Which condition is commonly associated with poor weight gain and frequent respiratory infection in infants

RUHS, Jaipur, M.Sc Nursing Entrance Exam-2024

Child Health Nursing (Pediatrics)

Medium

Appeared in: RUHS, Jaipur, M.Sc Nursing Entrance Exam-2024

Explanation

Cystic fibrosis (CF) is a genetic disorder causing abnormally thick mucus that affects multiple exocrine glands.
In the pancreas, this mucus blocks ducts, preventing the release of digestive enzymes. This leads to malabsorption of nutrients, especially fats, resulting in poor weight gain (failure to thrive) and steatorrhea (greasy, foul-smelling stools).
In the respiratory tract, the thick mucus clogs airways and impairs mucociliary clearance, trapping bacteria and leading to chronic inflammation and recurrent infections like pneumonia and bronchitis.

Option B: Asthma is a chronic inflammatory disorder of the airways. It primarily causes respiratory symptoms like wheezing and coughing but does not affect the digestive system or cause the malabsorption that leads to poor weight gain.
Option C: While severe congenital heart disease (CHD) can cause poor weight gain (due to increased metabolic demands and feeding fatigue) and respiratory symptoms (due to pulmonary congestion), it does not cause malabsorption or the type of chronic, purulent bacterial lung infections characteristic of CF.
Option D: Iron deficiency anaemia is a hematological condition that leads to pallor, fatigue, and irritability. It does not directly cause malabsorption or recurrent respiratory infections.

Clinical Relevance

Nursing practice connection: Knowing Clinical presentation of Cystic Fibrosis in infancy helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Recognizing the dual presentation of failure to thrive and recurrent chest infections is a critical nursing assessment skill for the early detection of Cystic Fibrosis.
Nursing care for an infant with CF focuses on aggressive nutritional support (high-calorie diet, pancreatic enzyme replacement therapy with every meal) and respiratory management (chest physiotherapy, antibiotics).
The gold standard for diagnosis is the sweat chloride test. A positive test shows a higher than normal concentration of chloride in the sweat.

How to Approach the Question

First, identify the key clinical features presented in the question stem: 1) poor weight gain and 2) frequent respiratory infections in an infant.
Next, consider the pathophysiology of each option and evaluate if it can logically explain both key features.
Analyze Asthma: It explains respiratory infections but not poor weight gain from malabsorption.
Analyze Congenital Heart Disease: It can explain poor weight gain (from increased cardiac workload) and respiratory distress, but not the specific pattern of recurrent, purulent infections and malabsorption.
Analyze Iron Deficiency Anaemia: It explains fatigue and potential poor feeding but not primary respiratory infections.
Analyze Cystic Fibrosis: Its pathophysiology involves thick mucus affecting both the respiratory system (trapping bacteria, causing infections) and the pancreas (blocking enzymes, causing malabsorption and poor weight gain). This option provides a unified explanation for both symptoms.

Concept Tested & Keywords

Concept Tested: Clinical presentation of Cystic Fibrosis in infancy
Stem keywords: poor weight gain, frequent respiratory infection, infants
Lead-in keywords: commonly associated with
Clinical cues: The combination of both gastrointestinal (poor weight gain) and respiratory (frequent infections) symptoms in an infant is a strong indicator for a specific systemic disease.

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