following is true? A. clinodactyly means short fingers B. hypertelorism means increased distance between the ears C. brachycephaly means a flat forehead D. amelia means absence of limbs

Answer 31

amelia means absence of limbs Extra: clinodactyly is abnormally bent/curved finger hypertelorism is between eyes brachycephaly is lower than normal ratio of skull's length to width

Question 32

Colon cancers associated with Lynch syndrome have the following characteristics apart from: A. predominantly affect the left colon B. early age of onset (below age 50) C. predilection for synchronous or metachronous colorectal tumours D. most exhibit microsatellite instability

Answer 32

Anki: A. predominantly affect the left colon (bc "This hypermutation phenotype is observed in nearly 15% of sporadic colorectal tumors and nearly all colorectal tumors that develop in patients with Lynch syndrome")

Question 33

Knudson's two-hit hypothesis describes: A. the activation process of protooncogenes B. the inheritance of an autosomal recessive trait C. the origins of fusion genes D. the inactivation process of tumour suppressor genes

Answer 33

the inactivation process of tumour suppressor genes

Question 34

Trastuzumab therapy for early breast cancer is effective in: A. individuals with BRCA1/2 mutations B. individuals with tumours harbouring KRAS gene mutation C. individuals with "triple negative" tumours D. individuals with cancers exhibiting HER2 amplification

Answer 34

individuals with cancers exhibiting HER2 amplification | HER2 is target

Question 35

In which of the following situations Amsterdam criteria Il are not met? A. proband: colon ca (45); mother: endometrial ca. (55); maternal grandfather: small bowel ca. (65) B. proband: endometrial cancer (51); sister: colon ca. (49); brother: colon ca. (46) C. proband: colon ca. (57); brother: colon ca. (49); father: colon ca. (67) D. proband: small bowel ca. (49); father: colon ca. (59); paternal grandmother: endometrial ca. (69)

Answer 35

proband: endometrial cancer (51); sister: colon ca. (49); brother: colon ca. (46) (bc not two successive generations described --> only siblings) Extra: Amsterdam criteria II: - at least three relatives with hereditary nonpolyposis colorectal cancer-associated cancer (all answers) - one is first-degree relative of other two - at least two successive generations - at least one needs to be diagnosed under 50 y.o. (all answers) - familial adenomatous polyposis should be excluded

Question 36

Oligodendrogliomas are characterised by the presence of: A. BCR-ABL fusion gene B. translocation between chromosomes 9 and 22 C. MITF amplification D. 1p/19q codeletion

Answer 36

1p/19q codeletion

Question 37

PALB2 germline mutations increase the risk of: A. breast and pancreatic cancers B. ovarian and thyroid cancers C. brain tumours and colon cancers D. endometrial and renal cancers

Answer 37

breast and pancreatic cancers

Question 38

Nijmegen breakage syndrome is characterised by: A. X-linked recessive inheritance pattern B. normal life expectancy C. increased risk for lymphomas D. multiple fractures of bones during lifetime

Answer 38

increased risk for lymphomas (half develop non-Hodgkin lymphoma before age 15) Extra: is autosomal recessive

Question 39

"Double minute chromosomes" are: A. small chromatin bodies containing amplified oncogenes B. small chromosomes that result from the fusion of p arms of chromosomes C. amplified satellites of acrocentric chromosomes D. extrachromosomal DNA that does not contain genes

Answer 39

small chromatin bodies containing amplified oncogenes

Question 40

The majority of chromosomal instability syndromes: A. increase a risk of various oncological diseases B. increase a risk of dementia C. have no clinical consequences D. have multifactorial etiology

Answer 40

increase a risk of various oncological diseases | old question

Question 41

Proto-oncogenes: A. are genes located outside the nucleus B. are viruses that initiate carcinogenesis C. are inactivated tumour suppressor genes D. when activated turn into oncogenes

Answer 41

Asli: | when activated turn into oncogenes

Question 42

HSR abbreviation means: A. high resolution chromosomes B. homogenously stained chromosomal regions C. homogenous regions in sister chromatids D. homogenous repetitive fragments in human genome

