ABOG Qualifying Exam
1. Parvo-B19: -ssDNA virus
Maternal:
-Diagnose: IgM and IgG antibodies
-Sx: arthropathy, truncal rash, aplasia
Fetal:
-SAB, aplastic anemia, nonimmune hydrops, IUFD
-Most severe if 13-16w
-Cytotoxic to fetal RBC precursors
-Dx: PCR of amniotic fluid
Confirmed maternal infection? --> USG for MCA q1-2w for 8-12w after infection
2. CMV: -dsDNA virus
-transmission: sexual or contact with blood, urine, saliva
-Most common congenital infection
-More severe sequelae if transmitted in 1st trimester
-Most commonly transmitted in 3rd trimester
-Bilateral periventricular hyperechogenicities/calcifications, congenital deafness, IUFD (30%)
3. Varicella: -DNA herpes virus
Exposed, no sx yet & nonimmune: VZIG Rash only:
PO acyclovir
Varicella PNA: IV acyclovir
Congenital:
-Microcephaly, skin scarring, limb hypoplasia
-Highest w/ exposure in 2nd trimester <20w
Neonatal:
-Highest risk of neonatal death if maternal symptoms develop w/in 5d before delivery to 48h
postpartum
-give VZIG+IV acyclovir to neonate if women develop si/sx bw 5d before and 2d after delivery
4. Rubella: Maternal-fetal transmission highest in 1st trimester and after 36w
-Cataracts, deafness, pulmonary artery stenosis, hepatosplenomegaly, CNS devel- opment issue
FGR
1/
43
, ABOG Qualifying Exam
5. Toxoplasmosis: -Intracranial hyperechoic foci/calcifications and ventricu- lomegaly
-chorioretinitis
-placentomegaly
-More likely to transmit later in gestation, worse disease if contracted <20w gestation
-Get from undercooked pork and lamb
Maternal infection: spiramycin (concentrates in placenta) Fetal
infection: pyrimethamine, sulfadiazine, folic acid
6. Listeria monocytogenes: -motile, gram positive bacillus
-unpasteurized cheese, processed foods
-flu like symptoms, N/V
-infection most common in 3rd trimester
-spreads hematogeneously
-Tx only if symptomatic: Ampicillin x14d +/- gentamicin for synergism (allergy = bactrim)
-foul smelling placenta with abscesses
7. HIV in pregnancy: -Check CD4 count and VL each trimester
-Get CD4 and VL at 34-36w for delivery planning
-VL >1000 = c/s at 38w
-VL <1000 can have trial of labor
8. HIV vertical transmission: VL>1000 copies, VD, no HAART = 25%
VL<1000 copies, VD, HAART = 1-2%
9. Fetal Growth Restriction: -EFW or AC <10%tile
-Isolated = deliver at 38.0-39.6
-Complicated (oligio, abnl dopplers, etc) = delivery 32.0-37.6
10.Risk of IUFD with Fetal Growth Restriction: <10%tile = 1.5%
<5%tile = 2.5%
11.Pregnancy Acid Base Satus: Respiratory Alkalosis 2/2 increased minute ven- tilation
12.Branches of Anterior Division of Internal Iliac Artery: Uterine Umbilical
Superior vesical
Obturator Internal
pudendal Inferior
gluteal
2/
43
, ABOG Qualifying Exam
Middle rectal
Vaginal
13.Branches of Posterior Division of internal Iliac Artery: Superior gluteal Lateral sacral
Iliolumbar
14.Embryo Implantation Staes: 1. Apposition: Blastocyst hatches and alligns itself adjacent to
endometrium
2. Adhesion: Decidualization occurs to mediate cell adhesion
3. Invasion: trophoblasts invade sinusoidal sacs at site of previous spiral arteries
15.Bartholin Gland Cyst in Postmenopausal Woman: -Need biopsy (excision not necessary)
16.Anticoagulation in Pregnancy: Unique considerations:
-Increased GFR = increased renal clearance
-Increased protein binding of meds
-Increased blood volume - decreased serum concentration
17.DHEA-S: >700 mcg/dL = need adrenal CT
18.Congenital Adrenal Hyperplasia (CAH): -Autosomal recessive
-#1 = deficiency in 21-hydroxylase --> increased 17-OHP --> increased androgens
--> virilization
-#1 cause of ambiguous genitalia
-If suspect at delivery, FIRST thing to do is order electrolytes (low Na, high K is common)
19.Nonclassical Congenital Adrenal Hyperplasia: -Diagnose with ACTH Stimu- lation test if 17-
OHP 200800 ng/dL. After stimulating, if 17-OHP is >1500ng/dL then test is positive for NCCAH.
