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Retired NBME 20 Answers

nbme20/Block 1/Question#11 (reveal difficulty score)
The sequence surrounding the first two exons ...
Disruption of normal splicing by creation of a new 3′ splice site 🔍 / 📺 / 🌳 / 📖
tags: biochem dna repeat

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 +20  upvote downvote
submitted by drdoom(1206)
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As described in the question stem, this mutation occurs within an intron (a gene segment which is transcribed [DNA->RNA] but not translated). RNA splicing enzyme(s) grab RNA and “loop it”; an intron is cut out and the exons on either side of the intron are adjoined, like this:

exon1—intron—exon2 => exon1—exon2

Typically, this splicing occurs at the very edges of the intron (what I denoted with the “—” character). But in our case, a mutation within the intron is causing RNA splicing enzyme to recognize a new site: the splicer cuts within the intron (instead of at the very edge, as it should). So, we get something that looks like this:

exon1—intr—exon2

That’s a totally different mRNA molecule, and it's going to make our β-globin protein look (and behave) awfully strange.

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drdanielr  I remember that in the pre-mRNA, the splicing sites of the intron where the spliceosome attaches are surrounded by "GU---AG" like "guac", so here the homologous DNA to this strand would be transcribed into "gu............ag......" and this would create a 3' slice site too soon +7
vivarin  if this is supposed to be pre-mRNA, why are there T's in the sequence? I'm so confused by this for some reason +8
sars  This is the gene (DNA), not heterogenous mRNA. +
athenathefirst  The biggest clue they said this is B thalassemia, which even if you didn't know anything about exons and introns you should have known that b thalassemia involves a mutation in splicing or promoter site (pathoma page 44). I got this question wrong too :( +1

Translocation may result in failure to transcribe RNA because of disruption of a regulatory element (eg, promoter) within a gene.

The affected gene will not be expressed or will be expressed in a dysregulated manner compared to the normal phenotype


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 +5  upvote downvote
submitted by monoloco(155)
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This has to do with intron splicing. Remember GTAG. This mutation induced an AG closer where it was supposed to be, so some of that intron just became an exon.

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 +4  upvote downvote
submitted by waterloo(126)
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I interpreted "sequence surrounding first two exons of gene" - to mean they must be talking about introns. Three of the answer choices don't have much to do with introns.

  • missense mutation would have to be in the exon to cause change in amino acid.
  • polyadenylation is at the end of the mRNA
  • inhibition of replication is DNA

that may not be air tight, but helps narrow down. Also knowing some B-thalassemia is due to variants in abnormal splicing helps. (FA 2019 pg 43)

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 +1  upvote downvote
submitted by s1khwitit(1)
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also remember that B-thalassemia is due to point mutations in splice sites and promoter sequences (FA19 pg410). If you create a mutation in a splice site you will surely mess up the correct mRNA needed to make a functional B-globin protein. That is how I answered the question.

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