Genetics Flashcards

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1
Q

Codominance

A

Both alleles participate in phenotype of heterozygote

Ex : blood groups, alpha1-antitrypsin deficiency

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2
Q

Variable expressivity

A

Same genotype, not same phenotype.

Ex : 2 NF1 patients not same symptoms/disease severity

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3
Q

Incomplete penetrance

A

Not all individuals with genotype have phenotype

Ex : BRCA1 not always ovarian or breast cancer (65% sein, 45% ovaire)

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4
Q

Pleiotropy

A

One gene contributes to multiple phenotypic effect (phenotype pas le reflet de l’effet seul du gène)
Ex: non-tx phenylketonuria manifests with light skin, intellectual disability, musty body odor

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5
Q

Anticipation

A

increased severity with generations

ex: huntington disease

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6
Q

Loss of heterozygosity

A

If patients inherits or develops mutation in tumor suppressor gene, complementary allele must be deleted/mutated before cancer develops
ex: Rb, Li-Fraumeni syndrome, Lynch syndrome

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7
Q

Dominant negative mutation

A

Exerts a dominant effect. Heterozygote produces nonfunctional altered protein that also prevents normal gene product.
ex: mutation of transcription factor in its allosteric site

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8
Q

Linkage desequilibrium

A

Tendency of certain alleles at 2 linked loci to occur together more or less often than expected by chance

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9
Q

Mosaicism

A

Presence of genetically distinct cell lines in the same individual (2 or more genetically different sets of cells). Can be somatic or gonadal.

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10
Q

Locus heterogeneity

A

Mutation at different loci produce similar phenotype

ex: albinism

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11
Q

Allelic heterogeneity

A

Different mutations in the same locus produce same phenotype.
ex: beta-thalassemia

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12
Q

Heteroplasmy

A

Presence of both normal and mutated mtDNA resulting in variable expression in mitochondrially inherited disease.

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13
Q

Uniparental disomy

A

Kid receive 2 copies of chromosome from 1 parent and no copie from the other. If heterozygous meiosis I error. If homozygous meiosis II error. (when recessive disorder but 1 parent only is carrier)

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14
Q

McCune-Albright Syndrome

A

Mutation affecting G-protein signaling
Sx :
-unilateral café-au-lait spots with ragged (irrégulier) edges
-Polyostotic fibrous dysplasia
-At least 1 endocrinopathy
Prognosis : lethal if before fertilization, survivable if mosaism

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15
Q

Imprinting

A

At some loci, one allele is active and the other is inactive. If active allele mutated -> disease

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16
Q

Prader-Willi syndrome

A

Mutation/deletion on chromosome 15 (same locus as Angelman)
Maternal imprinting : maternal gene is silent, dad gene is mutated/deleted.
25% maternal uniparental disomy
Sx : hyperphagia + obesity, DI, hypogonadism, hypotonia

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17
Q

Angelman syndrome

A

Mutation/deletion on chromosome 15 (same locus as Prader-Willi)
Paternal imprinting : maternal gene is mutated/deleted, dad gene is silent.
5% paternal uniparental disomy
Sx: inappropriate laugher (happy puppet), seizures, ataxia, severe DI

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18
Q

Hypophosphatemic rickets

A

X-linked dominant

Rickets-like symptoms

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19
Q

MELAS syndrome

A

Mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes (MELAS)
Mitochondrial myopathy disease, rare
Pathogenesis: failure in oxidative phosphorylation
Dx: muscle biopsie -> ragged red fibers

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20
Q

Autosomal dominant diseases

A
Achondroplasia (nainisme)
Autosomal dominant polycystic kidney disease (ADPKD)
Familial adenomatous polyposis
Familial hypercholesterolemia
Hereditary hemorrhagic telangiectasia
Hereditary spherocytosis
Huntington disease
Li-Fraumani syndrome
Marfan syndrome
Multiple endocrine neoplasias
NF1 and NF2
Tuberous sclerosis
von Hippel-Lindau disease
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21
Q

Autosomal recessive diseases

A
Albinism
Autosomal recessive polycystic kidney disease (ARPKD)
Cystic fibrosis
Glycogen storage diseases
Hemochromatosis
Kartagener syndrome
Mucopolysaccharidoses (except Hunter syndrome)
Phenylketonuria
Sickle cell anemia
Sphingolipidoses (except Fabry disease)
Thalassemias
Wilson disease
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22
Q

