FA Biochem II Flashcards
what is dominant negative mutation and give an example
exerts a dominant effect, a heterozygote produces a nonfxnal altered protein that also prevents the normal gene from functioning, mutation of Tx factor its allosteric site, nonfxning mutant can still bind DNA, preventing wild type Tx from binding
What is linkage disequilibrium
tendency for certain alleles at 2 linked loci to occur together more often than expected by chance - varies is different populations
What is mosaicism and give an example
occurs when cells in the body have different genetic makeup, can be germline mosaic, which may produce a disease that is not carried by parents somatic cells - lyonization-random X inactivation in females
What is locus heterogeneity and give an example
mutations at different loci can produce the same phenotype, marfans, MEN 2B, homocystinuria; all cause marfinoid habitus, also albinism
What is heteroplasmy
presence of both nl and mutated mtDNA resulting in mitochondrial inherited disease
What is uniparental disomy
offspring receives 2 copies of a chromosome from 1 parent and no copies from the other parent
What is the Hardy Weinberg disease prevalence equation
p2 +2pq+ q2 = 1
What is the hardy weinberg allele prevalence
p+q = 1
What is the hardy weinber heterozygote prevalence
2pq
What is the prevalence of an X-linked recessive disease in males and in females
q, q2
What are the 4 assumption of the Hardy Weinberg law
no mutation occuring at the locus, no selection for any genotypes at the locus, completely random mating, no migration
Gene imprinting implies that how many alleles are active at a single locus
one
If two alleles are present, but the active allele is deleted, what happens
disease
What are the characteristics of prader willi syndrome how does it occur
mental retardation, hyperphagia, obesity, hypogonadism, hypotonia - deletion of normally active paternal allele on chromosome 15
What are the characteristics of angelmans syndrome and how does it occur
mental retardation, seizures, ataxia, inappropriate laughter - deletion of normally active maternal allele
characterize autosomal domint inheritance
many generations, both male and female affected - often pleiotropic, can present clinically after puberty
characterize autosomal recessive inheritance
1/4 of offspring from 2 carrier parents are affected, often enzyme def, usually only seen in 1 generation - often more sever than AD, presents in childhood
characterize x linked recessive
sons of heterozygous mothers have 1/2 half chance of being affected - no male to male transmission, and often more severe in males, heterozygous females may be affected
characterize x linked dominant
transmitted through both parents, affected mother may have affected children, affected father will have affected children
What bone disorder has x linked dominant inheritance
hypophophatemia rickets - vit D resistant ricketts, inc wasting of phosphate in proximal tubule, rickets like presentation
characterize mitochondrial inheritance
transmitted only through mother, all offspring of affected females may show signs of disease
Give an example of a mitochondrial inherited disease
lebers hereditary optic neuropathy - degeneration of retinal ganglion cells and axons - leads to acute loss of central vision. Mitochondrial myopathies
cell signaling defect of fibroblast growth factor (FGF) receptor 3, results in dwarfism, short limbs, head/trunk nl size, associated with advanced paternal age
achondroplasia
bilateral, massive enlargement of of kidneys due to multiple large cysts
ADPKD
How does patients present with ADPKD
flank pain, hematuria, HTN, progressive renal failure
90% of ADPKD cases are due to a mutation in what gene
APKD1 on chromosome 16
ADPKD is associated with what additional conditions
polycystic liver disease, berry aneurysm, mitral valve prolapse
colon becomes covered witih adenomatous polyps after puberty, progresses to colon cancer unless resected
FAP
FAP is due to deletion on what gene on what chromosome
APC on chromosome 5
elevated LDL due to defective or absent LDL receptor - heterozygotes have cholesterol ~300, homozygotes ~700
familial hypercholesterolemia, hyperlipidemia type IIA
What are the complications/signs of familial hypercholesterolemia
sever atherosclerotic disease early in life, and tendon xanthomas on the achilles, MI may develop before 20
telangiectasia, recrrent epistaxis, skin discolorations, AVMs
hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu syndrome)
spheroid RBCs due to spectrin or ankyrin defect, hemolytic anemia, inc MHCH, splenectomy is curative
hereditary spherocytosis
depression, progressive dementia, choreiform movements, caudate atrophy and dec levels of GABA and ACH in the brain
Huntingtons
What trinucleotide repeat in Huntingtons and what chromosome is it found on
CAG, 4
fibrillin defect leading to connective tissue disorder affecting skeleton, heart, and eyes
marfans
what findings are associated with marfans
tall with long extremeties, pectus excavatum, hyperextensive joints, arachnodactyly
Describe the pathophys of the aorta in a pt with marfans, and the eyes
cystic medial necrosis of aorta leading to aortic incompetence and dissecting aortic aneurysms, floppy mitral valve, subluxation of lenses
