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MCBM > Craniogacial Dysmorphologies > Flashcards

Craniogacial Dysmorphologies Flashcards

1
Q

What are 1st pharyngeal arch disorders:

A
  1. Treacher Collins Syndrome

2. Pierre Robin Syndrome

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2
Q

What are 3/4th pharyngeal arch disorders

A
  1. digeorge syndrome

2. velocardiofacial syndrome

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3
Q

how do you get treacher collins syndrome

A
  1. malformations in 1st and 2nd pharyngeal arch derivatives; lack of nerual crest migration/population
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4
Q

what is the candidate gene for Treacher collins syndrome

A

Tcof1; transcription factor gene found on chromosome 5

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5
Q

what are features of TC syndrome

A
  1. malformation of facies, skull, eyes, ears nose and palate
  2. narrow face, hypoplastic supraorbital rims and zygomas
  3. sunken cheekbones
  4. malformed pinnae
  5. receding chin and downturned mouth
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6
Q

what is coloboma

A

notch on eyelid that can be in iris or other structures of eye

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7
Q

how do you get pierre robin syndrome

A

hypoplasia of mandible prior to week 9:
position of fetus in utero causes a constriction in the way the chin is pressed up against chest causesand backwards placement of tongue. the tongue cant get away in time for PS to flip up and fuse.
end up with cleft and hypoplatic jaw which keeps tongue placed backwardly which causes problems with respiration. Have short mandible. This corrects itself after birth. This is mechanical not genetic!

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8
Q

what are features of DiGeorge syndrome

A
  1. absence of thymus (immune system) and paraythyroids (calcium met)
  2. micrognathia: small jaw
  3. hypertelorism: wide set eyes
  4. low set, posteriorly angulated ears
  5. short philtrum: fish mouth deformity
  6. choanal atresia
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9
Q

How is DiGeorge syndrome inherited

A

AR, AD, sporadic; also can be induced by teratogens

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10
Q

What is the cause of DiGeorge Syndrome

A

lack of nerual crest cell migration into 3rd and 4th pharyngeal pouches.

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11
Q

what are candidate genes for digeorge syndrome

A
  1. Tbx1 and TUPLE- embryonic transcription factor genes found on chromosome 22.
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12
Q

Velocardiofacial syndrome is a ___monosomy

A

22q11 (deletion); similar to Digeorge

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13
Q

What does CATCH 22 stand for in velocardiofacial syndrome

A 
C: cardiac
A: abnormal facies
T: thymic hypoplasia
C: cleft palate
H: hypocalcemia
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14
Q

Cleft lip results from failure of ____ prominence to fuse with medial ____ prominence

A

maxillary; nasal

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15
Q

Cleft palate is caused by failure of the ____ ___ to fuse

A

palatine shelves

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16
Q

Which ethnic group is most affected by cleft lip/palate

A

japanese

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17
Q

what are risk factors for cleft/lip palate

A
  1. smoking
  2. alcohol
  3. retinoic acid
  4. dilantin
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18
Q

what is thyroglossal duct cyst

A

persistence of the thryoglossal duct results in cyst formation at the base of the throat

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19
Q

what is ankyloglossia/tongue tie

A

caused by frenulum that extends too far anteriorly, limiting movement of the tongue

20
Q

what is pharyngeal fistula

A

pharyngeal pouch 2 and pharyngeal grove 2 persist; forms opening from internal tonsilar area to external neck

21
Q

what is pharyngeal cyst

A

pharyngeal grooves persist, usually near angle of mandible

22
Q

what is ectopic thyms

A

abnormal migration of gland tissue from embryonic origin

23
Q

what are features of A1H1 Hypoplastic

A
  1. thin enamel overall in males
  2. regions of thick and thin enamel in female
  3. AmelX mutation
  4. Amelogenin defect
  5. X linked inheritance
24
Q

what are features of A1H2: hypomineralized

A
  1. Ameloblastin defect
  2. Enamel is of normal thickness bt is extremely soft
  3. AD inheritance
25
Q

what is dentinogenesis imperfecta

A

blue/gray coloration of teeth. Enamel flakes away and splits off easily.
-Caused by Dspp mutation

