Genetics Flashcards
Rendu-Osler-Weber syndrome
AKA - Hereditary hemorrhagic telangiectasia
Autosomal dominant
Pulmonary AVMs (hepatic and cerebral AVMs as well)
Can present with stroke
Bland-White-Garland syndrome
Anomalous origins of the left coronary artery from the PA
Turner syndrome clinical associations
- Short stature
- Premature ovarian failure
- Sensorineural hearing loss
- Webbing of neck
- Lower extremity edema
- Downslanting palpebral fissures
- Widely spaced nipples, shield chest
- Madelung deformity of the wrist
- Bicuspid aortic valve
- Coarctation
- PAPVR
Congenital rubella cardiac associations
- Pulmonary artery stenosis
- PDA
- Tetralogy of Fallot
- VSD
- Coarctation (rare)
Hypertrophic cardiomyopathy inheritance pattern
Autosomal dominant
Down syndrome genetic mutation
Trisomy 21 translocation (3-4%), mosaicism (1%)
Low tone, upslanting palpebral fissures, advanced maternal age, brushfield spots, low nasal bridge, single palmar crease
Down syndrome
Complete AV canal, VSD, ASD, PDA, ToF
Polyvalvar disease, clenched hands with overlapping fingeres, nail hypoplasia, low set ears, small mouth
Trisomy 18 - Edward syndrome
Polyvalvar disease, VSD, ToF, pulmonary hypertension
Orofacial clefts, micropthalmia, postaxial polydactyly, holoprosencephaly
Trisomy 13 - Patau syndrome
ASD, VSD, DORV, pulmonary hypertension
Turner syndrome inheritance pattern
45X
De novo or X-linked
Interrupted aortic arch type B genetic association
DiGeorge
DiGeorge clinical features
Absent thymus
Hypocalcemia
Immunodeficiency
Cleft palate
Bulbous tip nose
Low set ears
Conotruncal defects (ToF, IAA-B, truncus) or aortic arch anomalies
DiGeorge genetic inheritance
22q11.2 microdeletion
De novo in 90%, can be autosomal dominant
Williams syndrome genetic mutation
7q11.23 microdeletion
De novo or Autosomal dominant
Supravalvar aortic stenosis, supravalvar pulmonary stenosis, short stature, hoarse voice, stellate irises
William syndrome
Cri du chat genetic mutation
5p deletion
De novo or autosomal dominant
Cat-like cry, PDA, VSD, microcephaly, low birthweight, micrognathia
Cri du chat
Jacobsen syndrome genetic mutation
11q-telomere deletion
De novo or autosomal dominant
Jacobsen sydrome clinical features and cardiac disease
VSD, LVOTO (MS/BAV, AS, Coarc), HLHS
Trigonocephaly, small low set ears, ptosis, epicanthal folds, broad nasal bridge, platelet dysfunction, immune deficiency, pyloric stenosis
1p36 deletion syndrome cardiac associaton
LVNC cardiomyopathy
CHARGE syndrome clinical features
- Coloboma
- Heart (conotruncal defects - ToF, DORV, IAA, AV canal, arch anomalies)
- Atresia choanal
- Retarded growth/development
- Ear anomalies/deafness
CHARGE syndrome genetic mutation
CHD7 mutation
De novo/autosomal dominant
Alagille syndrome genetic mutation
JAG1 genet mutation
20p12 deletion
NOTCH2 gene
Peripheral pulmonic stenosis, triangular facies, butterfly vertebrae, hyperbili, cholestasis
Alagille syndrome
Upper extremity anomaly, absent thumb, common atrium, heart block, affected parent
Holt Oram
Genetic mutation in Holt Oram
TBX5
De novo/Autosomal dominant
Genetic mutation in Noonan Syndrome
PTPN11, RAF1
Pulmonic stenosis (dysplastic valve), HCM, short stature, neck webbing, low set ears
Noonan syndrome
LEOPARD syndrome
- Lentigines
- ECG abnormalities (PR prolongation)
- Ocular hepertelorism
- Pulmonic valve stenosis
- Abnormalities of genitalia
- Retardation of growth
- Deafness
Same gene as Noonan (PTNP11)
Cafe au lait spots, axillary/inguinal freckling, cutaneous neurofibromas Lisch nodules
Neurofibromatosis type 1
Risk for coarc or PS
Broad thumbs, intellectual disability, PDA, septal defects
Rubinstein-Taybi
Genetic mutation in Rubinstein-Taybi
CREBBP and EP300 mutation
De novo/autosomal dominant
Short stature, dental anomalies, polydactyly, common atrium, nail hypoplasia, neonatal teeth
Ellis van Creveld
Autosomal recessive (EVC and EVC2)
Growth deficiency, wide palpebral fissures, arched broad eyebrows, large ears, left sided lesions (HLHS)
Kabuki syndrome
Marfan syndrome genetic mutation
FBN1
Tall thin habitus with long armspan, scoliosis, thick glasses, pectus, aortic root dilation, mitral valve prolapse, ectopia letntis
Marfan syndrome
Indication to repair at > 45 mm dilated
Loeys Dietz genetic mutations
TGFBR1, TGFBR2, SMAD2, SMAD3, TGFB2, TGFB3
Arterial aneurysms, tortuosity, aortic root dilation, widely spaced eyes, bifid uvula, pectus, BAV, club foot
Loeys Dietz
Ehlers Danlos genetic mutation
COL5A1, COL5A2, COL3A1
Hypermobility and joint dislocations, thin skin, prominent veins, spontaneous arterial rupture, TV prolapse, MV prolapse, aortic root dilation
Ehlers Danlos
Kartagener syndrome genetic inheritance
