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General Medicine · Endocrinology: myxedema coma
Sample itemAn older patient with longstanding hypothyroidism presents with hypothermia, bradycardia, hypoventilation, hyponatremia, and reduced consciousness. What is the diagnosis?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
A. Myxedema coma
Myxedema coma is severe decompensated hypothyroidism with altered consciousness, hypothermia, bradycardia, and hypoventilation. It requires intensive supportive care and thyroid hormone replacement.
Option by option
A. Myxedema coma (correct)
Correct. This is the characteristic life-threatening hypothyroid presentation.
B. Neuroleptic malignant syndrome
NMS causes hyperthermia and lead-pipe rigidity after dopamine blockade.
C. Serotonin syndrome
Serotonin syndrome causes clonus and hyperreflexia.
D. Thyroid storm
Thyroid storm produces hypermetabolic features.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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