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Pediatric Questions > GENETIC DISORDERS > Flashcards

GENETIC DISORDERS Flashcards

1
Q

Both sexes are equally affected, both sexes transmit to offspring, no skipped generation, every child has a parent with disorder except new or spontaneous mutation

A

Autosomal dominant (AD)

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2
Q

Both sexes are equally affected, both sexes can transmit a copy of mutated gene, and their risk to have affected child is 25%, the disorder may be seen in one or more sibling, not all generations are affected

A

Autosomal recessive (AR)

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3
Q

No male-to-male transmission, only females transmit the disease to their sons, daughters are obligate carriers

A

X-linked recessive

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4
Q

Maternal transmission from egg to zygote; both males and females are affected

A

Mitochondrial inheritance

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5
Q

Hypotonia, upslanted palpebral fissures, epicanthal folds, systolic murmur, single transverse creases in
hands, brachydactyly, broad space between the first and second toe

A

Down syndrome (trisomy 21)

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6
Q

Screening for hypothyroidism in cases of Down syndrome is at what age?

A

Newborn screening after birth, at 6 and
12 months, then annually if normal

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7
Q

Acute myeloid leukemia (AML) is a higher risk in the patient with Down syndrome at what age?

A

< 1 year

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8
Q

Acute lymphocytic leukemia (ALL) is a higher risk in the patient with Down syndrome at what age?

A

> 1 year

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9
Q

Newborn with Down syndrome with no murmur on physical examination

A

Echocardiography (50% of children with Down syndrome have a cardiac defect)

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10
Q

The most common cardiac defects associated with Down syndrome

A

AV canal defects, ventricular septal defect, atrial septal defect, and tetralogy of Fallot

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11
Q

The most common gastrointestinal defects associated with Down syndrome

A

Duodenal atresia, Hirschsprung disease

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12
Q

Newborn with clenched fist with overriding fingers, rocker bottom feet, small head, eyes, and mouth with low-set malformed ears, micrognathia,
prenatal and postnatal growth deficiency, hypotonia, and ventricular septal defect

A

Trisomy 18 (Edward syndrome)

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13
Q

Newborn with cleft lip, cleft palate, microcephaly, microphthalmia, cutis aplasia, and postaxial polydactyly

A

Trisomy 13 (Patau syndrome)

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14
Q

A 5-year-old boy with intellectual disability, large hands and feet, long face with large ears, large testicles, and hyperextensible joints

A

Fragile X syndrome

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15
Q
A
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16
Q

Newborn girl with microcephaly, ocular
hypertelorism, prominent glabella, frontal bossing (Greek helmet face), beaked nose, hypotonia, and seizures

A

Wolf–Hirschhorn syndrome (4p-deletion)

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17
Q

Newborn with a cat-like cry, hypotonia,
microcephaly, moon face, widely-spaced eyes, down-slanting palpebral fissures, high-arched palate, and wide-flat nasal bridge

A

Cri du chat syndrome (5p-deletion)

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18
Q

Newborn with microcephaly, atresia of the ear canal, deep-set eyes, depressed mid-face, protruded mandible, legs are flexed, externally rotated, and in hyperabduction (frog-like position)

A

De Grouchy syndrome

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19
Q

Newborn with profound hypotonia, small for gestational age, feeding problems, failure to thrive, bitemporal narrowing, thin upper lip, almond-shaped eyes, hypogonadism, bilateral
cryptorchidism, and small penis

A

Prader–Willi syndrome (PWS) (paternally
derived deletion 15q11–13)

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20
Q

Child with hypotonia, jerky ataxic movement, fair hair, large chin and mandible, inappropriate bouts of laughter, and severe intellectual disability

A

Angelman syndrome (maternally derived deletion 15q11–13)

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21
Q

Child with an intellectual disability, supravalvar aortic stenosis, hypercalcemia, friendly “cocktail
party” personality, and strabismus

A

Williams syndrome

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22
Q

The most common cause of hypercalcemia in a child with Williams syndrome

A

Idiopathic

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23
Q

Wilms tumor, Aniridia, Genitourinary
malformation, Retardation (intellectual disability), long face, upward-slanting palpebral fissures, ptosis, and a beaked nose, due to the absence of PAX6 and WT1 (Wilms tumor) genes

