[toxnews] Toxicology Case Conference for October 13, , 2022 (1:30-3:30 PM)

[Christine Stork]

Upstate NY Poison Center

Toxicology Case Conference

October 13 2022

Time: 1330-1530
Location
JH 5th Floor


Zoom:

https://urldefense.com/v3/__https://upstate.zoom.us/j/94022814635?pwd=ZXdZOFN3OFMrN1FjWlhOTGRid3YyUT09__;!!GobTDDpD7A!K-rrgRepTS88v2CdtH1Hb-H4UaEHtOYxdf95EBN2a1j6-NCrZIm9CXux9bHiJikuzQzlfQp3CM9ACsf1A8YLzEA6$  

password: caseconf
Leader
Ahmed Alsakha, MD and Sarah Mahonski, MD

Case Presentation
Case 1

A 17-year-old female presents to the emergency department after an intentional overdose with multiple episodes of vomiting. Vital signs are: HR 93, BP 111/68, RR 18, Afebrile, 100% on room air. Exam is notable for abdominal tenderness. Labs are notable for an anion gap metabolic acidosis and a pH of 7.3.

Case 2

A 76 year old female with a history of atrial fibrillation, Sjogren's syndrome, and hypertension is admitted to the hospital after she is found to have an acute kidney injury, and dehydration secondary to persistent vomiting. During her admission, a medication reconciliation is performed and she is administered her home medications. Twenty minutes later, she experiences salivation, worsening vomiting, and dizziness. Her vital signs are: HR 55 ,BP 130/70, RR 18, Afebrile, and 100% on Room Air. Her exam is notable for excessive drooling, moist skin, and vomiting.

Case 3

A 2-year-old male from Puerto Rico is given an over-the-counter appetite stimulant purchased by his mother, as he is a picky eater. He is brought to the emergency department with altered mental status shortly thereafter. Vital signs are: HR 157, BP 108/72, RR 30, T 36.5, O2 Sat 97% on RA. Exam is notable for mydriasis, dry mucus membranes, and altered mental status.

Journal Club - Syracuse rotators, please read all articles and please let the fellow know who will briefly present each article.

Seifert SA, Armitage JO, Sanchez EE. Snake Envenomation. N Engl J Med. 2022 Jan 6;386(1):68-78. doi: 10.1056/NEJMra2105228. PMID: 34986287.

Isbister GK, Noutsos T, Jenkins S, Isoardi KZ, Soderstrom J, Buckley NA. D-dimer testing for early detection of venom-induced consumption coagulopathy after snakebite in Australia (ASP-29). Med J Aust. 2022 Aug 15;217(4):203-207. doi: 10.5694/mja2.51589. Epub 2022 Jun 7. PMID: 35670073.

Christine M. Stork, BSPharm, PharmD, MPH, DABAT, FAACT
Professor, Department of Emergency Medicine
Clinical Director, Upstate NY Poison Center
Upstate Medical University
Syracuse, NY

-------------- next part --------------
An HTML attachment was scrubbed...
URL: <http://lists.upstate.edu/pipermail/toxnews/attachments/20221010/29ac7eee/attachment-0001.html>
-------------- next part --------------
A non-text attachment was scrubbed...
Name: Isbister, et al, D Dimer for venom Coagulopathy.pdf
Type: application/pdf
Size: 4661060 bytes
Desc: Isbister, et al, D Dimer for venom Coagulopathy.pdf
URL: <http://lists.upstate.edu/pipermail/toxnews/attachments/20221010/29ac7eee/attachment-0002.pdf>
-------------- next part --------------
A non-text attachment was scrubbed...
Name: Seifert, et al, NEJM, Snake Envenomation, 2022.pdf
Type: application/pdf
Size: 1963561 bytes
Desc: Seifert, et al, NEJM, Snake Envenomation, 2022.pdf
URL: <http://lists.upstate.edu/pipermail/toxnews/attachments/20221010/29ac7eee/attachment-0003.pdf>