GPnotebook Podcast

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.

Hypothyroidism, or an underactive thyroid gland, is increasingly common as people get older, but it may often be undiagnosed or diagnosed late due to the insidious nature of some of its symptoms. These include fatigue, weight gain, sensitivity to cold, constipation, dry skin, hair loss and depression. Common causes of hypothyroidism include autoimmune diseases, thyroid surgery, radiation therapy, certain medications and iodine deficiency, which is the leading cause globally. Treatment typically involves hormone replacement therapy, and with proper treatment and monitoring most people with hypothyroidism can lead normal, healthy lives. In this episode, Dr Roger Henderson provides an overview of hypothyroidism and considers differential diagnoses, testing, referral criteria, thyroxine replacement principles and prognosis.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/diabetes-and-endocrinology/ep-109-hypothyroidism.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Restless leg syndrome (RLS) is prevalent in around 5–10% of the population and can result in an impact on quality of life that is comparable to conditions such as type 2 diabetes and osteoarthritis. It can result in significant impairments in sleep, energy, daily activities and behaviour and is associated with anxiety and depression in those who experience it. In this episode, Dr Kate Chesterman discusses the diagnosis and investigation of this distressing condition along with three principles that will help to guide its management.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/neurology/ep-108-restless-leg-syndrome.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Benign prostatic hyperplasia (BPH) is an extremely common condition seen in clinical practice, and one which can cause considerable difficulties in older men. Common symptoms include frequent urination, difficulty starting urination, weak urine stream or the need to urinate during the night – all of which significantly impact on quality of life. Treatment options vary depending on symptom severity and can include no treatment, medication, minimally invasive procedures or surgery. In this episode, Dr Roger Henderson looks at the key things to remember when assessing a patient with BPH and covers the newer treatments now available as well as more traditional conventional options.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/urology/ep-107-benign-prostatic-hyperplasia.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Understanding sexual violence is vitally important in primary care. A GP may be the first (or only) individual spoken to by a person who has experienced sexual violence. But how often does the experience disclosed represent the full scope of the issue? How much sexual violence goes unreported? What has changed about our understanding of sexual violence and its context? In this episode, the first of a series looking at this topic, Dr James Waldron speaks with Hayley Wilson (Consent and Sexual Violence Development Officer at Nottingham Trent University) about the spectrum of problems related to sexual violence and the critical importance of understanding this topic and responding well from the outset.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/general-information/ep-106-sexual-violence-part-1.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 topic which is at the heart of good clinical care: empathy. Research has shown that empathy decreases as medical students progress through medical school and that in society empathy levels have fallen over recent decades. But what does this mean for us working in primary care? What are the benefits that increasing empathy in our clinical practice can bring, and how can we all develop this vital skill?Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/mental-health/ep-105-empathy-who-cares-exploring-empathy-in-health-care.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disorder that primarily affects the joints. Causing joint pain, stiffness, swelling and reduced joint motion, its exact cause is still unknown, but is believed to involve a combination of factors. In this episode, Dr Roger Henderson looks at the aetiology of RA, diagnostic testing and the management pathway for patients with the condition.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/rheumatology/ep-104-rheumatoid-arthritis.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

