Medical Diagnoses in ER: A Comprehensive Review of Medical Conditions in Season 5
- 4 days ago
- 9 min read
Season 5 of ER brought a wave of new interns and high-stakes medical dramas, marking the beginning of the "post-Ross" era and the rise of Dr. Carter as a leader. This season didn't shy away from rare genetic disorders, complex toxicological emergencies, and the devastating impact of trauma. From the heartbreaking arc of a mother caring for her dying son to the innovative surgical salvage of a mangled limb, the medicine was as compelling as ever.
Below is a comprehensive, episode-by-episode review of the medical cases, diagnoses, and treatments presented in Season 5.
Content ⁉️
Episode 1
Diffuse Axonal Injury (DAI)
Emile Fernandez. A firefighter fell 20 feet, suffering blunt head trauma. He presented with a GCS of 4 and decorticate posturing. Diagnosis: CT ruled out operable hematomas but revealed Diffuse Axonal Injury with severe cerebral edema. This condition involves widespread shearing of brain connections and carries a catastrophic prognosis. Treatment: With surgery not an option, the team used steroids, hyperventilation, and ICP monitoring, preparing the family for the likelihood of brain death.
Spontaneous Abortion (Miscarriage)
Mrs. Draper. A patient with a history of recurrent loss presented with heavy bleeding and cramping. Diagnosis: Examination revealed tissue in the cervical os, confirming a Spontaneous Abortion. Treatment: The patient was observed to ensure the cervix closed and bleeding subsided.
Suspected Urologic Malignancy
Mr. Zwicki. A patient presented with weight loss and painless hematuria (blood in urine). Diagnosis: The classic presentation strongly suggested Renal, Bladder, or Prostate Carcinoma. Outcome: Despite the urgency, the patient left Against Medical Advice (AMA) to finish a work project.
Other Medical Diagnoses and Conditions Discussed
Scalp Laceration: Requiring sutures.
Thermal Burns: Sustained by a "fire-twirler."
Neonatal Drug Withdrawal: Infant born to a heroin-addicted mother.
Episode 2
Anhidrotic Ectodermal Dysplasia
Infant Patient. An infant presented with high fever but no sweat. Diagnosis: Dr. Ross identified Anhidrotic Ectodermal Dysplasia, a genetic condition where sweat glands are absent or malformed, leading to dangerous hyperthermia. Treatment: Cooling measures to lower body temperature.
Commotio Cordis
Karate Student. A 13-year-old collapsed after a chest blow. Diagnosis: Commotio Cordis, a lethal disruption of heart rhythm caused by blunt impact at a precise moment in the cardiac cycle. Treatment: CPR, defibrillation, and pacing saved his life.
Traumatic Ureteral Injury
Juan. A gunshot victim had a sudden drop in hemoglobin (later found to be a lab error). During surgery, methylene blue dye revealed the bullet had perforated the ureter. Treatment: Surgical repair with a stapler.
Other Medical Conditions Discussed
Sensorineural Hearing Loss: Diagnosed in a child (Reese) via ABR testing.
Pedunculated Papilloma: Causing urinary retention.
Episode 3
Ewing’s Sarcoma (Pathologic Fracture)
Dana. A young girl broke her leg playing soccer. The bone appeared to have "exploded from the inside." Diagnosis: Biopsy confirmed Ewing’s Sarcoma, a rare bone cancer. Treatment: The family faced the difficult choice between limb salvage and amputation.
Cardiac Arrest and DNR
Emily Holmes. An elderly woman was resuscitated before her Do Not Resuscitate (DNR) status was discovered. Ethical Dilemma: The "treatment" became adhering to her wishes by withdrawing life support.
Other Medical Conditions Discussed
Penetrating Abdominal Trauma: Evisceration complicated by embedded explosives.
Pediatric Hearing Loss: Reece Benton was fitted for hearing aids.
Episode 4
Tension Pneumothorax
Bo. A stab wound victim left AMA but returned in distress. Diagnosis: Tension Pneumothorax causing tracheal shift. Treatment: Needle decompression and chest tube, followed by thoracotomy for active bleeding.
Alcohol-Induced Liver Rejection
Liver Transplant Recipient. A transplant patient presented with jaundice. Diagnosis: Rejection caused by alcohol consumption, rendering her ineligible for a second transplant.
