Genetics - Multi-system Disease Flashcards

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1
Q

Multi-system disorders are caused by what?

A

Germ-line genetic variations

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2
Q

What modes of inheritance cause Multi-system disorders?

A

Chromosomal
Single gene disorders
Multifactorial

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3
Q

What are the common problems seen in multi-system disease?

A

Variable expression within as well as between families
Present to a large variety of specialists
Easy to miss FH

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4
Q

What type of inheritance causes Neurofibromatosis Type 1?

A

Autosomal dominant

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5
Q

How common is Neurofibromatosis Type 1?

A

1/2500-3500

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6
Q

How is Neurofibromatosis Type 1 diagnosed?

A
2+ of:
Cafe au lait spots (6+)
Neurofibromas (2+)
Axillary freckling
Lisch nodules 
Optic glioma
Thinning of long bone cortex
Family history
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7
Q

What are the other symptoms of Neurofibromatosis Type 1?

A
Macrocephaly
Short stature 
Noonan-look
Learning difficulties
Epilepsy
Scoliosis
Pseudoarthritis of tibia
HTN
Neoplasia
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8
Q

How is Neurofibromatosis Type 1 managed?

A
Annual review of children at risk and individuals with diagnosis of:
Blood pressure
Spine (scoliosis)
Tibia (angulation)
Educational assessment
Visual acuity/fields
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9
Q

What gene causes Neurofibromatosis Type 1?

A

Variable expression of tumour suppressor gene 17q (usually paternal)

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10
Q

How does Neurofibromatosis Type 2 present?

A

Acoustic (bilateral) neuromas
CNS/spinal tumours
Few CAL spots

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11
Q

Where is the NF2 gene located?

A

Chromosome 22

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12
Q

What is Tuberous Sclerosis?

A

Triad of Epilepsy, Skin lesions and Learning difficulty
Autosomal dominant
Hamartomas in different organs

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13
Q

What are the genetics of tuberous sclerosis?

A

Autosomal dominant with full penetrance

TSC1+2 genes

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14
Q

What are the clinical features of Tuberous Sclerosis?

A
Variable expression
Learning difficulty (autism)
Seizures (infantile, myoclonic)
Skin lesions 
Kidney cysts 
Phakomas in eye
Rhabdomyomas in heart
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15
Q

What skin lesions are seen in Tuberous sclerosis?

A
Angiofibromas
Depigmented macules
Fibrous plaques on forehead
Shagreen patches
Subungual fibromas
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16
Q

How are at-risk relatives managed?

A
Clinical examination
Cranial MR
Renal ultrasound
Echocardiogram
Genetic counselling
17
Q

What is Myotonic dystrophy?

A

Autosomal dominant CTG repeat, worse in each generation

18
Q

Clinical features of Myotonic dystophy?

A
Bilateral late-onset cataract
Muscle weakness, stiffness, myotonia
Low motivation
Diabetes
Bowel issues 
Heart block
Post-anaesthetic death
Learning difficulty