In this episode, which has been recorded for Chronic Conditions Month 2024, Dr Yassir Javaid (GP with a Specialist Interest in Cardiology) examines the role of the QRISK3 calculator in the primary prevention of cardiovascular disease. He considers the development of the tool, the differences between QRISK2 and QRISK3 (including the additional risk factors now included in the updated calculator) and the strengths and limitations of QRISK3 in understanding a person’s cardiovascular risk.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/cardiovascular-medicine/ep-103-primary-prevention-of-cardiovascular-disease-what-has-changed-in-qrisk3-and-why.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Diverticular disease is a condition characterised by the presence of small pouches, called diverticula, in the wall of the colon (large intestine). These pouches can develop when weak spots in the colon's muscular wall give way under pressure. Diverticular disease encompasses two main conditions: diverticulosis and diverticulitis. In this episode, Dr Roger Henderson takes an overview look at the symptoms and management of these as well as their prognosis and prevention.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/gastroenterology/ep-102-diverticular-disease.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Coeliac disease (CD) is a chronic autoimmune disorder that primarily affects the small intestine and is triggered by the consumption of gluten, a protein found in wheat, barley, rye and sometimes oats. When individuals with CD ingest gluten, their immune system responds by damaging the lining of the small intestine. This damage impairs the absorption of nutrients from food, leading to various symptoms and potentially serious complications. In this episode, Dr Roger Henderson looks at the diagnosis, testing and management of CD, along with the importance of longer-term follow-up in people with it.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/gastroenterology/ep-101-coeliac-disease.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 takes a look around the world at some of the different strategies that are being used to try to reduce the health complications caused by alcohol. She then looks at the latest research which links alcohol as a primary cause of a variety of cancers, before finishing with a consideration of the economic cost.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/general-practice/ep-100-a-review-of-the-latest-research-on-alcohol.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Obesity is a medical condition characterised by excessive accumulation of body fat, to the point where it may have adverse effects on health. Its incidence is steadily rising in both young people and adults. It is typically measured using BMI, but this has limitations and may not always accurately represent the level of obesity. While genetics and hormonal factors have a role in obesity, lifestyle choices (such as diet and physical activity level) and environmental factors also significantly contribute to its development. In recent years, the prevalence of obesity has been on the rise globally, leading to serious health concerns such as increased risks of heart disease, type 2 diabetes, certain types of cancer and other health problems. In this episode, Dr Roger Henderson provides an overview of the rise of obesity, the management options we have in general practice and the impact of newer injectable drugs for weight loss that many patients are now requesting.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/obesity/ep-99-assessment-and-management-of-obesity.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Recurrent vulvovaginal candidiasis is reported in 6% of women of reproductive age. It has a significant impact on an individual’s quality of life that is comparable to conditions such as asthma and migraine. Appropriate management of the acute infection and subsequent maintenance treatment can help to reduce the burden of this condition. In this episode, Dr Kate Chesterman discusses the risk factors for recurrence and considers appropriate investigations. She looks at options for management, including lifestyle changes and induction and maintenance regimens.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/gynaecology/ep-98-recurrent-vulvovaginal-candidiasis.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

The most common cause of peptic ulcers (gastric and duodenal) is infection with Helicobacter pylori (H. pylori) or the long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs). Other factors such as excessive alcohol consumption, smoking, stress and certain medical conditions may also contribute to the development of peptic ulcers. Symptoms of peptic ulcer disease can vary but may include burning stomach pain, nausea and vomiting, bloating or belching and loss of appetite. Treatment typically involves a combination of lifestyle changes and medication to reduce stomach acid production, eradicate H. pylori infection (if present) and protect the lining of the stomach and small intestine. In this episode, Dr Roger Henderson provides a thorough overview of peptic ulcer disease and talks about the latest advice on diagnosis, investigations and treatment.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/gastroenterology/ep-97-peptic-ulcer-disease.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Dysphagia refers to difficulty swallowing. It can occur at any age and may be caused by various conditions, including neurological disorders, muscular disorders, structural abnormalities, or even psychological factors. Dysphagia can range from mild to severe, and it can lead to complications such as malnutrition, dehydration and aspiration pneumonia if not properly managed. The treatment for dysphagia depends on the underlying cause and may include dietary modifications, swallowing therapy, medication or surgery. In this episode, Dr Roger Henderson takes an overview look at the causes, assessment, investigations and treatments of dysphagia, along with a reminder of oesophageal cancer, its treatment and prognosis.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/ear-nose-and-throat/ep-96-dysphagia.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Trigeminal neuralgia (TN) is a condition characterised by severe, shooting pain in the face, along the trigeminal nerve. The pain can be triggered by even mild stimulation of the face, such as brushing teeth, touching the face or eating. It is often described as one of the most excruciating pains known to medicine and it can significantly impact a person's quality of life. The exact cause of trigeminal neuralgia is often unknown and treatment options include carbamazepine or gabapentin, as well as surgical procedures that relieve pressure on the trigeminal nerve or disrupt the pain signals in some cases. In this episode, Dr Roger Henderson looks at what GPs need to know when patients present in surgery with trigeminal neuralgia, when to refer them to secondary care and the prognosis for these patients.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/neurology/ep-95-trigeminal-neuralgia.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Anal fissures are small tears or cracks in the lining of the anus which can cause pain, bleeding and discomfort, particularly during bowel movements. They are quite common and can be caused by various factors such as constipation, diarrhoea, childbirth or anal trauma. Treatment often involves keeping the stool soft and avoiding straining during bowel movements. This may include dietary changes, fibre supplements, topical medications, or in some cases, surgery. In this episode – which has been suggested as a topic by one of our listeners – Dr Roger Henderson looks at these in more detail as well as when to refer, and the options available for treatment in secondary care.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/gastroenterology/ep-94-anal-fissures.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Haemorrhoids are a very common finding in the Western world and are often seen in our surgeries. They are frequently under-reported so their exact incidence can be difficult to quantify; however, estimates are that 50% of the population experience them by the age of 50. Because many people attribute symptoms of more serious pathology to haemorrhoids, careful evaluation is always very important. Fortunately, most cases are simple to treat and often resolve very quickly, although up to 10% of sufferers may require surgery to fully alleviate their symptoms. In this episode, Dr Roger Henderson looks at the classification of haemorrhoids, their predisposing factors, symptoms — including red flag symptoms — and treatments.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/general-information/ep-93-haemorrhoids.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

