Pediatrics: Protein-Energy Malnutrition (PEM) - Kwashiorkor
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Pediatrics: Protein-Energy Malnutrition (PEM) - Kwashiorkor

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Questions and Answers

What is a characteristic of Kwashiorkor that distinguishes it from Marasmus?

  • Loss of subcutaneous fat
  • Severe wasting and emaciation
  • Edema of the face, arms, and legs (correct)
  • Fatty liver
  • What is the primary method of treatment for Kwashiorkor and Marasmus?

  • Dietary management with a high-protein, high-calorie diet (correct)
  • Anthropometric measurements and physical examination
  • Vitamin and mineral supplementation
  • Management of underlying infections and illnesses
  • What is the purpose of growth monitoring in children?

  • To identify children at risk of Kwashiorkor
  • To track response to dietary interventions (correct)
  • To identify children at risk of Marasmus
  • To identify children who require vitamin D supplementation
  • What is the recommended duration of exclusive breastfeeding?

    <p>Up to two years or beyond</p> Signup and view all the answers

    What is the primary indicator of PEM?

    <p>Weight-for-height less than -2 standard deviations</p> Signup and view all the answers

    What is the purpose of fortified foods in dietary interventions?

    <p>To provide essential nutrients</p> Signup and view all the answers

    Study Notes

    Protein-Energy Malnutrition (PEM) in Pediatrics

    Kwashiorkor

    • Definition: A form of PEM characterized by edema, often seen in children who have a diet deficient in protein but rich in calories
    • Causes: Inadequate protein intake, often accompanied by infections, diarrhea, or other illnesses
    • Clinical features:
      • Edema (swelling) of the face, arms, and legs
      • Skin and hair changes (e.g., flaky skin, thinning hair)
      • Fatty liver
      • Anemia
      • Poor appetite
      • Weakness
    • Treatment:
      • Dietary management: high-protein, high-calorie diet
      • Management of underlying infections and illnesses

    Marasmus

    • Definition: A form of PEM characterized by severe wasting, often seen in children who have a diet deficient in both protein and calories
    • Causes: Inadequate intake of both protein and calories, often accompanied by chronic diarrhea, infections, or other illnesses
    • Clinical features:
      • Severe wasting and emaciation
      • Muscle wasting
      • Loss of subcutaneous fat
      • Poor appetite
      • Weakness
      • Lethargy
    • Treatment:
      • Dietary management: high-protein, high-calorie diet
      • Management of underlying infections and illnesses

    Nutritional Assessment

    • Methods:
      • Anthropometric measurements (e.g., weight, height, head circumference, mid-upper arm circumference)
      • Dietary history and recall
      • Physical examination (e.g., edema, muscle wasting)
      • Laboratory tests (e.g., serum albumin, hemoglobin)
    • Indicators:
      • Weight-for-height (WHZ) or weight-for-age (WAZ) less than -2 standard deviations
      • Mid-upper arm circumference (MUAC) less than 13.5 cm
      • Presence of edema

    Growth Monitoring

    • Importance: Regular growth monitoring helps identify children at risk of PEM and track response to interventions
    • Methods:
      • Regular measurement of weight, height, and head circumference
      • Plotting of growth data on growth charts
      • Identification of children who fall below the 3rd percentile or cross two percentile lines

    Dietary Interventions

    • Breastfeeding: Exclusive breastfeeding for the first six months, continued breastfeeding up to two years or beyond
    • Complementary feeding: Introduction of nutrient-rich foods at six months, with continued breastfeeding
    • Fortified foods: Use of fortified foods, such as ready-to-use therapeutic foods (RUTFs), to provide essential nutrients
    • Micronutrient supplements: Provision of vitamin and mineral supplements, such as vitamin A and iron, to prevent deficiencies

    Infantile Rickets

    • Definition: A disease caused by vitamin D deficiency, leading to softening of bones in children
    • Causes:
      • Vitamin D deficiency
      • Calcium deficiency
      • Phosphorus deficiency
    • Clinical features:
      • Softening of bones (e.g., bowed legs, deformities)
      • Delayed closure of fontanelles
      • Weakness and muscle tone
      • Poor growth
    • Treatment:
      • Vitamin D supplementation
      • Calcium and phosphorus supplementation
      • Exposure to sunlight (UVB) to stimulate vitamin D production

    Protein-Energy Malnutrition (PEM) in Pediatrics

    • Kwashiorkor is a form of PEM characterized by edema, often seen in children who have a diet deficient in protein but rich in calories.
    • Causes of Kwashiorkor include inadequate protein intake, often accompanied by infections, diarrhea, or other illnesses.
    • Clinical features of Kwashiorkor include edema, skin and hair changes, fatty liver, anemia, poor appetite, and weakness.
    • Treatment of Kwashiorkor involves dietary management with a high-protein, high-calorie diet, and management of underlying infections and illnesses.

    Marasmus

    • Marasmus is a form of PEM characterized by severe wasting, often seen in children who have a diet deficient in both protein and calories.
    • Causes of Marasmus include inadequate intake of both protein and calories, often accompanied by chronic diarrhea, infections, or other illnesses.
    • Clinical features of Marasmus include severe wasting and emaciation, muscle wasting, loss of subcutaneous fat, poor appetite, weakness, and lethargy.
    • Treatment of Marasmus involves dietary management with a high-protein, high-calorie diet, and management of underlying infections and illnesses.

    Nutritional Assessment

    • Methods of nutritional assessment include anthropometric measurements, dietary history and recall, physical examination, and laboratory tests.
    • Indicators of PEM include weight-for-height or weight-for-age less than -2 standard deviations, mid-upper arm circumference less than 13.5 cm, and presence of edema.

    Growth Monitoring

    • Regular growth monitoring helps identify children at risk of PEM and track response to interventions.
    • Methods of growth monitoring include regular measurement of weight, height, and head circumference, and plotting of growth data on growth charts.
    • Identification of children who fall below the 3rd percentile or cross two percentile lines indicates PEM.

    Dietary Interventions

    • Exclusive breastfeeding is recommended for the first six months, and continued breastfeeding up to two years or beyond.
    • Complementary feeding involves introduction of nutrient-rich foods at six months, with continued breastfeeding.
    • Fortified foods, such as ready-to-use therapeutic foods (RUTFs), provide essential nutrients.
    • Micronutrient supplements, such as vitamin A and iron, are provided to prevent deficiencies.

    Infantile Rickets

    • Infantile Rickets is a disease caused by vitamin D deficiency, leading to softening of bones in children.
    • Causes of Infantile Rickets include vitamin D deficiency, calcium deficiency, and phosphorus deficiency.
    • Clinical features of Infantile Rickets include softening of bones, delayed closure of fontanelles, weakness and muscle tone, and poor growth.
    • Treatment of Infantile Rickets involves vitamin D supplementation, calcium and phosphorus supplementation, and exposure to sunlight (UVB) to stimulate vitamin D production.

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    Description

    This quiz covers the definition, causes, clinical features, and treatment of Kwashiorkor, a form of PEM characterized by edema, often seen in children with a diet deficient in protein but rich in calories.

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