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Raynaud’s phenomenon

Discussion

A 32-year-old female presents to the clinic with complaints of recurring episodes of colour changes in her fingers triggered by cold weather or emotional stress. She describes her fingers turning white, then blue, and finally red upon rewarming. These episodes are associated with tingling and numbness but no pain. The episodes last anywhere from 15 to 30 minutes and typically resolve when she warms her hands. She has no history of arthritis, skin rashes, or other autoimmune symptoms.

Her medical history is unremarkable, and she is otherwise healthy. She works in an office and spends long hours typing. She does not smoke or drink alcohol. Physical examination reveals normal findings, with no visible changes in the skin, and her peripheral pulses are intact.

Given the typical history of episodic colour changes in the fingers, the patient is diagnosed with Raynaud's phenomenon. She is counselled on avoiding cold exposure, managing stress, and protecting her hands with warm gloves. A baseline autoimmune workup is negative, ruling out secondary causes such as systemic lupus erythematosus or scleroderma. She is advised to monitor her symptoms and return if they worsen or if other systemic symptoms develop. No medication is prescribed at this time due to the mild nature of her symptoms.

Questions
1. What is the most likely diagnosis for this patient based on her symptoms?

A) Carpal tunnel syndrome

B) Raynaud's phenomenon

C) Peripheral artery disease

D) Rheumatoid arthritis

2. Which of the following triggers is most commonly associated with Raynaud's phenomenon?

A) Exercise

B) Cold exposure or emotional stress

C) Excessive caffeine consumption

D) Smoking

3.VWhich of the following is the typical colour progression seen during an episode of Raynaud’s phenomenon?

A) Red, blue, white

B) White, red, blue

C) White, blue, red

D) Blue, white, red

 

4. What is the first-line management approach for a patient with primary Raynaud’s phenomenon?

A) Immunosuppressive therapy

B) Calcium channel blockers

C) Avoiding cold exposure and stress, and using warm gloves

D) Aspirin and anticoagulation therapy

Reveal answers

Answers

  1. B) Raynaud's phenomenon
  2. B) Cold exposure or emotional stress
  3. C) White, blue, red
  4. C) Avoiding cold exposure and stress, and using warm gloves