USMLE Forum Archives - USMLE Step 3 - Lyme
Lyme
meduploader - 05-13-09 21:55
A 35-year-old woman who is 20 weeks pregnant develops a “rash” on her left thigh. She first thought that this was an insect bite, but the lesion has been getting larger over the past week. It is not pruritic or painful. She also has a mild headache but denies fever, chills, other skin lesions, and other systemic symptoms. Medical history is noncontributory. The patient is a landscaper in the Philadelphia suburbs. Her only medication is acetaminophen for the headache. She has no drug allergies.
On physical examination, temperature is 37.8 °C (100.0 °F); other vital signs are normal. A single 6-cm erythematous circular patch with partial clearing at its center is present on her left thigh, just below her groin. The lesion is slightly painful to palpation. Abdominal examination is consistent with a second-trimester pregnancy. Examination is otherwise normal. Complete blood count is normal. Results of assays for serum total and IgM Lyme antibody titers are pending.
Which of the following is most appropriate at this time?
meduploader - 05-13-09 21:55
A 35-year-old woman who is 20 weeks pregnant develops a “rash” on her left thigh. She first thought that this was an insect bite, but the lesion has been getting larger over the past week. It is not pruritic or painful. She also has a mild headache but denies fever, chills, other skin lesions, and other systemic symptoms. Medical history is noncontributory. The patient is a landscaper in the Philadelphia suburbs. Her only medication is acetaminophen for the headache. She has no drug allergies.
On physical examination, temperature is 37.8 °C (100.0 °F); other vital signs are normal. A single 6-cm erythematous circular patch with partial clearing at its center is present on her left thigh, just below her groin. The lesion is slightly painful to palpation. Abdominal examination is consistent with a second-trimester pregnancy. Examination is otherwise normal. Complete blood count is normal. Results of assays for serum total and IgM Lyme antibody titers are pending.
Which of the following is most appropriate at this time?
The correct answer and explanation will be available after you answer.
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