You Go Hiking in the Woods with Some of Your

question 5

Multiple Choice

You go hiking in the woods with some of your classmates. A few days after the hike, your friend Alice calls to tell you she is not feeling well and that she is going to skip soccer practice that evening. She says she has a weird rash on her leg and wonders if she was bitten by a spider while your were hiking. She sends you a photo of the rash. You are in your final semester of nursing school and have recently studied disease of the cardiovascular system. You think that the rash that Alice has is a sign of Lyme disease, and offer to take her to the urgent care to get medical help. While you are waiting to see a clinician, you review answer Alice's questions about Lyme disease.
-What causes the characteristic erythema migrans of Lyme disease?

• A) After a person acquires the causative bacteria by eating contaminated meat, the bacteria migrate to the skin in a corkscrew-like motion, killing host cells as they move and causing the bull's-eye rash.
• B) After being introduced into the skin by the bite of an infected tick, the Gram-negative bacteria migrate outward in a circular manner; the LPS in their outer layer causes an inflammatory reaction.
• C) After being introduced into the skin by the bite of an infected mosquito, the Gram-positive bacteria migrate outward in a corkscrew-like manner; the NAGs and NAMs in their cell wall causes an inflammatory reaction.
• D) Borrelia bergdorferi cells propel themselves from host cell to host cell using actin tails, in a manner similar to Shigella cells. As they move, the bacteria destroy the host cells, causing the characteristic rash.
• E) Borrelia bergdorferi is an encapsulated organism. The capsule of these cells is composed of hyaluronic acid that causes a widespread inflammatory response in the skin of the host that manifests as a rash.

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