Case Summary and Questions
Priya Krishnamurthy is a 73-year-old South Asian Indian woman with a history of hypertension who
went to the emergency room with her family, because they noticed she has been bumping into
objects on her right side after waking up in the morning. They claim she was not aware of this
problem. An urgent CT scan is performed, which demonstrates an evolving stroke involving the left
occipital lobe. Her exam reveals confusion, inattention, and some general slowing of her cognition
and speech. The patient does not speak English, so her family speaks for her.
Questions:
1.What impact might her inability to speak English have on the patient’s evaluation?
2.Although her age puts her at risk for neurovascular disease, what other factors may be influencing
her confusion?
Relevant Background Information
Mrs. Krishnamurthy is originally from Madras (Chemai), India, and her family is Hindu (please read
about Hindi beliefs, so as to adequately respond to some of the questions). She has been
widowed for 6 years, in that time, she has been living with her son and his family in the U.S. She has
a daughter who is a pulmonologist and lives 20 minutes away. Mrs. Krishnamurthy does not
manage her own finances or drive or cook meals. Culturally, her son felt that it was his duty as her
son to cook and do chores regardless of whether his mother could do them or not.
Question:
3.What other factors in her personal and social history would be helpful to know in caring for this
patient?
More Information for

Relevant Background Information
Mrs. Krishnamurthy is originally from Madras (Chemai), India, and her family is Hindu (please read
about Hindi beliefs, so as to adequately respond to some of the questions). She has been
widowed for 6 years, in that time, she has been living with her son and his family in the U.S. She has
a daughter who is a pulmonologist and lives 20 minutes away. Mrs. Krishnamurthy does not
manage her own finances or drive or cook meals. Culturally, her son felt that it was his duty as her
son to cook and do chores regardless of whether his mother could do them or not.
Question:
3.What other factors in her personal and social history would be helpful to know in caring for this
patient?