The disease which is characterized by 3 D's?

RUHS, Jaipur, M.Sc Nursing Entrance Exam-2019

Applied Nutrition & Dietetics

Easy

Appeared in: RUHS, Jaipur, M.Sc Nursing Entrance Exam-2019

Explanation

Pellagra is a systemic disease caused by a severe deficiency of niacin (vitamin B3).
It is classically known by the mnemonic of the '3 D's': Dermatitis, Diarrhea, and Dementia.
The dermatitis is typically a photosensitive rash on sun-exposed skin, famously known as Casal's necklace.
The diarrhea is due to inflammation of the gastrointestinal mucosa.
The dementia includes a range of neurological symptoms from confusion to memory loss.
If left untreated, Pellagra can lead to a fourth 'D' - Death.

Option A: Meningitis is an inflammation of the membranes surrounding the brain and spinal cord, typically caused by an infection. Its classic triad of symptoms is fever, headache, and nuchal rigidity (neck stiffness), not the 3 D's.
Option C: Beri-beri is caused by a deficiency of thiamine (vitamin B1). It manifests as 'wet' beri-beri (affecting the cardiovascular system, causing heart failure and edema) or 'dry' beri-beri (affecting the nervous system, causing neuropathy and muscle weakness).
Option D: Kwashiorkor is a form of severe protein-energy malnutrition. Its characteristic signs include bilateral pitting edema (swelling, especially in the legs and feet), a distended abdomen ('pot belly'), fatty liver, and skin changes, but not the specific triad of the 3 D's.

Clinical Relevance

Nursing practice connection: Knowing Nutritional Deficiency Diseases helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
A nurse's role includes nutritional assessment to identify patients at risk for deficiencies like pellagra, especially in populations with poor diet, alcoholism, or malabsorption syndromes.
Early recognition of the signs, such as the characteristic skin rash, allows for prompt intervention with niacin supplementation, which can rapidly reverse the symptoms and prevent progression to severe dementia or death.
What if? If a patient with a history of chronic alcoholism presents with confusion and a new skin rash after being in the sun, the nurse should consider pellagra as a potential diagnosis and advocate for nutritional screening and B-vitamin supplementation.

How to Approach the Question

First, identify the core of the question, which is to link a specific set of symptoms ('3 D's') to a disease.
Recognize that '3 D's' is a classic medical mnemonic. Your task is to recall what it stands for and which condition it describes.
Systematically review the options. Think about the key features of each disease.
Recall or deduce that Pellagra is associated with Dermatitis, Diarrhea, and Dementia.
Eliminate the other options by recalling their primary characteristics: Meningitis (infection with fever/headache/stiff neck), Beri-beri (thiamine deficiency with neuro/cardiac issues), and Kwashiorkor (protein deficiency with edema/pot belly).
Confirm that Pellagra is the only option that matches the '3 D's' mnemonic.

Concept Tested & Keywords

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

E6 textbook of Applied Biochemistry and Nutrition & DieteticsHarbans Lal (pp 26-464 of 479) p. 367-369