044. Diagnosis

[vicodincrutch]

DIFFERENTIAL DIAGNOSIS

SYMPTOM(S): Uncontrollable Laughter
                          Chest Pain
                          Clumsiness
                          Which caused cranial bleeding.

POSSIBLE DIAGNOSIS:
Amyotrophic Lateral Sclerosis--it explains the chest pains, clumsiness and the laughter. The curse is accelerating the effects the degeneration process of the disease, usually it's a lot more slow. Search for DNA abnormalities or any hereditary link.

Pseudobulbar palsy onset by a tumor in the high brain stem or motor neurone diseases that would cause the disorder int he brain stem and spinal column.

Dementia (scribbled in) by Kuru causes the laughter as well as the inability to cooperate. The laughter would be causing the chest pains all the way down to clumsiness if that's the case.

CJD-?

The first two are not entirely treatable. A sample of tricyclic antidepressants would rule out dementia.

[ooc;  Curse or not, he'd want to diagnosis this. Since House is kind of an investigatory doctor, for nowit is just ruling out different diagnosiseses since tomorrow is OH SNAP THIS ISN'T NORMAL day. Any questions, comments or things I shouldn't be doing plz do AIM me. That's why God LJ made edits.]

Comments

[vicodincrutch.livejournal.com]

The laughter is the main symptom. He hasn't been to New Guinea or had brains recently.

...But that would make sense. Dementia being one of the leading symptoms and the laughter as a branch off from that. An MRI and some brain fluid samples would rule that out.

I want to treat the dementia for now to make him shut up.

Great now I want to watch Indiana Jones AND One Flew Over the Cuckoos Nest.

[eduronox.livejournal.com]

It is not simple exposure nor brains that transmit Kuru, but ingestion of infected matter. It is cultivated by excessive cannibalism but can be extracted and implanted in just about anything, accidentally or otherwise. "Mad cow disease" is a notable variant.

Can the patient be coaxed to sleep naturally, or with a mild sedative? Prion infections make the brain highly unstable, treating dementia if prematurely misdiagnosed will only cause further irreparable brain damage.

[vicodincrutch.livejournal.com]

Sorry, I was caught up in the romanticism of eating people. That must have been one angry cow.

Logically, this much laughter would have caused a syncope. It hasn't. So much for naturally. I wasn't thinking of treating the dementia without the MRI. The thought of gagging him was getting to be appealing too.

It's relatively early into CJD, if that's what it is. The dementia has no bite.

[eduronox.livejournal.com]

I don't see the harm in gagging anybody, as long as their airway isn't restricted.

In that vein, there's always Gerstmann-Sträussler-Scheinker syndrome, but it's familial, and even more rare than Kuru. So is the fatal insomnia. It's not something that comes up in a usual family medical screening, but worth looking into.

The laughter without syncope side effects is notable, which makes me believe Kuru - pathologic uncontrollable laughter. While these infections are fatal and without known treatment, prions themselves can be reverted with exposure to intense heat - nearly three hundred degrees Fahrenheit if memory serves - for twenty minutes or so. It would kill a human to incubate a fever of even half that intensity.

[vicodincrutch.livejournal.com]

That's what noses are for.

He's to boring to be cooked at that temperature. That's not something to rule out. He's got a girlfriend in the City so he has been sleeping and he has been sleeping.

[eduronox.livejournal.com]

That is not the sort of fever that will do anybody any good.

[vicodincrutch.livejournal.com]

I don't think he's that hot to tell you the truth. Maybe an 6 or high 7 at tops.

[eduronox.livejournal.com]

I'm sure he's charming.

But did he eat anything contaminated, is the question.

[vicodincrutch.livejournal.com]

Answers are hard to get out of him. He's a growing boy, likely he had beef. Someone else (http://vicodincrutch.livejournal.com/11732.html?thread=767956#t767956) infected with the same symptoms had roast beef.

[eduronox.livejournal.com]

Vague at best.

Mild sedatives and restraints, if the condition worsens.

It would be negligent to wait until midnight to begin testing.

[vicodincrutch.livejournal.com]

Yeah. I got that.

The MRI is getting ready. I'm not neglectful and I want to know if this is right.

[eduronox.livejournal.com]

Good for you.

Transmissible spongiform encephalopathies are difficult to work with. If you're working with a technology level that relies on MRI machines...

Hopefully he's just hit his head.

[vicodincrutch.livejournal.com]

Busy bodies who don't introduce themselves and assume a medical authority are difficult to work with too. I manage just like I do with spongiform encephalopathies.

An MRI should do it. I left my lightsaber at home.

He didn't. I asked. No signs of concussion or spinal swelling.

[eduronox.livejournal.com]

Men who are familiar with prion pathogenic theory require introductions?

Unfortunate. I have my wand. I am otherwise occupied, however. As fascinating as observing the process sounds, I have idiots minors in my care.

[vicodincrutch.livejournal.com]

Only if they have any manners. It doesn't sound like you.

Prom will do that to you. Have fun screwing up make outs.

[eduronox.livejournal.com]

And you sound familiar with the malady.

You have a curious deflection tactic of mentioning mild sexuality in lieu of other response.

[vicodincrutch.livejournal.com]

Greg House, M.D. You likely don't have a standard medical back round because you didn't ask if the person is on any medications or if they have a standard medical history within the City. He isn't and he doesn't. Chances are you're a sort of magic based healer who likes to freelance in the practical world. Am I hot or cold?

Yeah. I do. Your clear avoidance is suspicious. How long have you been a monk?

[eduronox.livejournal.com]

Severus Snape, alchemist, professor, Headmaster, potions master. I am unfamiliar with most non-magical medication, though medical technology is peripherally known to me. I am not a healer, I am a scientist - though that likely carries a different connotation than your standard medical background.

I am but avoiding your displacement.

[vicodincrutch.livejournal.com]

You're inferiority complex is showing. You could have just said potions professor. Alchemy is implied. It's okay. You're still a jerk.

Good that we got the differential under headway. Results will be in tomorrow. Check for them or not. I don't care.

Play shrink with me and you'll get it back.

[eduronox.livejournal.com]

You guessed Amyotrophic Lateral Sclerosis before prion infection. For me to assume you understand anything about the science of potion making would be lax.

[vicodincrutch.livejournal.com]

By virtue of the fact that he said his head was bleeding and before consulting about family. Have you ever done a differential diagnosis before?

[eduronox.livejournal.com]

Have you ever worked with anything outside the scope of pills and patterns before?

[vicodincrutch.livejournal.com]

Patterns. Infectious diseases hardly pick out days in the year to go take a trip in my office. What the hell do you think a doctor is?

[eduronox.livejournal.com]

Patterns. Blood, symptoms, irregularities.

A doctor is someone who uses my diagnoses, apparently.

[vicodincrutch.livejournal.com]

Irregularities have similarities and it has to be narrowed down. It isn't all patters.

And you haven't done a differential diagnosis before or else you wouldn't be so butt hurt.