PEDIATRIC ARDMS EXAM AND PRACTICE
EXAM NEWEST 2026/ 2027 TEST BANK|
PEDIATRIC ARDMS EXAM REVIEW WITH
COMPLETE 350 REAL EXAM QUESTIONS
AND CORRECT VERIFIED ANSWERS/
ALREADY GRADED A+ (MOST RECENT!!)
DOMAIN 1: NEONATAL BRAIN & NEUROSONOLOGY (Questions
1-40)
1. The germinal matrix, the site of origin for intraventricular hemorrhage (IVH) in
premature infants, is located in the:
• A. Frontal lobe
• B. Occipital lobe
• C. Caudothalamic groove
• D. Choroid plexus
Rationale: The germinal matrix is located in the caudothalamic groove. It is a highly
vascular, fragile structure in premature infants that is the primary site of origin for IVH .
2. A full-term neonate is being evaluated for suspected hypoxic-ischemic injury.
Which is the BEST approach for assessing this condition?
• A. Coronal scan only
• B. Sagittal scan only
• C. Both coronal and sagittal scans through the anterior fontanelle
• D. Transcranial Doppler only
,Rationale: Hypoxic-ischemic injury in neonates is best assessed using both coronal and
sagittal scans through the anterior fontanelle. This allows comprehensive evaluation of
the brain parenchyma, including periventricular white matter, basal ganglia, and cortex .
3. The choroid plexus normally appears ________ on ultrasound.
• A. Anechoic (black)
• B. Hyperechoic (bright)
• C. Hypoechoic (dark gray)
• D. Isoechoic (same as brain)
Rationale: The choroid plexus normally appears hyperechoic (bright) due to its vascular
nature and the presence of calcifications. This is a normal finding and should not be
confused with pathology .
4. A neonate with a history of prematurity is being evaluated for germinal matrix
hemorrhage. The hemorrhage is confined to the germinal matrix and does not
extend into the ventricles. This is classified as:
• A. Grade I IVH
• B. Grade II IVH
• C. Grade III IVH
• D. Grade IV IVH
Rationale: Grade I IVH is bleeding confined to the germinal matrix without
intraventricular extension .
5. A neonate with intraventricular hemorrhage that fills the ventricle without
dilation is classified as:
• A. Grade I
• B. Grade II
• C. Grade III
• D. Grade IV
Rationale: Grade II IVH involves blood filling the ventricle without causing ventricular
dilation .
6. The corpus callosum is BEST visualized on which scan plane?
• A. Coronal scan through the anterior fontanelle
• B. Sagittal scan through the anterior fontanelle
• C. Axial scan through the temporal bone
, • D. Mastoid fontanelle scan
Rationale: The corpus callosum is best visualized on a midline sagittal scan through the
anterior fontanelle. It appears as a thin, curved hypoechoic band .
7. A neonate is being evaluated for possible vein of Galen malformation. Which
Doppler finding would be expected?
• A. High-resistance flow in the vein of Galen
• B. Low-resistance flow with arterialization of the venous waveform
• C. Absent flow in the vein of Galen
• D. Reversed flow in the vein of Galen
Rationale: Vein of Galen malformation is a rare congenital arteriovenous malformation.
Doppler shows low-resistance flow with arterialization (pulsatile flow) due to direct
communication between arteries and veins .
8. The normal lateral ventricle width in a neonate should be:
• A. < 3 mm
• B. < 5 mm
• C. < 7 mm
• D. < 10 mm
Rationale: Normal lateral ventricle width in neonates is less than 3 mm. Measurement >
3 mm may indicate ventriculomegaly.
9. Periventricular leukomalacia (PVL) occurs in premature infants due to ischemia
in:
• A. The germinal matrix
• B. The "watershed" areas of perfusion
• C. The choroid plexus
• D. Areas of increased CSF production
Rationale: PVL occurs due to ischemia in the watershed areas of the periventricular
white matter, located between major cerebral arteries and particularly vulnerable to
hypoxia-ischemia in premature infants .
10. A neonate is being evaluated for possible subependymal cyst. Which finding is
characteristic?
• A. Anechoic cyst adjacent to the lateral ventricle
, • B. Hyperechoic mass in the lateral ventricle
• C. Dilated lateral ventricle
• D. Midline shift
Rationale: Subependymal cysts are located adjacent to lateral ventricles, typically in the
caudothalamic groove. They appear as anechoic (black) cysts and are often incidental
findings .
11. Which is the MOST common type of intracranial hemorrhage in full-term
neonates?
• A. Germinal matrix hemorrhage
• B. Subarachnoid hemorrhage
• C. Intraventricular hemorrhage
• D. Subdural hemorrhage
Rationale: Subarachnoid hemorrhage is the most common type of intracranial
hemorrhage in full-term neonates. Germinal matrix hemorrhage (IVH) is more common
in premature infants .
12. The best acoustic window for evaluating the posterior fossa in a neonate is the:
• A. Anterior fontanelle
• B. Posterior fontanelle
• C. Mastoid fontanelle
• D. Temporal bone
Rationale: The posterior fontanelle provides the best acoustic window for evaluating
the posterior fossa, including the cerebellum and fourth ventricle.
13. Dandy-Walker malformation is characterized by:
• A. Absence of the corpus callosum
• B. Cystic dilation of the fourth ventricle with vermian hypoplasia
• C. Enlargement of the lateral ventricles
• D. Hydrocephalus without posterior fossa abnormality
Rationale: Dandy-Walker malformation involves cystic dilation of the fourth ventricle,
vermian hypoplasia, and an enlarged posterior fossa.
