General Flashcards
If a parent has balanced translocation, which type of segregation leads to phenotypically normal offspring? Chromosomally?
Alternate -> phenotypically normal, 50% chromosomally normal
G6PD heterozygote advantage
malaria resistance
Common severe HFE variant, second variant
Cis282Tyr
His63Asp (homozygote unaffected)
What does HFE do?
Regulate hepcidin signalling - iron response hormone that tells body to stop absorbing
When do you treat hemochromatosis
Ferretin > 300 for men or 200 for women
- Goal <50
Why does Factor IV leyden resolve with puberty?
mutation is on promoter which activates with hormone changes after puberty
What gender is hirschsprung more common in?
Males
Uplifted ear lobes, hirschsprung
Mowat Wilson
ZEB2
HTT repeat expansion location and cutoffs
exon 1
Normal 10-25
At risk 26-35
Low penetrance 36-39
Classic 40-59
Juvenile 60
What type of proteins do the most common HCM mutations affect?
Sarcomere or Z disk
What does having DR3 and DR4 alleles place someone at increase risk for? Why?
Insulin dependent diabetes
They are linked with DQB1*0201 and DQB1*0302 alleles (antiben binding clefts in pancreatic island cells)
DR2, which is linked with DQB1*602 is protective
Which 2 genes account for 80% of long QT
KCNQ1 and KCNH2
What do you need to offer relatives of patients with Jervell and Lange-Nielsen syndrome?
EKG. Jevell and Lange Nielsen is AR, but allelic with Romano Ward syndrome (AD long QT)
KCNQ1 and KCNH2
MSH2, MLH1, MSH6, PMS2
Mismatch repair genes -> Lynch Syndrome (HNPCC)
GI cancer (Colon, stomach, intestine, pancreas)
Endometrial/ovarian Ca
Renal Cancer
NO breast/lung ca
MSH6 and PMS2 low penetrance
Lynch syndrome surveillance
Age 20: Colonoscopy (or 5 years before earlierst family hx)
Age 30: Endometrial biopsy every 1-2 yrs, Urine cytology
Age 40: Gastric - EGD every 3-5 yrs
Age 50: MRCP for Pancreatic CA annually
What % of marfan mutations are de novo
~25-33%
What is the skeletal features of marfan
Tall with long arms/long legs: Arm span to height > 1.05, Upper to lower segment
arachnodactyly
Pectus
Scoliosis
joint laxity
narrow palate
Management of Marfan
Annual TTE (root, mitral valve), eye exam
Follow ortho
B-blocker
? Ace/Arb
How is increased nuchal thickness defined?
3mm in 1st trimestery, 6mm in 2nd trimester
What is the most common FAOD?
MCAD
ACADM gene
17p.13 deletion
Brain dysgenesis
Miller-Dieker
Key gene: LIS1
Platelet activating factor acetylhydrolase 1 (PAFAH1)
- Lisencephaly (LIS1) + dysmorphic features (unknown genes)
Recurrence risk for miller dieker
17p13.3 deletion
80% de novo (usual germline mosiacism risk)
20% translocation: 25% abnormal (either del or dup), 25% miscarriage
Mt8344G>A tRNAlys
MERRF
Myoclonic epilepsy with RR fibers
Complex I and IV reduced - mostly synthesized within mitochondria
- Heteroplasmy
- Can also cause multisystemic diasese
- Mutant mitochondrial accumulate with age (mtDNA has 10x mutaton rate vs chromosomal DNA)
Tx: CoQ10 and Carnitine
What % of NF patients have a de novo mutation?
50% - NF has a very high mutation rate
Pima Indian Tribe (Arizona)
Type 2 DM, MODY
Which type of diabetes have more twin concordance?
Type 2
What is the most common extra renal manifestation of ADPKD?
Colonic Diverticula
- PKD1 and PKD2 genes -> encore parts of multimer compled that affect how cilia sense flow
+ Heptaic, biliary, pancreatic, ovarian, splenic cysts
Mitral/Aortic insufficiency
+ 10% have aneurysms in brain
PKD1 and TSC are next to each other on Ch16
Almond shaped eyes, triangular mouth, small hands and feet, narrow bifrontal diameter + OCD, hyperphagia
Prader Willi
15p11 paternally expressed genes
70% pat deletion, 25% maternal UPD, <5% imprinting defect
+ obesity 2/2 hyperphagia,
Tx: growth hormone can normalize height
How often is RB1 germline mutation found in a patient with unilateral retinoblastoma?
