GPnotebook Podcast

What if one of the most misunderstood diagnoses of the past is now one of the most manageable chronic conditions? How can GPs play a pivotal role in tackling stigma, increasing testing and improving outcomes for people living with HIV?Dr James Waldron is joined by Dr Grace Bottoni (HIV and Hepatitis C GP Champion, Lewisham) for a series of podcasts about HIV. Together, they explore a range of topics with experts in the field. In this second episode, they talk with Dr Mel Rosenvinge (Consultant HIV Specialist, Lewisham and Greenwich NHS Trust) about what happens after a positive test result and how to help support people living with HIV. Listen to find out about the next steps in primary care.Access episode show notes containing key references and take-home points at:https://gpnotebook.com/en-GB/podcasts/infectious-disease/ep-160-rethinking-hiv-dealing-with-a-positive-test-result.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Baker's cysts commonly present in primary care. In this episode, Dr Kate Chesterman discusses the pathophysiology, underlying aetiology and management options for this condition, describing possible differential diagnoses and indications for investigations. She also explains the self-care options for those with minimal symptoms and how to escalate treatment, as well as when to consider a referral.Access episode show notes containing key references and take-home points at:http://gpnotebook.com/en-GB/podcasts/musculoskeletal-medicine/ep-159-bakers-cyst.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

A rotator cuff injury is an event that causes pain in the shoulder. This can be due to a tear, inflammation or narrowing of the space within the shoulder joint. The rotator cuff muscles interlock to work as a unit. They help to stabilise the shoulder joint and also help with shoulder joint movement. In this episode, Dr Roger Henderson takes a specific look at tears to the rotator cuff – a problem often seen in primary care. The episode covers causes, diagnosis and treatment, including conservative approaches and surgical options.Access episode show notes containing key references and take-home points at:Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Ganglion cysts, also sometimes referred to as synovial cysts, are the most common benign soft-tissue masses of the hand and wrist. These cysts arise from the synovial lining of joints or tendon sheaths and are filled with a gelatinous, mucin-rich fluid. Despite their benign nature, ganglion cysts can cause discomfort, restrict motion and cause neurovascular compression (requiring medical intervention in some cases). In this episode, Dr Roger Henderson looks at epidemiology, pathophysiology, clinical presentation, diagnostic modalities, differential diagnoses and treatment options.Access episode show notes containing key references and take-home points at:https://gpnotebook.com/en-GB/podcasts/orthopaedics/ep-157-ganglion-cysts.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy, primarily affecting the median nerve at the level of the wrist. The condition results from compression of the median nerve within the carpal tunnel, leading to sensory and motor impairments in the affected hand. There are a range of causes for the condition, and treatments range from simple conservative measures to surgery. In this episode, Dr Roger Henderson looks at how to recognise the condition, some of the clinical and diagnostic tests available, when to refer to secondary care and management options including both surgical and non-surgical measures.Access episode show notes containing key references and take-home points at:https://gpnotebook.com/en-GB/podcasts/musculoskeletal-medicine/ep-156-carpal-tunnel-syndrome.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Temporal arteritis, also known as giant cell arteritis, is an inflammatory condition that affects the large- and medium-sized arteries, primarily those in the head. It most commonly occurs in adults over 50, particularly women. The exact cause is unknown, but it is believed to be an autoimmune response that leads to inflammation and narrowing of the arteries, reducing blood flow. Symptoms include severe headaches, scalp tenderness, jaw pain when chewing and, in severe cases, sudden vision loss. Diagnosis typically involves blood tests, imaging and a temporal artery biopsy. Early detection is crucial to avoid permanent damage and blindness. In this episode, Dr Roger Henderson looks at how to diagnose this condition promptly and accurately, why urgent referral is crucial and the treatment options now available in primary care.Access episode show notes containing key references and take-home points at:https://gpnotebook.com/en-GB/podcasts/rheumatology/ep-155-temporal-arteritis.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Febrile seizures are common in the first 5 years of life, and many factors that increase the risk of such seizures occurring have been identified. Initial evaluation should determine whether features of a complex seizure are present, as well as identifying the source of fever. In this episode, Dr Roger Henderson provides an overview of febrile seizures in childhood and also looks at risk factors, referral criteria, treatment options and prognosis.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/paediatrics/ep-154-febrile-seizuresDid you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

