Raynaud's phenomenon

Question 1

What causes primary Raynaud’s phenomenon and what causes secondary Raynaud?

Answer 1

primary Raynaud’s: no underlying cause

secondary Raynaud’s: connective tissue dx, occlusive vascular conditions, sympathomimetic drugs,
vibrating tools
hyperviscosity syndromes
nicotine

Question 2

who gets primary Raynaud’s?

Answer 2

women <30 yrs
no tissue injury
negative ANA and ESR

Question 3

who gets secondary Raynaud’s?

Answer 3

men>40 yrs
symptoms of underlying dx
tissue injury and digital ulcers
abnormal nail fold capillary examination

Question 4

Management of primary Raynaud’s

Answer 4

avoid aggravating factors (avoid the cold, wear gloves)
CCB (nifedipine or amlodipine) for persistent symptoms

no further evaluation.

Question 5

Management of secondary Raynaud’s

Answer 5

evaluate and treat underlying disorder
CCB for persistent symptoms
aspirin for patient at risk for digital ulceration.

Question 6

Can beta blockers help with raynaud’s?

Answer 6

no it actually makes it worse.

Question 7

thumb involvement with Raynaud’s is often seen with?

Answer 7

secondary Raynaud’s

Question 8

what test must be ordered to differentiate between primary or secondary Raynaud’s syndrome?

Answer 8

nailfold capillary examination to help differentiate between primary and secondary RP.

Question 9

what is nailfold capillary exam?

Answer 9

place oil on nailfold/cuticle and observing the capillaries with an opthalmoscope.

Normal will have fine loops and abnormal ones will have enlarged with disorganized architecture and microhemorrhages

Question 10

abnormal nailfold capillary structure suggests

Answer 10

secondary Raynaud’s phenomenon and likely has an underlying disorder

Question 11

normal nailfold capillary structure and loops suggusts

Answer 11

primary Raynaud’s phenomenon and likely low risk for secondary connective tissue disorder.