There’s nothing we can do about the number of genes – even though we expect it to rise as DNA surveys are done in Asia, Africa and South America. Second, the categories have some overlap and one can, with a poor roll of the dice, suffer from more than one. Third, it seems like the syndromes could be clarified or clustered and the tally (perhaps) reduced. A fourth problem is that individual genes can have mutation, deletions, translocations and repeats that cause dramatically different effects. It is not uncommon to see a repeat, a mutation and a deletion of the same gene be defined as three syndromes. A fifth problem is that there are many long metabolic pathways where multiple genes interact. It is currently not usually possible to get a map of where a gene has influence.