About Kris Nañagas, MD

Associate Professor of Clinical Emergency Medicine
Medical Toxicology Faculty
Indiana University School of Medicine

ACMT Toxicology Visual Pearl | Substance-Induced Crystalluria: All That Glitters Is Not Gold

Which of the substances below causes crystalluria with hexagonal crystals that shimmer on macroscopic urine examination?

Acyclovir
Ethylene glycol
Indinavir
Primidone
Sulfamethoxazole/trimethoprim

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By Kris Nañagas, MD|2022-05-04T12:08:00-07:00May 6, 2022|ACMT Visual Pearls, Renal, Tox & Medications|

ACMT Toxicology Visual Pearls – In “Spore” Taste

A 15-year-old male presents symptomatic several hours after inhaling spores of this mushroom as a home remedy for epistaxis. What is the presentation and pathophysiology of the toxic syndrome associated with this mushroom?

For a video of this mushroom in action: https://youtu.be/G_DXTlvvsco

Dyspnea and cough from hypersensitivity alveolitis
Flushing, nausea and vomiting from acetaldehyde accumulation
Nausea, vomiting and hepatoxicity from RNA synthetase inhibition
Seizures from reduced GABA production in the central nervous system

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By Kris Nañagas, MD|2021-04-10T10:23:37-07:00Apr 7, 2021|ACMT Visual Pearls, Tox & Medications|

ACMT Toxicology Visual Pearls: Eating Foraged Wild Mushrooms

What clinical symptoms would be expected after eating a meal made with the pictured foraged wild mushrooms?

Bradycardia, urinary incontinence, and bronchospasm
Hallucinations
Seizures and rhabdomyolysis
Skin flushing and palpitations (more…)

By Kris Nañagas, MD|2019-11-12T19:03:03-08:00May 27, 2019|ACMT Visual Pearls, Expert Peer Reviewed (Clinical), Tox & Medications|