Medical Diagnoses in The Resident: A Comprehensive Review of Medical Conditions in Season 2
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- 10 min read
Following a debut season focused on the bureaucratic struggles of modern medicine, Season 2 of The Resident shifts its gaze toward the dangers of medical device fraud and the financial barriers to care. The clinical cases presented are equally high-stakes, ranging from rare genetic anomalies to catastrophic traumas caused by defective hardware. Below is a comprehensive episode-by-episode review of the medical conditions, diagnoses, and treatments presented in Season 2.
Content ⁉️
Episode 1
Hypoplastic Left Heart Syndrome and Anaphylaxis
The season opens with a crisis involving the Thoms family. Newborn Mabel Thoms presented with Hypoplastic Left Heart Syndrome (HLHS), a severe congenital defect where the left side of the heart is critically underdeveloped. While the defect was noted prenatally, the severity required immediate intervention to reroute blood flow. The surgery, performed by Drs. Austin and Okafor, was complicated by a total power failure, forcing the team to operate using manual perfusion and flashlights. Simultaneously, the father, Jason Thoms, collapsed with a blood pressure of 180/120 and disorientation. While initially worked up for a hemorrhagic stroke, Dr. Devon Pravesh noted reactive pupils and dropping pressure, revising the diagnosis to a severe anaphylactic reaction. The trigger was identified as mangos in a smoothie, and the patient was stabilized with epinephrine.
Other Medical Diagnoses and Conditions Discussed
Lupus and Kidney Failure: A chronic autoimmune disease leading to systemic complications and fatal renal failure.
Kidney Infection (Pyelonephritis): A severe progression of an untreated urinary tract infection.
Doxycycline Allergy: An adverse immune response to an antibiotic resulting in hives.
Alcohol Withdrawal: A physiological reaction to the cessation of heavy alcohol use, managed with diazepam.
Claustrophobia and Bathmophobia: Pathological fears of enclosed spaces and steep slopes/stairs, respectively.
Abdominal Gunshot Wound: Trauma involving damage to the spleen and descending aorta.
Episode 2
Localized Pancreatic Cancer
Jack Alderwood, a 14-year-old admitted for blunt abdominal trauma following a skating accident, underwent an emergency splenectomy. However, subtle signs—jaundice and weight loss—prompted a CT scan, which revealed localized pancreatic cancer. The trauma had caused a bleed on the tumor, making it visible. The treatment required was a Whipple procedure, a radical resection of the pancreas, gallbladder, and parts of the small intestine.
Diabetic Ketoacidosis (DKA)
Abby Arlen was found unconscious with a blood glucose of 583 and a pH of 6.8, confirming Diabetic Ketoacidosis (DKA). The underlying cause was social rather than biological: insulin rationing due to the inability to afford the $2,000 monthly cost. Treatment involved an emergency external jugular (EJ) line for fluid resuscitation and intubation for respiratory failure.
Other Medical Diagnoses and Conditions Discussed
Mitral Stenosis: Narrowing of the heart's mitral valve, often characterized by a diastolic rumble.
Aortic Stenosis: Narrowing of the aortic valve indicated by a systolic ejection murmur.
Pelvic Fracture: A severe orthopedic injury often requiring total hip replacement.
Aortic Aneurysm/Dissection: A complex cardiovascular condition requiring reconstruction of the body's primary artery.
Episode 3
Chronic Silicosis and Nocardia Infection
Newlyweds Brianna and John presented with respiratory failure and systemic symptoms after a trip to Hawaii. Initial theories regarding STDs were ruled out in favor of environmental exposure. The couple operated a home pottery workshop with poor ventilation, leading to chronic silicosis from inhaling silica dust. The acute flare-up was triggered by inhaling volcanic ash. John was further diagnosed with a nocardia infection and an empyema (pus in the lung), requiring surgical intervention.
Other Medical Diagnoses and Conditions Discussed
Pericardial Tamponade: Fluid accumulation in the sac surrounding the heart, preventing effective pumping.
Transplant Rejection: Immune response attacking a grafted organ, such as a liver.
Multisystem Organ Failure: Simultaneous dysfunction of vital organs following severe infection.
Episode 4
Auto-Brewery Syndrome (A.B.S.)
