GPnotebook Podcast

Cirrhosis represents the end stage of chronic liver injury, characterised by fibrosis and regenerative nodules that disrupt normal liver architecture. While the liver can compensate for years, patients often remain asymptomatic until complications such as ascites, variceal bleeding or hepatic encephalopathy arise. Understanding cirrhosis involves exploring its pathophysiology, systemic manifestations, diagnostic tools and management strategies. In this episode, Dr Roger Henderson discusses how chronic insults from viral hepatitis, alcohol or metabolic disease lead to progressive fibrosis, the development of portal hypertension and multisystem involvement.Access episode show notes containing key references and take-home points at:https://gpnotebook.com/en-GB/podcasts/gastroenterology/ep-195-liver-cirrhosis.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Plantar fasciitis is a common cause of heel pain, accounting for up to 15% of foot complaints requiring professional care and affecting both athletic and sedentary populations. It is best understood as a mechanically driven, degenerative condition resulting from repetitive loading that exceeds the plantar fascia’s capacity for repair, rather than a purely inflammatory process. Key risk factors include abnormal foot biomechanics, limited ankle dorsiflexion, posterior chain tightness, obesity and prolonged weight-bearing. In this episode, Dr Roger Henderson looks at the epidemiology and pathophysiology of plantar fasciitis, reviews key clinical features and examination findings, discusses differential diagnoses and appropriate investigations, and outlines evidence-based management strategies, with a focus on practical guidance for primary-care clinicians.Access episode show notes containing key references and take-home points at:https://gpnotebook.com/en-GB/podcasts/musculoskeletal-medicine/ep-194-plantar-fasciitis.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Barrett’s oesophagus sits at the crossroads of gastroesophageal reflux disease and oesophageal cancer, making it a condition every clinician should understand. Although most patients with Barrett’s will never develop malignancy, it remains the only identifiable precursor to oesophageal adenocarcinoma, a cancer with rising incidence and high mortality. In this episode, Dr Roger Henderson looks at how chronic reflux reshapes the oesophageal lining, who is at greatest risk and how modern surveillance and endoscopic therapies have transformed management. He also discusses evolving guidelines, emerging technologies and practical implications for everyday clinical practice.Access episode show notes containing key references and take-home points at:https://gpnotebook.com/en-GB/podcasts/gastroenterology/ep-193-barretts-oesophagus.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 Roger Henderson looks at adhesive capsulitis, commonly known as a frozen shoulder, reviewing its epidemiology, risk factors and underlying pathophysiology, as well as typical clinical presentations, disease staging and key examination findings that aid diagnosis in primary care. Diagnostic challenges, differential diagnoses and the role of imaging and injections are covered, alongside management strategies, prognosis and indications for surgical intervention, with particular attention to patients with diabetes and endocrine disorders who experience more severe and prolonged disease.Access episode show notes containing key references and take-home points at:https://gpnotebook.com/en-GB/podcasts/musculoskeletal-medicine/ep-192-adhesive-capsulitis.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Intertrigo is an inflammatory condition of opposing skin surfaces, driven by friction, heat and moisture that weaken the skin barrier and invite secondary infections, especially Candida and bacteria. It affects all ages, from infants with diaper dermatitis to older adults with limited mobility. It is more common in hot climates and in patients with obesity or diabetes. Clinically, it presents with symmetrical erythema that may progress to maceration, fissures, discharge and secondary infection. The diagnosis is mainly clinical, with cultures or potassium hydroxide testing when needed. Management focuses on reducing moisture and friction, treating infections and using gentle barrier protection. In this episode, Dr Roger Henderson looks at how to identify and manage this condition, which is commonly seen in primary care.Access episode show notes containing key references and take-home points at:https://gpnotebook.com/en-GB/podcasts/dermatology/ep-191-intertrigo.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Chondromalacia patella (CMP), sometimes called “runner’s knee”, is a degenerative condition involving softening and breakdown of the patellar articular cartilage, most often due to abnormal patellofemoral mechanics, muscular imbalance or repetitive micro-trauma. It commonly presents with anterior knee pain worsened by stair descent, squatting, running or prolonged sitting. Diagnosis relies on clinical evaluation supported by imaging (especially magnetic resonance imaging) to assess cartilage integrity and patellar alignment. Most patients improve with long-term conservative therapy focused on quadriceps strengthening, hip stabilisation and activity modification. Surgical intervention is reserved for persistent, symptomatic cases or significant maltracking. Early recognition helps prevent progression to patellofemoral osteoarthritis. In this episode, Dr Roger Henderson looks at how best to recognise the condition in our surgeries and the best plan of action for our patients.Access episode show notes containing key references and take-home points at:https://gpnotebook.com/en-GB/podcasts/musculoskeletal-medicine/ep-190-chondromalacia-patella.