For which of the following conditions can a child be advised ketogenic diet therapy?

DSSSB -28 August 2019 (Shift-2)

Child Health Nursing (Pediatrics)

Easy

Appeared in: DSSSB -28 August 2019 (Shift-2)

Explanation

The ketogenic diet is a primary, evidence-based medical nutrition therapy for specific pediatric conditions, most notably seizures.
It is specifically indicated for children with drug-resistant (or refractory) epilepsy, where at least two appropriate anti-seizure medications have failed to control seizures.
The diet induces a state of ketosis, where the body uses fat instead of glucose for energy. The resulting ketone bodies have been shown to have an anticonvulsant effect on the brain.
Certain genetic metabolic disorders, such as Glucose Transporter Type 1 (GLUT1) deficiency and Pyruvate Dehydrogenase (PDH) deficiency, are also primary indications for the ketogenic diet.

Option B: Encephalitis is acute inflammation of the brain, typically from an infection. Its treatment is focused on addressing the underlying cause (e.g., antiviral drugs) and providing intensive supportive care, not dietary management.
Option C: Guillain-Barre syndrome is an autoimmune disorder affecting the peripheral nervous system. The standard treatment involves immunotherapy (IVIG or plasmapheresis) and supportive care, particularly for respiratory function.
Option D: Cerebral palsy is a non-progressive motor disorder. Management is centered on rehabilitation (physical, occupational, and speech therapy) and managing associated symptoms like spasticity. The ketogenic diet is not a standard therapy for cerebral palsy.

Clinical Relevance

Nursing practice connection: Use the key finding related to Therapeutic use of the ketogenic diet in pediatric neurological conditions to guide bedside assessment, documentation, and the next nursing action.
Nurses play a critical role in educating families about the strict adherence required for the ketogenic diet, including weighing foods precisely and avoiding hidden carbohydrates in medications and other products.
Close monitoring is essential. Nurses must track the child's growth, hydration status, urine/blood ketones, and watch for potential side effects like constipation, kidney stones, and hypoglycemia.
What if the child on a ketogenic diet develops vomiting and lethargy? This is a 'sick day' emergency. The nurse must instruct the parents to immediately check blood glucose and ketones and seek medical help, as it could signal metabolic decompensation or severe hypoglycemia, requiring urgent intervention.

How to Approach the Question

First, identify the core of the question: it asks for the correct medical condition treated with a ketogenic diet in children.
This is a factual recall question based on knowledge of therapeutic diets and pediatric neurology.
Analyze the options provided: Seizures, Encephalitis, Guillain-Barre syndrome, and Cerebral palsy are all neurological conditions.
Recall the primary treatment modalities for each condition. The ketogenic diet is famously and strongly associated with the management of difficult-to-treat epilepsy (seizures).
Eliminate the other options by confirming their standard treatments: Encephalitis (antivirals/supportive care), Guillain-Barre syndrome (immunotherapy), and Cerebral palsy (rehabilitation/symptom management).
Select 'Seizures' as it is the most well-established and common indication for ketogenic diet therapy among the choices.

Concept Tested & Keywords

Concept Tested: Therapeutic use of the ketogenic diet in pediatric neurological conditions.
Stem keywords: ketogenic diet therapy, child, conditions
Lead-in keywords: For which
Clinical cues: Age/sex group narrows the expected diagnosis, intervention, or normal reference range.
Negative lead-in flag: false

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E6 Nelson Textbook of Pediatrics(2024) — Volume 2 pp. 1420-1422, 1413-1415