40%, but only 10% of patients have a family history.
- All patients with bilateral retinoblastomas have germline RB1 mutations
What is the function of RB1
Cell cycle regulatory element
What secondary neoplasms can be seen in patients wtih RB1 mutations?
Retinoblastoma + osteosarcoma, soft tissue sarcoma, melanoma
Where do nearly half of RB1 mutations occur?
CpG dinucleotide (CG island, often methylated motif)
What genes cause RETT syndrome or similar phenotype?
MECP2 (classic for females or males with XXY)
CDKL5 (XL)
FOXG1 (AD)
Normal at birth -> decelerating head circumference
Cortical and cerebellar atrophy without neuronal loss (densely packed neurons on path)
RETT syndrome - MeCP2
Clinical spectrum from neurodevelopmental to neurodegenerative disease
What is the most common cause of disorders of sexual differentiation
SRY
80% of 46XX males (transloction to X chromosome) - tx with androgens to complete virilization
30% of 46XY females (deletion/mutation - LOF) - tx with estrogen at 14, progesterone for periods, remove gonads to avoid gonadoblastoma
- also regulates sperm formation (Azoospermia factors AZFa, b, c)
Glu6Val - B Globin gene
SSD
- Can also be caused by compound heterozygousity in sickle cell mutation w/ B thal (non-expression) or Hg C (Glu6Lys)
What is HgbC?
Glu6Lys on B globulin gene -> affects solubility and can cause mild splenomegaly/anemia but not sickling
- Can cause SSD phenotype when compound het w/ Glu6Val (SS mutation)
What do you do if SSD is seen on NBS?
Antibiotic prophylaxis due to 11% mortality from sepsis in first 6 month of life.
What is the prior probability for female mother of one son who is affected w/ XL-R disorder to be a carrier?
2/3rd
What phase of the cell cycles do cells spend the most time in?
Interphase
Phase of cell cycle where cellular contents are duplicated?
G1 (part of interphase)
Phase of cell cycles where chromosomes are duplicated?
S (part of interphase)
Phase of cell cycle when cell gets split into 2
Cytokinesis
The cell is 2n, 4c entering ___ phase of mitosis. After ___ cells are 2n, 2c again
Prophase, cytokinesis
After what phase of the cell cycle are meiotic cells 2n, 4c?
Interphase (after S)
After what phase of meiosis are cells 1n, 2c
meiosis 1
After which phase of mieosis are cells 1n, 1c
Meiosis 2
When do meiotic cells become haploid
After meiosis 1
Haploind = 1n
When are homologous chromosomes separated in meiosis?
Anaphase 1
When are sister chromatids separated in meiosis?
Anaphase 2
What are the stages of prophase 1?
Leptotein - chromosomes condense
Zygotene - synapsis form
Pachytene - bivalent + crossing over
Diplotene - Synaptonemal complex dissolve
Diakinesis - nuclear membrane fragment
Which stage of meiosis do bivalents form and crossing over occur?
Prophase 1 -> pachytene
What are chiasma?
point between homologous chromosomes across which exchange of genetic maternal occur
When does meiosis start in males?
puberty
At what stage of meiosis does Oogenesis arrest in? Until what times?
Prophase 1 until puberty
Metaphase 2 until fertilization
What charactersitics must a cell have to be usable for karyotyping?
- have a nucleus
- spontaneously divide (marrow, prenatal tissue, skin) or can be induced to divide (blood)
What cell type(s) can be available for metaphase analysis immediatly? After 3 days? After 2 weeks?
Immediately: Bone marrow
3 days: Blood
10-14 days: amniotic fluids, CVS, skin
How many metaphases are counted in routine karyotype? When would you count more?
Routine = 20
Do more when looking for mosiacism (50)
Level 1 mosiacism
Only single cell is seen in multiple cultures
- Most likely artifact (pseudomosiacism)
NOT reported
When does level 2 mosiacism get reported?
