<prompt> A 14-year-old girl on exposure to cold has pallor of extremities followed by pain and cyanosis. In later stages of life she is most prone to develop:SLESclerodermaRheumatoid ahritisDermatomyositis  <response>: Pallor of extremities, followed by pain and cyanosis suggests a diagnosis of Raynaud;s phenomenon. Raynauds as the presenting manifestation is most strongly associated with scleroderma.Raynauds is associated with viually every patient of scleroderma98-99It is the presenting complaint in 70 of patients with sclerodermafeatureLimited sclerodermaDiffuse sclerodermaRaynauds phenomenon9998Secondary causes of Raynauds phenomenon:Rheumatologic:SclerodermaSLERASjogrens syndromeDermatomyositisPolymyositisvasculitisDrugs:sympathomimeticsdecongestants, diet pillsserotonin agonistssumatriptanchemotherapeuticsbleomycin, cisplatin,carboplatinergotaminecaffeinenicotineHaematologic disorders:cryoglobulinemiaparaproteinemiapolycythemiacold agglutininsVasospasm:migraine headachesMechanical:vibration injuryfrostbitethoracic outlet syndromevascular embolus or occlusionEndocrine disorders:hypothyroidismcarcinoid syndromepheochromocytomaRef: Harrisons 18e p2763, 17e p2096, 2101 