In this episode, Dr Hannah Rosa continues looking at the new asthma guideline from the British Thoracic Society (BTS), NICE and SIGN, which was published in 2024. This guideline, based on the latest research, contains some big changes, which will hopefully help you to improve the lives of your patients living with asthma. In the first episode in the series (episode 146), Dr Rosa covered suspected asthma, asthma diagnosis and treatment in people aged 12 and over. In this second episode, she focuses on pharmacological treatment in children aged 11 and under, as well as monitoring asthma control and self-management.Access episode show notes containing key references and take-home points at:https://gpnotebook.com/en-GB/podcasts/respiratory-and-chest-medicine/ep-153-asthma-treatment-monitoring-and-self-management-whats-changed-in-the-2024-bts-nice-and-sign-guideline.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

What if one of the most misunderstood diagnoses of the past is now one of the most manageable chronic conditions? How can GPs play a pivotal role in tackling stigma, increasing testing and improving outcomes for people living with HIV?Dr James Waldron is joined by Dr Grace Bottoni (HIV and Hepatitis C GP Champion, Lewisham) for the first episode in an insightful series that dives into the evolving landscape of HIV care. Together, they will explore a range of topics with experts in the field. In this episode, they talk with Dr Mel Rosenvinge (Consultant HIV Specialist, Lewisham and Greenwich NHS Trust) about what HIV is, how far treatments have come and the critical role of early diagnosis. From reducing stigma to understanding the life-changing impact of "U=U" (undetectable equals untransmittable). This episode sets the foundation for the series, with future parts diving into what GPs can do to improve health outcomes and address broader medical issues for people living with HIV.Access episode show notes containing key references and take-home points at:https://gpnotebook.com/en-GB/podcasts/infectious-disease/ep-152-rethinking-hiv-from-testing-to-transformation.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Dupuytren's disease is a chronic, progressive condition that primarily affects the palmar and digital fascia of the hand. Over time, fibrous cords form under the skin, thickening and contracting, which can cause the fingers (most often the ring and little fingers) to curl inward. This results in Dupuytren's contracture, limiting hand function and impacting daily activities. It often starts with the formation of painless nodules in the palm. As the disease progresses, these nodules develop into cords that restrict finger movement. While the condition is not life-threatening, it can significantly affect a person's quality of life and is a common presentation in general practice. In this episode, Dr Roger Henderson looks at the diagnosis of Dupuytren's, its risk factors, usual management and some of the newer treatment techniques now available.Access episode show notes containing key references and take-home points at:https://gpnotebook.com/en-GB/podcasts/dermatology/ep-151-dupuytrens-disease.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Roseola infantum is a viral infection primarily affecting infants and young children, most commonly between the ages of 6 and 12 months. It accounts for 10–45% of febrile illnesses in infants, and cases tend to peak in the spring and autumn seasons. Diagnosing roseola is almost always clinical, and for patients with the classic presentation a clinical diagnosis can be made based on physical examination findings and history alone. In this episode, Dr Roger Henderson looks at the causes and typical symptoms of roseola, along with illnesses that may mimic it, treatment options and possible complications of the illness.Access episode show notes containing key references and take-home points at:https://gpnotebook.com/en-GB/podcasts/dermatology/ep-150-roseola.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Raynaud's phenomenon is a relatively common condition seen in primary care (especially during the autumn and winter months) that is characterised by vasospasm. This causes digits to change colour to white due to a lack of blood flow, usually brought on by cold temperatures. Affected areas subsequently turn blue due to deoxygenation and red due to reperfusion. The most common type is primary (idiopathic) Raynaud's, affecting around 90% of people with the condition. Secondary Raynaud's is often the initial manifestation of an associated underlying connective tissue disease. Both primary and secondary Raynaud's can be painful, but secondary Raynaud's can lead to complications from prolonged periods of ischaemia. In this episode, Dr Roger Henderson looks at the typical triggers for and presentation of Raynaud's, along with lifestyle and treatment options including referral criteria.Access episode show notes containing key references and take-home points at:https://gpnotebook.com/en-GB/podcasts/dermatology/ep-149-raynauds-phenomenon.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Sickle cell anaemia is a disease of red blood cells, caused by an autosomal recessive single gene defect in the beta-chain of haemoglobin, which results in production of sickle cell haemoglobin. Sickle cells can obstruct blood flow and break down prematurely, and they are associated with varying degrees of anaemia. A common presentation of sickle cell disease (SCD) is a painful sickle crisis, caused by obstruction of small blood capillaries. Treatment includes symptom control (including pain management) and prevention and management of complications. Until now, haematopoietic stem-cell transplantation has been the only potentially curative treatment option, but a new type of gene therapy has just been launched by NHS England. In this episode, Dr Roger Henderson gives an overview of some of the key points of SCD, with a focus on this new treatment and its availability.Access episode show notes containing key references and take-home points at:https://gpnotebook.com/en-GB/podcasts/haematology/ep-148-sickle-cell-disease.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Paronychia is a common condition affecting the proximal and lateral nail folds of the hands or feet. In this episode, Dr Kate Chesterman discusses the differences between acute and chronic paronychia and the thinking around the causes and treatment of each. She also gives some tips that we can pass on to our patients regarding self-management and prevention.Access episode show notes containing key references and take-home points at:https://gpnotebook.com/en-GB/podcasts/dermatology/ep-147-paronychia.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

