Acute Malnutrition in Children Quiz
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Questions and Answers

What is the primary cause of primary acute malnutrition in children?

  • Inadequate food supply (correct)
  • High metabolic rate
  • Chronic diseases
  • Genetic disorders

    • Which of the following factors is NOT a contributor to primary acute malnutrition?

  • Chronic liver disease (correct)
  • Household food insecurity
  • Poor breastfeeding practices
  • Low birth weight

    • What physiological adaptation occurs due to inadequate energy intake in acute malnutrition?

  • Enhanced muscle growth
  • Increased basal metabolic rate
  • Loss of visceral mass (correct)
  • Increased total energy expenditure

    • Which hormone is typically found at reduced levels during acute malnutrition?

    <p>Insulin-like growth factor-1 (IGF-1)</p> Signup and view all the answers

    What condition is associated with poor water quality and hygiene practices contributing to acute malnutrition?

    <p>Environmental enteropathy</p> Signup and view all the answers

    In the context of secondary acute malnutrition, what is the most common underlying cause?

    <p>Chronic diseases</p> Signup and view all the answers

    What are the initial effects of acute malnutrition on glucose levels?

    <p>Depleted glycogen stores leading to low glucose levels</p> Signup and view all the answers

    Which process is involved in the protein conservation phase of malnutrition?

    <p>Lipolysis and ketogenesis</p> Signup and view all the answers

    What characterizes the brain changes associated with acute malnutrition?

    <p>Thinning of the cerebral cortex</p> Signup and view all the answers

    Which of the following signs is NOT commonly associated with marasmus?

    <p>Hypertension</p> Signup and view all the answers

    Kwashiorkor is primarily attributed to a deficiency in which of the following?

    <p>Protein</p> Signup and view all the answers

    What is a common physiological effect of acute malnutrition on children?

    <p>Decreased neuronal connections</p> Signup and view all the answers

    At what age are the effects of malnutrition on brain development potentially irreversible?

    <p>3 to 4 years old</p> Signup and view all the answers

    Which of the following describes a significant indicator of severe malnutrition in children?

    <p>Loss of buccal fat pads</p> Signup and view all the answers

    What differentiates marasmus from kwashiorkor in terms of nutrient deficiency?

    <p>Marasmus results from inadequate energy intake, while kwashiorkor results from inadequate protein intake.</p> Signup and view all the answers

    Which of the following symptoms is typical for children affected by marasmus?

    <p>Loose and wrinkled skin</p> Signup and view all the answers

    What is the primary clinical feature that distinguishes kwashiorkor from marasmus?

    <p>Edema</p> Signup and view all the answers

    In which demographic is kwashiorkor most commonly found?

    <p>Older infants and young children in developing countries</p> Signup and view all the answers

    What is a common skin manifestation associated with kwashiorkor?

    <p>Shiny, varnished-looking skin</p> Signup and view all the answers

    Which of the following is a significant laboratory indicator used in the assessment of malnutrition?

    <p>Prealbumin levels</p> Signup and view all the answers

    What characterizes marasmic kwashiorkor?

    <p>Concurrent wasting and edema</p> Signup and view all the answers

    Which dietary components are most commonly associated with the development of kwashiorkor?

    <p>Corn, rice, and beans</p> Signup and view all the answers

    During the assessment of malnutrition, what is the role of biochemical analysis?

    <p>To provide insight about nutritional status</p> Signup and view all the answers

    What is the grading scale for edema in kwashiorkor characterized by?

    <p>Specific grades ranging from pedal to ascites</p> Signup and view all the answers

    What is the recommended management for children with primary moderate acute malnutrition?

    <p>Counseling of parents with emphasis on breastfeeding</p> Signup and view all the answers

    What should be included in the diet for children with primary acute malnutrition?

    <p>Animal-source foods rich in essential fatty acids</p> Signup and view all the answers

    In cases of severe acute malnutrition without complications, where is the recommended place for management?

    <p>At home with ready-to-use therapeutic food</p> Signup and view all the answers

    Which symptom may indicate the need for hospitalization in a child with severe acute malnutrition?

    <p>Severe diarrhea or hypoglycemia</p> Signup and view all the answers

    What initial treatment is recommended for hypoglycemia in a lethargic child?

    <p>Intravenous glucose if available</p> Signup and view all the answers

    What rehydration method is preferred for treating dehydration in malnourished children?

    <p>ReSoMal, a special rehydration solution for malnutrition</p> Signup and view all the answers

    Which antibiotic is suggested initially for a child with no complications of severe acute malnutrition?

    <p>Oral amoxicillin at 15 mg/kg eight-hourly</p> Signup and view all the answers

    How should severe acute malnutrition with complications be treated?

    <p>Hospitalization until ready for home management</p> Signup and view all the answers

    What is the purpose of introducing carefully monitored feeding in a child after admission?

    <p>To ensure nutritional adequacy and support recovery</p> Signup and view all the answers

    Which formula is recommended for initial feeding in children admitted for malnutrition?

    <p>F-75</p> Signup and view all the answers

    What is a potential risk when preterm or low-birth-weight infants are given aggressive enteral feeding?

