Syndrome Cram Flashcards

1
Q

Difference between Prader-Willi and Angelman?

A

Both 15q11-13 - Prader-Willi only maternal contribution, Angelman only paternal contribution
PW - hypotonia, FTT, feeding difficulty then overeating & obesity and mild ID in childhood. SNRPN gene
Angelman - hypertonic, severe ID and intractable seizures. UBE3A gene

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2
Q

Short and obese child DDx?

A

PWS - hypotonia infancy, mild ID
Bardet-Biedel - renal anomalies, loss of vision, hypogenitalism
16p11.2 deletion obesity without overeating behaviour
Cohen - “wave shaped” palpebral fissures and microcephaly

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3
Q

Difference between BWS and Russel-Silver?

A

Both 11p15 methylation, IGF-2 gene affected.
BWS paternal UPD, RS maternal UPD. RS can also be caused by maternal UPD on 7
BWS - macrosomia, macroglossia, omphalocele, hemihypertrophy,
RS - IUGR, growth retardation, hemihypertrophy, neurodev delay

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4
Q

BWS malignancy risk?

A

Wilms - abdo US 3/12
Hepatoblastoma - serum AFP
Screen until age 8

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5
Q

Coat hanger ribs/bell shaped chest?

A

Paternal UPD 14q

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6
Q

Williams syndrome genetic cause, test of choice and clinical manifestations?

A

7q11 microdeletion, test w FISH for 7q
Elf like features. ID & cocktail party personality
Supravavular aortic stenosis (sometimes peripheral pulmonary stenosis), prolonged QT, SCD due to outflow tract obstruction
High calcium
Inguinal hernia, diverticula

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7
Q

DiGeorge/22q11/velocardiofacial syndrome genetic cause, test of choice and clinical manifestation?

A

Autosomal dominant 22q11 causing disruption of 3rd & 4th pharyngeal pouch. FISH for 22q
Conotruncal defect - ToF, truncus, IAA
Hypoplastic thymus - lymphopenia (1% have SCID)
Hypocalcaemia
Cleft palate
Psychosis

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8
Q

1q21.1 microdeletion vs duplication

A

Microdeletion - microcephaly ?TAR ?schizophrenia

Duplication - macrocephaly

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9
Q

15q11.2 microdeletion

A

Neurodev delay
Language delay
Psychosis

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10
Q

16p13.11 deletion

A

Short stature
Dev delay
Behaviour/psychiatric problems
Idiopathic epilepsy

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11
Q

Most common form of inherited intellectual disability?

A

Fragile X

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12
Q

Most common cause of primary hypogonadism?

A

Kleinfelter

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13
Q

Kleinfelter clinical presentation?

A
Hypospadias/cryptochordism/micropenis
Learning disability/autistic traits/behaviour problems
Delayed puberty, small testes
Gynaecomastia
INFERTILITY
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14
Q

Turner clinical presentation?

A
Short stature
Congenital lymphoedema
Early ovarian failure/primary amenorrhea
Risk of gonadoblastoma
Aortic valve disease (bicuspid), aortic dilatation/dissection
Autoimmune endocrinopathy - hypothyroidism, DM
Renal anomalies
Otitis media/conductive hearing loss
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15
Q

Impact of extra sex chromosomes on phenotype?

A

For every extra sex chromosome IQ drop of 10 and more severe phenotype

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16
Q

Trisomy 18/Edward clinical presentation?

A
IUGR & polyhydramnios
Hypertonia
Prominent occiput w small mouth and micrognathia
Flexed overlapping fingers
Horseshoe kidney
17
Q

Trisomy 13/Patau clinical presentation?

A
Micro/anophthalmia
Cleft lip and/or palate
Postaxial polydactyly
Holoprosencephaly
Cardiac anomalies
18
Q

Trisomy 8 clinical presentation?

A

Always mosaic otherwise FIDU

Genesis of corpus callous & ventriculomegaly

19
Q

Noonan Syndrome clinical presentation?

A

Dysmorphic face
Dev delay
Chest wall deformity
Pulmonary valve stenosis/hypertrophic cardiomyopathy
Cryptorchidism
Lymphatic dysplasia/easy brushing & bleeding (partial FVII def)

20
Q

Genetic cause and of Noonan?

A

Autosomal dominant RAS-MAPK defect

21
Q

Malignancy risk in Noonan?

22
Q

CHARGE genetic cause and presentation?

A
Autosomal dominant CHD7 gene mutation
Coloboma
Heart defect
choanal Atresia
Retardation of growth/dev
Genitourinary anomalies
Ear anomalies
23
Q

Alagille genetic cause and presentation?

A

Autosomal dominant JAG1/NOTCH2
Paucity of intralobar bile ducts (cholestasis, hepatitis, jaundice, cirrhosis)
Peripheral pulmonary stenosis (less common TOF)
Butterfly vertebrae
Posterior embryotoxin
Renal abnormalities

24
Q

Marfan syndrome genetic cause and key clinical findings?

A

FBN1 autosomal dominant
Aortic root dilatation
Ectopia lentis

25
Differential diagnosis of patient with marfanoid features (tall, lanky, hyper mobile, high arched palate) and differentiating features?
Marfan - ectopia lentis with upwards dislocation and aortic root dilatation, normal intellect Homocysteinuria - ectopia lentis with downward dislocation, mental retardation Loueys-Dietz - bifid uvula, cleft palate/craniosynostosis, velvet skin Stickler - Pierre robin sequence with myopia/glaucoma/retinal detachment Kleinefelter - small testes, mental retardation
26
Osteogenesis imperfect genetic cause and clinical presentation?
``` Autosomal dominant mutation of collagen COL1A1/COL1A2 gene Bone breaks/"wormian" bones Short stature Scoliosis Blue sclera Hearing loss ```
27
Triplet repeat disorders?
Fragile X Friedrich Ataxia Myotonic Dystrophy
28
Fragile X genetic cause, test of choice and clinical presentation?
``` X-liked recessive trinucleotide repeat disorder Triplet repeat measurement of FMR1 gene Long face, high arched palate Mitral valve prolapse Large testes Mental retardation. Behavioural/autism ```
29
Friedrich ataxia genetic cause, test of choice and clinical presentation?
Autosomal recessive trinucleotide repeat disorder GAA triplet repeat expansions in frataxin (FXN) gene Teenage onset gait ataxia, weakness, loss of deep reflexes Hypertrophic cardiomyopathy Scoliosis Diabetes
30
Myotonic Dystrophy genetic cause, test of choice and clinical presentation?
Autosomal dominant trinucleotide repeat disorder CTG repeat in the dystrophia myotonica protein kinase (DMPK) gene Weak facies Muscle weakness AND PAIN. Myotonia (delayed muscle relaxation) Respiratory insufficiency Cardiac conduction abnormalities/cardiomyopathy Cataracts