This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Pediatrics
All are true regarding Kwashiorkar except – 
Select and explain. 
A. Fatty liver, B. Edema, C. Megaloblastic anemia not responding to folic acid, D. Bitot's spot
C: Megaloblastic anemia not responding to folic acid
Answer: C: Megaloblastic anemia not responding to folic acid 
Explanation: Megaloblastic anemia due to folic acid deficiency responds well to folic acid supplementation.

Associated nutritional deficiencies in PEM

Iron deficiency → Anemia (Microcytic hypochromic)
Folate & Vit B12 deficiency → Anemia (megaloblastic).
Vit A deficiency →  Xeropthalmia (Night blindness, conjuctival xerosis, 'Bitot's spot, corneal xerosis, keratomalacia).
Vit B2 deficiency → Ariboflavinosis. 
Vit C deficiency → Scurvy
Vit D deficiency → Skeletal changes of rickets may not be clinically overt as no growth is occurring during malnutrition (Rickets is a disease of growing skeleton). Rickets becomes evident during Dietary therapy, when skeleton starts growing again → Paradoxical rickets.