Exophthalmos may occur in children with what diagnosis?

The correct answers are Choice A: Diabetes mellitus, Choice E: Urinary tract infection (UTI).

Choice A rationale:

Diabetes mellitus. This is one of the correct choices. Diabetes can lead to increased urinary frequency, urgency, and secondary enuresis (bedwetting) due to the impact of elevated blood glucose levels on the kidneys and bladder function.

Choice B rationale:

Hypocalciuria is not directly relevant to evaluating secondary enuresis with dysuria or urgency. Hypocalciuria refers to a lower-than-normal level of calcium in the urine and is not a common cause of urinary symptoms in this context.

Choice C rationale:

Nephrotic syndrome primarily involves the kidneys and is characterized by proteinuria, edema, hypoalbuminemia, and hyperlipidemia. While it can cause changes in urinary patterns, it is not typically associated with dysuria or urgency.

Choice D rationale:

Glomerulonephritis refers to inflammation of the glomeruli, which are the tiny filters in the kidneys. It can lead to hematuria (blood in the urine) and proteinuria, but it is not commonly associated with dysuria or urgency.

Choice E rationale:

Urinary tract infection (UTI). This is one of the correct choices. UTIs can cause symptoms such as dysuria (painful urination), urgency, and frequency. These symptoms are especially relevant in the context of evaluating a child with secondary enuresis.

The correct answer is choice A. Meconium ileus.

Choice A rationale:

Meconium ileus. This is the earliest recognizable clinical manifestation of cystic fibrosis (CF). Meconium ileus refers to the blockage of the small intestine by thick, sticky meconium, the earliest stool of a newborn. It occurs in the first 24-48 hours of life and can be a sign of underlying cystic fibrosis.

Choice B rationale:

Foul-smelling, frothy, greasy stools. Foul-smelling, frothy, greasy stools are characteristic of malabsorption, which can occur in cystic fibrosis. However, this manifestation typically appears after meconium ileus and is not the earliest recognizable clinical sign.

Choice C rationale:

History of poor intestinal absorption. While poor intestinal absorption is a common consequence of cystic fibrosis, it is not one of the earliest recognizable clinical manifestations. Meconium ileus takes precedence as the primary early sign.

Choice D rationale:

Recurrent pneumonia and lung infections. Recurrent pneumonia and lung infections are common in later stages of cystic fibrosis due to the buildup of thick mucus in the respiratory tract. However, they are not among the earliest recognizable clinical manifestations of the disease. Meconium ileus is the earliest indicator in this context.