- 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. 2. Peripheral Vascular Disease 1. What was the cause of patient’s pain and cramping in the Occlusive Peripheral Vascular disease? 2. Why is there decreased hair on the patient’s leg with arterial occlusion? 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?