This MCQ module is based on: Mutation Genetic Disorders
Mutation Genetic Disorders
This assessment will be based on: Mutation Genetic Disorders
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Mutation Genetic Disorders
5.11 Mutation
Mutation is a sudden, heritable change in the DNA sequence or chromosomal structure of an organism. Mutations are the ultimate source of all new genetic variation upon which natural selection acts.
5.11.1 Types of Mutation
| Level | Type | What changes | Example |
|---|---|---|---|
| Gene (Point) | Substitution | One base replaced by another | Sickle cell anaemia (A→T) |
| Gene (Point) | Insertion / Deletion | Base added or removed (frameshift) | Duchenne muscular dystrophy |
| Chromosome | Deletion | Loss of chromosome segment | Cri-du-chat syndrome |
| Chromosome | Duplication | Segment repeated | Charcot-Marie-Tooth |
| Chromosome | Inversion | Segment reversed | Some leukaemias |
| Chromosome | Translocation | Segment moved to another chromosome | Some cancers (BCR-ABL) |
| Genome | Aneuploidy | One chromosome gained/lost | Down (+21), Turner (XO) |
| Genome | Polyploidy | Whole extra set of chromosomes | Wheat (hexaploid 6n) |
5.11.2 Mutagens
Agents that cause mutations are called mutagens. They include:
- Physical mutagens: UV radiation, X-rays, gamma rays.
- Chemical mutagens: Base analogues (5-bromouracil), alkylating agents, intercalating dyes (ethidium bromide).
- Biological mutagens: Some viruses and transposons.
5.12 Genetic Disorders
Genetic disorders are broadly grouped into Mendelian disorders (caused by single-gene mutations) and Chromosomal disorders (caused by changes in chromosome number or structure).
5.12.1 Mendelian Disorders
a) Haemophilia (X-linked recessive)
A blood-clotting disorder caused by a defect in clotting factors (commonly factor VIII for haemophilia A, or factor IX for haemophilia B). The X-linked recessive allele means:
- Affected males (XhY) cannot clot blood properly — even minor cuts cause prolonged bleeding.
- Heterozygous females (XHXh) are carriers — they don't have the disorder but can pass it to sons.
- Homozygous females (XhXh) are very rare because they'd need two haemophilic alleles — usually fatal in pre-modern times.
b) Sickle Cell Anaemia (Autosomal recessive)
Sickle cell anaemia is caused by a substitution mutation: glutamic acid (Glu) is replaced by valine (Val) at position 6 of the β-globin chain. The mutated haemoglobin (HbS) polymerises under low oxygen, causing red blood cells to assume a sickle shape.
- HbA HbA (homozygous normal): unaffected.
- HbA HbS (heterozygous, sickle-cell trait): mildly affected; partly malaria-resistant.
- HbS HbS (homozygous): full sickle cell anaemia; severe anaemia, organ damage.
c) Thalassemia (Autosomal recessive)
Thalassemia is caused by mutations that reduce the production of either α-globin (α-thalassemia) or β-globin (β-thalassemia) chains. Unlike sickle cell where haemoglobin is made but defective, in thalassemia haemoglobin is not made in adequate amounts. Patients require regular blood transfusions.
d) Phenylketonuria (Autosomal recessive)
An autosomal recessive disorder where the enzyme that converts phenylalanine to tyrosine is defective. Phenylalanine accumulates and is converted to phenylpyruvic acid, which damages the developing brain — leading to mental retardation if untreated. Detected at birth and managed by a phenylalanine-restricted diet.
5.12.2 Chromosomal Disorders
These are caused by changes in chromosome number — usually due to non-disjunction (failure of chromosomes to separate during meiosis).
a) Down Syndrome (Trisomy 21)
Caused by an extra copy of chromosome 21 → karyotype 2n + 1 = 47 (47, XX or XY, +21). First described by Langdon Down (1866). Features: short stature, characteristic facial features (epicanthic folds, broad palm, simian crease), intellectual disability, congenital heart defects, mostly delayed mental and physical development.
b) Klinefelter Syndrome (47, XXY)
Caused by an extra X chromosome in males → XXY (47 chromosomes). Features: tall stature, mild gynaecomastia (breast development), small testes, sterility, sometimes mild learning difficulties. Phenotypically male but with some feminine features.
c) Turner Syndrome (45, XO)
Caused by absence of one X chromosome in females → XO (45 chromosomes). Features: short stature, webbed neck, broad chest, underdeveloped ovaries (sterility), no menstrual cycle, often normal intelligence.
| Disorder | Karyotype | Cause | Phenotype |
|---|---|---|---|
| Down syndrome | 47 (2n+1, +21) | Non-disjunction of chr 21 | Short stature, broad palm, intellectual disability |
| Klinefelter | 47 (XXY) | Extra X in male | Tall, sterile, gynaecomastia |
| Turner | 45 (XO) | Missing X in female | Short, webbed neck, sterile |
| Edwards | 47 (+18) | Non-disjunction of chr 18 | Severe defects, often fatal |
| Patau | 47 (+13) | Non-disjunction of chr 13 | Severe defects, often fatal |
🧬 Interactive: Genetic Disorder Identifier
Choose the inheritance pattern and chromosome change to identify the disorder:
Setup: A child has the following features: short stature, characteristic broad palm with a single transverse 'simian' crease, intellectual disability, and small ears.