We live in an age of increasing digital connectivity where technology plays an ever-prominent role in peoples’ lives. While social media can provide a platform for support and connection, we are all susceptible to the negative effects of overuse or misuse, particularly on our sleeping patterns and our mental health. In this episode, the second in a series on digital wellbeing, Dr James Waldron interviews Dr Alex Lai of the WorkWell Doctors about the patient perspective. It explores how we can: 1) help patients understand the impacts of social media use on their wellbeing during clinical consultations; and 2) suggest strategies to promote healthy use of digital tools.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/mental-health/ep-92-digital-wellbeing-for-patients.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Lateral hip pain is a common presenting complaint in primary care. It can result in significant morbidity with reduction in activity levels and associated implications for leisure activities, employment and overall wellbeing. In this episode, Dr Kate Chesterman reviews the likely differential diagnoses, including some key questions to consider when assessing a patient with lateral hip pain. She then delves deeper into the diagnosis of greater trochanteric pain syndrome (GTPS), exploring the reasons why it is no longer referred to as trochanteric bursitis, initial management options, the value of corticosteroid injections and indications for onward referral.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/musculoskeletal-medicine/ep-91-lateral-hip-pain.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

We are constantly connected to the web! You are likely connected right now, trying to decide what podcast to listen to! In this episode, Dr James Waldron interviews Dr Alex Lai of the WorkWell Doctors in the first of a series about staying well in an increasingly digital world. How do we check in with our use of digital tools? What impact might it have on our concentration and mental health? All will be explored in this episode.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/mental-health/ep-90-digital-wellbeing-for-clinicians.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Bowen's disease, also known as squamous cell carcinoma in situ, is a type of skin disorder characterised by the presence of precancerous or intra-epidermal squamous cell carcinoma. It was named after John T. Bowen, the dermatologist who first described the condition in 1912. Bowen's disease primarily affects the outermost layer of the skin (epidermis) and is considered a form of non-invasive skin cancer. Bowen's disease most commonly occurs on sun-exposed areas of the skin, such as the face, neck, head, hands and forearms. However, it can also occur in areas not exposed to the sun. In this episode, Dr Roger Henderson looks at how best to diagnose and manage Bowen’s disease, as well as looking at its prognosis and prevention.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/dermatology/ep-89-bowens-disease.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Obsessive–compulsive disorder (OCD) is a prevalent mental health condition characterised by persistent, intrusive thoughts (obsessions) and repetitive behaviours or mental acts (compulsions) aimed at alleviating anxiety. Individuals with OCD often find themselves trapped in a distressing cycle, as compulsions provide only temporary relief, perpetuating the need for repetition. OCD manifests in diverse forms, such as checking, counting or washing rituals, and its severity can range from mild to debilitating. Despite widespread misconceptions, OCD extends beyond a mere desire for order and cleanliness, impacting various aspects of daily life. Genetic, neurological, and environmental factors contribute to its development, and it often emerges in adolescence or early adulthood. In this episode, Dr Roger Henderson provides an overview of OCD, what we should be looking for to help identify patients with this condition, along with guidelines on effective treatments including cognitive behavioural therapy (CBT) and medication.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/mental-health/ep-88-obsessive-compulsive-disorder.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

