jsr-4 - usmlevictory1

[ArchivalUser]

A 19-year-old woman with anorexia nervosa undergoes
surgery for acute appendicitis. The postoperative
course is complicated by acute respiratory distress
syndrome, and she remains intubated for 10 days. She
develops wound dehiscence on postoperative day 10.
Laboratory data show a white blood cell count of 4000/
μL, hematocrit 35%, albumin 2.1 g/dL, total protein 5.8
g/dL, transferrin 54 mg/dL, and iron-binding capacity 88
mg/dL. You are considering initiating nutritional therapy
on hospital day 11. Which of the following is true regarding
the etiology and treatment of malnutrition in this
patient?
A. She has marasmus, and nutritional support should
be started slowly.
B. She has kwashiorkor, and nutritional support should
be aggressive.
C. She has marasmic kwashiorkor, kwashiorkor predominant,
and nutritional support should be aggressive.
D. She has marasmic kwashiorkor, marasmus predominant,
and nutritional support should be slow.

[ArchivalUser]

cc

[ArchivalUser]

def has marasmus... A?
in kwashiorkor, she wud be severely protein deficient, this case is starvation.

[ArchivalUser]

no idea

[ArchivalUser]

Bbbbbbbbbb

[ArchivalUser]

hey usmlevictory...i know marasmic child is starving and kwashirkor child has edema

now what makes b the correct answer in this question or anybody

[ArchivalUser]

hey, her protein and alb are not that decreased, though transferrin is very much so. Besides, in anorexia and starvation, there is decreased global nutritional intake, not just protein....
I dont understand why it is B. I anything, it should be MK - K dominant.

Anyone else?

[ArchivalUser]

anorexic patients are not protein selective, they have total caloric deficit.
it is either A or D, marasmus is the mainstay.