X-linked recessive disorders

A
Ornithine transcarbamylase deficiency
Fabry disease
Wiskott-Aldrich syndrome
Ocular albinism
G6PD deficiency
Hunter syndrome
Bruton agammaglobulinemia
Hemophilia A & B
Lesch-Nyhan syndrome
Duchenne (and Becker) muscular dystrophy
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23
Q

Cystic fibrosis

A

Autosomal recessive. Defect gene CFTR, chromosome 7.
Commonly deletion Phe508.
Most common lethal genetic disease in caucasian

Pathophysiology: CFTR encodes ATP-gated Cl- that secretes Cl- in lungs + GI and reabsorbs Cl- in sweat glands. Mutation -> protein not transported to cell membrane -> reduced Cl-/H2O secretion -> increased intracellular Cl- -> increased compensatory Na+ reabsorption -> increased H2O absorption -> thick mucus

Dx: Cl- > 60mEq/L in sweat. Raised immunoreactive trypsinogen (newborn screening). Can present with contraction alkalosis and hypokalemia.

CXR: reticulonodular pattern. Rx sinus: opacification

Complications: Recurrent pulmonary infections (S. aureus infancy -> P. aeruginosa adolescence), chronic bronchitis, bronchiectasis. Pancreactic insuffisency, malabsorption with steatorrhea, ADEK deficits, liver disease, biliary cirrhosis. Meconium ileus in newborns. Infertility in men (no vas deferens) and subfertility in women (thick cervical mucus). Clubbing. Nasal polyps.

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24
Q

Muscular dystrophy of Duchenne

A

X-linked recessive disorder (most frequent in male). Onset before 5 yo.
Frameshift or non-sense mutation = truncated or absent dystrophin protein -> progressive myofiber damage.

Sx:

  • muscular weakness starting in pelvic girdle and progress superiorly. (Gower sign + lordosis)
  • pseudohypertrophy of calf muscles (fibrofatty muscle replacement)
  • Waddling (dandinant) gait
  • dilated cardiomyopathy (main cause of death)
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25
Q

Muscular dystrophy of Becker

A

X-linked recessive disorder (most frequent in male). Onset ado or adult
Non-frameshift deletions in dystrophin gene -> partial . function instead of truncated. Less severe than Duchenne.

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26
Q

Myotonic type I

A
Autosomal dominant
(CTG)n -> trinucleotide repeat expansion in DMPK gene -> abnormal expression of myotonin protein kinase

Sx: myotonia, muscle wasting, cataracts, testicular atrophy, frontal balding, arrhythmia

27
Q

X Fragile syndrome

A

X-linked dominant
Trinucleotide repeat in FMR1 gene : (CGG)n -> reduced expression
Most common cause of inherited DI and autism
but 2 most common cause of genetically associated DI (after Down)

Sx:

  • post-pubertal macroorchidism
  • long face with large jaws (protruding chin)
  • large everted ears
  • autism
  • mitral valve prolapse
28
Q

X-linked dominant

A

X fragile syndrome, Alport syndrome, hypophosphatemic rickets

29
Q

Huntington disease

A

(CAG)n -> caudate has decreased Ach and GABA

30
Q

Friedreich ataxia

A

(GAA)n -> ataxic gait

31
Q

Trinucleotide repeat expansion disease

A

Huntington disease -> (CAG)n
X-Fragile syndrome -> (CGG)n
Myotonic dystrophy -> (CTG)n
Friedreich ataxia -> (GAA)n

32
Q

Down syndrome (T21)

A

1/700
Most common viable chromosomal disorder
Most common genetic cause of intellectual disability

95% meiotic nondisjunction (raised with maternal age: 1/1500 <20 -> 1/25 >45)
4% unbalanced Robertsonian translocation betweend chromosomes 14 and 21 usually
1% mosaicism

Dx: raised CN and b-hCG, hypoplastic nasal bone, reduced PAPP-A in T1. reduced alpha-foetoprotein/estriol and raised inhibin A/b-hCG in T2.

Sx:

  • DI
  • Flat facies
  • Proeminent epicanthal folds
  • Single palmar crease/simian crease
  • gap between 1st 2 toes
  • duodenal atresia
  • Hirschsprung disease
  • Congenital heart disease (AV septal defect)
  • Brushfield spots (eye)
  • early-onset alzheimer disease
  • raised risk of ALL and AML
  • hypoT4
33
Q

Edward syndrome (T18)

A

1/8000
2nd most common autosomal trisomy resulting in live birth. Death by 1 yo.

