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Point Breakdown

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Point Breakdown is case #10 in House M.D. - Critical Cases.

Cody Piper, a 20 year old professional surfer, was admitted when he started coughing up blood, had trouble breathing and had a sore throat.  He was accompanied by his uncle/manager Derek and his girlfriend Lauren.

House ordered an environmental scan of Cody's trailer.  The team found a pair of eyeglasses.  After using 11 digestive meds, 1 ward favor and 3 tongue depressors, they confirmed the eyeglasses were Cody's, but his girlfriend rarely remembered him wearing them.  This appeared to rule out hemolytic anemia as this would not explain deteriorating eyesight.

The team was ordered to do another environmental scan, but this time it had to do it in the dark.  They found a turtle.  After using 12 heart meds and a ward favor, they realized the turtle was suffering from some sort of bacterial infection.  This ruled out radiation poisoning as it was far more likely the vomitting was due to an infection.

The team did another environmental scan using silhouettes and found a raw steak on the counter.  After using 4 IV bags, 2 ward favors and $650 of the budget, the team realized they could rule out chronic kidney disease as Cody couldn't process that much protein with malfunctioning kidneys and not have other symptoms.

Given that Cody appeared to be eating raw steak and eggs, and given the blood cultures grown from the turtle, Cody was treated for salmonella with 18 body meds and a ward favor.  However, as the doctors were explaining the diagnosis, they saw a painful sore on Cody's arm that couldn't be explained by salmonella.

Cody went code blue and had to be defibrilated

With salmonella ruled out, House ordered imaging.  The team found blood in Cody's lungs, but no swelling.  After using 4 gauze and $650 of the budget, the lack of swelling ruled out sarcoidosis

A further round of imaging found that the sore was necrotic.  After using 3 thermometers, 2 ward favors and 2 body meds, they realized that the necrosis ruled out a staphylococcus infection would not cause it.

More imaging showed inflammation in the blood vessels of the neck, which most likely resulted in blockage.  After using 10 digestive mdes and 2 thermometers, the team realized that the problems with Cody's vision was due to a lack of flow of blood to the brain, ruling out pressure on the optic nerve.

Given the symptoms, Cody was treated for bronchiectasis with 2 ward favors, 12 digestive meds and 4 oxygen masks.  However, Cody didn't respond.  When they went to see him, he had a visitor, Todd, who was in an argument with Derek.  After Todd left, they asked Cody if he had ever suffered from an STD, but Cody said he wasn't sure.  All of a sudden, he started turning blue.

Cody went code blue again and once again had to be defibrilated.

House decided to order a blood analysis.  It showed a severe deficiency in 21-Hydroxylase, which helps regulate salt in the blood.  After using 10 body meds, $700 of the budget and 3 oxygen masks, the team realized that this deficiency would result in an electrolyte imbalance, which would prevent Cody from gaining weight.  His weight loss also ruled out steroid abuse.

A further blood analysis was performed.  After using 3 thermometers, a ward favour and 10 chem meds, they were able to rule out a pulmonary embolism.

Cody was treated for laryngeal papillomatosis with surgery, using 3 ward favours, 18 body meds and $700 of budget.  They realized that Cody had been exposed to the human papilloma virus through intimate contact, and given his lack of intimacy with his girlfriend, Cody admitted that he and Todd were lovers, although they had never had intercourse.  Derek, who had never been thrilled with Todd, still told Cody he wished he had not hid that from him as he could have marketed him to a LGBT market.

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