Season 5
Episode 13 - Big Baby
Brief Plot Summary
A teacher, Sarah, is admitted after coughing up blood during class. House believes it could be a problem with the patient's blood. They believe it could be ITP or lymphoma since her platelets are abnormal. They start treatment with methotrexate and prednisone. When she stands up she suffers cardiac arrest and they shock it into rhythm. Thirteen suggests it could be cold agglutinin disease which would explain her symptoms occurring in a cold classroom and cold nuclear study room. However, she doesn't have a heart attack after an ice bath. House believes it be a problem in her hippocampus and that it is multiple sclerosis. They do an MRI to find possible plaques but find none. The team moves on to do an ERCP exam to check for pancreatic tumors or malfunction, but during the procedure, she suffers a pleural effusion. When they find nothing on an endoscopic ultrasound, House does a nerve conduction test by cutting her skull open and testing electrical conduction. House then realizes Sarah has patent ductus arteriousus.
A teacher, Sarah, is admitted after coughing up blood during class. House believes it could be a problem with the patient's blood. They believe it could be ITP or lymphoma since her platelets are abnormal. They start treatment with methotrexate and prednisone. When she stands up she suffers cardiac arrest and they shock it into rhythm. Thirteen suggests it could be cold agglutinin disease which would explain her symptoms occurring in a cold classroom and cold nuclear study room. However, she doesn't have a heart attack after an ice bath. House believes it be a problem in her hippocampus and that it is multiple sclerosis. They do an MRI to find possible plaques but find none. The team moves on to do an ERCP exam to check for pancreatic tumors or malfunction, but during the procedure, she suffers a pleural effusion. When they find nothing on an endoscopic ultrasound, House does a nerve conduction test by cutting her skull open and testing electrical conduction. House then realizes Sarah has patent ductus arteriousus.
Diagnosed Disease: Patent Ductus Arteriousus - Congenital disorder where the ductus arteriousus fails to close after birth allowing for mixing of the blood.
SymptomsSmall openings can be asymptomatic although may cause problems under high stress due to a lack of oxygen. A larger ductus can cause breathlessness, rapid heart rate, blue tint when crying, and malnutrition in infants.
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CausesThe ductus arteriousus is a necessary vessel in the womb connecting the pulmonary artery and aorta, giving blood a means to bypass the undeveloped lungs. After birth this vessel is usually closed within a few days; however, sometimes, it doesn't close. This is mainly due to genetic and environmental factors.
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TestsAn echocardiogram is the most effective way to check for this defect.
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Treatment/CureNSAIDs are sometimes prescribed initially to help the PDA close. Sometimes a surgical procedure is needed to close the ductus and prevent this fatal mixing of blood.
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Source Links: Mayo Clinic
Episode 14 - The Greater Good
Brief Plot Summary
Dayna Miller, a former doctor, collapses during cooking class. They think it could be cystic fibrosis, but find that her abdomen has filled up with blood from her liver. She starts to have an itch on her head and itches straight through her scalp. She then starts experiencing spinal shocks and has masses in her spine, lungs, and heart. Wilson biopsies to see if it's cancer; however, her heart stops as she suffers cardiac tamponade. House realizes that during the surgery to resect the myoma from her uterus, the cuts that were made released endometrial cells from her uterus. The cells multiplied in the places they latched on to until they reached critical mass and began to function as uterus cells. The bleeds matched up with period cycles.
Dayna Miller, a former doctor, collapses during cooking class. They think it could be cystic fibrosis, but find that her abdomen has filled up with blood from her liver. She starts to have an itch on her head and itches straight through her scalp. She then starts experiencing spinal shocks and has masses in her spine, lungs, and heart. Wilson biopsies to see if it's cancer; however, her heart stops as she suffers cardiac tamponade. House realizes that during the surgery to resect the myoma from her uterus, the cuts that were made released endometrial cells from her uterus. The cells multiplied in the places they latched on to until they reached critical mass and began to function as uterus cells. The bleeds matched up with period cycles.
