Pathophysiology Unit 4 Genetics

Mutations

Result from the substitution of one base pair for another, rearrangement of base pairs or by the loss or addition of one or more base pairs

Mutations

________ occur when an error in the process of meiosis or mitosis occur

Mutations

May result from an exposure to harmful substance such as environmental agents, chemicals, and radiation or may be a spontaneous error

Mutations

Somatic ____________ are important causes of cancer and other tumors in which cell differentiation and growth get out of control

Mutations

Most _________ are corrected by the DNA repair mechanisms in the cell

Helpful Mutations

Antibiotic resistance in bacteria
Sickle cell anemia resistance to malaria
Resistance to atherosclerosis

Karyotype

A photograph of a person's chromosomes

Genotype

The genetic composition of a person

Phenotype

The observable expression of a genotype in terms of morphologic, biochemical or molecular traits

Harmful mutations

Humans with mutations resulting in a (theoretically) beneficial trait are generally not viable, because the mutations witch caused the trait, also caused other deformities, and the fetus is miscarried, stillborn, or dies shortly after birth

Mutations in somatic cells

Environmental factors such as ultraviolet radiation from the sun can cause mutations if a mistake is made as DNA copies itself during cell division

Mutations in somatic cells

Acquired (after birth) mutations in somatic cells cannot be passed on to the next generation

Mutations in germ (gametes) cells

If the gene is altered in the germ cell it is not expressed in the individual containing the mutation, but it will be expressed in the next generation

Alleles

Alternate member of gene pairs

Homozygote

Member of a gene pair that is identical

Homozygote

An individual with matching alleles at the same loci on both chromosomes are said to be a ___________

Heterozygote

Member of a gene pair that have different alleles at the same locus

Dominant Alleles

___________ need only be present in one copy to be expressed

Recessive Alleles

_______ Need to be present in two copies to be expressed

Dominant genes

Dominate any situation even if only one parent carries the gene

Recessive genes

Recede in the background, unless both parents carry the gene

Chromosomal disorders

______________ can be a result of alterations in the genetic code sequence, the presence of too many or too few chromosomes on a spot or alterations in the number of chromosomes

Euploid

Normal number of chromosomes

Polyploid

When a Euploid cell has more that the diploid number (23) of chromosomes pairs

Polyploid

A cell containing more than two pairs of chromosomes

Incompatible with life

A zygote having 3 or more copies of each chromosome

Triploidy and metalloids

Account for approximately 10% of all known miscarriages

Metalloids

Cell containing only one copy of the chromosome

Triploidy

69 chromosomes in each somatic cell

Triploidy

Cell containing 3 sets of chromosome

Teraploidy

92 chromosomes in each somatic cell

Teraploidy

Cell containing 4 sets of chromosome

Autosomal aneuploidy

Abnormal number of chromosomes in the cell (usually one more or one less)

Autosomal aneuploidy

A change in the chromosomal number caused by failure of the chromosomes to separate during oogenesis or spermatogenesis

Autosomal aneuploidy

Monosomies and Trisomies are examples of _________________

Monosomies

All are lethal

Monosomies

A cell that is missing a chromosome

Monosomies

If the __________ involves an autosome, the cell will not be viable, however if the cell involves the X chromosome it can be viable and results in a female who has turners syndrome

Trisomies

Some types survive

Trisomies

A cell that contains an extra chromosome

Non-disjunction

Can occur during the 1st or 2nd meiotic division and gives rise to germ cells that have an even # of chromosomes (22 or 23) instead of 23

Trisomy 21

Most common chromosomal disorder is ___________

Trisomy 21

Also known as Down syndrome

Trisomy 21

Extra chromosome in 21 position (3 chromosomes)

Trisomy 21

Incidence of have a child with ____________ increases with age

Trisomy 21

� of all pregnancies end in spontaneous abortions or the fetus being stillborn

Trisomy 21

20% of all children with ___________ die in the first 10 years

Trisomy 21

Children who make it past 10 years of age have a life expectancy of 60 years

Characteristics of Trisomy 21

Non-disjunction is responsible for 95% of cases

Characteristics of Trisomy 21

Caused by a non-disjunction during the first meiotic division, resulting in a trisomy of chromosome 21

