CLINICAL FEATURES OF MALNUTRITION

ANDREA

Mild malnutrition

1. Growth failure-slow or cessation of linear growth;static or decline in weight;MAC decrease;normal or decreased skin fold thickness;delayed bone maturation

2. Infection-gastroenteritis,pneumonia and TB3. Anemia-mild to moderate4. Activity-diminished5. Skin and hair changes –occur rarely

Moderate to severe malnutrition ■Marasmus –marked wasting of fat and muscle ■Main sign is severe wasting■Monkey facies and baggy pants appearance ■No edema ■Children appear alert inspite of their condition

■Kwashiorkor-children between 1-4yrs■ Main sign pitting edema■ General appearance-fat sugar baby appearance ■ Muscle wasting always present;child often

weak,hypotonic and unable to stand ■ Skin-flaky paint appearance;usually on

buttocks,perineum and upper thigh■ Mucous membrane-smooth tongue,cheilosis and

angular stomatitis

■ Hair-dyspigmentation,loss of characteristic curls and sparseness over temple and occipital region.Hair loses lustre and easily plucked;flag sign

■ Mental changes-apathy,irritable,intermittent cry,no signs of hunger

■ GIT-anorexia sometimes vomiting;abdominal distension ;semisolid or watery stools

■ CVS-cold pale extremities associated with prolonged circulation time,bradycardia,diminished cardiac output and hypotension

■ RENAL-GFR and renal plasma flow are diminished

Clinical features Marasmus Kwashiorkor

Occurrence More common Less common

Edema Absent Present

Activity Active Apathic

Appetite Good Poor

Hepatomegaly Absent Present

Mortality Less than kwashiorkor High in early stage

Infection Less prone More prone

Recovery Early Slowly

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