Protein-Energy Malnutrition — Clinical

A 2-year-old girl with kwashiorkor (weight-for-height Z-score –3.2 SD, presence of edema and skin changes) is admitted for nutritional rehabilitation. The child has hepatomegaly and biochemical evidence of liver dysfunction. Which investigation is most specific for detecting hepatic synthetic dysfunction and assessing the risk of refeeding syndrome in this child?

Which of the following clinical signs is pathognomonic for kwashiorkor and distinguishes it from marasmus?

A 18-month-old child from rural India presents with severe protein-energy malnutrition (PEM), presenting with edema, hepatomegaly, and skin changes. Anthropometric measurements show weight-for-height <60% of expected. The child has been started on a therapeutic diet. Which micronutrient supplementation is the drug of choice to prevent refeeding syndrome and support recovery in this case?

A 2-year-old child from rural India presents with severe wasting, loss of subcutaneous fat, and skin changes. On examination, the child has a wizened appearance with prominent ribs and sparse hair. Which is the most common form of protein-energy malnutrition in this clinical presentation?

A 18-month-old boy from rural Maharashtra is brought to the pediatric clinic with a 4-month history of poor weight gain, loose stools, and recurrent respiratory infections. On examination, he weighs 8 kg (expected 12 kg for age), has visible ribs, sparse hair, and mild hepatomegaly. Serum albumin is 2.1 g/dL (normal >3.5), and hemoglobin is 8.2 g/dL. He is alert and playful with no edema. What is the most appropriate next step in management?