House Attending Rounds Continued

[FootDocStudent]

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Dr House has a 4 year old Caucasian girl with severe deforming bilateral bunions on the big toes. She has no PMH with NKDA. Family history includes acute lymphocytic leukemia by a female cousin on the maternal side who died from the disease. Parents recall no trauma and nothing out of the ordinary. The bunions are painless but gives the patient difficulty ambulating and fitting into shoes. Dr House is suspicious what the disease could be.

Dr House asks you podiatry students, podiatry residents, and podiatry attendings:


What disease should be ON TOP of the differential diagnosis?
😕😕😕😕😕

 

[DPMer]

I'd say it is Juvenile Rheumatoid Arthritis

 

[dpmPOD]

I would think JRA would be painful--what I was thinking too however 🙁

 

[FootDocStudent]

I'd say it is Juvenile Rheumatoid Arthritis

House says: No try again. 😎

 

[FootDocStudent]

I would think JRA would be painful--what I was thinking too however 🙁

House would say: No. Try again.

 

[DPMer]

House says: No try again. 😎

How about Ehlers Danlos Syndrome? 😕

 

[FootDocStudent]

How about Ehlers Danlos Syndrome? 😕

Nope. Sorry! 😴

 

[backrowH20]

1. cerebral palsy
2. idiopathic myopathy
3. bursitis

 

[FootDocStudent]

1. cerebral palsy
2. idiopathic myopathy
3. bursitis

House would say: Nope. Try again. 😴

 

[sinustarsi]

what about acute childhood leukemia since she fits the age group? She can also be a intoe/out-toe walker.

 

[FootDocStudent]

what about acute childhood leukemia since she fits the age group? She can also be a intoe/out-toe walker.

House would say: I like your thinking. You paid attention to the history. Good. You are on the right track, but...nope. Try again. 😉

 

[NatCh]

How about Marfan Syndrome?

 

[FootDocStudent]

How about Marfan Syndrome?

House would say: HMMMMM???? Very interesting. 😱 I would rank this as maybe number 3 in my differential diagnosis. Not number 1. But good choice. Try again though.

 

[NatCh]

House would say: HMMMMM???? Very interesting. 😱 I would rank this as maybe number 3 in my differential diagnosis. Not number 1. But good choice. Try again though.

Good ol' Down's Syndrome? If that's not it I'm out.

 

[FootDocStudent]

Good ol' Down's Syndrome? If that's not it I'm out.

House would say: "The history did not say girl was ******ed. That would have frieked the parents out even more!" No not Down's.

 

[DPMer]

Dr House has a 4 year old Caucasian girl with severe deforming bilateral bunions on the big toes. She has no PMH with NKDA. Family history includes acute lymphocytic leukemia by a female cousin on the maternal side who died from the disease. Parents recall no trauma and nothing out of the ordinary. The bunions are painless but gives the patient difficulty ambulating and fitting into shoes. Dr House is suspicious what the disease could be.

Dr House asks you podiatry students, podiatry residents, and podiatry attendings:


What disease should be ON TOP of the differential diagnosis?
😕😕😕😕😕

Juvenile Hallux Abducto Valgus?

 

[FootDocStudent]

Juvenile Hallux Abducto Valgus?

Nope! Try again! 😴

 

[densmore22]

Aml.

 

[FootDocStudent]

Aml.

House would say: AML? HMMMMMM? Nope. 😎

 

[densmore22]

House would say: AML? HMMMMMM? Nope. 😎

Do you know what AML stands for? Just making sure.

 

[damhsoir]

I would tell Dr. House to go back to med school because bunion deformities occur at the 1st (or 5th) MTP not the "big toes".

 

[NatCh]

I would tell Dr. House to go back to med school because bunion deformities occur at the 1st (or 5th) MTP not the "big toes".

Ha ha ho! Nice one.

Better yet, tell Dr. House to go back to podiatry school so he can quit asking esoteric questions and just fix some damn bunions already.

 

[FootDocStudent]

Ha ha ho! Nice one.

Better yet, tell Dr. House to go back to podiatry school so he can quit asking esoteric questions and just fix some damn bunions already.

Dr House would say: That's a good idea! I will apply to podiatry school and get an extra doctorate! Gregory House, MD DPM! I like that! Allopath med schools do not focus too much on feet anatomy anyway! Just one lecture and that's it! BUMMER! That's why my feet anatomy sucks! For the meantime though....I'M WAITING FOR A DIAGNOSIS???? 😴 Oh, by the way. Do podiatry schools accept my MCAT scores from the 1970s? I had a 45 and an essay score of Z. 😛

 

[FootDocStudent]

Dr House asks: Does anyone have a diagnosis for this 4 year old girl? I am still waiting...and getting bored. 😴

 

[PapaJohn30]

Dr House asks: Does anyone have a diagnosis for this 4 year old girl? I am still waiting...and getting bored.

Why are you doing this??

 

[FootDocStudent]

Why are you doing this??

Dr House says: To educate and enlighten podiatry. I educate and enlighten myself! Podiatry needs to know this disease. So....Do you have a diagnosis??? Help alleviate my boredom! 😴 In the meantime I think I will order a PapaJohn's pizza!

 

[krabmas]

Does the patient have any other symptoms? Any craniofacial abnormalities?

 

[FootDocStudent]

Does the patient have any other symptoms? Any craniofacial abnormalities?

Dr House would say: AAH! Finally! No craniofacial abnormalities. Symptoms! Not yet. But soon, within a year or two, this girl will get bluish/greyish tumorous growths on her skin in response to any trauma on her body, and para-spinal calcifications on AP X-ray images. 😉

 

[AGDPM]

Paraspinal mesenchymal chondrosarcoma?

 

[FootDocStudent]

Paraspinal mesenchymal chondrosarcoma?

Dr House would say: I want you to be my resident! 😀 Now we are getting some fun here! You are on the right track. Nope. Try again. Even if you are wrong AGDPM, I want you as my resident! I like your thinking. You challenge me without trash talking! 😉

 

[backrowH20]

i am feeling a collagen vascular disease like......
myositis ossificans traumatica

 

[FootDocStudent]

i am feeling a collagen vascular disease like......
myositis ossificans traumatica

Dr House would say: I want you as a resident too! 👍 Forget about podiatry residency! Join my residency program! Dont worry, it is accredited in the US. I dont care if you have a DPM. I'll even take medical graduates who are DOs or ODs, as long as you think medically the way I want you to think: OUT OF THE BOX. Anyway, you are thinking along the right trail! Close! But not the right answer. Still, excellent job in your thinking! 😉

 

[krabmas]

Scleroderma

 

[FootDocStudent]

Scleroderma

Dr House would say: I want you as my Attending after you finish your fellowship! Join my Department! Nice diagnosis. But not the one I am looking for. Getting close though. 😉

 

[krabmas]

fibrodysplasia ossificans progressiva - it is the most common cause of congenital hallux valgus and at locations of trauma they form bony tumors.

 

[FootDocStudent]

fibrodysplasia ossificans progressiva - it is the most common cause of congenital hallux valgus and at locations of trauma they form bony tumors.

Dr House would say: CORRECT! EXCELLENT JOB!

 

[krabmas]

Dr House would say: CORRECT! EXCELLENT JOB!

where do I sign to be an attending?