Characteristics of Trisomy 21

After a woman is 35 she has a 1/365 chance of having a child with __________________ (reasons unknown)

Characteristics of Trisomy 21

Prenatal diagnosis involves procedures such as amniocentesis (16 weeks gestation) or chronic villus sampling (9-10 weeks gestation) AFP test

AFP Test

Low results indicate possible Down syndrome (trisomy 21)

What are some of the Clinical features of Trisomy 21

Patients have distinct facial features (lg. forehead, broad nasal bridge, wide spaced eyes, lg. protruding tongue, sm. Low set ears)

What are some of the Clinical features of Trisomy 21

Patients have developmental delays (some degree of mental retardation)

What are some of the Clinical features of Trisomy 21

1/3 of the patients suffer from a congenital heart defect

What are some of the Clinical features of Trisomy 21

Patients have an increased risk of leukemia

What are some of the Clinical features of Trisomy 21

Patients are at risk for premature aging

What are some of the Clinical features of Trisomy 21

Patients have an increased risk of developing Alzheimer's

Sex chromosome Aneuploidy

1:400 males and 1:650 females have a form of ___________________

Sex chromosome Aneuploidy

Klinefelters syndrome, turner syndrome, XXX syndrome, XYY syndrome,

Sex chromosome Aneuploidy

_______________ can be caused by deletion, duplication, inversions, translocations, and fragile sites

Klinefelter syndrome

47, XXY karyotype

Klinefelter syndrome

Male patients are born with an extra X chromosome

Klinefelter syndrome

In rare cases of __________ there may be more than one extra X (XXXXY)

Klinefelter syndrome

One of the most common genetic abnormalities

Klinefelter syndrome

Male patients are sterile, and have enlarged breasts, sparse facial and body hair, sm. Testies/penis, and tall abnormally proportioned bodies

Turner Syndrome

45 X Karyotype

Turner Syndrome

Female patients are born with the absence of all or part of an X chromosome

Turner Syndrome

Female patients are sterile, have no ovaries, webbing of neck, their breasts do not develop well and they have widely spaced nipples, they are short with a stocky build, and they have coarctation of their aorta (narrowing)

Deletion

Absent section of DNA

Deletion

When a chromosome is absent; either entirely or by only a portion

Deletion

A ______________ deletion of chromosome 5 causes cru de chat syndrome "cry of the cat

Duplication

Repeated gene or gene sequence

Duplication

More compatible with life than deletion

Duplication

A _____________of the chromosome 5 causes mental retardation but physical characteristics are nearly normal

Inversions

When the chromosome is broken at 2 points and is followed by reinsertion of missing fragment at its original site but in inverted order. Instead of ABCDE it is ACBDE

Inversions

When the chromosome has an ______________ genetic information is not lost or gained

Inversions

When the chromosome has an_______________it may or may not result in an abnormality

Inversions

Serious problems usually occur in the offspring of the person with the _______________

Translocation

Occurs when two different (none homologous) chromosomes break and rejoin in an abnormal arrangement

Translocation

There are two types, balanced (reciprocal) __________ and Robersonian _____________

Translocation

Usually shows up in the offspring of the individuals who have the _________________

Translocation

Usually shows up in the offspring of the individuals who have the _________________

Translocation

Example of _____________ is leukemia, breast cancer, schizophrenia, muscular dystrophy and Downs's syndrome, 5% of recurrent miscarriage

Balanced (reciprocal) translocation

No genetic info is lost, may have normal or abnormal babies

Robertsonian translocation

Break occurs near the centromere, affecting the short arm of one chromosome and the long arm of the other.

