Kwashiorkor is most directly diagnosed by which finding?

• A. Marasmus
• B. Kwashiorkor
• C. Mixed state
• D. Cachexia

Answer: (B)

Kwashiorkor is identified most directly by edema due to severe protein deficiency. When protein intake is very low, plasma albumin falls, lowering oncotic pressure and causing fluid to accumulate in interstitial spaces, leading to edema (often with an enlarged fatty liver). This edema is the hallmark that distinguishes kwashiorkor from marasmus, which presents with wasting but little or no edema. Cachexia and mixed states involve wasting from illness or a combination of factors and do not show the characteristic edema of kwashiorkor. Recognizing edema as the defining sign points to kwashiorkor, making this the best choice.