Clinical Cytogenetics II
Study Course Implementer
Residency Speciality
-
About Study Course
Objective
Learning Outcomes
Knowledge
1.- Principles and application of fluorescent in situ hybridisation (FISH) in prenatal and postnatal diagnosis of congenital diseases, including submicroscopic chromosomal abnormalities. - Aetiology of the most common microdeletion/microduplication syndromes, pathogenesis, clinical picture and genetic counselling. - Recording of FISH results according to the International System for Human Cytogenomic Nomenclature (ISCN). - Principles, platforms and application of chromosomal microarray analysis (CMA) in the diagnosis of congenital genetic disorders. - Pathogenicity classification of copy number variations (CNVs). - Recording of CMA test results according to the ISCN. - Incidental find in a CMA test. - Requirements for material to be cytogenetically examined in the diagnosis of genetic alterations in tumours (bone marrow, cell smears, solid tissues, histological preparations). - Indications for cytogenetic testing for the diagnosis of chromosomal aberrations in case of haemato-oncological diseases and solid tumours. - Application and role of karyotype analysis, FISH and CMA in the diagnosis of acquired chromosomal aberrations in case of haemato-oncology (acute and chronic leukaemias, myelodysplastic syndrome, etc.) and certain solid tumours (sarcomas, breast cancer, etc.). - Specifics of ISCN in the recording of results of karyotype analysis, FISH and CMA in the diagnosis of acquired chromosomal aberrations.
Skills
1.- Making of metaphase and cell smear (cytological) fluorescent in situ hybridisation (FISH) preparations. - Making of histological FISH preparations. - Analysis of FISH preparations under a fluorescent microscope. - Application of digital FISH analysis software in the microscopy of FISH preparations. - Able to apply the ISCN nomenclature in the recording of FISH test results in the diagnosis of congenital and acquired chromosomal abnormalities. - Able to classify copy number variations (CNVs) according to their clinical significance and apply the ISCN nomenclature in the recording of chromosomal microarray analysis (CMA) results in the diagnosis of congenital and acquired chromosomal abnormalities.
Competences
1.- Interprets fluorescent in situ hybridisation (FISH) results in relation to the clinical picture in prenatal and postnatal diagnosis of genetic diseases. - Able to provide genetic advise to the patient and their family in case of changes to hereditary copy number variations (CNVs). - Able to purposefully recommend cytogenetic tests for the diagnosis of acquired chromosomal aberrations in case of certain haemato-oncological and oncological diseases. - Able to identify patients with a possible hereditary cancer syndrome.
Assessment
Individual work
|
Title
|
% from total grade
|
Grade
|
|---|---|---|
|
1.
Individual work |
-
|
-
|
|
1. To search for phenotypic and genotypic correlations of genetic variation using evidence-based electronic databases.
2. Using evidence-based databases of scientific literature, to create an individualised disease description for patients with a syndromic-monogenic, chromosomal or inherited pathology.
|
||
Examination
|
Title
|
% from total grade
|
Grade
|
|---|---|---|
|
1.
Examination |
-
|
-
|
|
At the end of the course, teaching staff:
1. Assesses the practical skills acquired by medical genetics resident on a 10-point scale, recording the assessment in the medical resident’s book.
2. Assesses the theoretical knowledge of the medical genetics resident on a 10-point scale after a written examination – a multiple-choice test, recording the assessment in the medical resident’s book.
|
||
Study Course Theme Plan
-
Seminar
|
Modality
|
Location
|
|
|---|---|---|
|
-
|
-
|
Topics
|
Non-invasive diagnosis. AFP, PAPPA, HCG. First trimester biochemical screening. Triple test. NIPT. NIFTY
|
-
Seminar
|
Modality
|
Location
|
|
|---|---|---|
|
-
|
-
|
Topics
|
Ethical aspects of genetic investigation. Termination of pregnancy from the 12th to 24th week of gestation, indications (diseases with late onset, incomplete penetrance, variable expressivity).
|
-
Seminar
|
Modality
|
Location
|
|
|---|---|---|
|
-
|
-
|
Topics
|
Mothers and their children with identical mutations.
