Nutrition: kwashiorkor: practice question

A Biochemistry question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Biochemistry · Nutrition: kwashiorkor

Sample item

A 2-year-old is weaned to a starchy gruel after the birth of a sibling. He has pitting pedal oedema, flaky skin, sparse reddish hair and a distended abdomen. What is the principal cause of the oedema?

AHeavy renal albumin loss as in nephrotic syndromeBPrimary cardiac failure from thiamine deficiencyCLymphatic obstruction by parasitesDLow plasma albumin from inadequate dietary amino acids reduces oncotic pressure

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Low plasma albumin from inadequate dietary amino acids reduces oncotic pressure

Kwashiorkor results from diets low in protein but with adequate energy, so hepatic albumin synthesis falls and plasma oncotic pressure drops, causing fluid to move into tissues. Other factors include oxidative stress and altered gut barrier function. Marasmus, in contrast, has no oedema.

Option by option

A. Heavy renal albumin loss as in nephrotic syndrome
Renal protein loss is not the primary problem in kwashiorkor.
B. Primary cardiac failure from thiamine deficiency
Wet beriberi can cause oedema but does not fit the dietary picture and skin changes.
C. Lymphatic obstruction by parasites
Filariasis causes asymmetric lymphoedema and not generalised oedema with skin and hair change.
D. Low plasma albumin from inadequate dietary amino acids reduces oncotic pressure (correct)
Correct. Hypoalbuminaemia from amino acid shortage reduces the pull of fluid into vessels.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Biochemistry question

What is the answer to this Biochemistry question?

The best answer is D, Low plasma albumin from inadequate dietary amino acids reduces oncotic pressure. Kwashiorkor results from diets low in protein but with adequate energy, so hepatic albumin synthesis falls and plasma oncotic pressure drops, causing fluid to move into tissues.

Why is "Heavy renal albumin loss as in nephrotic syndrome" not the answer?

Renal protein loss is not the primary problem in kwashiorkor.

Why is "Primary cardiac failure from thiamine deficiency" not the answer?

Wet beriberi can cause oedema but does not fit the dietary picture and skin changes.

Why is "Lymphatic obstruction by parasites" not the answer?

Filariasis causes asymmetric lymphoedema and not generalised oedema with skin and hair change.

What concept does this question test?

It tests Nutrition: kwashiorkor in Biochemistry. Other factors include oxidative stress and altered gut barrier function. Marasmus, in contrast, has no oedema.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Nutrition: kwashiorkor?

Build one table of enzyme deficiency, disease, inheritance and key finding, then revise it by spaced recall. Then use the flashcards and the other Biochemistry questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.