Case Study 1 & 2 Lyme Disease and Peripheral Vascular Disease

using APA and include 2 scholarly references. Answer both case studies on the same document The answers must be in your own words with reference to journal or book where you found the evidence to your answer.
Diagnostic Analysis
Based on the patient’s history of camping in the woods and an insect bite and rash on the
thigh, Lyme disease was suspected. Early in the course of this disease, testing for specific
immunoglobulin (Ig) M antibodies against B. burgdorferi is the most helpful in diagnosing
Lyme disease. An elevated ESR, increased AST levels, and mild anemia are frequently seen
early in this disease. RF and ANA abnormalities are usually absent.

Critical Thinking Questions
1. What is the cardinal sign of Lyme disease? (always on the boards)
2. At what stages of Lyme disease are the IgG and IgM antibodies elevated?
3. Why was the ESR elevated?
4. What is the Therapeutic goal for Lyme Disease and what is the recommended treatment.

Diagnostic Analysis
With the clinical picture of classic intermittent claudication, the noninvasive Doppler and
plethysmographic arterial vascular study merely documented the presence and location of the
arterial occlusion in the proximal femoral artery. Most vascular surgeons prefer arteriography
to document the location of the vascular occlusion. The patient underwent a bypass from the
proximal femoral artery to the popliteal artery. After surgery he was asymptomatic.
Critical Thinking Questions
1. What was the cause of this patient’s pain and cramping?
2. Why was there decreased hair on the patient’s right leg?
3. What would be the strategic physical assessments after surgery to determine the
adequacy of the patient’s circulation?
4. What would be the treatment of intermittent Claudication for non-occlusion?