امرأة عمرها ٣٤ سنة تشتكي أن أصابع يديها تصير بيضاء ثم زرقاء ثم حمراء عند البرد أو التوتر، مع تنميل وألم، ثم ترجع طبيعية. تدخن ١٠ سجائر يومياً، والنبض في الرسغ طبيعي ولا توجد قرح. أي نصيحة صحيحة؟

A 34-year-old woman reports her fingers turn white, then blue, then red with cold or stress, with numbness and pain, then recover. She smokes 10 cigarettes a day; wrist pulses are normal and there are no ulcers. Which advice is correct?

1. Keep warm, stop smoking and avoid sudden cold
2. Drink plenty of coffee to improve circulation
3. Use non-selective beta-blockers for prevention
4. Dip the hands in ice water to train the vessels

Answer: A) Keep warm, stop smoking and avoid sudden cold. Raynaud’s is spasm of small arteries with cold or stress. Prevention is warmth, stopping smoking and caffeine, and stress management. Non-selective beta-blockers can worsen spasm; calcium channel blockers may be used.