Arrhythmia requiring ICD
Angel Munoz. A teen with syncope was diagnosed with a hereditary arrhythmia. Treatment: Implantation of an Internal Cardioverter Defibrillator (ICD), complicated by his undocumented status.
Other Medical Conditions Discussed
Flash Powder Inhalation: Chemical lung injury.
Arterial Thrombosis: In a patient with PVD.
Episode 5
Testicular Feminization (Androgen Insensitivity Syndrome)
Barbie Kligman. An 11-year-old girl in a car accident was found to have testicular tissue in her abdomen during surgery. Diagnosis: Testicular Feminization (now called Androgen Insensitivity Syndrome). She is genetically male (XY) but phenotypically female. Treatment: Removal of the undescended testes to prevent cancer.
Pseudocyesis and Schizophrenia
Coco. A woman presented in "labor" but had no fetal heartbeat. Diagnosis: Pseudocyesis (false pregnancy) driven by schizophrenia and medication non-compliance. Her "baby bump" was a full bladder.
GHB and Alcohol Toxicity
Medical Students. Two students overdosed on GHB (Liquid Ecstasy) and alcohol. Outcome: One required intubation, the other resuscitation for cardiac arrest.
Other Medical Conditions Discussed
Sigmoid Volvulus: Twisted intestine requiring decompression.
Myiasis: Maggots in an abscess.
Episode 6
Protein S Deficiency
Kevin Delaney. A homeless teen beaten on the street revealed he had Protein S Deficiency, a clotting disorder. Treatment: He required Coumadin (blood thinner), a dangerous medication for someone living on the streets due to bleeding risks.
Penetrating Trauma with Impalement
Eddy and Marcus Haney. Brothers arrived impaled together by a carpet stretcher. Diagnosis: One brother had the tool pressing on his heart, causing arrhythmias. Treatment: Careful extrication and cardiac repair in the OR.
Recurrent Leukemia
Brad Enloe. A child with recurrent leukemia was denied coverage for experimental therapy. Ethical Dilemma: Dr. Carter fabricated a diagnosis to admit him, but the mother refused to participate in insurance fraud.
Other Medical Conditions Discussed
Hypoglycemia: Insulin overdose.
Small Bowel Obstruction: Diagnosed via x-ray.
Episode 7
Reiter’s Syndrome
Mr. Bussey. A patient with urinary pain was initially treated for Chlamydia. Diagnosis: The triad of conjunctivitis, urethritis, and arthritis confirmed Reiter’s Syndrome (Reactive Arthritis). Treatment: NSAIDs (Indomethacin).
Infant Botulism
Sun Everly. An infant presented with lethargy and constipation. Diagnosis: Infant Botulism caused by ingesting honey containing Clostridium botulinum spores.
Magnesium Toxicity (Iatrogenic)
Mr. Ramos. An asthmatic patient suffered respiratory arrest after receiving a massive overdose of Magnesium Sulfate due to an intern's error. Treatment: Calcium gluconate reversal, intubation, and pacing.
Other Medical Conditions Discussed
Voluntary Trepanation: A patient drilled a hole in his own skull.
Acute Cholangitis: Septic shock requiring biliary decompression.
Episode 8
Splenic Laceration and Hemolytic Reaction
Corinna. A trauma patient required a transfusion but had antibodies to rare Vel and Lan antigens. Complication: She suffered a severe hemolytic reaction to unmatched blood. Treatment: Dr. Benton performed a "bloodless" splenectomy while the team hunted for her father, the only compatible donor.
Other Medical Conditions Discussed
Active Tuberculosis: Suspected in a patient coughing blood.
Anterior Shoulder Dislocation: Reduced in the field.
Episode 9
Pediatric Gunshot Wound
Andy Stiles. An 8-year-old arrived in cardiac arrest with a GSW to the abdomen. Despite a thoracotomy, he died. The "stranger danger" story was false; his friend had accidentally shot him.
Cochlear Implant Surgery
Patrick Shimahara. A toddler with profound hearing loss underwent Cochlear Implant surgery to restore hearing.
Other Medical Conditions Discussed
Ischemic Bowel: Discussed as a surgical emergency.
Magnesium Overdose: Mortality review case.
Episode 10
Subarachnoid Hemorrhage and Brain Death
Steven. A teen with a "killer headache" didn't wake up from a nap. Diagnosis: Ruptured aneurysm causing Subarachnoid Hemorrhage and brain death. Outcome: He became an organ donor for a patient with liver failure.
