Question 1

Which nutrient deficiency most commonly leads to delayed wound healing in postoperative patients?

Accepted Answer

Answer reason: Vitamin C (ascorbic acid) is essential for collagen synthesis, fibroblast activity, and capillary formation during tissue repair. Deficiency impairs collagen cross-linking, leading to fragile granulation tissue and delayed wound healing.

Question 2

Not seen in kwashiorkor?

Accepted Answer

Answer reason: Kwashiorkor presents with edema, apathy, fatty liver with elevated transaminases, and characteristic flaky paint dermatosis. The 'baggy pant' appearance is a hallmark of marasmus (severe wasting), not kwashiorkor.

Question 3

One of the important features of Kwashiorkor is?

Accepted Answer

Answer reason: Kwashiorkor (protein deficiency) presents with edema, apathy/lethargy, and muscle wasting that may be masked by edema. Obvious muscle wasting and severe loss of subcutaneous fat are characteristic of marasmus, not kwashiorkor.

Question 4

Vitamin K is synthesized in the human body by?

Accepted Answer

Answer reason: Intestinal microbiota synthesize vitamin K (menaquinones) in the colon; it is not produced by the spleen, liver, or muscle fibers.

Question 5

What is the amount of trisodium citrate in the WHO ORS?

Accepted Answer

Answer reason: WHO reduced-osmolarity ORS contains trisodium citrate dihydrate 2.9 g per liter.

Question 6

Compared to breast milk, colostrum is richer in?

Accepted Answer

Answer reason: Colostrum contains higher protein, especially immunoglobulins, while having lower fat and lactose than mature breast milk.

Question 7

Colostrum is rich in?

Accepted Answer

Answer reason: Colostrum contains high levels of protein, especially immunoglobulins; it has lower fat and lactose than mature milk.

Question 8

Compared with cow's milk, does mother's milk have more?

Accepted Answer

Answer reason: Human breast milk contains higher lactose than cow's milk, while cow's milk has more protein and vitamin D; fat content is similar. Therefore, lactose is higher in mother's milk.

Question 9

The first indicator of PEM in children is?

Accepted Answer

Answer reason: In protein-energy malnutrition, weight loss appears before height deficits; low weight-for-age is the earliest anthropometric sign used for early detection.

Question 10

Vitamin A is produced from carotene?

Accepted Answer

Answer reason: Beta-carotene is converted to retinal/retinol primarily in the intestinal mucosa; hence the intestinal tract is where vitamin A is produced from carotene.

Question 11

The principal feature of kwashiorkor is?

Accepted Answer

Answer reason: Kwashiorkor is protein-energy malnutrition characterized by edema from hypoalbuminemia; marasmus shows severe fat and muscle wasting with usually good appetite. Thus edema, especially in legs and face, is the principal feature.

Question 12

All of the following are signs and symptoms of a child with marasmus except?

Accepted Answer

Answer reason: Marasmus presents with severe wasting, sunken eyes, and loose wrinkled skin. A moon-shaped (puffy) face is typical of kwashiorkor due to edema, not marasmus.

Question 13

Which nutritional deficiency disorder is called "sickness of weaning"?

Accepted Answer

Answer reason: Kwashiorkor is protein-energy malnutrition that commonly occurs after weaning to a low-protein diet and is known as the "sickness of weaning.

Question 14

Causes of thiamine deficiency?

Accepted Answer

Answer reason: Thiamine (vitamin B1) deficiency classically causes beriberi. Pellagra is due to niacin deficiency, Keshan’s disease to selenium deficiency, and rickets to vitamin D deficiency.

Question 15

The average whey-to-casein ratio in breast milk is?

Accepted Answer

Answer reason: Mature human breast milk proteins are predominantly whey with an average whey-to-casein ratio of about 60:40 (colostrum higher in whey; cow’s milk more casein-heavy).

Question 16

'Flag sign' present in?

Accepted Answer

Answer reason: Flag sign refers to alternating bands of depigmented and normally pigmented hair due to intermittent protein deficiency, a classic finding in kwashiorkor.

Question 17

By origin, which word means "Red Boy"?

Accepted Answer

Answer reason: Kwashiorkor derives from a local term often interpreted as 'the red boy,' reflecting the reddish hair/skin changes seen in protein-energy malnutrition. Marasmus means wasting; the other terms do not mean 'red boy.

