3. Illustrated Textbook of Paediatrics ( PDFDrive ) 2

Poor growth, frontal bossing, delayed closure of anterior fontanelle, bowing of weight-bearing bones, and seizures.

It provides a nutrient-rich diet based on peanut butter, dried skimmed milk, vitamins, and minerals.

Nutritional vitamin D deficiency due to inadequate intake or insufficient exposure to direct sunlight.

Severe protein-energy malnutrition with symptoms like oedema, hyperkeratosis, and skin depigmentation.

2–4 weeks, but complete reversal of bony deformities may take years.

Symptoms include cranio-tabes, rachitic rosary, widened wrists and ankles, Harrison’s sulcus, and bowed legs.

Low or normal serum calcium, low phosphorus, high plasma alkaline phosphatase, low 25-hydroxyvitamin D, and elevated parathyroid hormone.

Weight for height more than 3 standard deviations below the median, MUAC less than 115 mm, or bilateral oedema.

By asking parents to record the food the child eats over several days.

Up to 30%.

When the digestive tract is functioning, as it maintains gut function and is safe.

Subcutaneous fat stores.

A sensation similar to pressing a ping-pong ball over the occipital or posterior parietal bones (cranio-tabes).

Inadequate food intake.

Weight for height, plotted against a standard growth chart to determine z-scores.

They are likely to become obese adults.

By advising a balanced diet, correcting risk factors, and administering vitamin D3.

Impaired immunity, delayed wound healing, increased operative morbidity and mortality.

To help them grow better when they have long-term disorders.

If an infant’s weight falls across two centile spaces.

Weight in kg divided by height in meters squared.

Treat hypoglycaemia, hypothermia, dehydration, correct electrolyte imbalance, treat infection, and correct micronutrient deficiencies.

Nasogastrically, by gastrostomy, or via a feeding tube in the jejunum.

Increased susceptibility to illness, poor academic performance, and higher risk of obesity and non-communicable diseases in adulthood.

To provide a nutritionally complete feed via intravenous fluid, either exclusively or as an adjunct to enteral feeds.

Rickets and osteomalacia.

An indentation of the softened lower ribcage at the site of attachment of the diaphragm.

Low serum calcium, low phosphorus, greatly increased alkaline phosphatase, low 25-hydroxyvitamin D, and elevated parathyroid hormone.

Marasmus, kwashiorkor, and marasmic kwashiorkor.

Generalized oedema, flaky-paint skin rash, distended abdomen, and low plasma levels of various nutrients.

Glucose, fat emulsion, synthetic amino acids, electrolytes, vitamins, and trace elements.

A form of severe malnutrition in infants, often due to inability to establish breastfeeding.

No appetite, severe oedema, medical complications, or being less than 6 months old.

Prolonged breastfeeding.

A 40% reduction in the number of stunted children.

Living in northern latitudes, dark skin, decreased sunlight exposure, maternal vitamin D deficiency, and diets low in calcium, phosphorus, and vitamin D.

Regulation of calcium and phosphate metabolism, essential for bone health and regulation of the immune system.

Inadequate UVB exposure, deficient intake, or defective metabolism of Vitamin D.

Sunlight.

Obesity.

It can worsen the outcome, such as delaying weaning from mechanical ventilation due to respiratory muscle weakness.

Milk, dairy products, margarine, breakfast cereals, and fruit juice.

Mid-upper-arm circumference; it uses color coding for identifying moderate and severe malnutrition.

About 156 million.

Dietary deficiency of phosphorus, along with low stores of calcium and phosphorus.

Anticonvulsants such as phenobarbital and phenytoin.

Wasted, wizened appearance and apathy.

Poverty, parental neglect, or poor education.

20–40%.

Wasted appearance without oedema; affected children are often withdrawn and apathetic.

To screen for malnutrition, especially in children aged 6 months to 5 years.

Synthesis in the skin (Vitamin D3) following UV light exposure and dietary sources (Vitamin D2 or D3).

Early physiological adaptation to malnutrition, but clinical history and anthropometry are more valuable.

Generalized edema, sparse and depigmented hair, skin rash, angular stomatitis, distended abdomen, enlarged liver, and diarrhea.

Short bowel syndrome, enteropathies, or motility disorders.

Bony deformity and the classical picture of rickets.

Weight, height, mid-upper-arm circumference (MUAC), and skinfold thickness.

Permanent delay in intellectual development.

Fish liver oil, fatty fish, and egg yolk.

CVC sepsis, blockage, venous thrombosis, and intestinal failure-associated liver disease.

The atmosphere blocks the UVB rays, reducing Vitamin D3 production.

Low serum calcium levels due to Vitamin D deficiency.

It is hydroxylated in the liver and kidney to produce 1,25-dihydroxyvitamin D, the most active form.

Full blood count, serum electrolytes, liver function tests, thyroid function tests, and more.

Iron-deficiency anaemia.

A description of inadequate weight gain in infants, not a diagnosis.

Dietary intake, anthropometry, and laboratory assessments.

The likelihood of weight faltering increases the further the weight is below the second centile.

It is responsible for about a third of all deaths in this age group.