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Questions and Answers
What is the most common symptom of early Lyme disease?
What is the most common symptom of early Lyme disease?
In which months does the risk of Lyme disease transmission begin in the Midwestern and eastern United States?
In which months does the risk of Lyme disease transmission begin in the Midwestern and eastern United States?
What is the primary host for the bacteria that causes Lyme disease?
What is the primary host for the bacteria that causes Lyme disease?
Which of the following is NOT a risk factor for Lyme disease?
Which of the following is NOT a risk factor for Lyme disease?
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How long must a tick be attached to a person before the Lyme disease bacterium can be transmitted?
How long must a tick be attached to a person before the Lyme disease bacterium can be transmitted?
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In what stage of Lyme disease is Erythema migrans most commonly observed?
In what stage of Lyme disease is Erythema migrans most commonly observed?
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Which state is NOT among the 14 states with the highest reported Lyme disease cases?
Which state is NOT among the 14 states with the highest reported Lyme disease cases?
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What is the most likely reason why Lyme disease diagnoses peak in summer months?
What is the most likely reason why Lyme disease diagnoses peak in summer months?
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Which of these symptoms are most characteristic of Lyme disease in its early stages (Stage 1)?
Which of these symptoms are most characteristic of Lyme disease in its early stages (Stage 1)?
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What is the main diagnostic tool for Lyme disease in its early stages?
What is the main diagnostic tool for Lyme disease in its early stages?
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Which of the following is NOT a common clinical manifestation of Stage 2 Lyme disease?
Which of the following is NOT a common clinical manifestation of Stage 2 Lyme disease?
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What is Posttreatment Lyme disease syndrome?
What is Posttreatment Lyme disease syndrome?
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Which of the following antibiotics is NOT a first-line treatment for adult patients with early Lyme disease (Stage 1)?
Which of the following antibiotics is NOT a first-line treatment for adult patients with early Lyme disease (Stage 1)?
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Which of the following is an appropriate treatment for Stage 3 Lyme disease?
Which of the following is an appropriate treatment for Stage 3 Lyme disease?
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Which of the following statements about the two-tiered approach to Lyme disease diagnosis is TRUE?
Which of the following statements about the two-tiered approach to Lyme disease diagnosis is TRUE?
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What is the significance of Lyme antibody index on cerebrospinal fluid (CSF)?
What is the significance of Lyme antibody index on cerebrospinal fluid (CSF)?
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Which of the following medications is used to prevent Lyme disease after a tick bite?
Which of the following medications is used to prevent Lyme disease after a tick bite?
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Which of the following statements about Lyme disease treatment is TRUE?
Which of the following statements about Lyme disease treatment is TRUE?
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Which of the following is a potential complication of Lyme disease?
Which of the following is a potential complication of Lyme disease?
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What is the most common presenting clinical manifestation of Lyme disease?
What is the most common presenting clinical manifestation of Lyme disease?
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Which of the following is a differential diagnosis for Lyme disease?
Which of the following is a differential diagnosis for Lyme disease?
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Which of the following is NOT a recommended first-line treatment for children with early Lyme disease (Stage 1)?
Which of the following is NOT a recommended first-line treatment for children with early Lyme disease (Stage 1)?
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Which of these is a reason why doxycycline is contraindicated in pregnant women?
Which of these is a reason why doxycycline is contraindicated in pregnant women?
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Flashcards
Lyme Disease
Lyme Disease
A multisystem illness caused by Borrelia burgdorferi infection and immune response, transmitted by infected ticks.
Borrelia burgdorferi
Borrelia burgdorferi
A bacterium that causes Lyme disease, transmitted via tick bites.
Ixodes ticks
Ixodes ticks
Genus of ticks that transmit various diseases including Lyme disease.
Erythema migrans
Erythema migrans
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Peak Incidence Ages
Peak Incidence Ages
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Lyme Disease Symptoms
Lyme Disease Symptoms
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Tick Attachment Time
Tick Attachment Time
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Prevention Timing
Prevention Timing
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Early Lyme Disease Symptoms
Early Lyme Disease Symptoms
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Early Disseminated Lyme Disease
Early Disseminated Lyme Disease
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Chronic Persistent Lyme Disease
Chronic Persistent Lyme Disease
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Posttreatment Lyme Disease Syndrome
Posttreatment Lyme Disease Syndrome
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Diagnostic Studies for Lyme Disease
Diagnostic Studies for Lyme Disease
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Two-Tiered Testing Approach
Two-Tiered Testing Approach
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Antibiotics for Early Lyme Disease
Antibiotics for Early Lyme Disease
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Treatment for Severe Manifestations
Treatment for Severe Manifestations
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Doxycycline Contraindications
Doxycycline Contraindications
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Children's Lyme Disease Treatment
Children's Lyme Disease Treatment
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Lyme Disease Prevention
Lyme Disease Prevention
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Differential Diagnoses
Differential Diagnoses
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Neurological Lyme Disease Symptoms
Neurological Lyme Disease Symptoms
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Classic Clinical Manifestation of Lyme Disease
Classic Clinical Manifestation of Lyme Disease
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Study Notes
Lyme Disease: Overview
- Caused by Borrelia burgdorferi infection, triggered by the body's immune response.
