(no subject)
So, really quickly, since House was on last night, and we were barely into the second act when I had to yell at the screen--VDRL is KNOWN to be a poor test for syphilis. Honestly, no one orders it any more because it has so many false positives. Lupus causes a false positive VDRL test. That's why all modern medicine docs order an RPR, which actually tests for syphilis. Also, did they not get a subsequent MRI with contrast to find out if the positive syphilis test actually correlated with neurosyphilis? I mean, just because the dude has syphilis doesn't mean it's in the tertiary phase, and even if its in the tertiary phase doesn't mean it's causing neurosyphilis. Way too many holes in it. And seriously, how can I trust House at all if HE didn't know about the VDRL stuff? Honestly, I learned about that as a first year medical student!
Also, while I don't know the answer to this, they already had a neurosyphilis patient. It was an old woman who was sexually inappropriate, and House convinced her to take her penicillin by reassuring her that it WOULDN'T change her personality because the damage was already done. And now they have a whole episode about how the treatment will reverse the personality changes? Do the writers see the old episodes?
EDIT: So, I looked it up. It doesn't take much, really. If the writers bothered to look at Up To Date at all, they would know the treatment is not, in fact, one pill daily for a month, but involves more than one medication or a shot for a few weeks. Also, they would have found that neurosyphilis is usually the cause of irreversible symptoms. Also, they would know that a lumbar puncture is necessary for the diagnosis. Given how often they enjoy sticking patients with needles, you'd think they'd love that opportunity.
Also, while I don't know the answer to this, they already had a neurosyphilis patient. It was an old woman who was sexually inappropriate, and House convinced her to take her penicillin by reassuring her that it WOULDN'T change her personality because the damage was already done. And now they have a whole episode about how the treatment will reverse the personality changes? Do the writers see the old episodes?
EDIT: So, I looked it up. It doesn't take much, really. If the writers bothered to look at Up To Date at all, they would know the treatment is not, in fact, one pill daily for a month, but involves more than one medication or a shot for a few weeks. Also, they would have found that neurosyphilis is usually the cause of irreversible symptoms. Also, they would know that a lumbar puncture is necessary for the diagnosis. Given how often they enjoy sticking patients with needles, you'd think they'd love that opportunity.