Primary care
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Bell's palsy is acute weakness of the facial muscles associated with compression of cranial nerve VII. The annual incidence is 20 to 30 per 100,000. Diagnosis is based on a thorough history and physical examination, with careful attention to exclude other causes of facial weakness, such as stroke or Lyme disease. ⋯ Physical therapy and Botox injections can help patients with persistent symptoms. The roles of surgery and acupuncture remain unclear. Close follow-up is warranted and patients without improvement should be referred to a specialist.
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Tinnitus is considered a symptom and not a diagnosis. It varies in its presentation from unilateral to bilateral and intermittent to constant. ⋯ Management includes helping the patient cope with their tinnitus using tools such as cognitive behavioral therapy among others. Education is also crucial to help patients understand and overcome the challenges associated with this symptom.
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Head and neck cancers are heterogenous cancers with rising incidence of treatable/curative cancers. They are treated comprehensively by multidisciplinary teams. Survivors of head and neck cancers often deal with the sequalae of therapy and with increasing survival rates, it is anticipated that the primary care physicians are going to encounter more patients in their clinics in the coming years. The clinicians should be aware of physiologic and functional changes in vital organs involving daily activities such as eating, drinking, speech and communication, and also be prepared to be a part of the cancer survivorship plans.
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Acute tonsillitis is a common illness that affects patients of all ages but the risk of complication increases with the young. Tonsillitis commonly presents with a sore throat and difficulty swallowing and will often have swelling of the tonsils with exudate on physical examination. Although acute tonsillitis secondary to group A beta-hemolytic Streptococcus should be considered so that antibiotic therapy can be initiated in a timely fashion to prevent complications such as a retropharyngeal abscess or acute rheumatic fever, the most common etiology of tonsillitis is viral. The treatment of viral tonsillitis is supportive with analgesia and hydration.