In Protein Energy Malnutrition, the pathological finding of 'fatty liver' (hepatomegaly with fatty infiltration) is characteristic of which condition?

• A Marasmus
• B Kwashiorkor ✓
• C Both marasmus and kwashiorkor equally
• D Nutritional marasmic-kwashiorkor

Explanation

Fatty liver (steatosis) is a characteristic feature of kwashiorkor, caused by protein deficiency with relatively adequate carbohydrate intake. The pathophysiology involves impaired synthesis of apolipoprotein B (which normally exports fat from the liver as VLDL), leading to fat accumulation. In marasmus (severe caloric and protein deficiency), the liver is typically small and atrophic with no fat accumulation because there is no substrate (carbohydrate/fat) for storage. In marasmic-kwashiorkor, features overlap but fatty liver is associated with the kwashiorkor component. Hypoalbuminaemia and oedema are also kwashiorkor-specific features.

Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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