GPnotebook Podcast

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.

In this episode, Dr Kevin Fernando looks at common questions around non-visible haematuria (NVH) – the condition formerly known as microscopic haematuria. Should we be screening for NVH? What follow-up investigations should we do for people with asymptomatic NVH? Should we change our approach for patients taking aspirin, warfarin or direct-acting oral anticoagulants (DOACs)? Finally, who should we refer and how urgently?Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/urology/ep-20-management-of-non-visible-haematuria-microscopic-haematuria-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 examines some common questions regarding vitamin B12 deficiency. In whom should we suspect it? What investigations should be carried out in primary care? How is it associated with folate deficiency? Once a deficiency in vitamin B12 is detected, how should it be managed? Finally, what approach should be taken during the current COVID-19 pandemic, when intramuscular administration of hydroxocobalamin may be challenging?Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/neurology/ep-19-investigating-vitamin-b12-deficiency-and-pernicious-anaemia-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 the first episode in a new season of the podcast, Kevin discusses helpful guidance on the corrected QT interval in the context of primary care prescribing. Why should we be concerned about prolongation of the QT interval? Which medications can affect QT interval? What other risk factors for QT prolongation should be considered? And for which patients should we recommend electrocardiogram monitoring?Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/cardiovascular-medicine/ep-18-managing-the-risk-of-drug-induced-qt-prolongation-in-primary-care.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Kevin is joined by Drs Patrick Holmes, Amrit Lamba and Amar Puttanna to discuss the key take-home points from last week’s American Diabetes Association Virtual Scientific Sessions congress.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/diabetes-and-endocrinology/diabetes-special-round-up-from-the-ada-2020-virtual-congress.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Kevin discusses the findings of NHS research on COVID-19 in people with diabetes with study author Professor Partha Kar, National Specialty Advisor – Diabetes with NHS England.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/diabetes-and-endocrinology/diabetes-and-covid-19-related-mortality-in-england-an-interview-with-partha-kar.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

In the first episode in a new season of the podcast, Kevin discusses helpful guidance on the corrected QT interval in the context of primary care prescribing. Why should we be concerned about prolongation of the QT interval? Which medications can affect QT interval? What other risk factors for QT prolongation should be considered? And for which patients should we recommend electrocardiogram monitoring?Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/diabetes-and-endocrinology/sick-day-guidance-for-diabetes-drugs-and-the-management-of-hypoglycaemia.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Kevin discusses some helpful and important clinical guidance on the prevention of adrenal crisis during the pandemic. Notably, this includes not only those patients with primary adrenal insufficiency but also all of those patients on long-term steroid treatment.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/diabetes-and-endocrinology/primary-adrenal-insufficiency-long-term-steroid-use-and-covid-19-infection.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Kevin summarises recommendations from the Faculty of Sexual and Reproductive Healthcare to help support women with contraceptive requirements as primary care cuts back on non-essential face-to-face contact to reduce viral transmission.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/covid-19/effective-contraception-provision-during-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.

Kevin covers recently updated guidance from the British Society for Haematology on managing vitamin B12 supplementation in primary care within the context of the pandemic.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/covid-19/vitamin-b12-supplementation-during-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.

Kevin covers helpful BSR guidance including a risk stratification and scoring grid for those with rheumatological conditions who are receiving immunosuppressive therapies, and considers which patients should be advised to practice shielding.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/covid-19/british-society-for-rheumatology-guidance-dmard-steroid-therapy-and-covid19.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Kevin discusses evidence-based practical advice to potentially reduce transmission of coronavirus, in the form of nasal irrigation and gargling with saline solution.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/infectious-disease/ep-10-covid-19-could-nasal-irrigation-reduce-transmission-and-is-there-a-role-for-anosmia-in-screening.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Kevin considers the challenges related to managing osteoporosis in the context of conflicting clinical guidelines, including who to assess for fracture risk, who to treat (and with what agent) and how long to treat individuals for.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/rheumatology/tips-hacks-on-the-diagnosing-managing-osteoporosis-in-primary-care.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Dr Kevin Fernando explains why the thinking around gout needs to change, along with common questions in relation to its management in primary care. What lifestyle advice should be given? When should urate-lowering therapy be offered, and what options are available? For those with a history of gout, how can future episodes be avoided?Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/rheumatology/tips-hacks-on-diagnosing-managing-gout-in-primary-care.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Dr Kevin Fernando provides a practical overview of the utility of sodium–glucose cotransporter 2 inhibitors, focusing on dosing, cardiovascular and renal safety and the management of adverse events, including dehydration and genital infections.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/diabetes-and-endocrinology/appropriate-use-and-safety-profile-of-sglt2-inhibitors.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Have your notebooks at the ready as Dr Kevin Fernando rounds off 2019 with tips on topical oestrogen, mirtazapine prescribing, symptoms associated with withdrawal of varenicline, valvular atrial fibrillation and gout, among others.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/general-information/top-10-hacks-tips-from-gpnotebook-clinics-2019.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Dr Kevin Fernando considers the optimal use of these tests: can we reduce unecessary testing, unecessary referrals and primary care workload?Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/general-practice/tips-hacks-on-the-use-of-esr-crp-in-primary-care.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Dr Kevin Fernando summarises the key points for primary care from the NICE guideline update.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/cardiovascular-medicine/hacks-tips-on-managing-hypertension-in-primary-care-including-nice-ng136-key-messages.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Dr Kevin Fernando discusses detection and management of the condition in primary care, including how presentation in children differs from that in adults.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/paediatrics/obstructive-sleep-apnoea-in-children.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Dr Kevin Fernando takes us through brief case scenarios to illustrate diagnostic tips and pitfalls in primary care.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/diabetes-and-endocrinology/diagnostic-dilemmas-and-classification-conundrums-in-diabetes.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Kevin discusses interpretation and management of mildly abnormal liver blood tests in primary care. What are the possible causes? And what should the next step be?Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/general-practice/abnormal-liver-blood-test.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.