Answer 42

homogenously stained chromosomal regions

Question 43

Delayed ossification of nasal bone in foetus is: A. a major I trimester ultrasound marker for Down syndrome B. a minor I trimester ultrasound marker for Down syndrome and bone dysplasias C. a direct indication for invasive prenatal tests D. always syndromic and combined with major morphological anomalies in foetus

Answer 43

Asli: | a minor I trimester ultrasound marker for Down syndrome and bone dysplasias

Question 44

cffDNA means: A. cell free foetal DNA B. cancer fraction free DNA C. cell free fragmented DNA D. chorionic fragmented free DNA

Answer 44

cell free foetal DNA

Question 45

Number of miRNAs (micro RNAs) identified in human genome is A. 2000 B. 20000 C. 10000 D. 100000

Answer 45

2000

Question 46

One of the regulators of human biological age is A. number of mutations B. telomere length C. number of protein coding genes D. alcohol consumption

Answer 46

telomere length

Question 47

Chromosomes are present in the human cells A. only during cell division B. only during mitosis C. only during metaphase D. through the entire cell cycle

Answer 47

through the entire cell cycle

Question 48

Chromosome interactions during interphase are called A. crossing-over B. mating C. kissing D. transitioning

Answer 48

kissing

Question 49

What is the consequence of alternative-splicing? A. increase in number of transcripts B. decrease in number of transcripts C. increase in number of exons D. increase in number of introns

Answer 49

Asli: | a or b ??

Question 50

The optimal time for performing amniocentesis is: A. 11 - 13+6 hbd B. 15 - 18 hbd C. after 10th hbd D. after 19th hbd

Answer 50

Asli: | 15 - 18 hbd

Question 51

Find the correct combination: A. FAP - APC gene B. Li-Fraumeni syndrome - MLH1 gene C. Lynch syndrome - TP53 gene D. HBOC - EPCAM gene

Answer 51

FAP - APC gene

Question 52

Genetic counseling is needed in case of: A. a 28 y.o. woman who has already had 3 miscarriages; no need to test the partner of this woman B. a 2 y.o. boy who has a brother with karyotype 47,XY,+21 C. a 30 y.o. man whose father is diagnosed with the disorder which is caused by the mutation in HTT gene D. a 35 y.o. woman whose father was diagnosed with colon cancer at the age of 57 and her mother was diagnosed with cervical cancer at the age of 29

Answer 52

Asli: | a 30 y.o. man whose father is diagnosed with the disorder which is caused by the mutation in HTT gene

Question 53

Sequencing of mutator genes should be perform in case of the suspicion of: A. HNPCC B. Li-Fraumeni syndrome C. HBOC D. FAP

Answer 53

Anki: FAP?? (bc if paste whole question in google first result is FAP) Extra: HNPCC: Hereditary nonpolyposis colorectal cancer HBOC: Hereditary breast and ovarian cancer FAP: familial adenomatous polyposis

Question 54

In which hereditary cancer predisposition syndromes malignancy often appears before adulthood? A. FAP, HNPCC B. HBC, HOC, HBOC C. FAP, hereditary retinoblastoma, Li-Fraumeni syndrome D. hereditary retinoblastoma, hereditary gastric cancer

Answer 54

Asli: | FAP, hereditary retinoblastoma, Li-Fraumeni syndrome

Question 55

Bilateral, prophylactic mastectomy should be offered to: A. all patients diagnosed with breast cancer B. all patients diagnosed with breast cancer before 50 C. carriers of BRCA1/BRCA2 mutations who were diagnosed with breast cancer D. all carriers of BRCA1/BRCA2 pathogenic mutations

Answer 55

all carriers of BRCA1/BRCA2 pathogenic mutations

Question 56

Which criteria are met on the following pedigree: A. Chompret criteria B. Bethesda criteria C. Amsterdam Il criteria D. none of the above

