1. Congenital anomalies

Question 1

Types of congenital anomalies

Answer 1

1. Renal agenesis
2. Renal hypoplasia
3. Ectopic kidney
4. Horseshoe kidney

Question 2

Renal agenesis is due to

Answer 2

1. Lack of metanephric primordial
2. Failure of ureteric bud formation
3. Failure of contact of ureteric bud & metanephros

Question 3

Bilateral renal agenesis

Answer 3

1. Incompatible with life, rare
2. Male : female = 25.1 : 1
3. Stillborn

Question 4

Unilateral renal agenesis

Answer 4

1. Male : Female = 2:1
2. Opposite kidney usually enlarged due to compensatory hypertrophy
3. Some eventually develop progressive glomerulosclerosis in the remaining kidney due to adaptive changes in hypertrophied nephrons

Question 5

Renal hypoplasia

Answer 5

1. Small kidney with reduced number of lobules & calyces
   (<5; normal >10)
   - Histologically: primitive glomeruli & tubules in dense fibrous or fatty interstitium
   - Usually unilateral; if bilateral, results in renal failure in early childhood
2. Renal hypoplasia with oligomeganephronia (kidney small with hypertrophied glomeruli)

Question 6

Ectopic kidney

Answer 6

1. Abnormal positions of the kidney:
   - Just above pelvic brim
   - Within the pelvis
2. Complications: Kinking or tortuosity of ureters, leading to urinary tract obstruction

Question 7

Horseshoe kidney

Answer 7

1. Fusion of lower (90%) or upper (10%) poles
2. 1 in 500 to 1 in 1000 incidence
3. Complications: Urolithiasis