Oedema is a sign in which of the following nutritional disorders?

AIIMS Bhopal NO - 2018 (Shift-1st)

Applied Nutrition & Dietetics

Easy

Appeared in: AIIMS Bhopal NO - 2018 (Shift-1st)

Explanation

Kwashiorkor is a form of severe acute malnutrition caused by a diet that is critically deficient in protein.
The lack of protein leads to hypoalbuminemia (low levels of the protein albumin in the blood).
Albumin is essential for maintaining plasma oncotic pressure, which keeps fluid within blood vessels.
When albumin is low, fluid leaks into body tissues, causing the characteristic generalized swelling (oedema).
The image provided shows a child with pitting oedema in the feet and a distended abdomen, which are classic signs of Kwashiorkor.

Option B: Marasmus is characterized by severe wasting of muscle and fat due to a deficiency of all nutrients, especially calories. Oedema is notably absent.
Option C: Underweight is a general term indicating a low weight for a child's age. It is a sign of malnutrition but not a specific disorder defined by the presence of oedema. Children with both Kwashiorkor and Marasmus are typically underweight.
Option D: Nutritional dwarfism, or stunting, refers to impaired linear growth (low height-for-age) resulting from chronic malnutrition. Its primary sign is short stature, not oedema.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Differentiating features of severe acute malnutrition, specifically Kwashiorkor and Marasmus as background academic context rather than a clinical decision trigger.
The presence of bilateral pitting oedema in a malnourished child is a critical diagnostic sign that points to Kwashiorkor, a medical emergency with a high mortality rate.
Nurses must perform a thorough nutritional assessment, including checking for oedema by applying gentle pressure to the top of the feet for a few seconds. This helps differentiate Kwashiorkor from Marasmus, guiding appropriate and urgent management.
Management of Kwashiorkor is complex, focusing on cautious reintroduction of nutrients (especially protein), correction of electrolyte imbalances, and treatment of infections, while carefully monitoring for fluid overload and refeeding syndrome.

How to Approach the Question

First, identify the key clinical sign presented in the question, which is 'oedema'.
Examine the provided image to find visual confirmation of the sign. The image clearly shows a child with swollen feet and a distended abdomen.
Recall the two main types of severe protein-energy malnutrition: Kwashiorkor and Marasmus.
Differentiate between the two based on their defining characteristics. Remember the mnemonic: Kwashiorkor has oedema due to protein deficiency, while Marasmus is wasting without oedema due to calorie deficiency.
Match the sign 'oedema' to the correct disorder, Kwashiorkor.
Rule out the other options. Marasmus is incorrect because it lacks oedema. 'Underweight' and 'Nutritional dwarfism' are general terms for poor growth, not specific syndromes defined by oedema.

Concept Tested & Keywords

Concept Tested: Differentiating features of severe acute malnutrition, specifically Kwashiorkor and Marasmus.
Stem keywords: Oedema, nutritional disorders
Lead-in keywords: is a sign in
Clinical cues: Image of a child with swollen feet and abdomen
Negative lead-in flag: false

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