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<p class="MsoIntenseQuote">Upstate NY Poison Center<o:p></o:p></p>
<p class="MsoIntenseQuote"><span style="font-family:"Arial",sans-serif">Toxicology Case Conference<o:p></o:p></span></p>
<p class="MsoIntenseQuote">October 13 2022<o:p></o:p></p>
<p class="MsoIntenseQuote"><span style="font-family:"Arial",sans-serif">Time: 1330-1530<o:p></o:p></span></p>
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<p class="MsoNormal"><span style="font-family:"Arial",sans-serif;color:black">Location<o:p></o:p></span></p>
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<p class="MsoNormal"><span style="font-size:12.0pt;font-family:"Arial",sans-serif;color:black">JH 5<sup>th</sup> Floor<o:p></o:p></span></p>
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<p class="MsoNormal"><span style="font-size:12.0pt;font-family:"Arial",sans-serif;color:black"><o:p> </o:p></span></p>
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<p style="background:white"><span style="font-size:9.0pt;font-family:"Arial",sans-serif;color:black">Zoom:
<o:p></o:p></span></p>
<p style="background:white"><span style="font-size:9.0pt;font-family:"Arial",sans-serif;color:#3C4043;letter-spacing:.15pt"><a href="https://urldefense.com/v3/__https://upstate.zoom.us/j/94022814635?pwd=ZXdZOFN3OFMrN1FjWlhOTGRid3YyUT09__;!!GobTDDpD7A!K-rrgRepTS88v2CdtH1Hb-H4UaEHtOYxdf95EBN2a1j6-NCrZIm9CXux9bHiJikuzQzlfQp3CM9ACsf1A8YLzEA6$">https://upstate.zoom.us/j/94022814635?pwd=ZXdZOFN3OFMrN1FjWlhOTGRid3YyUT09</a><o:p></o:p></span></p>
<p style="background:white"><span style="font-size:9.0pt;font-family:"Arial",sans-serif;color:#3C4043;letter-spacing:.15pt">password: caseconf</span><span style="font-size:10.5pt;font-family:"Arial",sans-serif;color:#3C4043;letter-spacing:.15pt"><o:p></o:p></span></p>
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<p class="MsoNormal"><span style="font-size:12.0pt;font-family:"Arial",sans-serif;color:black">Leader<o:p></o:p></span></p>
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<p class="MsoNormal"><span style="font-size:12.0pt;font-family:"Arial",sans-serif">Ahmed Alsakha<span style="color:black">, MD and
</span>Sarah Mahonski, MD<span style="color:black"><o:p></o:p></span></span></p>
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<p class="MsoNormal"><o:p> </o:p></p>
<p class="MsoNormal"><span style="font-size:14.0pt">Case Presentation<o:p></o:p></span></p>
<p class="MsoNormal">Case 1<span style="font-size:12.0pt"><o:p></o:p></span></p>
<p class="MsoNormal"><o:p> </o:p></p>
<p class="MsoNormal">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.<o:p></o:p></p>
<p class="MsoNormal"><o:p> </o:p></p>
<p class="MsoNormal">Case 2<o:p></o:p></p>
<p class="MsoNormal"><o:p> </o:p></p>
<p class="MsoNormal">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.<o:p></o:p></p>
<p class="MsoNormal"><o:p> </o:p></p>
<p class="MsoNormal">Case 3<o:p></o:p></p>
<p class="MsoNormal"><o:p> </o:p></p>
<p class="MsoNormal">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.<o:p></o:p></p>
<p class="MsoNormal"><o:p> </o:p></p>
<p class="MsoNormal">Journal Club – Syracuse rotators, please read all articles and please let the fellow know who will briefly present each article.<o:p></o:p></p>
<p class="MsoNormal"><o:p> </o:p></p>
<p class="MsoNormal"><span class="contentpasted0"><span style="font-size:12.0pt;font-family:"Calibri Light",sans-serif;color:#212121;background:white">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.</span></span><span style="font-size:12.0pt;color:black"><o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-size:12.0pt;color:black"><o:p> </o:p></span></p>
<p class="MsoNormal"><span class="contentpasted2"><span style="font-size:12.0pt;font-family:"Calibri Light",sans-serif;color:#212121;background:white">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.</span></span><o:p></o:p></p>
<p class="MsoNormal"><o:p> </o:p></p>
<p class="MsoNormal"><span style="font-family:"Script MT Bold"">Christine M. Stork, BSPharm, PharmD, MPH, DABAT, FAACT<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Script MT Bold"">Professor, Department of Emergency Medicine<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Script MT Bold"">Clinical Director, Upstate NY Poison Center<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Script MT Bold"">Upstate Medical University<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family:"Script MT Bold"">Syracuse, NY<o:p></o:p></span></p>
<p class="MsoNormal"><o:p> </o:p></p>
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