14. Holoprosencephaly results from:
• A. Excess CSF production
EXAM NEWEST 2026/ 2027 TEST BANK|
PEDIATRIC ARDMS EXAM REVIEW WITH
COMPLETE 350 REAL EXAM QUESTIONS
AND CORRECT VERIFIED ANSWERS/
ALREADY GRADED A+ (MOST RECENT!!)
DOMAIN 1: NEONATAL BRAIN & NEUROSONOLOGY (Questions
1-40)
1. The germinal matrix, the site of origin for intraventricular hemorrhage (IVH) in
premature infants, is located in the:
• A. Frontal lobe
• B. Occipital lobe
• C. Caudothalamic groove
• D. Choroid plexus
Rationale: The germinal matrix is located in the caudothalamic groove. It is a highly
vascular, fragile structure in premature infants that is the primary site of origin for IVH .
2. A full-term neonate is being evaluated for suspected hypoxic-ischemic injury.
Which is the BEST approach for assessing this condition?
• A. Coronal scan only
• B. Sagittal scan only
• C. Both coronal and sagittal scans through the anterior fontanelle
• D. Transcranial Doppler only
,Rationale: Hypoxic-ischemic injury in neonates is best assessed using both coronal and
sagittal scans through the anterior fontanelle. This allows comprehensive evaluation of
the brain parenchyma, including periventricular white matter, basal ganglia, and cortex .
3. The choroid plexus normally appears ________ on ultrasound.
• A. Anechoic (black)
• B. Hyperechoic (bright)
• C. Hypoechoic (dark gray)
• D. Isoechoic (same as brain)
Rationale: The choroid plexus normally appears hyperechoic (bright) due to its vascular
nature and the presence of calcifications. This is a normal finding and should not be
confused with pathology .
4. A neonate with a history of prematurity is being evaluated for germinal matrix
hemorrhage. The hemorrhage is confined to the germinal matrix and does not
extend into the ventricles. This is classified as:
• A. Grade I IVH
• B. Grade II IVH
• C. Grade III IVH
• D. Grade IV IVH
Rationale: Grade I IVH is bleeding confined to the germinal matrix without
intraventricular extension .
5. A neonate with intraventricular hemorrhage that fills the ventricle without
dilation is classified as:
• A. Grade I
• B. Grade II
• C. Grade III
• D. Grade IV
Rationale: Grade II IVH involves blood filling the ventricle without causing ventricular
dilation .
6. The corpus callosum is BEST visualized on which scan plane?
• A. Coronal scan through the anterior fontanelle
• B. Sagittal scan through the anterior fontanelle
• C. Axial scan through the temporal bone
, • D. Mastoid fontanelle scan
Rationale: The corpus callosum is best visualized on a midline sagittal scan through the
anterior fontanelle. It appears as a thin, curved hypoechoic band .
7. A neonate is being evaluated for possible vein of Galen malformation. Which
Doppler finding would be expected?
• A. High-resistance flow in the vein of Galen
• B. Low-resistance flow with arterialization of the venous waveform
• C. Absent flow in the vein of Galen
• D. Reversed flow in the vein of Galen
Rationale: Vein of Galen malformation is a rare congenital arteriovenous malformation.
Doppler shows low-resistance flow with arterialization (pulsatile flow) due to direct
communication between arteries and veins .
8. The normal lateral ventricle width in a neonate should be:
• A. < 3 mm
• B. < 5 mm
• C. < 7 mm
• D. < 10 mm
Rationale: Normal lateral ventricle width in neonates is less than 3 mm. Measurement >
3 mm may indicate ventriculomegaly.
9. Periventricular leukomalacia (PVL) occurs in premature infants due to ischemia
in:
• A. The germinal matrix
• B. The "watershed" areas of perfusion
• C. The choroid plexus
• D. Areas of increased CSF production
Rationale: PVL occurs due to ischemia in the watershed areas of the periventricular
white matter, located between major cerebral arteries and particularly vulnerable to
hypoxia-ischemia in premature infants .
10. A neonate is being evaluated for possible subependymal cyst. Which finding is
characteristic?
• A. Anechoic cyst adjacent to the lateral ventricle
, • B. Hyperechoic mass in the lateral ventricle
• C. Dilated lateral ventricle
• D. Midline shift
Rationale: Subependymal cysts are located adjacent to lateral ventricles, typically in the
caudothalamic groove. They appear as anechoic (black) cysts and are often incidental
findings .
11. Which is the MOST common type of intracranial hemorrhage in full-term
neonates?
• A. Germinal matrix hemorrhage
• B. Subarachnoid hemorrhage
• C. Intraventricular hemorrhage
• D. Subdural hemorrhage
Rationale: Subarachnoid hemorrhage is the most common type of intracranial
hemorrhage in full-term neonates. Germinal matrix hemorrhage (IVH) is more common
in premature infants .
12. The best acoustic window for evaluating the posterior fossa in a neonate is the:
• A. Anterior fontanelle
• B. Posterior fontanelle
• C. Mastoid fontanelle
• D. Temporal bone
Rationale: The posterior fontanelle provides the best acoustic window for evaluating
the posterior fossa, including the cerebellum and fourth ventricle.
13. Dandy-Walker malformation is characterized by:
• A. Absence of the corpus callosum
• B. Cystic dilation of the fourth ventricle with vermian hypoplasia
• C. Enlargement of the lateral ventricles
• D. Hydrocephalus without posterior fossa abnormality
Rationale: Dandy-Walker malformation involves cystic dilation of the fourth ventricle,
vermian hypoplasia, and an enlarged posterior fossa.
14. Holoprosencephaly results from:
• A. Excess CSF production