2 or more abnormal cells in the sinple flask, or a single abnormal colony in culture among many - usually pseudomosaicism
Report if:
- additiona studies inadequate
- fetal anomalies identified
- well recognized anomaly in mosaic state
What is level 3 mosiacism
multiple cells/colonies in independent cultures/dishes share same anomaly -> true mosaicism
What are the advantages of FISH analysis?
Rapid turnaround, high sensitivity
When would you choose a dual color break apart FISH probe instead of a dual-fusion probe?
When there are many possible translocation targets
What is an emumeration probe in FISH
Centromere control + target probe to look for amplification
Name 6 common tumor suppressor genes
RB1 - retinoblastoma
TP53 - Li frameni
APC - FAP
VHL
BRCA1/2 - familial breast/ovarian ca
MLH1 and MLH2 - Lynch
Which agent is used to prevent coagulation in cultures of liquid tumor cytogenetic analysis?
Sodium Heparin
What translocation is associated with CML?
How do you detect it?
t(9:22) - philadelphia chromosome
- BCR-ABL fusion expressed in der22
- detect w/ dual fushion FISH
What cytogenetic anomaly is seen in Polycythemia vera?
Trisomy 9 (JAK2 is on 9)
Polycythemia also seen in JAK2 GOF mutations
What ca is t(8:21) seen in?
AML
What is the only STAT cytogenic lab cancer case
Acute promyelocytic leukemia
t(15;17)
- Patients may go into DIC
What is the purpose of testing for Her-2 amplification?
Poor prognostic factor in invasive cancers, but also target for therapy (Trastuzumab)
t(8:14), t(8:22), or t(2:8)
Burkitt lymphoma - MYC is on 8
What type of tumor is associated with each translocation?
9: 22
8: 21
15: 17
11: 14
14: 18
8: 14
8: 22
2: 8
9: 22 - CML - BCR-ABL
8: 21 - AML
15: 17 - APML (Promyelocytic)
11: 14 - Mantle cell
14: 18 - Follicular
8: 14/8:22/2:8 - Burkitt (MYC)
Pleuroplumonary blastoma, pulmonary cysts, thyroid ca, ovarian ca, cystic nephroma
DICER 1
- also CNS sarcoma, pituitary, embryonal rhabdo
- Monitor w/ chest CT/CXR at birth and Thyroid/pelvic/abd US at age 8
Which populations have increased incidence of Tay Sachs?
Ashkenazi Jews, (1/30 carrier risk)
French Canadians,
Louisiana Cajuns,
Pennsylvania Amish
Which populations are at risk for HbH and Hydrops?
Southeast Asia and Mediterranean Basin - carreirs of a-globin deletions in cis
Hb H = 1 of 4 funcitonal a-globin genes
Hydrops = 0 of 4
High HbA2 and HbF
B thal trait
HbA2 = α2δ2
HbF=α2γ2
- Both use alternative proteins from B globin cluster
TPMT (thiopurine methyltransfarse)
Pharmacogenomic test for azathioprine toxicity -> catalyzes methylation/inactivation of drug (prevents myelosuppression)
TPMT*1 = wt
TPMT*2, *3A, *3C homozygotes = hematopoetic toxicity -> decrease dose to 10% of usual
What is the pathophys of FV Leiden and Protein C?
Factor V leiden - Arg506Gln = GOF - removal of preferred clevage site by protein C -> reduced inactivation of activated FV -> prothrombus formation
Proctein C = LOF - inability to cleave activated Factor V -> prothrombus formation
What % of turner syndrome patients are mosaic?
25%
50% 45, X
25% structural abnormality involving X
25% Mosaic
What % of 45, X conceptions result in a livebirth?
<1%
How is Turner Sydnrome managed?
