Comments on: House – Episode 22 (Season 2): “Forever”

By: neel

neel — Sat, 04 Jun 2011 11:40:25 +0000

PCR can be done for cancer diagnosis… it detects mutations…..

By: Athena

Athena — Mon, 14 Mar 2011 06:47:49 +0000

I haven’t heard of stress-induced coeliac’s, though I suppose it could be possible. It could just be stress-induced poor diet as for post-natal effect and not pre-natal.

However, my sister and I both have coeliac’s (her much more so than I), and my sister was showing signs of outright malnutrition just before it was picked up and confirmed without getting low enough in single nutrients to cause clotting disorders, pellegra, or anything like that. Gluten usually interferes with nutrient uptake across the board in coeliac’s – shouldn’t she have been showing signs of severe deficiency in many more areas than those?

By: Person

Person — Sun, 06 Mar 2011 20:43:24 +0000

ECMO specialist here, just a few additional comments about the ECMO. I know I’m a little late on this (by 5 years or so) but just saw this ep. on DVD.

1.) I’m not sure about the comment that pneumonia is not an indication for ECMO but bacterial sepsis is. Isolated respiratory failure from ARDS, pneumonia or influenza are some of the most common reasons ECMO is used. Any kind of reversible cardiac and/or respiratory failure which carries at least 50% predicted mortality can be an indication for ECMO support, so long as there is not preexisting neurological damage.

2.) This one is so obvious it may go without saying, but if they couldn’t get the baby’s potassium down with meds the next thing to do is immediately start dialysis. If his potassium was such a problem and he was already on ECMO why on Earth didn’t they just splice a CVVHDF machine in with the ECMO circuit? Very quick, safe and easy to do without needing additional access or interrupting the ECMO, and would remove the potassium efficiently.

3.) Assuming they put him on VA ECMO (venarterial which provides cardiac as well as respiratory support) due to his instability, the arrhythmia wouldn’t have necessarily killed him, especially if it was just from hyperkalemia (an easily correctable cause see above). Even patients with refractory pulseless arrhythmias can be adequately supported for days on VA ECMO, until either the cause is corrected or they get a bi-vad, heart transplant or whatever they need. You don’t always need a heartbeat to be “alive” (though it usually helps).

4.) And finally, this is just stupid:
“Dr. Chase: ECMO could kill him!
House: You don’t start him on ECMO and that infection can rampage through his body like Pistons fans after a championship.”
ECMO wouldn’t affect whether or not the infection “rampages through his body.” They’re called antibiotics.
Finally, short of mechanical disaster, ECMO doesn’t kill, the underlying disease process kills. Sometimes it just fails to keep alive ;)

By: Dr. R

Dr. R — Sat, 05 Feb 2011 01:15:19 +0000

Other medical errors: They supposedly used the infant’s biopsy to diagnose the mother’s Celiac’s. The flattened villi develop over time as they are destroyed by antibodies. The baby wasn’t even eating solid food yet, so it is unlikely that there would be any findings. Also, they attributed the reason the baby didn’t improve from the sodium polystyrene to malabsorption. This medication works in the gut WITHOUT being absorbed.

By: db

db — Mon, 15 Feb 2010 15:59:10 +0000

Because of this epsiode I don’t watch House M.D. anymore. Its total crap that the baby would be affected by Celicac disease at 4 weeks old because the baby is only drinking milk! And when you have celiac cisease you can not eat what barley or rye or anything that may contain those ingredients, often oats are also excluded. But the point is I do not think it goes from the mothers breast milk to the baby, because the gluten has to be in the babys intestines. And a dr. would notice right away if a baby is not thriving, plus the mother would be extremely sick. I think if goes to show Celiac disease is very miss understood in the US .

By: Polite Dissent » House — Episode 4 (Season 5): “Birthmarks”

Polite Dissent » House — Episode 4 (Season 5): “Birthmarks” — Wed, 15 Oct 2008 03:53:32 +0000

[...] Delirium tremens was only addressed superficially in the storyline. It is a life threatening condition, and tremors are only a small part of it. Nicole had the rapid heart rate and the tremors, but none of the other symptoms, so the diagnosis seems premature. Phenobarbital is not the recommended treatment for delirium tremens; Benzodiazepines are. But then, House has made this mistake before. [...]

By: Daniel

Daniel — Wed, 30 Jul 2008 19:30:23 +0000

Since the baby was already dead, can that still be called a “biopsy”?

By: whitebat

whitebat — Mon, 21 Jul 2008 02:56:12 +0000

P.C.R.= Polymerase Chain Reaction is a way to amplify a small sample of DNA. I wouldn’t call it a test. After you do PCR on a sample, then you can do other DNA tests on it, run gels, whatever.

By: Lin

Lin — Mon, 16 Jun 2008 22:39:06 +0000

Delirium tremens is not a “dangerous form of alcohol withdrawal.” It is acute delirium that is often – but not necessarily – a *symptom of* alcohol withdrawal. I am pretty sure that barbiturates can cause it too. There are probably other etiologies.

By: Ari

Ari — Sun, 02 Mar 2008 05:49:05 +0000

Rob’s right, though. No way you can detect estrogen with PCR. It’s about as logical as using PCR to test a patient’s sodium levels. Oddly, I caught that, while letting the ridiculousness of using PCR *at all* to look for cancer slide right past me.

I can totally buy House finding a pattern in when she yogurt binges, though. Spot on characterization.