Lyme disease

Question 1

What is the main cause of lyme disease?

Answer 1

Borrelia burgdorferi

Question 2

What is Borrelia burgdorferi?

Answer 2

Spirochaete

Question 3

What is Borrelia burgdorferi spead by?

Answer 3

Ticks

Question 4

When do the early features of lyme disease first appear?

Answer 4

Within 30 days

Question 5

What do the early features of lyme disease include?

Answer 5

Erythema migrans
Systemic
—headache
–lethargy
–fever
–arthralgia

Question 6

What is erythema migrans?

Answer 6

‘bulls-eye’ rash is typically at the site of the tick bite

Question 7

When do the later features of lyme disease occur?

Answer 7

After 30 days

Question 8

What do the later features of lyme disease affect?

Answer 8

Cardiovascular
Neurological

Question 9

What are the later cardiovascular features of lyme disease?

Answer 9

Heart block
Pericarditis
Myocarditis

Question 10

What are the later neurological features of lyme disease?

Answer 10

facial nerve palsy
radicular pain
meningitis

Question 11

How can lyme disease be diagnosed?

Answer 11

Clinically if erythema migrans is present

Question 12

How can lyme disease be diagnosed clincially?

Answer 12

If erythema migrans is present

Question 13

What is the first line investigation for lyme disease?

Answer 13

Enzyme-linked immunosorbent assay (ELISA) antibodies to Borrelia burgdorferi

Question 14

What would you do if ELISA test was negative but lyme disease was still suspected?

Answer 14

Repeat the ELISA 4-6 weeks after the first ELISA test

Question 15

What is the medical management of lyme disease?

Answer 15

Doxycycline

Question 16

What medication can be given if doxycycline is contraindictaed (pregnancy)?

Answer 16

Amoxicillin

Question 17

What is the management of people presenting with erythema migrans?

Answer 17

Start on antibiotics straight away without anymore testing

Question 18

What medication can be given for lyme disease if disseminated disease?

Answer 18

Ceftriaxone