GENETICS/GENES Flashcards
AD
CAG Trinucleotide repeat
HTT gene on Chrom 4
athetosis (shaking wrist/hands), chorea, dementia
Huntington’s disease- GABA neuron deficiency in caudate nucleus of BG
ATP7B gene
copper (Cu2+) accumulation in brain, kidneys, liver, eye (kayser-fleischer ring)
-DEFECT IN EXRCRETION OF COPPER INTO BILE
Wilson’s disease
*TOTAL COPPER levels are DECREASED
*CERULOPLASMIN DECREASE
*FREE COPPER LEVELS ARE INCREASED!!!
Prion disease
abnormal folding proteins in B pleated sheets
rapidly progressing dementia
ataxic
myoclonic
Creutzfeldt-Jakob disease
what is the pathogenesis of Lewy body dementia?
(visual hallucinations, parkinsonism, fluctuating consciousness, REM sleep disorder)
-Alpha -synuclein aggregates (lewy bodies)
what is the pathogenesis of Wenicke encephalopathy/Korsakoff syndrome?
Chronic alcohol abuse
W: ataxia, horizontal nystagmus, lateral rectus palsy, confusion
K: severe memory impairment, retrograde/anterograde, confabulation
-atrophy of mammillary bodies
what is the path of MS?
(visual disturb, ataxia, GI/urinary probs, weakness, sens/neuro probs)
-AI destruction of myelin and oligodendrocytes
what disease is excessive daytime sleepy, cataplexy, hallucinations, sleep paralysis with decreased orexins (hypocretins) in lateral hypothalamus?
Narcolepsy
AR
disease with absent DNA repair enzymes and increased incidence of UVB related skin cancers
Xeroderma pigmentosum
MC vitamin def in alcoholics?
folate
MC metal def in alcoholics?
magnesium
what vitamin is associated with pyruvate dehydrogenase?
thiamin
what happens to the other kidney if one is damaged?
it undergoes hypertrophy
what vit toxicity decreases the levels of Vit k factors, increases incidence of hemorrhagic strokes, and potentiates the action of warfarin?
Vitamin E
carboxylase reaction in conversion of pyruvate –> oxaloacetate?
Biotin reaction
-Cherry red macula
Tay Sachs disease
transamination reactions involving transaminases AST and ALT?
pyridoxine B6
what inhibits ADH release, ATII effect on stimulating thirst, aldosterone secretion, renal absorption of Na (direct effect, Na loss in urine), inhibits renal release, and vasodilator the peripheral resistance vessels?
Atrial Natriuretic Peptide (ANP)
**complete opposite of Angiotensin II
what is the chance of a male with cystic fibrosis to have a child?
less than 5%, since vas deferent never fully develop/are atretic
-females with CF can get pregnant but it is difficult w the thick cervical mucus
what are the vitamin supplements in CF?
all of the fat soluble vitamins (A, D, E, K)
Woman is a pure vegan, is breastfeeding her baby, and baby develops anemia?
B12 deficiency
-attaches to CD21 molecule in B cells
Ebstein Barr Virus
what syndrome is hypogonadism, mental retardation, and unilateral gynecomastia?
Klinefelter syndrome (XXY)
what syndrome is hypogonadism, absent GnRH, smell problems (anosmia), and color blindness?
Kallman syndrome (hypogonadotrophic hypogonadism)
what syndrome is hypogonadism, mental retardation, retinas pigmentosum?
Lawrence Moon Biedl syndrome
what syndrome is AD PTPN11 gene problem in RAS-MAPK pathway, hypogonadism, mental retardation, short stature, webbed neck?
Noonan syndrome
what syndrome is Chrom 15 MICROdeletion of paternal origin, hypogonadism, mental retardation, short stature, obesity
Prader-Willi (angelman is deletion of a maternal origin)
patient with neurofibromatosis has severe diastolic hypertension?
probable pheochromocytoma
complications of cyclophosphamide?
hemorrhagic cystitis and transitional carcinoma of the bladder
*employees working in car assembly plant w HA/N/V, muscle weakness, abd cramps
**or people making moonshine in an old car radiator
Lead poisoning from incineration of batteries
what syndrome is a newborn female that has edema of hands/feet, cystic mass in neck, with 45 XO karyotype?
Turners syndrome
what vitamin is absent in colostrum (baby first milk)
Vitamin D
low in folate, B6, iron
high in potassium, chloride, arach acids, linoleum acids
Baby getting anemia from switching from cows milk –> goats milk
retinal hemorrhages in young children?
possible child abuse–> shaking syndrome
what bite is multiple wheals that later develop into vesicles/pustules?
Fire ant bites
what bite is PAINFUL, followed by crampy pain in thighs/abdomen ?
