Archive Of Standardized Exam Questions: Lyme Disease


This page is dedicated to organizing various examples of standardized exam questions whose answer is lyme disease. While this may seem a odd practice, it is useful to see multiple examples of how lyme disease will be characterized on standardized exams (namely the boards and the shelf exams). This page is not meant to be used as a tradition question bank (as all of the answers will be the same), however seeing the classic “test” characterization for a disease is quite valuable.


When it comes to standardized exams, each topic has its own “code” marked by key buzzwords, lab findings, clues, etc. If you are well versed in this code you will be able to more quickly identify the condition that is being discussed, and get the right answer on the exam you are taking. Below is the “code” for lyme disease

  • Presence in endemic area: travel/hiking/etc. in areas like New England 
  • Tick bite is an important exposure 
  • Target lesion is classic 

Question # 1

A few weeks after a comparing trip in Massachusetts a 12 year old boy develops a 4-cm red, circular lesion that has a clear center. He also has lymphadenopathy, conjunctivitis, myalgia and nausea. What diagnosis would explain this presentation?

Explanation # 1

Target lesion = lyme disease

Question # 2

30-year-old male comes to the clinic with it today history of rash and fever. The patient also complains of  a headache, fatigue, and myalgias. The rash is not associated with pain, itching, burning, but has expanded over the last two days. Division explained that he was on a camping trip Vermont two weeks ago and was bitten by a tick at that time. His temperature 102.2°F, blood pressure is 125/80 mmHg, pulse is 95/min, and respirations are 16/min. The dermatological exam reveals a large single macule on his trunk, with central clearing. The rest of the physical exam is noncontributory.  What is the likely diagnosis in this patient?

Explanation # 2

Known tick bite + target lesion = lyme disease

Explanation # 3


Explanation # 3


Many questions on standardized exams go beyond simply recognizing the underlying topic. Often there are specific testable facts regarding some aspect of the topic’s pathophysiology/management/clinical implications that are commonly asked. Some of these are listed below:




Page Updated: 11.19.2016