Medical Diagnoses in ER: A Comprehensive Review of Medical Conditions in Season 7
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Season 7 of ER is defined by personal tragedy colliding with professional duty. It balances the high-octane chaos of mass casualty events—including a train wreck and a prison van accident—with the quiet, devastating progression of chronic illness within the staff itself. From the harrowing discovery of Dr. Greene's brain tumor to the ethical complexities of organ transplantation and the aftermath of a school shooting, the medical stakes were deeply personal.
Below is a comprehensive, episode-by-episode review of the medical cases, diagnoses, and treatments presented in Season 7.
Content ⁉️
Episode 1
Cardiac Tamponade Complicated by Iatrogenic MI
Mike Palmieri. A high school football player presented with chest pain and numbness after a severe hit. Diagnosis: A CT scan revealed internal bleeding into the pericardial sac, causing Cardiac Tamponade. Complication: During an emergency pericardiocentesis in the ER, the needle lacerated the Left Anterior Descending (LAD) artery, causing an Iatrogenic Myocardial Infarction. Treatment: The patient went into cardiac arrest (V-fib/Torsades), requiring an emergency thoracotomy, internal compressions, and defibrillation to restore a rhythm.
Other Medical Diagnoses and Conditions Discussed
Substance Use Disorder: Diaphoresis noted as a sign of withdrawal.
Phytodermatitis: Contact dermatitis consistent with poison ivy.
Massive Myocardial Infarction: Patient arrived in asystole and was pronounced dead.
Chronic Renal Failure: Fluid overload due to missed dialysis.
Open Tibial Fracture: Trauma from a football riot.
Head Trauma (ICP): Treated with intubation, mannitol, and Lasix.
Leaking Abdominal Aortic Aneurysm (AAA): Requiring surgical prioritization.
Polysubstance Overdose: Ingestion of Elavil, codeine, and lorazepam leading to Torsades.
Episode 2
Preterm Labor (Micro-Preemie)
Regina/Julian Morgan. A patient presented in preterm labor at roughly 21-22 weeks. Treatment: Tocolytics (terbutaline) were attempted but stopped due to pulmonary edema. Outcome: A male infant, Julian, was delivered as a Micro-Preemie. Despite normal anatomy, extreme prematurity made survival impossible, and he passed away after nine hours.
Stroke and Aspiration Pneumonia
Glenda Walton. A patient with a history of lacunar infarcts presented with slurred speech. Diagnosis: Atrial Fibrillation likely triggered a massive Cerebrovascular Accident (CVA), further complicated by aspiration pneumonia. Outcome: Life support was withheld in accordance with the patient's prior wishes.
Other Medical Diagnoses and Conditions Discussed
Renal Failure: Clotted-off fistula requiring revision.
Pheochromocytoma: Adrenal tumor causing hormonal overproduction.
Spinal Abscess: Located at L4-L5.
Shoulder Dystocia: Resulting in a broken clavicle in the newborn.
Alcoholism: Managed with naltrexone and mandatory support meetings.
Episode 3
Urinary Tract Infection in Paraplegia
Dennis. A paraplegic patient self-diagnosed a Urinary Tract Infection (UTI) based on increased need for catheterization. Diagnosis: Confirmed via urinalysis. Treatment: Prescribed Bactrim and supplied with extra catheters.
Other Medical Diagnoses and Conditions Discussed
Psychogenic Polydipsia: Excessive fluid intake.
Appendicitis: "Hot appy" at risk of rupture.
Compartment Syndrome: Leg injury requiring emergency fasciotomy.
Gonorrhea: Pharyngeal infection diagnosed in a patient's throat.
Crushed Pelvis: Resulting in unstable blood pressure.
Self-Mutilation: Ear wounds inflicted with kitchen shears.
Episode 4
Niemann-Pick's Type A
Kenneth. A child presented with sudden bruising and hepatosplenomegaly. Diagnosis: Niemann-Pick's Type A, a fatal genetic disease causing thrombocytopenia due to sphingomyelin deposits. Treatment: Palliative care (morphine), as surgery was deemed inappropriate.
Acute Subdural Hemorrhage
Unnamed Assailant. A trauma patient arrived with seizures and a blown pupil following an attack. Diagnosis: Subdural Hemorrhage with herniation. Treatment: Mannitol, posterior burr hole, and craniotomy, followed by a pentobarbital coma.
Other Medical Diagnoses and Conditions Discussed
Hypothermia: Patient in full arrest with core temp of 86°F.
Smoke Inhalation/Burns: From a chemical explosion.
