Veidlapa Nr. M-3 (8)
Study Course Description

Clinical Cytogenetics II

Main Study Course Information

Course Code
RGN_042
Branch of Science
Clinical medicine; Medicinal Genetics
ECTS
11.00
Target Audience
Medicine
LQF
Level 8

Study Course Implementer

Course Supervisor

Residency Speciality

Speciality
Supervisor of Medical Speciality
Contacts

-

About Study Course

Objective

To introduce the medical genetics resident to the indications, methods, and evaluation of results of cytogenetic testing.

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

FULL-TIME
Part 1
  1. Seminar

Modality
Location
-
-

Topics

Non-invasive diagnosis. AFP, PAPPA, HCG. First trimester biochemical screening. Triple test. NIPT. NIFTY
  1. 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).
  1. Seminar

Modality
Location
-
-

Topics

Mothers and their children with identical mutations.
  1. Seminar

Modality
Location
-
-

Topics

Indications for comparative genomic hybridisation, interpretation of data.
  1. Seminar

Modality
Location
-
-

Topics

Principles of CMA analysis, indications, data analysis, interpretation. UPD, LOH.
Total ECTS (Creditpoints):
11.00
Number of Residency Seminars:
5
Length (weeks):
8
Final Examination:
Residency exam (Theory and practice)

Bibliography

Required Reading

1.

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

2.

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

3.

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

4.

Harper, J. C. Preimplantation genetic diagnosis. In Preimplantation Genetic Diagnosis, 2nd Edition. https://doi.org/10.1017/CBO9780511581571, 2009

5.

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

6.

Twining’s Textbook of Fetal Abnormalities. In Twining’s Textbook of Fetal Abnormalities. https://doi.org/10.1016/c2010-0-67979-x, 2015

7.

Paladini, D., & Volpe, P. Ultrasound of Congenital Fetal Anomalies. In Ultrasound of Congenital Fetal Anomalies. https://doi.org/10.4324/9780429462450, 2018

8.

Stevenson, R., Hall, J., Everman, D., & Solomon, B. (Eds.), Human Malformations and Related Anomalies. Oxford, UK: Oxford University Press, 2015

9.

Harper, P. Practical Genetic Counselling (7th ed.). CRC Press, 2011

10.

Cassidy, S., Allanson, J. Management of Genetic Syndromes. Wiley-Blackwell, 2010

11.

Firth, H., Hurst, J. Oxford Desk Reference Clinical Genetics. Oxford, 2007

12.

Read, A, Donnai, D. New clinical Genetics. A guide to Genomics Medicine. Scion, 2021

13.

Dhar, S., Sandesh, N, Eble, T. Hanbook of Clinical adult Genetics and genomics. Elssevier, 2020

14.

Reardson, W. The Bedside Dysmorhologist. Oxford, 2016

15.

Jones, Kenneth L, Marilyn C. Jones, and Miguel . Campo. Smith's Recognizable Patterns of Human Malformation, 2013

16.

Norton, M.E., Scoutt, L., Feldstein, V. Callens Ultrasonography in Obstretics And Gynecology. Elsevier, 2017

17.

Hogge, A., Wilkins, I., Hills, L., Cohlan B. Sanders Structural Fetal Abnormalities. McGraw Hill Education, 2017

18.

Hollak, C., Lachmann, R. Inherited Metabolic Disease in Adults.Oxford, 2016

19.

Saudubray, F., Van den Berghe, W. Inbron Metabolic diseases. Springer, 2016

20.

Katirji, B., Kaminski, J.H, Ruff, R.L. Neuromuscular Disorders in Clinical Paractice Vol1., Vol2., Springer, 2014

21.

Govidan, R., Devarakonda, S. Cancer Genomics for the Clinician. Springer, 2019

Other Information Sources

1.

OMIM. https://omim.org

5.

Varsome. https://varsome.com/

8.

Vademecum Metabolicum. http://www.vademetab.org/

9.

Metabolic Emergency Protocol. https://www.emergencyprotocol.net/

11.

Treat NMD. https://treat-nmd.org/