Genetics Flashcards
What are chromosomes?
- are structures found within the cell nucleus
- composed of
- DNA
- RNA
- polysaccharides
- histone
- non histone proteins
-
thin thread like structures that have a
- short p arm
- long q arm
- separated by a centromere
- only seen under light microscope during cell division when condensed x1000 magnifcation

How many chromsomes does the normal human have?
- karotype of normal human is 46 chromosomes= diploid number
- this includes 22 autosomal pairs and **2 sex **chomosomes
What are the chromsomes basic shape?
- All depend on centromere location
-
Metacentric
- chromosomes have p and q arms of approx **equal length **
- e.g. chromosome 1
-
Submetacentric
- Chromosomes have a p and q arms of different length
- e.g. chromosome 6
-
Acrocentric
- centromere is near one end
- so very short p and q long
- e.g chromosome 13
What is DNA?
- Polymer of deoxyribonucleotides
- composed of
-
nitrogenous base
- purine or pyridamine
- contain genetic information
- a sugar
- phosphate group
-
nitrogenous base
What are the purine bases?
- Adenine
- Guanine
What are the pyrimidine bases?
- Thymine
- Cytosine
What is the structure of DNA?
- Watson and Crick deduced the Double helical structure of DNA with paired bases at the centre
- Hydrogen bonds between the bases hold them together
- Adenine always paired w Thyamine = ‘AT’
- Guanine always paired with Cytosine = “GC”

What process allow somatic cells to grow and divide?
- Mitosis
- replication of DNA involves unwinding of DNA
- allowing a complementary DNA daughter strand to be formed using the original strand as a template
- semi conserative process as each new helix contains one of the original chromosomal strands
What do genes code for?
- Protein synthesis
What happens in transcription?
- Templates are produced from the DNA in the form of messenger ribonucleic acid ( mRNA)
- the mRNA exits nucleus into the cellular cytoplasm
- By combining with other RNA moelcules such as tRNA ( transfer RNA) and ribosomal RNA ( rRNA) protein synthesis takes place at the ribosomes
What is the role of proteins?
- Mechanical tissue strength seen in skeletal tissue due to collagen
- muscle contraction occurs with interaction of actin and myosin protein filaments
- proteins act as transport molecules and enzymes during biological reactions
- immune system in the form of antibodies
What is the process of meisosis?
- in sexual reproduction the chromosomes separate to form a haploid number, including one copy of each autosome and a single sex chromosome
- a child inherits one half of his or her autosomal pair and one sex chromosome from each parent
Name some whole chromosome abnormalities?
- Monosomy = Turner’s syndrome
- Trisomy= Down’s syndrome/ Kleinefelter
What is the name given to loss or gain of whole chromosomes?
- Aneuploidy
- can effect autosomes or sex chromosomes
What is Turner’s syndrome?
-
Loss of one X chromosome
- ie XO ( paternal X chromsome absent- sporadic event)
- incidence 1 in 2000 live births
- exclusively females
- short female
- skeletal abnormalities
- cubitus valgus
- medial tibial exostosis
- short 4th MC/ MT
- cranoifacial
- renal tract
- cardiovascular anomalies

What is trisomy ?
- Cells have an extra chromosome
What is down’s syndrome?
- Trisomy 21 ( extrachromosome 21)
- Incidence 1 in 660 live births
- Risk assoc with increase maternal age > 35 yrs
- 95% aetiology is failure of separation of the autosomal pair during meisosis
- 3.5 % due to translocation of one autosomes
- 2.5 % due to mosaicism (where some cells have 47 chromosomes)
- orthopaedic manifestations
- atlantoaxial instability
- joint laxity with recurrent dislocation of patella
- increased risk of SUFE
What is Kleinfelter’s syndrome?
- An addition of an extra X chromsome
- so XXY
- incidence is 1 in 1000 male births
- Tall , thin male with infertility and hypogonadism

What is the genotype ?
- The inherited genetic code that produces the **physical appearance= ** phenotype
What is an allele?
- One or two alternative forms of the gene that can have the same locus on the homologous chromosome and are responsible for alternative traits
- if alleles similar = homozygous trait
- if alleles different = heterpzygous trait

Describe how the structure abnormalites of chromosomes can occur?
-
Point mutations
- specific nucleotide bases
-
Deletions
- loss of part of chromosome
-
Inversions
- inversion of chromosome by 180 degrees-> misreading of genetic code
-
Translocations
- movement of genetic material from one chromosome to naother
What is penetrance?
- relates to the probability that the phenotype will be expressed
What is incomplete penetrance?
- defined as inheritance of the mutant gene without expression of the phenotype of the disorder
What is variable expressivity?
- In which a patient always expresses some of the symptoms of the mutant gene
What is autosomal dominant inheritance?
- Affected individuals are heterozygous for the mutation
- homozygous individuals often don’t survive
- 50% of inheritance from one heterozygous parent
- M= F affected
Name some examples of autosomal dominant inheritance?
- Achondroplasia
- Osteogenesis imperfecta
- Neurofibromatosis type 1
- Marfan’s syndrome
- multiple epiphyseal dysplasia
- mutliple hereditary exostoses
What is achondroplasia?
- Most common form of disporportionate rhizomelic dwarfism ( short limb)
- inherited as complete penetrance
- 87% result of new mutation
- gene encoding on chromosome 4, p16.3
- mutation affects Fibroblast growth factor receptor 3 ( FGFR3)

