GPnotebook Podcast

In this episode, Dr Roger Henderson discusses an approach to the assessment of epicondylitis. Elbow epicondylitis is more common than is often thought and can cause significant pain and movement restriction. There can also be a number of possible differential diagnoses that need to be considered. This podcast episode looks at how to diagnose both tennis elbow and golfer’s elbow, what clinical tests to use, the best management and when to consider referral to secondary care.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/musculoskeletal-medicine/ep-70-epicondylitis.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 looks in detail at the maternal side of the postnatal 6-week check. NICE’s quality standard on postnatal care is explored and topics, such as contraception after childbirth, are delved into in further detail. Thereafter, there is an exploration of conditions that can arise during or after pregnancy which require management postpartum, such as gestational diabetes, hypertensive disorders in pregnancy and postpartum thyroiditis.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/obstetrics/ep-69-postnatal-care-the-maternal-6-week-check.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Vitamin D is a fat-soluble vitamin that is essential for human health. It regulates calcium and phosphate homeostasis and is therefore vital for musculoskeletal functioning. In the UK, up to 50% of the adult population may be vitamin D insufficient following the winter months, with one in six being severely deficient. In this podcast, Dr Roger Henderson looks at who is most at risk of vitamin D deficiency, how it should be diagnosed, what treatment options are available and why unlicensed vitamin D preparations should not be recommended.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/general-practice/ep-68-vitamin-d-deficiency-in-adults.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Actinic keratosis (AK) – also commonly known as solar keratosis – is a very common dermatological presentation in primary care, affecting large numbers of older people. It has the capacity to transform into a malignant lesion if untreated. In this podcast, Dr Roger Henderson looks at who is most at risk of AK, how it should be diagnosed, what treatment options are available, and when to consider referral to secondary care.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/dermatology/ep-67-actinic-keratosis.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 constipation in children. She takes us through the clinical features associated with idiopathic constipation and red flags that would cause concern. She discusses disimpaction regimes and when these should be used, as well as talking about the importance of ongoing maintenance regimes. She provides some tips on encouraging children to take laxatives and also highlights some useful patient and professional resources.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/paediatrics/ep-66-childhood-constipation.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Obstructive sleep apnoea (OSA) is a very common problem affecting around one and a half million adults in the UK, most of whom are undiagnosed and untreated. OSA has significant health consequences, including heart disease and an increased risk of fatal car crashes. In this episode, Dr Roger Henderson looks at who is most at risk of OSA, how it should be diagnosed, how to refer to secondary care and what treatment options are currently available to help people with the condition.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/respiratory-and-chest-medicine/ep-65-obstructive-sleep-apnoea.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 James Waldron and Dr Thuva Amuthan (GP with an Extended Role in Dermatology) explore dermatological presentations, treatments and complications in skin of colour. The topics that they cover include: inequalities faced in certain patient groups; the psychological impact of pigmentation, depigmentation and scarring; eczema and acne in skin of colour; melasma and vitiligo; traction alopecia; and folliculitis and its potential severe consequences.Thanks to Dr Thuva Amuthan for his time. All information in the episode is based on the personal experience of the presenters.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/dermatology/ep-64-primary-care-dermatology-skin-of-colour.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Oxygen is essential for our survival and is a powerful medical drug. Treatment with oxygen increases blood oxygen levels and helps to reduce cardiovascular workload. In this podcast, Dr Roger Henderson looks at how oxygen can be given in a home environment, the reasons it may be required and the different types of delivery systems available. He also looks at practical issues such as flying when requiring oxygen, smoking near oxygen supplies, how to arrange an emergency supply of oxygen for home use and which types of masks and nasal cannulae to use.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/respiratory-and-chest-medicine/ep-63-domiciliary-oxygen-guidance.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 cluster headaches. She talks through the clinical features that would lead to a diagnosis, the initial investigations in primary care and indications for a referral to a headache specialist. She considers the management of acute attacks, including considerations around prescribing oxygen, as well as the options for preventative treatment.