- Transmitted via infected Ixodes tick bites.
- Symptoms vary from mild to severe, including joint pain, flu-like symptoms, and rash.
- Ticks transmit other pathogens like anaplasmosis, ehrlichiosis, babesiosis, and Powassan virus.
- Peak incidence in children (5-9 years old) and adults (50-55 years old).
- Lyme disease risk starts in early spring, correlating with tick emergence.
- Rodents (mice, chipmunks) and deer are primary hosts.
- Borrelia burgdorferi is the causative spirochete, transmitted by Ixodid ticks.
- Diagnosed frequently in 14 states.
- Sixth most common nationally notifiable condition.
Lyme Disease: Incidence and Risk Factors
- Highest reported cases from 14 states (Connecticut, Delaware, Maine, Maryland, Massachusetts, Minnesota, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, Vermont, Virginia, and Wisconsin).
- Most common in boys aged 5-9 years old.
- Exposure to infected ticks is the primary risk factor.
- Midwestern/Eastern US: risk highest late May-early fall (June-July most prevalent).
- Pacific Northwest: January-May risk period.
- Activities like hunting, hiking, and camping increase exposure.
- Ticks can attach anywhere, usually hard-to-see places (groin, armpits, scalp).
- Transmission usually requires 36-48 hours of attachment.
Lyme Disease: Stages and Assessment Findings
Early Lyme Disease (Stage 1)
- Time between tick bite and skin lesion: 7 days.
- Tick bite symptoms often present 1-2 weeks post.
- May be asymptomatic.
- Erythema migrans (EM) rash (70-80% of cases): enlarging erythematous circular rash around the bite, spreading into a “bulls-eye” appearance; can be itchy or painful.
- EM can appear darker (black, brown, grey) on darker skin tones.
- Other symptoms include headache, malaise, fever, flu-like symptoms, lethargy, muscle/joint pain, and possible swelling.
Early Disseminated Lyme Disease (Stage 2)
- Occurs days to weeks after Stage 1.
- EM rash in other skin locations.
- Neurological/Cardiac complications: aseptic meningitis, iritis, heart block, pericarditis, bradycardia, Bell's palsy, headache, stiff neck, meningitis, facial nerve palsy, swelling in testicles.
- Arthritis of large joints (often knees).
- Swollen lymph glands.
Chronic Persistent Lyme Disease (Stage 3)
- Lasting months to years.
- Joint pain (especially knees), soft tissue pain (60% of cases).
- Intermittent arthritis, swelling, and pain in large joints.
- Neurological impairment (memory loss, dementia, confusion, concentration problems, neuropathy).
- Eye inflammation (iritis, optic neuritis).
Lyme Disease: Differential Diagnoses
- Multiple other conditions with overlapping symptoms (arthritis, multiple sclerosis, cellulitis, Parkinson's, eye disorders, chronic fatigue syndrome, other viral conditions, lupus).
Lyme Disease: Diagnostic Studies
- Erythema migrans (EM) rash is a definitive early indicator for diagnosis.
- Rash must be greater than 5cm in diameter
- Multi-step diagnostic approach (Centers for Disease Control):
- ELISA/EIA test (step 1)
- Immunoblot (Western blot) test (step 2) if ELISA positive or indeterminate.
- Serologic testing not routinely recommended for EM rash cases, treatment should proceed.
Lyme Disease: Treatment
- All stages treatable with antibiotics.
- Early Lyme disease (without neuro/cardiac involvement): doxycycline, amoxicillin, or cefuroxime.
- Doxycycline contraindicated for pregnant/breastfeeding women and children.
- Amoxicillin is an acceptable alternative
- Azithromycin if doxycycline or beta-lactams contraindicated.
- First-generation cephalosporins not effective.
- Early neuro/cardiac involvement: IV ceftriaxone, penicillin G, cefotaxime, and oral doxycycline.
- Stage 2: similar antibiotic options depending on complications (potentially longer course)
- Stage 3: similar antibiotic options (often prolonged duration), IV antibiotics if oral treatment fails.
- Important Note: Doxycycline should not be used in children.
Lyme Disease: Prevention
- Initiate treatment within 72 hours of tick removal.
- Doxycycline 200 mg single dose for 10 days is one preventive treatment.
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Description
This quiz covers key aspects of Lyme disease, including its causative agent, symptoms, and transmission via ticks. It also discusses the incidence and risk factors associated with Lyme disease across various states in the U.S., highlighting the peak occurrence in certain age groups and regions.
