Discuss the metabolic changes in fever and the dietary management of typhoid.

1. 1 · Open in two lines. Fever is a rise in body temperature above normal. It raises nutrient needs while lowering appetite.
2. 2 · Types of fever. Acute and chronic; continuous, intermittent and remittent, with one example each.
3. 3 · Metabolic changes. BMR up 13% per 1 °C, glycogen depletion, protein breakdown, water and salt loss, vitamin needs up.
4. 4 · Typhoid: cause and symptoms.
   • Salmonella Typhi through food and water.
   • Step-ladder fever, coated tongue, abdominal pain, rose spots, ileal ulcers.
5. 5 · Draw a fever chart. [Graph: temperature rising step by step over 7 days, then staying high]
6. 6 · Diet principles and menu. Energy calculation, high protein, moderate emulsified fat, low residue, 2.5-3 L fluid, small 2-3-hourly feeds; one-day menu.
7. 7 · Close in one line. Feeding the fever well shortens recovery and prevents wasting.

Scoring tip: Show one energy calculation with the 13% rule; it turns a descriptive answer into a scoring one.