An 18-month-old child from a rural area presents with bilateral pitting edema up to the knees, sparse hypopigmented hair that plucks easily, a 'flaky paint' rash on the lower limbs, and marked irritability, but weight is relatively preserved. What is the MOST likely diagnosis?
- A Kwashiorkor ✓
- B Marasmus
- C Pellagra
- D Scurvy
Correct answer: A. Kwashiorkor
Explanation
Kwashiorkor is severe acute malnutrition characterized by predominantly protein deficiency with adequate caloric intake, presenting with bilateral pitting edema, skin changes (flaky paint dermatosis), sparse hypopigmented hair (flag sign), hepatomegaly (fatty liver), and profound hypoalbuminemia. The edema can mask weight loss. Marasmus presents with severe wasting without edema. The WHO defines SAM as weight-for-height <-3 SD, MUAC <11.5 cm, or bilateral pitting edema.
Reference: Ghai Essential Pediatrics, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.