NICE published its last guideline on depression in 2009. Since that time, the prevalence of depression has increased, especially among vulnerable adults during the COVID-19 pandemic. NICE published a new guideline in June 2022 to reflect this. In this episode, Dr Roger Henderson looks at the new recommendations on managing depression in primary care, along with services providing psychological therapies that update and replace the 2009 guideline. Among the topics covered are treatments for first depressive episodes, advice on preventing relapse and withdrawing from antidepressant treatment.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/mental-health/ep-87-depression-in-adults.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Many pathology tests are ordered unnecessarily in primary care and this can include testing for inflammatory markers. The most common examples of tests typically ordered are for erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels, with occasional requests for plasma viscosity (PV) too. Although such tests can be useful in giving some information as to a patient’s inflammatory response in certain conditions, their lack of specificity means that they are not perfect tests and interpretation is not always straightforward. In this podcast, Dr Roger Henderson looks at how inflammatory markers work, what may or may not constitute a normal reading and what to do with abnormal results.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/immunology/ep-86-inflammatory-marker-testing.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Sweating is a crucial way to reduce our body temperature, such as when doing strenuous physical activity or when in a hot environment. Hyperhidrosis is defined as excessive sweating beyond what is physiologically required or normal. It can be categorised as primary (idiopathic), secondary to other conditions, or as a side effect of some medications. Primary hyperhidrosis can affect people at any age, but often starts in early life. The diagnosis of hyperhidrosis is typically made initially on the clinical history, and this can also determine between primary or secondary hyperhidrosis. It is usually diagnosed where there is visible sweating, which interferes with daily activities and which has lasted for at least 6 months. In this podcast, Dr Roger Henderson discusses what to look for when making the diagnosis, what investigations to undertake and the range of treatments currently available. Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/dermatology/ep-85-hyperhidrosis.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Testosterone deficiency (TD) is an increasingly common problem with significant health implications, but the diagnosis and management of this condition may present problems in primary care. Low levels of testosterone in men are associated with increased risk of incident type 2 diabetes mellitus, worse outcomes in chronic kidney disease and COVID-19 infection (with increased all-cause mortality), along with significant implications in the areas of mental health and relationships. In this podcast, Dr Roger Henderson provides a reminder of how to diagnose TD — including from the patient’s history as well as clinical findings — and current guidelines on its management.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/diabetes-and-endocrinology/ep-84-testosterone-deficiency.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Dry skin is an extremely common condition that occurs in all skin colours and ethnic groups; however, differences in skin colour can cause significant differences in the incidence, presentation and treatment of different skin conditions. Although dry skin may cause similar symptoms among different skin tones, the appearance may make it more challenging to easily recognise – a fact highlighted by hospital admissions linked to eczema being up to six times more likely in people of colour than in people with light skin.In this podcast, Dr Roger Henderson looks at the reasons for this, what impact skin of colour can have on both diagnosing and managing dry skin conditions and how best to manage dry skin in people with skin of colour.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/dermatology/ep-83-the-management-of-dry-skin-conditions-in-skin-of-colour.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Although pityriasis capitis (dandruff) is not a serious medical condition, it causes significant embarrassment and self-esteem issues in many people who suffer from it. It is extremely common, affecting up to half the global adult population, and its recurring nature is often a source of frustration. It can impact on primary care workload and can also be mistaken for other scalp conditions such as scalp psoriasis, seborrheic dermatitis or atopic eczema. In this podcast Dr Roger Henderson looks at how to distinguish dandruff from these conditions as well as how to effectively treat dandruff to stop patients from needing repeated consultations.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/dermatology/ep-82-pityriasis-capitis-dandruff.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Lyme disease can present a number of particular difficulties in primary care, and these are often linked to clinical findings and the availability and timing of testing. In this podcast, Dr Roger Henderson discusses those and looks at Lyme disease’s three stages — early, disseminated and late — and whether it can be diagnosed clinically if erythema migrans is or is not present. He also looks at diagnostic difficulties and whether acute or convalescent serological testing is helpful. Treatment with antibiotics is also discussed along with prognostic indicators.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/infectious-disease/ep-81-lyme-disease.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

With tourism having now rebounded from the declines during and after the coronavirus pandemic, our patients are once again travelling globally. But what happens when their destination is 5000 metres above sea level? Many GPs will have been faced with a “travel consultation”, but it can be a daunting prospect when carried out infrequently. What are the risks of high altitude? What medication might be needed? And why might beer taste funny at high altitude? In this episode, Dr James Waldron asks Dr Rashbal Ghattaora about his experiences working at high altitude in Tibet. They discuss how to approach a travel consultation, relevant medications, counselling and much more.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/general-information/ep-80-altitude-medicine-heightening-understanding-of-travel-consultations.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

The number of young people struggling with anxiety and depression seems to be on the rise and resources to help these young people are increasingly stretched. In this episode, Dr Kate Chesterman and Dr Dave Ledward (GP with an interest in mental health) discuss the growing problem of managing the mental health of children. They focus on the vital role that parents and caregivers play in supporting young people through emotional turmoil and discuss the educational sessions that Dave has run for the families of young people with mental health issues. Dave discusses some of the pitfalls and traps that caregivers can fall into when trying to support their young people and shares his top tips for parents and professionals to help manage an emotional crisis.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/mental-health/ep-79-child-mental-health.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 is joined by Dr Shan, a GP colleague and father to Oscar, an 8-week-old baby. Together, they go through the 6-week baby check, while discussing the recently updated guidance from Public Health England. They also explore the key role that the examination plays in screening for a variety of physical conditions, which, if picked up early, can make a huge difference to the future health of a child.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/paediatrics/ep-78-the-6-week-baby-check.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

