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Question 1
Incorrect
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Growth failure can be managed with recombinant human growth hormone (Somatropin) in the all of the following conditions except:
Your Answer: Short Stature Homeobox (SHOX) gene deficiency
Correct Answer: Achondroplasia
Explanation:Somatropin is a recombinant human growth hormone used to treat growth failure conditions associated with natural growth hormone deficiencies. According to the UK National Institute for Health and Care Excellence, these conditions include, Prader-Willi syndrome, Noonan syndrome, short stature Homeobox (SHOX) gene deficiency, Turner’s syndrome, chronic renal insufficiency and children who are small for gestational age. Treatment of short stature in achondroplasia has not seen any significant changes with somatotropin.
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This question is part of the following fields:
- Genetics And Dysmorphology
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Question 2
Correct
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Which among the following genetic conditions, does NOT present with cataracts?
Your Answer: Neurofibromatosis type 1 (NF1)
Explanation:Neurofibromatosis Type 1 (also known as von Recklinghausen disease) does not present with cataracts.The eye findings in NF1 are Lisch’s nodules, which are pigmentary lesions seen on the iris and constitute one of the major diagnostic features in this condition. Note:Interestingly, in another syndrome closely related to it, Neurofibromatosis type 2 (NF-2), cataracts can occur. Early detection in family members may be made by finding lens opacities (both congenital polar cataracts and posterior lenticular opacities). Other options:- Incontinentia pigmenti is an X-linked dominant disorder with pigmentary skin changes, mental retardation and eye involvement in 40% of cases. – Myotonic dystrophy is a triplet-repeat disorder with neurological symptoms and cataracts. – Lowe syndrome (oculo-cerebro-renal syndrome) is an X-linked recessive condition. Males with this X-linked recessive condition have cataracts, hypotonia, mental retardation, generalised aminoaciduria and renal tubular acidosis with hypophosphatemia. – Wilson disease is an inborn error of copper metabolism. The clinical features include hepatic involvement, progressive neurological features, eye involvement, including Kayser–Fleischer rings and cataracts.
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This question is part of the following fields:
- Genetics And Dysmorphology
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Question 3
Incorrect
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A 13-year-old girl presents with a swollen left knee following a fall. Her parents state she suffers from haemophilia and has been treated for a right-sided haemarthrosis previously. What other condition is she most likely to have?
Your Answer: Hunter's syndrome
Correct Answer: Turner's syndrome
Explanation:Haemophilia is a X-linked recessive disorder. In X-linked recessive inheritance only males are affected. An exception to this seen in examinations are patients with Turner’s syndrome, who are affected due to only having one X chromosome. X-linked recessive disorders are transmitted by heterozygote females (carriers) and male-to-male transmission is not seen. Affected males can only have unaffected sons and carrier daughters.
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This question is part of the following fields:
- Genetics And Dysmorphology
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Question 4
Incorrect
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Which of the given conditions is an X-linked recessive disease?
Your Answer: Wilson's disease
Correct Answer: Hunter's syndrome
Explanation:Hereditary diseases follow specific inheritance patterns according to the type of gene involved. Mutations in the genes which are on the sex chromosome, chromosome X are called X-linked diseases. X-linked recessive conditions result when both the copies of X-chromosomes are defective, which happens in the case of females since males have only one X- chromosome. Thus, these conditions are more common among males, and examples include colour blindness, haemophilia, Lesch-Nyhan syndrome, and hunter’s syndrome, etc. Hunter’s syndrome is a type of lysosomal storage disease which is also known as mucopolysaccharidosis II. Vitamin D resistant rickets is a X-linked dominant disease. Neurofibromatosis type 1 and 2 are autosomal dominant conditions while Wilson’s disease is autosomal recessive.
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This question is part of the following fields:
- Genetics And Dysmorphology
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Question 5
Correct
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A 3 year old male presents to the genetics clinic with a history of proximal myopathy. He has missed motor milestones and has pseudohypertrophy of the calves. Doctors suspect it might be Duchenne's muscular dystrophy. Which of the following should you advise the parents?
Your Answer: Girl offspring have a less than 10% chance of inheriting the condition
Explanation:Although initially thought to affect only boys, girls with DMD also have an estimated 10% chance of inheriting the condition. In girls, DMD may present with all or some clinical manifestations.
