During this initial encounter, we establish what the parents' concerns are, obtain a family history, and ask about previous medical problems. This begins the transition from parent to teen as the medical historian. We next ask parents to wait in the waiting room so that we can speak privately with the adolescent. We interview the adolescent alone, perform a physical examination with a chaperone, and then invite the parents back into the room at the conclusion of the visit to discuss our findings.
Hereditary (or acquired) angioedema = C1 inhibitor deficiency. Patient has a 9-year Hx of soft tissue swelling, especially of the face. It's Autosomal Dominant if inherited, or can be acquired through multiple mechanisms.