A Female patient was brought to the ER with altered sensorium. On examination BP was 88/67mm with a pulse of 60/min. Rectal temperature was 34 Celsius. There was associated history of constipation, dry skin and menorrhagia. What is the diagnosis?
(A) Myxedema Coma (B) Septic Shock (C) Hypothermia (D) Cardiogenic Shock
(A) Ans: A. Myxedema ComaRef: Harrison, I8't' ed., pg. 2922.Myxedema coma is a state of decompensated hypothyroidism.A person may have lab values identical to a "normal" hypothyroid state, but a stressful event (such as an infection, myocardial infarction or stroke) precipitates the myxedema coma state, usually in the elderly.Primary symptolns of myxedema coma are altered rnental status and low body ternperature.Low blood sugar, low blood pressure, hyponatrereria, hypercapnia, hypoxia, slowed hea rate, and hypoventilation may also occur.