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A 53-year-old woman is brought to the ED by her husband.

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)

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