Autosomal recessive
32 gene mutations
Dextrocardia, bronchiectasis, nasal polyps, situs inversus
Kartagener syndrome
Cardiac rhabdomyoma, angiofibromas, hypomelanotic macules, shagreen patch, infantile spasms
Tuberous sclerosis
TSC1 and 2 (autosomal dominant)
Carney complex clinical association
Atrial myxoma recuring within a family with skin and extracardiac tumors
VACTERL clinical findings
- Vertebral
- Anal
- Cardiac
-TEF with esophageal atresia
-Radial or renal dysplasia - Limb anomalies
Duchenne muscular dystrophy genetic inheritance
DMD
Frame shift mutations
Most common genes in HCM
MYH7 - autosomal dominant
MYBPC3 - autosomal dominant
TNNT2 - autosomal dominant
TNNI3 - autosomal dominant/recessive
TPM1 - autosomal dominant
Early childhood, delayed motor milestones, difficulty climbing stairs, Gower sign, dilated cardimyopathy
Duchenne
Mean age of 14 for cardiomyopathy onset
Friedreich ataxia genetic mutation
FXN
autosomal recessive
HCM, affected siblings with unaffected parents, ataxia, absent lower extremity reflexes
Friedreich Ataxia
MELAS cardiac manifestations
HCM, WPW, AV block
Lactiic acidosis and strokes
Kearns-Sayre cardiac manifestation
Heart block - class 1 indication for pacemaker insertion
Pompe disease cardiac association
Short PR, HCM, giant ECG voltages (infantile onset severe biventricular hypertrophy)
Most common glycogen storage disease to cause HCM
Tx with enzyme replacement
Pompe disease genetic mutation
GAA
Autosomal recessive
Hurler syndrome genetic mutation
IDUA - autosomal recessive
Hurler syndrome cardiac manifestation
HCM
DCM
thickening and dysfunction of mitral and aortic valves
NO EYE INVOLVEMENT (difference between Hunter and Hurler)H
Hunter syndrome genetic mutation
IDS
X-linked
Genetic mutation in Gaucher disease
GBA
Autosomal reessive
Clinical findings in Gaucher disease
Hepatosplenomegaly, anemia, HCM, thrombocytopenia, calcification of mitral and aortic valves
Genetic mutation in Fabry disease
GLA
X linked
Clinical findings in Fabry disease
Periodic pain crises, angiokeratomas, corneal clouiding, HCM
Male, neutropenia, growth delay, DCM, LVNC
Barth syndrome
X linked
Heart lesions associated with maternal PKU
Left sided lesions (coarc, HLHS), ToF and septal defects
ASD, thumb or carpal bone defect genetic condition
Holt Oram
TBX5 mutation
Lentigines, ECG changes (1st degree block), Ocular hypertelorism, Pulmonary stenosis, Abnormal genitals, Retarded growth, Deafness – genetic syndrome and defect
LEOPARD syndrome
Autosomal dominant PTPN11 or RAF1
Complete heart block and ASD genetic defect
NKX2.5 location on 5q
Genetic mutation that causes Kabuki syndrome
MLL2
Genetic conditions associated with PAPVR
Turner Syndrome and Noonan syndrome
Triangular shaped face, broad forehead, deep set eyes with biliary atresia and pulmonary stenosis
Alagile syndrome
Clinical features of Jacobsen syndrome
- Wide spaced eyes
- Ptosis
- Small ears
- Thrombocytopenia
- VSD
- Left sided lesions (mitral valve abnormalities)
Cardiac defects with fetal retinoic exposure
Conotruncal defects
Cardiac defect with Ellis van Creveld
Large ASD
Arched eyebrows, broad thumbs, cryptorchidism, severe constipation, septal defects (PDA/ASD/VSD)
Rubinstein Taybi
CREBBP mutation
No succinylcholine
Which two conditions can be tested for with chromosomal microarray
22q11
Williams
The majority of the other syndromes on boards are single gene disorders and not detected on CMA
Two main autosomal recessive diseases tested on boards
Kartagener
Ellis van Creveld
The majority are autosomal dominant
Elevated CK, DCM, skeletal muscle abnormalities
Test for DMD or Becker’s
Dystrophin gene abnormality
Genes associated with DCM and high risk for sudden arrhythmia associated death
EMD
LMNA
DES
Onset age < 20, pigmentary retinopathy, progressive external ophthalmoplegia, rapid progression to heart block
Kearns Sayre
Mitochondrial deletion syndrome
Class 1 indication for pacemaker
Giant ECG voltages, HCM in infant
Pompe disease
Glycogen storage disease
Bone pain, thrombocytopenia, HSM, calcification of mitral and aortic valves, oculomotor apraxia
Gaucher disease
Glucocerebrosidase deficiency
Males with severe periodic extremity pain, corneal clouding, renal disease, mitral valve disease, HCM
Fabry disease
Alpha-galactosidase-A deficiency
Infantile onset HCM
Noonan or RASopathy
Most common heart disease associated with mucopolysaccharidosis
Mitral and aortic valve disease
Long QT with sensorineural hearing loss
Jervell and Lange-Nielsen syndrome
- KCNQ1 gene mutation
- Autosomal recessive
Marfan like features with intellectual disability
Homocystinuria – also at risk for thromboembolic effects
Diagnose with homocysteine levels