TIME: 15 minutes
- Look at the four texts, A-D, in the separate Text Booklet.
- For each question, 1-20, look through the texts, A-D, to find the relevant information.
- Write your answers in the spaces provided in this Question Paper
- Answer all the questions within the 15-minute time limit.
- Your answers should only be taken from texts A-D and must be correctly spelt.
Note: You Can Highlight Keywords In the Reading Text
Text A : Lyme Disease – Causes, Symptoms, and Diagnosis
Lyme disease is a bacterial infection caused by *Borrelia burgdorferi*, transmitted to humans through the bite of infected black-legged ticks, commonly known as deer ticks. The disease is most prevalent in the United States and Europe, particularly in wooded and grassy areas where ticks thrive. If left untreated, Lyme disease can lead to severe health complications affecting the joints, heart, and nervous system. The primary cause of Lyme disease is the bite of a tick infected with *Borrelia burgdorferi*. Ticks become carriers of the bacteria after feeding on infected animals such as mice, deer, or birds. Humans contract the disease when bitten by an infected tick, typically during outdoor activities like hiking or gardening in areas where ticks are common. The tick must be attached to the skin for at least 36 to 48 hours for transmission to occur.
Symptoms of Lyme disease often vary depending on the stage of infection. Early symptoms typically appear 3 to 30 days after the tick bite and may include fever, chills, fatigue, headache, muscle and joint aches, and swollen lymph nodes. One of the most characteristic signs of Lyme disease is a rash called erythema migrans, which appears in about 70-80% of infected individuals. It starts as a small red spot at the site of the bite and gradually expands, sometimes resembling a bullseye. If left untreated, Lyme disease can progress to the early disseminated stage, where the bacteria spread to other parts of the body. This can lead to more severe symptoms such as facial palsy, meningitis, and pain in large joints.
Diagnosing Lyme disease can be challenging, particularly in its early stages when symptoms overlap with those of other conditions. Healthcare professionals typically base their diagnosis on a combination of factors, including a history of potential exposure to ticks, symptoms, and laboratory tests. The most common diagnostic test is the enzyme-linked immunosorbent assay (ELISA), which detects antibodies against *Borrelia burgdorferi*. A confirmatory test called the Western blot is often used to validate positive results from the ELISA test.
Text B: Treatment and Prevention of Lyme Disease
The successful treatment and prevention of Lyme disease depend on early diagnosis and appropriate medical intervention. Lyme disease can often be effectively treated, especially if caught in the early stages, but delayed treatment may lead to more severe complications, requiring longer and more intensive care. In most cases, Lyme disease is treated with antibiotics. The type and duration of treatment depend on the stage of the disease and the severity of symptoms. For early-stage Lyme disease, the standard treatment is a 10- to 21-day course of oral antibiotics. Commonly prescribed antibiotics include doxycycline, amoxicillin, or cefuroxime. These medications effectively eliminate the *Borrelia burgdorferi* bacteria and prevent the infection from progressing to more severe stages. Most patients treated in the early stages recover completely.
If Lyme disease is not treated promptly, the bacteria can spread to the joints, heart, and nervous system. For these cases, intravenous (IV) antibiotics may be required. The course of treatment typically lasts 14 to 28 days and is more intensive than oral therapy. Patients may experience lingering symptoms such as fatigue or muscle aches, known as post-treatment Lyme disease syndrome (PTLDS), even after the bacteria have been eliminated. Prevention is key to avoiding Lyme disease, especially for individuals who live or work in areas where tick populations are high. To reduce the risk of tick bites, individuals should avoid areas where ticks are common, such as tall grass, wooded areas, and leaf litter. Wearing long sleeves, pants, and using insect repellent containing DEET or permethrin on clothing can further decrease the risk of tick exposure. After spending time outdoors, individuals should thoroughly check their bodies and clothing for ticks. Ticks are often small and difficult to detect, so special attention should be paid to areas such as the scalp, armpits, and behind the knees. Prompt removal of ticks reduces the likelihood of infection. Modifying the environment around homes can also reduce the presence of ticks. Keeping lawns well-maintained, removing leaf litter, and using tick-control products on pets can help limit tick exposure.
Text C
Text D: Management and Complications of Late-Stage Lyme Disease
Category | Details |
Late-Stage Symptoms | – Lyme Arthritis: Swelling and pain in large joints (e.g., knees). – Neurological Issues: Meningitis, facial palsy, cognitive difficulties. – Cardiac Symptoms: Irregular heartbeats (arrhythmias), Lyme carditis, heart block. |
Diagnosis | – Based on clinical history, symptoms, and laboratory tests. – Cerebrospinal fluid analysis may be required for neurological symptoms. |
Treatment | – Antibiotics:Extended courses of oral or IV antibiotics. – Symptom Management:Pain relief, physical therapy, and neurological support for lingering symptoms. |
Complications | –Persistent symptoms may include joint pain, cognitive issues, or heart problems. –Post-treatment Lyme disease syndrome (PTLDS) may develop, with no standard treatment available. |
Long-Term Management | –Regular follow-ups with healthcare providers. – Use of NSAIDs or DMARDs for Lyme arthritis. – Specialized care (cardiologists, neurologists) for cardiac and neurological complications. |
END OF PART A
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