(a) The features are classic for Down syndrome (Trisomy 21).
(b) Cause: Non-disjunction of chromosome 21 during meiosis (usually maternal). This produces an egg with 2 copies of chr 21; after fertilization, the zygote has 3 copies (trisomy).
(c) Karyotype: 47, XX (or XY), +21 — total 47 chromosomes including an extra chr 21.
Note: Risk of Down syndrome rises sharply with maternal age (especially > 35 years) due to age-related increase in non-disjunction.
Worked Examples
Worked Example 1: Sickle Cell Inheritance
Both parents are carriers of sickle cell anaemia (HbA HbS × HbA HbS). What is the probability that their child (a) is fully affected (b) is a carrier (c) is fully unaffected?
Punnett: ¼ HbA HbA (normal), ½ HbA HbS (carrier), ¼ HbS HbS (affected).
(a) Affected (HbS HbS): 1/4 = 25%.
(b) Carrier (HbA HbS): 2/4 = 50%.
(c) Fully unaffected (HbA HbA): 1/4 = 25%.
This is why genetic counselling is important — if both parents are carriers, 50% of children will inherit at least one defective allele.
Worked Example 2: Karyotype Reading
A patient's karyotype reads "45, XO." What disorder do they have, and what is the cause?
Disorder: Turner syndrome.
Cause: Loss of one sex chromosome — usually due to non-disjunction in either parent's meiosis OR loss of one X during early embryonic mitosis.
Phenotype: Short stature, webbed neck, ovaries underdeveloped, infertile, but mostly normal intelligence. Affects ~1 in 2000 female births.
🎯 Competency-Based Questions
Q1. Down syndrome is caused by:L1 Remember
Q2. Fill in the blank: Sickle cell anaemia is caused by a substitution mutation that changes _____ to _____ at position 6 of the β-globin chain. L2 Understand
Q3. Compare: Sickle cell anaemia and thalassemia both cause anaemia. How are their molecular mechanisms different? L3 Apply
| Feature | Sickle cell | Thalassemia |
|---|---|---|
| Type of defect | Qualitative — wrong haemoglobin made | Quantitative — too little haemoglobin made |
| Mutation | Single point (Glu→Val) | Various (deletions, splice errors) |
| Cell shape | Sickle-shaped | Smaller, paler RBCs |
Q4. Analyse: Why is haemophilia called the "royal disease" and why does it affect mostly males? L4 Analyse
Why mostly males:
- Haemophilia gene is X-linked recessive.
- Males have only ONE X chromosome (XY) — a single recessive allele on that X is unmasked.
- Females (XX) usually carry one normal allele on the second X, so they are protected carriers, not affected.
- For a female to be affected, she'd need recessive alleles on BOTH X's — extremely rare (haemophilic father + carrier mother).
Q5. HOT (Create): Design a public-health programme to reduce the incidence of thalassemia in a high-risk population. L6 Create
- Awareness & education: School/college talks on inheritance; community campaigns; messaging that pre-marital screening is no stigma but a health check.
- Carrier screening: Offer free / subsidised blood test (HbA2 level + DNA analysis) to all young adults entering marriageable age. Identify HbA HbS carriers.
- Genetic counselling for couples:
- If both partners are carriers, explain the 25% risk per pregnancy.
- Offer prenatal diagnosis (chorionic villus sampling at week 10–12).
- Inform about preimplantation genetic diagnosis (PGD) for IVF.
- Support for affected: Subsidised blood transfusion, iron-chelation therapy, bone-marrow transplant access.
🧠 Assertion–Reason Questions
Choose: (A) Both true, R explains A. (B) Both true, R doesn't explain A. (C) A true, R false. (D) A false, R true.
A: Klinefelter syndrome individuals are sterile males.
R: They have an extra X chromosome (XXY).
A: Sickle cell trait (HbA HbS) provides resistance to malaria.
R: Sickle-shaped red cells are unfavourable for the malaria parasite's life cycle.
A: Mutation provides the raw material for evolution.
R: All mutations are beneficial to organisms.