Maramus And Kwashiorkor

Question 1

What are PEM diseases?

Answer 1

Protein Energy Malnutrition diseases

Question 2

Who do PEM diseases mainly affect?

Answer 2

Mainly children in poor countries

Secondary PEM can also be found in chronically ill, elderly and bed-ridden patients in developed countries

Question 3

Describe the 2 protein compartments in the body

Answer 3

The somatic compartent - skeletal muscle mainly

The visceral compartment - Mainly the liver (+ other organs)

Question 4

What is Marasmus?

Answer 4

This is the clinical picture when mainly the somatic protein compartment is being depleted.

Question 5

Describe the clinical picture of Marasmus

Answer 5

Body weight falls to less than 60%
Growth retardation
Muscle depletion (catabolsed to supply energy)
Subcutaneous fat is mobilisedand used as fuel
Low Leptin levels –> release of cortisol –> lipolysis
Emaciated extremities
Anemia
Vitamin Deficiency
Immune Deficiency

Question 6

What is Kwashiorkor

Answer 6

PEM disease which arises from depletion of the central (visceral) proetin compartment of the body. Occurs when protein deprevation is relatively greater than the reduction of total calories

Question 7

Less severe cases of Kwashiorkor may be due to…?

Answer 7

Malapsorption of proteins by the GI tract
Nephrotic syndrome
Extensive Burns

Question 8

Decribe the clinical picture of kwashiorkor

Answer 8

Hypoalbuninemia
Generalised or dependant edema
Loss of weight may be masked by fluid retention
Sparing of subcutaneous fat and muscle mass

Question 9

What are the typical SIGNS of kwashiorkor

Answer 9

Skin lesions
Hair changes (depigmentation)
Englarged fatty liver
Apathy
Listnessness
Loss of apetite
Vitamin deficiencies 
Defects in immunity 
Secondary infections