Coma
Thus, there is no ketoacidosis accompanying the hyperglycemia in hyperosmolar coma.
What our notes say
- Thus, there is no ketoacidosis accompanying the hyperglycemia in hyperosmolar coma. (Chemical pathology and Endocrine pathology — Past Paper Questions & Answers)
- Cerebral malaria with convulsions and coma, pulmonary oedema and acute respiratory distress, acute kidney injury, jaundice, and maternal death. (Junior Clerkship in Reproductive Health (MBOG 4200): end of year examination, 4 )
- Myxoedema coma: IV levothyroxine (with or without liothyronine), IV hydrocortisone, warming, and supportive care. (Integrated case paper: Medicine, Surgery, Gynaecology and Paediatrics (160 marks)
- Topics tested: diabetes (type 1 and 2, drugs, DKA, hyperosmolar state, hypoglycaemia), adrenal disease and Addisonian crisis, thyroid disease and myxoedema coma, and parathyroid disease. (Internal Medicine 4th Year Endocrinology CAT: 30 MCQs)
- Examination: dehydration (dry mucosa, poor skin turgor, low blood pressure, fast pulse), Kussmaul breathing and acetone breath, abdominal tenderness, reduced consciousness, and signs of infection, with a Glasgow Coma Scale and a search for the trigger. (Internal Medicine (MBIM 4100) main exam, Paper One: 3 July 2019)
- Severity (by pH): mild 7.25 to 7.30, moderate 7.00 to 7.24, severe below 7.00, together with drowsiness or coma. (Diabetic ketoacidosis and hyperglycaemic emergencies)
Study material on Coma
- Pathology of Demyelinating Diseases: MS, NMO, ADEM, CPM
- ENDOCRINE PATHOLOGY
- H2Tassessment
- EXAM: Vaccines & Antivirals, Rabies, CMV & EBV, Adenovirus & Enteroviruses
- CNS Trauma Neuropathology: Fractures, Concussion & CTE
Practice questions on Coma
Myxedema coma is the most severe form of hypothyroidism. It presents with
- Hyperthermia, agitation, and tachycardia
- Hypothermia, bradycardia, hypoventilation, and altered consciousness
- Exophthalmos and pretibial myxedema
- High TSH with normal T4
Answer: B. Myxedema coma = decompensated severe hypothyroidism. Precipitated by cold, infection, or sedatives in elderly. Features: hypothermia, bradycardia, hypoventilation, hyponatremia, hypoglycemia, altered consciousness. Treatment: IV T3/T4 + hydrocortisone + supportive care. ---
Myxedema coma is the most severe form of hypothyroidism. It presents with
- High fever and tachycardia
- Profound hypothermia and bradycardia
- Diarrhea and weight loss
- Muscle fasciculations and hyperreflexia
Answer: B. Myxedema coma is a critical state of hypothyroidism characterized by hypothermia (low body temperature), bradycardia (slow heart rate), hypotension, hypoventilation, and altered mental status, often progressing to coma.