1. Differential Diagnoses: Could it be a pesticide? Pesticide Health Effects Medical Education Database (PHEMED)

2. The Great Decievers Syphilis Lupus AIDS Pesticide Poisonings

3. Sometimes Easy-Sometimes Hard General Bad Feeling –Nausea, weakness, fatigue, lightheadedness, headache, nausea –Differential Diagnosis 1.Viral illness 2.Early onset diabetes 3.Incipient malaria 4.Dehydration 5.Pesticide poisonings S. Holland ‘07

4. (Semi) Unique Signs-Symptoms Miosis: cholinesterase inhibitors Mydriasis: cyanide/flouride Acral and perioral parasthesias: pyrethroids Yellow skin color: nitrophenols Hair loss: thallium Peripheral Neuropathy: arsenic & OP’s Methemoglobinemia (blue baby): sodium chlorate, creosote Skin burn: paraquat

5. Other Manifestations Seizures –Organochlorine insecticides may cause isolated grand mal seizures –Late stage organophosphates –Fipronil Metabolic Acidosis –Boric Acid ingestion (scalded baby syndrome) –Herbicides (glyphosate) Cardiac Arrythmias –Organophosphates and Torsade de pontes and bradycardia Bloody diarrhea –arsenic-thallium Pulmonary edema –organophosphates and carbamates Altered mental status –Several pesticides Hypermetabolism –Dinoseb –Pentachlorophenol

6. Manifest in Multiple Systems Nervous – central & peripheral Cardio-vascular Gastrointestinal & Hepatic Skin Eye Hematopoietic Respiratory Renal