In this episode, Dr Hannah Rosa discusses the new asthma guideline from the British Thoracic Society (BTS), NICE and SIGN, which was published in 2024. This guideline, based on the latest research, contains some big changes, which will hopefully help you to improve the lives of your patients living with asthma. In this first part of a two-episode series, topics covered include when to suspect asthma, how to confirm an asthma diagnosis and the pharmacological treatment pathway in people aged 12 and over. The second part of the series, which will be released later in the year, covers pharmacological treatment in children aged 11 and under, monitoring asthma control and self-management.Access episode show notes containing key references and take-home points at:https://gpnotebook.com/en-GB/podcasts/respiratory-and-chest-medicine/ep-146-asthma-diagnosis-and-treatment-whats-changed-in-the-2024-bts-nice-and-sign-guideline.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Around 0.5% of the adult population in England experience problems gambling, 3.8% are at elevated risk of gambling harms and an estimated 7% are negatively affected by someone else's gambling. NICE has published NG248 – its first recommendations on gambling, covering the identification, assessment and treatment of people over the age of 18 who are experiencing gambling-related harms. The recommendations are also for people of any age affected by someone close to them who is experiencing gambling that harms. In this episode, Dr Roger Henderson looks at some of the key points in the guideline as well as the pharmacological options that are recommended if required.Access episode show notes containing key references and take-home points at:https://gpnotebook.com/en-GB/podcasts/general-information/ep-145-gambling-related-harms.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

