Mosaicism
Mitochondrial Disorders
Metabolic Disorders
Clinical Diagnosis
Childhood Screening
200

I have café-au-lait macules and neurofibromas limited to one side of my body because my pathogenic variant occurred after fertilization

What is mosaic/ segmental NF1?

200

This maternally inherited disorder presents with painless, subacute bilateral vision loss in young adults

What is Leber Hereditary Optic Neuropathy (LHON)?

200

This baby wearing a “I Love Vermont” onesie presents with sweet smelling urine

What is Maple syrup urine disease ?

I Love Vermont: (I= isoleucine, L= leucine, V= valine)

200

6 café-au-lait macules and Lisch nodules

What is NF1?

200

APC

What is colonoscopies in adolescence?

400

This disorder is caused by a postzygotic pathogenic variant in GNAS and presents with café-au-lait macules, fibrous dysplasia, and precocious puberty

What is McCune-Albright Syndrome?

400

This disorder presents with stroke-like episodes before age 40, seizures, hearing loss, diabetes, and lactic acidosis

What is MELAS ?

400

An infant presents with developmental delay, hepatosplenomegaly, a cherry-red macula, and no hepatocellular dysfunction. Enzyme testing reveals deficient β-hexosaminidase A activity

What is Tay-Sachs Disease?

400

Three facial angiofibromas and a shagreen patch

What is Tuberous Sclerosis Complex?

400

RB1

What is retinoblastoma from infancy?

600

A parent tests negative for their child’s pathogenic variant on blood testing but has multiple affected children because the mutation is confined to the germ cells due to this

What is Gonadal/ Germline Mosaicism?

600

This syndrome presents with progressive external ophthalmoplegia, pigmentary retinopathy, heart block, and onset before age 20

What is Kearns-Sayre syndrome?

600

A neonate develops lethargy, poor feeding, respiratory alkalosis, hyperammonemia, and low citrulline without metabolic acidosis

What is OTC deficiency ?

600

Multiple mucocutaneous pigmentation and at least two PJ polyps

What is Peutz-Jeghers Syndrome?

600

PTEN

What is ultrasounds starting at 7 years old?

800

Following CVS, chromosome analysis demonstrates mosaic trisomy 16. The fetus appears normal on ultrasound. What phenomenon must be considered before counseling the patient?

What is confined Placental mosaicism?

800

This syndrome presents with myoclonic epilepsy, ragged-red fibers on muscle biopsy, ataxia, and sensorineural hearing loss

What is MERRF syndrome?

800

A child has angiokeratomas, acroparesthesias, hypohidrosis, progressive kidney disease, and hypertrophic cardiomyopathy. The disorder is X-linked

What is Fabry Disease?

800

Three major diagnostic criteria including ectopia lentis and aortic root dilation

What is Marfan syndrome?

800

TP53

What is whole body imaging from birth?

1000

Females with this x-linked condition affecting the muscles are considered manifesting carriers due to somatic mosaicism

What is Duchenne Muscular Dystrophy?

1000

Two siblings have the same mitochondrial disorder, but only one has severe symptoms despite inheriting the same pathogenic mitochondrial DNA variant from their mother. What genetic principle best explains this difference?

What is Heteroplasmy?

1000

This fatty acid oxidation disorder presents with hypoketotic hypoglycemia, elevated C8 acylcarnitine, and sudden decompensation after prolonged fasting

What is Medium-chain acyl-CoA dehydrogenase (MCAD) deficiency?

1000

Hypertelorism, a bifid uvula (or cleft palate), and widespread arterial aneurysms and tortuosity in an individual

What is Loey-Dietz Syndrome?

1000

What syndrome requires surveillance for CNS hemangioblastomas, renal cell carcinoma, pheochromocytoma, retinal angiomas, and pancreatic lesions beginning in childhood

What is Von Hippel Lindau?