A 30 y/o pregnant woman has a one week history of a slowly enlarging red lesion on her right thigh. She reports having gone on a camping trip about 3 weeks ago and now recalls that she removed a tick from the site of the lesion. An ELISA test is negative for Lymes. Upon further questioning, she also reports contact with poison Ivy like bushes during the same camping trip.
What is the next step?
A. Re-assurance
B. Ampicillin
C. Doxycycline
D. Western blot testing
A. Re-assurance
B. Ampicillin
C. Doxycycline
D. Western blot testing
E. Topical Corticosteroid
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Archer USMLE Step 3 Blog 
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D