Rock star Rhys Barrett appeared intoxicated despite claiming sobriety. A rising blood alcohol level during surgery—where only IV fluids were administered—confirmed Auto-Brewery Syndrome. This rare condition involves an overgrowth of yeast in the stomach fermenting carbohydrates into alcohol. Treatment involved antifungals and a low-carb diet.
Disseminated Intravascular Coagulation (DIC)
Josh Robinson developed Disseminated Intravascular Coagulation (DIC) following a stampede injury, triggered by liver toxicity from herbal supplements (kava kava). The depletion of clotting factors led to a massive cerebral hemorrhage. With a "blown" pupil indicating brain compression, Dr. Hawkins performed an emergency burr hole in the hallway to relieve pressure.
Other Medical Diagnoses and Conditions Discussed
Compartment Syndrome: Increased pressure within a muscle compartment causing nerve damage and necrosis.
Cushing’s Triad: Hypertension, bradycardia, and irregular respirations indicating increased intracranial pressure.
Refractory Seizures: Seizures unresponsive to standard medication, potentially requiring nerve stimulation.
Episode 5
Relapsed Leukemia and Intracerebral Hemorrhage
Jasper Barnett, in remission for two years, presented with a white blood cell count over 150,000. The diagnosis was aggressive relapsed leukemia. The condition progressed to a massive intracerebral hemorrhage; due to the inability of his blood to clot, the event was fatal.
Cauda Equina Syndrome
Penny, a patient with a spinal tumor, developed incontinence and loss of sensation, signaling Cauda Equina Syndrome. This compression of the nerves at the base of the spinal cord required emergency resection to prevent permanent paralysis.
Other Medical Diagnoses and Conditions Discussed
Pathologic Fracture: A bone break caused by underlying disease, such as a benign ulna cyst.
Absence Seizures: Brief lapses in consciousness starting in infancy.
MRSA: Methicillin-resistant Staphylococcus aureus, a difficult-to-treat bacterial infection.
Episode 6
Anti-NMDA Receptor Encephalitis
Laurie Dante presented with psychosis and Capgras syndrome (believing doctors were imposters). A clock-drawing test, where she crowded all numbers on one side, indicated a neurological deficit rather than mental illness. Imaging revealed an ovarian teratoma—an "incidentaloma" containing teeth and bone. The diagnosis was Anti-NMDA receptor encephalitis, caused by antibodies from the tumor attacking the brain.
Other Medical Diagnoses and Conditions Discussed
Traumatic Amputation: Accidental loss of a limb requiring surgical reattachment.
Hemorrhagic Shock: Organ failure resulting from massive blood loss.
Cardiac Tamponade: Emergency fluid buildup around the heart preventing effective beating.
Episode 7
Metallosis and Cytokine Storm Syndrome
Restaurateur Ernest LeVasseur suffered rapid decline resembling dementia, blindness, and heart failure. Dr. Hawkins diagnosed metallosis caused by a "metal-on-metal" hip replacement shedding cobalt into his bloodstream.
Separately, during a drug trial, healthy volunteers experienced multisystem organ failure. This was identified as a cytokine storm, a systemic inflammatory response. Treatment involved high-dose steroids; however, delays in administration led to one fatality and acute kidney failure in another patient (Jessie).
Other Medical Diagnoses and Conditions Discussed
Acetabular Osteolysis: Progressive destruction of bone tissue in the hip socket.
Pseudo-tumors: Inflammatory masses forming in response to metal debris.
Cardiomyopathy: Disease of the heart muscle making pumping difficult.
Episode 8
Status Epilepticus
Henry Barnett suffered a grand mal seizure lasting over 20 minutes, a condition known as status epilepticus. When the seizures proved refractory to medication, the team implanted a Vagus Nerve Stimulator (VNS) to control the electrical activity.
Takotsubo Cardiomyopathy
Wallace Troke was diagnosed with "broken heart syndrome," or takotsubo cardiomyopathy, triggered by extreme grief. He required a heart transplant. The donor heart suffered a blockage ex-vivo, requiring bypass surgery on the "heart in a box" before implantation.
Other Medical Diagnoses and Conditions Discussed
Sleep Apnea: Disorder characterized by stopping and starting breathing during sleep.
Small Bowel Obstruction (SBO): Blockage preventing passage of intestinal contents.
Methamphetamine-Induced Psychosis: Mental health crisis triggered by stimulant abuse.
