Pedigrees and risk Flashcards

1
Q

What do the following symbols stand for?

A
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2
Q

How are monozygotic (identical) twins shown on a pedigree?

A
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3
Q

How are dizygotic (non-identical) twins shown on a pedigree?

A
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4
Q

How are consanguineous couples shown on a pedigree?

A
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5
Q

What is a consanguineous couple?

A

Descend from the same ancestor

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6
Q

How are different generations presented on a pedigree?

A

Denoted by roman numerals

Oldest generation will be I

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7
Q

How much DNA do siblings share?

A

50%

25% for half-siblings

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8
Q

How much DNA does an individual share with their grandparents, aunts and uncles?

A

25%

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9
Q

How much DNA does an individual share with their 1st degree cousin?

A

12.5%

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10
Q

What are benefits of drawing a pedigree?

A

Able to spot patterns early

Explain pattern to patient

Identify potential carriers of risk gene

Calculate risk of passing on disease or being carrier

Allow informed choice

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11
Q

Why would you not test for a disease?

A

Many diseases are a mix of familial and sporadic factors

Many causative genes are unknown

Its impossible to test everyone for diseases

When a disease is familial and the mutation is known many don’t want the test

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12
Q

When are symptoms for huntingtons disease and when is the onset?

A

30- 50 years

Symptoms: difficulty concentrating, depression, stumbling, involuntary jerking, problems swallowing

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13
Q

What causes huntington’s disease?

A

Mutation: results from a DNA expansion of a CAG repeat on chromosome 4 causing production of polyglutamine tract (polyQ tract) - autosomal dominant

Abnormal intracellular huntington protein aggregate gains a pathologival function and is toxic to neurones resulting in cell death

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14
Q

What are potential difficulties with a pedigree diagram?

A

Incomplete information- may not have information on all relatives

Incorrect information

Family history may not be correct

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15
Q

What inheretance pattern is this?

A

Autosomal dominant

Males and females affected

Vertical transmission

Not all offspring affected

At least 1 affected parent- can be mother or father

50% risk of inheretance

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16
Q

What are complicating factors when investigating patterns of dominant forms of disease?

A

Age of onset- some diseases develop with age due to accumulation of damage

17
Q

What pattern of inheritance is this?

A

X- linked recessive

Only males affected

Not all generations affected

Not all offspring affected

Inherited from unaffected mother (carrier)

If mother is carrier: 50% risk of disease

Any daughters of affected father will be carriers

18
Q

What pattern of inheritance is this?

A

Mitochondrial

Vertical transmission

All offspring affected (if affected mother)

Males and females affected

Mitochondria inhereted from mother so inhereted from affected mother

19
Q

What pattern of inheritance is this?

A

Impossible to tell

No family history

Could be genetic or non-genetic

Could be a new dominant mutation but could be recessive

20
Q

What pattern of inheritance is this?

A

Autosomal recessive

Usually no family history of disease

Parents unaffected

Horizontal transmission

Not all offspring affected

Males and females affected

Obligate carriers

21
Q

What does risk mean?

A

This is a calculation of predicted chance of having a disease or being a carrier

22
Q

How do you calculate risk?

A

To calculate we work from the person with known phenotype to subject

Multiply the risks together

23
Q

What information needs to be taken into account when calculating risk?

A

Phenotype

Disease characteristics

If X-linked or mitochondrial: what side of family disease is on and which parent has disease

Ethnic background: diseases have different prevalence in different popultions

24
Q

Calculate the risk

A

Maternal grandmother (red) must be a carrier: 1/1 chace of being carrier

Mother (blue) must hve a 1/2 chance of being carrier

So her daughter (ther proband) has a 1/2 chance of inheriting the gene

Therefore risk is: 1 x 1/2 x 1/2 = 1/4 risk she’s a carrier

If’s she’s a carrier then theres a 1/2 chance of passing gene onto son

However only 1/2 chance of child being male

So risk of affected son is 1/4 x 1/2 x 1/2

25
Q

Calculate the risk

A

Chances are the population risk

Paternal grandmother is a carrier

Father is not affected so mutation not passed to daughter

26
Q

Calculate the risk

A

Risk is the population risk

Autosomal dominant- neither parents affected

Relatives likely to have sporadic form

27
Q

Calculate the risk

A

Mother affected therefor 1 in 2 chance he has inherited the gene

28
Q

Calculate the risk

A

Chance that Mr T is carrier is 1/2 x 1/2 x 1/2 = 1/8

Chance child being affected if both parents are carriers is 1/4

Population chance is 1/22

So chance child will have CF is 1/8 x 1/4 x 1/22

29
Q

What is hereditary haemochromatosis?

A

Autosomal recessive

Cuased by mutation in human haemostatic iron regulator protein

Results in excess iron absorption. Humans can’t excrete iron so it builds up in tissues

Wide range of symptoms including fatigue

Chronic tiredness fatigue one of main symptoms in primary care patients