A 3-year-old boy presents with pitting oedema of the feet, a miserable appearance, hepatomegaly, and a 'flaky paint' dermatosis but without significant wasting. His weight-for-height is 89% of standard. Which form of PEM is MOST likely?
- A Kwashiorkor ✓
- B Marasmus
- C Marasmic kwashiorkor
- D Nutritional dwarfism
Correct answer: A. Kwashiorkor
Explanation
Kwashiorkor is characterised by oedema (due to hypoalbuminaemia), skin changes ('flaky paint' dermatosis — areas of hyperpigmentation with peeling), hepatomegaly (fatty liver), and psychomotor changes ('moon face', miserable expression), with relative preservation of weight-for-height. Marasmus presents with severe wasting, loose skin ('old man's face'), no oedema, and normal skin. Marasmic kwashiorkor has features of both — oedema with severe wasting (weight-for-height < 70%). Nutritional dwarfism reflects chronic stunting without current wasting or oedema.
Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.