Genetics Flashcards
Holoprosencephalopathy, agensis of corpus callosum, polycystic kidneys, cardiac defects, limb abnormalities and aplasia cutis congenita
Trisomy 13
IUGR, low birth weight, clenched fists, rocker bottom feet, abnormal head shape
Trisomy 18
Long narrow face, prominent jaw, protuberant ears, ADHD/autism, macro-orchidism, recurrent AOM
Fragile X Syndrome
wide-set eyes, upturned nose, large maxilla, prominent philtrum, pointed chin
Williams Syndrome
wide spaced eyes, low set ears, shied like chest, pectus deformity and increased carrying angle of arms
Noonan Syndrome
What should you suspect in a patient with NF1 and precocious puberty?
Optic pathway glioma
Short stature, frontal bossing, triangular faces, shortend and incurved 5th fingers (clinodactyly), asymmetry and cafe au lait spots
Russel-Silver syndrome
Cholestasis, cardiac anomalies, butterfly vertebrae, broad nasal bridge, triangular facies and deep set eyes
Alagille syndrome
Unilateral or bilateral upper extremity defects with septal defects
Holt-Oram syndrome (heart-hand)
Fused cervical vertebrae - short neck, low hairline. Hearing difficulties, eye abnormalities, cleft palate, cardiac or GU anomalies
Klippel-Feil syndrome
Arched eyebrows, long eyelashes, long opening of eyelids, flat broadened tip of nose, long protruding earlobes. Prominent fetal finger pads
Kabuki syndrome
Microcephaly, intellectual disability and multiple internal organ malformations. Syndactyly of second and third toes, hypotonia and feeding difficulties
Smith-Lemli-Opitz
Wilms tumor, aniridia, GU anomalies, intellecutal delay
WAGR
Hypopigmented lesions (ash-leaf macules), seziures, developmental delay, adenoma sebaceum, periungal fibromas, and shagreen patches
Tuberous sclerosis
Tall stature, pectus excavatum, lens dislocation WITH developmental delay
Untreated homocysteinuria
Cleft lip/palate, external ear abnormalities leading to conductive hearing loss, malar hypoplasia, colobomata, lack of eyelashes
Treacher-Collins
Loss of gene activity on maternally acquired chromosome 15
angelMan syndrome
Loss of genea ctivity on paternally acquired chromsome 15
Prader wili
Likely in utero environment of an infant with poor tone, poor suck and weakness
Polhydraminos - unable to swallow the amniotic fluid in utero
Generalized hirsuitism, long curly eyelashes, depressed nasal bridge, thin philtrum with downward turned upper lip, micrognathia, limb contractures, digit anomalies, hypoplastic genitlas
Cornelia-de-lange
Cardiac rhabdomyomas are most likely to be symptomatic in first 6 years of life when they could obstruct blood flow before they spontaneously regress (typically by 6 years old). They are associated with what syndrome?
Tuberous sclerosis
Irritability, fever, anorexia, soft tissue swelling associated with subperiosteal cortical thickening of underlying bone. Leukocytosis, ESR and elevated alk phos present. Present prior to 6 months of age
Caffey disease
Micrognathia, glossoptosis, upper airway obstruction
Pierre-Robin Sequence
Things associated with Pierre-Robin sequence
Strickler syndrome, 22q11
Severe respiratory distress from pulmonary hypoplasia, narrow dysplastic thorax and extremity short ribs. May have natal teeth
Ellis-van Creveld syndrome
Small, hypoplastic mandible, micropthalmia, cataracts and neonatal teeth
Hallerman-Streiff syndrome
Posterior fossa malformations, hemangiomas, arterial anomalies, cardiac anomalies, eye abnormalities and sternal clefting/supraumbilical abdominal raphe
PHACES
Telangictasisas, photosensitivity, severe chelitis, growth deficiency, increased susceptibility to neoplasms, long face, long limbs
Bloom syndrome
Recurrent infections of mucous membranes, respiratory tract, and skin, oculocutaneous albinism, ataxia. Large granules in neutrophils.
