Kwashiorkor occurs mainly due to the deficiency of:

Appeared in: DSSSB 12 August 2024

Explanation

Kwashiorkor is a severe form of malnutrition primarily caused by a dietary deficiency of protein, while calorie intake may be adequate.
The term itself means 'the sickness of the weaning,' referring to when a child is weaned from protein-rich breast milk to a high-carbohydrate, low-protein diet.
A key pathophysiological feature is hypoalbuminemia (low protein in the blood), which decreases plasma oncotic pressure and leads to generalized edema, a hallmark sign of the condition.
Other signs include an enlarged fatty liver, a distended abdomen ('pot belly'), skin lesions, and changes in hair texture and color.

Option B: Vitamin deficiencies cause specific diseases, not the syndrome of Kwashiorkor. For example, lack of Vitamin C causes scurvy, and lack of Vitamin D causes rickets.
Option C: Calcium deficiency primarily affects bone density and neuromuscular function.
Option D: Deficiencies of specific minerals lead to distinct disorders, such as anemia from iron deficiency or goiter from iodine deficiency.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain The question tests the knowledge of Protein-Energy Malnutrition (PEM) and the specific cause of Kwashiorkor as background academic context rather than a clinical decision trigger.
Nurses must be able to differentiate between Kwashiorkor and Marasmus during nutritional assessments, as the management differs. The presence of edema is the key distinguishing sign for Kwashiorkor.
Management of Kwashiorkor requires a careful and gradual reintroduction of protein and calories to prevent refeeding syndrome, a potentially fatal complication caused by rapid metabolic shifts.
Patient education is crucial, especially for mothers in at-risk populations. Nurses should teach about the importance of protein in a child's diet after weaning.

How to Approach the Question

First, identify the core concept of the question, which is 'Kwashiorkor'.
Recall the definition and primary cause of Kwashiorkor from your knowledge of nutritional disorders.
Differentiate Kwashiorkor from Marasmus. Kwashiorkor is primarily a protein deficiency, while Marasmus is a deficiency of both protein and calories.
Evaluate the given options. 'Protein' directly matches the primary cause of Kwashiorkor.
Eliminate the other options by recalling the specific conditions caused by deficiencies of vitamins, calcium, and other minerals.

Concept Tested & Keywords

Concept Tested: The question tests the knowledge of Protein-Energy Malnutrition (PEM) and the specific cause of Kwashiorkor.
Stem keywords: Kwashiorkor, deficiency
Lead-in keywords: mainly due to
Negative lead-in flag: false

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

E6 Pathology- ROBBINS & COTRAN PATHOLOGIC BASIS OF DISEASE 10TH Ed p. 441-443

E6 Nutrition Monika Sharma 3e p. 345-347

Practise the full DSSSB 12 August 2024

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