In this podcast, Dr Kate Chesterman discusses recurrent urinary tract infection (UTI). She covers the pathophysiology, some risk factors for UTI recurrence and treatment options including lifestyle changes and the use of antimicrobials. She also focuses on non-antimicrobial management, including the current advice regarding the use of probiotics, cranberry products, D-mannose and methenamine hippurate.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/urology/ep-77-recurrent-urinary-tract-infection.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

In this follow-up to episode 52, Dr James Waldron and Mr Sam Dobson (Consultant Gynaecologist, Sub-specialist in Reproductive Medicine and BMS-accredited Menopause Specialist) consider the impact of menopause on libido. They talk through the physical and psychological features of menopause that can lead to a reduction in libido, the conversations and initial investigations in primary care, and consider available options for the management of menopause-related loss of libido, including topical and systemic hormone replacement therapy (HRT) and testosterone.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/gynaecology/ep-76-passing-the-test-of-testosterone-replacement-menopause-and-hormone-replacement-therapy-part-2-test.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

The call to adventure is felt by many and general practice is a career that can take you there! As GPs grow their portfolios, they look for interesting and unusual ways to forge their own paths. This can take them all round the world (and back again). In this follow-up to episode 71, Drs James and Rebecca Waldron continue their discussion about Rebecca's 3-month voyage with the marine conservation charity Sea Shepherd. As the boat's medic, she tended to crew members' daily illnesses, performed infection control during a COVID outbreak, and provided emotional support.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/general-information/ep-75-expedition-medicine-part-2.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 Kate Chesterman is joined by Dr Alex Brightwell (Consultant Paediatrician with a specialism in allergy) and Liz Ingham (Lead Paediatric Allergy Dietician), both of whom work at the Norfolk and Norwich University Hospital. Together, they explore paediatric dietary allergies. They discuss cow’s milk protein allergy (CMPA), including: its different types, how to differentiate it from other causes of unsettled infant behaviour and the importance of de-challenging and rechallenging to make the diagnosis. Furthermore, they offer practical advice for breastfeeding mothers, as well as covering the indications for the different formula milks. They highlight the importance of maintaining balanced nutritional intake for infants and breast-feeding mums and avoiding unnecessary exclusion diets. They finish by discussing the current evidence and advice regarding early introduction of potentially allergenic foods in infants at risk of food allergies.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/paediatrics/ep-74-paediatric-dietary-allergy.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 Kate Chesterman talks to Dr Briony Arrowsmith, who is a Consultant Paediatrician at the Haven, a sexual assault referral centre in London. They discuss the many and varied ways that sexual abuse can present, as well as the considerations surrounding who the abuse should be disclosed to. They talk through the physical health concerns that need to be addressed and the role of the sexual assault referral centre in the care of abused children and their families. Finally, they discuss agencies that can offer ongoing psychological support to children, families and healthcare practitioners who have been affected by cases of abuse.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/paediatrics/ep-73-sexual-abuse-in-children.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

In this episode, which has been recorded for Chronic Conditions Month 2023, Dr Yassir Javaid (GP with a Specialist Interest in Cardiology) discusses auscultation of the heart sounds. Auscultation is an important aspect of the cardiac examination and can give an indication of significant underlying structural heart disease – particularly valve disease, which is becoming increasingly prevalent as the population ages. But which patients should be auscultated and what specifically should clinicians be listening for? Dr Javaid answers these questions with reference to audio examples of heart sounds and murmurs, and it is highly recommended to listen to this episode using good-quality headphones.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/cardiovascular-medicine/ep-72-back-to-basics-heart-sounds-and-cardiac-examination.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

The call to adventure is felt by many and general practice is a career that can take you there! As GPs grow their portfolios, they look for interesting and unusual ways to forge their own paths. This can take them all round the world (and back again). In the first episode in a two-part series, Drs James and Rebecca Waldron discuss adventure and expedition medicine, finding inspiration and opportunities, preparing oneself and getting started on the journey. Rebecca recently returned from a 3-month voyage with the marine conservation charity Sea Shepherd. As the boat\'s medic, she tended to crew members\' daily illnesses, performed infection control during a COVID outbreak, and provided emotional support. In their conversation, James and Rebecca consider how such expeditions provide an opportunity for career diversification for primary care professionals.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/general-practice/ep-71-expedition-medicine-part-1.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.