A 2-year-old from a rural area presents with weight 7 kg (expected ~12 kg), bilateral pitting edema up to the knees, sparse reddish hair, and a 'flaky paint' dermatosis with areas of hyperpigmentation and desquamation. Serum albumin is 1.6 g/dL. The diagnosis is:
- A Marasmus
- B Marasmic kwashiorkor
- C Kwashiorkor ✓
- D Pellagra
Correct answer: C. Kwashiorkor
Explanation
Kwashiorkor is a severe acute malnutrition characterized predominantly by protein deficiency with relative caloric sufficiency, causing hypoalbuminemia, bilateral pitting edema, dermatosis ('flaky paint' or 'crazy pavement'), hair changes (flag sign, sparse/reddish), hepatomegaly, and a miserable, apathetic child. Marasmus is severe caloric (energy) deficiency without edema, presenting with extreme wasting and 'old man face.' Marasmic kwashiorkor has features of both: severe wasting plus edema.
Reference: Ghai Essential Pediatrics, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.