Pediatric Nutrition — MCQs

Q: Deficit in weight for height in a 3-year-old child indicates a type of malnutrition:

Acute malnutrition. ***Acute malnutrition*** - A deficit in **weight for height** is a key indicator of **acute malnutrition**, often referred to as **wasting**. - This condition reflects a recent and often rapid loss of weight, indicating insufficient nutritional intake or severe disease over a short period. *Chronic malnutrition* - **Chronic malnutrition** is characterized by a deficit in **height for age**, indicating **stunting**. - This reflects prolonged undernutrition, leading to impaired growth over a longer duration. *Concomitant acute and chronic* - This describes a situation where both **weight for height** (wasting) and **height for age** (stunting) are deficient. - While possible, a deficit in **weight for height** *specifically* refers to acute malnutrition, even if chronic malnutrition is also present. *Underweight* - **Underweight** refers to a deficit in **weight for age**, which can be caused by either **acute** or **chronic malnutrition**, or both. - It is a more general term and does not specifically differentiate between the acute or chronic nature of the malnutrition as precisely as weight-for-height or height-for-age.

Q: A 2-year-old child presents with severe acute malnutrition with features of kwashiorkor. Which of the following clinical signs is most indicative of this condition?

Edema. ***Edema*** - The presence of **bilateral pitting edema**, particularly in the feet and legs, is the **hallmark sign of kwashiorkor**, a form of severe acute malnutrition (SAM). - Edema is a **critical diagnostic criterion** for kwashiorkor and distinguishes it from marasmus (the other major form of SAM which presents with severe wasting without edema). - According to **WHO criteria**, bilateral pitting edema in the presence of malnutrition is diagnostic of kwashiorkor-type SAM. *Hyperpigmentation* - While skin changes including **hyperpigmentation** can occur in kwashiorkor, they are not the most specific or consistent diagnostic feature. - Hyperpigmentation may be seen in various nutritional deficiencies and dermatological conditions, making it less definitive than edema for diagnosis. *Alopecia* - **Hair changes** (sparse, thin, easily pluckable hair with flag sign) can occur in kwashiorkor as part of protein-energy malnutrition. - However, alopecia is not as specific or diagnostic as bilateral pitting edema, which is the defining clinical feature of kwashiorkor. *Scaly dermatitis* - **Dermatosis** with desquamating skin lesions (flaky paint dermatosis) can be seen in kwashiorkor, often in areas of friction. - While supportive of the diagnosis, scaly dermatitis is less specific than edema and can occur in various nutritional deficiencies including zinc deficiency and pellagra.

Practice by Chapter

Breastfeeding

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Infant Formula Feeding

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Complementary Feeding

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Nutritional Requirements by Age

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Malnutrition and Failure to Thrive

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Obesity in Children

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Vitamin Deficiencies

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Mineral Deficiencies

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Food Allergies and Intolerances

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Nutritional Management of Chronic Diseases

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Eating Disorders

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Parenteral and Enteral Nutrition

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