2: Raynaud's disease Flashcards
What is Raynaud’s phenomenon
excessive vasoconstriction of arterioles and arteries of the hand in response to cold or emotional stressor
How can the aetiology of Raynaud’s phenomenon be divided
primary and secondary
what is another term for primary Raynaud’s phenomenon
Raynaud’s disease
what is secondary Raynaud’s phenomenon referred to as
Raynaud’s phenomenon
what are 5 causes of Raynaud’s phenomenon
Medications (COCP, Ergot) Connective tissue disease Cold agglutinins Cervical rib Type I cryoglobulinaemia
what connective tissue disorders may cause Raynaud’s disease
Scleroderma
SLE
RA
what is the most common cause of secondary raynaud’s phenomenon
Scleroderma
in which demographic does primary raynaud’s often present
Young females
how does primary raynaud’s typically present
Bilateral
in which age group does secondary raynaud’s present
> 40y
how does secondary raynaud’s present
Unilateral. Presence of other features such as rash
What are the three phases of raynaud’s disease
- Ischaemic
- Hypoxic
- Hyperaemic
how does the ischaemic phase of raynaud’s present
White hands - presents with ischaemia, pallour, numbness, parasthesia and pain
how does the hypoxic phase of raynaud’s present
Blue hands
how does the hyperaemic phase of raynaud’s present
Erythematous hands
how long do spasms typically last in raynaud’s
15-20m after stressor has been removed
how is raynaud’s disease investigated
Clinical diagnosis
how is raynaud’s phenomenon investigated
Depends on features of underlying disorder. Should include a medication review
Who should be referred to a rheumatologist with Raynaud’s
everyone with secondary raynaud’s
What is first line management for raynauds
Lifestyle:
- Gloves for hands + feet
- Smoking cessation
- Reduce stress
- Exercise
What is first line pharmacological management for Raynaud’s
Nifedipine
What is nifedipine
Calcium channel blocker
What can be used as prophylaxis in Raynaud’s disease
IV prostacyclin (epoprostenole)
