Week 6: Biochemical Genetics Flashcards
Inheritance of PKU
AR
Enzyme deficiency in PKU
Phenylalanine hydroxylase
3 major features of PKU
Mousy/musty odor, DD/ID, epilepsy
Treatment for PKU
Dietary phe restriction and metabolic formula
Inheritance of Tyrosinemia Type 1
AR
Enzyme deficiency for Tyrosinemia Type 1
FAH
3 major features of Tyrosinemia Type 1
Cabbage-like odor in urine, liver/renal dysfunction, rickets, neurologic crises
Treatment for Tyrosinemia Type 1
Dietary phe/tyr restriction with formula; liver transplant
Inheritance of Maple Syrup Urine Disease
AR
Enzyme deficiency in MSUD
Branch chain keto-acid dehydrogenase
3 major features of MSUD
Maple syrup odor in urine, progressive encephalopathy, respiratory failure
Treatment for MSUD
Dietary restriction of BCAAs with formula
Inheritance of Homocystinuria
AR
Enzyme deficiency in homocystinuria
cystathionine beta synthase
3 major features of homocystinuria
Marfanoid skeletal changes, ectopia lentis, neuropsych disease, thromboembolism
Treatment for homocystinuria
Dietary restriction of Met with formula; B6; Betaine
Inheritance of non-ketotic hyperglycemia
AR
Enzyme deficiency in non-ketotic hyperglycemia
glycine cleavage system
3 major features of NKH
Intractable neonatal seizures, encephalopathy, hypotonia
Treatment for NKH
Sodium benzoate, dextromethorphan
Inheritance of OTC
XLR
Enzyme deficiency in OTC
Ornithine thranscarbamylase
3 major features of OTC deficiency
progressive hyperammoneia encephalopathy; recurrent headaches, neuropsych problems
Chronic treatment for OTC
Protein restriction and formula, oral citrulline/ammonia scavengers
Inheritance of ASS1 deficiency
AR
Enzyme deficiency in ASS1
Argininosuccinic acid synthetase I
3 major features of ASS1 deficiency
progressive hyperammonemia encephalopathy, recurrent headaches, liver failure
Chronic treatment for ASS1 deficiency
Protein restriction and formula, oral arginine/ammonia scavengers
Inheritance of ASL deficiency
AR
Enzyme deficiency in ASL deficiency
Argininosuccinate lyase
3 major features of ASL deficiency
progressive hyperammonemia encephalopathy, brittle hair, HTN, liver failure
Chronic treatment for ASL deficiency
protein restriction and formila, oral arginine/ammonia scavengers
Inheritance of ARG deficiency
AR
Enzyme deficiency in ARG deficiency
arginase
3 major features of ARG deficiency
slow growth, developmental regression, spasticity and seizures
Chronic treatment for ARG deficiency
Protein restriction and formula, oral ammonia scavengers
Inheritance of NAGS and CPS1 deficiency
AR
Enzyme deficiency in NAGS and CPS1
N-acetylglutamate synthetase; carbamoyl phosphate synthetase deficiency
3 major features of NAGS/CPS1 deficiency
progressive hyperammonemia encephalopathy
Chronic treatment for NAGS/CPS1 deficiency
protein restriction and formula, oral citrulline/ammonia scavengers
Inheritance of propionic acidemia
AR
Enzyme deficiency in propionic acidemia
propionyl-CoA carboxylase
3 major features of propionic acidemia
Poor feeding, lethargy, vomiting, hypotonia, encephalopathy
Chronic treatment of propionic acidemia
MTVI restriction and formula, L-citrulline, biotin, antibiotics
Inheritance of methylmalonic acidemia
AR
Enzyme deficiency in Methylmalonic Acidemia
methylmalonyl-CoA mutase, Cobalamin, Methylmalonyl-CoA Epimerase
3 major features of methylmalonic acidemia
Poor feeding, lethargy, vomiting, hypotonia, encephalopathy
Chronic treatment for methylmalonic acidemia
MTVI restriction and formula, L-carnitine, B12, antibiotics
Inheritance of isovaleric acidemia
AR
Enzyme deficiency in isovaleric acidemia
isoValeryl-CoA Dehydrogenase
