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Year Two - Neurology System > Lyme's Disease > Flashcards

Lyme's Disease Flashcards

1
Q

What is Lyme disease?

A

It is defined as a multisystem disease caused by the spirochaete, Borrelia Burgdorferi

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2
Q

How is Lyme disease transmitted?

A

Ticks

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3
Q

When does the localised stage of Lyme disease occur?

A

It occurs between 3 – 30 days following a tick bite

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4
Q

What are the five clincial features of Lyme disease at the localised stage?

A

Erythema Migrans

Fatigue

Fever

Headache

Arthralgia

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5
Q

What is erythema migrans?

A

It is defined as a bulls eye rash, which develops at the site of the tick bite

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6
Q

When does erythema migrans present in Lyme disease?

A

1 - 4 weeks > tick bite

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7
Q

What are the three charcteristic features of erythema migrans?

A

Painless

> 5cm in diameter

Slowly increases in size

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8
Q

In cases where individuals present with erythema migrans, what is the most appropriate next step?

A

Antibiotics

This is due to the fact that in these cases diagnosis is clincial

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9
Q

When does disseminated stage of Lyme disease occur?

A

It occurs after 30 days of a tick bite

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10
Q

What two organ systems are most commonly affected by Lyme disease in the disseminated stage?

A

Cardiology

Neurology

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11
Q

What are the six clincial features of Lyme disease in the disseminated stage?

A

Heart Block

Pericarditis

Myocarditis

Facial Nerve Palsy

Radicular Pain

Meningitis

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12
Q

What are the two investigations used to diagnose Lyme disease?

A

Enzyme-Linked Immunosorbent Assay (ELISA)

Immunoblot Test

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13
Q

What is the first line investigation used to diagnose Lyme disease?

A

Enzyme-Linked Immunosorbent Assay (ELISA)

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14
Q

What is ELISA?

A

It is used to detect the presence of antibodies within blood

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15
Q

What is the next appropriate step following a positive ELISA result?

A

It is recommended that an immunoblot test is conducted

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16
Q

What is the next appropriate step following a negative ELISA result, however Lyme disease is still suspected in individuals tested within four weeks of clinical feature onset?

A

It is recommended to repeat the test 4 – 6 weeks after the first ELISA test

17
Q

What is the next appropriate step following a negative ELISA result, however Lyme disease is still suspected in individuals tested after twelve weeks of clinical feature onset?

A

It is recommended to conduct an immunoblot test

18
Q

What is the second line investigation used to diagnose Lyme disease?

A

Immunoblot Test

19
Q

What is the immunoblot test?

A

It is used to detect specific antigens recognised by polyclonal or monoclonal antibodies

20
Q

How do we conduct tick removal?

A

It is conducted with fine-tipped tweezers, in which the head of the tick is grasped as close to the skin as possible and pulled firmly upwards

The area should then be washed following removal

21
Q

What is the management option for Lyme disease?

A

Antibiotics

22
Q

What is the first line antibiotic used in cases where individuals present at the localised stage of Lyme disease? At what dose?

A

Oral Doxycycline

100mg for 14-21 days

23
Q

What is the second line antibiotic used in cases where individuals present at the localised stage of Lyme disease?

A

Amoxicillin

24
Q

What is the first line antibiotic used in cases where individuals present at the disseminated stage of Lyme disease? At what dose?

A

IV Ceftriaxone

14 - 30 days

25
Q

Are prophylactic antibodies reocmmended following a tick bite?

A

No

26
Q

What is a common complication following antibiotic administration for Lyme disease?

A

Jarisch Herxheimer reaction

27
Q

When does Jarisch Herxheimer reaction present following antibitoic adminsitration?

A

It tends to occur after administration of the first antibiotic dose

28
Q

What are three Jarish Herxheimer reaction clincial features?

A

Fever

Rash

Tachycardia

Year Two - Neurology System (25 decks)

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