Practice 49 MCQs on COMPLEX MULTIGENIC AND CYTOGENETIC DISORDERS - 50 MCQs with OmpathStudy. Built for Kenyan medical and health students to revise key conce...
Q1. What is the minimum population frequency required for a genetic variant to be classified as a polymorphism?
Answer: 10%
Explanation: A polymorphism is defined as a genetic variant that has at least two alleles and occurs in at least 1% of the population.
Q2. In complex multigenic disorders, what percentage of type 1 diabetes risk is contributed by a few HLA alleles?
Answer: More than 50%
Explanation: Of the 20 to 30 genes implicated in type 1 diabetes, a few HLA alleles contribute more than 50% of the risk, demonstrating that different polymorphisms vary significantly in their contribution.
Q3. Which environmental factor is most commonly associated with unmasking the genetic trait in type 2 diabetes mellitus?
Answer: Obesity
Explanation: Type 2 diabetes often first manifests clinically after weight gain, demonstrating how obesity as an environmental factor unmasks the diabetic genetic trait.
Q4. What proportion of newborn infants has some form of chromosomal abnormality?
Answer: 1 in 200
Explanation: It is estimated that approximately 1 in 200 newborn infants has some form of chromosomal abnormality.
Q5. What percentage of first-trimester spontaneous abortions are associated with chromosomal abnormalities?
Answer: 50%
Explanation: Approximately 50% of first-trimester spontaneous abortions are associated with chromosomal abnormalities.
Q6. Which staining technique is widely used to produce distinctive banding patterns on chromosomes?
Answer: Giemsa stain (G banding)
Explanation: The Giemsa stain (G banding) technique is widely used and produces a distinctive pattern of alternating light and dark bands that allows identification of each chromosome.
Q7. A chromosome number of 3n is classified as
Answer: Polyploid
Explanation: Any exact multiple of the haploid number (n) is called euploid, and numbers such as 3n and 4n are specifically called polyploid.
Q8. What is the primary cause of aneuploidy?
Answer: Nondisjunction during meiosis
Explanation: The chief cause of aneuploidy is nondisjunction of a homologous pair of chromosomes at the first meiotic division or failure of sister chromatids to separate during the second meiotic division.
Q9. What is the chromosome count in a trisomic zygote?
Answer: 2n – 1
Explanation: When a gamete with an extra chromosome (n + 1) is fertilized by a normal gamete (n), the resulting zygote is trisomic with chromosome count of 2n + 1.
Q10. Which type of chromosomal abnormality is better tolerated: autosomal or sex chromosomal?
Answer: Sex chromosome imbalances
Explanation: Imbalances of sex chromosomes (excess or loss) are tolerated much better than similar imbalances of autosomes, often producing subtle abnormalities. --- ## SECTION B: CHROMOSOMAL TERMINOLOGY & NOTATION (Questions 11-16)
Q11. What does mosaicism refer to in cytogenetics?
Answer: Presence of two or more cell populations with different chromosome complements
Explanation: Mosaicism is the presence of two or more populations of cells with different complements of chromosomes in the same individual, commonly affecting sex chromosomes.
Q12. In cytogenetic notation, what does "p" represent?
Answer: Short arm (petit)
Explanation: In cytogenetic shorthand, "p" (French, petit) denotes the short arm of a chromosome, while "q" denotes the long arm.
Q13. What does the notation 46,XX,t(2;5)(q31;p14) indicate?
Answer: Reciprocal translocation between chromosomes 2 and 5
Explanation: This notation indicates a reciprocal translocation involving the long arm of chromosome 2 at region 3, band 1, and the short arm of chromosome 5, region 1, band 4.
Q14. What is a Robertsonian translocation?
Answer: Translocation between two acrocentric chromosomes
Explanation: Robertsonian (centric fusion) translocation is a reciprocal translocation between two acrocentric chromosomes involving the short arm of one and long arm of the other.
Q15. What is the most common isochromosome found in live births?
Answer: i(Xq)
Explanation: The most common isochromosome present in live births involves the long arm of the X chromosome and is designated i(Xq), resulting in monosomy for Xp genes and trisomy for Xq genes.
Q16. How does an isochromosome form?
Answer: Horizontal division of centromere
Explanation: Isochromosomes result when the centromere divides horizontally rather than vertically, leading to loss of one arm and duplication of the remaining arm. --- ## SECTION C: DOWN SYNDROME (TRISOMY 21) (Questions 17-27)
Q17. What percentage of Down syndrome cases are caused by trisomy 21?
