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House — Episode 1 (Season 5): “Dying Changes Everything”

""The fifth season starts with an enjoyable episode with a mostly-satisfying conclusion, though the writers played a little fast with the clues tonight.Lou, a thirty seven year old female, is admitted to House's service for what at first appear to be psychiatric symptoms. She works as the assistant to a high profile feminist activist and travels around the world at her boss’s side. In the middle of a meeting, Lou suddenly began to hallucinate ants crawling all over her body. Other admitting symptoms convinced the team that her problem was not psychiatric; she was also found to have abdominal pain, anemia, bradycardia (an abnormally slow heart rate), and some memory loss. Various diagnoses were suggested: an infection she obtained while traveling (but she didn’t have a fever), amphetamine abuse (drug screen was negative), vitamin B12 deficiency, and an insulinoma (an insulin secreting tumor). House felt that the labs were most consistent with B12 deficiency and ordered a B12 injection for Lou.
While Thirteen was administering the shot, Lou complained of fecal incontinence, but Thirteen discovered that she had instead passed a large amount of blood. Upper and lower endoscopies were normal and no source of bleeding could be found. Her pregnancy test came back positive, but when Kuttner performed a uterine ultrasound, he was unable to find a fetus. The team now considered the diagnoses of choriocarcinoma (a tumor that secretes βHCG, the “pregnancyhormone”), immunoglobulin A deficiency, and βHCG injections (injections of the “pregnancy hormone” would give a false positive pregnancy test). Housedisagrees with all three possibilities and reveals that the patient has an ectopic pregnancy (a pregnancy outside of the uterus). It has implanted in the intestine, and this is causing her bleeding and other symptoms. The fetus cannot survive where it is, and is a threat to Lou’s life, so Chase has to surgically terminate the pregnancy."""
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