A 53-year-old woman is brought to the ED by her husband. He states that his wife is feeling very weak over the last 2 days, is nauseated, and vomiting at least three times. The husband states that she was taking a high-dose medication for her joint pain but ran out of her pills last week. Her vital signs are BP of 90/50 mm Hg, HR 87 beats per minute, RR 16 breaths per minute, and temperature 98.1°F. You place her on the monitor, begin IV fluids, and send her blood to the laboratory. Thirty minutes later the metabolic panel results are back and reveal the following:
What is the most likely diagnosis?
a. Myxedema coma
b. Thyroid storm
c. Hyperaldosteronism
d. Adrenal insufficiency
e. Diabetic ketoacidosis (DKA)