What is Osteogenesis imperfecta?
- A generalised disease of connective tissue due to a quantitative or qualitative defect of type 1 collagen
-
Sillence classified
- 1-IV
- with subgroups in 1 and IV of A /B
- where B = dentinogenesis imperfecta
- Autosomal dominant condition- cases from unaffected parents is mosaicism
- pro-alpha 1 chain is encoded by COL1A1 gene on chromosome 17 and the pro-alpha 2 chain is encoded by COL1A2 gene on chromosome 7
What is neurofibromatosis inherited as?
- Autosomal dominance
- Complete penetrance but high variable expressivity
- 50% of pts have a fresh gene mutation
- gene encoded on chromosome 17 locus q11.2
- the gene encodes the protein Neurofibromin which acts as a tumour suppressor
What is the defect in marfan’s syndrome?
- Mutation in fibrillin 1 gene
- connective tissue disorder
- arachnodactyly
- scoliosis (50%)
- protrusio acetabuli (15-25%)
- ligamentous laxity
- recurrent dislocations (patella, shoulder, fingers)
- pes planovalgus
nonorthopaedic conditions
- cardiac abnormalities
- aortic root dilatation
- possible aortic dissection in future
- mitral valve prolapse
- superior lens dislocations (60%)
- pectus excavatum
- spontaneous pneumonthoraces
- dural ectasia (>60%)
- meningocele
What is the genetic mutation in mutliple hereditary exostoses?
- EXT 1 and EXt2 gene
- autosomal dominant
- individuals with the EXT1 mutation have a more severe presentation compared to patients with the EXT2 mutation including
- higher rate of chondrosarcoma 5-10% of transformation, proximal lesions more likely to undergo transformation than distal ones
- more exostoses
- more limb malalignment with less forearm and knee range of motion
- more pelvic and flatbone involvement
What is autosomal recessive inheritance?
- Affected individuals are homozygous for the genetic mutation
- Heterozgyous individuals are carriers
- 25% of producing an affected individual from 2 parent carriers
- M= F affected
- autosomal recessive conditions often produce errors of metabolism due to deficiency of specific enzymes
Can you name some examples of autosomal recessive conditions?
- Mucopolysaccharidoses ( except Hunters)
- Sickle cell anaemia
- Diastrophic dysplasia
What is type 1 mucopolysaccharidosis?
-
Hurler syndrome
- mental retardation
- disporportinate dwarfism
- diaphyseal bordening of short misshapen boness
- flaring of rib cage
- widening medial end of clavicle
- anterior wedging of verterbral bodies-> kyphosis/ thoracolumbar gibbus
- odontoid hypoplasia
- cloudy cornea
- caused by alpha 1 iduronidase deficiency
- Dermatan sulphate in urine
- death in first decade of life

What is type IV mucopolysaccharidosis?
-
Morquio
-
Type A= deficiency in galactosamine 6 sulphatase
- chromosome 16 q24.3
-
Type B= deficiency in beta -galactosidases
- chromosome 3 p21.33
-
Type A= deficiency in galactosamine 6 sulphatase
- Proportinate dwarfism
- Normal mental IQ
- both need enzyme to break down glycoaminoglycans- esp keratan sulphate interferes with cartilage at growth plate
- Keratan sulphate in urine
- type A more severe
- both live into adulthood
- skeletal
- platyspondyly
- ovoid vertebra & odontoid hypoplasia
- flaring of rib cage
- flattening of femoral heads
- Genu valgum
- Joint laxity

What other form of mucoploysaccharidosis is inherited by autosomal recessive?
San filipio
- Multiple enzyme defiencies
- Proportinate dwarfism
- Mental retardation
- clear cornea
- Urine- Heparan sulphate in urine
- death in 2nd decade of life
What is the inhertance of sickle cell disease?
- Autosomal recessive of single gene leading to the subsitution of glutamine for valine at position 6 of the beta-globulin chain of haemaglobin
What is the genetic defect in disatrophic dysplasia?
- Sulphate transporter
- DTDST gene (SLC26A2) on chromosome 5
- failure of formation of the secondary centres of ossification ( epiphysis)
- rhizomeliz dwarfism
- hitcher’s thumb
- cauliflower ears
- autosomal recessive

What is the genetic defect in multiple epiphyseal dysplasia?
- Cartilage oligomeric matrix protein (COMP) or type IX collagen ( **COL9A2) **
- causes type 2 collagen dysfunction as type IX collagen acts as a link protein for type 2 collagen
- autosomal dominant
- A form of dwarfism ( short limbed) characterized by irregular, delayed ossification at multiple epiphyses
What is x linked dominant inheritance?
- Either sex affected
- phenotype is dominant when a heterozygous female expresses the phenotype
- 50% sons and 50% daughters risk inheritance from an affected mother
Name an example of x linked dominant inheritance?
-
Hypophosphataemic rickets
- males express disease fully but females have expressivity in the heterozygous genotype
- PEX ( cellular endopeptidases)
What is X linked recessive inheritance?
- Phenotype is recessive when expressed by a homozygous female
- All males are affected
- Heterozygous females are carriers
- 25% of producing a normal male/female
- an affected male transmits the affected gene thru all his daughters
Name some x linked recessive disorders?
-
Duchenne muscular dystrophy
- deficiency of protein **dystrophin **
-
Haemophilia A
- deficiency in clotting factor VIII
-
Hunter’s syndrome - mucopolysaccharidosis
- sulpho-iduronate-sulphatase deficiency
- -> accumulation of dermatan and sulphate in urine
- proportionate dwardfism
- mental retardation
- clear cornea
What is the genetic mutation in spondyloepiphyseal dysplasia?
- caused by abnormal synthesis of Type II collagen
- **A form of short-trunk dwarfism caused by a defect in the secondary ossification center (epiphysis) **
- **mutation = COL2A1 on chromosome 12 **
- inheritance
* **autosomal dominant (SED congenita) X linked recessive (SED tarda) random mutation (50% of cases)**