Question 18

Which of the following is a feature of marasmus and not kwashiorkor?

Accepted Answer

Answer reason: Marasmus (calorie deficiency) typically presents with a good/voracious appetite, without edema or fatty liver and with relatively preserved albumin. Kwashiorkor shows poor appetite, fatty liver, edema, and marked hypoalbuminemia.

Question 19

Intestinal bacterial flora helps in the synthesis of?

Accepted Answer

Answer reason: Colonic bacteria synthesize menaquinones (vitamin K), contributing to host vitamin K supply; other listed vitamins are primarily obtained from diet.

Question 20

Breast milk is richer in _____ than cow's milk?

Accepted Answer

Answer reason: Human breast milk contains more lactose than cow’s milk, while cow’s milk is higher in protein; vitamin K is low in breast milk and fat is not higher.

Question 21

Which of the following are true about breast milk?

Accepted Answer

Answer reason: Breast milk has higher lactose, thus more carbohydrates, than cow’s milk. It is not a rich iron source, has lower protein than cow’s milk, and has more (not less) DHA.

Question 22

A 4-year-old child with severe wasting and a voracious appetite without pedal edema?

Accepted Answer

Answer reason: Marasmus presents with severe wasting, no edema, and often a voracious appetite, unlike kwashiorkor which has edema and poor appetite.

Question 23

Kwashiorkor is not an essential criterion?

Accepted Answer

Answer reason: Edema, growth failure, and hepatomegaly are core clinical features of kwashiorkor. Apathy is a common mental change but not an essential diagnostic criterion.

Question 24

Good sources of vitamin D include all except?

Accepted Answer

Answer reason: Blueberries are not a meaningful source of vitamin D, while sunlight enables endogenous synthesis and fatty fish and fortified dairy are recognized dietary sources.

Question 25

Sources of folic acid include?

Accepted Answer

Answer reason: Leafy green vegetables such as spinach are rich sources of folate; the other listed fruits/vegetables contain much less.

Question 26

Angular stomatitis occurs due to a deficiency of?

Accepted Answer

Answer reason: Angular stomatitis (cheilosis) is classically due to riboflavin deficiency and other B‑complex deficiencies; among the options, Vitamin B is correct.

Question 27

Is the Casal necklace seen in?

Accepted Answer

Answer reason: Casal's necklace is a photosensitive dermatitis around the neck characteristic of pellagra due to niacin (vitamin B3) deficiency.

Question 28

The most common deficiency seen in alcoholics is?

Accepted Answer

Answer reason: Chronic alcoholism commonly causes thiamine (vitamin B1) deficiency due to poor intake and impaired absorption, leading to conditions like Wernicke–Korsakoff syndrome.

Question 29

Green leafy vegetables are a rich source of?

Accepted Answer

Answer reason: Green leafy vegetables are rich in beta-carotene (provitamin A), which the body converts to vitamin A. They are not significant sources of vitamin D; B and C may be present but are not the primary rich nutrient.

Question 30

Which one of the following is a bioactive factor of human milk compared with formula milk?

Accepted Answer

Answer reason: Human milk contains bioactive cytokines such as transforming growth factor (especially TGF-β) that modulate infant immunity and gut maturation. The other choices are not characteristic bioactive components compared to formula (IgM is minimal; HMOs are oligosaccharides, not generic polysaccharides; lipoprotein A is not a recognized bioactive factor in this context).

Question 31

Kwashiorkor is caused by a deficiency of?

Accepted Answer

Answer reason: Kwashiorkor is a protein-energy malnutrition characterized by edema and fatty liver due to inadequate protein intake despite adequate calories.

Question 32

Consuming fewer than the required amount of carbohydrates per day may lead to?

Accepted Answer

Answer reason: Insufficient carbohydrate intake forces fat breakdown for energy, producing ketone bodies and resulting in ketosis. The other options relate to protein or overall calorie deficiency.

Question 33

Which vitamin deficiency is responsible for neonatal seizures?

Accepted Answer

Answer reason: Pyridoxine (vitamin B6) deficiency causes neonatal seizures due to impaired GABA synthesis. Vitamin C, thiamine, and cobalamin deficiencies do not typically present with neonatal seizures.

Question 34

Signs of marasmus except?

Accepted Answer

Answer reason: Marasmus is due to severe calorie deficiency and is characterized by marked muscle wasting and loss of subcutaneous fat. Vomiting is not a characteristic sign of marasmus.

