It's Not Always Appendicitis ()
Code Blue and Boo-Boo's ()
Squiggly Lines (ECG) ()
Who's Who ()
Scarborough Spots ()
100
33F presents to ED with nausea, vomiting, abdominal pain
Labs pending
RLQ pain on exam, tender, 0200 at time of assessment
LMP unknown vague, thinks recent as had some spotting a few days ago at time of period
POCUS Some small/moderate FF in abdomen
What is a ruptured ectopic pregnancy
100
You have an unplanned birth in the hospital, baby comes out flaccid, not breathing.
What are the steps to be completed in the first 1 minute
Neonatal Resuscitation:
What is:
1) Warm/ Dry the baby, 2)Stimulate, 3) Position Head and Neck 4)Clear Secretions
Then
Positive Pressure Ventilation/ Bag (Fio2 = 21%), Pulse Oximeter (spO2)
100
65 yo M coming in with palpitations, HR 160, BP 75/60, RR = 20,
What is definitive management
Synchronized Cardioversion
ECG: Vtach
100
This emergency doc has made a live television appearance reppin' SHN, interviewed by Devo Brown
Who is Mayo Ravichanidran!
100
Hail's itself as Scarborough's best spot to grab a patty
What is Patty Time
200
6M presents with intermittent abdominal pain , history of constipation, may have had some blood tinged stool, no known hemorrhoids but pain with bowel movements. Examines well in the ED. No fever or vomiting. Single episode of pain in the ED, but then resolved upon your repeat exam.
What is intussusception
Telescoping ileum into the colon, US demonstrative of a target sign
Had two fluoroscopic enemas with reduction, subsequent colonoscopy revealed a large descending colonic polyp as a pathologic lead point for the intussusception
Recurrent intussusception is relatively common.
200
6 month old comes in with cough, sob, mild difficulty breathing. What is the diagnosis:
What is: Non Accidental Trauma / Healing Rib fractures
Healing fractures of the left 4th to 8th posterior ribs along with multiple old bilateral posterior and lateral rib fractures.
Other: AP chest x-ray demonstrates a subtle airspace opacity in the right lower zone which may represent early infective/inflammatory changes.
200
20 yo M coming in with lightheadedness.
What is the Diagnosis
Mobitz Type 1 : aka Wenkebach
200
This SHN team member happens to be celebrating their birthday today!
Who is Morgan Mcneil! Happy Birthday Morgan!
200
This famous caffeine pick me up has its origins in Scarborough
What is Tim Hortons
🏡Scarborough Resident, Tim Horton lived on Warden, just south of Ellesmere in the 50s and 60s. He got his haircut at Warden & Lawrence at Colony Plaza. This is where he met Jim Charade, owner of a donut shop called "Your Do-Nut". Charade convinced Horton to endorse his donuts and re-named his Scarborough donut shop "Tim Horton Do-Nut". This was the first shop to use the name Horton. 🍩
In the spring of 1963, Toronto Maple Leafs defenceman Tim Horton met businessman Jim Charade. Charade had left his job as manager of a Scarborough, Ontario, doughnut plant to open a store called Your Do-nut in a strip mall at Lawrence and Warden avenues. The store was two doors from the barber shop where Horton got his signature brush cut. Horton had a long-standing interest in getting into the restaurant business.
300
50M with RLQ pain
Labs N, pain radiating to R testes
What is a pyocele
300
A 29-year-old male presents with dental pain and facial redness for the past 4 days. Today, he began to notice double vision. On exam, he has extensive erythema along his right face, as well as ipsilateral facial asymmetry and a cranial nerve 3 palsy. Which of the following is the most likely etiology of his exam findings?
A. Cavernous sinus thrombosis
B. Diabetic neuropathy
C. Ludwig's angina
D. Optic neuritis
E. Vestibular abscess
What is: A Cavernous Sinus Thrombosis
This patient presenting with a:
- dental abscess, facial cellulitis, and a new neurologic deficit
Treatment involves intravenous antibiotics and close monitoring.
