Medical Conditions

Question 1

What are the factors associated with retinopathy in paediatric anaesthesia

Answer 1

1. Prematurity (<31/40)
2. LBW (<1250g)
3. Hyperoxia
4. Hypoxia
5. Low IGF-1
6. Hyperglycaemia

Question 2

Classify thalassaemia and what are the important considerations for paediatric anaesthesia

Answer 2

Hb is made up of: 2 x alpha and 2 x beta globin chains and a Fe containing haem molecule

One gene for alpha defective = a thalassaemia minor
Two genes for alpha def. = a thalasaemia major

One gene for beta defective = b thal. minor
Two genes for beta defective = b thal. major

NB: As HbF is replaced by HbA in the first year of life, patients with Thalassaemia major –> haemolysis, jaundice and anaemia.
- Rx multiple blood transfusions –? good prognosis
- No blood transufusions death first years of life
- Rx with bone marrow transplant successful only with close match from first degree relative