A

WAGR syndrome

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24
Q

Newborn with Coloboma, Congenital Heart defects, choanal Atresia, growth and Retardation (intellectual disability), GU anomalies (hypogonadism), and Ear anomalies

A

CHARGE syndrome (gene defect CHD7 on chromosome 8q)

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25
Q

Vertebral defects, Anal atresia, Cardiac defects, Tracheoesophageal fistula, and/or Esophageal atresia, Renal anomalies, and Limb defects

A

VACTERL/VATER association

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26
Q

The most common association with VATER/ VACTERL syndrome

A

Congenital heart defects

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27
Q

Jaundice, bile duct paucity with cholestasis, peripheral pulmonary stenosis, butterfly vertebrae, triangular face with a pointed chin, long nose with
broad mid-nose, and posterior embryotoxon

A

Alagille syndrome (20p12)

28
Q

Cleft palate, absent thymus, hypocalcemia, tetralogy of Fallot, interrupted aortic arch, recurrent infection, short stature, and behavioral problem

A

DiGeorge syndrome (22q11.2)

29
Q

Cleft palate, micrognathia, glossoptosis,
respiratory distress (airway obstruction caused by backward displacement of the tongue base), and feeding difficulties

A

Pierre–Robin sequence

30
Q

Pierre–Robin sequence (cleft palate, glossoptosis, and micrognathia or retrognathia); severe myopia or other ocular abnormalities; sensorineural hearing loss; or skeletal abnormalities including hypermobility, scoliosis, or early arthritis

A

Stickler syndrome

31
Q

Newborn with a disruptive cleft on the face and amputated digits

A

Amniotic band sequence

32
Q

Newborn with underdeveloped mandibular and zygomatic bones, microtia, stenosis of the external ear canal, down-slanting palpebral fissures,
coloboma, and conductive hearing loss

A

Treacher-Collins syndrome (mandibulofacial dysostosis type 1)

32
Q

Preauricular pits, preauricular tags, microtia, hypoplastic cochlea, hearing loss, branchial fistula, and renal dysplasia or aplasia

A

Branchio-oto-renal syndrome

33
Q

Short stature below third percentile, short length of the proximal segment of upper arms and legs (rhizomelic shortening), trident hands, stenosis of
the foramen magnum, macrocephaly, flat nasal bridge and mid-face

A

Achondroplasia

34
Q

The most common cause of death in children younger than 4 years with achondroplasia

A

Brain stem compression

35
Q

Child, with multiple bruises, blue sclera, recurrent fractures, hyperextensible joints, and had delayed closure of fontanelle

A

Osteogenesis imperfecta (type I is the most common)

36
Q

Adolescent, tall, the lens is dislocated upward, high-arched palate, pectus carinatum, aortic dilatation, and lumbosacral ectasia

A

Marfan syndrome

37
Q

Adolescent with hyperextensible skin, hypermobile joints, kyphoscoliosis, easy bruising, skin scarring, mitral valve prolapse, and abnormal capillary fragility test

A

Ehler–Danlos syndrome

38
Q

Eight café-au-lait spots, freckling of the axilla, Lisch nodules, optic glioma, and pseudarthrosis of the fibula

A

Neurofibromatosis type I

39
Q

An 18-year-old boy with a family history of eighth cranial nerve masses presents with hearing loss, tinnitus, loss of balance, blurring of vision, and posterior subcapsular lens opacities on eye examination

A

Neurofibromatosis type II

40
Q

Adolescent presents with facial acne that is not responding to treatment, has ash leaf (hypopigmented macules), facial angiomas (adenoma sebaceum), nail fibroma, pitting of dental enamel, and renal angiomyolipomas

A

Tuberous sclerosis

41
Q

Infantile spasm is commonly associated with

A

Tuberous sclerosis

42
Q

Helpful sign to assist in early diagnosis of tuberous sclerosis

A

Ash leaf spots (hypopigmented macules)

