Orthopaedic Nurses Certification Board (ONCB) Metabolic/Inflammatory/Tumors Practice Exam

What is a characteristic early symptom of Lyme disease?

1. Erythema migrans

2. Variable heart block

3. Nerve palsy

4. Sleep disturbances

The correct answer is: Erythema migrans

A characteristic early symptom of Lyme disease is erythema migrans. This distinctive skin rash typically appears as a "bull's-eye" with a central clearing and occurs in a portion of patients who have been bitten by an infected tick. While erythema migrans is not present in all cases, it is a hallmark sign and serves as an important early indicator of Lyme disease, often developing within 3 to 30 days after the tick bite. The presence of erythema migrans is especially significant in the diagnostic process of Lyme disease, as it helps differentiate the condition from other illnesses that may have similar initial symptoms, such as flu-like symptoms. Recognizing this rash early is critical to initiating timely treatment, as Lyme disease can lead to more severe symptoms if left untreated. In contrast, the other symptoms listed occur later in the disease progression. Variable heart block may develop when Lyme disease affects the cardiac system, leading to heart rhythm abnormalities, while nerve palsy can occur if the disease progresses and affects the nervous system. Sleep disturbances are often associated with various health issues but are not specifically characteristic of early Lyme disease.