A patient with a positive Lyme titer presents with left-sided ...

[dejastew]

A patient with a positive Lyme titer presents with left-sided unilateral facial droop and inability to close the left eye. This is most likely due to:
 
  A. Trigeminal neuralgia
  B. Temporomandibular joint syndrome
  C. Multiple sclerosis
  D. Bell's palsy

Question 2

Your patient presents to the ER due to a bee sting on the cheek. As you are examining the patient, you note increasing facial swelling and redness as well as swelling of the lips and eyes. This condition is due to:
 
  A. Angioedema
  B. Parotitis
  C. Sinusitis
  D. Sialoadenitis

[sarajane1989]

Answer to Question 1

ANS: D
Bell's palsy is a unilateral paralysis of the face. The etiology is uncertain, but the paralysis is thought to be due to an inflammation of cranial nerve (CN) VII. Lyme disease is a common cause. The onset of Bell's palsy is sudden, and the symptoms are unilateral. The affected side of the face droops with asymmetrical facial movement; there is pain in or around the ear, excessive lacrimation and salivation, and inability to close the eye.

Answer to Question 2

ANS: A
Angioedema is basically anaphylaxis that is restricted to the skin and is generally benign and self-limiting. The causes are numerous and include insect stings; atopic conditions; food allergies (typically nuts, eggs, shellfish, fruit, and sulfites); drug allergies; allergy desensitization injections; a reaction to blood products; a response to exercise, cold, or pressure; heredity; and vasculitis.