A

Hypothermia (34 °C), bradycardia, hypotension, altered sensorium, and classic hypothyroid features—constipation, dry skin, menorrhagia—strongly suggest decompensated severe hypothyroidism (myxedema coma), not primary shock states or simple environmental hypothermia [Amin 2023 PMID 37719600; Villalba 2019 PMID 31762876].