Partial Chromosomal Deletions And Duplications ✅ Flashcards

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1
Q

What does the phenotypic effect of a deletion or duplication depend on?

A

The genes it encompasses

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2
Q

In general, is a deletion or a duplication more likely to have a phenotypic effect?

A

Deletion

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3
Q

Why can partial chromosomal deletions and duplications be hard to diagnose?

A

With conventional karyotype, many of the common pathogenic deletions and duplications are too small to be visible on conventional karyotyping

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4
Q

What was historically required to diagnose many chromosomal deletions and duplications?

A

The clinician to recognise the disorder and request the correct FISH test

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5
Q

What has made the diagnosis of partial chromosomal deletions and duplications much easier?

A

Array CGH

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6
Q

Why has array CGH made the diagnosis of partial chromosome deletions and duplications much easier?

A
  • Much higher resolution than karyotyping

- Tests across the whole genome for microdeletions and duplications in a single test

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7
Q

What is the result of array CGH being better at detecting partial chromosomal deletions and duplications?

A

It has replaced karyotyping as the first line test for suspected chromosomal abnormalities in paediatrics

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8
Q

Give 2 microdeletion syndromes

A
  • 22q11 deletion syndrome

- Williams syndrome

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9
Q

What is 22q11 deletion syndrome also known as?

A
  • DiGeorge syndrome

- Velocardiofacial syndrome

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10
Q

What causes DiGeorge syndrome?

A

Deletion of 22q11 region of one copy of chromosome 22

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11
Q

What is the inheritence pattern of DiGeorge syndrome?

A

Autosomal dominant

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12
Q

Who else may be tested when a child is diagnosed with DiGeorge syndrome?

A

The parents

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13
Q

Why may it be helpful to test the parents when a child is diagnosed with DiGeorge syndrome?

A

The parents may have a milder phenotype and not be aware of it

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14
Q

Are more cases of DiGeorge syndrome inherited or de novo?

A

The majority are de novo

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15
Q

What are the characteristic facial features of patients with DiGeorge syndrome?

A
  • Long face
  • Narrow palpebral fissures
  • Over-folded ear helices
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16
Q

What is the limitation of the identification of DiGeorge syndrome based on facial features?

A

The facial phenotype is often subtle

17
Q

What medical complications might patients with DiGeorge syndrome experience?

A
  • Cardiac defects
  • Palatal abnormalities
  • Immune deficiency
  • Hypocalcaemia
  • Renal tract abnormalities
  • Mild to moderate learning difficulties/developmental delay
18
Q

What cardiac defects might be present in DiGeorge syndrome?

A
  • Tetralogy of Fallot
  • Interrupted aortic arch
  • Ventricular septal defect
  • Truncus arteriosus
19
Q

Give an example of a palatal abnormality that may be present in DiGeorge syndrome

A

Cleft palate

20
Q

What immune deficiencies may be present in DiGeorge syndrome?

A
  • Impaired T-cell production and function

- Thymic hypoplasia

21
Q

Who is at particularly high risk of hypocalcaemia in DiGeorge syndrome?

A

Neonates

22
Q

What causes hypocalcaemia in DiGeorge syndrome?

A

Parathyroid dysfunction

23
Q

What is the chromosomal abnormality in Williams syndrome?

A

Deletion of a region of chromosome 7q11.23

24
Q

What gene is contained within chromosome 7q11.23?

A

Elastin gene

25
Q

Is Williams disease inherited or de novo?

A

Usually de novo

26
Q

How does Williams disease often present?

A

Poor feeding and hypocalcaemia as a neonate

27
Q

What is the result of elastin deletion in Williams syndrome?

A

Arteriopathy

28
Q

What arteries are affected in Williams syndrome?

A

Can affect any artery

29
Q

What is the characteristic arteriopathic lesion in Williams syndrome?

A

Supra-valvular aortic stenosis

30
Q

What are the characteristic facial features of Williams syndrome?

A
  • Puffy etes
  • Long philtrum
  • Stellate iris
31
Q

How does Williams syndrome present cognitively?

A
  • Moderate learning difficulties

- Chatty demeanour and overfriendliness