PEDIATRIC ARDMS EXAM TEST BANK ACTUAL 2026/2027
PRACTICE QUESTIONS AND STUDY GUIDE COMPLETE
ACCURATE EXAM APPROVED QUESTIONS AND
CORRECT DETAILED ANSWERS WITH RATIONALES
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1. A 6-month-old infant presents with a palpable right upper
quadrant mass, jaundice, and acholic stools. Sonographic evaluation
reveals a cystic structure at the porta hepatis, separate from the
gallbladder, communicating with the intrahepatic bile ducts. What is
the most likely diagnosis?
A) Choledochal cyst
B) Biliary atresia
C) Caroli disease
D) Hepatic hemangioma
Correct Answer: B) Biliary atresia
Rationale: The clinical presentation of a palpable right upper
quadrant mass, jaundice, and acholic stools in a neonate or young
,infant is highly suspicious for biliary atresia. Sonographic findings
include the "triangular cord" sign (echogenic fibrous tissue at the
porta hepatis) and an absent or small, non-distended gallbladder.
While a choledochal cyst also presents with a cystic mass and
jaundice, it typically communicates with the biliary tree, whereas the
cyst in biliary atresia is a fibrous remnant. The key differentiator is
the presence of the triangular cord sign and non-visualization of the
common bile duct. Caroli disease involves cystic dilatation of the
intrahepatic ducts, and hepatic hemangiomas are vascular lesions
that are typically hyperechoic or hypoechoic, not simple cysts at the
porta hepatis .
2. A 2-year-old child presents with recurrent urinary tract infections
and a palpable left flank mass. A renal ultrasound reveals a large,
solid, heterogeneous mass in the left kidney with areas of necrosis
and calcification. The contralateral kidney appears normal. What is
the most likely diagnosis?
A) Hydronephrosis
B) Neuroblastoma
C) Renal cell carcinoma
D) Wilms tumor (nephroblastoma)
Correct Answer: D) Wilms tumor (nephroblastoma)
,Rationale: Wilms tumor is the most common primary renal
malignancy in children, typically presenting between 2 and 5 years of
age with a palpable abdominal/flank mass. Sonographically, it
appears as a large, solid, heterogeneous mass that may contain areas
of necrosis, hemorrhage, or calcification. In contrast, neuroblastoma
often displaces the kidney and is more likely to encase vessels.
Hydronephrosis would show a dilated collecting system. Renal cell
carcinoma is exceptionally rare in this age group, and its
presentation is typically different, often being more focal and less
commonly presenting as a large, heterogeneous mass causing a
palpable flank mass in a toddler.
3. A newborn is diagnosed with a suspected spinal dysraphism. An
ultrasound of the spine is performed through the open posterior
fontanelle and any bony defects. Which of the following findings on
ultrasound would be most indicative of a tethered cord?
A) A normal conus medullaris ending at the L3 level
B) A conus medullaris terminating below the L2-L3 level
C) The presence of a prominent filum terminale
D) A completely normal spinal ultrasound with no visible
abnormalities
Correct Answer: B) A conus medullaris terminating below the L2-L3
level
, Rationale: In a neonate, the conus medullaris typically ends at the
level of L2 or L3. A conus level below L3 is a key indicator of a
tethered cord, which may be associated with spinal dysraphism. The
filum terminale is a normal structure, but it can appear prominent in
some cases. However, the gold standard sonographic finding for a
tethered cord is an abnormally low-lying conus. A completely
normal study would rule out the most common causes of a tethered
cord.
4. A 4-year-old with a history of prematurity presents with
developmental delay and a progressive increase in head
circumference. A cranial ultrasound is performed through the
anterior fontanelle. The images demonstrate enlarged lateral
ventricles with a "bat wing" appearance on the coronal view and
periventricular echogenicity. What is the most likely diagnosis?