GH until bone age 15
Estrogen after 15 to promote 2nd sexual characteristics
Progesterone to promote menses
TTE monitoring for root dilation (2/2 bicuspid AV)
Monitor for Diabetes and renal disease
Nucleotide excision repair
Xeroderma Pigmentosum
Photosensitivity, freckling, photophobia -> premature skin again
- Actinic keraotsis + skin ca (melanoma, BCC, SCC)
+ ocular abnormlaities, neurodegeneration
(Also Trichothiodystrophy but no skin ca)
What are the 3 disorders of UV damage DNA repair
XP, Cockyne, and Trichothiodystrophy
XP, TTD = nucleotide excision, CS = transcription coupled repair
All three: thin skin w/ photosenstivity + neurodegeneration
XP = skin Ca
Cockayne = RP, deafness
TTD = brittle hair/nails, ichthyosis
What is the incidence of single gene disorders? prevalence?
Incidence 1:300 live borns
1:50 lifetime prevalence
How many genes are in the human genome?
~20,000 protein coding
~20,000 noncoding RNA
what are the componnents of the nucleo some complex?
4 core histones (H2A, H2B, H3, H4)
~140bp DNA
Histone H1 bind to DNA at edge of nucleosome in spacer region.
How much genetic variation is between 2 randomly selected individuals?
~0.5%
What is G0 in cell cycle?
Permanently arrested phase for cells that have stopped dividing. (neurons, RBCs)
What are the 5 phases of mitosis
Prophase - DNA condense, centromere form
Prometaphase - Nuc membrane dissolves
Metaphase - Chromosomes align
Anaphase - Separation
Telophase - Decondence/cytokinesis
When does crossing over occur?
Prophase 1 of meiosis
- Zygotene = homologous choromsomes align in “synapsis”
- Pachytene = meiotic crossing over
When is meiosis I compelted for Oocytes?
Just before ovulation (pause at metaphase II until fertilization
What enzymes initiates trancription at start site?
RNA polymerase II
What sequence specifies the location of polyadeenylation on 3’ end of mRNA
AAUAAA
Which two amino acides are only specified by a single unique codon?
Met (AUG) - start codon - establishes reading frame
Trp (UGG) - UAA, UAG, and UGA are STOP codons
What are the stop codons?
UAG, UGA, UAA
What strand of DNA is used as the template for Transcription?
Noncoding/antisense in 3’->5’ direction
Sense/coding strand is identical to mRNA transcript but NOT used as template
What is the TATA box
region rich in A and T ~25bp upstream of start codon ipmoratnt for initiation.
-CAT box further upstream
What are CpG islands?
CG rich areas found in promoter regions that are sites for methylation
What are enchancers, promotors, and locus control regaions?
Promoters: regulate transcription initiation for small distance upstream; same orientation as gene, 5’ UTR
Enchancer: regulate from a distance (can be any orientation/location)
Locus control: regulate chromatin context needed for expression
What chemical reaction happens in dna methylation
Cytoseine -> 5-methylcytosine
Which allele is XIST expressed in?
Only the inactivated X
What are the 2 classes of splicing mutations?
Mutations that interfere w/ normal RNA splicing (donor/acceptor site)
Mutations that creat alternative splice site
What is the mutation rate in a dominant gene?
affected cases/ (total births x2)
- x2 for both parent alleles
Average genome has ___ of de novo mutations? LOF variants? inactivated genes?
75 de novo, 200 LOF, 25 inactivated genes
What is the resolution of karytyping w/ banding?
~1 million bp
What is the most commonly used tissue for karyotyping? Why?
T lymphocytes
Accessible, can be culture and stimulated to divide, then arrested in metaphase
3-4 days
What is the incidence of chromosome abnormalities among livebirths? Stillbirths? Infant deaths?
Livebirths <1%
Stillbirth, Infant death ~10%
What FISH probes are used to ID chromosome copy number?
α-satellite family of centromere repeats
What are the 5 acrocentric chromosomes?
13, 14, 15, 21, 22
What are 2 diadvantages to microarray?
1) VUS
2) does not reveal structure (ie translocation)
What kind of inversion is more likely to result in abnormal offspring?
Pericentric
What causes partial hydatidiform mole?
Triploidy with extra paternal chromosome set - abnormal degenerative placenta
Aneuploidy is seen in ___ % of recognized pregnancies?
5%
What is the most common autosome aneuploidy?
Trisomy 16
What is the most common aneuoploidy?
45 X
(Trisomy 16 is second)
In a balanced translocation, what kind of segregation results in normal phenotypic offspring?
