Malnutrition

Question 1

WHO classification
1. Duration
2. Severity

Answer 1

1. Acute- wt reduced WASTING wt for height chart
   Chronic -height reduced STUNTING height for age chart
2. Moderate -2 to -3 SD
   Severe > -3 SD

Question 2

Kwashiorkor
1. Predominant deficiency
2. Main sign
3. Onset
4. General appearance
5. Skin changes
6. Hair changes
7. Also k/a

Answer 2

1. Protein
2. Pitting Oedema
3. 1-4 years
4. Dull/lethargic, poor appetite
5. Flaky paint dermatosis(hyper & dyspigmented areas) , Enamel spots (isolated) , Crazy pavement dermatosis (cracks in skin surface)
6. Brittle, Lustureless, Easily Pluckable , Flag sign
7. Fat sugar baby

Question 3

Marasmus
1. Predominant deficiency
2. Main feature
3. Onset
4. General appearance
5. Other signs

Answer 3

1. Calories
2. Wasting
3. <1 yr
4. Alert good appetite
5. Baggy pant appearance, Simian facies (monkey like)

Question 4

SAM diagnosis

Answer 4

Any 1 of the following
1. WFH : <-3 SD
2. Bipedal edema
3. MUAC </= 11.5 cm (6m to 5 y)

Question 5

Home Management in SAM

Answer 5

For uncomplicated (good appetite, no anasarca, no medical complications)

1. Nutrition - 175kcal/kg/day
   Protein - 4-6 gm/kg/day
   By home based diet or RUTF
2. Amoxicillin 5days
3. Albendazole single dose
   > 2 yrs :400 mg
   <2 yrs : 200 mg
4. Vit A
   <6m : 50000 IU
   6-12 m : 1,00,000 IU
   >1yr : 2 lakh IU
5. Age appropriate vaccine