PEM

Question 1

PEM refers to

Answer 1

form of malnutrition which is defined in a range of Pathological conditions arising from coincident lack of protein and/or energy in varying proportion

Question 2

PEM is measured in terms of

Answer 2

underweight - low weight for age
stunting - low height for age
wasting - low weight for height

Question 3

Different types of PEM

Answer 3

Kwashiorkar
Marasmic Kwashiorkar
Marasmus
Nutritional Dwarfing
Under weight child

Question 4

Kwashiorkar is also known as __

Answer 4

edematous malnutrition
becus of its association with edema (fluid retention)

Question 5

Symptoms of Kwashiorkar

Answer 5

FADADFASCA
failure to thrive
anorexia
diarrhea
apathy
dermatosis
flaky paint appearance
Angular stomatitis
Sparse soft thin hair
cheliosis
anemia

Question 6

Symptoms of Marasmus

Answer 6

FIFAD the ww cmd
failure to thrive
irritability
fretfullness
apathy
diarrhea
the temperature is subnormal
watery diarrhea and acid stools
weak muscle and atrophy
child is shrunk and there is little to no subcutaneous fat
many are hungry but some may be anorexic
dehydration

Question 7

Symptoms of marasmic kwashiorkar

Answer 7

mixture of some features of both marasmus and kwashiorkar

Question 8

Nutritional dwarfing

Answer 8

as an adaptation to prolonged insufficieny of food - energy and protein which is marked by retardation of growth

Question 9

the underweight child has a risk of

Answer 9

gastroenteritis and respiratory infections

Question 10

Energy requirement in pem

Answer 10

-child should be given 150-200kcal/weight/day for existing weight
-child below 2 years 200kcal/weight/day
-malted cereals to increase calorie density
-50% of total calorie from carbohydrates

Question 11

Energy requirement in pem

Answer 11

-child should be given 150-200kcal/weight/day for existing weight
-child below 2 years 200kcal/weight/day
-malted cereals to increase calorie densit

Question 12

___ to be given to increase calorie density in pem

Answer 12

malted cereals

Question 13

Protein requirements in pem

Answer 13

5g/weight/day
10% of calorie from protein
high bv protein

Question 14

fat requirements in pem

Answer 14

40% of total cal from fats
sfa’s better tolerated
butter
milk
coconut oil

Question 15

treatment of pem in 3 stages

Answer 15

resolving life threatening condition

restoring nutritional status without disrupting homeostasis

ensuring nutritional rehabilitation

Question 16

criteria for improvement of pem

Answer 16

disappearance of mental apathy - 4-5d
disappearance of edema - 7-10 days
weight gain - 3-4 weeks
rise in serum albumin level in 2 weeks

Question 17

hospital treatment
hypothermia

Answer 17

child must be kept warm and practiced bedding in with mother

Question 18

hospital treatment
hypoglycemia

Answer 18

10% dextrose,4ml/kg

Question 19

septicaemia/infection

Answer 19

broad spectrum antibiotic, crystalline penicillin or ampicillin with aminoglycoside

Staphylococcus infection should be treated

Question 20

in children with diarrhea if no dehydration

Answer 20

half to 1 glass ors

Question 21

in mild to moderate dehydration

Answer 21

70ml/kg ors in 4 hr sip by sip or as intra gastric dip

Question 22

severe dehydration

Answer 22

100ml/kg sodium saline/ringer lactate in 3-6 hrs

Question 23

in oedematous children

Answer 23

70ml/kg given as slow ration
half the calculated fluid can be sodium saline or RL and rest 10% glucose

Question 24

potassium supplement

Answer 24

2-4mEq/kg/d continued for 1-2 weeks in kwashiorkar
fruit juice

Question 25

sodium restricted to

Answer 25

2-3mEq/say

Question 26

if evidence of acidosis

Answer 26

Sodium bicarbonate 2ml/kg IV fluid diluted with equal quantity of dw

Question 27

severe anemia corrected by

Answer 27

small packed cell transfusion 5-10ml/kg slowly along with frusemide

Question 28

mild to moderate anemia

Answer 28

6mg/kg elemental iton
after patient stabilized and after dewormimg

Question 29

for infants dose of 1lakh IU OF ___

Answer 29

vit a

Question 30

what is given in florid pem

Answer 30

2-5mg IM/IV of vit K for 2-3 days

Question 31

what is given if seizure due to tetany/apathy

Answer 31

Magnesium
upto 0.8Eq/kg/d given in 2 divided doses for 1-3 days