GPnotebook Podcast

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.