INSTRUCTIONS FOR THE DOCTOR
Please take a focused history from Rosie. Outline to Rosie your differential diagnosis and negotiate a management plan with her.
Rosie Inkamala is a 36-year-old Indigenous woman. Rosie has come to see you because two days ago, on the weekend, she could not move her right side for about half an hour. She thought she was having a stroke and was relieved that her movement came back. She has come to see you for a check-up now that the clinic is open.
The following information is on her summary sheet:
INSTRUCTIONS FOR THE PATIENT, ROSIE INKAMALA
You are a 36-year-old Indigenous woman. Two days ago, on the weekend, you could not move your right arm or leg for about half an hour. You thought that you were having a stroke and were relieved when the movement came back. Today you have decided to come to see the GP for a check-up, now that the clinic is open. You drink heavily whenever you can afford it, which works out at more than 10 standard drinks three to four days a week. When you drink you tend to forget your medications, which are in a Webster pack.
You live with extended family and your two children and feel safe at home.
You are very scared of having a stroke after seeing your aunt suffer from a big stroke last year; you are motivated to do what the doctor thinks you should do. If they suggest stopping drinking, tell them you will need help to stop.
You are fluent in four Aboriginal languages, but your English is limited.
Clinical examination findings
No evidence of cardiac failure
Rate-controlled atrial fibrillation (AF)
No residual neurological findings.
The following information is on your medical record:
SUGGESTED APPROACH TO THE CASE
Request the assistance of an interpreter
Open-ended questions to explore Rosie’s ...