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A 30 y/o F presents to the Emergency Department with decreased LOC and confusion. She is bradycardic and slightly hypotensive. Temperature is within normal limits. Pupil examination reveals miosis and dermatologic examination reveals diaphoresis. She has vomited three times and has diarrhea. You also notice urinary incontinence and significant oral secretions. Which toxin is MOST likely to cause this syndrome?
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