A child with secondary enuresis who reports of dysuria or urgency should be evaluated for what condition? (Select all that apply.)

Choice A rationale:

A goiter refers to the enlargement or hypertrophy of the thyroid gland. This can occur due to various reasons, such as iodine deficiency, autoimmune disorders like Hashimoto's thyroiditis, or Graves' disease (which is associated with hyperthyroidism). The thyroid gland produces hormones that regulate metabolism and growth, and when it becomes enlarged, it can lead to visible swelling in the neck.

Choice B rationale:

The posterior pituitary gland is responsible for the release of hormones like vasopressin (antidiuretic hormone) and oxytocin. A goiter is not associated with the posterior pituitary gland. Issues with the posterior pituitary can lead to problems with water balance and uterine contractions, but not thyroid enlargement.

Choice C rationale:

The adrenal glands are responsible for producing hormones like cortisol and adrenaline. While adrenal disorders can lead to various hormonal imbalances, a goiter is not related to adrenal gland function. Adrenal issues might cause symptoms like fatigue, weight changes, and blood pressure irregularities.

Choice D rationale:

The anterior pituitary gland produces hormones that regulate the functions of other endocrine glands, including the thyroid gland. However, a goiter is not directly associated with the anterior pituitary. The anterior pituitary's malfunction can result in disorders like growth hormone deficiency or Cushing's disease, but not thyroid enlargement.

The correct answer is choice A: Rotavirus.

Choice A rationale:

Rotavirus is a viral pathogen that frequently causes acute diarrhea in young children. It is highly contagious and is responsible for a significant portion of severe diarrhea cases worldwide. Rotavirus infections are most common in infants and young children, and they can lead to dehydration, especially in developing countries where access to clean water and proper sanitation might be limited.

Choice B rationale:

Salmonella organisms can cause food poisoning and gastrointestinal infections that lead to diarrhea. However, they are more commonly associated with bacterial infections rather than viral-induced acute diarrhea.

Choice C rationale:

Shigella organisms are also bacterial pathogens that cause diarrhea, specifically bacillary dysentery. While they can cause severe diarrhea, they are not the viral pathogen typically responsible for acute diarrhea in young children.

Choice D rationale:

Giardia organisms are parasites that can cause gastrointestinal infections leading to diarrhea. However, they are not viruses, and they are less commonly associated with acute diarrhea in children compared to rotavirus.