Season 6
Episode 5 - Instant Karma
Brief Plot Summary
Roy Randell decides to admit his son, Jack, to the hospital after their home doctor has ruled out what he think are possible options. The team, now Foreman, Cameron, and Chase find constipation from an x-ray, relieving his pain for the first time in months. He then begins to seize and they relieve the excess intracranial pressure by drilling in his skull. Fluid continues to build in his abdomen and dural cavities, the shape of which indicates brain cancer. They do a biopsy which comes back negative. House thinks adenocarcinoma of the stomach could explain the problem, but the biopsy for that comes up negative as well. Cameron thinks abdominal epilepsy could explain seizures, which would first manifest as pain, and fever could be caused by protein malnutrition. Jack develops a rash on his chest. House then believes it could be Dego disease, which causes micro-blood vessels in the skin and brain to malfunction and break down. Jack then goes into cardiac arrest. House believes its primary antiphospholipid syndrome and they treat with heparin and IV immunoglobulin.
Roy Randell decides to admit his son, Jack, to the hospital after their home doctor has ruled out what he think are possible options. The team, now Foreman, Cameron, and Chase find constipation from an x-ray, relieving his pain for the first time in months. He then begins to seize and they relieve the excess intracranial pressure by drilling in his skull. Fluid continues to build in his abdomen and dural cavities, the shape of which indicates brain cancer. They do a biopsy which comes back negative. House thinks adenocarcinoma of the stomach could explain the problem, but the biopsy for that comes up negative as well. Cameron thinks abdominal epilepsy could explain seizures, which would first manifest as pain, and fever could be caused by protein malnutrition. Jack develops a rash on his chest. House then believes it could be Dego disease, which causes micro-blood vessels in the skin and brain to malfunction and break down. Jack then goes into cardiac arrest. House believes its primary antiphospholipid syndrome and they treat with heparin and IV immunoglobulin.
Diagnosed Disease: Antiphospholipid Syndrome - Autoimmune disease that provokes a hyper coagulative state due to the presence of antiphospholipid antibodies.
SymptomsBlood clots throughout the body, deep vein thrombosis, stroke, neuropathy
|
CausesGenetic factors predispose one to this autoimmune disorder. Antibodies are formed in the body that react against proteins binding to phospholipids on the plasma membrane.
|
TestsCan be tested for genetically or using liquid phase coagulation assays.
|
Treatment/CureTreatment is to use blood thinners to help prevent further clots.
|
Source Links: Wiki
Episode 6 - Brave Heart
Brief Plot Summary
Donny Compson is admitted after falling from a roof while chasing a suspect in a crime. His father's side also has all died at the age of 40 from a mysterious heart disease. They perform a battery of tests to find any possible underlying conditions. After discharging him, he is found dead a few hours later while doing his laundry. While doing the autopsy, Donny suddenly wakes up screaming; he wasn't dead after all. He then has a severe toothache. They look for cancer and find nothing. House realizes that he has an intracranial aneurysm on his brainstem, which pressured various nerves, including causing extreme bradycardia which appeared to have stopped his heart.
Donny Compson is admitted after falling from a roof while chasing a suspect in a crime. His father's side also has all died at the age of 40 from a mysterious heart disease. They perform a battery of tests to find any possible underlying conditions. After discharging him, he is found dead a few hours later while doing his laundry. While doing the autopsy, Donny suddenly wakes up screaming; he wasn't dead after all. He then has a severe toothache. They look for cancer and find nothing. House realizes that he has an intracranial aneurysm on his brainstem, which pressured various nerves, including causing extreme bradycardia which appeared to have stopped his heart.
Diagnosed Disease: Intracranial Aneurysm - Localized dilation or ballooning in a cranial artery wall.
SymptomsSmall aneurysms will usually present with little or no symptoms; however, larger ones can press on nerves or parts of the brain causing other symptoms.
|
CausesArterial wall weakness or defects can lead to the creation of an aneurysm.
|
TestsAngiograms, MRI, CT, and PET scans can help detect the malformation.
|
Treatment/CureTreatment involves surgically removing the aneurysm or putting coils into the balloon to wall it off and prevent further blood flow and ballooning.
|
Source Links: Wiki, Mayo Clinic
Episode 7 - Known Unknowns
Brief Plot Summary
Jordan is admitted when she has swollen limbs and joints. House believes it's rhabdomyolysis from the fall that she had; however, tests reveal that there is no muscle break down but her potassium levels are still very low, causing muscle weakness. Bulimia could explain her symptoms, but they find no tears. During the test she suffers cardiac tamponade. Foreman finds that she has a bleed in her brain affecting her thalamus, which is causing her to lie. She also starts to bleed behind her kidneys and needs transfusions. They believe she might have been drugged or has rickettsia. House then figures out she has Vibrio from the oysters that she ate; however, she has hemochromatosis which gave her unique susceptibility to the infection.