Hepatic Coma (Biliary Atresia)
Lizzie Mikami. A teen with Biliary Atresia presented in hepatic coma. She shared the rare AB blood type with the brain-dead donor (Steven), allowing for a life-saving transplant.
Gastric Perforation (Post-Gastroplasty)
Mr. DeMisa. A patient with a stomach stapling ate a massive meal, blowing his staples. Diagnosis: Gastric Perforation and sepsis. Treatment: Emergency surgery by Dr. Benton (covering for an intoxicated attending).
Other Medical Conditions Discussed
Panic Attack: Mimicking a heart attack in a musician.
Episode 11
Adrenoleukodystrophy (ALD)
Ricky Abbott. A child presented with advanced ALD, a fatal genetic disorder destroying myelin. His mother was malnourished from caretaking. Treatment: Supportive care. The case highlighted the toll of chronic illness on caregivers.
Agoraphobia
Edie Harvelle. A trauma patient hadn't left her house in 5 years. Dr. Greene used guided imagery to manage her Agoraphobia and panic during the trauma workup.
Other Medical Conditions Discussed
Acute Appendicitis: Diagnosed in a deaf child.
TB Exposure: Staff testing required.
Episode 12
Epidural Hematoma
Jim Haggerty. A patient fell from a ladder and was left at the scene. He arrived with a "blown pupil" and Cushing's triad. Diagnosis: Epidural Hematoma. Treatment: Dr. Greene performed an emergency burr hole in the ER to relieve pressure when neurosurgery was delayed.
Hypoxic Ischemic Injury
Charley Barnes. An elderly man with Carotid Stenosis suffered cardiac arrest during anesthesia induction. Outcome: Although revived, he suffered severe hypoxic brain injury.
Other Medical Conditions Discussed
Choledocholithiasis: Bile duct stones.
Anaphylaxis: Peanut allergy requiring dopamine.
Episode 13
Pulmonary Embolism
Alice Presley. A traveler with shortness of breath was suspected of having pneumonia. Diagnosis: V/Q scan confirmed Pulmonary Embolism from DVT caused by immobility.
Hodgkin’s Disease
Medical Student Strauss. A student discovered his own lymph node during a physical diagnosis class. Diagnosis: Biopsy confirmed Hodgkin’s Lymphoma, a treatable cancer.
Traumatic Erectile Dysfunction
Mobalage Ekabo. A patient with back pain revealed impotence. Dr. Greene diagnosed vascular damage from prior torture/trauma as the cause, recommending bypass surgery.
Other Medical Conditions Discussed
Hypercholesterolemia: Severe genetic lipid disorder.
Episode 14
Terminal ALD and Palliative Sedation
Ricky Abbott. Ricky returned in terminal agony. Treatment: Dr. Ross set up a PCA pump for home use. He instructed the mother on how to bypass the lockout to administer a lethal dose, sparking a major legal and ethical investigation into euthanasia.
Other Medical Conditions Discussed
Pediatric Constipation: Due to poor diet.
Myocardial Infarction: Priority case.
Episode 15
Hepatitis C
Jeanie Boulet. After a car accident, Jeanie's labs showed liver abnormalities. Diagnosis: Hepatitis C, acquired despite her HIV status. Confirmed by biopsy.
Polytrauma and Hypothermia
Dennis Martino. A child ejected from a bus was severely hypothermic (84°F). Treatment: Active rewarming (bladder lavage) and surgery for a splenic injury diagnosed via DPL.
Tension Pneumothorax
Mrs. Ekabo. A stab wound victim developed a Tension Pneumothorax. Treatment: Immediate needle decompression.
Other Medical Conditions Discussed
Popliteal Artery Injury: Complicating a leg fracture.
Episode 16
Ventricular Septal Defect (VSD)
Adelina Young. A diabetic patient had a high glucose level. Dr. Benton missed a heart murmur, which a nurse practitioner identified. Diagnosis: Ventricular Septal Defect (hole in the heart), unrelated to diabetes.
Breech Delivery
Melanie Ebee. A woman in labor in a rural cabin had a footling breech presentation. Treatment: Dr. Benton performed a complex manual breech delivery guided by a textbook.
Traumatic Ischemia
Boat Explosion Victim. A patient with a flail chest and severed femoral artery was saved in the field using Saran Wrap for the chest and fishing line to ligate the artery.
Other Medical Conditions Discussed
Hepatitis C: Discussion of treatment.
