A 3-year-old rescued from chronic neglect has pitting pedal edema, mooning of the face, flaky paint dermatosis, sparse discolored hair, and an enlarged fatty liver, yet subcutaneous fat over the buttocks is reasonably preserved. The pattern of malnutrition demonstrated is:

• A Marasmus, from total caloric deprivation
• B Kwashiorkor, from predominant protein deficiency ✓
• C Marasmic kwashiorkor with equal deficits
• D Rickets from vitamin D deficiency

Explanation

Kwashiorkor results from predominant protein deficiency with relatively adequate calories, producing edema, hypoalbuminemia, fatty liver, flaky paint dermatosis, and hair changes while some subcutaneous fat persists. Marasmus features total caloric deprivation with marked wasting, absence of edema, and loss of subcutaneous fat. Rickets produces bony deformity rather than edema or fatty liver, and the preserved fat excludes combined marasmic kwashiorkor.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.