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/neurology/ep-62-cluster-headaches.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 Nicky Mulgrew discuss autism and the role we play within general practice. They focus on when we should refer children and adults to specialists to get a possible diagnosis of autism and also explore how we can adapt our workplaces and our communication styles to make our surgeries more comfortable places for autistic people to visit.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/general-practice/ep-61-autism.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Chronic spontaneous urticaria (CSU) is a common problem, often affecting younger people. It refers to chronic urticaria that has no obvious cause or trigger and which causes weals to occur on the skin most days for 6 weeks or more. It can be a deeply distressing and frustrating condition for sufferers that can greatly affect their quality of life. In this episode, Dr Roger Henderson looks at the possible triggers of CSU, how to approach the treatment of people with the condition and what drug therapies may be helpful.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/dermatology/ep-60-chronic-spontaneous-urticaria.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Dermatology is a vast subject and accounts for a significant proportion of the workload in general practice. Managing dermatological conditions can be a challenge and staying up-to-date is equally so. In this episode, Dr James Waldron and Dr Thuva Amuthan (GP with an Extended Role in Dermatology) discuss topics such as: getting into dermatology as a specialist interest; improving patient engagement and adherence; improving eczema care; acne; psoriasis and the impact of dermatology on mental health.Thanks to Dr Thuva Amuthan for his time. All information in the episode is based on the personal experience of the presenters.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/dermatology/ep-59-primary-care-dermatology-improving-care-by-getting-back-to-basics.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

After smoking and diet, hypertension is the biggest risk factor in the UK for premature death and disability. One in four people have hypertension in the UK, with around one in three treated to target. In this episode, Dr Roger Henderson gives an overview of the management of hypertension, covering its definition, risk factors, lifestyle management, investigations and medical treatments, including those recommended in the latest NICE guidelines.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/cardiovascular-medicine/ep-58-hypertension-management.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Malnutrition can have significant adverse effects for patients with chronic obstructive pulmonary disease (COPD). In this podcast, Dr Kate Chesterman discusses how to identify and categorise those at risk of malnutrition. She also discusses how to treat malnutrition, including the appropriate use of oral nutritional supplements (ONS).Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/nutrition/ep-57-malnutrition-in-people-with-chronic-obstructive-pulmonary-disease.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Dry skin conditions are one of the commonest skin problems that present to primary care physicians, but their psychological impact and psychiatric comorbidities are often underestimated. In this podcast episode, Dr Roger Henderson looks at dry skin, its impact on mental well-being and how it should be assessed and treated. He also gives useful consultation hints and tips about both the dermatological and psycho-dermatological aspects of dry skin problems.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/dermatology/ep-56-dry-skin-and-its-impact-on-mental-health.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

In 2019, vaccine hesitancy was listed as one the top ten threats to global health by the World Health Organization. In this episode, Dr Hannah Rosa explores vaccine hesitancy further, thinking about how we can make a difference in primary care.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/infectious-disease/ep-55-addressing-vaccine-hesitancy-in-primary-care.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Back in 2009, the conclusion of the first Lancet Climate Change Commission was that “Climate change is the biggest global health threat of the 21st Century.” In response to this, in October 2020, the NHS became the world’s first health service to commit to reaching carbon net zero, and in July 2022 it published its plan for delivery. So, what does all this mean for general practice? In this podcast episode, Dr Hannah Rosa shares her 10 practical sustainability tips for how we in primary care can make a difference.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/general-practice/ep-54-ten-practical-tips-for-sustainability-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 episode, Dr Roger Henderson discusses the common problem of insomnia. He looks at what it is, how it is assessed, what causes it and ways of treating it. He also discusses simple tips patients can do at home that can cure one in three cases of insomnia without the need for any medication and mentions some famous people who suffered from insomnia along the way!Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/general-practice/ep-53-management-of-insomnia.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Menopause and hormone replacement therapy (HRT) can be a source of anxiety for both patients and clinicians. Menopause is frequently in the media and is at the forefront of many consultations. It’s on our minds and on our patients’ too. In the first in a series of episodes on menopause, Dr James Waldron explores its background, its coverage in the media, the changing attitudes towards it, the impact of menopause on patients and the true risks of HRT. Future episodes in the coming weeks will explore prescribing and other treatments.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/gynaecology/ep-52-menopause-and-hormone-replacement-therapy-part-1.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Using electronic cigarettes (e-cigarettes), or ‘vaping’, has become the most popular form of nicotine replacement therapy in the UK. In this podcast episode, Dr Roger Henderson looks at why this is, the benefits to smokers, and whether we should be recommending such products to our patients who smoke. He also talks about current concerns over their increasing popularity in adolescents and what their potential long-term risks may be.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/respiratory-and-chest-medicine/ep-51-e-cigarettes-and-vaping.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 post-sepsis syndrome. She talks about the long-term implications for physical and mental health following sepsis and highlights the considerations for primary care clinicians in managing this cohort of individuals. She also discusses the role of the wider multidisciplinary team, including input from voluntary organisations.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/general-practice/ep-50-post-sepsis-syndrome.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Heat-related illnesses are increasing as a result of climate change. In this episode, Dr Roger Henderson looks at various aspects of heat exhaustion and heatstroke, including why they are different conditions and how to recognise them. He also talks about how they are treated and when hospital admission should be considered.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/general-practice/ep-49-heat-exhaustion-and-heatstroke.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 discusses the treatment pathway for people suffering from hay fever. This comprises options ranging from simple measures for allergen avoidance to the treatments to consider for specific symptoms and when to refer for specialist advice and consideration of immunotherapy.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/immunology/ep-48-hay-fever-management.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 2022, Dr Peter Bagshaw (Clinical Lead in Dementia and Mental Health, South Glos CCG) and Dr Rob Hampton (Portfolio GP, Leicestershire) discuss the prescribing of medicines associated with dependence and approaches to their withdrawal. Is there a link between deprivation and long-term use of pain medications? What is the role of \"sensitisation\" in primary pain conditions? What are the particular challenges associated with benzodiazepine withdrawal? What alternatives should we be considering?Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/neurology/ep-47-prescribing-medicines-associated-with-dependence-how-can-nice-guideline-ng215-support-our-practice.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 2022, Dr Rob Hampton (Portfolio GP, Leicestershire) and Dr Yassir Javaid (Cardiovascular and Diabetes Lead, Northamptonshire CCG) discuss the \"neglected chronic condition\" that is heart valve disease and the new NICE guideline covering its investigation and management in adults. Why can we expect an increase in cases over the coming years? What is the importance of timely diagnosis and referral? In which patients is a murmur more likely to represent a valve lesion? When should an electrocardiogram be recommended? How effective are current management options? What is best practice for follow-up?Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/cardiovascular-medicine/ep-46-heart-valve-disease-in-adults-an-update-from-nice.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 2022, Dr Steve Holmes (GP, Shepton Mallet and Clinical Respiratory Lead, NHS England South West and NHS Somerset) and Dr Sarah Davies (GPwSI in Diabetes, Cardiff) discuss non-alcoholic fatty liver disease (NAFLD) in the context of diabetes. How is NAFLD best detected, diagnosed and managed in high-risk populations? How can primary care professionals identify those who are at risk of fibrosis?Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/diabetes-and-endocrinology/ep-45-detecting-and-managing-non-alcoholic-liver-disease-in-type-2-diabetes.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 2022, Dr Yassir Javaid (Cardiovascular and Diabetes Lead, Northamptonshire CCG) and Dr Patrick Holmes (GP, Darlington) examine the latest developments in renal medicine, with a focus on assessing and managing chronic kidney disease (CKD). What role do sodium–glucose cotransporter 2 inhibitors have in the management of the condition, both in people with diabetes and those without diabetes?Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/renal-medicine/ep-44-latest-thinking-and-evidence-on-chronic-kidney-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, which has been recorded for Chronic Conditions Month 2022, Dr Anthony Cunliffe (Macmillan National Clinical Adviser for Primary Care) and Dr Peter Bagshaw (Clinical Lead in Dementia and Mental Health, South Glos CCG) discuss the exacerbation of health inequalities related to the COVID-19 pandemic, with a specific focus on cancer services. Which common avoidable cancers and their risk factors might be related to health inequalities? What can primary care professionals do to address the issue?Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/oncology/ep-43-addressing-health-inequalities-in-cancer-the-role-of-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 episode, which has been recorded for Chronic Conditions Month 2022, Dr Yassir Javaid (Cardiovascular and Diabetes Lead, Northamptonshire CCG) and Dr Steve Holmes (GP, Shepton Mallet and Clinical Respiratory Lead, NHS England South West and NHS Somerset) discuss the \"heart–lung connection\" – specifically, the overlap between chronic obstructive pulmonary disease (COPD) and heart failure. What are the challenges in distinguishing between these conditions when they present in general practice, and how can they be addressed? After diagnosing a patient with either COPD or heart failure, how important is it to also look for the condition?Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/cardiovascular-medicine/ep-42-the-overlap-between-copd-and-heart-disease.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

n this episode, which has been recorded for Chronic Conditions Month 2022, Dr Sarah Davies (GPwSI in Diabetes, Cardiff) and Dr Peter Bagshaw (Clinical Lead in Dementia and Mental Health, South Gloucestershire CCG) discuss the interplay between mental health and conditions such as diabetes, dementia and heart disease. What role do lifestyle factors such as diet and physical activity have in modulating such relationships? Most importantly, what can we do to help patients who may be stuck in a vicious cycle whereby physical ailments adversely impact mental health, which can, in turn, make positive lifestyle changes more difficult to achieve.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/mental-health/ep-41-emotional-wellbeing-and-long-term-conditions.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 discusses binge-eating disorder. She explores the defining characteristics of the condition and highlights the importance of referring to eating disorder services for treatment.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/mental-health/ep-40-identifying-and-supporting-people-with-binge-eating-disorder.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 Kevin Fernando and Dr Jim McMorran discuss the ongoing NHS-Galleri trial. The study, which is being conducted among 140,000 asymptomatic patients in England, will assess whether the new Galleri blood test can assist in detecting cancer early when used alongside existing screening measures in the NHS. Kevin and Jim consider the sensitivity, specificity and positive predictive value of the test, reflect on how the test compares with other investigative measures for cancer and contemplate the key practical aspects primary care professionals should be aware of.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/oncology/ep-39-early-detection-of-cancer-in-primary-care-what-role-for-the-galleri-test.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 discusses the finding of an undescended testicle at the 6-week baby check. She considers the possible diagnoses and associated risks. Kate also takes us through the primary care assessment and clarifies the important question of when to refer.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/urology/ep-38-undescended-testes-in-infants.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 Kevin Fernando considers the case of Juliana, a 43-year-old journalist who requests a cholesterol check because her father experienced a heart attack in his early 50s. She has no past medical history of note. Her lipid profile returns as follows: total cholesterol (TC), 7.5 mmol/L; HDL-cholesterol, 1.4 mmol/L; triglycerides, 2.2 mmol/L; LDL-cholesterol, 2.9 mmol/L. What should we do next, and what do current guidelines recommend regarding the detection and management of familial hypercholesterolaemia (FH)?Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/cardiovascular-medicine/ep-37-identifying-and-managing-familial-hypercholesterolaemia.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 discusses the role of the primary care practitioner in the long-term follow-up of people who have undergone bariatric surgery. She highlights the current variability in monitoring and makes listeners aware of where to access the current guidance on postoperative biochemical monitoring and micronutrient replacement.Access episode show notes containing key references and take-home points at:https://gpnotebook.com/en-GB/podcasts/obesity/ep-36-postoperative-follow-up-of-people-who-have-undergone-bariatric-surgery.