Alternate
What is the most common type of chromosome arrangement?
Robertsonian
rob(13;14)(q10;q10) and rob(14;21)(q10;q10) are first and second
What is i(X)q(10)
isochromosome X
Most common isochromosome, seen in Turner syndrome often
Which type of inversion involved in centromere
PerIcentric -> Includes the centromere
What causes terminal deletion and duplication within the same chromosome
PerIcentric inversion
What is the most common abnormalitity in abortuses?
45, X
- 20% of chromosomally abnormal abortuses
<1% chromosomally abnormal liveborns
Trisomy 16 is #2
What are the most common chromosomal abnormalities in liveborns?
1) Balanced rearrangement
2) extra sex chromosome (XXY, XYY, XXX)
3) trisomy 21
What are the most common chromosomal abnormalities in abortuses?
1) 45X
2) Trisomy 16
3) Trisomy 21
Who should you screen for aneurysms in ADPKD?
People with a positive family history (Aneurysms cluster in familites)
What is the most common mechanism for the second hit in RB1
Deletion or isodisomy
When is the high risk age for developing retinoblastoma in RB1
Until age 7
Most patients develope in first 3 years
What type of SRY variant is seen in 46XX males? 46XY females?
80% of 46XX males (translocation to X chromosome) - tx with androgens to complete virilization
30% of 46XY females (deletion/mutation - LOF) - tx with estrogen at 14, progesterone for periods, remove gonads to avoid gonadoblastoma
What do breakpoints of aneusomies (segmental duplicatons/deletions) cluster?
Low copy repeated sequences (aka segmental duplications)
Microcephaly, hypertelorism, epicanthal folds, low set ears, micrognathia, high pitched cry
Cri Du Chat
5p15 deletion syndrome
What are the 3 most common mechanisms of Prader Willi syndrome?
1) Pat 15p11 del - 70%
2) Mat UPD - 25%
3) Imprinting defect
What are the 5 most common mechanisms for Angelman syndrome?
1) Mat 15q11 deletion - 70%
2) UBE3A point mutation - 10%
3) Pat UPD - 7%
4) imprinting defect - 3%
5) Unknown - 10%
Which X chromosome is preferentially inactivated when a balanced translocation involving X is present? What about an unbalanced offspring?
Balanced: normal X preferentially inactivated -> this allows for the other translocated part to be expressed.
Unbalanced: Normal X active
Which autosomal gene is the effector (up-regulated) by SRY?
SOX 9 (causes campomelic dysplasia)
What is the offspring prognosis for a male with an X-Y translocation involving SRY?
All children will have sex reveral:
XY offsping will look female (SRY deleted)
XX offspring will look male (SRY present)
Male with infertility, hypotonia, decreased bone density, low-normal IQ, androgen deficiency
Klinefelters
47 XXY
Many can look normal. ALWAYS infertile (germ cell does not develope)
What are the most common chromosomal abnormalites in oocytes and sperm?
Oocytes: aneuploidy (~20% of total)
Sperm: Sturctural rearrangement (~10% of total)
What is the most common error (stage of meiosis and parent) that leads to aneuploidies?
Maternal meiosis 1
Which anueploidy is usually a maternal meiosis II error
Trisomy 18
Which aneuoploidies are most likely to be due to paternal meiosis error?
XXY - 50% pat MI
X - 75% pat
XYY - 100% pat MII
What is the predominant mechanism of aneuoploidy in females?
Premature separation of sister chromatids (BEFORE anaphase) during M1
Males have more classic nondysjunction
What is the most common autosomal trisomy in a SAB?
Trisomy 16 (30% o f SABs)
25% of all SABs are due to autosomal aneuploidy
What are the most common karyotype findings in Down syndrome?
95% trisomy
4% Robertsonian translocation - t(14:21) usually
1% mosaic/structural rearrangements
What are the most common Karyotype findings in Edwards syndrome
97% maternal nondisjunction (usually Meiosis II)
What are the most common karyotype findings in Patau syndrome?
75% trisomy 13
20% robertsonian translocation - der (13;14)
5% mosaic
What is anaphase lag?
