Which of the following statements is true regarding kwashiorkor? 1. Occurs with a long-term loss of protein. 2. Often causes facial and limb edema. 3. Child often has a pot belly. 4. May occur in combination with marasmus

a. 1, 2, and 3 only
b. 2 and 3 only
c. 2, 3, and 4 only
d. 1 and 4 only

ANS: C
Kwashiorkor results from the more sudden lack of protein and calories, as in the first-born infant weaned suddenly on the arrival of a new sibling, when a diet of nutrient-rich breast milk is trad-ed for a nutrient-poor cereal-based diet. The protruding belly and edematous face and limbs, characteristics of kwashiorkor, result from a lack of circulating proteins needed to maintain fluid balance and to transport fat out of the liver.