Genetic linkage and mapping US Medical PG Practice Questions and MCQs
Practice US Medical PG questions for Genetic linkage and mapping. These multiple choice questions (MCQs) cover important concepts and help you prepare for your exams.
Genetic linkage and mapping US Medical PG Question 1: A 25-year-old man with a genetic disorder presents for genetic counseling because he is concerned about the risk that any children he has will have the same disease as himself. Specifically, since childhood he has had difficulty breathing requiring bronchodilators, inhaled corticosteroids, and chest physiotherapy. He has also had diarrhea and malabsorption requiring enzyme replacement therapy. If his wife comes from a population where 1 in 10,000 people are affected by this same disorder, which of the following best represents the likelihood a child would be affected as well?
- A. 0.01%
- B. 2%
- C. 0.5%
- D. 1% (Correct Answer)
- E. 50%
Genetic linkage and mapping Explanation: ***Correct Option: 1%***
- The patient's symptoms (difficulty breathing requiring bronchodilators, inhaled corticosteroids, and chest physiotherapy; diarrhea and malabsorption requiring enzyme replacement therapy) are classic for **cystic fibrosis (CF)**, an **autosomal recessive disorder**.
- For an autosomal recessive disorder with a prevalence of 1 in 10,000 in the general population, **q² = 1/10,000**, so **q = 1/100 = 0.01**. The carrier frequency **(2pq)** is approximately **2q = 2 × (1/100) = 1/50 = 0.02**.
- The affected man is **homozygous recessive (aa)** and will always pass on the recessive allele. His wife has a **1/50 chance of being a carrier (Aa)**. If she is a carrier, she has a **1/2 chance of passing on the recessive allele**.
- Therefore, the probability of an affected child = **(Probability wife is a carrier) × (Probability wife passes recessive allele) = 1/50 × 1/2 = 1/100 = 1%**.
*Incorrect Option: 0.01%*
- This percentage is too low and does not correctly account for the carrier frequency in the population and the probability of transmission from a carrier mother.
*Incorrect Option: 2%*
- This represents approximately the carrier frequency (1/50 ≈ 2%), but does not account for the additional 1/2 probability that a carrier mother would pass on the recessive allele.
*Incorrect Option: 0.5%*
- This value would be correct if the carrier frequency were 1/100 instead of 1/50, which does not match the given population prevalence.
*Incorrect Option: 50%*
- **50%** would be the risk if both parents were carriers of an autosomal recessive disorder (1/4 chance = 25% for affected, but if we know one parent passes the allele, conditional probability changes). More accurately, 50% would apply if the disorder were **autosomal dominant** with one affected parent, which is not the case here.
Genetic linkage and mapping US Medical PG Question 2: A 30-year-old man presents to his primary care physician for a routine check-up. During the appointment, he remarks that he has started noticing some thinning and hair loss without other symptoms. The physician reassures him that he is likely experiencing male-pattern baldness and explains that the condition is largely inherited. Specifically he notes that there are multiple genes that are responsible for the condition so it is difficult to predict the timing and development of hair loss. What genetic principle is being illustrated by this scenario?
- A. Uniparental disomy
- B. Polygenic inheritance (Correct Answer)
- C. Pleiotropy
- D. Anticipation
- E. Heteroplasmy
Genetic linkage and mapping Explanation: ***Polygenic inheritance***
- This scenario describes male-pattern baldness as being influenced by **multiple genes**, which is the definition of polygenic inheritance.
- The difficulty in predicting the timing and development of hair loss further supports polygenic inheritance, as the combined effect of several genes and environmental factors can lead to a **continuous variation** in phenotypic expression.
*Uniparental disomy*
- This refers to the inheritance of **two copies of a chromosome** or part of a chromosome from **one parent** and no copies from the other parent.
- It is typically associated with specific genetic disorders like Prader-Willi or Angelman syndromes and does not explain the general inheritance pattern of male-pattern baldness.
*Pleiotropy*
- **Pleiotropy** occurs when a **single gene** affects **multiple seemingly unrelated phenotypic traits**.
- This principle is incorrect because the scenario explicitly states that male-pattern baldness is influenced by "multiple genes," not a single gene affecting multiple traits.