**carrying logs from outside, moving boxes in basement
Black widow bite
what is PAINFUL STING, followed by local itching, paresthesias, N/V, HTN?
poisonous type of scorpion bite in southwest
what bite is PAIN-LESS beginning with slightly tender red papular lesion on arm that later form a hemorrhagic blister with purpura?
Brown recluse spider bite
what bites are extremely itchy, bright red papules on legs and around waist?
Chigger bites
what disease is more likely to infect the fetus after the first trimester?
Syphilis
THC metabolites in urine after dying in accident?
delayed reaction time, impairs the persons ability to judge speed and distance
What is caused by vinyl chloride, arsenic, and thorotrast?
Angiosarcoma of the liver
Female pseudohermaphrodite with ^ ACTH, ^ urine 17-ketosteroids, LOW cortisol, LOW urine 17-hydroxycorticoids
21-hydroxylase deficiency
Female pseudohermaphrodite with ^ ACTH, ^ urine 17-ketosteroids, ^ 17-hydroxycorticoids, LOW cortisol
11-hydroxylase deficiency
MALE pseudohermaphrodite with ^ ACTH, LOW urine 17-ketosteroids, LOW urine 17-hydroxycorticoids, LOW cortisol
17-hydroxylase deficiency
what syndrome has LOW AFP?
downs syndrome
what tumor marker leads to hepatocellular carcinoma, germ cell tumors (yolk sac), testicular/ovarian cancer?
AFP/AAT
what tumor marker leads to multiple myeloma, light chains in urine (BJ protein)?
B2-microglobulin
what tumor marker leads to small cell carcinoma of lung, neuroblastoma?
Bombesin
what tumor marker leads to breast cancer?
CA 15-3
what tumor marker leads to pancreatic cancer?
CA 19-9
what tumor marker leads to ovarian cancer?
CA 125
what tumor marker leads to colorectal, pancreatic, breast, Small cell canc of lung, and BAD prognostic sign if elevated peroperatively?
CEA
what tumor/disease is assoc with oncogenic RNA virus HTLV-1?
Adult T Cell Leukemia/Lymphoma
what tumor/disease is assoc with oncogenic RNA virus HTLV-2?
Hairy Cell Leukemia
what tumor/dz is assoc with oncogenic RNA virus HCV and oncogenic DNA virus HBV?
hepatocellular carcinoma
what tumor/dz is assoc with oncogenic DNA virus EBV?
Burkitt’s, nasopharyngeal carc, polyclonal malignant lymphoma
what tumor/dz is assoc with oncogenic DNA virus HPV?
SCC of cervix, vag, vulva, anus
what tumor/dz is assoc with oncogenic DNA virus HSV8?
Kaposi’s sarcoma
-zebra bodies in lysosomes
Niemann pick disease
what disease is DEC protein intake but NORMAL total caloric intake, fatty liver from dec apolipoproteins, pitting edema, flaky pain dermatitis?
Kwashiorkor
what disease is decreased total caloric intake, loss of muscle mass?
marasmus
Craniotabes, rachitic rosary, increase in unmineralized osteoid
Rickets
gene products E6 and E7 in HPV infections inhibit what gene leading to cancer?
P53 suppressor gene
what metalloenzyme aids tumor invasion of tissue?
collagenase with Zn as a cofactor
-X linked
most common genetic cause of mental retardation in males, triplet repeat, macroorchidism at puberty
Fragile X
what is the gene mutation in Cri du chat?
-mental retardation, cry like a cat, relation with VSD
deletion of short arm on chromosome 5
AD
fibrillin defect in elastic tissue
MVP with sudden death
dissection is MCC of death
dislocated lens
Marfan’s syndrome
NF 1/2, AD
brain tumors: meningioma, acoustic neuroma, pheochromocytoma
Cafe au lait spots, Lisch nodules (hamartomas in iris)
Neurofibromatosis
AD
cerebellar hemangioblastomas
acoustic neuroma
pheochromocytoma
renal adenocarcinoma
Von hippel Lindau
Burkitts lymphoma is what translocation
t8:14
Chronic myelogenous leukemia is what translocation
t9:22
follicular B cell lymphoma is what translocation
bcl-2
t14:18
what renal acidosis is:
Normal AG metabolic acidosis
Aldosterone mediated proton pump in CD is dysfunctional
-cant secrete H, regenerate bicarb, urine >5.5
Type 1 Renal tubular acidosis (distal)
what renal acidosis is:
Normal AG metabolic acidosis
-lower the threshold for bicarb, initially urine ph >5.5, and then when equilibrium is reached, urine ph <5.5
Type 2 Renal Tubular acidosis (proximal)
what is the best initial screen for temporal arteritis?