The National Osteoporosis Guideline Group (NOGG) clinical guideline for osteoporosis was updated in December 2024. In this episode, Dr Hannah Rosa shares 10 things she learnt from the updated guideline about how to prevent and treat osteoporosis.Access episode show notes containing key references and take-home points at:https://gpnotebook.com/en-GB/podcasts/musculoskeletal-medicine/ep-144-osteoporosis-key-learnings-from-the-nogg-2024-clinical-guideline.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Irritable bowel syndrome (IBS) is a chronic condition characterised by abdominal pain associated with bowel dysfunction and is one of the most common gastroenterology presentations in primary care. The pain is often relieved by defecation and is sometimes accompanied by abdominal bloating, with no structural abnormalities to explain the pain. IBS occurs in up to 20% of the adult population, and its aetiology is multi-factorial. In this episode, Dr Roger Henderson looks at the diagnosis of IBS along with lifestyle options and newer medications now available for its management.Access episode show notes containing key references and take-home points at:https://gpnotebook.com/en-GB/podcasts/gastroenterology/ep-143-irritable-bowel-syndrome.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Colorectal cancer (CRC) is the fourth most common malignancy in the UK and a major cause of morbidity and mortality. It refers to malignancies that arise from the caecum to the rectum and can be detected on screening, on imaging or endoscopy, or following presentation with change in bowel habit, iron deficiency anaemia or bowel obstruction. Its management depends on the stage of the disease and patient factors, with treatment options including surgical resection, chemotherapy and radiotherapy. In this episode, Dr Roger Henderson gives an overview of CRC and looks at how to achieve early diagnosis, which is essential for effective treatment and the greatest chance of survival.Access episode show notes containing key references and take-home points at:https://gpnotebook.com/en-GB/podcasts/gastroenterology/ep-142-colorectal-cancer.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Hidradenitis suppurativa (HS) is a chronic inflammatory dermatosis that typically affects areas of pilosebaceous gland-containing skin. In HS, patients often suffer recurrent attacks of discharging and painful lesions that can require multiple courses of antibiotics or surgical drainage. The condition causes significant morbidity, distress and sometimes long-term scarring. In this episode, Dr Roger Henderson looks at the disease process, classification and classical features of HS as well as conservative, medical and surgical treatment options.Access episode show notes containing key references and take-home points at:https://gpnotebook.com/en-GB/podcasts/dermatology/ep-141-hidradenitis-suppurativa.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Seasonal affective disorder (SAD) is a form of depression that occurs at specific times of the year, most commonly during the autumn and winter months when daylight hours are shorter. Characterised by symptoms such as persistent sadness, fatigue and changes in appetite or sleep patterns, SAD is more than just the "winter blues." It is a clinically recognised but often underdiagnosed condition that can significantly impact an individual's quality of life. In this episode, Dr Roger Henderson looks at how to diagnose SAD as well as the causes, symptoms and treatment options in primary care.Access episode show notes containing key references and take-home points at:https://gpnotebook.com/en-GB/podcasts/mental-health/ep-140-seasonal-affective-disorder.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Perinatal mental health (PNMH) problems affect one in five women and one in ten men. They can present in several ways, including depression and anxiety, but also post-traumatic stress disorder, adjustment disorder, obsessive-compulsive disorder and psychosis. In the third episode of the perinatal mental health series, Dr James Waldron and Dr Jenny Barnes (GP and Perinatal Mental Health Champion, Warwickshire) discuss what to do in clinical practice when PNMH issues are suspected. Prevention is better than cure, so it is worth taking steps to identify people at risk and offering support and treatment where necessary.Access episode show notes containing key references and take-home points at:https://gpnotebook.com/en-GB/podcasts/mental-health/ep-139-identification-and-treatment-of-perinatal-mental-health-problems.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Morton's neuroma is a common condition that results in forefoot pain. It is a condition that can often be diagnosed in primary care and managed with simple changes in footwear and over-the-counter treatments. In this episode, Dr Kate Chesterman discusses the classic presentation of Morton's neuroma, considers the need for any investigations, and updates us on appropriate self-care advice that can be given to patients.Access episode show notes containing key references and take-home points at:https://gpnotebook.com/en-GB/podcasts/orthopaedics/ep-138-mortons-neuroma.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

The 6–8-week postnatal check is a chance to better support mental health in new parents. In this second episode in a series on perinatal mental health, Dr James Waldron speaks with Dr Jenny Barnes – a GP in Warwickshire and perinatal mental health champion – about making the most of this critical opportunity. This episode discusses addressing mental health in both mothers and partners, the hidden toll of social media and understanding associated conditions such as obsessive-compulsive disorder and psychosis. It also offers practical insights for healthcare professionals to expand their approach and improve care for the whole family.Access episode show notes containing key references and take-home points at:https://gpnotebook.com/en-GB/podcasts/mental-health/ep-137-beyond-baby-blues-supporting-mental-health-in-parents-and-partners.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

