All are the criteria for the diagnosis of severe acute malnutrition(SAM) except:
Correct Answer: Visible severe wasting
Description: Visible severe wasting is no longer a criteria to diagnose Severe acute Malnutrition (SAM) Severe acute malnutrition(SAM) in children of ages 6 to 59 months is defined by WHO as any of the following: Weight-for-length (or height) below -3SD of the WHO child growth standards Presence of bipedal edema Mid-Upper arm circumference <11.5cm The previous name Protein-Energy malnutrition is avoided, as it oversimplifies the complex multi-deficiency etiology. Clinical features: Treatment: The general treatment involves 10 steps in 2 phases Phases: Initial Stabilization Phase: Focuses on restoring homeostasis and treating medical conditions 2-7 days of inpatient treatment Rehabilitation Phase: Treat hypoglycemia (Blood Glucose level <54 mg/dl): If symptomatic give 10% Dextrose IV 5 ml/Kg. Feeding should be initiated with staer F-75 (Formula with 75 Kcal/100 ml of feed) Treat hypothermia (axillary <35oC or 95oF) : Skin-to-Skin contact with care ("Kangaroo technique") of dress in warmer clothes, cover head, wrap in a warmed blanket, and provide indirect heat. Treat dehydration: Hydrate with ReSoMal (45 mmol Na/L). It is a low-sodium rehydration solution for malnutrition. Correct electrolyte imbalance: There is a deficit of potassium and magnesium and excess sodium. Give extra potassium (3 to 4 mEq/Kg/day) and magnesium (4 mEq/Kg/day) for atleast 2 weeks. Treat infection: Staing on the first day, give broad-spectrum antibiotics to all children. Correct micronutrient deficiencies: Donot give iron in the stabilizing phase, because excess iron leads to free radical injury. Give iron 3mg/Kg/day once the child stas gaining weight after the stabilization phase. Give Vitamin A on day 1. Repeat on day 2 and day 14 Folic acid 1 mg (5 mg on day 1) Zinc (2 mg/Kg/day) Copper (0.3 mg/Kg/day) Sta caitious feeding: Give 8 to 12 small feeds of F75 to provide 130 mL/Kg/day, 100 Kcal/kg/day, and 1 to 1.5 g protein/Kg/day Rehabilitation: The indications of entry to this phase are reduced/minimal edema and the return of appetite Begining of feeding After 3 days, the transition to energy-dense feeding Stimulation of emotional and sensorial development Transfer to home-based diet Ref: Ghai Essential Pediatrics 9th edition Pgno: 97
Category:
Pediatrics
Get More
Subject Mock Tests
Practice with over 200,000 questions from various medical subjects and improve your knowledge.
Attempt a mock test nowMock Exam
Take an exam with 100 random questions selected from all subjects to test your knowledge.
Coming SoonGet More
Subject Mock Tests
Try practicing mock tests with over 200,000 questions from various medical subjects.
Attempt a mock test now