Question 35

Nyctalopia and Bitot Spot are due to a deficiency of?

Accepted Answer

Answer reason: Night blindness (nyctalopia) and Bitot spots are classic ocular signs of vitamin A deficiency.

Question 36

Selenium deficiency is seen?

Accepted Answer

Answer reason: Selenium deficiency is classically associated with Keshan disease (endemic dilated cardiomyopathy). Wilson disease involves copper metabolism, and acrodermatitis enteropathica is due to zinc deficiency.

Question 37

Kwashiorkor is diagnosed in growth-retarded children along with?

Accepted Answer

Answer reason: Kwashiorkor, a severe protein malnutrition, is characterized by pitting edema from hypoalbuminemia and typical skin changes including hypopigmentation; these are classic diagnostic features.

Question 38

Which disorder are children under one year of age more likely to suffer from if breastfeeding is replaced by foods low in calories and protein?

Accepted Answer

Answer reason: Early weaning to a diet low in both calories and proteins leads to protein-energy malnutrition presenting as marasmus, common in infants under 1 year. Kwashiorkor is mainly protein deficiency with adequate calories.

Question 39

Which vitamin is called alpha-tocopherol?

Accepted Answer

Answer reason: Alpha-tocopherol is the major active form of vitamin E.

Question 40

Cardiac edema and neuropathy are seen in which micronutrient deficiency?

Accepted Answer

Answer reason: Thiamine (vitamin B1) deficiency causes beriberi: wet beriberi leads to cardiac failure with edema, and dry beriberi causes peripheral neuropathy.

Question 41

The daily requirement of vitamin C for an adult man is?

Accepted Answer

Answer reason: Standard RDA used in many nursing texts and ICMR guidelines historically list about 40 mg/day vitamin C for an adult male; thus 40 mg is correct.

Question 42

Thiamine deficiency can manifest as?

Accepted Answer

Answer reason: Thiamine (vitamin B1) deficiency causes beriberi; the wet form leads to high-output cardiac failure. Gingival bleeding is from vitamin C deficiency, and mental retardation is not typical. Memory loss can occur in Wernicke–Korsakoff, but the classic manifestation is cardiac failure.

Question 43

The conditions caused by a deficiency of vitamin A?

Accepted Answer

Answer reason: Bitot's spots are a classic sign of vitamin A deficiency. Beriberi is due to thiamine (vitamin B1) deficiency, scurvy is due to vitamin C deficiency, and retrolental fibroplasia is associated with high oxygen exposure in preterm infants, not vitamin A deficiency.

Question 44

The first indicator of protein-energy malnutrition (PEM) in children is?

Accepted Answer

Answer reason: In PEM the earliest anthropometric change is a fall in weight-for-age due to acute loss of body mass. Weakness or reduced intake are nonspecific; overweight is opposite.

Question 45

What is the first clinical sign of vitamin A deficiency?

Accepted Answer

Answer reason: Night blindness is the earliest symptom, and the first clinical sign is conjunctival xerosis (X1A). Poor growth is nonspecific, hydrocephalus is unrelated, and phrynoderma occurs later as follicular hyperkeratosis.

Question 46

In kwashiorkor, the letter 'K' is postfixed to denote?

Accepted Answer

Answer reason: In the IAP classification of protein-energy malnutrition, a 'K' suffix denotes kwashiorkor, identified by the presence of edema.

Question 47

Marasmus disease is caused due to the deficiency of?

Accepted Answer

Answer reason: Marasmus is a form of severe protein-energy malnutrition resulting from overall deficiency of energy (calories) and protein.

Question 48

Which of following is precursor to vitamin A?

Accepted Answer

Answer reason: Beta-carotene is a provitamin A carotenoid that is converted in the body to retinol (vitamin A).

Question 49

The disease which is characterized by 3D's?

Accepted Answer

Answer reason: Pellagra (niacin deficiency) is classically described by the 3 Ds: dermatitis, diarrhea, and dementia.

Question 50

All are true regarding Vitamin A EXCEPT?

Accepted Answer

Answer reason: Vitamin A occurs in leafy greens (as provitamin A carotenoids), high doses in pregnancy are teratogenic, and supplementation reduces measles mortality. It is not an indicated therapy to reduce morbidity in diarrhea—zinc is, so this statement is false.

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