An elderly female patient has presented to the emergency department with altered mental status, hypothermia, and clinical signs of heart failure. Myxedema is suspected. Which of the following laboratory findings support this diagnosis?
a. Elevated adrenocorticotropic hormone
b. Elevated cortisol levels
c. Elevated T3 and T4
d. Elevated thyroid-stimulating hormone
D
Thyroid hormones are low in myxedema. Thyroid-stimulating hormone is usually high in relation to the feedback mechanisms for hormone regulation if myxedema is caused by primary hypothyroidism. Elevated adrenocorticotropic hormone may be seen in pituitary conditions or adrenal insufficiency. Elevated cortisol levels accompany Cushing's syndrome. Elevated T3 and T4 levels are consistent with hyperthyroidism.
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