PALS Shock Management 3

Question 1

A child with known congenital heart disease develops cardiogenic shock. Which vasoactive agent is most appropriate to improve cardiac contractility?

Accepted Answer

Dobutamine

Answer

Dobutamine is a beta-1 agonist that increases myocardial contractility and is first-line for cardiogenic shock with preserved blood pressure.

Question 2

A 4-year-old with purpuric rash, fever, and hypotension most likely has which type of shock?

Accepted Answer

Septic (distributive) shock

Answer

Purpuric rash with fever and hemodynamic instability suggests meningococcemia causing septic shock, a form of distributive shock.

Question 3

Which hemodynamic pattern is characteristic of hypovolemic shock?

Accepted Answer

Low CO, high SVR

Answer

Hypovolemic shock causes reduced preload, leading to low cardiac output and compensatory increased systemic vascular resistance.

Question 4

A child in septic shock with fluid-refractory hypotension and suspected adrenal insufficiency should receive which additional treatment?

Accepted Answer

Hydrocortisone stress dosing

Answer

Hydrocortisone is indicated for catecholamine-resistant septic shock when adrenal insufficiency is suspected to restore vascular responsiveness.

Question 5

What is the target mean arterial pressure (MAP) goal when managing pediatric septic shock?

Accepted Answer

Age-appropriate normal MAP

Answer

MAP goals in pediatric septic shock should be age-appropriate, as normal MAP varies significantly from infants to adolescents.

PALS - Pediatric Advanced Life Support Practice Test