*Anticipation*
- **Anticipation** is a phenomenon where the symptoms of a genetic disorder become more severe or appear earlier with each successive generation.
- This phenomenon is observed in conditions like Huntington's disease or myotonic dystrophy and is not the genetic principle described for male-pattern baldness.
*Heteroplasmy*
- **Heteroplasmy** refers to the presence of **more than one type of mitochondrial DNA** (mtDNA) within a single cell or individual.
- This principle is exclusive to mitochondrial inheritance and is not relevant to the inheritance pattern of male-pattern baldness, which is generally considered to be affected by nuclear genes.
Genetic linkage and mapping US Medical PG Question 3: A 23-year-old woman and her husband come to a genetic counselor because she is concerned about the chance of having an inherited defect if they had a child. Family history reveals no significant family history in her husband; however, her sister had a son who has seizures, failure to thrive, and neurodegeneration. She does not remember the name of the disease but remembers that her nephew had sparse, brittle hair that kinked in odd directions. She does not think that any other members of her family including her sister's husband have had this disorder. If this couple had a son, what is the most likely chance that he would have the same disorder that affected the patient's nephew?
- A. 100%
- B. 12.5%
- C. 25% (Correct Answer)
- D. 50%
- E. Close to 0%
Genetic linkage and mapping Explanation: ***25%***
- The nephew's symptoms of **seizures, failure to thrive, neurodegeneration**, and **sparse, brittle, kinky hair** are highly indicative of **Menkes disease**, an **X-linked recessive** disorder.
- Since the patient's sister had an affected son, the sister is an **obligate carrier** of the mutation.
- The patient and her sister share the same parents, so their mother must be a carrier (or have the mutation).
- The patient herself has a **50% chance of being a carrier**.
- **If the patient is a carrier**, each son has a **50% chance** of being affected.
- **Overall probability**: 0.5 (chance patient is carrier) × 0.5 (chance son inherits mutation) = **0.25 = 25%**.
*Close to 0%*
- This would only be correct if the patient had no chance of being a carrier, which is not the case given her family history.
- Her sister's affected son confirms the mutation is present in the maternal lineage.
*100%*
- This would only occur if the patient were definitely a carrier AND all male offspring inherited the mutation, or if the disorder were autosomal dominant with complete penetrance.
- For **X-linked recessive** disorders, even carrier mothers only pass the mutation to 50% of sons on average.
*12.5%*
- This percentage might represent additional generational steps or compound probabilities not relevant to this direct parent-child scenario.
- The correct calculation for this scenario is 50% × 50% = 25%.
*50%*
- This would be correct if we knew with certainty that the patient is a carrier.
- However, since we only know her sister is a carrier, the patient has a 50% chance of being a carrier herself, making the overall risk 25%.
- This is a common error in genetic counseling calculations—forgetting to account for the uncertain carrier status of the at-risk individual.
Genetic linkage and mapping US Medical PG Question 4: A deficiency in which of the following lysosomal enzymes is inherited in a pattern similar to a deficiency of iduronate sulfatase (Hunter syndrome)?
- A. Sphingomyelinase
- B. Glucocerebrosidase
- C. Galactocerebrosidase
- D. Alpha-L-iduronidase
- E. Alpha-galactosidase A (Correct Answer)
Genetic linkage and mapping Explanation: ***Alpha-galactosidase A***
- A deficiency in **alpha-galactosidase A** causes **Fabry disease**, which, like Hunter syndrome (iduronate sulfatase deficiency), is inherited in an **X-linked recessive** pattern.
- Both conditions primarily affect males, with carrier females potentially exhibiting milder symptoms.
*Sphingomyelinase*
- A deficiency in sphingomyelinase leads to **Niemann-Pick disease types A and B**, which are inherited in an **autosomal recessive** pattern.
- This mode of inheritance differs from the X-linked pattern of Hunter syndrome.
*Glucocerebrosidase*
- A deficiency in glucocerebrosidase causes **Gaucher disease**, inherited in an **autosomal recessive** pattern.
- This is a common lysosomal storage disorder, but its inheritance pattern is distinct from X-linked disorders.
*Galactocerebrosidase*
- A deficiency in galactocerebrosidase causes **Krabbe disease (globoid cell leukodystrophy)**, which is inherited in an **autosomal recessive** pattern.
