Nutrition & Immunisation · NEET PG Preparation Paediatrics
A 10-month-old infant is brought to the pediatric outpatient department with generalized edema, sparse and brittle hair that easily pulls out, flaky…
Practice question from Nutrition & Immunisation (NEET PG Preparation Paediatrics), with the correct answer and a step-by-step solution.
medium · MCQ · Q-D07BAD
A 10-month-old infant is brought to the pediatric outpatient department with generalized edema, sparse and brittle hair that easily pulls out, flaky paint dermatosis, and apathy. Hepatomegaly is also noted on examination. The child's diet predominantly consists of dilute starchy porridges with negligible protein intake. Which of the following is the most appropriate initial management step in this child?
- A.Aggressive high-calorie and high-protein refeeding immediately to reverse wasting.
- B.Intravenous bolus of normal saline to treat potential hypovolemic shock.
- C.Initial stabilization addressing hypoglycemia, hypothermia, and fluid/electrolyte balance using starter F-75 formula.Correct answer
- D.Immediate administration of therapeutic zinc and high-dose iron supplements.
Solution
The child presents with classical features of Kwashiorkor (edema, flaky paint dermatosis, hair changes, apathy, hepatomegaly due to fatty liver), which is a form of severe acute malnutrition (SAM). According to WHO guidelines, the management of SAM is divided into phases. The stabilization phase focuses on treating and preventing hypoglycemia, hypothermia, dehydration, and electrolyte imbalances using a low-protein, low-sodium, high-carbohydrate formula known as F-75. Aggressive refeeding or iron supplementation should be delayed until the stabilization phase is successfully completed to prevent refeeding syndrome and iron-induced oxidative damage.
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