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DIAGNOSTIC MEDICAL SONOGRAPHER
(RDMS) – FETAL ECHOCARDIOGRAPHY
(FE) EXAM | QUESTIONS WITH ANSWERS
AND RATIONALES
1. What is the optimal gestational age for a
comprehensive fetal echocardiogram (evaluation of
cardiac structures)?
A) 18-22 weeks (typically 18-24 weeks)
B) 10-12 weeks
C) 28-32 weeks
D) 36-40 weeks
Correct answer: A
Rationale: 18-22 weeks is optimal for detailed fetal
cardiac imaging due to adequate fetal size and
amniotic fluid.
2. Which of the following is the first view obtained in a
standard fetal echocardiogram to assess situs?
A) Four-chamber view (apical or transverse)
B) Outflow tract view
,C) Three-vessel trachea (3VT) view
D) Aortic arch view
Correct answer: A
Rationale: The four-chamber view establishes
cardiac position, axis, and ventricular symmetry.
3. Which of the following is the normal cardiac axis
(orientation of the interventricular septum) in the fetal
chest?
A) 45° (±20°) relative to the midline, pointing to the
left
B) 90° (pointing straight)
C) 0° (parallel to midline)
D) 135° to the right
Correct answer: A
Rationale: Normal cardiac axis is approximately 45°
leftward; deviation suggests congenital heart disease
or mass effect.
4. Which of the following is the normal position of the
fetal heart (stomach, heart, and apex)?
A) Stomach on left, heart on left, apex pointing left
(levocardia)
,B) Stomach on right, heart on right, apex right
(dextrocardia)
C) Stomach on left, heart on right, apex right
(dextrocardia with situs inversus)
D) Stomach on right, heart on left, apex left
(mesocardia)
Correct answer: A
Rationale: Normal situs: stomach and heart both on
left, cardiac apex points left (levocardia).
5. Which of the following is a normal finding in the
four-chamber view?
A) Two symmetric ventricles, two atria, intact
interatrial and interventricular septum, crux of the
heart formed by the atrioventricular valves
B) Single ventricle
C) Ventricular septal defect
D) Atrial septal defect
Correct answer: A
Rationale: Normal four-chamber view shows
balanced ventricles, intact septa, and crossing
atrioventricular valves (crux).
, 6. Which of the following is the normal size ratio of the
right ventricle (RV) to left ventricle (LV) in the fetal
heart?
A) RV slightly larger than LV (RV:LV ratio
approximately 1:1 in mid-gestation, but RV may be
dominant in early gestation; normal 1:1 or RV 1.2:1)
B) LV twice the size of RV
C) RV twice the size of LV
D) Equal size (1:1)
Correct answer: D
Rationale: In mid-gestation (18-22 weeks), the
ventricles are approximately equal in size (1:1 ratio).
7. Which of the following is the normal appearance of
the fetal foramen ovale (flap valve) on the four-
chamber view?
A) Flap of tissue (septum primum) in the left atrium,
moving into the left atrium
B) A defect in the interatrial septum with no flap
C) Complete absence of septum
D) Aneurysmal septum
Correct answer: A
DIAGNOSTIC MEDICAL SONOGRAPHER
(RDMS) – FETAL ECHOCARDIOGRAPHY
(FE) EXAM | QUESTIONS WITH ANSWERS
AND RATIONALES
1. What is the optimal gestational age for a
comprehensive fetal echocardiogram (evaluation of
cardiac structures)?
A) 18-22 weeks (typically 18-24 weeks)
B) 10-12 weeks
C) 28-32 weeks
D) 36-40 weeks
Correct answer: A
Rationale: 18-22 weeks is optimal for detailed fetal
cardiac imaging due to adequate fetal size and
amniotic fluid.
2. Which of the following is the first view obtained in a
standard fetal echocardiogram to assess situs?
A) Four-chamber view (apical or transverse)
B) Outflow tract view
,C) Three-vessel trachea (3VT) view
D) Aortic arch view
Correct answer: A
Rationale: The four-chamber view establishes
cardiac position, axis, and ventricular symmetry.
3. Which of the following is the normal cardiac axis
(orientation of the interventricular septum) in the fetal
chest?
A) 45° (±20°) relative to the midline, pointing to the
left
B) 90° (pointing straight)
C) 0° (parallel to midline)
D) 135° to the right
Correct answer: A
Rationale: Normal cardiac axis is approximately 45°
leftward; deviation suggests congenital heart disease
or mass effect.
4. Which of the following is the normal position of the
fetal heart (stomach, heart, and apex)?
A) Stomach on left, heart on left, apex pointing left
(levocardia)
,B) Stomach on right, heart on right, apex right
(dextrocardia)
C) Stomach on left, heart on right, apex right
(dextrocardia with situs inversus)
D) Stomach on right, heart on left, apex left
(mesocardia)
Correct answer: A
Rationale: Normal situs: stomach and heart both on
left, cardiac apex points left (levocardia).
5. Which of the following is a normal finding in the
four-chamber view?
A) Two symmetric ventricles, two atria, intact
interatrial and interventricular septum, crux of the
heart formed by the atrioventricular valves
B) Single ventricle
C) Ventricular septal defect
D) Atrial septal defect
Correct answer: A
Rationale: Normal four-chamber view shows
balanced ventricles, intact septa, and crossing
atrioventricular valves (crux).
, 6. Which of the following is the normal size ratio of the
right ventricle (RV) to left ventricle (LV) in the fetal
heart?
A) RV slightly larger than LV (RV:LV ratio
approximately 1:1 in mid-gestation, but RV may be
dominant in early gestation; normal 1:1 or RV 1.2:1)
B) LV twice the size of RV
C) RV twice the size of LV
D) Equal size (1:1)
Correct answer: D
Rationale: In mid-gestation (18-22 weeks), the
ventricles are approximately equal in size (1:1 ratio).
7. Which of the following is the normal appearance of
the fetal foramen ovale (flap valve) on the four-
chamber view?
A) Flap of tissue (septum primum) in the left atrium,
moving into the left atrium
B) A defect in the interatrial septum with no flap
C) Complete absence of septum
D) Aneurysmal septum
Correct answer: A