Answer 56

Asli: | Amsterdam Il criteria

Question 57

A 30 y.o. women who already has a daughter diagnosed with DiGeorge syndrome is in 15 week of gestation. The result of first trimester screening test shows increased risk of Patau syndrome. What kind of genetic examination should be performed: A. NIPT (cffDNA) B. karyotype and molecular examination of the UBE3A gene C. karyotype and molecular examination of the MECP2 gene D. karyotype and FISH

Answer 57

Asli: | karyotype and FISH

Question 58

A healthy couple has two sons diagnosed with achondroplasia: A. the situation is not possible B. the situation is possible because of the risk of germline mosaic mutation C. they have 100% risk of having the third child with achondroplasia D. they have 50% risk of having the third child with achondroplasia

Answer 58

Asli: | the situation is possible because of the risk of germline mosaic mutation

Question 59

Which of the following are done as invasive prenatal genetic tests: A. PAPPA measurement B. NIPT (cffDNA) C. aCGH D. AFP measurement

Answer 59

Asli: | aCGH

Question 60

The fetus seen on the picture below should be diagnosed towards: A. campomelic dysplasia B. Wolf-Hirschhorn syndrome C. cri-du-chat syndrome D. thanatophoric dysplasia

Answer 60

thanatophoric dysplasia

Question 61

The following pedigree shows a family with two men with an "in-frame" deletion in the DMD gene. Who is an obligatory carrier? A. I.2, II.5, III.2, III.3 B. III.2, III.3, III.6 C. II.5, II.7, III.2, III.3 D. II.2, II.5, II.7

Answer 61

Asli: | I.2, II.5, III.2, III.3

Question 62

Increased nuchal translucency in a foetus: A. means that the foetus has Down syndrome B. rules out giving birth to a healthy child C. is a second trimester marker of chromosomal abnormalities D. may be a marker of congenital heart anomaly

Answer 62

Asli: | may be a marker of congenital heart anomaly

Question 63

A skull anomaly that originates from premature fusion of the sagittal suture and leads to a long and narrow head appearance is called: A. trigonocephaly B. plagiocephaly C. dolichocephaly D. normocephaly

Answer 63

Anki: dolichocephaly (long head) --> A & D not for sure Extra: trigonocephaly - premature fusion of metopic suture plagiocephaly - flat spot (from sleeping/lying same position) normocephaly - normal head shape

Question 64

A newborn was referred to a clinical geneticist because of ambiguous genitalia. Previous testing revealed a 46,XX karyotype. The next genetic test that should be offered is: A. androgen receptor gene sequencing B. FMR1 gene sequencing C. CYP21A gene sequencing D. sequencing of gene encoding 5-alfa-reductase

Answer 64

Anki: androgen receptor gene sequencing? Extra: "A 46,XX karyotype in a newborn with ambiguous genitalia indicates that the child is a genetic female who was exposed to excessive amounts of androgens during fetal life." "Maternal androgen excess due to maternal ovarian tumor or drug intake also causes female pseudohermaphroditism" - Female Pseudohermaphroditism - 5α‐reductase deficiency in males - 21-hydroxylase deficiency in females often --> Congenital adrenal hyperplasia

Question 65

Low birth weight, microcephaly, cleft lip with distinctive facial features of hypertelorism, prominent glabella and wide nasal bridge in a newborn suggest the diagnosis of: A. Wolf-Hirschhorn syndrome B. DiGeorge syndrome C. Patau syndrome D. Edwards syndrome

Answer 65

Wolf-Hirschhorn syndrome

Question 66

A man with achondroplasia marries a woman with the same disorder. Parents on both sides have height within normal range. What is the probability for this couple to have a child with a normal stature? A. 0% B. 25% C. 50% D. 100%

Answer 66

Anki: 50%? (internet says 50%)

Question 67

Pedigrees for autosomal dominant and X-linked dominant diseases are sometimes difficult to distinguish (exclude de novo mutations). What is true only for an X-linked dominant pedigree? A. both males and females are affected B. affected fathers have affected daughters C. affected mothers have affected sons D. affected males always have affected mothers (exclude de novo mutations)

Answer 67

Anki: affected mothers have affected sons (bc X usually affects more males so if mum is affected son will be 100% and daughter might not be)