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Intermittent claudication is a hallmark symptom of peripheral arterial disease and reflects widespread atherosclerosis. It presents as predictable exertional leg pain caused by inadequate blood flow during exercise. The pain location helps localise arterial stenosis and diagnosis relies on history, examination and the ankle–brachial index, with imaging reserved for intervention planning. Management focuses on cardiovascular risk reduction, smoking cessation, supervised exercise therapy, antiplatelet treatment and statins. Revascularisation is considered only when symptoms continue to limit lifestyle despite optimal therapy. Although limb loss is uncommon, cardiovascular mortality is high, making systemic risk management essential. In this episode, Dr Roger Henderson gives an overview of the condition and looks at how best to diagnose and manage it.Access episode show notes containing key references and take-home points at:https://gpnotebook.com/en-GB/podcasts/cardiovascular-medicine/ep-189-intermittent-claudication.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Pityriasis versicolor is a fungal condition caused by overgrowth of Malassezia – a yeast that is commonly found on the skin in most people. In this episode, Dr Kate Chesterman discusses the clinical findings that become visible when there is overgrowth of this yeast and explores the treatment options available to manage initial and recurrent episodes.Access episode show notes containing key references and take-home points at:https://gpnotebook.com/en-GB/podcasts/dermatology/ep-188-pityriasis-versicolor.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, Dr Kate Chesterman and Dr Roger Henderson invite you to join them for the annual GPnotebook quiz. 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 meetings. This quiz is based on the facts that they have found the 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-187-quiz-of-the-year-2025.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Olecranon bursitis is the inflammation of the bursa overlying the olecranon process, presenting as localised, fluctuating posterior elbow swelling that necessitates clinical differentiation between aseptic (traumatic, crystalline) and septic aetiologies for appropriate management. In this episode, Dr Kate Chesterman discusses the risk factors for olecranon bursitis as well as its diagnostic features. The differences in presentation between septic and non-septic cases are explored, and the management of both is reviewed. Also included are the criteria for secondary-care involvement and advice that we can pass on to patients to try to prevent recurrent episodes of this condition.Access episode show notes containing key references and take-home points at:https://gpnotebook.com/en-GB/podcasts/musculoskeletal-medicine/ep-186-olecranon-bursitis.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Lung cancer is the leading cause of cancer-related death worldwide and is classified into two main types: non-small cell lung cancer (NSCLC), which accounts for most cases and the more aggressive small cell lung cancer (SCLC). Early detection is crucial for improving outcomes, but symptoms often emerge late in the disease course. In episode 126, Dr Hannah Rosa looked at the challenges of diagnosis, reviewed guidelines and latest research and discussed when to continue investigations after a normal chest X-ray. In this episode, Dr Roger Henderson gives an overview of detecting lung cancer in primary care and looks at treatment – including newer options for some late-stage cancers.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/oncology/ep-185-lung-cancer.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Parvovirus B19 (slapped cheek syndrome) is a common and usually mild, self-limiting viral illness. Certain populations, such as pregnant women and their unborn babies, those who are immunocompromised or those with underlying haematological conditions, are at increased risk of complications as the virus can affect red blood cell production. In this episode, Dr Kate Chesterman explores the common signs and symptoms in healthy individuals, as well as discussing the investigation and management of those at higher risk of complications.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/infectious-disease/ep-184-parvovirus-b19.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Post-traumatic stress disorder (PTSD) may develop (either immediately or delayed) following exposure to a stressful event or situation of an exceptionally threatening or catastrophic nature. It is characterised by four groups of symptoms: intrusion symptoms, avoidance, negative alterations in cognition and mood and alterations in arousal and reactivity. These symptoms must persist for more than 1 month and cause functional impairment for a diagnosis to be made. Its presentation is often comorbid with conditions such as depression, anxiety, anger and substance use disorder. In this episode, Dr Roger Henderson looks at the aetiology of PTSD, its assessment, treatment options and prognosis.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/psychiatry/ep-183-post-traumatic-stress-disorder.