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An 8-year-old child comes to the physician's office complaining of swelling and pain in the knees. His mother says, ''The swelling occurred for no reason, and it keeps getting worse.'' The initial diagnosis is Lyme disease. When talking to the mother and child, questions related to which of the following would be important to include in the initial history?
Suggested Answer: D
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(A) Urinary tract symptoms are not commonly associated with Lyme disease. (B) A fever of 103F is not characteristic of Lyme disease. (C) The rash that is associated with Lyme diseasedoes not appear on the palms of the hands and the soles of the feet. (D) Classic symptoms of Lyme disease include headache, malaise, fatigue, anorexia, stiff neck, generalized lymphadenopathy, splenomegaly, conjunctivitis, sore throat, abdominal pain, and cough.
30 comments · newest first
TA
Tammy
10 months ago
What about headaches? Do they matter in this case?
KI
Kip
10 months ago
Wait, how can they be sure it's Lyme? Could be something else.
BI
Billy
10 months ago
Definitely need to check for rashes, that's classic Lyme!
MA
Mariann
10 months ago
Fever is a big sign too, can't overlook that!
TR
Tresa
11 months ago
Lyme disease can cause joint pain, especially in kids.
SH
Sheldon
11 months ago
I’m confused about the decreased urinary output option; I don’t recall it being a typical symptom of Lyme disease.
NA
Nadine
11 months ago
I practiced a similar question about Lyme disease, and I think asking about headaches or malaise could help assess if there’s more systemic involvement.
RI
Rickie
11 months ago
I’m not entirely sure, but I feel like rashes on the palms and soles might be more related to other conditions, not Lyme disease specifically.
RE
Reena
12 months ago
I remember discussing Lyme disease in class, and I think fever could be a key symptom, especially if it’s been persistent.
ME
Melynda
12 months ago
This is a good one. I'd make sure to ask about any recent tick bites or outdoor activities, since that can help point to Lyme disease. And of course, I'd want to get details on the joint swelling and pain the patient is experiencing.
GR
Gracie
12 months ago
Okay, for this type of question, I think it's important to really zero in on the key symptoms associated with Lyme disease. Based on the information provided, I'd be sure to ask about fever, rashes, and any other systemic symptoms the patient may be experiencing.
DE
Detra
1 year ago
Hmm, I'm a bit unsure about this one. I know Lyme disease can cause joint swelling, but I'm not sure which specific symptoms would be most important to ask about in the initial history. I'll have to think this through carefully.
LE
Lenita
1 year ago
This seems like a pretty straightforward question. I'd focus on gathering information about any recent fever, rashes, or other symptoms that could point to Lyme disease.
MA
Margery
1 year ago
Yes, rashes could also be a symptom of Lyme disease, so that's an important question to include in the history.
IR
Irene
1 year ago
But what about rashes? Shouldn't we ask about any rashes on the hands and feet?
LE
Leslee
1 year ago
I agree, a fever could indicate an infection like Lyme disease.
DO
Doug
1 year ago
Hmm, I'm torn between B and D. Maybe the kid's just really excited about the swelling and can't decide which symptom to complain about first. Classic Lyme move.
JO
Joesph
1 year ago
B, a high fever is a dead giveaway. This kid's got Lyme, no doubt about it. Time to break out the antibiotics!
RU
Ruthann
1 year ago
B, a high fever is a dead giveaway. This kid's got Lyme, no doubt about it. Time to break out the antibiotics!
CA
Callie
1 year ago
D) Headaches, malaise, or sore throat
DE
Deeann
1 year ago
C) Rashes covering the palms of the hands and the soles of the feet
JA
Janey
1 year ago
B) A fever of over 103F occurring over the last 2--3 weeks
FR
Freeman
1 year ago
I think the important question to ask would be about any fever the child has had.
TA
Taryn
1 year ago
I'm going with C, the rashes on the palms and soles are a telltale sign of Lyme. Gotta catch it early!
BR
Brandon
1 year ago
B: Yeah, those rashes could definitely be a clue to Lyme disease.
RE
Rebeca
1 year ago
A: I think it's important to ask about any rashes on the palms and soles.
DE
Denae
1 year ago
Definitely D, headaches, malaise, and sore throat are classic signs of Lyme disease. The initial history should focus on those symptoms.
MA
Mariko
1 year ago
C) Rashes covering the palms of the hands and the soles of the feet
AN
Andra
1 year ago
D) Headaches, malaise, or sore throat
TI
Tish
1 year ago
B) A fever of over 103F occurring over the last 2--3 weeks