Cheidiak-Higashi
Elevated leucine, isoleucine and valine in plasma and urine
Maple Syrup Urine disease
Treatment for homocysteinuria
pyridoxine, folic acid and vitamin B12
Lipid storage disease with splenomegaly, hepatomegaly, skeletal abnormalities, anemia and thrombocytopenia
Gaucher disease
Exaggerated startle at birth with loss of motor skills, axial hypotonia, extremity hypertonia and hyperreflexia
Tay-Sachs
vomiting, diarrhea, failure to thrive, hepatosplenomegaly, hypotonia, loss of motor skills (around 6 months)
Niemann-Pick
Erlenmyer flask on x-ray
Gaucher
Developmental delays, intellectural disability, dystonic movemetns, hypotonia, hyperreflexia and self-mutilation
Lesch-Nyhan syndrome
Absence of hypoxanthine guanine phosphoribosyltransferase leading to excessive levels of uric acid in blood and urine
Lesch-Nyhan syndrome
Hypoglycmeia, lactic acidosis and hyperlipidemia
glycogen storage disease type 1
Liver dysfunction, jaundice, hepatomegaly, cataracts, urinary ketones and reducing substance often presents early in life
Galactosemia
Light pigmented skin, eczema, blonde hair, blue eyes, if untreated will be significantly developmentally delayed
Phenylketonuria
Cystathione Beta synthase deficiency
homocystinuria
branched chain ketoacid dehydrogenase complex deficiency
maple syrup urine disaease
Treatment for glycogen storage disease type 1
noctunal NG infusion of glucose until 2-3 years of age with frequent daytime feeding. Raw constrach in water when older
short stature, multiple skeletal deformities, joint stiffness, thickened skin, hypertelorism, and coarce facial features
Hunter syndrome
Deficiency of lysosomal enzymes responsible for degradation of mucopolysaccharides or GAGs
mucopolysaccharidosis
Deficiency of 7 dehydrocholesterol reductase
Smith-Lemli-Opitz syndrome
Microcephaly with narrow bifrontal diameter, broad nasal tip with anteverted nares, hypertelorism and ptosis, cleft palate and micrognathia and low set ears
Smith-Lemli-Opitz syndrome
Elevated very long chain fatty acids
Zellweger syndrome
heaptic and renal dysfucntion with large anterior fontanelle, high forehaed, cataracts, broad nasal bridge and epiphyseal stippling
Zellweger syndrome
Full cheeks with sagging jowls and lips. little hair pigment. Collagen abnormalities. Impaired copper uptake
Menkes disease
Infant who was normal at birth who develops marked hypotonia, hepatomegaly and cardiomegaly early in life
Pompe disease (glycogen storage disease type 2)
Deficient activity of alpha glucosidase
Pompe disease
Deficit in glucose-6-phosphatase
Von Gierke (type 1 glycogen storage disease)
presents with severe hypoglycemia around 3-4 months
Von Gierke
Normal at birth and then within first 2 years develop coarsened facial features, large tongue, macrocephaly, corneal clouding and thickened heart valves
Hurler syndrome
Macrocephaly at birth, normal development until first febrile illness –> hypotonia and dystonia
Glutaric acidemia
Head imaging demonstrates frontal and cortical atrophy with increased extraaxial space. Will develop degeneration of caudate nucleus and putamen
Glutaric acidemia
Hypoketotic hypoglycemia when a kid placed under metabolic stress during first 3 years of life
Medium chain acyl CoA dehydrogenase
Diagnostic test for fatty acid oxidation disorder
Plasma acylcarnitines
Failure to thrive, hepatic dysfunction, renal dysfunction without hypoglycemia, x-ray findings of rickets
Tyrosinemia type 1
Succinylacetone in urine
Tyrosinemia type 1
Academic difficulty, impulsivity, gait abnormalities, slurred speech, hyperpigmentation on physical exam
adrenoleukodystrophy
By 5 days of age - poor feeding, lethargy, respiratory alkalosis, hyperammonemia and hypotonia
Urea cycle disorder
Differentiation between ornithine transcarbamylase deficiency and carbamoyl phosphate synthetase deficiency?
check urine orotic acid. Will be low or normal in CPS and high in OTC
Rapid growth in early childhood without an endocrine explanation. Continues until 4-5 years of age and then return to normal growth pattern and reach typical adult heights. Have large hands, feet, foreheads and intellectual disability
Sotos syndrome
Bilateral premature closure of coronal sutures with midface hypoplasia, proptosis, and normal intelligence, normal hands and feet
Crouzon syndrome
Premature closure of multiple sutures with syndactyly, “mitten hand” and intellectual disability
Apert syndrome
Fusion of mulitple sutures (commonly lamboid and sagittal), syndactyly, intellectual disability, CHD, corneal opacities
Carpenter syndrome
Rake an object without grasping it
6 months
Scissor grasp - grab object between thumb and side of curved index finger
8 months
Early pincer grasp with distal thumb joint slightly flexed
10 months
Fine pincer grasp with index finger and thumb joints flexed
12 months
Cardiac differences between noonan and turners
Noonans - ASD and pulmonic stenosis
Turners - aortic
hearing loss, iris heterochromasia, white forelock, premature graying, cutaneous depigmentation
Waardenburg syndrome
Crowe sign
axillary freckling
Absent/underdeveloped uterus and vagina, but normal developing external genitalia and ovaries. So still have pubic hair and breast development, but often diagnosed when no mensturation
Mullerian Aplasia/MRKH Syndrome