Failure of chromosome to attach to spindle or migrate to pole during meiosis -> thus not included in nucleus of daughter cell
Mechanism of chromosomal mosciacism in addition to nondysjunction
Isochromosome 12p
Pallister Killian
isochromosome -> tetrasomy 12 p
- Always mosaic (can be detected on amnio, but not always CVS)
- DD, seizures, high hairline, diaphgramatic hernia
Which Chorionic villus tissue is MOST likely to have save genetic makeup as fetus? (least likely to be confined moasicism)
- Cytotrophoblast
- Syncythiotrophoblast
- Mesenchymal core
Mesenchymal core (in cultured prep only)
What does finding confined placenta mosiacism mean for fetus?
- most like normal
- high risk for iUGR, pregnancy loss
- 2% risk for UPD
What do Chromosomes 6, 7, 11, 14, 15, 20 have in common?
Imprinted
What is the most common interpretation for trisomy 16 seen on CVS vs amnio
CVS - usually confined placental mosiacism
Amnio - usually fetus is mosiac
True trisomy 16 not viable
What is the most common chromosomal abnormalities in SABs
Monosomy X
Which 45X patients are at risk for gonadoblastoma?
When there is mosaic 46XY cells
What causes partial hydatiform mole?
Paternal triploidy (2 sperm, 1 egg)
- AFP, hCG elevated
- Hydropic villi + normal villi + small fetus
Maternal triploid fetus
Small placenta, small fetus with large head
- AFP, hCG low
What is the difference between maternal (digyny) and paternal (dispermy) triploidy?
Paternal -> partial mole, large villi, small fetus, high AFP, hCG
Maternal -> small plaenta, small fetus w/ large head, low AFP, hCG
What is the difference between partial and compelte hydatiform mole?
Partial = triploid w/ 2 paternal chromosome sets -> large villi w/ small fetus
Complete = diploid w/ 2 paternal chromosome sets (NO mat chromosomes) -> NO fetus
Which X chromosome will be nonrandomly inactived if a structually abnormal X is present?
abnormal X
Which X will be nonrandomly inactived if there is a balanced translocation?
normal X
Which X chromosome will be nonrandomly inactivated when there is an unbalanced tranlsocation involving X?
Abnormal X
Which X is usually missing in Turner syndrome?
paternal
What are the 3 more common karyotypes in Turner Syndrome?
45, X - 15%
46, X, i(Xq) - 15% - missing most PAR genes in Xp
45X/46,XX mosaic - 15%
Why is it important to look for marker chromosomes in Turner syndrome?
Marker Y -> risk for gonadoblastoma
What are the most common robertsonian translocations?
t(13:14) - 75% - can cause patau syndrome if unbalanced
t (14:21) - 8%
What is a trivalent
3 aligned chromosomes due to a robertsonian translocation carrier
In a trivalent, which segregation leds to normal offspring?
Alternate
What is the difference between adjacent 1 and adjacent 2 segretation?
Adjacent 1 -> chromosomes with different centromeres go together in daughter cell -> more common
Adjacent 2 -> chromosomes with same centromere go together in daugher cell -> very rare
What segregation might produce offspring with down syndrome if a parent is a carrier for t(14:21)?
Adjacent 1 -> different centromeres go together, more common and more likely to be viable
What are the clinical consequences of having a balanced X-autosome translocation?
Females: decreased fertility (oogenesis needs both X); may also lead to abnormal offspring due to skewed inactivtion in oogenesis
Male: almost always infertile
What is the most common isochromosome?
Xq (seen in turners) - NOT Xp because p is where most PAR genes are
What type of inversion is most likely to lead to abnormal offspring?
Pericentric -> del and dup in terminal ends of same chromosome
Which type of inversion will almost always result in normal offspring?
Paracentric -> recombinant version acentric or dicentric -> not viable
How does size of inverion affect offspring risk in pericentric inversions?
