Pediatric ARDMS Exam Review 2026/2027 — Complete Test Bank & Study
Guide
350 Board-Style Questions with Verified Answers & Detailed Rationales
Introduction
SECTION 1: NEONATAL HEAD & SPINE (50 Questions)
1. A neonate is being evaluated for possible hydrocephalus. What is the
most common cause of congenital hydrocephalus?
A) Aqueductal stenosis
B) Dandy-Walker malformation
C) Arnold-Chiari malformation
D) Choroid plexus papilloma
Answer A: — Aqueductal stenosis
Rationale: Aqueductal stenosis is the most common cause of congenital
hydrocephalus, accounting for approximately 20% of cases. It involves
narrowing of the cerebral aqueduct (aqueduct of Sylvius), obstructing CSF flow
,from the third to fourth ventricle. Dandy-Walker malformation and Chiari
malformations are also causes but less common. ---
2. A 3-day-old infant presents with a sacral dimple, a skin tag, and an
abnormal patch of hair on the lower back. These findings are collectively
known as:
A) Overt spinal dysraphism
B) Dorsal stigmata
C) Diastematomyelia
D) Lipomeningocele
Answer B: — Dorsal stigmata
Rationale: Dorsal stigmata are cutaneous markers seen with occult spinal
dysraphism and include sacral dimples, skin tags, and abnormal hair growth
(hypertrichosis). These markers prompt spinal ultrasound to evaluate for
underlying occult spinal dysraphism. ---
3. A sagittal cleft is present in the spinal cord, causing it to divide into two
hemicords. This condition is termed:
A) Lipomyelomeningocele
B) Myelomeningocele
C) Diastematomyelia
,D) Tethered cord
Answer C: — Diastematomyelia
Rationale: Diastematomyelia is defined as a sagittal cleft in the spinal cord
that divides it into two hemicords. It may be associated with a bony or fibrous
septum. Lipomyelomeningocele and myelomeningocele are forms of spinal
dysraphism, and tethered cord is a general term for abnormal cord fixation. ---
4. Myelocele and myelomeningocele are types of:
A) Occult spinal dysraphism
B) Overt spinal dysraphism
C) Dorsal stigmata
D) Closed spinal defects
Answer B: — Overt spinal dysraphism
Rationale: Myelocele and myelomeningocele are non-skin-covered defects,
classifying them as overt spinal dysraphism. Occult spinal dysraphism involves
skin-covered defects like lipomas and tethered cord. ---
5. In a Papile grade I germinal matrix hemorrhage, where is the bleed
located?
A) Subependymal/caudothalamic groove
B) Within lateral ventricles without dilation
, C) Within ventricles with ventriculomegaly
D) Intraparenchymal extension
Answer A: — Subependymal/caudothalamic groove
Rationale: Papile grade I IVH is confined to the subependymal germinal matrix
at the caudothalamic groove and does not extend into the ventricle. This is
the mildest form of germinal matrix hemorrhage. ---
6. A neonatal head ultrasound shows blood within the lateral ventricle with
ventricular dilation. What is the Papile IVH grade?
A) Grade I
B) Grade II
C) Grade III
D) Grade IV
Answer C: — Grade III
Rationale: Papile grade III is intraventricular hemorrhage with
ventriculomegaly. Grade IV adds intraparenchymal involvement
(periventricular hemorrhagic infarction). ---
7. Periventricular leukomalacia (PVL) initially appears on neonatal
ultrasound as which finding?
A) Echogenic ventricular casts
Guide
350 Board-Style Questions with Verified Answers & Detailed Rationales
Introduction
SECTION 1: NEONATAL HEAD & SPINE (50 Questions)
1. A neonate is being evaluated for possible hydrocephalus. What is the
most common cause of congenital hydrocephalus?
A) Aqueductal stenosis
B) Dandy-Walker malformation
C) Arnold-Chiari malformation
D) Choroid plexus papilloma
Answer A: — Aqueductal stenosis
Rationale: Aqueductal stenosis is the most common cause of congenital
hydrocephalus, accounting for approximately 20% of cases. It involves
narrowing of the cerebral aqueduct (aqueduct of Sylvius), obstructing CSF flow
,from the third to fourth ventricle. Dandy-Walker malformation and Chiari
malformations are also causes but less common. ---
2. A 3-day-old infant presents with a sacral dimple, a skin tag, and an
abnormal patch of hair on the lower back. These findings are collectively
known as:
A) Overt spinal dysraphism
B) Dorsal stigmata
C) Diastematomyelia
D) Lipomeningocele
Answer B: — Dorsal stigmata
Rationale: Dorsal stigmata are cutaneous markers seen with occult spinal
dysraphism and include sacral dimples, skin tags, and abnormal hair growth
(hypertrichosis). These markers prompt spinal ultrasound to evaluate for
underlying occult spinal dysraphism. ---
3. A sagittal cleft is present in the spinal cord, causing it to divide into two
hemicords. This condition is termed:
A) Lipomyelomeningocele
B) Myelomeningocele
C) Diastematomyelia
,D) Tethered cord
Answer C: — Diastematomyelia
Rationale: Diastematomyelia is defined as a sagittal cleft in the spinal cord
that divides it into two hemicords. It may be associated with a bony or fibrous
septum. Lipomyelomeningocele and myelomeningocele are forms of spinal
dysraphism, and tethered cord is a general term for abnormal cord fixation. ---
4. Myelocele and myelomeningocele are types of:
A) Occult spinal dysraphism
B) Overt spinal dysraphism
C) Dorsal stigmata
D) Closed spinal defects
Answer B: — Overt spinal dysraphism
Rationale: Myelocele and myelomeningocele are non-skin-covered defects,
classifying them as overt spinal dysraphism. Occult spinal dysraphism involves
skin-covered defects like lipomas and tethered cord. ---
5. In a Papile grade I germinal matrix hemorrhage, where is the bleed
located?
A) Subependymal/caudothalamic groove
B) Within lateral ventricles without dilation
, C) Within ventricles with ventriculomegaly
D) Intraparenchymal extension
Answer A: — Subependymal/caudothalamic groove
Rationale: Papile grade I IVH is confined to the subependymal germinal matrix
at the caudothalamic groove and does not extend into the ventricle. This is
the mildest form of germinal matrix hemorrhage. ---
6. A neonatal head ultrasound shows blood within the lateral ventricle with
ventricular dilation. What is the Papile IVH grade?
A) Grade I
B) Grade II
C) Grade III
D) Grade IV
Answer C: — Grade III
Rationale: Papile grade III is intraventricular hemorrhage with
ventriculomegaly. Grade IV adds intraparenchymal involvement
(periventricular hemorrhagic infarction). ---
7. Periventricular leukomalacia (PVL) initially appears on neonatal
ultrasound as which finding?
A) Echogenic ventricular casts
