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|Prompt=A male patient presents to your office to inquire about a disease that is prevalent in his family.  He is unsure what the disease is.  Instead, he has a pedigree that he created that shows the list of affected and unaffected family members.  The patient’s pedigree is shown below. What is the most likely disease in this patient’s family?
|Prompt=A male patient presents to your office to inquire about a disease that is prevalent in his family.  He is unsure what the disease is.  Instead, he has a pedigree that he created that shows the list of affected and unaffected family members.  The patient’s pedigree is shown below. What is the most likely disease in this patient’s family?


[[Image:X-linked-dominant.gif|300px]]
[[Image:X-linked-dominant.gif|500px]]
|Explanation=The pedigree in the vignette shows an X-linked dominant pattern of inheritance.  Daughters of affected fathers are also affected.  Sons of affected mothers are also affected.  Among the list of options, hypophosphatemic rickets, or vitamin D-resistant rickets, is the only option with X-linked dominant inheritance.  It is characterized by increased phosphate wasting at the level of renal proximal tubule.
|Explanation=The pedigree in the vignette shows an X-linked dominant pattern of inheritance.  Daughters of affected fathers are also affected.  Sons of affected mothers are also affected.  Among the list of options, hypophosphatemic rickets, or vitamin D-resistant rickets, is the only option with X-linked dominant inheritance.  It is characterized by increased phosphate wasting at the level of renal proximal tubule.



Revision as of 02:59, 10 September 2013

 
Author [[PageAuthor::Rim Halaby, M.D. [1]]]
Exam Type ExamType::USMLE Step 1
Main Category MainCategory::Genetics
Sub Category SubCategory::Endocrine
Prompt [[Prompt::A male patient presents to your office to inquire about a disease that is prevalent in his family. He is unsure what the disease is. Instead, he has a pedigree that he created that shows the list of affected and unaffected family members. The patient’s pedigree is shown below. What is the most likely disease in this patient’s family?

]]

Answer A AnswerA::Leber’s hereditary optic neuropathy
Answer A Explanation AnswerAExp::Leber’s hereditary optic neuropathy is a mitochondrial disease. All mitochondrial diseases are characterized by maternal transmission to all offspring.
Answer B AnswerB::Albinism
Answer B Explanation AnswerBExp::Albinism has an autosomal recessive mode of inheritance.
Answer C AnswerC::Hypophosphatemic rickets
Answer C Explanation AnswerCExp::Hypophosphatemic rickets has an X-linked dominant mode of inheritance.
Answer D AnswerD::Ocular albinism
Answer D Explanation AnswerDExp::Ocular albinism has an X-linked recessive mode of inheritance.
Answer E AnswerE::Schizophrenia
Answer E Explanation AnswerEExp::Schizophrenia has a polygenic mode of inheritance.
Right Answer RightAnswer::C
Explanation [[Explanation::The pedigree in the vignette shows an X-linked dominant pattern of inheritance. Daughters of affected fathers are also affected. Sons of affected mothers are also affected. Among the list of options, hypophosphatemic rickets, or vitamin D-resistant rickets, is the only option with X-linked dominant inheritance. It is characterized by increased phosphate wasting at the level of renal proximal tubule.

Educational Objective: X-linked dominant inheritance pattern is characterized by transmission of disease from affected fathers to daughters and affected mothers to sons. Hypophosphatemic rickets is an example of X-linked dominant inheritance pattern that causes phosphate wasting at the level of renal proximal tubule.
Educational Objective:
References: ]]

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