1. Mr. and Mrs. James come to you for genetic counseling concerning their risk of having a child with the kidney disease seen in other family members. Mr. James is 30 and Mrs. James is 23. Both are in good health. They have a healthy 18-month-old daughter. Mr. James' mother was found to have high blood pressure at age 18, and was diagnosed on kidney x-ray as having polycystic kidneys. She had slowly progressive renal insufficiency and died of renal failure at age 48. One of her two brothers died of a cerebral aneurysm at age 35 and on autopsy was also found to have polycystic kidneys. Her other brother (58 years old) and her sister (age S1) were tested and found to have normal kidneys and are well. Mr. James' maternal grandfather died of similar kidney disease ate age 40. The maternal grandmother died at age 76 of adult-onset diabetes. Mr. James has a sister, age 35 who is in good health and has two healthy sons. Mrs. James has a sister who is 26 years old and in good health and has a healthy 3-year-old son. Mrs. James' parents are alive and well in their late 40's A. Draw a pedigree of this family. Indicate proband(s), affected individuals, other family information, and give a key. B. What is the most likely pattern of inheritance of polycystic kidney disease in this family? Why? C. At his birth, what was Mr. James' risk of developing polycystic kidneys? D. You do a kidney ultrasound and find that Mr. James has mildly large kidneys with many cysts. How is it possible that he seems so mildly affected when his mother was already having problems at age 18? e. What is the chance that Mr. James' daughter will inherit polycystic kidney disease? His next child? If Mr. James' sister has normal kidneys, what is the chance that her son will inherit the gene?