Clinic and Biochem - Protein and General Appearance

• Apathy is a sign of malnutrition that happens in a child when they become unreactive, unresponsive, disinterested, and inattentive to their surroundings.
• Irritability is a sign of malnutrition in general appearance that happens in a child wherein they become hyperresponsive, excessive or overreaction to minor stimuli, particularly manifest through crying or unusual indication of fear as a result of minor or relatively insignificant happenings.
• Clinical marasmus is a sign of malnutrition in general appearance wherein a child is pronounced wasting of subcutaneous fat without edema, apathy may be present and a child is underdeveloped in relation to age.
• Kwashiorkor is a sign of malnutrition that happens in the general appearance of a child. They have pitting edema, is underweight, undersize, and underdeveloped for age, their hair becomes thin, easily pluckable with flag sign and there's changes in texture to silken, sparse hair.
• Pallor is a sign of malnutrition that happens in the general appearance of a child where there's paleness and loss of color of skin, nail buds, mucosa, and lips.
• Musculo-skeletal hemorrhages is a sign associated with malnutrition in the muscular system where there's bleeding into muscles.
• Muscle wasting is a sign associated with malnutrition in the muscular system that is exhibited by unusual prominence of bone skeleton, undue degree of folding of the skin of the buttocks, or the abnormal flabby feel of the child with poor muscle tone. It is also associated with starvation, marasmus
• In Protein-Energy Malnutrition, Kwashiorkor results from a diet grossly deficient in protein, which means “sickness of the older child when the next baby is born”, occurs after breastfeeding stops, the child is weaned into a starchy diet and mostly in children 1 to 3 years of age
• Signs of Kwashiorkor


  • Hair: scanty and discolored and tends to be reddish or greyish, with weak roots
  • Face: puffy (moon face)
  • Short for his age
• Marasmus results from a diet severely lacking in calories, the diet is also low in protein, fats, and carbohydrates. It is a Greek word meaning “wasting”. It is characterized by a wizened old man’s face or “monkey” face that is due to inadequate breastfeeding or improper (diluted) milk formula and mostly in children below 3 years old.
• Marasmic kwashiorkor is the third form of protein-energy malnutrition that combines features and symptoms of both marasmus and kwashiorkor. The child’s upper body is wasted, but the lower limbs are swollen with edema.
• Dyspigmentation/Depigmentation is a physical sign where there's a definite change from normal pigment of the hair, includes both change of pigment usually lightening of color, is a flag sign and is associated with niacin deficiency.
• Easily Pluckable is a physical sign of the hair where the shafts are readily removed when a few strands are grasped between the finger and thumb and gently pulled. It is also associated with protein deficiency.
• Sparse is a physical sign of the hair that is associated with protein, biotin and zinc deficiency; and consider excess of Vitamin A
• Dependent edema is a sign associated with malnutrition present in the skin where there's the presence of abnormally large amounts of fluid in the intercellular tissue spaces of the body
• Dermatitis is a sign associated with malnutrition present in the skin where it has desquamation or crazy-pavement type, inflamed, associated kwashiorkor, and protein deficiency.
• Follicular hyperkeratosis is a sign present in the skin where it mimics a sandpaper feel and is similar to gooseflesh which is seen on chilling and associated with deficiency of Vitamin A and C.
• Pellagrous dermatitis is a sign present in the skin where there are symmetrical lesions typical of acute or chronic, mild or severe pellagra, lesions are red, often swollen or blistered skin, and associated with Niacin deficiency
• Purpura or petechiae is a sign present in the skin where there's small localized extravasations of blood that are red or purplish in color.
• Petechiae are smaller lesions that are associated with ascorbic acid deficiency Purpura are larger lesions associated with Vitamin C and K deficiency
• Xerosis - Clinical term used to describe a dry and crinkled skin
• Dyspigmentation - Excessive lightness or darkness of skin and Associated with niacin deficiency