Episode 17
Stage IV Lung Cancer (Brain Mets)
Mrs. Fong. A patient presented with seizures. Diagnosis: Metastatic Lung Cancer to the brain. Ethical Conflict: The family refused to tell the patient the diagnosis, forcing the doctors to discharge her with a false diagnosis of epilepsy.
Open-Book Pelvic Fracture
Avery Campbell. A teen run over by an ambulance suffered a crushed pelvis. Diagnosis: Open-Book Pelvic Fracture and bladder rupture. Treatment: Angio-embolization to stop bleeding instead of open surgery.
Other Medical Conditions Discussed
Penetrating TBI: Fatal gunshot wound to the head.
Episode 18
Osteogenesis Imperfecta (OI)
Mrs. Leason’s Baby. An infant with multiple fractures was suspected of abuse. Diagnosis: Dr. Greene realized he caused a rib fracture during an exam. The bone fragility confirmed Osteogenesis Imperfecta (Brittle Bone Disease), clearing the mother of abuse.
Other Medical Conditions Discussed
Methylene Blue Ingestion: Causing blue urine.
Congestive Heart Failure: In a DNR patient.
Episode 19
Lead Poisoning
Lonnie. An infant with irritability and weight loss lived in an old building. Diagnosis: Blood smear showed basophilic stippling, confirming Lead Poisoning aggravated by iron deficiency anemia.
Other Medical Conditions Discussed
Rheumatoid Arthritis: Requiring anti-inflammatories.
Penetrating Neck Trauma: Causing nerve damage (hoarseness).
Episode 20
Cardiac Tamponade (Overanticoagulation)
Phyllis Farr. A patient on Coumadin developed Cardiac Tamponade due to blood being too thin (high INR). Treatment: Blind pericardiocentesis performed during a power outage.
Rhabdomyolysis
Repairman. A lightning strike victim had red urine. Diagnosis: Rhabdomyolysis (muscle breakdown) releasing myoglobin, not blood, into the urine.
Other Medical Conditions Discussed
Gunshot Wound: Disguised as a bedsore.
Episode 21
Spinal Cord Compression
Shannon Mitchell. A teen ejected from a car had paralysis. Diagnosis: L1 Vertebral Fracture with a bone fragment compressing the cord. Treatment: High-dose steroids and emergency decompression surgery.
Full-Thickness Burns
Travis Mitchell. The driver suffered 80% burns. Treatment: Massive fluid resuscitation and escharotomy to release pressure from edema.
Gunshot Wound (Saline Implant)
"Amber". An undercover agent was shot in the chest. Outcome: Her saline breast implant slowed the bullet, preventing vital organ damage.
Other Medical Conditions Discussed
Liver Laceration: From a fishing pole impalement.
Episode 22
Opiate Intoxication
Jack Toberen. A lost toddler presented with pinpoint pupils and respiratory depression. Diagnosis: Opiate Overdose. He was also found to have a VP shunt for hydrocephalus. Narcan reversed the toxicity.
Abdominal Aortic Aneurysm (AAA)
David Chameides. An elderly smoker with back pain was diagnosed with a stable AAA via ultrasound.
Colles Fracture
Antoine Bell. A student suffered a Colles Fracture (wrist) and metacarpal fracture in a fight, requiring surgical pinning.
Other Medical Conditions Discussed
Leukemia: Observed in the waiting room.
Twin Pregnancy: Confirmed by ultrasound.
🔖 Key Takeaways
🗝️ Genetic Disorders: The season highlighted rare genetic conditions like Adrenoleukodystrophy (ALD), Osteogenesis Imperfecta, and Testicular Feminization, educating viewers on their clinical presentation.
🗝️ Surgical Innovation: Dr. Corday introduced new procedures like the Osteochondral Allograft, reflecting the surgical advancements of the late 90s.
🗝️ Ethical Dilemmas: The storyline of Dr. Ross assisting a mother in ending her suffering child's life (euthanasia) was a central ethical conflict.
🗝️ Diagnostic Vigilance: Cases like the missed VSD and the Osteogenesis Imperfecta misdiagnosis emphasized the importance of thorough physical exams and keeping an open mind.
🗝️ Trauma Management: The season continued to showcase critical interventions, from ED thoracotomies to escharotomies for burn victims.
Keywords: Medical Diagnoses ER Season 5
Medical Diagnoses ER Season 5