Jordan is admitted when she has swollen limbs and joints. House believes it's rhabdomyolysis from the fall that she had; however, tests reveal that there is no muscle break down but her potassium levels are still very low, causing muscle weakness. Bulimia could explain her symptoms, but they find no tears. During the test she suffers cardiac tamponade. Foreman finds that she has a bleed in her brain affecting her thalamus, which is causing her to lie. She also starts to bleed behind her kidneys and needs transfusions. They believe she might have been drugged or has rickettsia. House then figures out she has Vibrio from the oysters that she ate; however, she has hemochromatosis which gave her unique susceptibility to the infection.
Diagnosed Disease: Hemochromatosis - Hereditary disorder which causes the body to absorb too much iron.
SymptomsJoint pain, fatigue, weakness, bleeding, liver and kidney failure.
|
CausesSpecific gene mutations in the HFE gene raises susceptibility to the condition. Environmental factors may trigger onset of symptoms as well.
|
TestsBlood tests check for serum ferritin levels and transferrin level, proteins used to transport and store iron in the body. Liver function is also tested for any deterioration.
|
Treatment/CureImmediate treatment is usually taking blood out of the patient's body to lower iron levels and mobilize deposits stored in organs and joints. Blood may be needed to drawn on a schedule depending on iron levels.
|
Source Links: Mayo Clinic
Episode 8 - Teamwork
Brief Plot Summary
House orders an STD panel, toxin screen, ANA, and lumbar puncture on Hank, who was admitted for pulsating eye pain. All are negative but during the lumbar puncture, he has tetany in his arms. They believe it could be cerebral vasculitis and begin treating with steroids. When the tests are negative, they believe he has vitamin D deficiency and put him in a tanning booth. He then begins to bleed from his nose and inside his leg. The wide-spread rash and nervous system involvement points to an infection. They treat with antibiotics, but he continues to decline and gets a fever. Taub suggest surgically draining the sinuses to allow the antibiotics to reach the pocketed bacteria. His liver begins to fail, and they look for any tumors obstructing his bile ducts. They find thread worms instead and treat with mebendazole. His lungs then fill up with fluid and they think lymphoma might explain his symptoms. Suddenly, he has cardiac arrest and his red cell, white cell, and platelets counts are very low. Leukemia seems to fit and House suggests ablating the patient's bone marrow. Before they start the procedure, Taub and Thirteen call to share that he has Crohn's Disease; the thread worms were keeping his immune system active and preventing it from performing autoimmune functions.
House orders an STD panel, toxin screen, ANA, and lumbar puncture on Hank, who was admitted for pulsating eye pain. All are negative but during the lumbar puncture, he has tetany in his arms. They believe it could be cerebral vasculitis and begin treating with steroids. When the tests are negative, they believe he has vitamin D deficiency and put him in a tanning booth. He then begins to bleed from his nose and inside his leg. The wide-spread rash and nervous system involvement points to an infection. They treat with antibiotics, but he continues to decline and gets a fever. Taub suggest surgically draining the sinuses to allow the antibiotics to reach the pocketed bacteria. His liver begins to fail, and they look for any tumors obstructing his bile ducts. They find thread worms instead and treat with mebendazole. His lungs then fill up with fluid and they think lymphoma might explain his symptoms. Suddenly, he has cardiac arrest and his red cell, white cell, and platelets counts are very low. Leukemia seems to fit and House suggests ablating the patient's bone marrow. Before they start the procedure, Taub and Thirteen call to share that he has Crohn's Disease; the thread worms were keeping his immune system active and preventing it from performing autoimmune functions.
Diagnosed Disease: Crohn's Disease - Type of inflammatory bowel disease, an autoimmune condition in which the immune system attacks the colon causing inflammation, cancer, and abscesses.
SymptomsDiarrhea, abdominal pain and cramps, ulcers, weight loss, loss of appetite, blood in stool, fever, fatigue, skin legions.
|
CausesGenetic disease. Several genes have been identified that increase susceptibility to this condition. It's onset is sporadic and can occur at any point in life lending to the importance of environmental factors. There is also a theory that the immune system is attack a particular bacterial antigen it has become sensitized to.
|
TestsDiagnosis is based after ruling out other possibilities. Colonoscopies, CT scans and MRIs can also reveal any chronic inflammation in the bowel.
|
Treatment/CureThere is currently no cure, and treatment focuses on halting disease progression and treating symptoms. Corticosteroids and other anti-inflammatory drugs are used.
|
Source Links: Mayo Clinic, Wiki