Question 68

Find a false statement: A. individuals with Smith-Magenis syndrome commonly expose self-injurious behaviour B. individuals with Williams syndrome typically have an overfriendly personality C. individuals with Beckwith-Wiedmann syndrome usually have moderate intellectual disability D. individuals with Prader-Willi syndrome manifest hyperphagia in early childhood

Answer 68

Anki: individuals with Beckwith-Wiedmann syndrome usually have moderate intellectual disability (bc A, B & D correct)

Question 69

The result for QF-PCR analysis: rsa(X,13,18)x2, (21)×3 means: A. normal result, female foetus B. abnormal result, female foetus, trisomy of 21 C. abnormal result, male foetus, trisomy of 21 D. abnormal result, female foetus, trisomy of 13

Answer 69

abnormal result, female foetus, trisomy of 21 | bc 2xX and 3x21

Question 70

What is the explanation for a female carrier of DMD gene mutation to have clinical signs of muscle weakness? A. skewed X-inactivation B. a dominant mutation C. triple X in this female D. female carriers are never symptomatic

Answer 70

Ilja: A. skewed X-inactivation Extra: female carriers can sometimes have mild symptoms, DMD gene is on X chromosome

Question 71

Mutations that cause fragile X syndrome: A. typically they are non-sense mutations in the FMR1 gene B. in most cases arise as de novo mutations C. are dynamic mutations that may expand during life time of an individual D. result in no production of mRNA and hence no FMR1 protein

Answer 71

Asli: | result in no production of mRNA and hence no FMR1 protein

Question 72

Find a false statement about Charcot-Marie-Tooth disease: A. manifests clinically with muscle weakness, atrophy and pes cavus B. may be inherited in an autosomal dominant and recessive or X-linked pattern C. results from deterioration of anterior horn cells D. is characterised by sensory and motor neuropathy

Answer 72

Asli: | results from deterioration of anterior horn cells

Question 73

Which diagnosis is the most probable in a 15-year-old boy with muscle cramps, difficulties in running and climbing stairs, significantly elevated CK serum levels and primary myopathic electromyography (EMG)? A. Becker's muscular dystrophy B. spinal muscular atrophy C. fragile X syndrome D. juvenile Huntington's disease

Answer 73

Becker's muscular dystrophy

Question 74

The risk of hepatoblastoma and Wilms tumour (compared to the population risk) in increased in the following syndrome: A. Smith-Lemli-Opitz syndrome B. Smith-Magenis syndrome C. Beckwith- Wiedemann syndrome D. Silver-Russell syndrome

Answer 74

Beckwith- Wiedemann syndrome

Question 75

You are asked to consult a 10-year-old girl. She has short stature, is mildly mentally retarded, but very talkative and easy going; an ultrasound of the heart revealed an aortic stenosis. You learn that she had high calcium levels during childhood. As for dysmorphic features you note: a wide mouth and abnormal shape of the ears. What is the likely diagnosis? A. Turner syndrome B. Williams syndrome C. Down syndrome D. Prader-Willi syndrome

Answer 75

Williams syndrome

Question 76

The following is incorrect about Smith-Lemli-Opitz syndrome: A. the disease is caused by 7-dehydrocholesterol reductase deficiency B. 7-dehydrocholesterol serum levels are elevated C. total cholesterol serum levels are decreased D. 7-dehydrocholesterol urine levels are elevated

Answer 76

Anki: total cholesterol serum levels are decreased Extra: A is correct, B (and D?) too, bc have increased concentrations of 7DHC in body fluids and tissues "Cholesterol levels are usually low in SLOS patients, but they can also be normal"

Question 77

A balanced translocation between whole short arms of chromosomes 3 and 7 will be not detected using: A. FISH with whole chromosome painting probes B. aCGH C. GTG D. FISH with subletomeric probes