ESR
benign adenoma in zona glomerulosa
-LOW renin HTN
-LOW (severe) hypokalemia
-normal to increased serum Na
-no pitting edema
-muscle weakness, U waves
-Metabolic alkalosis
Primary Aldosteronism (conn)
Increase PaCO2
Decrease PaO2 and SaO2
Respiratory Acidosis
Normal PaO2 and SaO2
Decreased Hb concentration
Anemia
what causes Pneumococcus infection in HbSS?
autosplenectomy/ or functional asplenia
What vessels are involved in esophageal varices?
Left gastric vein
Azygous vein
How to DX rotavirus?
Rotazyme test of stool
ELISA test with Antibodies against virus
Tx of astrocytoma?
Radiation
when you remove the ovaries or testes, what enzymes are increased?
FSH and LH
Hypernatremia
very dilute urine
thirsty, polyuria
*CDI IS CORRECTED WITH VASOPRESSIN
*NDI NOT CORRECTED WITH VASOPRESSIN
diabetes insipidus
MCC of rabies in USA
skunk bites
osteophytes in DIP joints in OA are called
Heberden’s nodes
flask shaped ulcers in the cecum
Amebiasis
Anti-pulmonary antibodies
Anti-glomerular capillary BM antib
-begins with hemoptysis, ends with renal failure
**CRESCENTIC GLOMERULONEPHRITIS
*linear immunofluorescence
Goodpastures syndrome
MCC of post transfusion hepatitis
HCV
MCC of septic arthritis
N. gonorrhea, knees/wrist/feet
Rust colored sputum
S. pneumo
MC cyanotic CHD
*degree of infravalvular pulmonary stenosis is key to whether patient has cyanosis/acyanotic
Tetralogy of fallot
abdominal abscess MC due to
B. fragilis below diaphragm
B. melanogenicus above diaphragm
AD
mental retardation, astrocyte hamartomas in CNS
*candlestick drippings on ventricles
-adenoma sebaceous, angiomyolipoma of kidneys, rhabdomyoma of heart
Tuberous Sclerosis
Protein A attaches to Fc receptor of Macrophages, blocks opsonization of bacteria
Staph Aureus
AD
-INC ALA synthase when heme is decreased
-decreased activity of uroporphyrinogen synthase
-INC IN S -AMINOVULIN. ACID, PORPHOBILINOGEN, PSYCHOSIS, COLICKY ABD PAIN (frequently mistaken for surgical emergency- “belly full of scars”)
Acute intermittent Porphyria (AIP)
acquired disease
decreased activity of uroporphyrinogen DECARBOXYLASE
-INC excretion of UROPORPHYRIN I
-normal porphobilinogen levels
-photosens skin lesions in sun exposed areas
-hyperpigmentation, fragile skin
-inc vellus hair (hypertrichosis)
Porphyria Cutanea Tarda (PCT)
-pharygitis predisposes to RF
-skin infections predispose to glomerulonephritis
what bacteria?
S. Pyogenes (GAS)
upper urinary tract infection in females with a vesicoureteral reflux
Acute pyelonephritis
resting tremor
parkinsons disease
intention tremor
multiple sclerosis
same as ALS
destruction of upper and lower motor neurons
-defective superoxide dismutase
-neuron damage by superoxide free radicals
-intrinsic muscles of hand is common starting point
Lou Gehrig’s disease
MCC of CHD in downs syndrome
Endocaridal cushion defect (ASD + VSD)
*alzheimers mc death after age 35 in downs
AD
berry aneurysm relationship and subarachnoid hemorrhage
-cysts not present at birth
-HTN
adult polycystic kidney disease
HLA B27 positive
*young man with low back pain progressing to bamboo spine, aoritits/uveitits
(other relationships- Reiter’s syndrome, psoriasis, Enterocolitis, UC
Anklyosing Spondylitis
chrom 22 with bcr:abl fusion
Chronic myelogenous leukemia
Philadelphia chromosome
cause of familial hypercholesterolemia
AD disease with absent LDL receptor
what is the defect in B chain in sickle cell trait/disease?
Valine for Glutamic Acid in 6th position of B chain
pathognomic lesion of rheumatic fever
Aschoff body
rheumatoid arthritis will have what positive tests
rheumatoid factor, anti cyclic citrulinated peptide ab
dermatomyositis/polymyositis will have what positive tests
anti nuclear ab, anti Jo 1 ab
diffuse systemic sclerosis will have what positive tests
anti nuclear ab, antitopisosmerase I (Scl-70 ab)
sjogren syndrome will have what positive tests
anti nuclear ab, anti SSA/Ro, anti SSB/La ab
SLE will have what positive tests
antinuclear ab
anti DS-DNA ab
anti Smith Ab