Lyme Disease: The Daily PANCE Blueprint

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Lyme Disease: The Daily PANCE Blueprint

A 12-year-old male patient presents with a circular, expanding rash located where a tick had bitten him. He had recently been camping in the upper Midwest. He also complains of a headache and mild fever. Which of the following is a known cardiac complication of the patient’s most likely diagnosis?

A. Supraventricular tachycardia
B. Atrioventricular block
C. Wandering atrial pacemaker
D. Sinus bradycardia
E. None of the above

Answer and topic summary

The answer is B. Atrioventricular block

The patient most likely has Lyme disease, which is a tick-borne illness usually caused by Borrelia burgdorferi. It is more prevalent in the Northeast and upper Midwest. Erythema migrans, which is a circular, expanding rash that may look like a “bull’s eye” is seen about 20% of the time with Lyme disease. Clinical features in the early localized disease include fever, headaches, malaise, arthralgia, and lymphadenopathy. Treatment is doxycycline for non-pregnant adults and children over the age of 8. Amoxicillin is a second-line treatment. A well-known cardiac complication is an atrioventricular block.

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Smarty PANCE Content Blueprint Review:

Covered under ⇒ PANCE Blueprint Infectious Disease ⇒ Spirochetal Disease ⇒ Lyme disease

Also covered as part of the Internal Medicine EOR and Family Medicine EOR topic list