It isn't really a surprise in this case since both ethnic Mongolians and those with Downs syndrome are not in many Americans' social circles.
"Almost all" does sound like a bit of a surprise, but thinking back on it the only one I know for a fact I heard for the first time outside of a corrective context was my elder uncles friends who enjoyed self-depreciating jokes, usually with slurs for eastern Europeans in them. I first heard those as a child and only realized years later they were offensive. Most others, I think, I honestly have no idea when i was first exposed to them.