Answer: 95%
Explanation: About 95% of affected persons with Down syndrome have trisomy 21, with a chromosome count of 47, most commonly caused by meiotic nondisjunction.
Q18. What is the maternal age-related incidence of Down syndrome in women older than 45 years?
Answer: 1 in 25
Explanation: Down syndrome occurs in 1 in 1550 live births in women younger than 20 years but increases dramatically to 1 in 25 live births in women older than 45 years.
Q19. In what percentage of Down syndrome cases is the extra chromosome of maternal origin?
Answer: 95%
Explanation: In 95% of Down syndrome cases, the extra chromosome is of maternal origin, supporting that meiotic nondisjunction occurs primarily in the ovum.
Q20. What percentage of Down syndrome cases result from translocation?
Answer: 15%
Explanation: In about 4% of all patients with trisomy 21, the extra chromosomal material is present as a translocation of the long arm of chromosome 21 to chromosome 22 or 14.
Q21. What percentage of Down syndrome patients are mosaics?
Answer: 10%
Explanation: Approximately 1% of patients with trisomy 21 are mosaics, usually having a mixture of 46- and 47-chromosome cells resulting from mitotic nondisjunction during embryogenesis.
Q22. What percentage of Down syndrome patients have congenital heart disease?
Answer: 40%
Explanation: Approximately 40% of Down syndrome patients have congenital heart disease, most commonly endocardial cushion defects including atrial septal defects and ventricular septal defects.
Q23. What is the increased risk of acute leukemia in children with Down syndrome?
Answer: 10- to 20-fold
Explanation: Children with trisomy 21 have a 10- to 20-fold increased risk of developing acute leukemia, including both acute lymphoblastic leukemias and acute myeloid leukemias.
Q24. At what age do virtually all Down syndrome patients develop neuropathologic changes characteristic of Alzheimer disease?
Answer: Over age 40
Explanation: Virtually all patients with trisomy 21 older than age 40 develop neuropathologic changes characteristic of Alzheimer disease.
Q25. What is the current median age at death for persons with Down syndrome?
Answer: 47 years
Explanation: Improved medical care has increased the longevity of persons with trisomy 21, with the current median age at death being 47 years, up from 25 years in 1983.
Q26. Which immune cell function is primarily affected in Down syndrome patients?
Answer: T cell functions
Explanation: Patients with Down syndrome demonstrate abnormal immune responses affecting mainly T cell functions, predisposing them to serious infections and thyroid autoimmunity.
Q27. What is the typical IQ range for approximately 80% of individuals with Down syndrome?
Answer: 25 to 50
Explanation: Down syndrome is a leading cause of severe mental retardation, with approximately 80% of those afflicted having an IQ of 25 to 50. --- ## SECTION D: OTHER AUTOSOMAL DISORDERS (Questions 28-30)
Q28. Which deletion syndrome results from partial deletion of the short arm of chromosome 5?
Answer: Cri du chat syndrome
Explanation: Cri du chat syndrome results from partial deletion of the short arm of chromosome 5 and was one of the first chromosomal abnormalities identified.
Q29. What is the chromosomal abnormality in Patau syndrome?
Answer: Trisomy 13
Explanation: Patau syndrome is caused by trisomy 13, occurs less commonly than trisomy 21, and is associated with increased maternal age and severe malformations.
Q30. What is the chromosomal abnormality in Edwards syndrome?
Answer: Trisomy 18
Explanation: Edwards syndrome is caused by trisomy 18, occurs less commonly than trisomy 21, and affected infants have severe malformations with most dying within the first year of life. --- ## SECTION E: 22q11.2 DELETION SYNDROME (Questions 31-36)
Q31. Which chromosome is involved in 22q11.2 deletion syndrome?
Answer: Chromosome 22
Explanation: The 22q11.2 deletion syndrome results from a small interstitial deletion of band 11 on the long arm of chromosome 22.
Q32. Which two previously separate syndromes are now known to be caused by 22q11.2 deletion?
Answer: DiGeorge and velocardiofacial syndromes
Explanation: DiGeorge syndrome and velocardiofacial syndrome were previously believed to be different disorders but are now known to both be caused by 22q11.2 deletion.
Q33. Which transcription factor gene is suspected to be responsible for 22q11.2 deletion syndrome?
