Which condition is caused by the deficiency of Vitamin 'D' in children?

RRB Nsg. Superintendent-20 July 2019 (Shift-2)

Child Health Nursing (Pediatrics)

Easy

Appeared in: RRB Nsg. Superintendent-20 July 2019 (Shift-2)

Explanation

Rickets is a skeletal disorder caused by a deficiency of vitamin D, calcium, or phosphate, which is specifically seen in growing children.
Vitamin D is crucial for intestinal absorption of calcium and phosphorus. Its deficiency leads to inadequate mineralization of the bone matrix and cartilage at the epiphyseal growth plates.
This failure of mineralization in growing bones results in the characteristic softening, weakness, and deformities of the skeleton, such as bowed legs and a 'rickety rosary'.

Option A: Muscular dystrophy is a group of genetic disorders that cause progressive muscle weakness and loss of muscle mass. It is not caused by a nutritional deficiency.
Option C: Osteomalacia is the term for the same pathological process (inadequate bone mineralization) but in adults, after the epiphyseal growth plates have closed. The question specifies 'children'.
Option D: Haemolysis is the destruction or rupture of red blood cells. It is unrelated to vitamin D metabolism or bone health.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Complications of Vitamin D deficiency in children as background academic context rather than a clinical decision trigger.
Nurses are vital in preventing rickets through parent education on adequate sunlight exposure and vitamin D supplementation, especially for exclusively breastfed infants, as breast milk is low in vitamin D.
Assessment for rickets includes observing for skeletal deformities, delayed motor development, and bone pain during physical examinations of infants and children.
In India, where sun exposure may be limited by cultural practices or in urban areas with high pollution, and where diets can be low in vitamin D, nurses should have a high index of suspicion for nutritional rickets.

How to Approach the Question

First, identify the core components of the question: the specific nutrient ('Vitamin D') and the specific population ('children').
Analyze the options to see how they relate to vitamin D and pediatric health.
Recall that vitamin D deficiency has different names based on the patient's age. 'Rickets' applies to children with open growth plates.
Recognize that 'Osteomalacia' is the adult counterpart, making it an incorrect choice for a pediatric patient.
Eliminate 'Muscular dystrophy' as it's a genetic muscle disease, not a nutritional bone disease.
Eliminate 'Haemolysis' as it's a hematological issue involving red blood cells, unrelated to vitamin D or bone structure.

Concept Tested & Keywords

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E6 Nelson Textbook of Pediatrics(2024) — Volume 2 p. 2189-2191

E6 Pathology- ROBBINS & COTRAN PATHOLOGIC BASIS OF DISEASE 10TH Ed p. 446-448

E6 Textbook of Biochemistry for medical StudentsDM Vasudevan Part 2 — Subpart A (pp 1-239 of 478) p. 126-128