Pathology · single question
A 9-year-old recently adopted child presents with a geographic tongue and diffuse swelling of the tongue. The MOST likely underlying cause is:
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Correct answer: A. Malnutrition
Malnutrition is the most likely cause in a recently adopted child from potentially resource-limited circumstances. Nutritional deficiencies (especially B vitamins — B12, folate, iron) can cause glossitis, geographic tongue, and macroglossia/tongue swelling. The clinical context (recently adopted, 20 kg at 9 years old — likely underweight) strongly points to nutritional deficiency as the systemic cause.
- A. ✅ CORRECT – In a recently adopted child with potential nutritional deficiency, malnutrition (especially B-vitamin deficiency) explains geographic tongue and tongue swelling.
- B. ❌ Hypothyroidism causes macroglossia and developmental delay — possible but malnutrition is more likely in this specific context.
- C. ❌ While geographic tongue is often idiopathic, the clinical context (recently adopted, likely malnourished) suggests a nutritional etiology.
- D. ❌ Allergic reaction typically presents acutely with angioedema, urticaria, or systemic symptoms — not chronic geographic tongue with diffuse swelling.