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NBME 19 Answers

nbme19/Block 2/Question#5 (6.6 difficulty score)
38 yo woman, 6 months depressed mood, joint ...
Lyme disease🔍

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submitted by mahitha(0),

Can anyone PLZZ explain how lymes disesa has memory problems and depressed mood?

drdoom  Chronic inflammation, and the persistent elaboration of cytokines that go along with it, can cause all sorts of unusual and nonspecific problems, including cognitive compromise. (Just imagine how you might feel if you had low-grade fever for, say, a decade.) Patients who have suffered significant cardio- or cerebrovascular “events” report depressed mood following the event. My guess is that the memory problems can be from chronic inflammation or as a result of spirochete vasculitis which, over time, results in a kind of vascular dementia (“multi-infarct”). You see spirochete vasculitis (of the thoracic aorta), as well as vascular dementia, in another famous spirochete, Treponema pallidum, the culprit behind Syphilis. +2