3 major features of isovaleric acidemia
Poor feeding, lethargy, sweaty foot odor, encephalopathy
Chronic treatment of isovaleric acidemia
Leu restriction and formula, L-carnitine, L-glycine
Inheritance of biotinidase deficiency
AR
Enzyme deficiency in biotinidase deficiency
biotinidase
3 major features of biotinidase deficiency
DD, seizures, ataxia, hearing loss, alopecia, eczematous skin rash, vision loss, limb weakness
Chronic treatment of biotinidase deficiency
biotin therapy
Inheritance of 3-MethylCrotonyl-CoA (3-MCC) Carboxylase Deficiency
AR
Enzyme deficiency in 3-MethylCrotonyl-CoA (3-MCC) Carboxylase Deficiency
3-MCC carboxylase
3 major features of 3-MethylCrotonyl-CoA (3-MCC) Carboxylase Deficiency
Episodic liver dysfunction, hypotonia, hypoglycemia, DD, seizures
Chronic treatment of 3-MethylCrotonyl-CoA (3-MCC) Carboxylase Deficiency
Leu restriction and formula, carnitine and biotin supplement
Inheritance of 3-Hydroxy-3-Methylglutaryl (3-HMG) CoA Lyase Deficiency
AR
Enzyme deficiency in 3-Hydroxy-3-Methylglutaryl (3-HMG) CoA Lyase Deficiency
3-HMG-CoA Lyase
3 major features of 3-Hydroxy-3-Methylglutaryl (3-HMG) CoA Lyase Deficiency
Liver dysfunction (Reye), hyperammonemia, hypoglycemia
Chronic treatment of 3-Hydroxy-3-Methylglutaryl (3-HMG) CoA Lyase Deficiency
Leu restriction and formula, carnitine supplement
Inheritance of Glutaric acidemia type 1
AR
Enzyme deficiency in Glutaric acidemia type 1
glutaryl-CoA dehydrogenase
3 major features of Glutaric Acidemia type 1
Neurologic decompensation- encephalopathy, ataxia, epilepsy, stroke-like episodes
Chronic treatment for glutaric acidemia type 1
Lys/Trp restriction and formula, riboflavin B2, carnitine
Inheritance of Galactosemia
AR
Enzyme deficiency for Galactosemia
galactose-1-phosphate uridylyltransferase
3 major features of Galactosemia
lethary, liver and renal dysfunction, cataracts
Treatment of Galactosemia
Dietary restriction of galactose
Inheritance of Glactokinase deficiency
AR
Enzyme deficiency in Galactokinase deficiency
Galactokinase 1
1 feature of Galactokinase Deficiency
Cataracts
Inheritance of GALE deficiency
AR
Enzyme deficiency in GALE deficiency
UDP-galactose-4-epimerase
3 clinical features of GALE deficiency
Cataracts, delayed growth/development, ID, liver and kidney problems
Inheritance of Fructosemia
AR
Enzyme deficiency in Fructosemia
fructose-1-P Aldolase B
3 major features of fructosemia
Lethargy, liver and kidney dysfunction, hypoglycemia, liver failure, acidosis, growth failure
Treatment of Fructosemia
Dietary restriction of fructose
Inheritance of Fructokinase deficiency
AR
Enzyme deficiency in fructokinase deficiency
Fructokinase
Clinical features in Fructokinase deficiency
None
Inheritance of Fructose-1,6-Bisphosphatase Deficiency
AR
Enzyme deficiency in Fructose-1,6-Bisphosphatase Deficiency
Fructose-1,6-Bisphosphatase
3 major features of Fructose-1,6-Bisphosphatase Deficiency
Episodes of hypoglycemia, lactic acidosis, hyperventilation
Chronic treatment of Fructose-1,6-Bisphosphatase Deficiency
Avoid fasting, limit fructose
Inheritance of Von Gierke disease
AR
Enzyme deficiency in Von Gierke disease
Glucose-6-phosphatase
3 major clinical features of von gierke disease
hepatomegaly, hypoglycemia, hyperuricemia, hyperlipidemia, doll-like face
Treatment for Von Gierke disease
Avoid fasting and maintain blood glucose
Inheritance of Pompe disease
AR
Enzyme deficiency in Pompe disease
Glucosidase acid alpha
3 major features of Pompe disease
Muscle and organ enlargement- macroglossia, cardiomegaly, HSM; progressive muscle breakdown and weakness
Treatment for Pompe disease
ERT