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This question is part of the following fields:
- Genetics And Dysmorphology
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Question 6
Correct
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Genetic point mutation occurs in which of the given genetic abnormalities?
Your Answer: Haemochromatosis
Explanation:Point mutations are the type of mutations in which only a single nucleotide of the DNA is either deleted, substituted or a new single nucleotide is inserted into the DNA, causing alterations in the original normal DNA sequencing. The examples of point mutations include hemochromatosis, sickle cell disease, and Tay-Sach’s disease. Huntington’s disease is a trinucleotide repeat disorder. Down’s syndrome is characterized by an extra copy of chromosome 21, while Klinefelter syndrome is marked by an extra X chromosome. Fragile X syndrome is also a trinucleotide repeat disorder.
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This question is part of the following fields:
- Genetics And Dysmorphology
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Question 7
Incorrect
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Which of the following is true regarding Prader-Willi syndrome?
Your Answer: It is also known as happy puppet syndrome
Correct Answer: Affected individuals typically have small gonads
Explanation:Prader-Willi Syndrome is a genetic disorder that occurs when a chromosome from paternal chromosome 15q is deleted or unexpressed during the formation of the egg or sperm, or in embryonic development. Individuals usually inherit one copy of this gene from each parent, and in this case on the paternal gene remains active in parts of the brain and other organs. This phenomenon is known as genetic imprinting, and is also seen in Angelman’s syndrome. Symptoms seen in Prader-Willi range from poor muscle tone during infancy to developmental and cognitive delays. Many individuals suffer from hypogonadism that affects fertility in both males and females. In Angelman’s syndrome the maternal chromosome 15q is unexpressed. The condition is also called happy puppet syndrome as affected children present with a happy demeanour, ataxic gait, and flapping movements of the limbs.
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This question is part of the following fields:
- Genetics And Dysmorphology
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Question 8
Incorrect
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Which of the following conditions is due to a deletion of chromosome 15q inherited from the father?
Your Answer: Angelman's syndrome
Correct Answer: Prader-Willi
Explanation:Most cases of Prader-Willi syndrome are not inherited, particularly those caused by a deletion in the paternal chromosome 15 or by maternal uniparental disomy. These genetic changes occur as random events during the formation of reproductive cells (eggs and sperm) or in early embryonic development. Affected people typically have no history of the disorder in their family.Rarely, a genetic change responsible for Prader-Willi syndrome can be inherited. For example, it is possible for a genetic change that abnormally inactivates genes on the paternal chromosome 15 to be passed from one generation to the next.Prader-Willi syndrome is a complex genetic condition that affects many parts of the body. In infancy, this condition is characterized by weak muscle tone (hypotonia), feeding difficulties, poor growth, and delayed development. Beginning in childhood, affected individuals develop an insatiable appetite, which leads to chronic overeating (hyperphagia) and obesity. Some people with Prader-Willi syndrome, particularly those with obesity, also develop type 2 diabetes (the most common form of diabetes).
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This question is part of the following fields:
- Genetics And Dysmorphology
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Question 9
Incorrect
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The merlin gene is implicated in the Neurofibromatosis type 2 phenotype. On which chromosome is merlin located?
Your Answer: Chromosome 11
Correct Answer: Chromosome 22
Explanation:Neurofibromatosis type 2, also known as schwannomin, is an autosomal dominant genetic disease caused by mutation of the merlin gene located on chromosome 22. Merlin is a tumour suppressor protein, which is responsible for controlling cell shape, growth and adhesion, and is predominantly found in nervous tissue. Its mutation increases the risk of tumour development especially bilateral vestibular schwannomas, the hallmark of neurofibromatosis 2.
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This question is part of the following fields:
- Genetics And Dysmorphology
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Question 10
Correct
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Choose the karyotype associated with short stature:
Your Answer: 45,XO
Explanation:Turner syndrome (TS) is one of the most common genetic disorders| occurs with an incidence of I: 2,500 female live births. It results from complete or partial chromosome X monosomy. TS is associated with abnormalities of the X chromosome and characteristic clinical features of short stature, gonadal dysgenesis, sexual developmental deficiencies, cardiac and/or renal defects, webbed neck, low-set ears, skeletal deformities including cubitus valgus, a propensity to ear infections and hearing deficits.
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This question is part of the following fields:
- Genetics And Dysmorphology
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