A 1 1/2 year old child was classified as having 3rd degree of protein energy malnutrition, kwashjorkor. Which of the following signs will be most apparent in this child?

Correct Answer: D

Rationale: The correct answer is D: Edema. In severe protein energy malnutrition like kwashiorkor, edema is a hallmark sign due to low protein levels causing fluid to leak into tissues. A: Voracious appetite is incorrect as malnourished children often have reduced appetite. B: Wasting is more associated with marasmus, another form of malnutrition. C: Apathy can be seen in malnourished children, but it is not specific to kwashiorkor. In summary, edema is the most apparent sign in a child with 3rd-degree protein energy malnutrition, distinguishing it from other forms of malnutrition.

Correct Answer: D

Rationale: Step 1: Lower conjunctival sac is the best area to examine for pallor as it is a mucous membrane that reflects the true color of blood vessels. Step 2: Anemia causes decreased hemoglobin levels, leading to paleness visible in lower conjunctival sac. Step 3: Palms, nailbeds, and around the lips may also show pallor, but they can be affected by other factors like skin pigmentation or lighting. Summary: Lower conjunctival sac is the best site for assessing pallor due to its direct reflection of blood vessel color, making it superior to other areas prone to external influences.

Correct Answer: C

Rationale: The correct answer is C: Instruct mothers to keep their babies at home to prevent disease transmission. This is the best course of action during a measles epidemic because keeping babies at home helps reduce their exposure to the virus and prevent its spread. Babies under 6 months are too young for the measles vaccine (choice A), and giving high doses of Retinol (choice B) is not a recommended treatment for measles. Adequate nutrition (choice D) is important for overall health but does not directly address preventing measles transmission.

Correct Answer: B

Rationale: The correct answer is B: Antibiotic to prevent pneumonia. Measles can lead to secondary bacterial infections like pneumonia, making antibiotics crucial to prevent complications. Choice A is incorrect as Gentian violet is not recommended for mouth lesions in measles. Choice C is incorrect as Tetracycline eye ointment is not indicated for corneal opacity in measles. Choice D is incorrect as giving Retinol capsules is not a standard management for measles. Antibiotics are essential to prevent and treat bacterial infections associated with measles.

Correct Answer: B

Rationale: The correct answer is B: Destroying breeding places of mosquitoes. This is the most effective strategy in controlling Dengue fever because it targets the source of the problem by eliminating the breeding grounds of mosquitoes, which are essential for their reproduction. By removing stagnant water and other potential breeding sites, the mosquito population is significantly reduced, thus lowering the risk of Dengue fever transmission. Choice A, stream seeding with larva-eating fish, may help in controlling mosquito larvae in certain water bodies but may not be as effective in widespread control of Dengue fever transmission. Choice C, chemoprophylaxis, is not a primary prevention strategy and may not be practical for large populations. Choice D, teaching people to use mosquito nets, is a helpful preventive measure but may not be as effective as eliminating breeding sites in reducing Dengue fever transmission.