Term
| Incidence of lyme dz in men vs women |
|
Definition
|
|
Term
| Peak ages of lyme disease? |
|
Definition
|
|
Term
| What areas of the US show greater risk of Lyme disease |
|
Definition
The North East
Wisconsin
Minnesota
(and in Canadian provinces just north of these states) |
|
|
Term
| Name some reservoirs for B. burgdorferi |
|
Definition
|
|
Term
| Organism that causes Lyme disease |
|
Definition
| The spirochete Borrelia burgdorferi |
|
|
Term
| How do Deer ticks/black legged ticks become infected with B. burgdorferi |
|
Definition
| As larvae and nymphs, they feed on small animals that are a reservoir for the organism |
|
|
Term
| Describe how deer are involved in the life cycle of 'lyme disease' |
|
Definition
| They host the infected adult ticks but do not get infected themselves |
|
|
Term
| How do humans acquire lyme disease? |
|
Definition
| The infected tick feeds on the human and transmits the spirochete B. burgdorferi into the human tissue. |
|
|
Term
| How long does a tick need to be attached to a human before it can transmit lyme disease? |
|
Definition
|
|
Term
Human contact
flies
fleas
mosquitos
deer ticks
squirrel meat
From which of these can you get lyme disease from? |
|
Definition
| deer ticks, NONE of the rest |
|
|
Term
| Which stage of the tick lifecycle is most likely to transmit lyme disease to humans? |
|
Definition
|
|
Term
| What is the most common manifestation of lyme disease |
|
Definition
| Erythema migrans (visible in 80% of cases) |
|
|
Term
| Time line of appearance of signs and symptoms of lyme dz |
|
Definition
| 3-30 days, average 7 days |
|
|
Term
| 3 characteristics of Erythema Migrans required for it to be specified as EM |
|
Definition
At least 5cm in size
Expanding
>1 week duration |
|
|
Term
T/F
EM is barely visible and does not cause any pain or itchiness so it is probably not EM |
|
Definition
| False, can still be EM without pain or itchiness |
|
|
Term
| Name a common extracutaneous manifestation of early disseminated lyme dz |
|
Definition
|
|
Term
| Name some neurological manifestations of early disseminated lyme dz |
|
Definition
Cranial neuropathy (facial nerve palsy)
Meningitis
Acute febrile polyneuritis
|
|
|
Term
| Name some cardiac manifestations of early disseminatd lyme dz |
|
Definition
Myopericarditis
AV conduction defects
tachyarrhythmias |
|
|
Term
| Time line of the different stages of lyme dz |
|
Definition
Early Infection 3-30 days
Early disseminated days to weeks
Late disseminated months to years |
|
|
Term
| Common chronic neurological manifestation of late disseminated lyme dz |
|
Definition
|
|
Term
| Briefly describe lyme arthritis in late disseminated form |
|
Definition
Migratory monoarthritis
or
asymmetric oligoarthritis
(intermittent, marked swelling with pain) |
|
|
Term
3 chronic neurological manifestations of late disseminated lyme dz
|
|
Definition
Encephalopathy
mild reversible CNS inflammation
Peripheral neuropathy (paresthesias) |
|
|
Term
| Ocular manifestations of early lyme dz |
|
Definition
Follicular conjunctivitis
Episcleritis
Periorbital edema |
|
|
Term
Ocular manifestations of late lyme dz
|
|
Definition
pupil abnormalities
nerve palsies
pars planitis
choroiditis
granulomatous anterior uveitis
disc edema (esp. children)
keratitis (rare) |
|
|
Term
T/F
Allowed to diagnose Lyme dz based solely on EM without serological testing |
|
Definition
True
(may not be advanced enough to develop a serological response, but pt still needs treatment) |
|
|
Term
| Testing/Treatment plan for patients with no EM or history of tick bite, just signs and symptoms of disease |
|
Definition
First: ELISA or IFA
Second: Western blot (if first was positive)
Treatment can only be initiated upon laboratory confirmation of infection
|
|
|
Term
| Name some causes of false positives in testing for lyme disease |
|
Definition
SLE
RA
Mono
Malaria
Syphillis
|
|
|
Term
| What time line of lyme dz infection is required to avoid false negative results |
|
Definition
|
|
Term
| What does a positive serological test for lyme disease indicate |
|
Definition
Indicatees exposure, not necessarily infection
Since they are antibody tests |
|
|
Term
| Preferred drug used in tx of early lyme disease |
|
Definition
|
|
Term
| 3 1st line choices in treatment of early lyme disease |
|
Definition
Doxycycline
Amoxicillin
Cefuroxime
for 14d for adults |
|
|
Term
| 2 populations that Doxycycline is contraindicated for |
|
Definition
Children under 8
pregnant women |
|
|
Term
| Why is Doxycycline contraindicated for some patients |
|
Definition
| It binds to calcium, can result in permanent teeth darkening and prevent bones from growing |
|
|
Term
| Drug choice for treatment of meningitis or acute febrile polyneuritis |
|
Definition
IV Ceftriaxone
or
Penicillin G
for 14 days
or Doxycycline if allergies x28 days |
|
|
Term
| drug choice for treatment of arthritis due to EARLY lyme disease |
|
Definition
Doxycycline
Amoxicillin
Cefuroxime axetil
for 28 days |
|
|
Term
| Drug choice for treatment of Lyme arthritis in late dz |
|
Definition
Another 28d course of same drugs as early (doxy, amox and cef)
or
IV ceftriaxone 14-28days
NSAIDs
Corticosteroids
DMARDs |
|
|
Term
| Drug choice for treatment of Neurological manifestations of late lyme disease |
|
Definition
| IV Ceftriaxone 14-28 days |
|
|
Term
| Describe Post-lyme disease |
|
Definition
- 10-20%, resolving within 6mo-5+ years, fatigue, sleep problems, arthralgias, myalgias, neck pain, HA
|
|
|
Term
| What must be true in order to allow treatment of a pt with an asymptomatic tick bite |
|
Definition
All of:
Tick attached for >36 hours (adult or nymph)
Local infection rate >20%
Within 72 hours of tick removal
Doxycycline is not contraindicated |
|
|
Term
| CDC recommendation for seropositive patient with no symptoms consistent with lyme disease |
|
Definition
|
|
