Storyboard Presentation HCA/220

Storyboard Presentation of House

By: Laura Davis Axia College December 6,2009

I have two Episodes of House Episode 1: Ignorance of Bliss, and Episode 2: Teamwork.

House: Episode 8 Ignorance is Bliss

James: My hand is tremoring and I am losing coordination, and I have a mild cough. Chase: The CT scan was negative and also the screen for toxins. Chase to Foreman: The differential diagnosis is the West Nile Virus, meningitis, sickle cell anemia, or TTP. Chase: Foreman check a blood smear and Adam TS13 antibodies.


Foreman: The blood smear shows schistocytes (fragmented red blood cells), a sign of TTP. Chase: plasmapheresis is treatment of choice, but James is allergic to one of the components of the procedure, so instead they perform a splenectomy. Chase: He is showing symptoms of a stroke.


Chase: Rush him to the cath lab. Foreman: right away Taub: Removes the blood clot and the blood flow is restored and there is not permanent brain damage.


Chase: since James has had a stroke this means he did not have TTP. He may have CNS vasculitis, DIC, acquired pancytopenia, or toxin exposure. Chase and Taub: are sent to check out Jamess apartment. Thirteen and Foreman are expanding toxicity screen.


Chase to Taub: hey we found the apartment has mice and a bottle of booze. Taub: James may have Leptospirosis Chase: James has to have liver failure from the alcohol abuse. Chase: lets do a liver biopsy Taub: The tests show the liver is normal Thirteen: What about renal failure?


Thirteen: The reasons for the kidney failure could be rhabdomyolysis, multiple myeloma, polycystic kidney disease, or Goodpastures Syndrome. Chase: start him on immunosuppresant drugs and dialysis for Goodpastures Syndrome Wilson: I was talking with James and he is abusing Robitussin DM.


James: I have no feelings in my legs. Foreman: James has no feeling in the legs. Foreman: you could be lacking vitamin B12. Chase and Foreman: James could have lupus or bone marrow malignancy.


House: James what is going on ? James: I have been abusing dextromethorphan. I have tried to commit suicide. By jumping off of a tall building. House: What kind of injuries did you have from that? James: Broken ribs, I got addicted to a narcotic pain medication. that is how I found Robitussin DM


House to Chase: after the attempt of suicide he injured his spleen causing it to multiple into smaller spleens. Chase: I was right about TTP. I just needed to get all of the spleen. Chase: we will remove the rest of the spleen. James: Surgery again.


Chase: Yes, we have to remove all of the smaller spleens. When you fell off of the building your spleen was injured and multiplied into smaller ones. Foreman: James is resting and will be discharged in a few days

House: Episode 7 Teamwork

Hank: I have severe headaches and sensitivity to light. House: Test him for STD panel, a toxin screen, C- Reactive Protein, ANA, and a lumbar puncture. Foreman: He is having muscle spam and pain while the spinal tap was being performed. Put him on Demerol.


Foreman: Hank may be suffering from cerebral vasculitis. House: Start him on steroids and get a brain angiogram, an EEG and a nerve biopsy. Chase is to perform the angiogram, as it turns out Cameron and Chase suspect Hank of suffering from Vitamin D deficiency. Chase starts Hank on light therapy and intravenous vitamin replacement. Hank has a nosebleed and is found that he has petechia in his


Cameron diagnosed Hank with disseminated intravascular coagulation. House: I agree with Cameron so lets start Hank on heparin and a broad spectrum antiboitic. Hank is running a fever. Taub suggest that he has a infection hidden in is sinuses. Chase: lets perform a sinus surgery to clear the sinuses. Hank complain of severe abdominal pain.


Cameron discovers fluid in the abdomen so she is diagnosing him with liver failure. Foreman suggests that Hank has sclerosing cholangitis. House: Orders an ERCP. They discover a large clump of worms in the bile duct. House gives him mebendazole to kill the worms.


Hanks condition is getting worse. He has developed pulmonary edema. Chase is thinking it may be a combination of hematological problem and cardiomyopathy. Foreman thinks he has lymphoma with peritoneal carcinomatosis and paraneoplastic syndrome. House: Start him on chemotherapy. House: The paitent is urinating blood and his blood pressure and heart rate is off the charts.


House: Hank is in cardiac arrest! I got him stable. House: the test results shows that Hank hardly has any red blood cells, white blood cells or platelets. Now the team thinks it may be hypopituitarism, renal cell carcinoma,aleukemic leukemia. House: I am putting in an order to destroy his bone marrow in hopes of a bone marrow transplant.


Thirteen and Taub says it is extraintestinal Crohns disease. The team all agrees that it is extraintestinal Crohns disease. They put worms back in to see if that is what it was. The diagnoses was correct.

References:

http://www.politedissent.com/page/2 Medical Language book from the course.

Documents

Storyboard Presentation HCA/220