Pediatric Advanced Life support (PALS) 2022 Manual QUESTIONS WITH
COMPLETE SOLUTIONS
List 11 clinical signs of tissue hypoxia that indicate respiratory distress. Correct Answer: 1-
tachypnea
2-bradypnea (late)
3-apnea (late)
4-tachycardia (early)
5-bradycardia (late and ominous)
6-cyanosis (late)
7-pallor
8-nasal flaring
9-fatigue
10-agitation
11-altered mental status
The above were signs of what medical condition that can be immediately life threatening?
Explain difference between hypoxemia and tissue hypoxia. Correct Answer: 1-Hypoxemia is
low oxygen content in arterial blood. Initially measured with pulse oximetry.
2-Tissue hypoxia is low oxygen content in tissues other than arterial blood. There is no direct test
for measuring tissue hypoxia. We depend on clinical signs to detect this condition.
3-Hypoxemia and hypoxia are not mutually assured. You can have hypoxia without hypoxemia
and vica-versa,
Is hypoxia the same as hypercarbia? Correct Answer: No. HypOxIA and HypERCARBIA are
two different conditions. They have different clinical signs, but these signs do overlap, making
the use of ABG critical in differentiating the two conditions.
What blood test can be used to differentiate hypoxia from hypercarbia as causes of signs of
respiratory distress? Correct Answer: Arterial Blood Gas can pick up hypercarbia, but not
hypoxemia.
Compare signs of hypoxia and hypercarbia. Correct Answer: Hypoxia Hypercarbia
1-tachypnea 1-tachypnea
2-bradypnea (late)
3-apnea (late)
4-tachycardia (early)
5-bradycardia (late)
6-cyanosis (late)
7-pallor
8-nasal flaring 2-nasal flaring
9-fatigue 3-fatigue
10-agitation 4-agitation
11-altered mental status 5-altered mental status
, How is respiratory distress/failure categorized? Correct Answer: By severity (failure is more
severe by definition than distress)
By anatomic location of cause.
What are the possible anatomic sites causing respiratory distress? Correct Answer: 1-upper
airway
a-nose
b-pharynx
c-hypopharynx(=larynx)
2-lower airway
a-trachea
b-bronchi
c-bronchioles
3-Lung tissue
a-pneumonia
b-pulmonary edema
c-ARDS
4-Disordered respiratory control system
a-CNS
i-seizures
ii-Central Nervous System infections
iii-head injury
iv-hydrocephalus
v-brain tumor
vi-neuromuscular disease
1)-myasthenia gravis
2)-Lou Gehrig's disease/Amyotrophic lateral sclerosis
The above describe what?
Signs of upper airway obstruction (10)? Correct Answer: 1-tachypnea
2-increased respiratory effort
3-crying
4-change in voice ( hoarseness or "barky" cough)
5-stridor (usually inspiratory)
6-poor chest excursion (chest rise)
7-see-saw chest/abdominal motion on inspiration
8-poor air entry on auscultation
9-increased inspiratory respiratory effort ( inspiratory retractions, use of accessory muscles of
respiration, nasal flaring)
10-drooling, snoring or gurgling sounds
The above are signs of what condition or of what classification of cause of respiratory distress?
Signs of lower airway obstruction (6)? Correct Answer: 1-tachypnea
2-increased respiratory effort
COMPLETE SOLUTIONS
List 11 clinical signs of tissue hypoxia that indicate respiratory distress. Correct Answer: 1-
tachypnea
2-bradypnea (late)
3-apnea (late)
4-tachycardia (early)
5-bradycardia (late and ominous)
6-cyanosis (late)
7-pallor
8-nasal flaring
9-fatigue
10-agitation
11-altered mental status
The above were signs of what medical condition that can be immediately life threatening?
Explain difference between hypoxemia and tissue hypoxia. Correct Answer: 1-Hypoxemia is
low oxygen content in arterial blood. Initially measured with pulse oximetry.
2-Tissue hypoxia is low oxygen content in tissues other than arterial blood. There is no direct test
for measuring tissue hypoxia. We depend on clinical signs to detect this condition.
3-Hypoxemia and hypoxia are not mutually assured. You can have hypoxia without hypoxemia
and vica-versa,
Is hypoxia the same as hypercarbia? Correct Answer: No. HypOxIA and HypERCARBIA are
two different conditions. They have different clinical signs, but these signs do overlap, making
the use of ABG critical in differentiating the two conditions.
What blood test can be used to differentiate hypoxia from hypercarbia as causes of signs of
respiratory distress? Correct Answer: Arterial Blood Gas can pick up hypercarbia, but not
hypoxemia.
Compare signs of hypoxia and hypercarbia. Correct Answer: Hypoxia Hypercarbia
1-tachypnea 1-tachypnea
2-bradypnea (late)
3-apnea (late)
4-tachycardia (early)
5-bradycardia (late)
6-cyanosis (late)
7-pallor
8-nasal flaring 2-nasal flaring
9-fatigue 3-fatigue
10-agitation 4-agitation
11-altered mental status 5-altered mental status
, How is respiratory distress/failure categorized? Correct Answer: By severity (failure is more
severe by definition than distress)
By anatomic location of cause.
What are the possible anatomic sites causing respiratory distress? Correct Answer: 1-upper
airway
a-nose
b-pharynx
c-hypopharynx(=larynx)
2-lower airway
a-trachea
b-bronchi
c-bronchioles
3-Lung tissue
a-pneumonia
b-pulmonary edema
c-ARDS
4-Disordered respiratory control system
a-CNS
i-seizures
ii-Central Nervous System infections
iii-head injury
iv-hydrocephalus
v-brain tumor
vi-neuromuscular disease
1)-myasthenia gravis
2)-Lou Gehrig's disease/Amyotrophic lateral sclerosis
The above describe what?
Signs of upper airway obstruction (10)? Correct Answer: 1-tachypnea
2-increased respiratory effort
3-crying
4-change in voice ( hoarseness or "barky" cough)
5-stridor (usually inspiratory)
6-poor chest excursion (chest rise)
7-see-saw chest/abdominal motion on inspiration
8-poor air entry on auscultation
9-increased inspiratory respiratory effort ( inspiratory retractions, use of accessory muscles of
respiration, nasal flaring)
10-drooling, snoring or gurgling sounds
The above are signs of what condition or of what classification of cause of respiratory distress?
Signs of lower airway obstruction (6)? Correct Answer: 1-tachypnea
2-increased respiratory effort
