**Question:** Lymes disease all are true except aEUR'

A. Spirochetes are the causative agents of Lymes disease.
B. Lymes disease is primarily transmitted through tick bites.
C. Lymes disease can present with cardiac manifestations.
D. Lymes disease is not associated with neurological complications.

**Core Concept:** Lymes disease is a bacterial infection caused by the bacterium Borrelia burgdorferi. It is transmitted to humans through the bite of infected black-legged ticks, also known as deer ticks or Ixodes ticks. The infection can spread to various organs and systems, including the cardiovascular, musculoskeletal, and nervous systems, leading to a variety of clinical manifestations.

**Why the Correct Answer is Right:**

D. Lymes disease is not associated with neurological complications is incorrect because neurological manifestations are indeed a part of the disease spectrum. Examples include meningitis, encephalitis, polyneuropathy, and radiculoneuropathy.

**Why Each Wrong Option is Incorrect:**

A. Spirochetes are the causative agents of Lymes disease is correct, as Borrelia burgdorferi is a spiral-shaped bacterium, known as a spirochete, which is responsible for causing Lymes disease.

B. Lymes disease is primarily transmitted through tick bites is correct, as the primary mode of transmission is through the bite of infected black-legged ticks, which are also known as deer ticks or Ixodes ticks.

C. Lymes disease can present with cardiac manifestations is correct, as Lymes disease can affect the cardiovascular system, leading to symptoms like arrhythmias, heart failure, and myocarditis.

**Clinical Pearls and Mnemonic:**

To remember the key points:

1. "Infectious Spirochetes (A) cause Lymes disease (B, C, D) transmitted by ticks (B). Cardiac (C) and neurological (D) manifestations may occur."

**Explanation:**

Lymes disease is a bacterial infection caused by the spirochete bacterium, Borrelia burgdorferi. The infection is transmitted through the bite of infected black-legged ticks, commonly known as deer ticks or Ixodes ticks. The disease can present with cardiac manifestations, such as arrhythmias, heart failure, and myocarditis. Additionally, neurological complications, including meningitis, encephalitis, polyneuropathy, and radiculoneuropathy, can occur. While the infection primarily affects the cardiovascular and nervous systems, it can also involve other organ systems, such as the musculoskeletal system, causing arthritis and joint pain.