43
Q

Most common cardiac finding in infants with tuberous sclerosis

A

Cardiac rhabdomyomas

44
Q

Newborn with long eyelashes, hirsutism, low hairline, downward-turned mouth, intrauterine growth restriction (IUGR), thin upper lip, micromelia, and syndactyly

A

Cornelia De Lange syndrome

45
Q

Child with partial albinism, white forelock, premature gray hair, iris heterochromia, cleft lip, and cochlear deafness

A

Waardenburg syndrome

46
Q

Child with a history of hypoglycemia and omphalocele at birth, coarse facial features, large tongue, earlobe creases, posterior auricular pits, Wilms tumor, and cryptorchidism

A

Beckwith–Wiedemann syndrome

47
Q

Infant with macrodactyly, hemihypertrophy, lipoma, hemangioma, soft-tissue hypertrophy, and accelerated growth

A

Proteus syndrome

48
Q

Newborn large for gestational age, macrocephaly, prominent forehead, hypertelorism, intellectual disability, large hands and feet

A

Soto syndrome

49
Q

Brachycephaly, frontal bossing, wormian bones, hypoplastic or absent clavicles, delayed eruption of deciduous teeth, and joint laxity

A

Cleidocranial dysostosis

50
Q

Early fusion of sagittal suture, and the head is long and narrow

A

Scaphocephaly (the most common type of craniosynostosis)

51
Q

Newborn with craniosynostosis, brachycephaly, strabismus, hypertelorism maxillary hypoplasia,
beaked nose, proptosis, syndactyly, single nail, broad thumb

A

Apert syndrome

52
Q

Craniosynostosis, short stature, deviated nasal septum, malocclusion, malposed teeth, no limb defects

A

Crouzon syndrome

53
Q

Craniosynostosis, broad thumb and toes

A

Pfeiffer syndrome

54
Q

Tower or clover-leaf skull due to multiple fused sutures, preaxial polydactyly, obesity

A

Carpenter syndrome

55
Q

Genetic counseling requires

A

A specific diagnosis with known inheritance mechanism

56
Q

Indications for obtaining a karyotype: examples

A

Unusual appearance, multiple congenital anomalies, and/or possible mental disability

57
Q

Child has a routine karyotype that reveals 47, XX+21. Appropriate counseling for the parents is

A

To explain that their child has Down syndrome due to aneuploidy and that they do not need to have their chromosomes checked

58
Q

Cytogenetic nomenclature for embryonic germ cells from a female fetus with the trisomy form of
Down syndrome would be

A

47, XX+21

59
Q

A couple desires prenatal diagnosis because the woman is 39 years old. They want the safest and most reliable form of prenatal testing

A

Amniocentesis

60
Q

Child has obesity, compulsive overeating, and underdeveloped genitalia, which make you suspect
Prader–Willi syndrome. You recall that FISH testing for a chromosome 15 submicroscopic deletion may be diagnostic. The best approach for
obtaining a laboratory diagnosis

A

Obtain a green-top (heparinized) tube for the harvest of white cells with the indication of routine karyotype, including FISH for microdeletion 15

61
Q

Chorionic villus sampling is performed at which weeks of pregnancy?

A

10–12 weeks of pregnancy

62
Q

Amniocentesis is performed at which weeks of pregnancy?

A

12–16 weeks of pregnancy

63
Q

Female with tall stature; speech/language delay; learning disabilities; normal intelligence, sexual
development, and fertility

A

47, XXX syndrome “triple X syndrome”

63
Q

Male with tall stature, speech and language delay, learning disabilities, cystic acne in adolescence, no facial dysmorphology, normal intelligence

A

47, XYY syndrome

64
Q

Male infant with short webbed neck, low posterior hairline, edema of hands and feet, mild intellectual disability mutation of PTPN11 gene

A

Noonan syndrome

65
Q

A 10-year-old boy with progressive motor disability, cognitive decline, and psychiatric disturbances; his father had the same condition at age 40 years, died at age of 60

A

Juvenile Huntington disease (because of CAG trinucleotide repeat expansion, clinical onset can occur in childhood) AD

Pediatric Questions (31 decks)

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