In this episode, Dr Hannah Rosa invites you to join her in the first ever GPnotebook quiz of the year. The GPnotebook education team have been reflecting upon all that they have learnt over the past 12 months, in both their day-to-day clinical work and through delivering GPnotebook Study Group events. The quiz is based on the facts that the team have found most useful, interesting and sometimes surprising. So, have a pen and a piece of paper ready, and give it a go!Access episode show notes containing key references and take-home points at:https://gpnotebook.com/en-GB/podcasts/general-information/ep-136-quiz-of-the-year-2024.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Tinnitus can be frustrating for both patients and clinicians as there is some misinformation and misunderstanding about its aetiology and treatment options. For some people with tinnitus there is significant distress and a reduced quality of life that may not always be appreciated by healthcare professionals. Fortunately, most cases of tinnitus can be treated successfully, and there are a number of management techniques that can reduce its impact, including sound therapy, stress reduction and treatment of any underlying causes. In this episode, Dr Roger Henderson gives an overview of this common problem, with a reminder of how to evaluate it and when to refer a patient to secondary care.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/ear-nose-and-throat/ep-135-tinnitus.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

One in six UK males will be diagnosed with prostate cancer in their lifetime. In the UK prostate cancer is the most common male cancer, with over 55,000 new cases diagnosed every year. There has been much discussion in the media recently regarding whether men under the age of 50 should have access to prostate-specific antigen (PSA) testing, particularly if they have a strong family history of prostate cancer. In this episode, Dr Roger Henderson takes a look at prostate cancer, including guidance on screening, investigations and treatment.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/oncology/ep-134-prostate-cancer.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Syphilis is a sexually transmitted infection caused by the bacterium Treponema pallidum. Known for its varied symptoms and potential to progress through multiple stages, syphilis can have serious health consequences if left untreated, affecting organs like the heart, brain and nerves. The infection spreads primarily through direct contact with syphilitic sores, which typically occur on the genital, anal or oral areas. Though syphilis was once thought to be largely under control, its prevalence has resurged in recent years, prompting renewed focus on prevention, early diagnosis and effective treatment. In this episode, Dr Roger Henderson discusses new syphilis guidelines issued by the British Association for Sexual Health and HIV and how these impact treatment in primary care.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/infectious-disease/ep-133-syphilis.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