Answer 77

aCGH | bc method detects copy number alterations but not spatial rearrangements

Question 78

Which answer presents a correct matching of typical ocular signs and corresponding genetic syndromes? A. Williams syndrome - aniridia, neurofibromatosis type 1 - Lisch nodules B. Wilson disease - Keyser-Fleischer ring, Wolf-Hirschhorn syndrome - aniridia C. Williams syndrome - Brushfield spots, Marfan syndrome - ectopia lentis D. Wilson disease - stellate pattern of the iris, Patau syndrome - microphthalmia

Answer 78

Asli: | Wilson disease - Keyser-Fleischer ring, Wolf-Hirschhorn syndrome - aniridia

Question 79

Healthy parents have already one child with Hunter syndrome. Which sentence correctly describes the theoretical risk of recurrence in the offspring? A. there is a 25% risk of recurrence, sons and daughters are equally likely to be affected B. there is a 50% risk of recurrence, sons and daughters are equally likely to be affected C. there is a 25% risk of recurrence, only sons might be affected D. there is a 25% risk of recurrence, only sons might be affected

Answer 79

Asli: | there is a 25% risk of recurrence, only sons might be affected

Question 80

Molecular testing has revealed that a woman has 29 and 99 CGG triplet repeats in each of the alleles of the FMR-1 gene. Choose the correct statement: A. she must have intellectual disability B. she has no intellectual disability but is at risk of having children affected by fragile X syndrome C. she is healthy but is a mutation carrier D. she has two wild-type alleles

Answer 80

Asli: | she has no intellectual disability but is at risk of having children affected by fragile X syndrome

Question 81

You requested a methylation test in a girl with Prader-Willi phenotype. An abnormal result means? A. the girl has Angelman syndrome B. this is a conformation that the girl has a microdeletion in the critical region 15q11-13 C. this is a conformation that the girl has a maternal disomy of chromosome 15 D. this is a conformation that the girl has Prader-Willi syndrome, but the cause is not clarified

Answer 81

Asli: | this is a conformation that the girl has Prader-Willi syndrome, but the cause is not clarified

Question 82

Which genes would you test in a 30-year-old woman with breast cancer and strong family history of the disease? A. MLH1 and MSH2, B. only TP53 C. only BRCA1, BRCA2 D. BRCA1, BRCA2 and TP53

Answer 82

BRCA1, BRCA2 and TP53

Question 83

Achondroplasia - find a true statement: A. affects the long bone growth but does not affect the intelligence B. is characterised by a proportional short stature and is caused by a mutation in FGFR3 gene C. is caused by a mutation in bone growth factor and is inherited in an autosomal recessive manner D. is caused by a mutation in FGFR3 gene which in most cases is inherited from one of the parents

Answer 83

affects the long bone growth but does not affect the intelligence

Question 84

Mismatch repair genes encode proteins involved in: A. correcting double-strand breaks B. removing DNA adducts C. cellular proliferation D. correcting erroneously paired bases

Answer 84

Asli: | correcting erroneously paired bases

Question 85

Anti-EGFR monoclonal antibody therapy for metastatic colorectal cancer is effective in: A. individuals with Lynch syndrome B. individuals with tumours harbouring KRAS gene mutation C. carriers of the APC gene mutation D. individuals with cancers exhibiting HER2 amplification

Answer 85

Asli: | individuals with tumours harbouring KRAS gene mutation

Question 86

Hereditary colon cancer syndrome with an autosomal recessive pattern is associated with mutations in the following gene: A. APC B. MLH1 C. EPCAM D. MYH

Answer 86

Asli: | MYH

Question 87

Find a false statement about the MGMT promoter methylation: A. it is the only potential marker that predicts response to treatment with alkylating agents in glioblastoma B. it is constant in every tumour cell of a particular patient C. methylation of the MGMT promoter leads to loss of gene function D. the MGMT gene encodes a DNA repair protein

Answer 87

it is constant in every tumour cell of a particular patient

Question 88

Hereditary breast cancer is most frequently caused by mutations in: A. BRCA1 B. TP53 C. PALB2 D. APC