Episode 9 & 10
Severe Aortic Stenosis and Crohn’s Disease
An elderly patient required a Transcatheter Aortic Valve Replacement (TAVR) for severe aortic stenosis. Concurrently, Marshall Winthrop suffered a flare of Crohn's Disease. An intestinal stricture led to a bowel perforation and acute massive hemorrhage, requiring massive transfusion and emergency resection.
Other Medical Diagnoses and Conditions Discussed
Intractable Seizures: Seizure activity unresponsive to standard medical treatment.
Sepsis: Life-threatening response to infection caused by gut perforation.
Episode 11
Gossypiboma and Ovarian Torsion
Marisol suffered years of pain due to a "gossypiboma"—a retained surgical sponge from a previous C-section. This foreign body caused ovarian torsion, necessitating emergency surgery to untwist the organ and remove the sponge.
Defective Heart Valve Strut
Bradley Jenkins died of sudden cardiac arrest. While initially blamed on operator error, an autopsy revealed the strut of his QuoVadis mitral valve had shattered. This marked the beginning of the investigation into defective medical devices.
Other Medical Diagnoses and Conditions Discussed
Peripheral Vascular Disease (PVD): Reduced blood flow leading to leg ulcers and staph infection.
Childhood Motor Tic: Benign repetitive movements ruled out as epilepsy via EEG.
Episode 12
Multi-Drug Resistant Yersinia pestis
Patients Meg and Sam presented with seizures and buboes. The diagnosis was Yersinia pestis (the Black Plague), contracted from fleas in Yosemite. The strain was multi-drug resistant, requiring treatment with colistin.
Other Medical Diagnoses and Conditions Discussed
Thyroid Storm: Life-threatening crisis ruled out by a thyroid panel.
Cryptococcosis: Fungal infection from pigeon droppings.
Viral Hemorrhagic Fevers: Severe infections like Marburg considered in the differential.
Episode 13
Cystic Fibrosis with Multi-Organ Failure
Medical student Eloise, suffering from cystic fibrosis, developed liver failure and pancreatic insufficiency. She required a triple transplant (lung, liver, pancreas). The procedure utilized a deceased donor for the abdominal organs and living donors (her parents) for the lung lobes.
Other Medical Diagnoses and Conditions Discussed
Pulmonary Artery Hemorrhage: Critical bleed requiring conversion to open surgery.
Reperfusion Injury: Tissue damage occurring when blood supply returns to an organ.
Episode 14
Polycystic Kidney Disease (PKD)
An unauthorized autopsy on a patient named Gertie revealed Polycystic Kidney Disease (PKD) and a ruptured brain aneurysm. This prompted the screening of her niece, Nora, who was found to have two unruptured aneurysms, which were successfully clipped.
Polyarteritis Nodosa (PAN)
Otto presented with hemoptysis and "confabulation" (creating false memories). He was diagnosed with Polyarteritis Nodosa, an autoimmune vascular disease. The memory issues were attributed to permanent alcohol-related dementia.
Other Medical Diagnoses and Conditions Discussed
Galeazzi Fracture: Fracture of the radius with dislocation of the distal radioulnar joint.
Atherosclerosis: Hardening of arteries often used as a default diagnosis for sudden death.
Episode 15 & 16
Triple-Negative Breast Cancer
Adaku was diagnosed with aggressive triple-negative breast cancer and a BRCA1 mutation. She eventually consented to a double mastectomy to save her life.
VNS Malfunction
Henry Barnett experienced cardiac arrest (asystole). It was discovered that his QuoVadis Vagus Nerve Stimulator was malfunctioning, stopping his heart every time it fired. The device was deactivated, and he was transferred for experimental surgery.
Other Medical Diagnoses and Conditions Discussed
Atrial Myxoma: A cardiac tumor obstructing blood flow, complicated by infective endocarditis.
Acute Cholecystitis: Gallbladder infection triggered by a high-fat meal.
Episode 17
Infectious Mononucleosis and ARDS
Evan Weston developed severe pneumonia secondary to mononucleosis, requiring ECMO (Extracorporeal Membrane Oxygenation) as a life-saving measure.
Traumatic Gunshot Wound
Dr. Abe Benedict suffered a GSW resulting in multisystem organ failure. With ECMO unavailable, the team utilized proning (rotating the patient onto their stomach) to improve oxygenation despite the risk to his surgical incisions.
