Peggy is a 52 year-old female. She presents to the clinic with severe fatigue. Upon further questioning, she reports she also has a headache and muscle pain. On examination you find a bulls-eye rash (Erythema chronicum migrans) on her left arm. She tells you she recently returned from a vacation to New Hampshire. What is your diagnosis?Group of answer choicesWest Nile virusLyme diseaseMalariaPlague
Question
Peggy is a 52 year-old female. She presents to the clinic with severe fatigue. Upon further questioning, she reports she also has a headache and muscle pain. On examination you find a bulls-eye rash (Erythema chronicum migrans) on her left arm. She tells you she recently returned from a vacation to New Hampshire. What is your diagnosis?Group of answer choicesWest Nile virusLyme diseaseMalariaPlague
Solution
The diagnosis for Peggy is Lyme disease.
Here's the step by step reasoning:
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Peggy's symptoms of severe fatigue, headache, and muscle pain are common in many illnesses, but the presence of a bulls-eye rash, also known as Erythema chronicum migrans, is a characteristic sign of Lyme disease.
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Lyme disease is caused by the bacterium Borrelia burgdorferi and is transmitted to humans through the bite of infected blacklegged ticks.
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Her recent vacation to New Hampshire also supports this diagnosis, as Lyme disease is most commonly reported in the northeastern and upper mid-western United States.
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The other options (West Nile virus, Malaria, Plague) can be ruled out as they either do not present with a bulls-eye rash or are not common in the area where Peggy recently vacationed.
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