In this episode, Dr Hannah Rosa reflects upon the changing relationship between young people and alcohol. She examines the latest statistics before discussing the Chief Medical Officer for England's guideline on alcohol consumption for children and young people. The focus then moves on to the harms that we now know that alcohol can cause to young people, especially to the developing brain, before finishing with emphasising the role that professionals in primary care play in supporting these young people and their families.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/general-practice/ep-132-young-people-and-alcoholDid you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Perinatal mental health (PNMH) issues refer to the period from the point of conception to a child's first birthday. It encompasses several different mental health conditions and components far beyond the traditional understanding of post-natal depression and has an important impact on families and society. In part, the huge burden and associated cost is driven by how common PNMH problems are for both men and women. PNMH issues are more common than any physical health problem in pregnancy, so there is a need for GPs to look for and manage them to ensure the best outcomes for families and children. In this episode, Dr James Waldron welcomes Dr Jenny Barnes (GP, Warwickshire) to discuss PNMH problems and help raise awareness of the risks and impact, as well as simple ideas to support families in clinical practice.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/mental-health/ep-131-perinatal-mental-health-awareness-risks-and-impacts.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Croup is a respiratory condition typically affecting children, characterised by a distinctive barking cough, hoarseness and difficulty breathing. Caused primarily by viral infections, especially the parainfluenza virus, it inflames the larynx, trachea and bronchi, leading to swelling and obstruction in the airway. Croup symptoms often worsen at night and can be triggered by environmental factors such as cold air. Treatment ranges from home remedies like humidified air and hydration to medical interventions, such as corticosteroids or nebulised epinephrine, depending on the severity of the condition. While most cases resolve within a few days, severe instances can lead to hospitalisation. In this episode, Dr Roger Henderson looks at how best to diagnose it, whether scoring systems are useful, and principles of effective management – including when to consider hospital referral.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/respiratory-and-chest-medicine/ep-130-croup.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Acute appendicitis is a medical emergency characterised by the sudden onset of inflammation in the appendix. As one of the leading causes of abdominal pain that necessitates surgical intervention, appendicitis can occur at any age, though it is most common in adolescents and young adults. The condition is primarily caused by a blockage in the appendix, which leads to bacterial infection, swelling and increased pressure. If left untreated, acute appendicitis can progress to life-threatening complications such as perforation, peritonitis and sepsis. Due to the non-specific symptoms, particularly in the early stages, diagnosing appendicitis can be challenging. Prompt recognition and treatment, typically through surgical removal of the appendix, are critical to preventing complications and ensuring a swift recovery. In this episode, Dr Roger Henderson looks at the clinical presentation, diagnosis and management of acute appendicitis, highlighting its significance as a common yet potentially dangerous medical condition.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/gastroenterology/ep-129-acute-appendicitis.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Breast pain affects around 70% of women at some point in their lives and is a common reason for referral to breast clinics. It is often a cause of anxiety for women who may be concerned that their pain might be associated with breast cancer. In this episode, Dr Kate Chesterman discusses the assessment of the patient presenting with breast pain and explains the lack of association between breast cancer and breast pain in those with a normal clinical examination. She considers cyclical, non-cyclical and extra-mammary pain and discusses the causes and management options for these, as well as considering when referral to secondary care would be appropriate.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/gynaecology/ep-128-mastalgia-breast-pain.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Fibromyalgia is a condition characterised by chronic widespread pain together with multiple muscular tender points or associated fatigue, sleep disturbance or cognitive dysfunction in the absence of a well-defined underlying organic disease. The majority of patients present with both tender points and associated symptoms, although the exact aetiology of fibromyalgia is unknown. In this episode, Dr Roger Henderson takes a look at possible triggers, diagnostic approaches, possible treatments (including non-pharmacological methods) and the prognosis for patients with this often poorly understood and underdiagnosed condition.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/neurology/ep-127-fibromyalgiaDid you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

In this episode, Dr Hannah Rosa reflects upon the poor lung cancer survival rates in the UK. She asks whether we are doing enough chest X-rays in primary care and whether we could be detecting lung cancers earlier. She delves further into this by exploring why diagnosing lung cancer is challenging, reviewing the guidelines and latest research and then discussing when we should continue to investigate for lung cancer even if the patient has had a normal chest X-ray. She finishes by reviewing the targeted lung health check programme that is currently being rolled out across England.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/oncology/ep-126-are-we-doing-enough-chest-x-rays-in-primary-care.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Generalised anxiety disorder (GAD) is a common condition defined as chronic, excessive worry for at least 6 months that causes distress or impairment, and is hard to control. It is in part a diagnosis of exclusion: physical examination and laboratory studies are generally normal if no co-existing physical or mental health conditions or substance misuse issues exist. Treatment is primarily with psychotherapy (usually cognitive behavioural therapy), serotonergic antidepressants or a combination of these approaches. In this episode, Dr Roger Henderson looks at how best to diagnose GAD, what treatment options should be considered, possible differential diagnoses and the long-term outlook for patients.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/mental-health/ep-125-generalised-anxiety-disorder.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Ovarian cancer is a common female malignancy. Patients often present with vague, non-specific symptoms such as abdominal bloating, early satiety and dyspepsia (suggestive of upper abdominal disease). Other symptoms are more suggestive of pelvic disease, such as pelvic pain, abdominal or pelvic pressure, low back pain and urinary urgency. Late diagnosis has a significantly adverse impact on survival rates, so prompt diagnosis and treatment is crucial. In this episode, Dr Roger Henderson looks at the key symptoms of ovarian cancer to be aware of in clinical practice, the NICE guidance on diagnostic tests, treatments and survival rates.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/oncology/ep-124-ovarian-cancer.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

