Thyroid storm typically features which combination?

• A. Weight gain and bradycardia
• B. Hypothermia, lethargy
• C. Lethargy with normal heart rate
• D. Acute mental status changes with hyperthermia and tachycardia

Answer: (D)

Thyroid storm is an extreme, life-threatening surge of thyroid hormone that drives the body's metabolism to an intense, hyperactive state. The most telling combination is acute mental status changes (agitation, confusion, delirium) paired with hyperthermia and tachycardia. The CNS changes reflect overwhelming thyroid hormone impact on brain function, while the high fever and rapid pulse show the accelerated metabolism and sympathetic activation underway. Scenarios with weight gain and bradycardia, or hypothermia with lethargy, don’t fit because they point toward reduced metabolic activity or hypothyroid-like states, not a storm of thyrotoxicosis. So the presentation including acute mental status changes with high fever and a fast heart rate best matches thyroid storm.