Answer 88

BRCA1

Question 89

Find a false statement about personalized treatment of oncological diseases in light of current evidence: A. it targets the so-called „drive mutations" B. it is used in case of breast and ovarian cancer, lung cancer, melanoma, gastrointestinal stromal tumour and metastasis of colorectal cancer C. detection of particular mutation in tumour cells is necessary to guide personalized treatment strategies D. targeted treatment is usually effective in every reoccurrence of the malignancy

Answer 89

targeted treatment is usually effective in every reoccurrence of the malignancy

Question 90

Olaparib, used in personalised ovarian cancer therapy, induces death of cancer cells with: A. TP53 mutations B. Her2 amplification C. either germline or somatic BRCA1 mutations D. KRAS gene mutation

Answer 90

either germline or somatic BRCA1 mutations

Question 91

Familial adenomatous polyposis: A. is characterised by the presence of hamartomas in the intestine B. increases the risk of endometrial cancer C. may have extracolonic manifestations D. may be caused by mutations in MSH2 gene

Answer 91

Anki: may have extracolonic manifestations (bc one old question asked which those were)

Question 92

Short stature in females with Turner syndrome is caused mainly by: A. haploinsufficency of IGF-1 gene that in localised in pseudoautosomal region 1 B. methylation of FGFR1 gene in pseudoautosomal region 2 C. haploinsufficency of SHOX gene that is localised in pseudoautosomal region 1 D. methylation of GHR gene in pseudoautosomal region 2

Answer 92

Asli: | haploinsufficency of SHOX gene that is localised in pseudoautosomal region 1

Question 93

Lumacaftor/Ivacaftor combined therapy is used for the treatment of: A. spinal muscular atrophy in patients with at least 2 copies of SMN2 pseudogene B. Duchenne muscular dystrophy in patients with „out-of-frame" mutations C. hyperphenylalaninemia caused by a deficiency of BH4 (tetrahydrobiopterin) D. cystic fibrosis in patients homozygous for F508del mutation

Answer 93

Asli: | cystic fibrosis in patients homozygous for F508del mutation

Question 94

Chromosome interactions are responsible for A. crossing-over B. gene transcription regulation C. gene transfer D. DNA repair

Answer 94

Anki: | (I think he said in class:) gene transcription regulation

Question 95

Indicate genes that do not code for proteins A. para-genes B. miRNAs C. immunoglobulins D. DNA repair genes

Answer 95

miRNAs

Question 96

A 25 y.o. women is in 12th week of gestation. Both partners are carriers of the SMN1 gene mutation. What genetic advice should be given? A. first trimester screening test and after that decision about invasive prenatal examination according to the results of the non-invasive test B. invasive prenatal test: karyotype should be the first-choice examination C. invasive prenatal test: targeted molecular test of the mutations which are already found in the family D. regardless of the result of the first trimester screening test - no indication for invasive prenatal test

Answer 96

Asli: first trimester screening test and after that decision about invasive prenatal examination according to the results of the non-invasive test

Question 97

The first-choice genetic test in case of the suspicion of spinal muscular atrophy is: A. aCGH B. MLPA of SMN1 gene C. sequencing of SMN1 gene D. FISH

Answer 97

Asli: | MLPA of SMN1 gene

Question 98

The microdeletion critical for DiGeorge syndrome can be detected using FISH technique with a: A. 22q11 centromeric probe B. 22 whole chromosome painting probe C. 22q11.2 locus specific identifier probe D. 22q11 subtelomeric probe

Answer 98

Asli: | 22q11.2 locus specific identifier probe

Question 99

Which of the following is true for neurofibromatosis type 1 (NF1)? A. there is no variability in phenotypic expression B. the penetrance is nearly 100% C. mutations causing the disorder never arise de novo D. the diagnosis of the disorder can only be made through molecular testing

Answer 99

Asli: | the penetrance is nearly 100%

Question 100

Male infertility may be caused by: 1) Klinefelter syndrome 2) MAIS 3) microdeletions involving AZF region(s) 4) CFTR mutations 5) 47,XYY karyotype A. 1, 2, 4 B. 1, 3, 4 C. 1, 2, 3, 4 D. 1, 2, 3, 4, 5

Answer 100

1, 2, 3, 4, 5