Small inversions are not likely to cross over-> low risk of viable abnormal offspring
Large inversion -> more like to cross over AND del/dup are smaller -> more likely to have viable abnormal offspring
What does ring chromosome look like on microarray?
if normal chromosome number: terminal deletions on both ends
If additional ring: partial trisomy in middle but not the ends of chromosome
Name the following syndromes:
5q35 del
7q11 del
15q11 del
17p11 del
17p12 del
17p12 dup
22q11 del
5q35 del - Sotos
7q11 del - Williams
15q11 del - PWS/Angelman
17p11 del - Smith Magenis
17p12 del - HNPP
17p12 dup - CMT type 1A
22q11 del - VCF/Digeorge
What is the mechanism for recurrent chromosomal rearrangements?
non-allelic homologous recombination in low copy repeat (LCR; aka segmental duplications)
What is the mechanism for non-recurrent structural chromosomal rearrangements?
Nonhomologous end joining
How many copies of each alleles are present in isodicentric chromosomes?
2x in most cases
When is there risk to fetus after a marker chromosome is found?
If parent is phenotypically normal, non-mosaic, and a carrier
idic(22)
Isodicentric 22 -> if present patient has tetraploidy of ch 22
Cat eye syndrome: Iris coloboma, CHD, ear tags, anal atresia w/ normal intellect
what is r(20) associated with?
Ringed chromosome 20
- usually mosiac
May be fused at telomere so no loss of termianl DNA - need to do FISH/karyotype
-intractable epilepsy
What is a haplotype
A set of alleles at two or more neighboring loci on ONE of two homologous chromosomes
What is the difference between penetrance and expressivity
Penetrance is chance ANY phenotype is expressed
Expressivity is the severity of phenotype
Semidominant (incompete dominant) vs codominant
Semidominant: Homozygotes are more severely affected than heterozygotes
Codominant: both alleles expressed togehter in compound heterozygotes
What is the genetic risk of offpring of first cousin marriages?
3-5% (background 2-3%)
What is reprodutive fitness?
(# Offspring of affected individuals that survive to reproductive age)/(#Offspring of unaffected)
For X linked disorder with fitness of 0, what % of cases should be de-novo?
<50%; since allele is partially protected from selection in female carriers
For an AD disorder with fitness of 0, what % of cases should be de novo?
100%
In HD, which parent is more likely to pass along an expanded allele?
Father
In Fragile X, which parent is more likely to pass along an expanded allele?
Mother
What is allelic heterogeneity?
Different Mutations (same gene) -> same phenotype
What is locus heterogeneity?
Different genes -> same phenotype
What is clinical/phenotypic heterogeneity?
same gene (different mutations) -> different phenotype
What is the difference between allelic, locus, and clinical heterogeneity?
Allelic: Different variants (same gene) -> same phenotype
Locus: DIfferent genes -> same phenotype
Clinical/phenotypic: Same gene (different variants?) -> different phenotypes
What is the relative risk ratio?
Measure of familiam aggregation
Lamda = prevalence in relatives of affected/prevalence if general population
What does a Heritabilty (H2) of 1 mean?
Heritability = fraction of phenotypic variance of quantitative trait due to allelic variance
1 means completely attributed to genetics
How is Heritability (H2)calculated?
Subtracting coefficient of correlation in dizygotic twins (50% IBD) from monozygotic twins (100% IBD) and multiplying by 2
What is the difference between ascertainment and recall bias?
Ascertainment bias = affected more likely to come to researcher’s attention
Recall bia = affected more likely to be aware of disease than controls
Name 2 modifier genes for cystic fibrosis.
1) MBL2 - mannose binding lectin (binds pathogens) - lower levels -> worse outcome
2) TGFB1 - cytokine transforming growth factor B (promotes scarring) -high level -> worse outcomes
What is the most common gene seen in Hirschsprung?
RET
Which gender is at higher risk for dementia?
females
How does the APOE gene modify alzheimer risk?
3 alleles (E2, E3, E4)
Baseline risk 10% by age 80
If one E4 risk is 40% by age 80
If 2 E4 risk is 60% by age 80
Which chromosomes cannot be distinguished by centromeric FISH?
13, 14, 21, 22 -> common robertsonian translocations; too similar sequences
What is the advantage of using FISH to test for aneuoploidy?
Fast - only 1-2 days vs weeks for CMA/karyotype
Often used prenatally
When would you want to do interphase instead of metaphase fish?
when looking for tandem duplications (easier to see when stuff is less condensed)