- Krabbe disease is a severe neurodegenerative disorder, but its genetic transmission is not X-linked.
*Alpha-L-iduronidase*
- A deficiency in **alpha-L-iduronidase** causes **Hurler syndrome (MPS I)**, which is inherited in an **autosomal recessive** pattern.
- While both Hunter and Hurler syndromes are mucopolysaccharidoses, their genetic inheritance patterns are different.
Genetic linkage and mapping US Medical PG Question 5: A 3-year-old boy is brought to his pediatrician by his parents for a follow-up visit. Several concerning traits were observed at his last physical, 6 months ago. He had developmental delay, a delay in meeting gross and fine motor control benchmarks, and repetitive behaviors. At birth, he was noted to have flat feet, poor muscle tone, an elongated face with large, prominent ears, and enlarged testicles. He takes a chewable multivitamin every morning. There is one other member of the family, on the mother’s side, with a similar condition. Today, his blood pressure is 110/65 mm Hg, heart rate is 90/min, respiratory rate is 22/min, and temperature of 37.0°C (98.6°F). On physical exam, the boy repetitively rocks back and forth and has difficulty following commands. His heart has a mid-systolic click, followed by a late systolic murmur and his lungs are clear to auscultation bilaterally. Several vials of whole blood are collected for analysis. Which of the following studies should be conducted as part of the diagnostic screening protocol?
- A. Northern blot with RNA probes
- B. Two-dimensional gel electrophoresis
- C. Southern blot with DNA probes (Correct Answer)
- D. Western blot
- E. PCR followed by northern blot with RNA probes
Genetic linkage and mapping Explanation: ***Southern blot with DNA probes***
- The patient's presentation with developmental delay, repetitive behaviors, flat feet, hypotonia, elongated face, prominent ears, and macroorchidism (*enlarged testicles*) is highly suggestive of **Fragile X syndrome**.
- **Fragile X syndrome** is caused by an abnormal expansion of a **CGG trinucleotide repeat** in the *FMR1* gene on the X chromosome, which leads to hypermethylation and silencing of the gene. **Southern blot analysis with DNA probes** is the gold standard for detecting these expansions, as it can measure the size of the *CGG* repeat and the methylation status of the gene.
*Northern blot with RNA probes*
- **Northern blot analysis** is used to detect and quantify specific **RNA molecules**.
- While the *FMR1* gene's mRNA expression is affected in Fragile X syndrome, northern blot is not the primary diagnostic test for detecting the underlying **DNA repeat expansion** and methylation.
*Two-dimensional gel electrophoresis*
- **Two-dimensional gel electrophoresis** is a technique used to separate **proteins** based on their **isoelectric point** and then by **molecular weight**.
- This method is used for proteomic studies and is not relevant for diagnosing a genetic disorder caused by a DNA repeat expansion.
*Western blot*
- **Western blot analysis** is used to detect specific **proteins** in a sample.
- In Fragile X syndrome, the *FMR1* gene product, **FMRP (Fragile X Mental Retardation Protein)**, is absent or reduced, which could be theoretically detected by Western blot. However, the definitive diagnosis relies on identifying the genetic mutation (CGG expansion and methylation) in the DNA, for which Southern blot is superior.
*PCR followed by northern blot with RNA probes*
- **PCR (Polymerase Chain Reaction)** is used to amplify specific **DNA sequences**. While *PCR* can detect smaller *CGG* expansions, it often fails to accurately size the full mutations found in Fragile X syndrome due to the large repeat numbers.
- Combining *PCR* with **northern blot (RNA detection)** would still not be the primary diagnostic approach for the DNA-based *CGG* repeat expansion and methylation status, which is essential for diagnosing Fragile X.
Genetic linkage and mapping US Medical PG Question 6: An 11-year-old male with light purple eyes presents with gradual loss of bilateral visual acuity. Over the past several years, vision has worsened from 20/20 to 20/100 in both eyes. He also has mild nystagmus when focusing on objects such as when he is trying to do his homework. He is diagnosed with a disease affecting melanin production in the iris. If both of his parents are unaffected, which of the following represents the most likely probabilities that another male or female child from this family would be affected by this disorder?
