What’s Your Diagnosis? Managing Patients with Thyroid Emergencies

Welcome to this month’s What’s Your Diagnosis Challenge!

But before we begin, check to see if you got the previous case on Emergency Department Management of Patients With Complications of Chronic Neurologic Disease correct.

Case Presentation:  Emergency Department Management of Patients With Thyroid Emergencies 

A 67-year-old woman presents to the emergency department by EMS with altered mental status…

  • According to EMS, a family member found her at home, without heat, with an outdoor ambient temperature of 36°F. She was in a confused mental state.
  • On EMS arrival, the patient was noted to be obtunded, with a temperature of 31.6°C, heart rate of 43 beats/min, blood pressure of 78/45 mm Hg, and respiratory rate of 15 breaths/min.
  • In the ED, you note the patient to be cold and minimally responsive.
  • Review of her medical record shows she currently takes lisinopril, atorvastatin, levothyroxine, and citalopram. Because the differential diagnosis for this patient is so broad, you wonder whether her medication list provides any clues…

Make your best guess, and check back next month to find out the correct answer!

Click to review this Emergency Medicine Practice Issue, PTSD Symptoms

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