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Single Gene Disorders
Medical Biochemistry 1
69
Medical
Graduate
11/20/2008

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Term
What is the most common cause for familial hypertrophic cardiomyopathy?
Definition
Beta-Myosin Heavy chain (B-MyHC) (35-50%)
Term
How do mutations involved in Familial Hypertrophic Cardiomyopathy cause ventricular hypertrophy?
Definition
By enhancing contractile function.  Recall, the more a muscle is used, the larger it becomes.
Term
What is locus heterogeneity?
Definition
Mutations in DIFFERENT GENES cause the same symptoms.
(ex: familial hypertrophic cardiomyopathy)
Term
What do FGFs influence after binding to their receptor (FGFR)?
Definition
cell proliferation, migration, differentiation.  This is especially important in early development.
Term
What gene is mutated in Achondroplasia?
Definition
FGFR-3 gene
Term
What substitution in FGFR-3 gene is responsible for achondroplasia?
Definition

G1138A = guanosine to adenine at position 1138

(98% of the time)

 

this causes a glycine to argenine amino acid substitution at aa # 380

Term

What kind of inheritance is familial Hypertrophic Cardiomyopathy?

Definition
autosomal dominant
Term
What kind of inheritance is Achondroplasia?
Definition
Autosomal Dominant
Term
What happens to individuals homozygous for the achondroplasia mutation?
Definition
It is lethal and they die before birth
Term
What is the role of FGFR-3?
Definition

An FGF receptor that negatively regulates bone growth.

G380R mutation causes constitutive activation of receptor.  This in turn promotes decreased bone formation.

Term
How are Hypochondroplasia, Thanatophoric Dysplasia, and achondroplasia related?
Definition
They are examples of allelic heterogeneity.
(mutations in the same gene cause different phenotypes)
Term
What type of inheritance is Osteogenesis Imperfecta Type 1?
Definition
Autosomal Dominant
Term
What mutations in collagen type 1 are lethal?
Definition
Glycine sibstitutions
Term
What type of Osteogenesis Imperfecta is lethal and what substitution is involved?
Definition
OI type 2, glycine substitutions
Term
Which Osteogenesis Imperfecta is least severe?
Definition
Type 1
Term
Which Osteogenesis presents with Blue Sclera?
Definition
Type 1
Term
What role do glycines play in collagen?
Definition
They are necessary for the proper formation of the triple helix.
Term
Which Osteogenesis Imperfecta presents with bowing femurs and tibias?
Definition
Type IV
Term

What does Osteogenesis type 3 present with?

Definition
Progressive deformity after birth
Term
Is it worse to have a mutation in the C-Terminus or N-Terminus of a collagen gene? why?
Definition
C-terminus because this is the location where triple helix formation is initiated.
Term
In Osteogenesis type 1 is it worse to have the mutation in the a1 or a2 gene?
Definition
a1 gene because it is expressed with 2x the level of a2, and therefore the effects of its mutation are more severe.
Term
What disease is characterized by Hyperextensibility, Joint Hypermobility, and Connective Tissue Fragility?
Definition
Ehlers-Danlos Syndrome
Term
What type of inheritance is Ehlers-Danlos Syndrome type 1, 2, 4?
Definition
Autosomal Dominant
Term
What type of collagen is mutated in EDS 1 and 2?
Definition
Type 5 and type 1
Term
A patient presents with translucent skin, visible veins, but NO hyperflexibility of joints or skin.  What is your diagnosis? what is mutated?
Definition
Ehlers-Danlos Type IV.
Collagen type 3
Term
What type of inheritance is EDS 6 and 7?
Definition
Autosomal Recessive
Term
Which type of EDS is the most often lethal form of the disease?
Definition
EDS type 4
(Vascular-Type EDS)
Term
What type of EDS is vascular-type EDS?
Definition
Type 4
Term
Defects in Lysyl Hydroxylase cause which form of EDS?
Definition
Type VI
Term
Defects in conversion of type 1 procollagen to collagen are characteristic of which EDS?
Definition
EDS VII
Term

What specific defects create an inability to convert procollagen type 1 to collagen type 1 in EDS VII?

Definition

1) Deletions of Exon 6 (cleavage site for N-protease)

 

2) Defect in N-Protease

Term
What associated cardiovascular problems are encountered with Marfan Syndrome?
Definition

Aortic Aneurysm

Mitral Valve Prolapse

Term
What inheritance pattern is Marfan Syndrome?
Definition
Autosomal Dominant
Term
What mutation is the most common cause of Marfan Syndrome?
Definition
Fibrillin-1 gene mutation

*a Dominant negative mutation*
Term
What is the inheritance pattern for Hypophostphatemia?
Definition

1)X-linked
2)Autosomal Dominant
3)Hereditary (?)