- A. Male: 25% Female: 25%
- B. Same as general population
- C. Male: 50% Female: 50%
- D. Male: 50% Female: 0% (Correct Answer)
- E. Male: 100% Female: 0%
Genetic linkage and mapping Explanation: ***Male: 50% Female: 0%***
- The symptoms (light purple eyes, gradual vision loss, nystagmus, defective melanin production) are characteristic of **ocular albinism**. This condition is typically **X-linked recessive**.
- If the patient's mother is a **carrier** (XAXa) and the father is unaffected (XAY), there is a **50% chance** that a male child will inherit the affected X chromosome (XaY) and thus be affected, and a **0% chance** for a female child to be affected if the father is unaffected (all female children would either be carriers XAXa or unaffected XAXA).
*Male: 25% Female: 25%*
- This probability pattern would typically suggest an **autosomal recessive** inheritance pattern, where both parents are carriers (Aa x Aa), and there is a 25% chance for any child to be affected regardless of sex.
- However, ocular albinism most commonly follows an X-linked recessive pattern, and the described clinical features (e.g., light purple eyes due to melanin defect in the iris) are highly suggestive of ocular albinism.
*Same as general population*
- This would only be true if the disorder was not genetic or if the parents' carrier status did not increase the risk for subsequent children.
- Given the heritable nature of albinism and the specific family history (parents unaffected, one affected child), the risk for subsequent children is significantly higher than the general population.
*Male: 50% Female: 50%*
- This pattern would occur in an **autosomal dominant** disorder with 100% penetrance, where one parent is affected (Aa x aa), or in some specific scenarios of X-linked inheritance if the father was affected and the mother was a carrier.
- Ocular albinism is X-linked recessive, not autosomal dominant, and the father is stated to be unaffected.
*Male: 100% Female: 0%*
- This genetic pattern is highly unlikely unless the mother was fully mosaic for the condition or an extremely rare and specialized inheritance pattern was at play.
- In a typical X-linked recessive inheritance with an unaffected father and a carrier mother, there is always a 50% chance for a male child to be unaffected.
Genetic linkage and mapping US Medical PG Question 7: A Caucasian 32-year-old woman has an uncomplicated vaginal delivery, giving birth to male and female fraternal twins at term. At 2 days of life, the twin sister develops abdominal distension without emesis, and the mother states that she has not noticed the passage of stool for this infant. Genetic testing identifies deletion of an amino acid in a membrane channel for the girl. Both parents are healthy. Assuming that twin brother's disease status/symptomatology is unclear, which of the following best approximates the probability that the twin brother is a carrier of the disease allele?
- A. 100%
- B. 67% (Correct Answer)
- C. 0%
- D. 50%
- E. 25%
Genetic linkage and mapping Explanation: ***67%***
- The sister's symptoms of **abdominal distension** without emesis and lack of stool passage, along with genetic testing identifying a **deletion of an amino acid in a membrane channel**, strongly suggest **Cystic Fibrosis (CF)**. CF is an **autosomal recessive disorder**.
- Since the affected twin sister has CF (genotype **aa**), and both parents are healthy, both parents must be **heterozygous carriers (Aa)**. When two carriers (Aa x Aa) have offspring, the probability of any child being a carrier (Aa) is **2/3** among the unaffected offspring. The twin brother is currently unaffected (phenotypically healthy), so the probability of him being a carrier is 2/3, or approximately 67%.
*100%*
- This would only be true if one or both parents were **homozygous affected (aa)**, or if the disease inheritance was **dominant** and the parents were carriers, which is not the case for this autosomal recessive disorder where the parents are healthy carriers and the brother is phenotypically unaffected.
- While both parents *are* carriers, the brother, being unaffected, has a chance of being **homozygous dominant (AA)**, meaning he is not a carrier.
*0%*
- This is incorrect because we know both parents are **obligate carriers** (heterozygous, Aa) for the recessive allele, given their affected child (aa). Therefore, their children have a 75% chance of inheriting at least one disease allele (50% carrier, 25% affected).
- The twin brother being unaffected means he has a 2/3 chance of being a carrier, not 0%.
*50%*
- This probability (1/2) is the chance of a child inheriting a specific allele from one parent, or the chance of being a carrier if one parent is affected and the other is homozygous dominant.
