A 3-year-old has Bitot's spots on the temporal bulbar conjunctiva, night blindness, and a dry, rough skin. Serum retinol is 0.18 µmol/L (normal >0.70). Per WHO protocol for clinical vitamin A deficiency in a child aged 12–59 months, the CORRECT treatment dose on Days 1, 2, and 14 is:
- A 100,000 IU on day 1, 100,000 IU on day 2, 100,000 IU at 2 weeks
- B 50,000 IU on day 1, 50,000 IU on day 2, 50,000 IU at 2 weeks
- C 200,000 IU on day 1 only
- D 200,000 IU on day 1, 200,000 IU on day 2, 200,000 IU at 2 weeks ✓
Explanation
WHO therapeutic protocol for clinical vitamin A deficiency in children 12-59 months (and >8 kg): 200,000 IU oral retinyl palmitate on Day 1 (at presentation), Day 2, and Day 14 (2 weeks later). This three-dose schedule rapidly replenishes liver stores and restores night vision and mucosal integrity. Children aged 6-11 months (or <8 kg) receive 100,000 IU. Infants <6 months receive 50,000 IU. Bitot's spots indicate xerophthalmia (X1B stage) requiring treatment. Vitamin A deficiency also increases measles and diarrheal mortality; prophylactic supplementation every 6 months is part of national programs.
Reference: Ghai Essential Pediatrics, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.