Pediatric ARDMS Exam Review 2026/2027 — Complete Test Bank &
Study Guide
350 Board-Style Questions with Verified Answers & Detailed
Rationales
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
Study Guide
350 Board-Style Questions with Verified Answers & Detailed
Rationales
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