20.Androgen Insensitivity Syndrome (AIS): -46, XY
-Nonfunctional androgen receptor --> development of female genitalia (short vagina, no uterus bc
they have AMH)
-Testosterone aromatized to estrogen --> breast development
-Testes need to be removed after puberty 2/2 increased risk of germ cell tumor
21.5a-reductase deficiency: -Can't convert testosterone --> DHT (so can't make male external
genitalia, prostate, male-pattern hair)
-Female phenotype, but around puberty may see virilization bc testosterone gets high enough
22.Gonadal dysgenesis (Swyer Syndrome): -Mutated SRY gene --> underdevel- oped testes -->
no AMH/testosterone
-46, XY
-Have uterus and cervix 2/2 no AMH
3/
43
, ABOG Qualifying Exam
-No breasts or pubic hair bc no testosterone to be aromatized
-Remove testes 2/2 increased risk of gonadoblastoma
23.MRKH: 46, XX
-Failure of paramesonephric system to form
-No uterus/cervix, short vagina
+Breast development and body hair (bc have ovaries)
24.American Society of Anesthesiologists (ASA) Physical Status Classifica- tion System: I:
Healthy, nonsmoking, no/minimal EtOH use
II: Mild diseases, current tobacco use, EtOH, pregnancy, obese, well controlled DM/HTN, Mild lung
dx
III: Severe disease (poorly controlled DM/HTN, hepatitis, drug abuse, hx CVA/TIA/CAD/stents
IV: <3mo since CVA/TIA/CAD/stents
V: ongoing ischemic event, intracranial bleed VI:
declared brain-dead
25.Diabetes Perioperative Management: Preop: BG <200, labs = CBC, BMP, HgA1c
Intraop/Posop: BG 140-180
-long acting insulin (insulin glargine): take 1/2-2/3 regular dose preop
-Hold: short acting insulin, sulfonylureas (glyburide), biguanides (metformin), thiazo- lidinediones
(Pioglitazone), SGLT2 inhibitors (Jardiance)
26.Hypertension Perioperative Management: -check BUN and Cr
-if on ACEI/ARB/Diuretics also check K, Na, Cl, CO2
-continue beta blocker for decreased risk of MI
-stop diuretics
-stop ACEI/ARB unless being used for heart failure
27.Hypertension management (non-pregnant): HTN+DM: ACEI No DM: CCB,
Thiazide diuretics
28.Hidradenitis suppurativa: Mild disease (inflammation)
1. Topical clindamycin, warm compresses
2. Oral tetracycline
3. Intralesional steroids, surgical unroofing
Mod/Severe Disease (fibrotic scarring, tracts)
1. Oral tetracycline, clindamycin+rifampin, subcutaneous adalimumab, oral retinoids,
wide local excision
29.Vulvar psoriasis: -Thick, scaly, raised edges, silvery plaques, also present on extensor
surfaces
-Common in summer months
4/
43
1. Parvo-B19: -ssDNA virus
Maternal:
-Diagnose: IgM and IgG antibodies
-Sx: arthropathy, truncal rash, aplasia
Fetal:
-SAB, aplastic anemia, nonimmune hydrops, IUFD
-Most severe if 13-16w
-Cytotoxic to fetal RBC precursors
-Dx: PCR of amniotic fluid
Confirmed maternal infection? --> USG for MCA q1-2w for 8-12w after infection
2. CMV: -dsDNA virus
-transmission: sexual or contact with blood, urine, saliva
-Most common congenital infection
-More severe sequelae if transmitted in 1st trimester
-Most commonly transmitted in 3rd trimester
-Bilateral periventricular hyperechogenicities/calcifications, congenital deafness, IUFD (30%)
3. Varicella: -DNA herpes virus
Exposed, no sx yet & nonimmune: VZIG Rash only:
PO acyclovir
Varicella PNA: IV acyclovir
Congenital:
-Microcephaly, skin scarring, limb hypoplasia
-Highest w/ exposure in 2nd trimester <20w
Neonatal:
-Highest risk of neonatal death if maternal symptoms develop w/in 5d before delivery to 48h
postpartum
-give VZIG+IV acyclovir to neonate if women develop si/sx bw 5d before and 2d after delivery
4. Rubella: Maternal-fetal transmission highest in 1st trimester and after 36w
-Cataracts, deafness, pulmonary artery stenosis, hepatosplenomegaly, CNS devel- opment issue
FGR
1/
43
, ABOG Qualifying Exam
5. Toxoplasmosis: -Intracranial hyperechoic foci/calcifications and ventricu- lomegaly
-chorioretinitis
-placentomegaly
-More likely to transmit later in gestation, worse disease if contracted <20w gestation
-Get from undercooked pork and lamb
Maternal infection: spiramycin (concentrates in placenta) Fetal
infection: pyrimethamine, sulfadiazine, folic acid
6. Listeria monocytogenes: -motile, gram positive bacillus
-unpasteurized cheese, processed foods
-flu like symptoms, N/V
-infection most common in 3rd trimester
-spreads hematogeneously
-Tx only if symptomatic: Ampicillin x14d +/- gentamicin for synergism (allergy = bactrim)
-foul smelling placenta with abscesses
