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Challenging Cases in Toxicology - 5 CME Credits

A question-based review of cases encountered in emergency medicine

Start Date: May 8, 2018
Duration: ~5 hours
Price: $249

Course Description

Course registration is currently closed while we upgrade our learning platform with enhanced functionality and self-service options for learners. If you would like to be notified when the course re-opens in March 2020, please click here.

This course will provide a series of multiple-choice, question-based cases involving life-threatening clinical poisonings and adverse drug reactions typically encountered in the emergency department or other acute care settings.

This course is designed for emergency medicine physicians as well as other clinicians who practice in an acute care setting (e.g., internists, family practice physicians, pediatricians, hospitalists, and intensivists). Participants will have an opportunity to review and advance their knowledge of current practice patterns and recent advances in clinical emergency medicine.

What You'll Learn

  • Define the general principles of caring for the poisoned patient
  • Differentiate specific and crucial points of pathophysiology, diagnosis, and management of particular poisonings
  • Discuss important medical literature that serves as the underpinning for the rational practice of toxicology
  • Develop case-based clinical problem-solving skills


Michael Ganetsky, MD, FACEP, FACMT

Michael Ganetsky, MD, FACEP, FACMT Assistant Professor of Emergency Medicine, Harvard Medical School; Director, Division of Medical Toxicology, Department of Emergency Medicine, Beth Israel Deaconess Medical Center


Challenging Cases in Toxicology is organized as follows:

Precourse Information:
Accreditation and AMA Credit Designation
Disclosure Statement
How to Take This Course
Viewing Videos
Grading and Certificates

Case 1: Intentional Overdose
Case Introduction
Additional Information
Metabolic Acidosis

Case 2: Unresponsive Patient
Case Introduction
Additional Information

Case 3: Nausea, Vomiting, and Mild Abdominal Pain
Case Introduction
Additional Information
Acute Liver Injury
Medical Management

Case 4: Depressed Male Found Unresponsive
Case Introduction
Wide QRS Complex
Medial Management
Additional Information Summary

Case 5: Attempted Suicide after a Breakup
Case Introduction
Additional Information

Case 6: Weakness, Vomiting, and Bradycardia
Case Introduction
Additional Information
Medical Management

Case 7: Found Down at Work
Case Introduction
Additional Information
Medical Management

Case 8: Female Transferred from Endoscopy Suite
Case Introduction
Medical Management
Agitated Patient

Case 9: Attempted Suicide by Medication
Case Introduction
Additional Information
Hyperglycemia and Bradycardia

Case 10: Found Unresponsive in a Hotel Room
Case Introduction
Additional Information
Metabolic Acidosis

CME Certificate
CME Posttest
Course Evaluation



The Harvard Medical School is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.


The Harvard Medical School designates this enduring material for a maximum of 5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.


Disclosure Policy

Harvard Medical School has long held the standard that its continuing medical education courses be free of commercial bias.

In accord with the disclosure policy of the Medical School as well as standards set forth by the Accreditation Council for Continuing Medical Education, course planners, speakers, and content reviewers have been asked to disclose any relevant relationship they, or their spouse or partner, have to companies producing, marketing, re-selling or distributing health care goods or services consumed by, or used on, patients. In addition, faculty have been asked to list any off-label uses of pharmaceuticals and/or devices for investigational or non-FDA approved purposes that they plan to discuss.

Such disclosure is not intended to suggest or condone bias in any presentation, but is elicited to provide the course director and participants with information that might be of potential importance to their evaluation of a given presentation.

Disclosure Statement

All individuals including course directors, planners, reviewers, faculty, staff, etc., who are in a position to control the content of this educational activity have, on behalf of themselves and their spouse or partner, reported no financial relationships related to the content of this activity.


Dr. Michael Ganetsky is the director of the Medical Toxicology Division based in the Department of Emergency Medicine at Beth Israel Deaconess Medical Center and an assistant professor of emergency medicine at Harvard Medical School. Dr. Ganetsky runs the toxicology rotation for the BIDMC Emergency Medicine residents and received the prestigious BIDMC Emergency Medicine Residency Teaching Attending Award in 2009. He is an attending physician in the BIDMC Emergency Department and core faculty of the BIDMC Emergency Medicine Residency. Dr. Ganetsky is core medical toxicology faculty at the Harvard Medical Toxicology Fellowship and a staff consultant at the MA/RI Poison Control Center. He teaches Introductory Pharmacology to first-year medical students at Harvard Medical School. Dr. Ganetsky's research interests include acetaminophen toxicity, adverse effects of novel oral anticoagulants, opiate abuse, and alcohol withdrawal syndrome.


The following individuals contributed to past iterations of this course:

Valerie Byrnes, MD
John Halamka, MD, MS
Stephen J. Traub, MD
Sage W. Weiner, MD


Cases 1-7 made up Challenging Cases in Toxicology 1:
Original Release: 5/27/2004
Most Recent Update: 11/1/2017

Case 8-10 made up Challenging Cases in Toxicology 2:
Original Release: 1/3/2012
Most Recent Update: 11/7/2017

Both courses were combined into the current version of Challenging Cases in Toxicology for release on 5/8/2018.

End Date: 5/8/2021 (Enrollment ends 4/8/2021)


How long will this course take?

This course should take approximately 5 hours to complete. You do not need to complete it all at once. You may come back as often as you like.

How long will this course be available?

This self-paced course will end three years after its start date.

What web browser should I use?

The platform works best with current versions of Chrome, Firefox, or Safari, or with Internet Explorer version 11 and above. See our list of supported browsers for the most up-to-date information.

What if I want to learn more about this topic?

HMS Continuing Education holds live topic-focused conferences throughout the year. Please see our course catalog for upcoming events.