26
Q

what is most disabling to the process of embryogeniss

A
  1. Growth factors (FGF)
  2. Growth factor receptors (SHH)
  3. transcription factors (Gli3, TWIST)
27
Q

what is craniosynostosis

A

premature fusion of the cranial structures; changes shape of head

28
Q

what are some shapes of premature fusion of cranial sutures

A
  1. metopic: pointy

2. coronal: growth out in 1 direction

29
Q

what are types of syndromic craniosynostosis:

A
  1. Pheiffer: clover like head
  2. apert/crouzon
  3. saethre-chotzen
  4. greig cephalopolysyndactly
30
Q

what are non syndromic types of craniosynostosis

A

can be induced mechanically; compression associated due to:

  • multiple fetuses
  • uterine malformation: fetus grows on one side
31
Q

How many FGF genes are there? what is it for?

A

22; FGF signaling alters levels of many TF’s impt in dev of bone, cartilage and teeth.

32
Q

Most FGFR mutations are clustered around

A

Ig domain 3; gain of function type of mutaiton; dimerize on their own w/o FGF around; send PKC act signal for cytoskeletal org, also inhibits apoptosis, aso causes proliferation (MAPK signaling)

33
Q

FGFR mutations that cause craniosynostosis result in ___ type of mutation due to self dimerization.

A

gain of function type of mutaiton; dimerize on their own w/o FGF around; send PKC act signal for cytoskeletal org, also inhibits apoptosis for suture formation, also causes proliferation (MAPK signaling)

34
Q

fgfr3 gene causes ___

twist gene causes ____

A

achondroplasia (dwarfism)

saethre-chotzen (TF act by FGFR signaling)

35
Q

If proline convertts to argenine it causes receptor to ____

A

dimerize

36
Q

what is Apert syndrome

A

fgfr2 mutation:

  1. AD inheritance
  2. osseous syndactyly
  3. coronal craniosynostosis
  4. mental deficiency
  5. +/- cleft palate
37
Q

What are features of Saethre chotzen syndrome

A
  1. AD inheritance
  2. coronal cranio synostosis
  3. maxillary hypoplasia
  4. facial assymetry
  5. hypertelorism
  6. cutaneous syndactyly
38
Q

what is holoprosencephaly

A

a dev field defect of impaired midline cleavage of the embryonic forebrain.

39
Q

Heterogenous causes and pathology of holoprosencephaly

A
  1. 15-20% genetic causes: SHH signalers:
    - AD w wide expressivity and incomplete penetrance
    - AR
    - X linked
  2. Teratogens: alcohol, RA
  3. Maternal DM
  4. maternal hypocholesterlomeia: too little cholesterol
40
Q

____ is a signaling protein found to be defective in many forms of holoprosencephaly

A

SHH

41
Q

Other proteins in the pathway include: patched which is a SHH receptor for ____binding, smoothened whch is SHH receptor for ____ and ____ which is a TF

A

ligand; signaling; gli3

42
Q

SHH has a ____ peptide which sends it to the ER and will be cleaved off by signaling peptidase which makes it go to ER and Golgi and gets secreted. Also has two major domains

A

signaling

43
Q

what are the SHH domains

A

Signaling domain

autocatalytic cleavage and cholesterol transferase domains

44
Q

why does SHH need cholesterol

A

SHH req cholesterol binding in order to be rec by its receptor. Transfers cholesterol and cleaves itself off which is active form of SHH

45
Q

what is SHH signaling pathway

A
  1. binds to patched which then
  2. activates smoothened (actual signaling component) which then activates
  3. Gli TF
  4. ACtivates other growth factors and more of its own receptor
46
Q

no hypothalamus:

A

no thyroud funciton
no rep function
diabetes insipidis

MCBM (59 decks)

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