Season 3
Episode 13 - Needle in a Haystack
Brief Plot Summary
While making out with his girlfriend, Stevie has a bloody effusion in his lungs and begins having trouble breathing. He is admitted to the hospital, but as 16 year old needs his parents for medical decisions. They find out he is Romanian and a gypsy meaning cooperation will be a problem. After running a venogram to check for leakage in the lungs, they find nothing. While doing an arteriogram they find a clot in the hepatic vein frying his liver. House insists on finding a leak; he thinks it could be a tumor or sarcoidosis. During the MRI they have reason to believe that it's Wegener's granulomatosis. They treat which improves liver function but causes another bleed in his bladder. Stevie's spleen then ruptures but there are no granulomas meaning they can't confirm Wegener's. They do a colonoscopy and find a toothpick in his stomach causing the symptoms.
While making out with his girlfriend, Stevie has a bloody effusion in his lungs and begins having trouble breathing. He is admitted to the hospital, but as 16 year old needs his parents for medical decisions. They find out he is Romanian and a gypsy meaning cooperation will be a problem. After running a venogram to check for leakage in the lungs, they find nothing. While doing an arteriogram they find a clot in the hepatic vein frying his liver. House insists on finding a leak; he thinks it could be a tumor or sarcoidosis. During the MRI they have reason to believe that it's Wegener's granulomatosis. They treat which improves liver function but causes another bleed in his bladder. Stevie's spleen then ruptures but there are no granulomas meaning they can't confirm Wegener's. They do a colonoscopy and find a toothpick in his stomach causing the symptoms.
Diagnosed Disease: Swallowed a toothpick - he swallowed a toothpick which caused several and seemingly unrelated bleeds throughout his body as the toothpick pierced internal organs
Episode 14 - Insensitive
Brief Plot Summary
Hannah and her mom have been in a car accident and House notices that Hannah has Congenital Insensitivity to Pain with Anhydrosis (CIPA). He orders a battery of tests and a spinal nerve biopsy. However, she suddenly develops a 105 degree fever. The team believes a nerve biopsy is unnecessary and thus Chase convinces them to try overloading her body with pain (drilling into her skull) and asking her where it hurts. She fakes once more and falls off of the balcony when her legs are suddenly paralyzed. After looking at a nerve biopsy, the team realizes that the nerve degeneration is too fast. While talking to her mom, she begins to cry and feels pain in her head. House puts guilt as a symptom and deduces vitamin B-12 deficiency. Foreman points out that the ER gave her B-12 but House realizes a tapeworm "ate" it. Hannah's psychotic breakdowns were caused by the nitric oxide sedative.
Hannah and her mom have been in a car accident and House notices that Hannah has Congenital Insensitivity to Pain with Anhydrosis (CIPA). He orders a battery of tests and a spinal nerve biopsy. However, she suddenly develops a 105 degree fever. The team believes a nerve biopsy is unnecessary and thus Chase convinces them to try overloading her body with pain (drilling into her skull) and asking her where it hurts. She fakes once more and falls off of the balcony when her legs are suddenly paralyzed. After looking at a nerve biopsy, the team realizes that the nerve degeneration is too fast. While talking to her mom, she begins to cry and feels pain in her head. House puts guilt as a symptom and deduces vitamin B-12 deficiency. Foreman points out that the ER gave her B-12 but House realizes a tapeworm "ate" it. Hannah's psychotic breakdowns were caused by the nitric oxide sedative.
Diagnosed Disease: Vitamin B12 Deficiency - literally a lack of vitamin B12 which can lead to a host of symptoms due to its versatility in the body
SymptomsSince B12 is stored well in the body with levels decreasing very slowly, this deficiency is hard to get. In its mild form, it has mild symptoms such as weariness if any at all. More severe cases lead to anemia which can eventually lead to neurological complications by damaging nerve cells such as memory loss, neuropathy, and depression (this is where House got guilt as a symptom).
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CausesNormal B12 consumption is low; however, its absorption reduced by: a lack of intrinsic factor - the protein needed for B12 absorbtion; alcohol consumption; thinning of the stomach lining; and more.
However, a tapeworm that consumes nutrients caused severe B12 deficiency in the episode and due to her CIPA Hannah had no pain that pointed to the parasite. |
TestsA B12 lab test can give levels in the blood. Also to note is that folic acid and B12 need to be taken together. A MTHFR gene function test can be taken to ensure one's body is capable of metabolizing B12.
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Treatment/CureTaking B12 and/or folic acid supplements can fix the problem in a short period of time.
