Question

Passage: A one and a half year old girl, fed mostly on dilute cow's milk, develops diarrhea that persists for 10 days. This is followed by swelling on her feet, and the likely diagnosis is Kwashiorkor.

One life-threatening complication of this condition is

• A. Hyperkalemia
• B. Hypernatremia
• C. Metabolic acidosis
• D. Hypoglycaemia

Hint:

Think about what 10 days of diarrhea does to the body's bicarbonate and acid base balance.

Answer 1

The Correct Option is C

This child has Kwashiorkor plus 10 days of diarrhea, a combination that puts real strain on the body's fluid and acid base balance. Let's weigh each option against that background.

1. Hyperkalemia: Diarrhea typically drains potassium out of the body through the stool, so these children usually trend toward low potassium, not high, making this an unlikely fit.
2. Hypernatremia: Prolonged diarrhea washes out both water and salt, and malnourished children commonly end up with low or near normal sodium rather than an excess, so this does not match well either.
3. Metabolic acidosis: Stool from long standing diarrhea carries away large amounts of bicarbonate, and a malnourished body has little reserve left to buffer or correct this loss. The combined effect is a build up of acid in the blood, which is exactly why this complication is highlighted in management guidelines for severe malnutrition.
4. Hypoglycaemia: This is a genuine risk in malnourished children too, since their glycogen stores run low, but the specific clue of ten days of ongoing diarrhea in this case points more directly at bicarbonate loss and acidosis as the complication being tested.

Given the heavy bicarbonate loss from prolonged diarrhea layered on top of a malnourished child's weak buffering capacity, metabolic acidosis is the complication that fits best.

Let's summarize:

• Long diarrhea drains bicarbonate from the gut.
• A malnourished child cannot buffer this loss well, so acid builds up in the blood.

So the life threatening complication here is metabolic acidosis.