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Melanoma is among the most common forms of cancer – and causes of cancer-related death – among young adults. Its prevalence in this group has been associated with sunbathing and sunbed use. Reducing exposure to ultraviolet light is critical in the primary prevention of melanoma. Clinical features of lesion asymmetry, border irregularity, colour variability, diameter and evolution over time should raise suspicion for melanoma and prompt further assessment with dermoscopy. In this episode, Dr Roger Henderson looks at melanoma, including the different types and how to recognise them, referral criteria, treatments and prognosis.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/dermatology/ep-182-melanoma.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 and Dr Will Hinchliffe (Consultant in Renal and General Medicine working in the north-east and north Cumbria) discuss the management of hyperkalaemia in primary care. They break the management down into six steps, so that when you are next faced with blood test results that show a raised potassium level, you will know exactly what to do. They first discuss who needs admission into hospital, then how to manage hyperkalaemia in the community and finally the role of potassium binders.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/renal-medicine/ep-181-management-of-hyperkalaemia-in-primary-care.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

In this final episode of a four-part series on HIV and primary care, Dr James Waldron is joined again by Dr Grace Bottoni (HIV and Hepatitis C GP Champion, Lewisham) and special guest Darren Knight (CEO of George House Trust). Together, they explore the importance of language in healthcare and how reducing HIV-related stigma is key to increasing engagement with primary care, improving lives and helping to prevent HIV transmission. This conversation brings together clinical insight, lived experience and practical strategies for making HIV care truly inclusive.Access episode show notes containing key references and take-home points at:https://gpnotebook.com/en-GB/podcasts/infectious-disease/ep-180-rethinking-hiv-reducing-hiv-related-stigma.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Paraesthesia is an indication of an abnormality that impacts the sensory pathways at any point from the peripheral sensory nervous system right up to the sensory cortex. The essential tool for the diagnosis of this condition is obtaining a concise patient history. This history must accurately reflect the patient's experience, including the provoking and alleviating factors, along with any existing concurrent conditions, such as diabetes and all treatments that might potentially lead to neuropathies. Treatment is based on the relevant diagnosis and mechanism to address the cause. In this episode, Dr Roger Henderson discusses paraesthesia, covering its causes, investigations and treatment.Access episode show notes containing key references and take-home points at:https://gpnotebook.com/en-GB/podcasts/neurology/ep-179-paraesthesia.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

A tremor is defined as an involuntary rhythmic oscillation of one or more body parts, mediated by alternating contractions of reciprocally acting muscles. Tremors typically affect the upper extremities but can also affect the head, chin, voice or legs. Although some tremors may be mild and cause little impact to quality of life, requiring no treatment, others may impair activities of daily living or occupation, which may lead to embarrassment and social withdrawal. In this episode, Dr Roger Henderson gives an overview of the different types of tremor, looking at ways of distinguishing them and how each is usually managed.Access episode show notes containing key references and take-home points at:https://gpnotebook.com/en-GB/podcasts/neurology/ep-178-tremor.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Postnasal drip is a condition where excess mucus from the nose and sinuses accumulates and flows down the back of the throat. This can lead to symptoms such as throat clearing, coughing, a scratchy or sore throat, hoarseness and bad breath. Common causes include allergies, colds, sinus infections, weather changes, acid reflux and irritants such as smoke. Treatment typically involves managing the underlying cause through medications such as antihistamines, decongestants and nasal sprays, as well as maintaining proper hydration. If symptoms persist for more than 10 days or are accompanied by fever or discoloured mucus, medical evaluation is recommended to rule out infections or other issues. In this episode, Dr Roger Henderson provides an overview of these areas to help us easily diagnose this common problem in our surgeries.Access episode show notes containing key references and take-home points at:https://gpnotebook.com/en-GB/podcasts/ear-nose-and-throat/ep-177-postnasal-drip.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Lower urinary tract symptoms (LUTS) are storage, voiding and post-micturition symptoms affecting the lower urinary tract. LUTS can significantly reduce men's quality of life and may point to serious problems in the urogenital tract. The pathogenesis of LUTS is multifactorial and can include one or several diagnoses, commonly benign prostatic obstruction, nocturnal polyuria (polynocturia) and detrusor muscle instability. LUTS are common and not necessarily a reason for suspecting prostate cancer. In this episode, Dr Roger Henderson gives an overview of male LUTS, including investigations, referral criteria and treatment options.Access episode show notes containing key references and take-home points at:https://gpnotebook.com/en-GB/podcasts/urology/ep-176-lower-urinary-tract-symptoms-in-men.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.