A Skyean od woman is shoveling snow on a cold day When she oncts meitic Aro of the fingers on her feft hand are Dowish and Rainmh Careful medioal examination rules ovt irostbite and finds instead aberrant arteriolar constriction in thase two fingers. What is the most likely disease? Giant cell anteritis Poldarteritis nodasa Raynauds disease Takayasu anteritis

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The symptoms described in the scenario suggest that the woman is experiencing episodes of reduced blood flow to her fingers, which is characterized by the coldness and numbness. The key points to consider are:

1. **Coldness and numbness in fingers**: This is often associated with conditions that affect blood flow.
2. **Exclusion of frostbite**: This indicates that the symptoms are not due to external cold exposure but rather an internal vascular issue.
3. **Aberrant arteriolar constriction**: This suggests a problem with the small blood vessels, which is a hallmark of certain vascular diseases.

Now, let's analyze the options:

1. **Giant cell arteritis**: This condition primarily affects the large arteries and is associated with headaches, jaw claudication, and visual disturbances. It is less likely to cause symptoms localized to the fingers.

2. **Polyarteritis nodosa**: This is a systemic vasculitis that affects medium-sized muscular arteries and can cause a variety of symptoms, but it typically does not present with isolated finger symptoms.

3. **Raynaud's disease**: This condition is characterized by episodic vasospasm of the small arteries and arterioles, leading to coldness, numbness, and color changes in the fingers, especially in response to cold or stress. This fits the description of the symptoms perfectly.

4. **Takayasu arteritis**: This is a large vessel vasculitis that primarily affects the aorta and its major branches, leading to systemic symptoms and claudication but is less likely to cause isolated finger symptoms.

Given the symptoms of coldness, numbness, and the finding of aberrant arteriolar constriction, the most likely disease is:

**Raynaud's disease**.
The most likely disease is Raynaud's disease.

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