7. HIV in pregnancy: -Check CD4 count and VL each trimester
-Get CD4 and VL at 34-36w for delivery planning
-VL >1000 = c/s at 38w
-VL <1000 can have trial of labor
8. HIV vertical transmission: VL>1000 copies, VD, no HAART = 25%
VL<1000 copies, VD, HAART = 1-2%
9. Fetal Growth Restriction: -EFW or AC <10%tile
-Isolated = deliver at 38.0-39.6
-Complicated (oligio, abnl dopplers, etc) = delivery 32.0-37.6
10.Risk of IUFD with Fetal Growth Restriction: <10%tile = 1.5%
<5%tile = 2.5%
11.Pregnancy Acid Base Satus: Respiratory Alkalosis 2/2 increased minute ven- tilation
12.Branches of Anterior Division of Internal Iliac Artery: Uterine Umbilical
Superior vesical
Obturator Internal
pudendal Inferior
gluteal
2/
43
, ABOG Qualifying Exam
Middle rectal
Vaginal
13.Branches of Posterior Division of internal Iliac Artery: Superior gluteal Lateral sacral
Iliolumbar
14.Embryo Implantation Staes: 1. Apposition: Blastocyst hatches and alligns itself adjacent to
endometrium
2. Adhesion: Decidualization occurs to mediate cell adhesion
3. Invasion: trophoblasts invade sinusoidal sacs at site of previous spiral arteries
15.Bartholin Gland Cyst in Postmenopausal Woman: -Need biopsy (excision not necessary)
16.Anticoagulation in Pregnancy: Unique considerations:
-Increased GFR = increased renal clearance
-Increased protein binding of meds
-Increased blood volume - decreased serum concentration
17.DHEA-S: >700 mcg/dL = need adrenal CT
18.Congenital Adrenal Hyperplasia (CAH): -Autosomal recessive
-#1 = deficiency in 21-hydroxylase --> increased 17-OHP --> increased androgens
--> virilization
-#1 cause of ambiguous genitalia
-If suspect at delivery, FIRST thing to do is order electrolytes (low Na, high K is common)
19.Nonclassical Congenital Adrenal Hyperplasia: -Diagnose with ACTH Stimu- lation test if 17-
OHP 200800 ng/dL. After stimulating, if 17-OHP is >1500ng/dL then test is positive for NCCAH.
20.Androgen Insensitivity Syndrome (AIS): -46, XY
-Nonfunctional androgen receptor --> development of female genitalia (short vagina, no uterus bc
they have AMH)
-Testosterone aromatized to estrogen --> breast development
-Testes need to be removed after puberty 2/2 increased risk of germ cell tumor
21.5a-reductase deficiency: -Can't convert testosterone --> DHT (so can't make male external
genitalia, prostate, male-pattern hair)
-Female phenotype, but around puberty may see virilization bc testosterone gets high enough
22.Gonadal dysgenesis (Swyer Syndrome): -Mutated SRY gene --> underdevel- oped testes -->
no AMH/testosterone
-46, XY
-Have uterus and cervix 2/2 no AMH
3/
43
, ABOG Qualifying Exam
-No breasts or pubic hair bc no testosterone to be aromatized
-Remove testes 2/2 increased risk of gonadoblastoma
23.MRKH: 46, XX
-Failure of paramesonephric system to form
-No uterus/cervix, short vagina
+Breast development and body hair (bc have ovaries)
24.American Society of Anesthesiologists (ASA) Physical Status Classifica- tion System: I:
Healthy, nonsmoking, no/minimal EtOH use
II: Mild diseases, current tobacco use, EtOH, pregnancy, obese, well controlled DM/HTN, Mild lung
dx
III: Severe disease (poorly controlled DM/HTN, hepatitis, drug abuse, hx CVA/TIA/CAD/stents
IV: <3mo since CVA/TIA/CAD/stents
V: ongoing ischemic event, intracranial bleed VI:
declared brain-dead
25.Diabetes Perioperative Management: Preop: BG <200, labs = CBC, BMP, HgA1c
Intraop/Posop: BG 140-180
-long acting insulin (insulin glargine): take 1/2-2/3 regular dose preop
-Hold: short acting insulin, sulfonylureas (glyburide), biguanides (metformin), thiazo- lidinediones
(Pioglitazone), SGLT2 inhibitors (Jardiance)
26.Hypertension Perioperative Management: -check BUN and Cr
-if on ACEI/ARB/Diuretics also check K, Na, Cl, CO2
-continue beta blocker for decreased risk of MI
-stop diuretics
-stop ACEI/ARB unless being used for heart failure
27.Hypertension management (non-pregnant): HTN+DM: ACEI No DM: CCB,
Thiazide diuretics
28.Hidradenitis suppurativa: Mild disease (inflammation)
1. Topical clindamycin, warm compresses
2. Oral tetracycline
3. Intralesional steroids, surgical unroofing
Mod/Severe Disease (fibrotic scarring, tracts)
1. Oral tetracycline, clindamycin+rifampin, subcutaneous adalimumab, oral retinoids,
wide local excision
29.Vulvar psoriasis: -Thick, scaly, raised edges, silvery plaques, also present on extensor
surfaces
-Common in summer months
4/
43
