47 clinical MCQs in General Pathology. What is the minimum population frequency required for a genetic variant to be classified a. Kenya, Africa and glo...
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. ---
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 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 produces a distinctive pattern of alternating light and dark bands allowing 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; 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 (2n + 1). ---
Q10. Which type of chromosomal abnormality is better tolerated: autosomal or sex chromosomal?
Answer: Sex chromosome imbalances
Explanation: Imbalances of sex chromosomes are tolerated much better than similar imbalances of autosomes. ### SECTION B: CHROMOSOMAL TERMINOLOGY & NOTATION ---
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. ---
Q12. In cytogenetic notation, what does "p" represent?
Answer: Short arm (petit)
Explanation: "p" (French, petit) denotes the short arm of a chromosome; "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 and the short arm of chromosome 5. ---
Q14. What is a Robertsonian translocation?
Answer: Translocation between two acrocentric chromosomes
Explanation: Robertsonian 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 in live births involves the long arm of the X chromosome, designated i(Xq). ---
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 other. ### SECTION C: DOWN SYNDROME (TRISOMY 21) ---
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 (chromosome count of 47). ---
Q18. What is the maternal age-related incidence of Down syndrome in women older than 45 years?
Answer: 1 in 25
Explanation: Incidence 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 cases, the extra chromosome is of maternal origin, indicating meiotic nondisjunction primarily in the ovum. ---
Q20. What percentage of Down syndrome cases result from translocation?
Answer: 15%
Explanation: In about 4% of patients, 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 are mosaics, having a mixture of 46- and 47-chromosome cells. ---
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. ---
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. ---
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 Alzheimer-like neuropathologic changes. ---
Q25. What is the current median age at death for persons with Down syndrome?
Answer: 47 years
Explanation: Improved medical care has increased longevity, with the current median age at death being 47 years. ---
Q26. Which immune cell function is primarily affected in Down syndrome patients?
Answer: T cell functions
Explanation: Patients demonstrate abnormal immune responses affecting mainly T cell functions, predisposing them to infections. ---
Q27. What is the typical IQ range for approximately 80% of individuals with Down syndrome?
Answer: 25 to 50
Explanation: Approximately 80% of those afflicted have an IQ of 25 to 50. ### SECTION D: OTHER AUTOSOMAL DISORDERS ---
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 (5p-). ---
Q29. What is the chromosomal abnormality in Patau syndrome?
Answer: Trisomy 13
Explanation: Patau syndrome is caused by trisomy 13. ---
Q30. What is the chromosomal abnormality in Edwards syndrome?
Answer: Trisomy 18
Explanation: Edwards syndrome is caused by trisomy 18. ### SECTION E: 22q11.2 DELETION SYNDROME ---
Q31. Which chromosome is involved in 22q11.2 deletion syndrome?
Answer: Chromosome 22
Explanation: The syndrome results from a small interstitial deletion 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 are both 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 the clinical features. ---
Q34. What diagnostic technique is used to establish the diagnosis of 22q11.2 deletion syndrome?
Answer: Fluorescence in situ hybridization (FISH)
Explanation: Diagnosis is established by detecting the deletion using 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. ---
Q36. What metabolic abnormality is commonly seen in DiGeorge syndrome due to parathyroid hypoplasia?
Answer: Hypocalcemia
Explanation: Parathyroid hypoplasia results in hypocalcemia. ### SECTION F: COMPLEX INHERITANCE & GENETIC CONCEPTS ---
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 disorders occur when many polymorphisms, each with a modest effect, are co-inherited. ---
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, 6 or 7 are considered most important. ---
Q39. What does QTL stand for in genetics?
Answer: Quantitative trait loci
Explanation: Quantitative trait loci (QTLs) govern multigenic inheritance showing continuous variation (e.g., height). ---
Q40. In general, which produces more severe defects?
Answer: Loss of chromosomal material
Explanation: Loss of chromosomal material (deletion, monosomy) generally produces more severe defects than gain (trisomy). ---
Q41. What is the outcome of polyploidy in most cases?
Answer: Spontaneous abortion
Explanation: Polyploidy (3n, 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; autosomal mosaicism is rare. ---
Q43. What is the result of anaphase lag during cell division?
Answer: Aneuploidy
Explanation: Anaphase lag (failure of pairing followed by random assortment) leads to aneuploidy. ---
Q44. Why is monosomy involving an autosome incompatible with life?
Answer: Loss of essential genetic material
Explanation: Autosomal monosomy is incompatible with life due to the loss of essential genetic material. ### SECTION G: STRUCTURAL CHROMOSOMAL ABNORMALITIES ---
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: Transfer of segments between acrocentric chromosomes leads to one large chromosome and one small one (usually lost). ---
Q46. What happens to the isolated fragment lacking a centromere after deletion?
Answer: It almost never survives
Explanation: Fragments lacking a centromere almost never survive during cell division. ---
Q47. What type of structural abnormality is a ring chromosome considered to be?
Answer: Variant of deletion
Explanation: A ring chromosome is a variant of a deletion where both ends of a chromosome are lost and the remaining ends fuse.