Downs Syndrome

Question 1

What is Down’s Syndrome also known as?

Answer 1

Trisomy 21

Question 2

What does the mnemonic ‘Always Anticipate Cardiac Risks, Neurological Patients Get Increased Infection’ represent?

Answer 2

Key considerations for Down’s syndrome patients

Question 3

List three airway considerations for Down’s syndrome patients.

Answer 3

• Macroglossia
• Mandibular hypoplasia
• Subglottic stenosis

Question 4

What is macroglossia?

Answer 4

Large tongue that complicates airway obstruction and mask ventilation

Question 5

What is atlanto-axial instability?

Answer 5

Excessive movement at the junction between the first and second cervical vertebrae (C1-C2)

Question 6

True or False: Up to 15% of Down’s syndrome patients have atlanto-axial instability.

Answer 6

True

Question 7

What are common congenital heart defects found in Down’s syndrome patients?

Answer 7

• Atrioventricular septal defects (AVSD)
• Ventricular septal defects (VSD)
• Atrial septal defects (ASD)
• Patent ductus arteriosus (PDA)

Question 8

What is a significant respiratory consideration for Down’s syndrome patients?

Answer 8

Increased susceptibility to respiratory complications

Question 9

What is the impact of hypotonia on Down’s syndrome patients’ respiratory function?

Answer 9

Leads to ineffective cough and poor airway clearance

Question 10

Fill in the blank: Patients with Down’s syndrome may have increased sensitivity to _______.

Answer 10

[sedatives and opioids]

Question 11

What gastrointestinal condition is common in Down’s syndrome patients?

Answer 11

Gastroesophageal reflux disease (GERD)

Question 12

What is a key infection risk for patients with Down’s syndrome?

Answer 12

Higher susceptibility to perioperative infections

Question 13

What should be considered during the preoperative assessment of Down’s syndrome patients?

Answer 13

• Airway management
• Cardiovascular evaluation
• Respiratory status optimization

Question 14

What are two considerations for pharmacology in Down’s syndrome patients?

Answer 14

• Increased sensitivity to sedatives and opioids
• Higher risk of respiratory depression

Question 15

True or False: Down’s syndrome patients typically have a lower risk of aspiration during anesthesia.

Answer 15

False

Question 16

What is the importance of monitoring in patients with significant cardiac disease during anesthesia?

Answer 16

To assess pulmonary hypertension and avoid complications

Question 17

List two airway management tips for Down’s syndrome patients.

Answer 17

• Use a smaller-than-usual endotracheal tube size
• Consider awake fiberoptic intubation if difficult airway is anticipated

Question 18

What is the role of preoperative antibiotics in Down’s syndrome patients?

Answer 18

To reduce the risk of perioperative infections

Question 19

What are the effects of developmental delay on anesthesia in Down’s syndrome patients?

Answer 19

May affect cooperation during preoperative assessments

Question 20

What should be avoided in patients with atlanto-axial instability during intubation?

Answer 20

Excessive neck manipulation

Question 21

What can chronic constipation in Down’s syndrome patients lead to?

Answer 21

Increased risk of aspiration due to delayed gastric emptying

Question 22

What should be done during postoperative care for respiratory function in Down’s syndrome patients?

Answer 22

Consider monitoring in a high-dependency unit (HDU) or intensive care setting

Question 23

What is the recommended approach for titrating sedatives and opioids in Down’s syndrome patients?

Answer 23

Start with lower doses and titrate slowly