Multiple Gunshot Wounds: Resulting in hemopneumothorax and ventricular septal defect.
UTI: Causing altered mental status in an elderly patient.
Episode 5
End-Stage Heart Failure and MI
Tom Coggins. A transplant candidate suffered a heart attack mid-transport. Treatment: Thrombolytics in-flight, followed by an Intra-Aortic Balloon Pump (IABP) and pacemaker insertion to bridge him to transplant.
HIV Disclosure
Trent Larson. A teen treated for a hand laceration was found to be HIV-positive (perinatal transmission) but unaware of his status. Ethical Conflict: Dr. Carter disclosed the status due to public health risks, leading to the testing and diagnosis of his girlfriend, Emma.
Ruptured Abdominal Aortic Aneurysm
Unnamed Patient. A patient left waiting with a "backache" collapsed. Diagnosis: Ruptured AAA. Treatment: Immediate massive transfusion protocol and surgery.
Other Medical Diagnoses and Conditions Discussed
Acute Respiratory Failure: Infant with pneumonia requiring intubation.
Transient Ischemic Attack (TIA): Patient awaiting clearance.
Pneumothorax: Decreased breath sounds requiring chest tube.
Pulmonary Fibrosis: Coccidioidomycosis suspected.
Brain Herniation: Autopsy confirmed occipital contusions.
Episode 6
Iatrogenic Cord Compression
Al Patterson. A patient with a herniated disk underwent an outpatient endoscopic discectomy. Complication: He returned with paralysis and severe pain. Diagnosis: Spinal fluid leak causing Cord Compression. Treatment: Emergency return to the O.R.
Other Medical Diagnoses and Conditions Discussed
Repetitive Blunt Trauma: Suggestive of abuse.
Traumatic Amputation: Shotgun injury.
Hypersexual Dementia: Geriatric presentation.
Hemorrhagic Shock: Secondary to tension hemopneumothorax from a GSW.
Lithium Intolerance: In a bipolar patient.
Episode 7
Intracranial Mass
Dr. Mark Greene. Presented with dizziness and aphasia (inability to speak). Diagnosis: Imaging revealed a 3.5 cm Mass in the Frontal Cortex (Brain Tumor).
Pulmonary Embolism (PE)
Mr. Florea. A frequent visitor initially suspected of drug-seeking returned in critical condition. Diagnosis: Deep Vein Thrombosis (DVT) progressing to a PE. Treatment: Tissue Plasminogen Activator (TPA) administered despite contraindications due to hypoxia.
Other Medical Diagnoses and Conditions Discussed
Metastatic Breast Cancer: Spread to the spine.
Intracranial Hemorrhage: Drug-induced hypertension (BP 260/140).
Femoral Artery Laceration: Severe vascular trauma.
Atypical Migraine: Considered in differential for aphasia.
Episode 8
Glioblastoma Multiforme (GBM)
Dr. Mark Greene. Biopsy confirmed the brain mass was a Glioblastoma Multiforme. Prognosis: Initially deemed inoperable due to invasion of Broca's area (speech center), with a survival estimate of eight weeks without treatment. Treatment: Started on Dilantin for seizures.
Other Medical Diagnoses and Conditions Discussed
Wolff-Parkinson-White Syndrome: Causing tachycardia of 300 bpm.
Meningocele: CSF leak causing paralysis post-surgery.
Facial Fracture: Assault victim.
Sexual Assault: Rape kit ordered.
Episode 9
Operable GBM (Awake Craniotomy)
Dr. Mark Greene. A functional MRI revealed the tumor had not yet invaded the language centers. Plan: A revolutionary Awake Craniotomy to resect the tumor while mapping speech, followed by the insertion of chemotherapy wafers.
Other Medical Diagnoses and Conditions Discussed
Superior Vena Cava Syndrome: Cancer complication.
Leukemia: Child undergoing chemotherapy.
Cyclothymic Disorder: Patient attempting a sit-up record.
Closed Head Trauma: Motorcycle accident with CSF otorrhea.
Seat-Belt Injury: MVA victim.
Episode 10
Intraoperative Seizure
Dr. Mark Greene. During the awake craniotomy, cortical stimulation triggered a Seizure. Outcome: The surgery proceeded successfully with clean margins and wafer insertion.
Coronary Dissection
Dan Harris. A trauma patient diagnosed with an MI suffered a complication during catheterization. Diagnosis: Left Main Coronary Artery Dissection. Treatment: Emergency open-heart bypass.
