Hepatic Failure/GI/Endocrine Emergencies

(Answer C is incorrect). Although previous guidelines

recommended initiating PPIs before endoscopy, the

most recent version does not recommend for or against

this practice (Answer A is incorrect). High-dose PPIs

should be continued for 48 hours after endoscopy and

then followed by twice-daily treatment from days 4–14.

(Answer B is incorrect).

Answer: A

The patient, who presented with signs and symptoms

of myxedema coma, was given this diagnosis by the

treating team. Of the possible answers listed, only levo-

thyroxine is appropriate for the treatment of myxedema

coma (Answer A is correct). Insulin, propylthiouracil,

and propranolol play no role in the treatment of myx-

edema coma (Answers B–D are incorrect).