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 Kevin Fernando discusses diagnostic and management tips – as well as pitfalls to avoid – related to subclinical hyperthyroidism. Fatima is a 71-year-old woman who presents in primary care with non-specific malaise and a past medical history of atrial fibrillation, ischaemic heart disease and osteoporosis. On examination, there is no evidence of thyroid swelling. Her blood tests reveal a suppressed thyroid-stimulating hormone (TSH), but normal free thyroxine (FT4) and free triiodothyronine (FT3). Given Fatima's comorbidities, what should we do next?Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/diabetes-and-endocrinology/ep-35-subclinical-hyperthyroidism-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 episode, Dr Kate Chesterman discusses the case of Lauren, a 32-year-old lady who is 30 weeks pregnant. Lauren presents with dysuria and increased frequency. Kate talks us through the current guidance on urinary symptoms in pregnancy and considers who to investigate, when to treat and what to treat with. She highlights physiological changes in pregnancy, important obstetric and non-obstetric causes for urinary symptoms as well as relevant red flags.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/obstetrics/ep-34-urinary-symptoms-during-pregnancy.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

In this episode, Kevin considers the diagnosis and management of superficial venous thrombosis. Lesley is a 64-year-old woman who presents to us with a sore, itchy right leg and no past medical history of note. On examination, she has a tender, hard, erythematous varicose vein extending from her thigh to ankle. What should we do next? Should we be worried about underlying deep vein thrombosis?Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/cardiovascular-medicine/ep-33-superficial-venous-thrombosis-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 episode, Kate discusses gynaecomastia and its investigation and management in primary care. She talks us through an infographic produced by The Association of Breast Surgery called Guidance on Gynaecomastia and considers the following important questions: “who do I need to be worried about?”, “what investigations should I consider?” and “when should I make a referral?”.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/general-practice/ep-32-gynaecomastia-investigation-and-management-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 episode, Kevin discusses the case of Louise, a 19-year-old who has been living with type 1 diabetes for the last 12 years and hypothyroidism for the last 8 years. She presents to us in primary care with a history of recurring unexplained hypoglycaemic episodes despite proactive adjustments to her insulin regimen. In addition to her insulin, she is taking levothyroxine 150 μg/day. She has not recently made significant changes to her diet or daily physical activity. Louise has also been experiencing light-headedness when rising from a sitting position. She has a BMI of 19 kg/m2, and a recent HbA1c value was 63 mmol/mol (7.9%). You record her sitting blood pressure as 119/67 mmHg and her standing value as 99/72 mmHg. You notice some patches of vitiligo on her face. What should we do next?Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/diabetes-and-endocrinology/ep-31-diagnosing-and-managing-addisons-disease-in-primary-care.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

n this episode, which has been recorded for Chronic Conditions Month 2021, Dr Peter Bagshaw (Clinical Lead in Dementia and Mental Health, South Gloucestershire CCG) and Dr Rob Hampton (Portfolio GP, Leicester) explore the use of opioids for musculoskeletal pain and examine alternative approaches to treatment. Do opioids have a role in managing musculoskeletal pain? How are guidelines in this area evolving? In what ways is our understanding of psychosomatic contributors improving? What should GPs be looking at in consultations, especially when time is limited?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/rheumatology/ep-30-opioids-and-musculoskeletal-pain.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 2021, Dr Yassir Javaid (Cardiovascular and Diabetes Clinical Lead, Nene CCG) and Dr Kevin Fernando (GP Partner at North Berwick Health Centre and Education Director for GPnotebook Education) discuss the detection of chronic kidney disease in primary care. What do the different tests tell us? What are the most up-to-date guidelines on investigations for CKD, and what do they recommend we do? How often should we be conducting tests for renal function and albuminuria?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-29-investigations-for-chronic-kidney-disease-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 episode, which has been recorded for Chronic Conditions Month 2021, Dr Steve Holmes (Clinical Respiratory Lead for NHS Somserset) and Dr Peter Bagshaw (Clinical Lead in Dementia and Mental Health, South Gloucestershire CCG) explore the impact that COVID-19 has had on mental health, including among people who have not been infected. How has self-isolation and shielding affected different people? What is the particular impact on children and younger people? What has the toll been on carers? Which people may struggle with "returning to normal"? How can we support people with "long COVID"? What is the potential role for talking therapies in this area?More information on Chronic Conditions month can be found here.Resources discussed in this episode:Somerset Emotional Wellbeing PodcastAccess episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/covid-19/ep-28-mental-health-implications-of-the-covid-19-pandemic.