Other Medical Diagnoses and Conditions Discussed
Teratoma: Cardiac tumor scheduled for resection.
Retinal Artery Occlusion: Eye emergency.
SIDS: Historical diagnosis mentioned.
Ruptured Aortic Trunk: Post-operative complication.
Episode 11
Cocaine Toxicity (Body Packer Syndrome)
Anne. A traveler presented with abdominal pain and bloody discharge. Diagnosis: Mallory-Weiss Tear and gastric obstruction caused by a swallowed condom full of cocaine. Complication: The condom leaked, causing severe toxicity (BP 240/100). Treatment: Endoscopic removal, phentolamine, esmolol, and charcoal.
Other Medical Diagnoses and Conditions Discussed
Liver Laceration: Stage 3 stellate fracture requiring Pringle maneuver.
Mallory-Weiss Tear: Esophageal laceration.
Osteoarthritis: Flare-up treated with steroids.
Alcohol Intoxication: BAL of 0.35 complicating trauma assessment.
Episode 12
Traumatic Aortic Dissection
30-year-old Male. A victim of a sweatshop fire presented with 92% burns. Diagnosis: Transesophageal echo confirmed a Traumatic Aortic Dissection. Treatment: Surgical repair with a Dacron graft, involving reimplantation of intercostal arteries to prevent paralysis.
Other Medical Diagnoses and Conditions Discussed
Electrical Injury: High-voltage shock causing fatal arrhythmia.
Priapism: Linked to cocaine use.
Uterine Fibroids: Causing severe hemorrhage.
Laryngeal Injury: Tracheotomy required for airway obstruction.
Chlamydia: Outbreak in a nursing home.
Episode 13
Congestive Heart Failure (Transplant Rejection)
Nick Stevens. A teenager with two prior heart transplants presented in acute CHF and pulmonary edema. Outcome: Despite cardiac arrest, he was resuscitated and listed for a third transplant, overriding his wish to stop treatment.
Systemic Lupus Erythematosus (SLE)
Bishop Stewart. A patient seeking steroids for "arthritis" was found to have protein in urine and hyperglycemia. Diagnosis: Systemic Lupus Erythematosus with potential renal and cardiac involvement (pericarditis).
Other Medical Diagnoses and Conditions Discussed
Mononucleosis: Confirmed via blood test.
Diabetic Ketoacidosis: History induced by steroids.
Aspiration: Leading to respiratory arrest.
Expressive Aphasia: Post-operative swelling in Dr. Greene.
Episode 14
Measles Encephalitis
Zack Woodman. An unvaccinated 4-year-old presented with fever, Koplik spots, and a rash. Diagnosis: Acute Measles complicated by viral pneumonia and encephalitis. Outcome: Fatal cardiac arrest due to severe hypoxia.
Acute Lupus Flare
Bishop Stewart. Returned with hypoxia and lung inflammation. Diagnosis: Acute Lupus Flare. Outcome: Left AMA and collapsed with impending respiratory arrest.
Other Medical Diagnoses and Conditions Discussed
Non-Hodgkin's Lymphoma: Chemo-induced nausea.
Meningitis: Ruled out via spinal tap.
Bradycardia: Preceding arrest in hypoxia.
Episode 15
Crush Injury (Field Amputation)
Lorcan. A firefighter trapped under a train car suffered massive crush injuries. Treatment: Dr. Corday performed a Bilateral Field Amputation to free him before exsanguination occurred.
Epidural Hematoma
Myles. A 7-year-old pinned in wreckage showed signs of herniation (blown pupil, bradycardia). Treatment: Dr. Greene performed a field burr hole to evacuate the clot.
Other Medical Diagnoses and Conditions Discussed
Tension Pneumothorax: Required decompression.
Traumatic Aortic Rupture: Fatal injury suggested by asymmetric BPs.
Impalement Injury: Complicated by spinal shock.
Traumatic Extrusion of Tibia: Severe open fracture.
Episode 16
Hypothermia (Infant)
May Jeffries. A 4-month-old was kidnapped from the ER and found abandoned on a train platform. Diagnosis: Hypothermia (Core temp 93°F). Treatment: Aggressive rewarming with heated oxygen and fluids.
Other Medical Diagnoses and Conditions Discussed
Anabolic Steroid Abuse: Wrestler with kidney failure risks and aggression.
Self-Inflicted Scalp Laceration: "Blading."
Suicide Attempt: Patient drove onto train tracks.
Aspiration Pneumonia: Suspected in a frequent flyer.