several distinct syndromes characterized by familial tumors of endocrine glands including pancreas, parathyroid, pituitary, thryoid and adrenal medulla - disorders and gene association
MEN - 2A and 2B with ret gene
café au lait spots, neural tumors, lisch nodules, skeletal disorders, optic pathway gliomas
neurofibromatosis type 1 (von Recklinghausens disease)
What chromosome is the NF gene on
17, 17 letters in von Recklinghausen
bilateral acoustic schwannomas, juvenile cataracts
NF2 on chromosome 22
facial lesions, hypopigmented “ash leaf spots,” cortical and retinal hamartomas, seizures, mental retardation, renal cysts, renal angiomyolipomas, cardiac rhabdomyomas, inc risk of astrocytomas
tuberous sclerosis
deletion of VHL gene on chromosome 3 leading to hemangioblastomas of retina/cerebellum/medulla bilateral RCC - dz and overexpression product
von hippel lindau, 3
What do albinism, ARPKD, CF, glycogen storage diseases, hemochromatosis, mucopolysaccharidoses (except Hunters) PKU, sickle cell, sphingolipodoses (except Fabrys) thalassemias have in common
autosomal recessive diseases
CF, is AR deletion in what gene on what chromosome resulting in a deletion inf what
CFTR gene, 7, Phe 508
What does the CFTR channel do in the lungs, GI tract and skin
active secretion in lungs and GI, reabsorbs in skin
What does a defective Cl channel do
secretion of abnl thick mucus that plugs lungs, pancreas, liver
recurrent pulmonary infxns in CF are due to what organisms
pseudomonas and s aureus
What are the results of pancreatic insuff in CF
malabsorption and steatorrhea (ADEK)
What are the results of CF on male fertility
males are infertile due to bilateral absence of vas deferens
How do you diagnose CFTR
inc Cl- in sweat
What does the mutation in the gene cause in protein synthesis
abnormal protein folding, degradation before reaching cell surface
What is the TX for CF and what does it do
N-acteylcysteine, cleave disulfide bonds within mucus glycoproteins
Name as many x-linked recessive disorders as you can
bruton’s agammaglobulinemia, wiskott-aldrich, fabrys disease, G6PD def, ocular albinism, Lesch-Nyhan syndrome, Duchenne and Becker Muscular Dystrophy, hunter’s syndrome, hemophilia A and B
What leads to the deletion of the dystrophin gene in duchenne’s muscular dystrophy
x linked frame shif mutation
what does the deletion of the dystrophin gene lead to
accelearted muscle breakdown
What is pseudohypertrophy in the calf a result of, and what are the cardiac manifestations
fibrofatty replacement of muscle, cardiac myopathy
What is Gowers maneuver
assistance of upper extremities to stand up
What is the mutation in beckers muscular dystrophy, what is the severity and time of onset
mutated dystrophin gene, less severe, adolescence
What is the physiologic role of dystrophin
anchor muscle fibers, primarily in skeletal and cardiac muscle
What is used to diagnose muscular dystrophies
inc CPK and muscle biopsy
what gene is implicated in fragile X syndrome, and what is the mutation
FMR1 gene, methylation, associated with chromosomal breakage
What are the physical findings of fragile x syndrome
mental retardation, macro-orchidism, long face with large jaw, large everted ears, autism, and mitral valve prolapse
What is the trinucleotide repeat in fragile X
CGG
trinucleotide repeat for huntingtons
CAG
trinucleotide repeat fo myotonic dystrophy
CTG
nucleotide repeat for fragile x
CGG
nucleotide repeat for fredreich’s ataxia
GAA
What are the findings in Down’s syndrome
mental retardation, flat facies, prominent epicanthal folds, simian crease, gap between 1st 2 toes, duodenal atresia, congenital heart disease (ASD), inc risk of ALL and Alzheimers
What causes Down syndrome
meiotic nondisjunction of homologous chromosomes (associated with advanced maternal age) leading to trisomy 21
A small proportion of Down syndrome is due to what two genetic events
robertsonian translocation and mosaicism
What are the fetal screening measures for Down
dec AFP, inc betahCGH, dec estradiol, inc inhibin - inc nuchal translucency on US
What causes Edwards syndrome and what is it
trisomy 18, severe mental retardation, rocker bottom feet, micrognathia, low set ears, clenched hands, prominent occiput, congenital heart disease, death usually within the first year
What causes patau’s syndrome and what is it
trisomy 13, severe mental retardation, rocker bottom feet, micophthlamia, microcephaly, cleft lip/palate, holoprosencephaly, polydactyly, congenital heart disease, death usually within the first year
Describe robertsonian translocation
nonreciprocal chromosomal translocation that commonly involves chromosome pairs 13, 14, 15, 21, 22
Do balanced translocations cause abnl phenotype
no
What are the results of unbalanced translocation
miscarriage, stillbirth, chromosomal imbalance (down, patau)
congenital microdeletion of short arm of chromosome 5 with microcephaly, moderate to severe mental retardation, high pitched crying/meying, epicanthal folds, cardiac abnl
cri du chat
congenital microdeletion of long arm of chromosoe 7 with findings of elfin facies, mental retardation, hypercalcemia, well developed verbal skills, extreme friendliness with strangers, cardiovascular problems
williams syndrome