Diagnosed Disease: Endometriosis - Condition during which endometrial cells appear outside of the uterine cavity.
SymptomsAbdominal pain, internal bleeding, menstrual pain, ovarian cysts, pelvic inflammation
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CausesSurgical aftermath, retrograde menstruation, cell transport through lymphatic system.
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TestsPelvic exams, ultrasounds, MRI or CT scans
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Treatment/CureLaparoscopy can be used to excise the masses. Hormone therapy is also used to control symptoms. In rare cases, a hysterectomy may be needed to remove the uterus.
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Source Links: Mayo Clinic
Episode 15 - Unfaithful
Brief Plot Summary
A young priest, Daniel Bresson, begin hallucinating after excessive drinking. They test for epilepsy, but find nothing. When they're about to discharge him, they find that his toe has fallen off. House believes it could be carbon monoxide poisoning. They put him in a hyperbaric chamber but he begins to have trouble breathing. They find neuralgia in his chest and loss of vision in his right eye. House thinks it could be his spleen. They realize he has pneumocystis, which is virtually harmless except in immuno-compromised people, which is why they think he has AIDS. House finally realizes that he has Wiskott-Aldrich syndrome, which has symptoms very similar to AIDS.
A young priest, Daniel Bresson, begin hallucinating after excessive drinking. They test for epilepsy, but find nothing. When they're about to discharge him, they find that his toe has fallen off. House believes it could be carbon monoxide poisoning. They put him in a hyperbaric chamber but he begins to have trouble breathing. They find neuralgia in his chest and loss of vision in his right eye. House thinks it could be his spleen. They realize he has pneumocystis, which is virtually harmless except in immuno-compromised people, which is why they think he has AIDS. House finally realizes that he has Wiskott-Aldrich syndrome, which has symptoms very similar to AIDS.
Diagnosed Disease: Wiskott-Aldrich Syndrome - X-linked genetic condition which causes immune system dysfunction and inhibits proper platelet clotting.
SymptomsBruising from low platelet count, external bleeding, dermatitis, spleen enlargement, severe infection
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CausesX-linked inherited WAS gene mutation leading to a lack of functional WASP protein which is found in all blood cells. WASP helps trigger immune activation and is key in platelet adhesion. This causes a severe delay in immune response and clotting ability leading to the symptoms which are similar to AIDS.
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TestsDNA sequencing can reveal inheritance of the mutated gene, blood smears reveal an imbalance of immuno-globulin.
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Treatment/CureNo cure and treatment focuses on managing the symptoms; protective gear, transfusions, avoiding anti-coagulants, and sometimes a splenectomy can help.
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Episode 16 - The Softer Side
Brief Plot Summary
13 year-old Jackson, who has genetic-mosaicism with half-female and half-male cells, collapses after a game of basketball. He complains of pelvic pain and suffers from fluid build-up in his pericardium. A swab reveals bacteria and they treat for an infection. When he begins vomiting blood, they reach a diagnosis of systemic scleroderma. However, House realizes that there was nothing wrong with him in the first place. He came in with simple dehydration but the the contrast material he was given for the MRI was absorbed into his other organs which caused his other symptoms.
13 year-old Jackson, who has genetic-mosaicism with half-female and half-male cells, collapses after a game of basketball. He complains of pelvic pain and suffers from fluid build-up in his pericardium. A swab reveals bacteria and they treat for an infection. When he begins vomiting blood, they reach a diagnosis of systemic scleroderma. However, House realizes that there was nothing wrong with him in the first place. He came in with simple dehydration but the the contrast material he was given for the MRI was absorbed into his other organs which caused his other symptoms.
Diagnosed Disease: Dehydration - Occurs when not enough fluid enters the body, causing a wide variety of symptoms. Treatment is simple and the patient just needs to be given fluids.
Source Links: Mayo Clinic