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Cyberschool Creators: Kevin Baumlin, MD & Michael Bessette, MD
Module Author: Edward Mintz, MD
Web Authors: Carol Lewis & Marcy Wang
| It's the Sunday of Labor Day weekend and you are working in Urgent Care. A young man, Surf N. Dude, presents with a complaint of a tick bite noticed while playing frisbee with his dog, Wave, on the beach on Fire Island earlier the same day. The tick is still attached and he wishes you to remove it. His girlfriend, Spacey N. Blonde, examined herself for ticks and noticed a painless rash on her leg and wants it checked out. Spacey's housemate, Juana C. Mytanlyne, found a tick on her leg on Friday, but was able to remove it earlier today. Juana did not want to come to the ED. Both Surf and Spacey feel well. They deny any fevers or joint pains. Surf reports that the preceding week, he noticed two larger ticks on Wave which were removed easily. |
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1. |
How should you remove Surf's tick? |
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2. |
After removing the tick, you do not find any other ticks. Nor do you find any rashes. Surf is afebrile. How should you proceed in your treatment of Surf? |
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3. |
Spacey is afebrile and feels well. On exam, you do not find any ticks. However, she does have the rash shown. What are important questions in your history and review of symptoms? |
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4. |
Should Spacey receive any medication? |
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5. |
After learning of your treatment of Surf and Spacey, Juana comes to the ED later that evening. Juana feels well, has no rashes or ticks, and is afebrile. Would you offer her any treatment? |
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6. |
If Spacey had waited two days to see you would you act differently? Two weeks? Two months? |
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7. |
Wave seems to have frequent ticks despite his use of a flea collar. Does he pose a health hazard to Surf, Spacey, and Juana? |
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8. |
How can tick bites, and therefore tick-borne illness, be prevented? |
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9. |
Suppose Juana never seeks medical attention. What possible illness(es) can she develop? |
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