SPECIFIC KNOWLEDGE REQUIREMENTS GENETICS/NEOPLASIA/DEVELOPMENT

 

XIII.   What are the components of embryological development?

A.    Gametogenesis, fertilization, Mitosis vs Meiosis

1.     Rates of mutation, chromosome rearrangements

 

2.     Chromosomal aberrations (numerical, structural, mosaic) – See IIC

Disease Ex: T21, T18, T13, 45X, 47XXY, 4p-, 5p-, 22q11 del, 7q11 del

 

B.    Embryotic cell cycle and regulation

1.     Initial cell divisions

2.     Blastocyst and implantation

3.     Gastrulation and cell differentiation

Germ layers – ectoderm, mesoderm, endoderm

 

C.    Tissue & organ development

1.     Placentation

2.     Body cavity development 

3.     Cardiac development, heart migration, and septation

Disease Ex: Holt-Oram, Kartagener, 22q11 del, 7q11 del

4.     GI tract development, rotations, mesentery alignment (with accessory organ budding)

Disease Ex: omphalocele, gastroschisis, Beckwith-Weidemann, Alagille

5.     Lung formation and branching morphogenesis

Disease Ex: Potter sequence

6.     Skeletal development

      Disease Ex: Achondroplaisa, osteogenesis imperfecta

7.     Limb bud development and limb rotation

Disease Ex: Holt-Oram, split hand/split foot, thalidomide, amniotic bands

8.     UG development and relationship with hindgut

Disease Ex: polycystic kidneys, OEIS complex

9.     Gender development

Disease Ex: androgen insensitivity, Smith-Lemli-Opitz, congenital adrenal hyperplasia, 5 alpha reductase

10.  Pharyngeal/Branchial arch contributions

Disease Ex: 22q11 del, brancho-oto-renal, Goldenhar, Treacher-Collins

11.  Head and face development

Disease Ex: types of clefts (lip, palate, Tessier), Robin sequence, Stickler, T13, vanderWoude, folate

12.  Eye development

Disease Ex: micro/anophthalmia, cataracts, coloboma, CHARGE, Alagille, TORCH

13.  Ear development

Disease Ex: connexin 26, TORCH / teratogens, Pendred, CHARGE

14.  Brain development

Disease Ex: neuronal migration, lissencephaly, Miller-Dieker / LIS1, holoprosencephaly, T13 / sonic hedgehog, anencephaly, hydranencephaly, porencephaly, schizencephaly, hydrocephalus, TORCH / teratogens

15.  Neural crest cell migration

Disease Ex: Hirschprung, Waardenburg, neural tube defects, folate

16.  Stem cells, bone marrow

Disease Ex: Fanconi anemia, Bloom, severe combined immunodeficiency

D.    Dysregulation – genetic vs environmental

1.     Normal development vs aberrant development (spontaneous abortion)

2.     Birth defect classification: deformation, disruption, dysplasia, malformation (minor, major), syndrome, sequence, association  

3.     Pattern recognition:

Associations:

      Disease Ex: VACTERL

 

Sequences:

      Disease Ex: Pierre-Robin, Potter

 

Teratogens

      Disease Ex:

Drugs (alcohol, tobacco, cocaine, other illicit drugs)

Medications (antiepileptics, folate antagonists, lithium, thalidomide, warfarin, tetracylines, amnioglycosides, alkylating agents, DES, ACE inhibitors)

Environmental (TORCH, X-rays)

Dietary (iodide, folate, vitamin A),

Maternal conditions (diabetes, PKU, epilepsy)

 

Chromosomal

      Disease Ex: T21, T18, T13, 45X, 47XXY, 4p-, 5p-, 22q11 del, 7q11 del

 

Single gene defects

      Disease Ex: Achondroplasia, Apert, Cornelia deLange, Holt-Oram, Treacher-Collins,

 

Embryonic patterning genes

Disease Ex: sonic hedgehog, T-box, Wnt, SRY

 

4.     Maternal message vs new transcription

      Maternal RNA