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 2021, Dr Steve Holmes (Clinical Respiratory Lead for NHS Somserset) and Dr Anthony Cunliffe (National Lead GP Adviser at Macmillan Cancer Support) discuss cancer as a long-term condition from a primary care perspective. How is the landscape of cancer care changing, with respect to the role of primary care clinicians? Why is accurate coding so important? In what ways can clinicians better individualise care in this area? What resources are available to support difficult conversations?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/oncology/ep-27-managing-cancer-in-the-primary-care-setting.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 2021, Dr Peter Bagshaw (Clinical Lead in Dementia and Mental Health, South Gloucestershire CCG) and Dr Kevin Fernando (GP Partner at North Berwick Health Centre and Education Director for GPnotebook Education) discuss the interplay between diabetes and severe mental illness (SMI). What exactly is meant by SMI? How prevalent is mental illness in people with diabetes? What is the role of the gut–brain axis? What signs should clinicians be looking out for in spotting depression?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-26-severe-mental-illness-and-diabetes.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

In this epsiode, which has been recorded for Chronic Conditions Month 2021, Dr Peter Bagshaw (Clinical Lead in Dementia and Mental Health, South Gloucestershire CCG) and Dr Yassir Javaid (Cardiovascular and Diabetes Clinical Lead, Nene CCG) discuss the management of palpitations in primary care. How can we identify those patients with palpitations who have a significant cardiac abnormality or are at risk of an adverse outcome? What are the main causes of palpitations – including those that might have a psychological basis? What are the roles of history-taking and investigations? Finally, what red flags do we need to look out for?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-25-palpitations-when-to-worry-and-what-is-the-interplay-with-mental-illness.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Steroids are prescribed for a range of health conditions. In this podcast, which has been recorded for Chronic Conditions Month 2021, Dr Steve Holmes (Clinical Respiratory Lead for NHS Somserset) and Dr Kevin Fernando (GP Partner at North Berwick Health Centre and Education Director for GPnotebook Education) discuss the factors that primary care clinicians need to be aware of when prescribing these drugs. What are the most common side effects with steroid use? What do clinicians need to do to minimise the risk of adrenal crisis when withdrawing steroids? What should sick-day guidance look like for people on long-term steroid treatment? How vigilant do clinicians need to be for steroid-induced diabetes?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-24-key-considerations-when-prescribing-steroids.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

In her first podcast for GPnotebook, Dr Kate Chesterman discusses new evidence on the management of children with non-blanching rashes with Dr Edward Snelson. Dr Snelson is a Consultant Emergency Paediatrician at Sheffield Children’s Hospital and is the author of the blog GPpaedstips. Should we be treating every non-blanching rash as meningococcal disease, and if not, why not? What important differentials do we want to consider in children with a fever and a non-blanching rash? Can GPs safely decide which children require emergency treatment?Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/paediatrics/ep-23-non-blanching-rash-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, Kevin Fernando discusses the case of Lyndsey: a 44-year-old lady who presents to us in primary care with recurrent dizzy episodes over the last month. Lyndsey feels like her head is spinning. She feels nauseated with these episodes, but there is no history of vomiting. Lyndsey can walk unaided but feels very unsteady on her feet during these episodes. The dizziness can last for hours before resolving. There is no clear precipitant to these episodes, and there is no history of headache. Lyndsey denies any hearing loss or tinnitus. What should we do next?Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/neurology/ep-22-diagnosis-and-management-of-vertigo-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 episode, Dr Kevin Fernando discusses thrombocytosis in the context of suspected cancer. How should an unexplained high platelet count be interpreted and managed in primary care? Which cancers are most commonly associated with thrombocytosis? Aside from underlying malignancy, what are the other possible causes? What further investigations and referrals should we consider, and when?Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/haematology/managing-unexplained-high-platelet-counts-in-primary-care.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.