A form of malnutrition caused due to deficiency of energy and protein in children :

Appeared in: IGNOU PB. Bsc. Nsg. Entrance-2025

Explanation

Marasmus is a severe form of protein-energy malnutrition (PEM).
It is caused by a prolonged and severe deficiency of both calories (energy) and protein.
This leads to extreme muscle wasting, loss of subcutaneous fat, and a characteristic 'wizened' or 'old man' appearance, without the presence of edema.

Option A: Kwashiorkor results primarily from a severe protein deficiency, while calorie intake might be adequate or near-adequate. The question specifies a deficiency of both energy and protein.
Option C: Nightblindness is a specific symptom of Vitamin A deficiency, which is a micronutrient deficiency, not a form of protein-energy malnutrition.
Option D: Anaemia is a condition of low red blood cells or hemoglobin, most commonly caused by deficiencies in micronutrients like iron, vitamin B12, or folate.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Protein-Energy Malnutrition (PEM) in children as background academic context rather than a clinical decision trigger.
Nurses must be able to differentiate between Marasmus and Kwashiorkor as the dietary management and potential complications, like refeeding syndrome, differ significantly.
A key nursing assessment is checking for bilateral pitting edema by pressing on the top of the feet. The presence of edema in a malnourished child is a defining sign of Kwashiorkor.
In community health settings in India, Anganwadi workers use growth charts and mid-upper arm circumference (MUAC) tapes to screen for and classify malnutrition, enabling early intervention.

How to Approach the Question

First, identify the key terms in the question stem: 'deficiency of energy and protein'.
Recall the definitions of the two main types of severe protein-energy malnutrition (PEM).
Marasmus is defined by a deficiency in both protein and energy (calories).
Kwashiorkor is defined by a primary deficiency in protein, often with adequate energy intake.
Evaluate the other options. Nightblindness (Vitamin A deficiency) and Anaemia (Iron/B12/Folate deficiency) are primarily micronutrient deficiencies, not PEM.
Select the option that directly matches the definition of a combined energy and protein deficiency, which is Marasmus.

Concept Tested & Keywords

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E6 textbook of Applied Biochemistry and Nutrition & DieteticsHarbans Lal (pp 26-464 of 479) p. 355-357

E6 Biochemistry U Satyanarayana— Part 2 (pp 421-820 of 840) p. 143-145

E6 Textbook of Biochemistry for medical StudentsDM Vasudevan Part 2 — Subpart A (pp 1-239 of 478) p. 191-193

Practise the full IGNOU PB. Bsc. Nsg. Entrance-2025

Attempt every question from this paper in a timed mock, then review the full solution for each one.