Street diagnosing

Started by J-Rad
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J-Rad

J-Rad

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Do the rest of you find yourselves diagnosing people on the street? You know you see that somewhat odd looking kid and say to yourself-they have X condition. Or like I mentioned in another thread, you spot the former preemies (At Chucky Cheese: four yearish old looking kid was a serious NICU grad with that toaster head, coke bottle glasses, tippy toe walking and his VP shunt going down the side of his head/neck). The adults are even more fun sometimes. I don't think I'm every going to find a polite way to ask a nurse at our place if she has Leri-Weill like I think, or Turner's which others have opined. Anyone else do this?
 
Occasionally, but I think my knowledge is still very limited right now. Last year, I was on vacation and noticed two adults who had some of the features characteristic of Down Syndrome. I simply haven't seen many patients yet who have conditions that affect their development.
 
I know a man who I think has Treacher-Collins syndrome, although I never asked (don't know him that well)...
Sometimes, I see people on the street with odd-looking nevi, and I'm fighting with myself whether I should tell them to show their lesion to a doctor, or if they would be annoyed that people do notice the thing so much and angrily reply that they've been seeing the 13th dermatologist in a row about this and the biopsy of the other lesion of the kind (that I can't see) has been reassuring, if that made me happy 😡!
Same dilemma applies to marfanoid types.

More out of the derm realm that you often see in public: port-wine stains/ Sturge-Weber syndrome, eczema (of course), psoriasis...
One time, I was sitting in the streetcar across from a person with a white forelock - could have been Waardenburg's syndrome.
 
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J-Rad said:
NICU grad with that toaster head
Click to expand...

Back in the old days, this was very common as we didn't do a good job at positioning premies. I used to be able to walk through the mall and guess at the gestational age of the kids..😉

Nowadays, this is much less common/severe, but sometimes you can figure it out....
 
This is funny because for our residency skit (the end of residency banquet) we did a little brief piece on this. We had our genetics resident (going into fellowship next year after peds is done) wearing safari gear and using binoculars shouting at parents across the park. It was really funny. He says, "Oh my gosh, is it what I think it is?" Runs up the stairs and gets his Smith's book and runs like mad after the baby stroller. It is hard not to look at kids and people sometimes and not make opinions as to what's wrong with them.
 
Warning: The following is an extremely non-PC observation, please skip if you have a congenital deletion of 4q at the humor locus.

Sometimes with our more ahem, backwoods patients it isn't always so easy to tell. The Dallas-metropolitan area is just like any other major American city, but once you move out to the rural east towards Arkansas, things can get interesting.... I've encountered entire clans from this area code of 903 where I've thought "What the f@*&? It's not infrequent our Genetics clinic lands a few of these for no other reason than "FLK".

By the way, an entirely acceptable differential in these kids is: Chromosomal abnormality vs. 903. Everyone here will know what you mean.
 
oompaloompa said:
Warning: The following is an extremely non-PC observation, please skip if you have a congenital deletion of 4q at the humor locus.

Sometimes with our more ahem, backwoods patients it isn't always so easy to tell. The Dallas-metropolitan area is just like any other major American city, but once you move out to the rural east towards Arkansas, things can get interesting.... I've encountered entire clans from this area code of 903 where I've thought "What the f@*&? It's not infrequent our Genetics clinic lands a few of these for no other reason than "FLK".

By the way, an entirely acceptable differential in these kids is: Chromosomal abnormality vs. 903. Everyone here will know what you mean.
Click to expand...


:laugh:
Remember the most common cause of FLK is FLP.
 
My favorite way to try to sort this problem out is to ask if the kid looks like mom or dad... especially if they both aren't in the room. Can be a very telling answer!
 
oompaloompa said:
The Dallas-metropolitan area is just like any other major American city, but once you move out to the rural east towards Arkansas, things can get interesting....
Click to expand...

:laugh: I went to med school in Arkansas. I know what you mean

I see a lot less of ARkids syndrome now that I'm in California
 
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