Vasopspatic Disorders

Question 1

Raynaud’s phenomenon definition

Answer 1

Episodic digital vasospasm in the absence of identifiable disorder

Question 2

Symptoms of Raynaud’s phenomenon

Answer 2

1) pallor
2) cyanosis
3)redness
Females
COCP

Question 3

Management of Raynaud’s phenomenon

Answer 3

Reassurance
Stop smoking 
Avoid cold
Ca Chanel blockers/vasodilator so
Severe attack-> 5 day infusion of prostacyclin

Question 4

Raynaud’s syndrome definition

Answer 4

Phenomenon occurs in response to a secondary condition

Question 5

Raynaud’s syndrome causes

Answer 5

Autoimmune/connective tissue disorders -> ESR/antibodies, sclerodactyl and calcinosis

• systemic sclerosis
• mixed connective tissue disorder
• SLE

Macro vascular disease

• thoracic outlet obstruction
• atherosclerosis
• Buegers disease
• radial artetitis

Occupational

• vibration white finger
• chemical
• extreme cold

Drugs

• cytotoxic
• ergotamine
• b blockers
• ciclosporin

Malignancy
Av fistula

Question 6

Thoracic outlet syndrome definition and anatomy

Answer 6

The lower trunk of the brachial plexus and/or the subclavian vessels are compressed as they pass over the first rib/cervical rib/cervical band

Question 7

Clinical features of thoracic outlet syndrome

Answer 7

Females 20-40y
Commonly neurological symptoms:
-pain
-parasthesia
-weakness 
-> ulnar hand + forearm
Palpable cervical rib
External rotation and hyperabduction of the shoulder-> radial pulse lost
Digital ischemia

Question 8

Investigations of thoracic outlet syndrome

Answer 8

Plain radiograph
MRI
Angiography 
Duplex
Nerve conduction studies

Question 9

Management of thoracic outlet

Answer 9

Physiotherapy if no nerve or artery damage

Operative decompression