Raynauds Phenomenon

Question 1

what is Raynauds phenomenon?

Answer 1

This is a condition due to vasospasm of the digits.

It is painful and is characterised by a typical sequence of colour changes in response to a cold stimulus.

It is often also precipitated by stress.

Question 2

what do the colours of the digits indicate in raynauds?

Answer 2

white- inadequate blood flow

blue -venous stasis

red -re-warming hyperaemia.

Question 3

what is raynauds syndrome?

Answer 3

This term is used when Raynaud’s phenomenon is idiopathic.

It is quite common in young women and may improve as they get older.

It may be familial.

Treatment comprises measures to keep warm and to avoid smoking.

Question 4

what diseases are associated with raynauds phenomenon?

Answer 4

• if they develop in someone >30 years, suspect underlying disease
• associated with Scleroderma, SLE, dermatomyositis and polymyositis, Sjogren’s syndrome

Question 5

what are some physical causes of RP?

Answer 5

• use of heavy vibrating tools
• cervical rib
• ‘sticky’ blood e.g cryoglbulinaemia

Question 6

what drugs can induce RP?

Answer 6

beta blockers

Question 7

what is the treatment for RP?

Answer 7

• keep warm
• avoid smoking
• CCB are first line
• phosphodiesterase 5 inhibitors and prostacyclins are usually effective

Question 8

what are the complications in RP?

Answer 8

• digital ulcers
• severe digital ischaemia
• infection
• gangrene

Question 9

if there is underlying disease, how long will episodes of RP last?

Answer 9

If there is underlying disease, then episodes may last for hours and the pattern is often asymmetrical, with only a few digits affected

otherwise, episodes usually last minutes