Term
What 3 genes are involved in hypophosphatemia?
Definition

NPT2
PHEX

FGF23

Term
What is the role of NPT2?
Definition
It is a sodium-phosphorous cotransporter involved in phosphate absorption in the intestines and reabsoption in the kidneys
Term
What is the role of PHEX protein?
Definition
It is a protease that inactivates PNT, an inhibitor of NPT2 synthesis, thereby increasing NPT2 synthesis
Term
What is the role of FGF23?
Definition
An inhibitor of NPT2 synthesis, causing a decrease in phosphate absorption and low phosphate serum levels
Term
What results from a mutation in PHEX? What hypophosphatemia is this characteristic of?
Definition
Decreased PHEX causes an increase of the NPT2-inhibitor PTN.  Therefore, NPT2 is decreased, less phosphate is reabsorbed, and more is excreted by the kidney (phosphate wasting)

X-linked hypophosphatemia
Term
a gain of function mutation in FGF23 prevents its proteolytic cleavage and therefore keeps its serum levels high.  How does this affect Phosphate levels and why?

Of which Hypophosphatemia is this characteristic?
Definition
increased FGF23 causes increased Inhibition of NPT2. Therefore, less phosphate is absorbed and more is excreted by the kidneys.

Autosomal Dominant Hypophosphatemic Rickets
(ADHR)
Term

Loss of funtion mutations in NPT2 result in decreased phosphate absorption. 

These mutations are characteristic of which type of hypophosphatemia?

Definition
Hereditary hypophosphatemic rickets with Hypercalciuria
(HHRH)
Term
What type of inheritance does hemochromatisis display?
Definition
Autosomal Recessive
Term
What is the treatment for Hemochromatisis?
Definition
Phlebotomy:
weekly removal of 500ml of blood.  This will remove approximately 250mg iron until appropriate range is reached.  Then, once every 3 months.
Term
What is HFE? what does it do?
Definition
A membrane protein in enterocytes.  Regulates the amount of iron exporter (ferroprotein) and importer (DMT1) based on iron saturation of transferrin protein.
Term
What mutation is most often responsible for Hemochromatosis?
Definition

C282Y mutation in HFE protein
(cysteine replaced by tyrosine causing misfolded, and thereby degraded protein product)

 

Homozygous individuals for thismutation will develope HHC 80% of the time.

Term
What gene and protein are most commonly defective in Hereditary Spherocytosis?
Definition
Ankyrin
Term
What is the treament for Hereditary Spherocytosis?
Definition
Splenectomy
Term
Anemia, Jaundice, and Splenomegaly can indicate what genetic disorder?
Definition
Hereditary Spherocytosis
Term
What is defective in Hereditary Elliptocytosis?
Definition

Spectrin

 

a-spectrin mutations cannot form aB heterodimers

b-spectrin mutations cannot form tetramers

(when spectrin tetramers are absent, cell stays elliptical)

Term
What is the clinical presentation of Epidermolysis Bullosa?
Definition
Blistering of skin even after slight contact
Term
Defects in the epidermal basal layer cause what variation of Epidermolysis Bullosa?
Definition
EB Simplex
Term
Defects in the basement membrane cause which variation of Epidermolysis Bullosa?
Definition
Junctional
Term
Defects in the subepidermal anchoring fibrils cause which variation of Epidermolysis Bullosa?
Definition
Dystrophic
Term
What mutations are present in EB Simplex?
Definition
Keratin 5 and 14 mutations.
Term
What mutation is responsible for Junctional EB?
Definition
Laminin 5 mutation
Term
What mutation is responsible for Dystrophic EB?
Definition
Collagen VII mutations
Term

What cancer is often associated with Recessive-Type Dystrophic EB?

Definition
Squamous Cell Carcinomas (SCC)
Term
Squamous Cell Carcinoma is often associated with which form of Epidermolysis Bullosa?
Definition
Recessive-type Dystrophic EB
Term
Frequent Urination, Blood in the Urine, High Blood Pressure, and discomfort in the abdominal side are symptoms of which disease?
Definition
Polycystic Kidney Disease
Term
What genes are mutated in Polycystic Kidney Disease?
Definition

PKD1 - encodes polycystin 1

 

PKD2 -encodes polycystin 2

Term

How do Polycystin 1 & 2 function?

Definition

Both are located on cilia and involved in the activation of Ca++ channels.
They are also believed to play a role in the prevention of cell division.  Once mutated, they promote cell division and the accumulation of fluid, causing cysts.

 

 

Term
Which polycystin gene is more commonly defective?
Definition
PKD1 gene (85%)
Term

How is the PKD1 gene typically mutated?

Definition
Erroneous repair owing to the propensity of PKD1 gene to unwind and form a triple helix.  RNA polymerase II makes an unnecessary repair and introduces a mutation.
Term
Hemartomas, Mental deficits, and Seizures are typical manifestations of which disease?
Definition
Tuberous Sclerosis
Term
What genes are responsible for PREVENTING Tuberous Sclerosis?
Definition

TSC1 - Hamartin Protein

TSC2 - Tuberin Protein

 

these are tumor suppressor genes that inhibit cell growth.

Term
Which Tuberous Sclerosis preventing gene/protein is more commonly mutated?
Definition
TSC2 = Tuberin Protein
Term
What is the protein pathway involving prevention of Tuberous Sclerosis?
Definition
Hamartin and Tuberin collectively inhibit Rheb.  Rheb normally promotes mTOR, which promotes cell growth.  Presence of Hamartin/Tuberin complex therefore prevents cell growth.  Mutation in either Tuberin OR Hamartin will produce a non-functional complex and result in Tuberous Sclerosis.
Term
What type of genes are TSC1 and TSC2?
Definition
Tumor Suppressor genes
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