In episode 121, care and consultations for children with additional needs, and how to help these children and their families, were discussed. In this episode, Dr James Waldron is again joined by Dr Naomi Fox. Here, they look at harnessing the power of proprioception to improve behaviour and sleep and reduce stress in children.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/paediatrics/ep-123-proprioception-and-sleep-for-children-with-additional-needs.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Emollients are moisturisers that help soothe, hydrate and protect the skin by forming an occlusive barrier to lock in moisture. They are commonly used to treat dry, rough and scaly skin conditions such as eczema, psoriasis and dermatitis, and work by softening and smoothing the skin, reducing water loss and improving the skin's natural barrier function. As a result, they play a vital role in skin care, especially for those with dry or compromised skin, and come in various forms, each suited to different levels of dryness and skin conditions. Regular use of the right emollient can help maintain the skin's moisture balance, provide relief from irritation and support overall skin health. In this episode, Dr Roger Henderson looks at the different types of emollients available, which ones to choose for your patient, and how they should be used for the best results.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/dermatology/ep-122-emollients-an-overview.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Many children have additional needs, and occupational therapy can play an important role in helping these children take part in everyday activities as well as in supporting their families and carers. In this episode, Dr James Waldron talks with Dr Naomi Fox, a paediatric occupational therapist, about ways to improve care and consultations for children with additional needs.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/paediatrics/ep-121-improving-consultations-for-children-with-additional-needs.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Echocardiography is an essential tool in a wide range of clinical scenarios. Appropriate use of an echocardiogram ("echo" scan) can improve clinical outcomes by increasing diagnostic accuracy, providing non-invasive or minimally invasive assessment of disease status and risk stratification and enabling real-time monitoring and guidance of interventional procedures. However, there can be confusion surrounding when to appropriately refer a patient from primary care. In this episode, Dr Roger Henderson looks at various conditions and when to consider the use of echo scans for them.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/cardiovascular-medicine/ep-120-echocardiography.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

The term goitre refers to an abnormal enlargement of the thyroid gland, typically caused by iodine deficiency or autoimmune diseases such as Graves' disease or Hashimoto's thyroiditis, as well as hormonal changes, thyroid nodules or thyroid cancer. Symptoms include a visible neck swelling, throat tightness, coughing, hoarseness and difficulty swallowing or breathing. Untreated goitre can lead to complications and thyroid dysfunction. The prevalence of goitre in the UK is lower than in many developing countries due to adequate dietary iodine intake, but it may still be seen in primary care. In this episode, Dr Roger Henderson looks at the diagnosis of goitre and the treatment options available, including observation, medication, radioactive iodine treatment and surgery.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/diabetes-and-endocrinology/ep-119-goitre.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Global travel offers many opportunities for adventure – but some come with medical considerations. An infrequent but important consultation is altitude medicine for people planning to travel to areas high above sea level. In episode 80, Dr James Waldron and Dr Rashbal Ghattaora talked about how to approach a travel consultation, with notes on relevant medications and counselling. In this episode, they consider the role of medics travelling with groups at high altitude – ideal information for those interested in becoming an expedition doctor.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/general-information/ep-118-altitude-medicine-the-role-of-the-expedition-doctor.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Undiagnosed type 2 diabetes is an increasing and concerning trend in the UK, particularly among Black and Asian ethnic groups and in areas of high deprivation. Early diagnosis and management are crucial, particularly in younger adults and underserved populations. Therefore, education, screening, and tailored treatment pathways are needed, but reaching these groups can be challenging. In this episode, which was recorded for Chronic Conditions Month 2024, Dr Kashif Ali (GP Partner and Primary Care Lead for Diabetes MCN, Glasgow) and Dr Sarah Davies (GP with a Special Interest in Diabetes, Cardiff) discuss what we can do to improve earlier diagnosis of type 2 diabetes in our undiagnosed population.More information on Chronic Conditions Month can be found here.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/diabetes-and-endocrinology/ep-117-improving-early-diagnosis-of-type-2-diabetes-addressing-the-challenge-of-undiagnosed-cases.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Transient loss of consciousness (TLoC) affects nearly half the population of the UK at some point in their lives and is not an uncommon presentation in primary care. In this episode, Dr Kate Chesterman discusses the initial assessment of these patients and the factors that will help to differentiate between vasovagal syncope, cardiac syncope and epilepsy. She gives guidance on referral criteria and signposts useful resources that help assess fitness to drive and provide important safety information for patients.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/general-information/ep-116-transient-loss-of-consciousness.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Polycystic ovary syndrome (PCOS) is the most common endocrinopathy in women of reproductive age, as well as being a major cause of infertility and pregnancy complications. It includes symptoms of hyperandrogenism, the presence of hyperandrogenaemia, oligo-ovulation or anovulation and polycystic ovarian morphology on ultrasound. It is strongly associated with complications that may arise from it, including insulin resistance, metabolic syndrome, fatty liver disease and an increased risk of developing type 2 diabetes. The main aims of treatment are directed at reducing hyperandrogenism or inducing fertility. In this episode, Dr Roger Henderson looks at these in more detail as well as what to remember when dealing with patients with PCOS in primary care.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/diabetes-and-endocrinology/ep-115-polycystic-ovary-syndrome.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

