by Adam Rosh, MD
Welcome to the next episode of The Reveal where we take you inside the mind of a test-taker to deconstruct and connect the dots of a board-style question so you can become a better student, transform how you learn, and excel not only on high-stakes exams, but also in your general medical knowledge. Let’s get started.
A 74-year-old woman with a history of hypothyroidism presents to the ED with confusion, rigors, and lightheadedness. Vital signs are BP 110/64 mm Hg, HR 48 beats per minute, RR 12 breaths per minute, and T 95.2°F. Her electrocardiogram is shown above. Which of the following is the most likely diagnosis?
A) Digoxin toxicity
B) Hyperosmolar nonketotic coma
C) Myxedema coma
D) Nephrogenic diabetes insipidus