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Source Links: WebMD
Episode 15 - Half Wit
Brief Plot Summary
Patrick Obyedkov is a piano savant who gained his musical talents after an accident when he was in 4th grade. While playing in a piano concert to raise money for similar neurological conditions, Patrick's hand begins to cramp uncontrollably (dystonia). House thinks it could be caused by a heart condition or clot. In surgery, they find a renal bleed but have no cause. However, he seizes during surgery despite being on anti-convulsants. They decide to take him off the meds and then do a PET scan while he's seizing to find out what's wrong. An angiogram reveals that he is bleeding in the brain. Doing an internal EEG to find the problem areas, they find that his right hemisphere is actually mostly brain dead; however, by showing he can still play the piano, a global brain process, House realizes that the right half is still slightly functional and has always been bad. He advises a hemispherectomy (removing the right side of the brain) to allow the left side to take over and let him learn, grow, and function like normal.
Patrick Obyedkov is a piano savant who gained his musical talents after an accident when he was in 4th grade. While playing in a piano concert to raise money for similar neurological conditions, Patrick's hand begins to cramp uncontrollably (dystonia). House thinks it could be caused by a heart condition or clot. In surgery, they find a renal bleed but have no cause. However, he seizes during surgery despite being on anti-convulsants. They decide to take him off the meds and then do a PET scan while he's seizing to find out what's wrong. An angiogram reveals that he is bleeding in the brain. Doing an internal EEG to find the problem areas, they find that his right hemisphere is actually mostly brain dead; however, by showing he can still play the piano, a global brain process, House realizes that the right half is still slightly functional and has always been bad. He advises a hemispherectomy (removing the right side of the brain) to allow the left side to take over and let him learn, grow, and function like normal.
Diagnosed Disease: Takayasu's Arteritis - a type of vasculitis that affects the aorta and its branches causing inflammation and thus blocking blood flow to the arms and legs which can cause the hand spasms Patrick had
Symptomsinflammation of the aorta and branches; no tangible pulse in extremities; muscle spasms, joint pain, fever, etc.
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CausesA very rare genetic condition that mostly affects young Asian women.
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TestsAngiograms can usually reveal the blockages that may have been caused by the disease.
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Treatment/CurePrednisone is usually prescribed to decrease inflammation and autoimmune damage since it's a type of corticosteriod.
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Episode 16 - Top Secret
Brief Plot Summary
The episode begins with House having a dream about a soldier who lost his leg below the knee. When he wakes up Cuddy hands him a file of an ex-marine who believes he is suffering from Gulf War Syndrome. When he looks at the picture in the file, it's one of the soldiers from his dream.The team doesn't believe there's anything wrong with the patient. They test his sleeping cycle but when he wakes up, he complains about a bad smell, which is in his mouth and oddly turns out to be bacterial vaginosis. The new diagnosis is parotid cancer. Wilson notices the patient can't hear while doing tests and an MRI reveals 6 tumors in the brain. House doesn't believe the tumors could grow that fast. Before starting surgery, they notice the tumors have miraculously disappeared. His urine has levels of depleted uranium, which the team begins to treat for. House then points out that his nose has been cauterized to stop his childhood nosebleeds which point to hereditary hemorrhagic telangiectasia.
The episode begins with House having a dream about a soldier who lost his leg below the knee. When he wakes up Cuddy hands him a file of an ex-marine who believes he is suffering from Gulf War Syndrome. When he looks at the picture in the file, it's one of the soldiers from his dream.The team doesn't believe there's anything wrong with the patient. They test his sleeping cycle but when he wakes up, he complains about a bad smell, which is in his mouth and oddly turns out to be bacterial vaginosis. The new diagnosis is parotid cancer. Wilson notices the patient can't hear while doing tests and an MRI reveals 6 tumors in the brain. House doesn't believe the tumors could grow that fast. Before starting surgery, they notice the tumors have miraculously disappeared. His urine has levels of depleted uranium, which the team begins to treat for. House then points out that his nose has been cauterized to stop his childhood nosebleeds which point to hereditary hemorrhagic telangiectasia.
Diagnosed Disease: Hereditary Hemorrhagic Telangiectasia - A very rare genetic disorder that leads to abnormal blood vessel formation in the body. Instead of blood flowing to the capillaries, vessels form that connect the arteries and veins which leads to starvation of respective tissues and organs.
SymptomsVery frequent childhood nosebleeds; high oxygen levels in the veins; GI bleeds; in severe stages, the capillaries of major organs begin to be bypassed causing organ failure
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CausesIt's a genetic disorder, but it's pathway of maliciousness is still unknown. Some genes have been identified but the exact dysfunction has not yet been identified.
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TestsUsually detected in physical check ups; echograms and endoscopy can help identify the disease; family history is a primary indicator of the disorder
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Treatment/CureSurgery can usually take care of the problem along with cauterizations for areas of constant bleeding
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Source Links: NIH
