Season 1
Episode 21 - Three Stories
Brief Plot Summary
House's former lover, Stacy, show up and asks him to treat her husband who has been suffering from abdominal pain and fainting. After talking to a class of third year med students, House finally agrees to see him. During the class, House talks about three separate stories during which he explains his diagnostic process and explains that they will all make mistakes one day. One of those stories is about House and how he got his limp.
House's former lover, Stacy, show up and asks him to treat her husband who has been suffering from abdominal pain and fainting. After talking to a class of third year med students, House finally agrees to see him. During the class, House talks about three separate stories during which he explains his diagnostic process and explains that they will all make mistakes one day. One of those stories is about House and how he got his limp.
Diagnosed Disease: Necrotizing Fasciitis, Osteosarcoma, and Aneurysm - Necrotizing Fasciitis is a bacterial infection that is capable of literally "eating flesh". It rapidly causes necrosis of the bitten area and can spread quickly. It can kill within hours by spreading to vital organs through the blood stream. It is cause by a streptococcus bacterium. Sarcomas are cancers of the bone, cartilage, fat, muscle, vascular tissue, or blood. Carcinomas on the other hand are cancers of epithelial cells. Osteosarcoma is a bone cancer. An aneurysm is an abnormal ballooning of a portion of an artery that is prone to rupturing and producing blood clots.
SymptomsNecrotizing Fasciitis - incredible pain in the area, redness follows, then blisters, then the skin can turn black and blue indicating necrosis; organ failure; fever may be present
Osteosarcoma - pain in the area, swelling, palpable lump Aneurysm - usually symptom-less, however if a blood clot is release, it can cause death to the tissue surround the area where the clot gets lodged. |
CausesNecrotizing Fasciitis - animal bites; scrapes and cuts
Osteosarcoma - higher rate of occurance in faster growing bones, genetic pre-disposition Aneurysm - a weakness in the arterial wall will eventually give and enlarge as the blood pushes against it |
TestsNecrotizing Fasciitis - symptoms are obvious but a tissue biopsy or blood sample can confirm the bacterial type
Osteosarcoma - an X-ray can reveal the growth and a biopsy can confirm its malignancy and nature Aneurysm - an angiogram can be used to detect the enlargements but it maybe hard to know where to look without any symptoms. |
Treatment/CureNecrotizing Fasciitis - usually the dead tissue must be removed to stop the spread of the infection, a hyperbaric oxygen chamber, a container that contains high levels of oxygen, can be used since high oxygen levels will kill the bacteria and help the immune system fight the infection.
Osteosarcoma - usually surgery is done to remove the infected bone and chemotherapy and radiation treatment is given Aneurysm - usually a surgery is done to place a coil in the aneurysm to close it and then add a stent to reinforce the artery walls |
Episode 22 - Honeymoon
Brief Plot Summary
At dinner House drugs Mark in order to do a check-up on him at the hospital. After a battery of tests that reveal nothing, House orders an exploratory surgery and finds smooth muscle tremors which indicate abdominal epillepsy and a neurological issue. As the team continues the search, Mark's brain continues to degrade, and he is soon paralyzed in his feet and hands. However, when he learns that Mark is delusional, he diagnoses Acute Intermittent Porphyria and treats him with glucose and hematin.
At dinner House drugs Mark in order to do a check-up on him at the hospital. After a battery of tests that reveal nothing, House orders an exploratory surgery and finds smooth muscle tremors which indicate abdominal epillepsy and a neurological issue. As the team continues the search, Mark's brain continues to degrade, and he is soon paralyzed in his feet and hands. However, when he learns that Mark is delusional, he diagnoses Acute Intermittent Porphyria and treats him with glucose and hematin.
Diagnosed Disease: Acute Intermittent Porphyria (AIP) - AIP is a rare metabolic disorder in which the body lacks an enzyme crucial in converting porphyrins to heme, the pigment in red blood that is also used in other processes.
SymptomsAbdominal pain, paranoia, mood swings, paralysis, seizures, and delusions. There can be a variety of other neurological symptoms namely psychiatric symptoms.
|
CausesBecause some heme can still be produced by other means, the disease's symptoms only occur when a sudden increase in the body's heme needs is brought on. This increase can be caused by a variety to environmental triggers such as alcohol use, sun exposure, infection, stress, smoking, surgery, and certain drugs.
|
TestsA urine test, stool sample, and blood test can all reveal high levels of porphyrin.
|
Treatment/CureTreatment is usually an injection of hematin (a form of heme) to stop production of porphyrins, intravenous glucose to inhibits the needs of heme, and avoid any triggers in the patiet's environment.
|
Source Links: NIH Porphyrias, American Porphyria Foundation
