What physical examination findings might suggest sympathomimetic toxidrome?

The findings characteristic of sympathomimetic toxidrome include mydriasis (dilated pupils) and hyperthermia (elevated body temperature). This toxidrome is often associated with the use of stimulant drugs, such as cocaine, amphetamines, and certain hallucinogens, which activate the sympathetic nervous system.

Mydriasis occurs due to sympathetic stimulation of the dilator muscle of the iris, while hyperthermia can result from increased metabolic activity and heightened autonomic function stimulated by these substances. Patients may also exhibit other signs such as tachycardia, increased blood pressure, agitation, and tremors.

The other physical examination findings mentioned in the options do not align with the typical presentation of sympathomimetic toxidrome. Bradycardia and hypothermia are usually associated with a different type of toxidrome, often involving central nervous system depressants or opioids. Decreased bowel sounds can suggest opioid intoxication or a different metabolic condition rather than sympathomimetic toxicity. Lastly, normal vitals would not support a diagnosis of toxidrome, where one would expect abnormal presentations due to the drugs' stimulatory effects.