    <p>Necrotizing enterocolitis</p> Signup and view all the answers

    In the management of chronic liver disease, which dietary consideration is essential?

    <p>Protein-sparing diet</p> Signup and view all the answers

    What is a characteristic of children with congenital heart disease in terms of their nutritional needs?

    <p>They have increased demands for energy and protein.</p> Signup and view all the answers

    What type of dietary fat is recommended for children with chronic liver disease to aid absorption?

    <p>Medium-chain triglycerides</p> Signup and view all the answers

    How does cachexia occur in children with cancer?

    <p>As a result of tumor metabolites and inflammatory cytokines</p> Signup and view all the answers

    What is a key investigative step in managing secondary acute malnutrition?

    <p>Identification of underlying diseases</p> Signup and view all the answers

    Study Notes

    Acute Malnutrition in Children

    • Primary Acute Malnutrition:
      • Caused by inadequate food supply due to socioeconomic, political, and environmental factors.
      • Most common in low and middle-income countries.
      • Contributing factors: household food insecurity, poverty, poor maternal nutrition, low birth weight, inadequate breastfeeding and complementary feeding, frequent infections, poor water, sanitation, and hygiene.
    • Secondary Acute Malnutrition:
      • Due to abnormal nutrient loss, increased energy expenditure, or decreased food intake.
      • Frequently associated with chronic diseases like cystic fibrosis, chronic renal failure, chronic liver diseases, childhood malignancies, congenital heart disease, and neuromuscular diseases.

    Pathophysiology of Acute Malnutrition

    • Physiological Adaptations:
      • Growth restriction, loss of body mass (fat, muscle, visceral), reduced basal metabolic rate, and reduced energy expenditure.
    • Biochemical Changes:
      • Changes in thyroid hormones, insulin, and growth hormone (GH).
      • Decreased levels of tri-iodothyroxine (T3), insulin, and insulin-like growth factor-1 (IGF-1).
      • Increased levels of GH and cortisol.
      • Initial low glucose levels, followed by rapid gluconeogenesis and protein conservation with fat mobilization.
      • Electrolyte changes: sodium retention and intracellular potassium depletion.
    • Brain Development:
      • Reduced number of neurons, synapses, dendritic arborizations, and myelination.
      • Decreased brain size and cerebral cortex thinning.
      • Delays in global function, motor function, and memory.
      • Effects on brain development may be irreversible after age 3-4 years.

    Clinical Syndromes of Acute Malnutrition

    • Marasmus:
      • Most frequent syndrome.
      • Results from severe energy and nutrient deficiency over months to years.
      • Characterized by wasting of body tissues, especially muscles and subcutaneous fat.
      • Common in children under 5 years old due to higher caloric needs and infection susceptibility.
      • Clinical signs: emaciation, weakness, lethargy, bradycardia, hypotension, hypothermia, xerotic wrinkled skin, and muscle wasting.
      • Severe cases may involve facial muscle wasting, leading to an aged appearance.
    • Kwashiorkor:
      • Thought to result from inadequate protein but relatively normal calorie intake.
      • Common in developing countries, particularly areas of famine or limited food supply.
      • Characterized by edema (swelling) due to low serum albumin, increased cortisol, and impaired antidiuretic hormone activation.
      • Clinical features: near-normal weight for age, dermatoses, hypopigmented hair, distended abdomen, hepatomegaly, and edema progression.
    • Marasmic Kwashiorkor:
      • Mixed features of marasmus and kwashiorkor.
      • Wasting and edema are present.
      • Mild cutaneous and hair manifestations.
      • Enlarged palpable fatty liver is common.

    Management of Acute Malnutrition

    • Assessment:
      • Nutritional Screening: Malnutrition Universal Screening Tool (MUST) or Mini Nutritional Assessment tool.
      • Clinical Evaluation: detailed history taking and physical examination.
      • Biochemical Analysis: blood tests for albumin, prealbumin, electrolytes, and other markers.
    • Therapeutic Recommendations:
      • Primary Acute Malnutrition:
        • Moderate: home management, counseling, continued breastfeeding, and appropriate complementary feeding.
        • Severe without complications: ready-to-use therapeutic food (RUTF), following WHO recommendations.
        • Severe with complications: hospitalization, RUTF, and management of complications (hypoglycemia, hypothermia, shock, dehydration, infection).
      • Secondary Acute Malnutrition:
        • Identification of underlying disease is crucial.
        • Individualized dietary approaches based on underlying disease:
          • Preterm and low-birth-weight infants: exclusive breastfeeding for 6 months with iron supplementation.
          • Mild inflammatory bowel disease: normal diet or specially prepared liquid formulas.
          • Advanced chronic liver disease: protein-sparing diet, medium-chain triglycerides, and water-soluble vitamins.
          • Chronic renal disease: high-energy and high-quality protein diet.
          • Congenital heart disease: sufficient energy and protein without excessive fluid.
          • Cancer: manage cachexia (muscle wasting syndrome).

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    Description

    This quiz explores the concepts of acute malnutrition in children, focusing on its primary and secondary forms. It delves into the causes, contributing factors, and pathophysiological adaptations involved. Test your understanding of the complexities surrounding this critical health issue.

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