Fragile sites

Areas on the chromosome break or have gaps for unknown reasons

Fragile sites

Most of the _________________ have no apparent relationship to disease except one _____________ on the lone arm of X which leads to Fragile X syndrome (the gene is called FMR1)

Fragile site syndrome

Most important feature is mental retardation

Fragile site syndrome

Has a high population prevalence 1:2000 boys and 1:4000 girls are estimated to be affected

Fragile site syndrome

Approximately 1/400 individuals in the general population are believed to carry the gene

Fragile site syndrome

There is a pattern of inheritance, carrier men pass the permutation to their daughters, but none of their sons, and each child from a carrier woman has a 50% chance of inheriting the gene

Single-Gene disorders

Include Autosomal dominant, Autosomal Recessive, X-linked recessive, and X-linked dominant inheritance

Autosomal dominant

Male and females are equally affected

Autosomal dominant

One of the parents is AFFECTED, there are NO silent Carriers, and unaffected people do NOT transmit the disease

Autosomal dominant

Defect present in only one of the alleles produces the clinical expression of the disease

Autosomal dominant

If one parent has the disease there is a 50% probability that the children will have the disease

Autosomal dominant

If both parents have the disease all their children will have the disease

Autosomal dominant

Examples of ________________ diseases include Marfans Syndrome, Huntington's chorea, Familial Hypercholesterolemia, and Achrondroplasia

Penetrance

______________is a measure of the proportion of individuals in a population who carry a specific gene and express the related trait

Reduced penetrance

An individual has the genotype for the disease, but may or may not express the disease phenotype

Retinoblastoma

A person with ____________may inherit an altered copy of the gene from one parent, or the altered gene may be the result of a new mutation

Variable expression

Complete gene penetrance; however severity of disease is variable within the same family.

Delayed age of onset

Genotype for disease id present at birth, however the disease does not express itself until adulthood

Delayed age of onset

An example of ___________________ is Huntington's disease. The typical age f onset is between ages 30 and 45 but there is a juvenile type.

Huntington's disease

When a patient has _____________ they have usually inherited the altered gene from one affected parent.

Huntington's disease

Progressive brain disorder that causes uncontrolled movements, mental and emotional problems, and the loss of cognition

Plitrophy

One gene mutation causes effects on multiple body systems or structures

Plitrophy

A good example of _________________ is Marfans disease

Marfans disease

A disorder of connective tissue which causes skeletal defects

Marfans disease

Patient is tall and lanky, with long limbs and spider like fingers, chest abnormalities, has curvature of the spine, crowded teeth and heart abnormalities

Autosomal recessive inheritance

Male and female are equally affected

Autosomal recessive inheritance

Parents may just be carriers, and both parents must pass on a recessive gene to produce an affected (homozygous) child

Autosomal recessive inheritance

If both parents are affected, all their offspring will be affected

Autosomal recessive inheritance

If the child has one normal gene and one defective gene (heterozygous), that child becomes a carrier and shows no clinical sign of the disease

Autosomal recessive inheritance

With two carrier parents a child has a 25% of becoming affected, 50% chance of becoming a carrier and a 25% chance of being normal

Autosomal recessive inheritance

With one carrier parent and one normal parent a child has a 50% chance of being a carrier

Autosomal recessive inheritance

With one affected parent and one normal parent a child has a 100% chance of being a carrier

Autosomal recessive inheritance

Examples of ___________________ are Cystic fibrosis, Tay-Sach, Phenylketonuria, and sickle-cell trait.

Tay-Sach

Patient seems normal at birth, however manifests progressive weakness, muscle flaccidity, and rapid deterioration of motor and mental function, etc....

Tay-Sach

Death usually happens by age 4

Phenylketonuria

Deficiency of liver enzymes that converts the amino acid phenylalanine to tyrosine, so toxic levels of phenylalanine accumulate in the blood/tissue.