Dx: reduced PAPP-A/b-hCG in T1. Also, reduced, alpha-foetoprotein/estriol and inhibin A (or N)

Sx:
P rominent occiput
R ocker-bottom feet (piolet)
I ntellectual disability
N ondisjuntion (chromosome 18)
C lenched fist (overlapping fingers)/C ongenital heart disease
low-set Ears
\+ small jaw (micrognatie)
34
Q

Patau syndrome (T13)

A

1/15000. Death by 1 yo.

Dx: redeuced b-hCG/PAPP-A

Sx:

  • severe DI
  • rocker-bottom feet (piolet)
  • microphtalmia
  • microcephaly
  • cleft lip/palate
  • holoprosencephaly
  • polydactyly
  • cutis aplasia (absence zone de peau)
  • congenital heart disease
35
Q

Disease on Ch 3

A

von Hippel-Lindau disease, renal cell carcinoma

36
Q

Disease on Ch 4

A

ADPKD (PKD2), achondroplasia, Huntington disease (CAG)

37
Q

Disease on Ch 5

A

Cri-du-Chat syndrome, familial adenomatous polyposis

38
Q

Disease on Ch 6

A

Hemochromatosis (HFE)

39
Q

Disease on Ch 7

A

Cystic fibrosis, Williams syndrome

40
Q

Disease on Ch 8

A

None for exam

41
Q

Disease on Ch 9

A

Friedreich ataxia

42
Q

Disease on Ch 1

A

None for exam

43
Q

Disease on Ch 2

A

None for exam

44
Q

Disease on Ch 10

A

None for exam

45
Q

Disease on Ch 11

A

Wilms tumor, beta-globin gene defects (sickle cell diseasem beta-thalassemia, MEN1)

46
Q

Disease on Ch 12

A

None for exam

47
Q

Disease on Ch 13

A

Patau syndrome, Wilson disease, retinoblastoma (RB1), BRCA 2

48
Q

Disease on Ch 14

A

None for exam

49
Q

Disease on Ch 15

A

Prader-Willi syndrome, Angelman syndrome, Marfan syndrome

50
Q

Disease on Ch 16

A

ADPKD (PKD1), alpha-globin gene defects (alpha-thalassemia)

51
Q

Disease on Ch 17

A

NF1, BRCA 1, p53

52
Q

Disease on Ch 18

A

Edwards syndrome

53
Q

Disease on Ch 19

A

None for exam

54
Q

Disease on Ch 20

A

None for exam

55
Q

Disease on Ch 21

A

Down syndrome

56
Q

Disease on Ch 22

A

NF2, DiGeorge syndrome (22q11 deletion)

57
Q

Disease on X

A

X-Fragile syndrome, X-linked agammaglobulinemia, Klinefelter syndrome (XXY)

58
Q

Robertsonian translocation

A

Usually pairs 13,14,15,21,22 as the centromere is near the end of the Ch (acrocentric Ch).
Long arms fuse at the centromere and short arms are lost.
If balanced -> no change in phenotype
If unbalanced -> miscarriage, stillbirth, ch imbalance (Down, Patau)

59
Q

Cri-du-Chat syndrome

A

Congenital microdeletion of short-arm of Ch 5

Sx: microcephaly, moderate to severe DI, high-pitch crying/meowing, epicanthal folds, cardiac abnormalities (VSD)

60
Q

Williams syndrome

A

Congenital microdeletion long arm Ch 7 (includes elastin gene)

Sx:

  • Elfin facies
  • DI
  • hyperCa (raised sensitivity to vit D)
  • well-developed verbal skills
  • extreme friendliness with strangers
  • CV problems (?)
61
Q

22q11 deletion syndromes

A

Microdeletion at chromosome 22q11 -> aberrant development of 3rd and 4th branchial pouches

Sx (variable -> ligne médiane surtout!!):

  • cleft palate
  • abnormal facies
  • thymic aplasia -> T-cell deficiency
  • Cardiac defects
  • Hypocalcemia (parathyroid aplasia)
62
Q

DiGeorgeo syndrome

A

22q11 deletion syndrome

Sx:

  • Thymic defect
  • Parathyroid defect
  • Cardiac defect
63
Q

Velocardiofacial syndrome

A

22q11 deletion syndrome

Sx:

  • Palate defect
  • Facial defect
  • Cardiac defect