- In an **autosomal recessive** inheritance pattern where both parents are carriers (Aa x Aa) and the offspring is unaffected, the probability of being a carrier is **2/3**, not 1/2.
*25%*
- This is the probability of a child being **homozygous dominant (AA)** from two carrier parents (Aa x Aa), meaning they would neither have the disease nor be carriers.
- It is also the probability of a child being affected (aa) if both parents are carriers. Neither of these scenarios matches the question asking for the probability of the *unaffected* twin brother being a carrier.
Genetic linkage and mapping US Medical PG Question 8: A 5-year-old boy is brought to the emergency department after he fell on the playground in kindergarten and was unable to get up. His right leg was found to be bent abnormally at the femur, and he was splinted on site by first responders. His past medical history is significant for multiple prior fractures in his left humerus and femur. Otherwise, he has been hitting normal developmental milestones and appears to be excelling in kindergarten. Physical exam also reveals the finding shown in figure A. Which of the following is the most likely cause of this patient's multiple fractures?
- A. Decreased collagen hydroxylation
- B. Non-accidental trauma
- C. Abnormal collagen production (Correct Answer)
- D. Mutation in neurofibromin
- E. Increased adenylyl cyclase activity
Genetic linkage and mapping Explanation: ***Abnormal collagen production***
- This patient presents with **recurrent fractures** from minor trauma and **blue sclerae**, which are classic features of **osteogenesis imperfecta (OI)**.
- OI is caused by **genetic defects in type I collagen synthesis**, leading to fragile bones and thin sclerae that allow the underlying choroid to show through.
*Decreased collagen hydroxylation*
- This refers to a defect in post-translational modification of collagen, a core issue in **scurvy** (Vitamin C deficiency).
- Scurvy is characterized by **bleeding gums, petechiae, and impaired wound healing**, not recurrent fractures, and is not associated with blue sclerae.
*Non-accidental trauma*
- While recurrent fractures raise suspicion for **child abuse**, the presence of an underlying genetic condition like **osteogenesis imperfecta** (indicated by blue sclerae and easy fracturability) must be ruled out.
- The combination of **blue sclerae** and multiple fractures points strongly towards a genetic disorder, making child abuse less likely as the primary cause.
*Mutation in neurofibromin*
- A mutation in **neurofibromin** is characteristic of **Neurofibromatosis Type 1 (NF1)**.
- NF1 is associated with **café-au-lait spots, neurofibromas, Lisch nodules, and optic nerve gliomas**, but not blue sclerae or repeated fractures as the primary manifestation.
*Increased adenylyl cyclase activity*
- Increased adenylyl cyclase activity is seen in conditions like **McCune-Albright syndrome**, which involves somatic mutations in the **GNAS gene**.
- While McCune-Albright can cause **polyostotic fibrous dysplasia** (leading to fractures), **café-au-lait spots**, and **precocious puberty**, it is not associated with blue sclerae.
Genetic linkage and mapping US Medical PG Question 9: A 2-month-old boy is presented to the clinic for a well-child visit by his parents. They are concerned with his weak cry and difficulty with feeding. Birth history reveals that the boy was born at the 37th week of gestation by cesarean section due to poor fetal movement and fetal distress. His Apgar scores were 3 and 5 at 1st and 5th minute respectively and his birth weight was 2.5 kg (6 lb). His vital signs include heart rate 120/min, respiratory rate 40/min, blood pressure 90/50 mm Hg, and temperature 37.0°C (98.6°F). Physical examination reveals a malnourished boy with a small narrow forehead and a small jaw. His mouth is small and he has comparatively small genitals. He has a poor muscle tone. After repeated follow-up, he gains weight rapidly but his height fails to increase. Developmental milestones are delayed at the age of 3 years. Genetic testing reveals Prader-Willi syndrome. Which of the following is the most common mechanism for the development of this patient’s condition?