Answer: TBX1
Explanation: The transcription factor gene TBX1 is suspected to be responsible for 22q11.2 deletion syndrome, as its loss seems to correlate with the occurrence of DiGeorge syndrome.
Q34. What diagnostic technique is used to establish the diagnosis of 22q11.2 deletion syndrome?
Answer: Fluorescence in situ hybridization (FISH)
Explanation: The diagnosis of 22q11.2 deletion syndrome can be established only by detection of the deletion using fluorescence in situ hybridization (FISH).
Q35. Which type of immunity is impaired in DiGeorge syndrome?
Answer: T cell immunity
Explanation: DiGeorge syndrome features thymic hypoplasia with impaired T cell immunity along with parathyroid hypoplasia resulting in hypocalcemia.
Q36. What metabolic abnormality is commonly seen in DiGeorge syndrome due to parathyroid hypoplasia?
Answer: Hypocalcemia
Explanation: Parathyroid hypoplasia in DiGeorge syndrome results in hypocalcemia, which is one of the characteristic features of the condition. --- ## SECTION F: COMPLEX INHERITANCE & GENETIC CONCEPTS (Questions 37-44)
Q37. According to the common disease-common variant hypothesis, complex multigenic disorders occur when
Answer: Many polymorphisms with modest effects are co-inherited
Explanation: Complex multigenic disorders occur when many polymorphisms, each with a modest effect and low penetrance, are co-inherited according to this hypothesis.
Q38. How many genes are most important among the 20 to 30 genes implicated in type 1 diabetes?
Answer: 6 to 7
Explanation: Of the 20 to 30 genes implicated in type 1 diabetes, 6 or 7 are considered most important, demonstrating that polymorphisms vary in significance.
Q39. What does QTL stand for in genetics?
Answer: Quantitative trait loci
Explanation: Quantitative trait loci (QTLs) are characteristics governed by multigenic inheritance that show continuous variation within and across populations, such as height and intelligence.
Q40. In general, which produces more severe defects?
Answer: Loss of chromosomal material
Explanation: In general, loss of chromosomal material (deletion, monosomy) produces more severe defects than does gain of chromosomal material (trisomy).
Q41. What is the outcome of polyploidy in most cases?
Answer: Spontaneous abortion
Explanation: Polyploidy, which refers to exact multiples of the haploid number such as 3n and 4n, generally results in spontaneous abortion.
Q42. Which type of mosaicism is more common?
Answer: Sex chromosome mosaicism
Explanation: Mosaicism affecting sex chromosomes is common, whereas autosomal mosaicism is not commonly observed.
Q43. What is the result of anaphase lag during cell division?
Answer: Aneuploidy
Explanation: Failure of pairing of homologous chromosomes followed by random assortment (anaphase lag) can lead to aneuploidy.
Q44. Why is monosomy involving an autosome incompatible with life?
Answer: Loss of essential genetic material
Explanation: Monosomy involving an autosome is incompatible with life due to the loss of essential genetic material, whereas monosomy involving sex chromosomes can be compatible with life. --- ## SECTION G: STRUCTURAL CHROMOSOMAL ABNORMALITIES (Questions 45-50)
Q45. What type of chromosome rearrangement results in formation of one abnormally large chromosome and one extremely small one in Robertsonian translocation?
Answer: Transfer of segments between acrocentric chromosomes
Explanation: In Robertsonian translocation, the transfer of segments between acrocentric chromosomes leads to formation of one abnormally large chromosome and one extremely small one that is usually lost.
Q46. What happens to the isolated fragment lacking a centromere after deletion?
Answer: It almost never survives
Explanation: After deletion with two interstitial breaks, the isolated fragment which lacks a centromere almost never survives, and thus many genes are lost.
Q47. What type of structural abnormality is a ring chromosome considered to be?
Answer: Variant of deletion
Explanation: A ring chromosome is considered a variant of deletion where, after loss of segments from each end of the chromosome, the arms unite to form a ring.
Q48. In most chromosomal disorders, what is the typical pattern of inheritance?
Answer: De novo changes
Explanation: In most cases, chromosomal disorders result from de novo changes (parents are normal, and risk of recurrence in siblings is low).
Q49. Which form of Down syndrome is an important exception to the low recurrence risk principle?
Answer: Translocation form of Down syndrome
Explanation: An uncommon but important exception to the low recurrence risk is exhibited by the translocation form of Down syndrome, which can be inherited from a parent who is a carrier.