Sporadic ALS: Search for Environmental Etiology

This month's topic is "Treatment of Cyclopeptide Mushroom Poisoning". The articles will be reviewed by the VCU Program in Medical Toxicology and led by Dr. Brandon Wills.

Prepare for your MedTox Board Exam with ACMT

1. A 2-year-old child eats some midwinter buds and presents to the emergency department with nausea and vomiting. 2. A 59-year-old woman comes to the ED from an urgent care center with several days of hematuria and intermittent epistaxis. The bleeding does not resolve with oxymetazoline or nasal packing. 3. A 32-year-old woman with a history of diabetes and opioid use disorder develops sudden onset respiratory distress while awaiting placement into an inpatient treatment program.

ACMT members Gillian Beauchamp, MD, and Elizabeth (Elissa) Moore, DO deliver evidence-based medical toxicology core content and trending topics in easily digestible bites. Visit toxinten.com and follow on Twitter @toxinten.

ACMT members Gillian Beauchamp, MD, and Elizabeth (Elissa) Moore, DO deliver evidence-based medical toxicology core content and trending topics in easily digestible bites. Visit toxinten.com and follow on Twitter @toxinten.

1. A 7-week-old infant born full-term is diagnosed with COVID-19 at 6 weeks of age. The mother states that the infant is not breast feeding well. 2. A couple presents with bradycardia (HR 48 and 53) and hypotension (BP: low 80s/mid-50s) shortly after drinking tea to which they had added a teaspoonful of a sweetener they purchased from overseas. 3. A 36-year-old woman presents to the ED with abdominal pain and an abnormal ECG several hours after initiation of an elective termination of pregnancy.

1. A 55-year-old man presents with A-Fib with a rapid ventricular response. He is given digoxin and later diltiazem without improvement. He develops progressive hypoxic, ultimately requiring intubation. A short time later, his temperature increases to 42C (107.6F). 2. A 22-year-old man with a history of substance use presents to the ED with two weeks of progressive peripheral neuropathy. 3. Three siblings, age 7, 10, and 12, make tacos for lunch using ingredients from their garden. They develop GI distress, bradycardia, and mild hypotension and require admission to the hospital.

1. A 2-year-old child is found by EMS with a depressed level of consciousness after getting into his brother's medication. EMS finds a HR of 69/min and is unable to obtain a BP. They note that he has "really wide" QRS complexes. 2. A 53-year-old woman presents in cardiac arrest after eating a meal made of veggies picked at an abandoned community garden. 3. A 66-year-old man with arthritis presents to the ED with a week-long history of rash, diarrhea, and fatigue.

Algal Toxins: Toxidromes, Molecular Mechanisms and Human Health Effects

1. Six high school students develop a sedative-hypnotic toxidrome after ingesting "Xanax" they received from another student. 2. A 19-year-old man presents with uncontrolled muscle contractions after drinking a home-brewed tea given to him by his family. 3. A 7-day-old boy presents after being recalled for an abnormal bio-surveillance laboratory test that was sent at time of birth (cord blood mercury level of 89.9 mcg/L). He has the following vital signs: BP: 81/51, P: 156, RR: 60, T: 98.7, length 47.5 cm, weight 2.6 kg.

This webinar is part of an ongoing series of educational presentations by experts on issues that focus on current and emerging aspects of pediatric and reproductive environmental health. These presentations focus on the impact of environmental exposures to chemicals on human health at the vulnerable stages of in utero and pediatric development.

Herbal Toxicology

1. A 58-year-old woman and 58-year-old man present to the ED within hours of each other complaining of stroke-like symptoms after sharing a meal. 2. A family at a holiday party finds their 4-year-old son walking awkwardly. In the ED he is ataxic but otherwise clinically well. After observing for a few hours, they are set to discharge him when he has a 15 second asystolic event. 3. A 17-year-old boy presents with vomiting two hours after ingesting 7 seeds. His vital signs are: BP, 136/85 mmHg; HR, 102 beats/minute; RR, 20 breaths/min; O2 Sat, 96% (RA); T, 98.6°F.

This month's topic is Thiamine: A beri beri good vitamin. The articles will be reviewed by the NYU / NYCPCC Medical Toxicology Fellowship, led by Dr. Rana Biary.