In this episode, Dr Hannah Rosa discusses erectile dysfunction. Using the latest guidelines, this episode takes you through everything to consider when first reviewing a patient with erectile dysfunction, including key points to cover in the history and examination and which investigations to order. A four-step approach to management is discussed, along with guidance on referral and follow up.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/urology/ep-114-erectile-dysfunction.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Quitting smoking is the single most important thing a smoker can do to improve their health, and with the right combination of support, medication and determination, individuals can successfully overcome their nicotine addiction and enjoy a smoke-free life. For many, quitting smoking completely can be a challenge due to the addictive nature of nicotine, but various strategies and treatments are available to help support patients who are trying to stop smoking. Benefits are immediate, both in the short- and long-term, and it is never too late to stop smoking. The rise in e-cigarette use has contributed to increased numbers of smokers quitting their tobacco, but e-cigarette use in younger people has caused significant concerns. In this episode, which is an update to episode 51, Dr Roger Henderson provides an overview of vaping, and the pros and cons of e-cigarette use.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/respiratory-and-chest-medicine/ep-113-vaping-update.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

In this episode, Dr Hannah Rosa discusses a condition that affects 95% of people aged 11–30 to some extent: acne. The 2021 NICE guideline on acne vulgaris is explored in detail, and broken down into four steps:Getting the diagnosis of acne right, including how to grade its severityWhat constitutes good general skin-care adviceManagement optionsThe new MHRA guideline on isotretinoin.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/dermatology/ep-112-acne-getting-the-management-spot-on.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Testicular torsion is a urological emergency that usually affects young men, and a high index of suspicion is vital to ensure prompt diagnosis and management. A history and physical examination consistent with testicular torsion requires immediate surgical assessment for scrotal exploration – and if the initial examination suggests testicular torsion, the surgical approach should take precedence over other diagnostic tests. In this episode, Dr Roger Henderson discusses what to look for when diagnosing this condition, the importance of prompt treatment and the options available in primary care.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/urology/ep-111-testicular-torsion.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Disclosing sexual violence is a difficult and emotional prospect for a patient and the way a GP responds can set the course of that person's journey. It is important we get it right, but it is a complex topic. In this second part of our series on sexual violence, Dr James Waldron is joined again by Hayley Wilson (Consent and Sexual Violence Development Officer at Nottingham Trent University) to explore the consultation in detail. This episode discusses how to respond to a disclosure and the importance of “listen, believe, validate” when supporting a patient. They outline the concept (and myth) of the “perfect victim”, the importance of the language we use and how to help guide someone who has made a disclosure.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/general-information/ep-110-sexual-violence-part-2.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.