Genes and Genomes

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Department of Clinical Genetics

Nottingham University Hospitals NHS Trust

Genes and GenomesAll you need to know about genetics.....

Training day for ST trainees 13th June 2017

Why do you need to know about

Genetic Conditions?

• 1 in 17 people have a rare disease

• To be able to spot common genetic

conditions

• To know when to refer to us

• Because you will be doing genetic testing

in the future – mainstreaming is here!

East Midlands Regional Genetics ServiceCovers population of 2.2 million in Nottinghamshire, Derbyshire, Lincolnshire

and North Leicestershire

Three components

1. Clinical Genetics (doctors & genetic counsellors)

• For diagnosis and management of patients

2. Cytogenetics Lab

• For chromosome tests

3. Molecular Genetics Lab (also covers all of

Leicestershire in addition)

• For DNA tests

Clinical Genetics

• 7 Consultants and 2 StRs

• 12 Genetic Counsellors

• Outpatient based service but also– On-call Mon to Fri 9-5 for telephone queries and Ward referrals

– Phone 0115 962 7728

Individuals with

genetic condition

& their family

Counsel

& adviseDiagnose

Investigate

Investigations

/ diagnosisFamily picture

Counsel / advise

• Explaining condition to family

• Cascade genetic screening

• Organising physical screening – e.g. breast

cancer screening, cardiology

• Prenatal options

• Future follow up in the family e.g. teen review

• Predictive testing

Who are our patients?

Pregnant women/couples with

concerns

Children with dysmorphic

features +/- LD

Pts with strong family history of

cancer

Pts with a family history of a genetic

condition

Adults with a suspected genetic

condition

Patients seen in Genetics Clinics

Clinics Specialist or joint

clinics

Community Paediatrics

Adult learning disability

Paediatric Cardiology

Adult Cardiology

Skeletal dysplasia

Lymphoedema

Ophthalmology

Paediatric Nephrology

Paediatric Endocrinology

Disorders of sex

differentiation

Regional and National Regional NF2

National ataxia telangiectasia

General ClinicsNottingham (City and QMC)

8 other Hospitals in East Mids

Urgent Prenatal Clinic 1/wk every Wed in City

What we don’t do

• Haematology

– Thalassaemias, sickle cell anaemia, haemophilias are seen in Haematology service

– Genetic testing carried out by separate QMC lab

• Hypercholesterolemia

– Lipid clinic at City Hospital

Dr Peter Prinsloo, Consultant Chemical Pathologist

• Haemochromatosis

– Specialist Nurse at City Hospital, Ext 54139vicky.sugden@nuh.nhs.uk

Money matters

• Commissioned as a specialised service by the NHS

• One of 23 services in UK (17 in England)

• Can refer directly to us

• To facilitate assessment of affected or at-risk relatives

‘To whom it may concern’ letters

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