- A. Anticipation
- B. Heteroplasmy
- C. Incomplete penetrance
- D. Maternal uniparental disomy
- E. Paternal deletion of 15q11-q13 (Correct Answer)
Genetic linkage and mapping Explanation: ***Paternal deletion of 15q11-q13***
- This is the **most common genetic mechanism** (occurring in about 70-75% of cases) for Prader-Willi syndrome, involving the loss of genetic material from the paternally inherited chromosome 15 in the specified region
- The deletion affects genes that are **normally expressed only from the paternal chromosome** due to genomic imprinting, leading to the characteristic features of hypotonia, feeding difficulties in infancy, subsequent hyperphagia with obesity, hypogonadism, and developmental delays
*Incorrect: Anticipation*
- Anticipation describes a genetic phenomenon where a disorder appears earlier or symptoms become more severe with each successive generation
- This is typically seen in disorders caused by expanding **trinucleotide repeats** (e.g., Huntington's disease, myotonic dystrophy), not applicable to Prader-Willi syndrome
*Incorrect: Heteroplasmy*
- Heteroplasmy refers to the presence of more than one type of mitochondrial DNA within a cell or individual
- This concept is relevant to **mitochondrial genetic disorders** which are maternally inherited, not to Prader-Willi syndrome which is a nuclear chromosomal imprinting disorder
*Incorrect: Incomplete penetrance*
- Incomplete penetrance occurs when individuals carrying a pathogenic mutation do not express the associated clinical phenotype
- Prader-Willi syndrome typically presents with a **consistent set of features** when the genetic defect is present; incomplete penetrance is not the mechanism of disease development
*Incorrect: Maternal uniparental disomy*
- Maternal uniparental disomy (UPD) of chromosome 15 is the **second most common mechanism** for Prader-Willi syndrome (occurring in about 20-25% of cases)
- This involves inheriting **both copies of chromosome 15 from the mother** and none from the father, leading to absence of paternal gene expression in the critical 15q11-q13 region
- While less common than paternal deletion, this is still a significant cause of the syndrome
Genetic linkage and mapping US Medical PG Question 10: Although nucleotide addition during DNA replication in prokaryotes proceeds approximately 20-times faster than in eukaryotes, why can much larger amounts of DNA be replicated in eukaryotes in a time-effective manner?
- A. Eukaryotes have multiple origins of replication (Correct Answer)
- B. Eukaryotes have helicase which can more easily unwind DNA strands
- C. Eukaryotes have fewer polymerase types
- D. Eukaryotes have less genetic material to replicate
- E. Eukaryotes have a single, circular chromosome
Genetic linkage and mapping Explanation: ***Eukaryotes have multiple origins of replication***
- Eukaryotic chromosomes are much larger than prokaryotic chromosomes and require multiple origins of replication to complete DNA synthesis within a reasonable timeframe.
- Each origin of replication initiates simultaneously, allowing DNA synthesis to occur at many sites along the chromosome, effectively increasing the overall speed of replication.
- This compensates for the slower rate of nucleotide addition by DNA polymerase in eukaryotes compared to prokaryotes.
*Eukaryotes have helicase which can more easily unwind DNA strands*
- While helicase activity is crucial for unwinding DNA, there is no evidence to suggest that eukaryotic helicases are significantly more efficient or faster at unwinding DNA compared to prokaryotic helicases in a way that would account for the large difference in overall replication time.
- The rate of DNA unwinding by helicase is a factor in replication speed, but it does not overcome the fundamental limitation of a single origin of replication in prokaryotes.
*Eukaryotes have fewer polymerase types*
- Eukaryotic cells actually have **more** types of DNA polymerases than prokaryotic cells, each specialized for different functions like replication, repair, and mitochondrial DNA synthesis.
- The number of polymerase types does not directly relate to the speed or efficiency of overall DNA replication in terms of replicating large amounts of DNA.
*Eukaryotes have less genetic material to replicate*
- Eukaryotic organisms typically have significantly **more** genetic material (a larger genome size) than prokaryotic organisms, not less.
- If eukaryotes had less genetic material, the question itself about effective replication of "much larger amounts of DNA" would be contradictory.
*Eukaryotes have a single, circular chromosome*
- Eukaryotic cells have **multiple, linear chromosomes** within a membrane-bound nucleus, not a single circular chromosome.
- Prokaryotic cells typically have a single, circular chromosome located in the nucleoid region.
- The linear structure of eukaryotic chromosomes with multiple origins is actually what enables efficient replication of large genomes, making this statement both factually incorrect and contradictory to the mechanism in question.
More Genetic linkage and mapping US Medical PG questions available in the OnCourse app. Practice MCQs, flashcards, and get detailed explanations.
