PRACTICE QUESTIONS
SECTION 1: NEONATAL BRAIN & CRANIAL SONOGRAPHY
1. According to the current ARDMS content outline, which domain
accounts for the largest percentage of questions on the Pediatric
Sonography (PS) exam?
A. Anatomy and Physiology
B. Congenital Variants, Pathology, and Pathophysiology
C. Data and Protocols
D. Physics and Instrumentation
Correct Answer: B
Rationale: The ARDMS Pediatric Sonography examination content
outline specifies that "Congenital Variants, Pathology, and
Pathophysiology" accounts for 45% of the exam, making it the
single largest domain . "Anatomy and Physiology" comprises 26%,
"Data and Protocols" 19%, and the combined "Physics and
Instrumentation" and "Treatment and Emerging Technologies"
domains each account for only 5% .
,2. During a neonatal cranial ultrasound through the anterior
fontanelle, the sonographer identifies echogenic material within
the caudothalamic groove. What should be suspected?
A. Periventricular leukomalacia
B. Germinal matrix hemorrhage
C. Agenesis of the corpus callosum
D. Hydrocephalus
Correct Answer: B
Rationale: The caudothalamic groove is the classic location for
germinal matrix hemorrhage in premature infants. The germinal
matrix is highly vascular and particularly vulnerable to
hemorrhage in this population .
3. A premature infant has a grade III intraventricular hemorrhage.
What does this grade indicate?
A. Hemorrhage confined to germinal matrix
B. Hemorrhage within the ventricles with ventricular dilation
C. Hemorrhage with parenchymal involvement
D. Hemorrhage with hydrocephalus
Correct Answer: B
Rationale: Papile grade III IVH is defined as intraventricular
hemorrhage with ventriculomegaly. Grade I is confined to the
subependymal germinal matrix; Grade II is intraventricular without
dilation; Grade IV adds intraparenchymal involvement .
,4. Which sonographic finding is characteristic of periventricular
leukomalacia (PVL)?
A. Increased periventricular echogenicity
B. Decreased periventricular echogenicity
C. Ventricular dilation
D. Corpus callosum agenesis
Correct Answer: A
Rationale: PVL appears initially as increased periventricular white
matter echogenicity, often progressing to cystic changes over 2-4
weeks. It is a hypoxic-ischemic injury commonly seen in
premature infants .
5. Which cranial ultrasound finding is associated with agenesis of
the corpus callosum?
A. Parallel, widely separated lateral ventricles
B. Dilated third ventricle
C. Normal cavum septum pellucidum
D. Cerebellar hypoplasia
Correct Answer: A
Rationale: Agenesis of the corpus callosum results in parallel,
widely separated lateral ventricles (colpocephaly) and absence of
, the cavum septum pellucidum. A "sun-ray" or radial gyral pattern
may also be seen .
6. A newborn with a suspected vein of Galen malformation is
evaluated. Which finding is expected on ultrasound?
A. Anechoic midline mass with turbulent flow
B. Hyperechoic midline mass without flow
C. Multiple small cysts
D. Ventricular collapse
Correct Answer: A
Rationale: A vein of Galen malformation appears as an anechoic
midline structure with high-velocity turbulent flow on Doppler. It
is an arteriovenous malformation .
7. What is the most common cause of congenital hydrocephalus?
A. Aqueductal stenosis
B. Dandy-Walker malformation
C. UPJ obstruction
D. Chiari malformation
Correct Answer: C
Rationale: UPJ obstruction is identified as the #1 cause of
congenital hydrocephalus in pediatric sonography test materials .