Phenylketonuria

(PKU)

Phenylketonuria

Can cause signs of mental retardation, delayed speech, and other signs of impaired neuro development

Consanguinity

Mating's of related individuals

Consanguinity

Can increase risk of autosomal recessive disease

boys

XY

girls

XX

X-linked recessive inheritance

Usually carried by the female sex chromosome

X-linked recessive inheritance

Since males only receive one X chromosome, they will be affected by the disease; men are always more affected by sex-linked diseases than woman

X-linked recessive inheritance

Carrier females have a 50% chance of producing an affected make child and an equal chance of producing carrier female child with each pregnancy

X-linked recessive inheritance

Affected males will transmit the defect to all their daughters, (who then become carriers) and none of their sons

X-linked recessive inheritance

Examples of ________________ are Duchenne's muscular dystrophy, Hemophilia A, Fragile X syndrome, Aneuploidy, Trisomy, and Polyploid

Fragile X syndrome

Males are affected more than females

Fragile X syndrome

Patients are mentally retarted, have long faces, lg. mandibles, lg. everted ears, and lg. testicles.

X-linked Dominant disorder

Only a few known diseases exist and they are seldom encountered

X-linked Dominant disorder

If father has a ___________, all of his daughters and none of his sons will be affected.

X-linked Dominant disorder

If mother has a _____________there is a 50% chance each of her children will be affected

X-linked Dominant disorder

Examples of _____________Deafness, incontinentia Pigmeni, Familial rickets and hereditary nephritis.

Multifactorial Inheritance

Is similar to polygenic traits but also includes environmental effects on genes

Multifactorial Inheritance

Is caused from multiple genes

Multifactorial Inheritance

_______________that are expressed later in life include Primary hypertension, diabetes mellitus, some cancers, and schizophrenia

Multifactorial Inheritance

_______________that are expressed at birth (congenital) include cleft lip/palate, club foot, and congenital heart disease

Familial patterns of inheritance

Disease with _____________________include Coronary artery disease, hypertension, breast cancer, colorectal cancer, diabetes (type 1 and 2), alcoholism, Alzheimer's disease, schizophrenia, and bipolar affective disorder

Genetic counseling

Patient that should have ____________ include patients with known genetic diseases in the family and Patients that are adoptees without information on genetic heritage

Genetic counseling

Process of evaluation includes a pedigree analysis and gene mapping

Genetic counseling

Diseases requiring _________________ include autosomal dominant and recessive disorders, sickle cell anemia, x-linked disorders, hemophilia A, known genetic or chromosomal abnormalities, maternal pattern deafness

Pedigree analysis

A graphic method of portraying a family history of an inherited trait

Pedigree analysis

Constructed from a carefully obtained family history

Pedigree analysis

Is useful for tracing the pattern of inheritance for a particular trait

Pedigree analysis

Reliable predictions of whether a member of a family will develop the disease can be made through a _____________________

Gene mapping

______________ can find the location of genes on chromosomes

Gene mapping

The location of a gene can tell much about the function of the gene, its interaction with other genes, and the likelihood that certain individuals will develop a genetic disease

Gene mapping

Example of ___________ is the human genome project

Teratogens

A __________is an agent or substance that may cause physical defects in the developing embryo or fetus when a pregnant female is exposed to that substance

Teratogens

If the period of exposure to a _________ is from fertilization through early implantation (post fertilization days 0-15), the effect of an insult is often all or nothing; implantation failure or spontaneous abortion would be the likely outcome

Teratogens

If the period of exposure to a _________ is from the second stage of development, the period of organogenesis (day 15-60), anatomical malformations may be induced

Teratogens

If the period of exposure to a _________ is from the third stage, the period of fetal development during the second and third trimesters of pregnancy, exposures may lead to growth restriction, stillbirth, or impaired cognitive development

Teratogens

Agents of _____________ include radiation, drugs, alcohol, chemical substances, and infectious agents such as viruses

Teratogens

Environmental ___________include radiation, viruses, and chemicals

Genes may predispose

while the enviornment triggers genetic defects

Gene technology

Current use and future potential for DNA manipulation, DNA cloning, Biochip

Biochip

Squares of glass etched with DNA strands and can be used for genetic screening, research and diagnosis

Genetic research

______________ includes development of drugs and vaccines, agricultural applications, pesticide and pest resistant crops and hybrid animals, stem cell research.