Main event

A famous cyclist, Jeff Forester, has difficulty breathing and suffered a fall during a charity bike race cross country. House is not interested in the case because he thinks that all athletes use steroids. But he changes his mind when the rider recognizes that makes doping to enhance athletic performance. Forester openly tells House that performs blood doping, sleeping in a hyperbaric pressure chamber is injected electrolytes and herbal supplements consumed anabolic steroids, amphetamines and diuretics. Furthermore, she informs House that has not used anabolic steroids or Epogen (EPO), which in recent days has been suspended for doping this was a charity race. The House faces cyclist himself when he says "I do what I do to patearles's ass all in my work, do not you ". At that time House smiles and takes another pill over Vicodin. Many possible causes for a single symptom, shortness of breath.Foreman thinks it is blood doping, which thickens the blood, which in turn produces clots that can obstruct breathing. House dismisses this possibility because the spiral chest CT is clean. Cameron thinks the hyperbaric chamber in which sleep may have caused damage to lung cells, but House rejects the hypothesis because it should have pulmonary edema. Chase notes that taking anabolic supplements containing yohimbe, which causes nerve palsy, but the toxicological analysis is normal. House assumes that what might have happened is that due to the large number of daily injections received by the cyclist, generated an air embolus. To search and order a scan level of perfusion (the process of gas exchange across the alveolar capillary barrier). House's team discusses the sports doping. Cameron challenges for moral behavior related to social example.Chase has a tolerant attitude, noting that all the people take all kinds of drugs, all the time. Foreman suggests that sports doping causes serious health problems. The scan indicates that the rider actually has an air bubble in the lung and the problem seems to be over, but when you are extracting the Chase bubble through embolectomy, Jeff begins to drool. The patient presents with muscle fatigue in the jaw and neck, also in the legs. These symptoms than doping. Chase suggested the possibility that the case of lupus or polymyositis. Cameron adds some ALS or muscular dystrophy, but Foreman says it's too young for the first and too old for the second (the scientific basis for this statement is questionable). House is not ruling anything out, order a complete blood and a muscle biopsy, and signals to establish if this is a myopathy (muscle disease) or neuropathy (nerve disease). Muscle weakness is accentuated and tests show no abnormality.House then asks the reason for this apparent normality that record analysis, when all these manipulations of doping that has been done should produce a special biochemical status. If blood was injecting Forester to have more red blood cells, why does the analysis indicate that red blood cells are normal Faced with the possibility of infection (encephalitis) ordered administer broad spectrum antibiotics and perform a lumbar puncture (LP). To be seen sooner than other patients, the cyclist "donates" a large sum for the hospital. As he made the puncture again have a respiratory arrest, something they thought had been resolved by removing the air embolus. Thymoma (tumor of the thymus). The cyclist had a thymoma, but compensated doping prevented the symptoms and submit comments. The PL was negative for encephalitis. Red blood cells fall by 39 , Jeff has lost about 1 liter of blood. Doctors "spin" without hitting the nail.O Chase made a mistake when removing the plunger, or the rider has cancer. But the tests are negative for both possibilities, and biopsy revealed that she has pure red cell aplasia (APGR), a condition associated with the use of Epogen (EPO). House accuses the rider to lie, but as actually told the truth, then he must be his manager gave him the drugs secretly. Jeff is outraged and says goodbye, but we shall see that House is wrong. We administered prednisone. But the patient still does not respond to treatment and the blood cells continue to fall. House thinks that perhaps APGR acute but not chronic, and that could be suffering for some time. Manda scan the neck and the team then finds a thymoma, a tumor in the thymus.