Snapshot A 34-year-old woman with a history of hypothyroidism presents to the emergency department with altered mental status. According to the husband, she woke up this morning generally confused and was unable to answer questions. She had 3 episodes of nonbloody, nonbilious emesis shortly after and has been agitated since. She was recently discharged from the hospital status post-elective cesarean section. Her temperature is 99.5°F (37.5°C), blood pressure is 160/100 mmHg, pulse is 142/min, and respirations are 22/min. Laboratory studies show low TSH. Introduction Clinical definition login to view 2 more bullets Epidemiology login to view 7 more bullets Associated conditions login to view 1 more bullet Presentation Symptoms login to view 7 more bullets Physical exam login to view 5 more bullets Studies Thyroid function tests login to view 3 more bullets Liver functioning test login to view 1 more bullet Differential Sepsis login to view 3 more bullets Treatment Management approach login to view 1 more bullet First-line login to view 16 more bullets Long-term management login to view 1 more bullet Complications Arrhythmias Decompensated heart failure Death