Which of the features/sign is always present in Kwashiorkor?

NVS- 2025

Applied Nutrition & Dietetics

Easy

Appeared in: NVS- 2025

Explanation

Kwashiorkor is a severe form of malnutrition resulting from inadequate protein intake, even if calorie intake is sufficient.
The hallmark and defining clinical sign of Kwashiorkor is bilateral pitting oedema (swelling due to fluid retention).
Low protein levels in the blood (hypoalbuminemia) cause fluid to leak from blood vessels into body tissues, leading to oedema.
The presence of oedema is a mandatory criterion for the diagnosis of Kwashiorkor.

Option B: Diarrhoea is a common complication in malnourished children due to infections and gastrointestinal changes, but it is not a universal or defining feature of Kwashiorkor.
Option C: While muscle wasting occurs in Kwashiorkor, it is often concealed by the overlying oedema and preserved subcutaneous fat. It is not the most prominent or defining sign.
Option D: Children with Kwashiorkor often have a near-normal or only moderately low weight for their height because the severe fluid retention from oedema masks their true weight loss.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Defining clinical feature of Kwashiorkor as background academic context rather than a clinical decision trigger.
Accurate identification of oedema is a critical nursing assessment skill for diagnosing Kwashiorkor, as it distinguishes it from Marasmus, requiring different management priorities.
Nurses must monitor for the resolution of oedema as a key indicator of successful treatment. A decrease in weight might initially be a positive sign, indicating fluid loss, not a worsening of nutritional status.
What if? If a child presents with very low weight for height but no oedema, the diagnosis shifts from Kwashiorkor to Marasmus. The immediate priority for Marasmus is providing energy and nutrients for tissue rebuilding, whereas for Kwashiorkor, it's about carefully restoring metabolic function and correcting electrolyte imbalances before aggressive feeding.

How to Approach the Question

First, identify the core subject of the question, which is 'Kwashiorkor'.
Next, focus on the keyword 'always present'. This asks for the defining, or hallmark, feature of the condition.
Recall the two major types of severe protein-energy malnutrition: Kwashiorkor and Marasmus.
Systematically evaluate each option against the known pathophysiology of Kwashiorkor.
Remember that Kwashiorkor is primarily a protein deficiency, leading to low albumin and oedema. Marasmus is a total energy (calorie) deficiency, leading to severe wasting.
Eliminate options that are common but not universal (like diarrhoea) or are more characteristic of Marasmus (like severe wasting/very low weight for height). This leaves oedema as the only feature that is 'always present' by definition.

Concept Tested & Keywords

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