Episode 18
Androgen Insensitivity Syndrome (AIS)
Valerie, a gymnast, presented with amenorrhea and abdominal pain. Imaging revealed she had XY chromosomes and testicular cancer within undescended testes, confirming Androgen Insensitivity Syndrome.
Pheochromocytoma
Brett suffered an abdominal aortic aneurysm (AAA). Repair was complicated by a pheochromocytoma on his adrenal gland, a tumor that releases catecholamines, causing massive blood pressure spikes during surgery.
Other Medical Diagnoses and Conditions Discussed
Hyperkalemia: High potassium levels indicating kidney failure.
Deep Vein Thrombosis (DVT): Blood clot in the leg treated with thinners.
Episode 19
Malignant Hyperthermia
Mr. Garcia, found frozen (severe hypothermia), was rewarmed but then developed rigid limbs and a temperature of 105°F. He was diagnosed with Malignant Hyperthermia, a reaction to succinylcholine triggered once his metabolism returned. Treatment involved dantrolene and snow cooling.
Other Medical Diagnoses and Conditions Discussed
Cardiac Tamponade: Bleeding into the pericardium caused by trauma during rewarming.
Strangulated Hernia: Surgical emergency in a terminal cancer patient.
Episode 20
Iatrogenic Bladder Tear
Lea Davies died from catastrophic postpartum hemorrhage. The cause was a bladder tear during her C-section, missed by staff despite hematuria, leading to hypovolemic shock.
Other Medical Diagnoses and Conditions Discussed
Migrating Intraspinal Bullet: A projectile moving within the spinal canal threatening paralysis.
Traumatic Liver Laceration: Injury repaired during the same surgery as the spine extraction.
Episode 21
Sickle Cell Trait Crisis
Fritz presented with massive blood loss from a stable splenic injury. The cause was Sickle Cell Trait crisis triggered by altitude and dehydration, causing red blood cells to lyse. He was treated in a hyperbaric chamber.
Septic Arthritis
Vivian presented with a swollen knee diagnosed as septic arthritis caused by a disseminated gonococcal infection.
Other Medical Diagnoses and Conditions Discussed
Nitrogen Narcosis: "Martini effect" impairing judgment in a hyperbaric chamber.
Peritonitis: Inflammation of the abdominal lining.
Episode 22
Pulmonary Alveolar Proteinosis (PAP)
Taylor Emeye presented with low oxygen saturation and lungs with an "irregular appearance." The diagnosis was Pulmonary Alveolar Proteinosis, treated via lung lavage to clear protein buildup.
Dextrocardia with Situs Inversus
A patient requiring bypass surgery presented with situs inversus, a congenital condition where internal organs are mirrored.
Other Medical Diagnoses and Conditions Discussed
Heart Failure: Secondary to drug toxicity from a clinical trial.
Concussion: Mild traumatic brain injury requiring "brain rest."
Episode 23
Ruptured Aneurysm in Broca’s Area
An unidentified patient presented with expressive aphasia (inability to speak but preserved understanding). A CT revealed a ruptured aneurysm in Broca’s area. Surgery restored his ability to speak.
Dual Organ Failure
Jessie Nevin required a kidney transplant to reverse heart failure caused by renal strain. During the surgery, she entered V-fib, requiring defibrillation before the new kidney could be perfused.
🔖 Key Takeaways
🗝️ The Danger of Medical Devices: The season's central arc revolves around the QuoVadis heart valves and VNS devices, illustrating how mechanical failure and corporate fraud can lead to catastrophic patient outcomes like cardiac arrest and shattering valves.
🗝️ Maternal Mortality: The death of Lea Davies highlights the critical issue of "never events" and the fatal consequences of dismissing patient pain and symptoms like hematuria in postpartum care.
🗝️ Barriers to Care: From insulin rationing leading to DKA to the financial inability to treat gallstones until they become septic, the season heavily focuses on how lack of insurance drives medical emergencies.
🗝️ Complex Anatomical Anomalies: The writers utilized rare conditions such as Situs Inversus (mirrored organs) and Androgen Insensitivity Syndrome to create unique surgical challenges.
🗝️ Genetic "Time Bombs": Several cases, including the Polycystic Kidney Disease aneurysms and malignant hyperthermia, emphasize the importance of family history and genetic predisposition in acute medicine.
Keywords: Medical Diagnoses The Resident Season 2
Medical Diagnoses The Resident Season 2
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