A South Indian person who is taking only maize in food may suffer from which disease?

Appeared in: SGPGI Nursing Officer-2023

Explanation

A diet consisting almost exclusively of maize is a classic cause of pellagra.
Pellagra is caused by a deficiency of niacin (Vitamin B3).
Maize contains niacin, but it is in a bound, unavailable form called niacytin.
Maize is also deficient in the amino acid tryptophan, which the body can use to synthesize niacin.
The combination of unavailable niacin and low tryptophan leads to the development of pellagra.
The disease is characterized by the '3 Ds': Dermatitis (especially on sun-exposed areas), Diarrhea, and Dementia.

Option A: Scurvy is caused by a deficiency of Vitamin C, not niacin. It is associated with a diet lacking fresh fruits and vegetables.
Option C: Beri Beri is caused by a deficiency of thiamine (Vitamin B1). It is classically associated with diets consisting mainly of polished rice, not maize.
Option D: Rickets is a disease of bone development in children caused by a deficiency of Vitamin D, calcium, or phosphate. It is not directly related to a maize-based diet.

Clinical Relevance

Nursing practice connection: Knowing Nutritional deficiency diseases related to specific diets helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Nurses play a vital role in dietary education for communities with monotonous diets. Advising the inclusion of pulses, legumes, groundnuts, and fortified cereals can prevent pellagra.
Early recognition of pellagra's '3 Ds' (Dermatitis, Diarrhea, Dementia) is critical for timely intervention and preventing irreversible neurological damage or death.
What if? If the maize was prepared using nixtamalization (soaking in an alkaline solution like lime water), the bound niacin would be released, making it available for absorption and preventing pellagra. This traditional practice is common in Latin America but not in India.

How to Approach the Question

First, identify the key information in the question: the diet is exclusively maize.
Next, analyze the connection between a maize-only diet and the listed deficiency diseases.
Recall or deduce that maize has a specific issue with niacin (Vitamin B3) availability.
This links the maize diet directly to pellagra.
Eliminate the other options by recalling their causes: Scurvy (Vitamin C), Beri Beri (Vitamin B1 from polished rice), and Rickets (Vitamin D).
Confirm that Pellagra is the most fitting diagnosis based on the dietary information provided.

Concept Tested & Keywords

Concept Tested: Nutritional deficiency diseases related to specific diets.
Stem keywords: South Indian, maize, food, disease
Lead-in keywords: which disease
Clinical cues: Diet consisting only of maize is a key indicator for a specific nutrient deficiency.
Negative lead-in flag: false

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E6 Parks TextBook of Preventive & Social Medicine part 2 — Subpart A (pp 1-232 of 464) p. 154-156

E6 Medicine Davidson Principles Practice 24e p. 734-736

Practise the full SGPGI Nursing Officer-2023

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