A 59 year old male with a 35-pack year history of smoking an…
A 59 year old male with a 35-pack year history of smoking and a “closet” drinker for many years, presents to the office with left-sided sore throat and left ear pain present for 2 weeks. He has a history of chronic otitis externa and believes he needs a refill on the otic antibiotic drops. The NP notices the patient’s speech is very hard to understand and it seems hard for him to speak. He admits over the last month his wife told him she cannot understand him. “It feels like my tongue isn’t moving right. After completing a thorough ENT/neck exam which is normal other than a left 1.5 cm nontender immobile anterior cervical node and mild inflammation of the left external auditory canal without exudate, the NP will order :
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