Genetic Syndromes Flashcards
47, XXY
Klinefelter Syndrome
45, X
Turner’s Syndrome
Results from mutations in Fibrillin 1 (FBN1)
Marfan Syndrome
Autosomal dominant mutation in FGFR3 Fibroblasy growth factor receptor 3
Achondroplasia
Learning disability, macro-orchidism, autism, seizures
Fragile X syndrome
Trisomy 21
Down’s syndrome
Trisomy 18
Edwards Syndrome
Trisomy 13
Patau Syndrome
Short stature, flare face/brachycephaly (short skull from ant to post), flat nasal bridge, developmental delay, third fontanelle, hypotonia - protruding tongue, upward slanted palpebral fissures, small ears, simian crease, joint hyperflexibility, short neck, sandal sign
Down’s Syndrome
Associated with AVSD
Downs Syndrome
Associated with duodenal atresia and Hirschprung
Downs
Ncreased nuchal transleucy at 12 week dating scan
Downs
Ass with Hirschprung disease
Down syndrome
Ass with atlantoaxial subluxation
Down’s syndrome
Affect midline structures of the face - scalp defects, cleft lip, microcephalic, cyclopia, polydactyl, holoproencephaly
Patau’s (Trisomy 13)
Microcephalic, rockerbottom feet, omphalocele, micrognatia, hypertelorism (wide set eyes) , upturned nose, clenched fists, hypertonic
Edwards syndrome
22q11 microdeletion
DiGeorge Syndrome
Autosomal dominant CHD7 mutation
CHARGE syndrome
Hypotonia, hyperphagia, obesity, hypogonadism
Prader Willi
Horseshoe kidney
Turners (and Edwards)
Coloboma
CHARGE, treacher Collins, patau
Athymia
Di George
Cherry red spot
Metabolic storage diseases - Tay Sachs, Nieman Pick
Tubular nose
Di George syndrome
7q11.23 microdeletion
Williams syndrome
Macrosomia, macroglossia, hermihypertrophy, exomphalos, hypoglycaemia, linear ear groove, Wilm’s tumour
Beckwith Wiedemann
Agenesis of corpus callosum, severe developmental delay, seizures, lacunae of retina
Aicardi syndrome
Macrocephaly, developmental delay, skin papillomas, facial tichilemmomas, increased risk of thyroid/breast/endometrial tumours
Cowden syndrome
Macrocephaly, learning difficulties, macrorchidism, high arch palate, large jaw, joint hyperextensibility,
Fragile x
Friendly personality, upturned nose, full lips, stellate iris, Supervalavar aortic stenosis, hypercalcaemia, hypertension
Williams syndrome
Fair hair and eyes, seizures, happy with bursts of laughter, coarse facies, hypotonic gait,
Angelman syndrome
Generalised oedema and cystic hygroma in utero, oedema and hypoplastic nails at birth
Turners syndrome
Short, coarctation of aorta, shield shaped chest, webbed neck, low hairline, primary amenorrhea streak gonads, horseshoe kidney
Turners
Male, normal intelligence, tall, long arms, gynaecomastia, hypogonadism
Klinefelters
TOF, cholestasis, butterfly vertebrae, eye abnormalities
Alagille syndrome
Haematuria, deafness
Alport syndrome
Mitochondrial Encephalopathy, Lactic acidosis, and Stroke-like episodes
MELAS
Risk of Down syndrome recurrence with 14q21q translocation
10-15%
Risk of Down syndrome recurrence with 21q21q translocation
100%
Hypotonia, clinodactyly, single palmer crease, sandal gap in toes, upstanding palpebral fissures,
Downs
Brushfield spots at eye exam
Downs
Short, bleeding disorder, pulmonary stenosis murmur, webbed neck
Noonan’s
Aniridia, Wilm’s tumour
WAGR - Wilm’s, Aniridia, Genitourinary abnormality, Retardation
CATCH 22
CHD - TOF, truncus arteriosus, interrupted aortic arch A - abnormal facies T- thymus absent / immunodeficiency C - cleft palate H - hypocalcaemia/ hypo parathyroidism 22
5p deletion
Cri du Chat
Macrocephaly, short stature, short limbs, trident hand
