Exam II Review Slides Flashcards
List the four current screening (non-invasive) techniques.
- Maternal serum screening
- Sequencing of cell-free DNA in maternal plasma (NIPT)
- Prenatal ultrasound
- Fetal MRI
List the five current diagnostic (invasive) techniques.
- Amniocentesis
- Chorionic villus sampling
- Cordocentesis
- Fetal biopsy
- Pre-implantation genetic diagnosis (PGD)
List the timeline for prenatal testing.
Pre-
PGD
8-10 Weeks
Dating US
9-10+ Weeks
NIPT
11-13 Weeks
NT, MSS, CVS
15-18 Weeks
2nd Trimester MSS
15-19 Weeks
Amnio
18-20 Weeks
Fetal Anomaly Scan
What are the three widely accepted clinical applications for PGD?
- Single gene diagnosis by PCR
- Familial chromosome arrangement by FISH
- Fetal sex selection
When is it acceptable to perform PGD when there is a single gene diagnosis by PCR?
- Autosomal
- X-Linked (usually untreatable or lethal)
When is it acceptable to perform PGD when there is a familial chromosome rearrangement detected by FISH?
- Reciprocal or Robertsonian Translocation
- Pericentric Inversion***
***Not taught
When is it acceptable to perform PGD for sex selection?
- X-linked conditions
- Autism
What are four controversial indications for PGD?
- Pre-disposition for adult-onset disorders.
- Aneuploidy screening by FISH
- Sex selection for “family balance”
- Creation of HLA-matched stem cell donros
What conditions are controversial for PGD in regards to pre-disposition for adult-onset disorders?
- Breast cancer
- Autosomal dominant cancer syndromes
What conditions are controversial for PGD in regards to aneuploidy screening by FISH?
- AMA
- Recurrent SAB
- Creation of HLA-matched stem cell donors.
At what block in Meiosis does heterodisomy occur?
A non-disjunction in Meiosis I.
At what block in Meiosis does isodisomy occur?
A non-disjunction in Meiosis II.
When does trisomic rescue occur?
It occurs when there is a detected trisomy. It wants to get rid of the extra chromosome, but doesn’t always get the right one.
How does UPD occur?
A poorly executed trisomic rescue. A trisomic rescue can indeed create normal cells with the correct chromosome, but can sometimes “kill” the new (or outsider) chromosome, resulting in UPD. UPD is a result of a trisomic rescue that TRIES to fix heterodisomy or isodisomy.
What is a translocation?
The exchange of material between two or more chromosomes.
What are the two types of translocations that can occur?
- Balanced (reciprocal)
- Unbalanced
Ubalanced translocations will have a combination of ____ and ____.
Monosomy and trisomy.
Close your eyes.
What is an example karyotype for a Robertsonian Translocation?
45,XY,der(15;22)(q10;q10)
45,XX,der(13;14)(q10;q10)
What does the following karyotype mean?
45,XX,der(14;21)(q10;q10),+21
Robertsonian Translocation–down syndrome!
What’s more serious, a deletion or an unbalanced translocation?
Definitely a deletion.
What can a deletion be used for?
Identifying genes involved in a phenotype.
FAP (APC) was mapped due to a child with ID and polyps.
Retinoblastoma was also mapped due to inherited forms of cancer.
How can one derive the shortest region of overlap, and why is the SRO significant?
You can compare multiple individuals with the same disorder and chromosome change, deriving the SRO, therefore “narrowing down” where the gene of interest/significance that was deleted–is located.
SRO
The region that is deleted in all samples, which is generally defined as the smallest deletion among many samples.
How does the ISCN assignment of break points work?
The smallest numbers are closest to the centromere, and the largest numbers are at the end of the chromosome.