A) Subdural hematoma
B) Dandy-Walker malformation
C) Periventricular leukomalacia (PVL)
D) Hydrocephalus
Correct Answer: C) Periventricular leukomalacia (PVL)
Rationale: PVL is a form of white matter brain injury that occurs in
premature infants, often leading to motor deficits and developmental
delay. On cranial ultrasound, PVL appears as periventricular
PRACTICE QUESTIONS AND STUDY GUIDE COMPLETE
ACCURATE EXAM APPROVED QUESTIONS AND
CORRECT DETAILED ANSWERS WITH RATIONALES
(100%CORRECT VERIFIED SOLUTIONS) CURRENTLY
UPDATED VERSION 2026 EDITION |GUARANTEED
SUCCESS A+ |JUST RELEASED
1. A 6-month-old infant presents with a palpable right upper
quadrant mass, jaundice, and acholic stools. Sonographic evaluation
reveals a cystic structure at the porta hepatis, separate from the
gallbladder, communicating with the intrahepatic bile ducts. What is
the most likely diagnosis?
A) Choledochal cyst
B) Biliary atresia
C) Caroli disease
D) Hepatic hemangioma
Correct Answer: B) Biliary atresia
Rationale: The clinical presentation of a palpable right upper
quadrant mass, jaundice, and acholic stools in a neonate or young
,infant is highly suspicious for biliary atresia. Sonographic findings
include the "triangular cord" sign (echogenic fibrous tissue at the
porta hepatis) and an absent or small, non-distended gallbladder.
While a choledochal cyst also presents with a cystic mass and
jaundice, it typically communicates with the biliary tree, whereas the
cyst in biliary atresia is a fibrous remnant. The key differentiator is
the presence of the triangular cord sign and non-visualization of the
common bile duct. Caroli disease involves cystic dilatation of the
intrahepatic ducts, and hepatic hemangiomas are vascular lesions
that are typically hyperechoic or hypoechoic, not simple cysts at the
porta hepatis .
2. A 2-year-old child presents with recurrent urinary tract infections
and a palpable left flank mass. A renal ultrasound reveals a large,
solid, heterogeneous mass in the left kidney with areas of necrosis
and calcification. The contralateral kidney appears normal. What is
the most likely diagnosis?
A) Hydronephrosis
B) Neuroblastoma
C) Renal cell carcinoma
D) Wilms tumor (nephroblastoma)
Correct Answer: D) Wilms tumor (nephroblastoma)
,Rationale: Wilms tumor is the most common primary renal
malignancy in children, typically presenting between 2 and 5 years of
age with a palpable abdominal/flank mass. Sonographically, it
appears as a large, solid, heterogeneous mass that may contain areas
of necrosis, hemorrhage, or calcification. In contrast, neuroblastoma
often displaces the kidney and is more likely to encase vessels.
Hydronephrosis would show a dilated collecting system. Renal cell
carcinoma is exceptionally rare in this age group, and its
presentation is typically different, often being more focal and less
commonly presenting as a large, heterogeneous mass causing a
palpable flank mass in a toddler.
3. A newborn is diagnosed with a suspected spinal dysraphism. An
ultrasound of the spine is performed through the open posterior
fontanelle and any bony defects. Which of the following findings on
ultrasound would be most indicative of a tethered cord?
A) A normal conus medullaris ending at the L3 level
B) A conus medullaris terminating below the L2-L3 level
C) The presence of a prominent filum terminale
D) A completely normal spinal ultrasound with no visible
abnormalities
Correct Answer: B) A conus medullaris terminating below the L2-L3
level
, Rationale: In a neonate, the conus medullaris typically ends at the
level of L2 or L3. A conus level below L3 is a key indicator of a
tethered cord, which may be associated with spinal dysraphism. The
filum terminale is a normal structure, but it can appear prominent in
some cases. However, the gold standard sonographic finding for a
tethered cord is an abnormally low-lying conus. A completely
normal study would rule out the most common causes of a tethered
cord.
4. A 4-year-old with a history of prematurity presents with
developmental delay and a progressive increase in head
circumference. A cranial ultrasound is performed through the
anterior fontanelle. The images demonstrate enlarged lateral
ventricles with a "bat wing" appearance on the coronal view and
periventricular echogenicity. What is the most likely diagnosis?
A) Subdural hematoma
B) Dandy-Walker malformation
C) Periventricular leukomalacia (PVL)
D) Hydrocephalus
Correct Answer: C) Periventricular leukomalacia (PVL)
Rationale: PVL is a form of white matter brain injury that occurs in
premature infants, often leading to motor deficits and developmental
delay. On cranial ultrasound, PVL appears as periventricular
