WBR0057: Difference between revisions
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|Prompt=A 39-year-old woman presents to her primary care physician complaining of fever, muscle soreness, headache and severe malaise one week after returning from a summer vacation on Cape Cod. Physical exam is significant for a red rash on her leg with an inner ring clearing resembling a bullseye. What is the most likely causal organism? | |Prompt=A 39-year-old woman presents to her primary care physician complaining of fever, muscle soreness, headache and severe malaise one week after returning from a summer vacation on Cape Cod. Physical exam is significant for a red rash on her leg with an inner ring clearing resembling a bullseye. What is the most likely causal organism? | ||
|Explanation=The patient in this vignette has the early stages of Lyme disease caused by the spirochete Borrelia burgdorferi. Borrelia burgdorferi is a zoonotic bacteria that is carried by the Ixodes tick. In its early stages, Lyme disease causes flu-like symptoms and a characteristic “bullseye” rash called erythema chronicum migrans in 80% of patients. The incubation period of Lyme disease can vary greatly, but is typically 1 to 2 weeks. If untreated, Lyme disease can cause facial palsy and AV nodal block (secondary Lyme disease) progressing to chronic monoarthritis or migratory polyarthritis (tertiary Lyme disease). | |Explanation=The patient in this vignette has the early stages of Lyme disease caused by the spirochete Borrelia burgdorferi. Borrelia burgdorferi is a zoonotic bacteria that is carried by the Ixodes tick. In its early stages, Lyme disease causes flu-like symptoms and a characteristic “bullseye” rash called erythema chronicum migrans in 80% of patients. The incubation period of Lyme disease can vary greatly, but is typically 1 to 2 weeks. If untreated, Lyme disease can cause facial palsy and AV nodal block (secondary Lyme disease) progressing to chronic monoarthritis or migratory polyarthritis (tertiary Lyme disease). | ||
Note: This question is linked to WBR0058 and WBR0059 | Note: This question is linked to WBR0058 and WBR0059 | ||
|AnswerA=Borrelia Burgdorferi | |AnswerA=Borrelia Burgdorferi | ||
|AnswerAExp= | |AnswerAExp=Borrelia burgdorferi causes [[Lyme disease]]. | ||
|AnswerB=Rickettsia Rickettsii | |AnswerB=Rickettsia Rickettsii | ||
|AnswerBExp= | |AnswerBExp=Rickettsia Rickettsii causes Rocky Mountain Spotted Fever | ||
|AnswerC=Coxiella burnetii | |AnswerC=Coxiella burnetii | ||
|AnswerCExp= | |AnswerCExp=[[Coxiella burnetii]] causes Q Fever. | ||
|AnswerD=Brucella species | |AnswerD=Brucella species | ||
|AnswerDExp= | |AnswerDExp=[[Brucella]] causes undulant fever. | ||
|AnswerE=Francisella Tularensis | |AnswerE=Francisella Tularensis | ||
|AnswerEExp= | |AnswerEExp=Francisella tularensis causes [[tularemia]]. | ||
|EducationalObjectives=Lyme disease is caused by the organism Borrelia burgdorferi. | |||
|References=First Aid 2014 page 141 | |||
|RightAnswer=A | |RightAnswer=A | ||
|WBRKeyword=Microbiology, Zoonotic, Animal, Tick, Lyme disease, Lyme, Bacteria, Rash, Dermatology, Linked | |WBRKeyword=Microbiology, Zoonotic, Animal, Tick, Lyme disease, Lyme, Bacteria, Rash, Dermatology, Linked | ||
|Approved=Yes | |Approved=Yes | ||
}} | }} | ||
Revision as of 21:19, 15 March 2014
| Author | PageAuthor::William J Gibson |
|---|---|
| Exam Type | ExamType::USMLE Step 1 |
| Main Category | MainCategory::Microbiology |
| Sub Category | SubCategory::Dermatology, SubCategory::Infectious Disease |
| Prompt | [[Prompt::A 39-year-old woman presents to her primary care physician complaining of fever, muscle soreness, headache and severe malaise one week after returning from a summer vacation on Cape Cod. Physical exam is significant for a red rash on her leg with an inner ring clearing resembling a bullseye. What is the most likely causal organism?]] |
| Answer A | AnswerA::Borrelia Burgdorferi |
| Answer A Explanation | [[AnswerAExp::Borrelia burgdorferi causes Lyme disease.]] |
| Answer B | AnswerB::Rickettsia Rickettsii |
| Answer B Explanation | AnswerBExp::Rickettsia Rickettsii causes Rocky Mountain Spotted Fever |
| Answer C | AnswerC::Coxiella burnetii |
| Answer C Explanation | [[AnswerCExp::Coxiella burnetii causes Q Fever.]] |
| Answer D | AnswerD::Brucella species |
| Answer D Explanation | [[AnswerDExp::Brucella causes undulant fever.]] |
| Answer E | AnswerE::Francisella Tularensis |
| Answer E Explanation | [[AnswerEExp::Francisella tularensis causes tularemia.]] |
| Right Answer | RightAnswer::A |
| Explanation | [[Explanation::The patient in this vignette has the early stages of Lyme disease caused by the spirochete Borrelia burgdorferi. Borrelia burgdorferi is a zoonotic bacteria that is carried by the Ixodes tick. In its early stages, Lyme disease causes flu-like symptoms and a characteristic “bullseye” rash called erythema chronicum migrans in 80% of patients. The incubation period of Lyme disease can vary greatly, but is typically 1 to 2 weeks. If untreated, Lyme disease can cause facial palsy and AV nodal block (secondary Lyme disease) progressing to chronic monoarthritis or migratory polyarthritis (tertiary Lyme disease).
Note: This question is linked to WBR0058 and WBR0059 |
| Approved | Approved::Yes |
| Keyword | WBRKeyword::Microbiology, WBRKeyword::Zoonotic, WBRKeyword::Animal, WBRKeyword::Tick, WBRKeyword::Lyme disease, WBRKeyword::Lyme, WBRKeyword::Bacteria, WBRKeyword::Rash, WBRKeyword::Dermatology, WBRKeyword::Linked |
| Linked Question | Linked:: |
| Order in Linked Questions | LinkedOrder:: |