Mr. and Mrs. Kim, a couple in their late 50s, are concerned about their son, John, who is 14 years old. John is a tall, outgoing, cheerful-appearing adolescent, who is nevertheless nervous about having his parents accompany him as they seek advice about his possible problems. Mr. and Mrs. Kim have no other children.

John’s penis and testicles are small for a 14-year-old. His testicles have not matured with puberty, and retain the appearance of those of a child. Mr. Kim says that John has gotten into trouble with school authorities over fighting with other boys in gym class and in the school hallways. This is a new problem during the current school year, but there have been other behavioral difficulties earlier in John’s school career.

“People make fun of me,” John says. “I’m getting tired of it.” On examination, it is noted that John’s legs are exceptionally long in proportion to his trunk, which is short and stocky. In addition to the small testicles and penis, John has gynecomastia. His facial features are those of a normal 14-year-old. John is scheduled for lab tests to determine his hormone levels and also to have chromosomal testing.

What is the likely diagnosis for John? What lead you to this diagnosis?
What recommendations would be made for John and his parents?

The answer is Klinefelter’s Syndrome.

I only need speaker notes for 3-5 minutes of talking.

Please look at the rubric for the directions. Two scholarly recourses are needed from the lat 5 years.