Achondroplasia (short limb dwarfism)
Indications for GH therapy
- Growth hormone deficiency (GHD), including acquired GH deficiency as the result of brain tumours, cranial irradiation or other brain injury, defined as a peak growth hormone of less than 6.7micrograms/L on two stimulation tests
- Turner syndrome (TS)
- Prader-Willi syndrome
- Chronic renal insufficiency (CRI)
- Children born small for gestational age (SGA) with subsequent growth failure at 4 years of age or later
- Short stature homeobox-containing gene (SHOX) deficiency
Lens dislocation, chest deformity, joint laxity, aortic dissection
Marfan s syndrome
Auto dominant, skin hyperextensibility, kyposcoliosis, aortic root dilation, frequent skin lacerations and scarring
Ehlers danlos
Multiple fractures, blue sclera, hearing loss
Osteogenesis imperfecta
COL1A1 and COL1A2 gene mutations
Osteogenesis imperfecta
Decreased cervical motion, short webbed neck , low hair line
Klipple feil syndrome
External auditory canal stenosis/ ear abnormalies - conductive hearing loss , downward slating palpebral fissures, coloboma, mandible/zygoma underdevelopment , cleft palate
Treacher collins
Autosomal dominant - failure of migration of neural crest cells to 1st and 2nd pharyngeal arches required for craniofacial development
Sensorineural hearing loss, white forelock, abnormal pigmentation of iris
Waarenburg syndrome - autosomal dominant
Profound sensorineural deafness, vestibular dysfunction, goitre
Pendred syndrome (Dx: bilateral dilation of vestibular aqueducts at MRI)
Bilateral vestibular schwanomma
NF2
microcephaly, failure to thrive, short stature, premature aging, severe photosensitivity, occular - cataracts, optic atrophy
Cockayne syndrome
Synophry (mono brow) / bushy eyebrows, short stature, intellectual disability
Cornelia de Lange syndrome
Learning difficulties, broad thumbs, clinodactyly of 5th finger, microcephaly, short stature,
Rubinstein taybi syndrome
Learning difficulties, obesity, hypothalamic abnormalities - central diabetes insipidus, brightness - retinitis pigmentosa,
Laurence-Moon- Biedl Syndrome
Short stature, obesity shortened 4th and 5th metacarpals, subcutaneous plaque, hypocalcaemia
Albright hereditary osteodystrophy
Girl with initially normal development, then regression, secondary microcephaly, wringing midline movements,
Ret syndrome
Low serum/amniotic alpha feto protein in pregnancy
Trisomies, turners
Elevated alpha feto protein
Risk of spina bifida, omphalocele/gastroscesis
Dysmorphia, cleft palate, eye problems, early onset arthritis
Stickler syndrome
Autosomal recessive, isolated motor developmental delay, absent deep tendon reflexes, lower motor neurone pathology on EMG
Spinal muscular atrophy
Lisch nodules on iris and optic glioma
Neurofibromatosis
Posterior embryotoxon at eye exam
Alagille syndrome
Cleft palate, depressed nasal bridge, hypertelorism, short nails, hypoplasia of nails, hirsutism, mum with epilepsy
Maternal phenytoin use (fetal hydrantoin syndrome)
Flat nasal bridge, smooth long philtrum, thin vermillion border, low set ears, spina bifida, intellectual disability, cleft palate, congenital heart defects, mother on antiepileptics
Maternal sodium valproate use
Female baby with an unguinal hernia
Consider complete androgen insensitivity syndrome (AIS), 46xy
Retinal hamartoma and retinal hypo pigmented patched
Tuberous sclerosis
Exocrine pancreatic deficiency, severe eczema, pancytopenia p, skeletal dysplasia, short stature
Schwannman Diamond