Which of the following is a classical clinical feature of myxedema coma?

AIIMS M.Sc. Nsg Entrance exam-2026

Medical & Surgical Nursing

Easy

Appeared in: AIIMS M.Sc. Nsg Entrance exam-2026

Explanation

Myxedema coma is a decompensated state of severe hypothyroidism, characterized by a critically low metabolic rate.
A low metabolic rate leads to decreased heat production, resulting in hypothermia (a core body temperature below 35°C or 95°F).
The profound lack of thyroid hormone also slows down cardiac function, causing bradycardia (a heart rate below 60 bpm).
Therefore, the combination of hypothermia and bradycardia is a classic presentation of this medical emergency.

Option A: Tachycardia (fast heart rate) and hypertension (high blood pressure) are signs of an accelerated metabolic state.
Option C: Hyperthermia (high temperature) is the opposite of what occurs in myxedema coma. Additionally, patients experience hypoventilation (slow breathing), not tachypnea (fast breathing).
Option D: This option repeats the same error as the first distractor. Tachycardia and hypertension are signs of a hypermetabolic state, which is the opposite of myxedema coma.

Visual 1: Infographic: A side-by-side comparison of the signs and symptoms of Hypothyroidism (Myxedema Coma) vs. Hyperthyroidism (Thyroid Storm), highlighting the opposing effects on heart rate, temperature, and metabolism.
Visual 2: Flowchart: Illustrating the progression from untreated hypothyroidism to the precipitating factors (e.g., infection, cold exposure) and the development of myxedema coma with its key systemic effects.

Clinical Relevance

Nursing practice connection: Knowing The primary clinical manifestations of myxedema coma, a severe complication of hypothyroidism helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Recognizing the triad of altered mental status, hypothermia, and a precipitating event is crucial for a nurse to suspect myxedema coma, a condition with a 30-40% mortality rate.
Nurses must use passive rewarming techniques (e.g., warm blankets) and avoid active rewarming (e.g., heating pads), as rapid vasodilation can cause profound hypotension and cardiovascular collapse.
What if? If an elderly patient with known hypothyroidism presents with confusion and a normal temperature after a fall, the nurse should still have a high index of suspicion. The stress from the trauma can precipitate myxedema coma, and an underlying infection could be masking the typical hypothermia.

How to Approach the Question

First, identify the key term in the question: 'myxedema coma'.
Recall the underlying pathophysiology: Myxedema coma is the most severe form of hypothyroidism.
Connect the pathophysiology to the clinical picture: 'Hypo-' means low or slow. Therefore, hypothyroidism causes the body's metabolism to slow down.
Evaluate each option based on this 'slow metabolism' principle.
Hypothermia (low temperature) and bradycardia (slow heart rate) are direct results of a slowed metabolism.
Conversely, tachycardia, hypertension, and hyperthermia are signs of a fast metabolism, which would be seen in hyperthyroidism. Eliminate these options.

Concept Tested & Keywords

Concept Tested: The primary clinical manifestations of myxedema coma, a severe complication of hypothyroidism.
Stem keywords: classical clinical feature, myxedema coma
Lead-in keywords: Which of the following

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