PALS COMPREHENSIVE REVIEW 2026
VERIFIED QUESTIONS AND SOLUTIONS
◉What are the signs of instability in a patient with arrhythmias?
Answer: Respiratory distress or failure
Shock with poor end-organ perfusion, may occur with or without
hypotension
Irritability or decreased level of consciousness
Irritability or decreased level of consciousness
chest pain or vague feeling of discomfort in older children
sudden collapse
◉Priorities in initially managing arrhythmias are? Answer: The
same as they are for all critically ill children: Support ABC and treat
underlying cause
,◉Bradycardia Answer: A heart rate that is slow in comparison with
a normal heart rate range for the childs age, level of activity and
clinical condition
◉What is the leading cause of symptomatic bradycardia in children?
Answer: Tissue hypoxia
◉Symptomatic Bradycardia Answer: Heart rate below 60/min
associated with cardiopulmonary compromise
◉Cardiopulmonary compromise Answer: * Hypotension
* Acutely altered mental status
* Signs of shock
◉Bradycardia is an ominous sign of? Answer: Sign of impending
cardiac arrest in infants and children. Especially if hypotension or
poor tissue perfusion is present
◉Children with severe cardiovascular compromise from pulmonary
embolism, what treatment should be considered? Answer:
Fibrinolytic agents
, ◉What is the initial treatment of pediatric bradycardia with
cardiopulmonary compromise? Answer: Bag mask ventilation with
100% O2
◉Fibrinolytic agents Answer: tissue plasminogen activator,
streptokinase, reteplase tenecteplase
◉Primary bradycardia Answer: A result of congenital or acquired
heart conditions
◉Causes of primary bradycardia Answer: Congenital abnormality of
the heart pacemaker or conduction system
Surgical injury to the pacemaker or conduction system
Cardiomyopathy
Myocarditis
◉Secondary bradycardia Answer: Result of noncardiac conditions
that alter the normal function of the heart (Slow sinus node
pacemaker or slow conduction)
◉secondary bradycardia causes Answer: Hypoxia
VERIFIED QUESTIONS AND SOLUTIONS
◉What are the signs of instability in a patient with arrhythmias?
Answer: Respiratory distress or failure
Shock with poor end-organ perfusion, may occur with or without
hypotension
Irritability or decreased level of consciousness
Irritability or decreased level of consciousness
chest pain or vague feeling of discomfort in older children
sudden collapse
◉Priorities in initially managing arrhythmias are? Answer: The
same as they are for all critically ill children: Support ABC and treat
underlying cause
,◉Bradycardia Answer: A heart rate that is slow in comparison with
a normal heart rate range for the childs age, level of activity and
clinical condition
◉What is the leading cause of symptomatic bradycardia in children?
Answer: Tissue hypoxia
◉Symptomatic Bradycardia Answer: Heart rate below 60/min
associated with cardiopulmonary compromise
◉Cardiopulmonary compromise Answer: * Hypotension
* Acutely altered mental status
* Signs of shock
◉Bradycardia is an ominous sign of? Answer: Sign of impending
cardiac arrest in infants and children. Especially if hypotension or
poor tissue perfusion is present
◉Children with severe cardiovascular compromise from pulmonary
embolism, what treatment should be considered? Answer:
Fibrinolytic agents
, ◉What is the initial treatment of pediatric bradycardia with
cardiopulmonary compromise? Answer: Bag mask ventilation with
100% O2
◉Fibrinolytic agents Answer: tissue plasminogen activator,
streptokinase, reteplase tenecteplase
◉Primary bradycardia Answer: A result of congenital or acquired
heart conditions
◉Causes of primary bradycardia Answer: Congenital abnormality of
the heart pacemaker or conduction system
Surgical injury to the pacemaker or conduction system
Cardiomyopathy
Myocarditis
◉Secondary bradycardia Answer: Result of noncardiac conditions
that alter the normal function of the heart (Slow sinus node
pacemaker or slow conduction)
◉secondary bradycardia causes Answer: Hypoxia
