This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Pediatrics
Baby born at 30 weeks for 18 year old primi gravida of weight 2 kg which died after 48 hours. Apgar scores were 5 and 8 at 1 and 5 minutes. On autopsy bilateral enlarged kidney with multiple radially arranged cysts. Which of the following finding is expected to be associated with ? 
Select and explain. 
A. Imperforate anus, B. Hepatic cyst and fibrosis, C. Absence of ureter, D. Holoprosencephaly
B: Hepatic cyst and fibrosis
Answer: B: Hepatic cyst and fibrosis 
Explanation: Ans. is 'b' i.e., Hepatic cyst and fibrosis o The clinical findings suggest autosomal recessive polycystic kidney disease. o The diagnosis of autosomal recessive polycystic kidney disease is strongly suggested by bilateral papable flank masses in an infant with pulmonary hypoplasia, oligohydramnios and hypeension and the absence of renal cysts in the parents. o On imaging and biopsy the kidney shows innumerable cysts radiating from medulla to the coex. o Autosomal recessive kidney disease is associated with liver disease in about 45% cases. Both kidneys are markedly enlarged and grossly show innumerable cysts throughout the coex and medulla. Microscopic studies demonstrate microcysts radiating from medulla to the coex located primarily within the collecting tubules and the ducts. o Development of progressive interstitial fibrosis and tubular atrophy during advanced stages of disease eventually leads to renal failure. o Liver involvement is characterized by bile duct proliferation and ectasia as well as by hepatic fibrosis.