Other incorrect answers:
Diabetic cranial nerve neuropathy can present with an isolated loss of ocular movements and diplopia, but would be atypical in this young patient with an associated facial infection.
Ludwig's angina is another dangerous complication of dental infections, which can be life-threatening as progressive sublingual swelling may cause an airway emergency. However, this patient is not presenting with submandibular swelling.
Optic neuritis is an inflammation of the optic nerve which presents with blurred vision and pain with extraocular movements. Cranial nerve palsies are uncommon, unless this is associated with a multiple sclerosis flare.
Vestibular abscess is a local facial abscess associated with dental infections, but does not cause neurologic abnormalities.
300
A patient presents to the ED with Shortness of Breath, no chest pain at the moment, and perhaps chest pain earlier.
What is the diagnosis? What is the cause
What is: Wellens Syndrome (ECG shows biphasic T Wave w/ Inversion )
High LAD occlusion
300
Most likely person to have inside news like Michael Scofield
Who is Dov Soberman
300
Born and raised in Scarborough, this player played with the Leafs
Who is Wayne Simmonds, born and raised in Scarborough, he went to school at Birchmount CI, played with the Leafs from 2020-2023
400
85M presents with abdominal pain to the RLQ sudden onset with associated radiation and pain to the R leg. No fever. 
What is a ruptured iliac anerytsm w/ thrombosis and active leakage.
CT revealed an 80 mm EIA aneruysm
Typically open repair for ruptured, endovascular repair for intact.
400
Previously healthy 56 yo F coming in with Chest Discomfort and Shortness of Breath
What is her Diagnosis?
What is:
Pneumomediastinum and soft tissue emphysema in the neck (figure 2).
Pneumomediastinum is the presence of air within the mediastinum. On imaging, it is more central in location and outlines the mediastinum (thin lucency is seen between the lung and the mediastinum as shown in the figure).
400
A 61-year-old lady is brought in by ambulance with palpitations and dizziness. GCS 15. HR 190, BP 115/50.
How would you manage
What is the diagnosis:
Fast Atrial Fibrillation w/ Accessory Pathway
Treatment:
Unstable: Synchronized Cardioversion
Stable: Procainamide
- Procainamide is a class I antiarrhythmic that targets the AP
- Prolongs action potential duration in atrial and ventricular myocardium
- No AV nodal blocking effect
- Effective in both reversion, and in slowing ventricular rate
400
The Emergency Department "broke" this esteemed colleagues "ankle"
Who is Moh Habbal
400
These four boundaries make up the City of Scarborough (must name all four)
What is Victoria Park Avenue to the west, Steeles Avenue to the north, Scarborough-Pickering Townline and the Rouge River to the east and Lake Ontario as the southern boundary
500
54Y F presents with generalized abdominal pain, constipation, saw PCP 2 weeks earlier for back pain and advised likely MSK. Possibly some weight changes, no fevers. Ht HTN, Anemia and fibroids.
Hb 82 MCV 107 Cr 316 Ca 18.4 BUN 33
What is the unusual presentation here
What is hypercalcemia secondary to a new diagnosis of multiple myeloma
Remember your hypercalcemia pneumonic and to order the labs
Other ddx includes primary hyperparathyroidism, malignancy, drug therapy, familial hypercemic hupocalciuria 
500
Pt comes in concerned because his urine suddenly looks like this.
What is the Diagnosis AND What causes it?
Purple Urine Bag Syndrome (PUBS) i
- associated with bacterial urinary tract infection.
Tryptophan in Diet is broken down/ converted to Indoxyl which changes to blue and red -> reacts with catheter bag to form Purple.
NOTE: urinary catheter materials are stained, but the urine itself is not generally discoloured.
500
A young patient presents with an episode of “loss of conciousness” while lying in a supine position
What is her diagnosis?
What is- Brugada Syndrome: Type 1
500
In their prior life this ER doc represented us at the 2000 Sydney Olympic Games
Who is Garret Pulle (2000 Syndey Games Swimming)
500
The year these iconic balloons were removed and where these were located
What is the hot air balloons at Scarborough Town Centre, removed in 2009