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Anatomy · Genetics: Robertsonian translocation
Sample itemA phenotypically normal woman has had two children with Down syndrome and a miscarriage, and her husband has a normal karyotype. Her affected child's karyotype is 46,XY,der(14;21)(q10;q10),+21. What does her own karyotype most likely show?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
D. 45 chromosomes with a balanced 14;21 Robertsonian translocation
A carrier of a balanced Robertsonian translocation has only 45 chromosomes, with two long arms fused, and is phenotypically normal. Her gametes can contain an extra copy of chromosome 21 material, giving translocation Down syndrome that recurs regardless of maternal age. Genetic counselling and parental karyotyping are indicated.
Option by option
A. 47 chromosomes with mosaic trisomy 21
A mosaic trisomy 21 mother would usually show features of Down syndrome and would not explain the translocation chromosome.
B. 46 chromosomes with a balanced reciprocal translocation between 14 and 21
A reciprocal translocation preserves 46 chromosomes and cannot produce a der(14;21) with fused long arms.
C. 46 chromosomes with a normal karyotype and general-population recurrence risk
Normal parental karyotypes would imply an age-related low recurrence, which does not fit the translocation seen in the child.
D. 45 chromosomes with a balanced 14;21 Robertsonian translocation (correct)
Correct. A balanced 14;21 carrier has 45 chromosomes, and recurrence risk is substantially raised.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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