Episode 17
Stroke via Fertility Drugs
Laura Beckton. A young egg donor presented with altered mental status after a car crash. Diagnosis: Stroke caused by hypercoagulability from fertility injections, resulting in quadriplegia. Treatment: Heparin, cancelling the egg retrieval.
Toxin-Induced Liver Failure
Bo. A student huffing "spot remover" presented with liver failure. Diagnosis: Carbon Tetrachloride Toxicity. Treatment: Listed for liver transplant.
Other Medical Diagnoses and Conditions Discussed
Profound Dehydration: Causing delirium in an elderly patient (Sodium 172).
Duodenal Hematoma: Required Whipple procedure.
Status Asthmaticus: Caused by chemical fumes.
Episode 18
Environmental Hypothermia
Bryan Cooley. A 7-year-old found unconscious on a soccer field. Diagnosis: Secondary Hypothermia (Core temp 86°F). Treatment: Active rewarming via warm saline and bladder lavage.
Trauma-Induced Cardiac Arrest
Van Driver. A victim of a prison van crash arrived in arrest. Diagnosis: Likely aortic tear or pericardial effusion. Outcome: Pronounced dead after failed resuscitation.
Other Medical Diagnoses and Conditions Discussed
Open Radius Fracture: Orthopedic emergency.
Renal Colic: Kidney stones.
Splenic Injury: Suspected due to LUQ tenderness.
Episode 19
Diphenhydramine Overdose
Maggie Wyczenski. A patient with Bipolar Disorder ingested 900mg of Diphenhydramine. Diagnosis: Acute Overdose causing wide QRS complexes and seizures. Treatment: Intubation, charcoal, and sodium bicarbonate.
Other Medical Diagnoses and Conditions Discussed
Diabetic Ketoacidosis: Blood sugar of 400.
Atrial Fibrillation: Causing stroke.
Alcohol Poisoning: BAL 0.529 leading to arrest.
Claustrophobia: Panic attack in a car trunk.
Episode 20
Incomplete Miscarriage and Coagulopathy
Noni. Presented with hypotension and bleeding. Diagnosis: Incomplete Miscarriage complicated by coagulopathy induced by herbal abortifacients. Treatment: D&C and plasma transfusion.
Ovarian Tumor
Faye. Patient with constipation was found to have a large ovarian tumor blocking the bowel. Outcome: Left AMA.
Other Medical Diagnoses and Conditions Discussed
Congestive Heart Failure: With rapid A-fib and MI.
Salicylate Toxicity: Suspected from oil of wintergreen.
Scaphoid Fracture: Wrist injury.
Episode 21
Non-Accidental Trauma (Child Abuse)
Ben Fossen. A 7-year-old presented with burns and a hand fracture. Diagnosis: Skeletal survey revealed healed spiral fractures inconsistent with falls, confirming Child Abuse. Outcome: Protective custody.
Other Medical Diagnoses and Conditions Discussed
ACL Tear: Knee injury.
Ringworm: Patient with 40 cats.
Multiple Trauma: Shattered pelvis and hemorrhagic shock.
Episode 22
Soft-Tissue Sarcoma
Mark Ainsley. A foster child treated for a GSW was found to have a proximal lesion. Diagnosis: Suspected Extra-osseous Ewing’s Sarcoma. Prognosis: Good (70% survival) due to incidental early detection.
Other Medical Diagnoses and Conditions Discussed
Compartment Syndrome: Risk assessed in GSW limb.
Aorta-esophageal Fistula: Suspected in fatal hemorrhage.
Spinal Shock: Immediate paralysis from cord injury.
Pneumocystis: Complication in an AIDS patient.
🔖 Key Takeaways
🗝️ Dr. Greene's Medical Arc: The season is anchored by the complex diagnosis and innovative "awake craniotomy" treatment of a Glioblastoma Multiforme.
🗝️ Mass Casualty Management: The team faced extreme field medicine scenarios, including a train wreck requiring bilateral field amputations and on-site neurosurgery.
🗝️ Pediatric Vulnerability: Cases highlighted the dangers of being unvaccinated (Measles), child abuse (spiral fractures), and environmental neglect (hypothermia).
🗝️ Iatrogenic Complications: The season did not shy away from medical errors, including a fatal needle slip during pericardiocentesis and paralysis following routine back surgery.
🗝️ Psychiatric Emergencies: The progression of untreated Bipolar Disorder was explored through acute overdose and the legal complexities of involuntary commitment.
Keywords: Medical Diagnoses ER Season 7
Medical Diagnoses ER Season 7
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