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8 Cards in this Set
- Front
- Back
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What is it? |
Episodic, revesible digitial ischaemia triggered by cold, stress and emotion |
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Causes |
Primary (20-40s) Secondary (>35) |
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Pathophysiology? |
Hyperactive sympathetic system causing vasoconstriction. Colour change from white (ischamia) to blue (hypoxia) and red (is the reactive hyperaemia) |
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Is primary or secdonary more common?
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Primary |
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How do u diagnose primary? |
Its a diagnosis of exclusion |
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Signs |
Colour change Pain Numbing COld throbbing If secondary Tissue ischaemia and injury (digital ulcers) Abdnormal nail fold exam |
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Do u know any secondary causes? |
CHAT about DRUGS CTD: SSc, SLE, RA, Sjorgrens Haematology: Cryo, Wald, Antiphospho Arterial: authero, thrombo obliteran (abnormal pulses) Trauma: vibration Drugs: cocaine, oestrogens,ergot |
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Mx |
Educaation about precipitants Meds: Long acting CCB, Topical Nitrates, ARBs, alplha blckers, SSRI Severe: PDE-I, digitial sympathectomy Digit Threatening IV prostaglandins Digitial Sympathectomy Consider Anticoagulants If ulcers --> abx, consider fish oils in primary |
