Which of the following is NOT a cardinal sign of Pellagra?

Appeared in: Bihar CHO - 2021

Explanation

Pellagra is a disease caused by niacin (vitamin B3) deficiency, characterized by the '3 Ds': Dermatitis, Diarrhea, and Dementia.
Dehydration is not considered a cardinal (primary) sign of pellagra.
While severe diarrhea, a cardinal sign, can lead to dehydration, dehydration itself is a secondary complication, not a defining feature of the disease triad.

Option A: Diarrhea is one of the classic '3 Ds' of pellagra. It results from inflammation of the gastrointestinal tract due to niacin deficiency.
Option B: Dermatitis, particularly a photosensitive rash on sun-exposed areas (like Casal's necklace), is a hallmark cardinal sign of pellagra.
Option C: Dementia, along with other neurological symptoms like confusion and depression, is the third of the classic '3 Ds' of pellagra.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain The question tests the knowledge of the cardinal signs of Pellagra, a disease caused by niacin (vitamin B3) deficiency as background academic context rather than a clinical decision trigger.
Nurses must be able to recognize the signs of pellagra, especially in at-risk populations such as individuals with alcoholism, malabsorption syndromes, or those on maize-based diets.
Patient education is crucial. Nurses should teach patients about dietary sources of niacin (e.g., meat, nuts, legumes) and the importance of a balanced diet to prevent deficiency.
What if the patient presents with only one of the '3 Ds'? Pellagra can present with just one or two of the cardinal signs initially. A high index of suspicion is needed, and a dietary history is essential for diagnosis.

How to Approach the Question

First, identify the keywords in the question: 'NOT' and 'cardinal sign of Pellagra'. The word 'NOT' indicates you are looking for the option that does not fit.
Recall the classic signs of Pellagra. A common mnemonic for this is the '3 Ds'.
Evaluate each option against the '3 Ds':
Is Diarrhea a sign? Yes, it's one of the Ds.
Is Dermatitis a sign? Yes, it's one of the Ds.
Is Dementia a sign? Yes, it's one of the Ds.

Concept Tested & Keywords

Concept Tested: The question tests the knowledge of the cardinal signs of Pellagra, a disease caused by niacin (vitamin B3) deficiency.
Stem keywords: Pellagra, cardinal sign
Lead-in keywords: NOT
Negative lead-in flag: Question is negatively framed (NOT)

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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) pp. 367-369, 67-187

Practise the full Bihar CHO - 2021

Attempt every question from this paper in a timed mock, then review the full solution for each one.