|
-
Seminar
|
Modality
|
Location
|
|
|---|---|---|
|
-
|
-
|
Topics
|
Indications for comparative genomic hybridisation, interpretation of data.
|
-
Seminar
|
Modality
|
Location
|
|
|---|---|---|
|
-
|
-
|
Topics
|
Principles of CMA analysis, indications, data analysis, interpretation. UPD, LOH.
|
Bibliography
Required Reading
Gross, S. J. Introduction to Perinatal Disorders and Reproductive Genetics. In Emery and Rimoin’s Principles and Practice of Medical Genetics and Genomics. https://doi.org/10.1016/b978-0-12-815236-2.00001-1, 2022
Milunsky, A., & Milunsky, J. M. Genetic Disorders and the Fetus: Diagnosis, Prevention and Treatment: 6th Edition. In Genetic Disorders and the Fetus: Diagnosis, Prevention and Treatment. https://doi.org/10.1002/9781444314342, 2010
Leung, P. C. K., & Qiao, J. Human reproductive and prenatal genetics. In Human Reproductive and Prenatal Genetics. https://doi.org/10.1016/C2016-0-05333-0, 2018
Harper, J. C. Preimplantation genetic diagnosis. In Preimplantation Genetic Diagnosis, 2nd Edition. https://doi.org/10.1017/CBO9780511581571, 2009
DiMaio, M. S., Fox, J. E., & Mahoney, M. J. Prenatal Diagnosis: Cases and Clinical Challenges. In Prenatal Diagnosis: Cases and Clinical Challenges. https://doi.org/10.1002/9780470696262, 2010
Twining’s Textbook of Fetal Abnormalities. In Twining’s Textbook of Fetal Abnormalities. https://doi.org/10.1016/c2010-0-67979-x, 2015
Paladini, D., & Volpe, P. Ultrasound of Congenital Fetal Anomalies. In Ultrasound of Congenital Fetal Anomalies. https://doi.org/10.4324/9780429462450, 2018
Stevenson, R., Hall, J., Everman, D., & Solomon, B. (Eds.), Human Malformations and Related Anomalies. Oxford, UK: Oxford University Press, 2015
Harper, P. Practical Genetic Counselling (7th ed.). CRC Press, 2011
Cassidy, S., Allanson, J. Management of Genetic Syndromes. Wiley-Blackwell, 2010
Firth, H., Hurst, J. Oxford Desk Reference Clinical Genetics. Oxford, 2007
Read, A, Donnai, D. New clinical Genetics. A guide to Genomics Medicine. Scion, 2021
Dhar, S., Sandesh, N, Eble, T. Hanbook of Clinical adult Genetics and genomics. Elssevier, 2020
Reardson, W. The Bedside Dysmorhologist. Oxford, 2016
Jones, Kenneth L, Marilyn C. Jones, and Miguel . Campo. Smith's Recognizable Patterns of Human Malformation, 2013
Norton, M.E., Scoutt, L., Feldstein, V. Callens Ultrasonography in Obstretics And Gynecology. Elsevier, 2017
Hogge, A., Wilkins, I., Hills, L., Cohlan B. Sanders Structural Fetal Abnormalities. McGraw Hill Education, 2017
Hollak, C., Lachmann, R. Inherited Metabolic Disease in Adults.Oxford, 2016
Saudubray, F., Van den Berghe, W. Inbron Metabolic diseases. Springer, 2016
Katirji, B., Kaminski, J.H, Ruff, R.L. Neuromuscular Disorders in Clinical Paractice Vol1., Vol2., Springer, 2014
Govidan, R., Devarakonda, S. Cancer Genomics for the Clinician. Springer, 2019
Other Information Sources
OMIM. https://omim.org
Genereviews. https://www.ncbi.nlm.nih.gov/books/NBK1116/
Phenomizer. HPO. https://hpo.jax.org/app/tools/phenomizer
Varsome. https://varsome.com/
Reprotox. https://www.reprotox.org/
Metagene. https://www.metagene.de/
Vademecum Metabolicum. http://www.vademetab.org/
Metabolic Emergency Protocol. https://www.emergencyprotocol.net/
Treat NMD. https://treat-nmd.org/
NCCN Guidelines. https://www.nccn.org/guidelines/guidelines-detail?category=2&id=1503