PROTEIN ENERGY MALNUTRITION (PEM)- Kwashiorkor and Marasmus

PEM
Protein-energy undernutrition (PEU)
Kwashiorkor
Marasmus
causes
Cases
treatment
Case 1
A 4 year old girl brought to the hospital with a complaint of failure to thrive and generalized swelling all over the body. She had a history of repeated respiratory infections and intermittent diarrhea. She belongs to a poor family and resides in a slum area.
Diagnosis- Kwashiorkor (Protein-energy malnutrition)
Cause - Low protein in the diet
Treatment - high protein diet
Case 2
A 3 year old child from a poor illiterate family reported with edema, discoloration of hair and skin, anemia, diarrhea. His serum albumin and K+ were low.
i) Give the diagnosis and etiology
ii) What is the cause of edema
Albumin level decreases in kwashiorkor hence oncotic pressure decreases. The oncotic pressure is in direct opposition with the hydrostatic pressure and tends to draw the water back into capillaries by osmosis. Hence in albumin deficiency, fluid accumulates in the tissues and causes edema.
iii) Suggest line of treatment and preventive measures
Supportive therapy-ORS for diarrhea
High protein diet- Eggs, meat, fish, pulses, mushrooms etc
Vitamin and mineral supplementation
Vaccination for the age

[@himanshuambilkar4160]

PROTEIN energy malnutrition- The range of condition arising from lack of calories and protein in a child below 5 years of age..... Classes- Kwashiorkor Marasmus Marasmickwashior..... Weight/height Mid upper arm circumference... Kwashiorkor- 1-5 year age PROTEIN Weight/height 60- 80 percent Hair flag, sparse Moon face Dermatitis Distension , hepatosplenomegaly Fatty liver Edema Albumin .5-2 gm/DL...... Marasmus- Less than 1 year Calories W/h less than 60 Percent No change in hair Old man Shrunken abdomen No liver enlargement More than 2 gm/ dL... Cause- Poverty Improper weaving Chronic infection Malabsorption.... Complications- Repeated infection Hypoglycemia Hypothermia Dehydration Shock Vitamin and mineral deficiency.... Treatment- Cause treatment Complications Vitamins and minerals supplemention Vaccination.... Thank you sir

[@Rajesh_Jambhulkar]

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[@burhanuddinmohammadi8566]

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[@tanyagowda4876]

Sir, serum cortisol levels in marasmus is increased and kwashiorkor is decreased. Is it because in marasmus, since we have a calorie deficiency, it's increased to increase levels of glucose ? Thank you. Very helpful video, sir! :)

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[@divyanshichoudhary6001]

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[@romesaabid7158]

Which is the first indicator for Protein-Energy malnutrition 1. Weight for height or Mid upper arm circumference??

[@HimanshuKumar-dq1sy]

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[@dr.gauravarora6052]

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[@smritigupta986]

Sir, if marasmus is the overall deficiency of nutrients then why is it kept in the category of protein energy malnutrition?

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Sir , what abt marasmic Kawashirkor

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sir what about PEM in adults ?

[@iammanojnarayan]

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[@Dimensionalalteration]

I'm in a developed country and still malnourished and fat due to fluid retention. Looks can be deceiving.

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[@huzaifazaheer3296]

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[@Karvarez.]

Sir, in marasmus, there is primary calorie deficiency, so we see hypoglycemia. Similar way , all proteins are also used for producing energy isn't? then why we are not seeing HYPOPROTEINEMIA in marasmus? sir

[@Rajesh_Jambhulkar]

It goes down but not below 2gm/dl

[@Karvarez.]

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Liablility

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[@tylertaws476]

Malnutrition is the enemy. People who suffer from Malnutrition get sick a lot easier. We need more propaganda to encourage people to eat plenty of fruits and vegetables. If you don't eat your fruits and vegetables no dessert. Those are the rules.

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