A 20-Year-Old Woman Comes to the Physician Because Her Fingers

question 818

Multiple Choice

A 20-year-old woman comes to the physician because her fingers turn white episodically.  The symptoms started 6 months ago during the summer when she noticed that opening the freezer or holding cold beverages precipitated these episodes.  She was advised to avoid cold stimuli and wear protective gloves.  However, the symptoms worsened during the winter and the episodes occurred more frequently.  She feels numbness and pain with each episode and seeks relief.
The patient has no skin thickening, chest pain, acid reflux symptoms, or shortness of breath.  She has no other past medical history.  She does not smoke but drinks alcohol occasionally.
Her vital signs are within normal limits.  The remainder of the physical examination is within normal limits.  The hand is shown in the picture.

Laboratory results are as follows:

Which of the following is the most appropriate pharmacotherapy?

• A)Amlodipine
• B)Aspirin
• C)Hydroxychloroquine
• D)Prednisone
• E)Propranolol

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Definitions:

Nasopharynx

The upper part of the pharynx, connecting the nasal cavity above the soft palate to the oropharynx and laryngopharynx.

Tonsil

Small masses of lymphatic tissue located at the back of the throat that help in fighting off infections.

Pharyngeal

Relating to the pharynx, the part of the throat behind the mouth and nasal cavity.

Lingual

Lingual pertains to the tongue, often regarding its anatomical structure, functions, or associated phenomena like lingual nerves or lingual tonsils.