More stories from the genetic clinic Flashcards

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1
Q

What happens if the full genome of an embryo derives from one parent and what is the significance of this finding?

A

Paternal – hydatidiform mole

Maternal – ovarian teratoma Shows that the origin of the parental DNA is important

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2
Q

What is the mechanism of imprinting and X-chromosome inactivation

A

DNA Methylation

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3
Q

Which base gets methylated?

A

5’ position on the pyrimidine ring of the cytosine. This only occurs in humans at CpG dinucleotides ( Where cytosine nucleotide is followed by a guanine nucleotide in the 5’-3’ direction)

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4
Q

What is involved in DNA methylation to occur?

A

SAM is S-Adenosyl Methionine (source of the methyl group) and DNMT is DNA Methyltransferase (the catalytic enzyme)

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5
Q

What is the general effect of methylation on the gene promoter?

A

Repressed gene transcription

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6
Q

The loss of function of a gene on which chromosome causes the 2 imprinting disorders and which parental chromosome is responsible for each?

A

Chromosome 15

Paternal- Prader Willi
Maternal- Amgelman

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7
Q

What are the symptoms of prader willi syndrome and management of it

A
Hyperphagia-obesity
Mental impairment (avg. IQ 60-70)
Behavioural problems
Muscle hypotonia
Short stature, small hands and feet
Delayed/incomplete puberty, infertility

Management:

  • Hyperphagia- diet restriction
  • exercise to increase muscular mass
  • growth hormone treatment for short stature
  • hormone replacement at puberty
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8
Q

State some symptoms of Angelman Syndrome and the managment.

A
  • Severe developmental delay
  • poor or absent speech
  • gait ataxia
  • happy demeanour
  • microcephaly ( incomplete development of the brain)
  • seizures

Management:

  • Symptomatic- anticonvulsant (used to prevent or reduce the severity of epileptic fits or other convulsions.), physio, communication therapy
  • Normal life span
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9
Q

What are the three possible causes of Prader-Willi and Angelman Syndrome?

A

Deletion of the PWS/AS critical region on chromosome 15

Uniparental disomy - Failure to separate the chromosomes in meiosis II and the failure to remove the correct chromosome following the non-disjunction.

mutation in an imprinting region.

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10
Q

What are some of the treatments of angelman syndrome?

A

-Anti-convulsant ( to reduce severity of epileptic fits)
-physiotherapy
-communication therapy
NORMAL LIFE SPAN

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11
Q

Describe how uniparental disomy can lead to Prader-Willi and Angelman Syndrome.

A

Non-disjunction in meiosis 2 makes a gamete that has two copies of chromosome 15 resulting in a zygote with three copies of chromosome 15. Failure to remove the duplicated chromosome results in the zygote having two copies of chromosome 15 from the same parent.

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12
Q

How is PWS and AS diagnosed? Which genes near/in the PWS/AS critical region are used?

A

FISH – fluorescence in situ
hybridisation. Fluorescently labelling regions on chromosomes.

PML (promyelocytic leukaemia) gene is just outside the PWS/AS critical region snRNP (small nuclear ribonucleoprotein) gene is inside the PWS/AS critical region.

As prader willi syndrome and angelman are caused by the loss of the function of the same region of chr 15, you would expect them to be similar but they are not.

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13
Q

How else can PWS and AS be diagnosed?

A

Using methylation-specific PCR.

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14
Q

What is heteroplasmy

A

The situation in which, within a single cell, there is a mixture of mitochondria ( energy producing cytoplasmic organelles), some containing mutant DNA and some containing normal DNA.

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15
Q

State two examples of mitochondrial disease

A

Mitochondrial Encephalomyopthy with Lactic Acidosis and Stroke-like episodes (MELAS)
&
Leber’s Hereditary Optic Neuropathy (LHON)

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16
Q

State some symptoms of MELAS and what part of the body it affects

A

Muscle weakness, Vomiting, Episodic seizures and headache, hemiparesis( weakness on one side of the body), Dementia.

MELAS affects the muscles and the brain because they both have high energy requirements and hence a lot of mitochondria.

17
Q

How is MELAS diagnosed?

A

Diagnosis by muscle biopsy

18
Q

What mutations cause MELAS?

A

MTTL1 – tRNA translates codon as Phenylalanine instead of leucine during mitochondrial protein synthesis
MTND1 and MTND5 – NADH Dehydrogenase subunits 1 and 5

19
Q

State some symptoms of LHON

A

Bilateral, Painless, loss of central vision
optic atrophy
eventually leads to blindness.

20
Q

Mutations in what genes cause LHON?

A

MTND1, 4,5 and 6 – NADH Dehydrogenase subunits 1, 4, 5 and 6 MTCYB – cytochrome B

21
Q

How is LHON diagnosed?

A
  • opthalmological findings

- blood test for mtDNA mutations

22
Q

State some symptoms of Phenylketonuria

A

-Mental retardation caused by phenylalanine hydroxylase deficiency
-Blonde hair/blue eyes
Tyrosine deficiency- reduced melanin
-Phenylalanine accumulates and is converted to phenylpyruvic aicd- excreted in urine
-Eczema and musty odour

23
Q

How is phenylketonuria detected?

A

Elevated levels of phenylalanine in the blood

24
Q

What is the treatment for PKU?

A

Remove phenylalanine from the diet and give protein supplements to supply amino acids.

25
Q

What is a common feature of MCAD deficiency Medium-Chain Acyl-CoA Dehydrogenase

A

Episodic Hypoketotic Hypoglycaemia.

26
Q

A mutation in which gene causes MCAD Deficiency?

A

ACAD

27
Q

What are the symptoms with MCAD

A
  • vomiting, coma, metabolic acidosis, encephalopathy (functioning of the brain is affected by some agent). if undiagnosed- 25% mortality of first episode
28
Q

Explain what happens in MCAD deficiency and ways to manage it?

A

if you get rid of MCAD, you fail to switch to fatty acid oxidation/b-oxidation when your blood glucose goes down but if that can’t happen you have no source of energy for the cell.

  • Avoiding fasting
  • Nutritional supplements at times of increased stress
29
Q

what is genomic imprinting?

A

Genetic imprinting refers to a situation where genes are expressed differently according to whether they are inherited on the chromosome that came from the mother or that from the father.