A 10 years old girl presented with fever and bruises for last 2 weeks. On examination she is pale; however there is no evidence of lymphadenopathy or hepatosplenomegaly. Her Hb is 6g/dl, TLC is 2700 and platelets are 90000. The most appropriate investigation to clinch the diagnosis is:

Correct Answer: A

Rationale: Bone marrow aspiration is essential to rule out conditions like aplastic anemia or leukemia, which could explain the symptoms and lab findings.

Correct Answer: D

Rationale: Marasmus is a form of severe malnutrition characterized by a deficiency of both calories and protein in the diet. It typically occurs in young children and is often associated with a lack of adequate food intake. The classic presentation of marasmus includes extreme wasting of muscle and fat tissues, resulting in a gaunt appearance with thin limbs and a distended abdomen due to diminished muscle and subcutaneous fat. This differentiates it from kwashiorkor, another form of severe acute malnutrition characterized by edema and a protruding belly but with retained muscle mass. Therefore, option D, characterized by thin, wasted extremities and a prominent abdomen resulting from edema (ascites), accurately describes marasmus.

Correct Answer: D

Rationale: Head circumference is less likely to be affected by short-term malnutrition because brain growth is prioritized during infancy and early childhood.

Correct Answer: D

Rationale: By 24 months, a child should be able to follow simple commands without gestures.

Correct Answer: A

Rationale: Infants crying in response to others may indicate early empathy development.