GPnotebook Podcast

Parvovirus B19 (slapped cheek syndrome) is a common and usually mild, self-limiting viral illness. Certain populations, such as pregnant women and their unborn babies, those who are immunocompromised or those with underlying haematological conditions, are at increased risk of complications as the virus can affect red blood cell production. In this episode, Dr Kate Chesterman explores the common signs and symptoms in healthy individuals, as well as discussing the investigation and management of those at higher risk of complications.

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Post-traumatic stress disorder (PTSD) may develop (either immediately or delayed) following exposure to a stressful event or situation of an exceptionally threatening or catastrophic nature. It is characterised by four groups of symptoms: intrusion symptoms, avoidance, negative alterations in cognition and mood and alterations in arousal and reactivity. These symptoms must persist for more than 1 month and cause functional impairment for a diagnosis to be made. Its presentation is often comorbid with conditions such as depression, anxiety, anger and substance use disorder. In this episode, Dr Roger Henderson looks at the aetiology of PTSD, its assessment, treatment options and...

Melanoma is among the most common forms of cancer – and causes of cancer-related death – among young adults. Its prevalence in this group has been associated with sunbathing and sunbed use. Reducing exposure to ultraviolet light is critical in the primary prevention of melanoma. Clinical features of lesion asymmetry, border irregularity, colour variability, diameter and evolution over time should raise suspicion for melanoma and prompt further assessment with dermoscopy. In this episode, Dr Roger Henderson looks at melanoma, including the different types and how to recognise them, referral criteria, treatments and prognosis.

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In this episode, Dr Hannah Rosa and Dr Will Hinchliffe (Consultant in Renal and General Medicine working in the north-east and north Cumbria) discuss the management of hyperkalaemia in primary care. They break the management down into six steps, so that when you are next faced with blood test results that show a raised potassium level, you will know exactly what to do. They first discuss who needs admission into hospital, then how to manage hyperkalaemia in the community and finally the role of potassium binders.

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In this final episode of a four-part series on HIV and primary care, Dr James Waldron is joined again by Dr Grace Bottoni (HIV and Hepatitis C GP Champion, Lewisham) and special guest Darren Knight (CEO of George House Trust). Together, they explore the importance of language in healthcare and how reducing HIV-related stigma is key to increasing engagement with primary care, improving lives and helping to prevent HIV transmission. This conversation brings together clinical insight, lived experience and practical strategies for making HIV care truly inclusive.

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Paraesthesia is an indication of an abnormality that impacts the sensory pathways at any point from the peripheral sensory nervous system right up to the sensory cortex. The essential tool for the diagnosis of this condition is obtaining a concise patient history. This history must accurately reflect the patient's experience, including the provoking and alleviating factors, along with any existing concurrent conditions, such as diabetes and all treatments that might potentially lead to neuropathies. Treatment is based on the relevant diagnosis and mechanism to address the cause. In this episode, Dr Roger Henderson discusses paraesthesia, covering its causes, investigations...

A tremor is defined as an involuntary rhythmic oscillation of one or more body parts, mediated by alternating contractions of reciprocally acting muscles. Tremors typically affect the upper extremities but can also affect the head, chin, voice or legs. Although some tremors may be mild and cause little impact to quality of life, requiring no treatment, others may impair activities of daily living or occupation, which may lead to embarrassment and social withdrawal. In this episode, Dr Roger Henderson gives an overview of the different types of tremor, looking at ways of distinguishing them and how each is usually...

Postnasal drip is a condition where excess mucus from the nose and sinuses accumulates and flows down the back of the throat. This can lead to symptoms such as throat clearing, coughing, a scratchy or sore throat, hoarseness and bad breath. Common causes include allergies, colds, sinus infections, weather changes, acid reflux and irritants such as smoke. Treatment typically involves managing the underlying cause through medications such as antihistamines, decongestants and nasal sprays, as well as maintaining proper hydration. If symptoms persist for more than 10 days or are accompanied by fever or discoloured mucus, medical evaluation is recommended to...

Lower urinary tract symptoms (LUTS) are storage, voiding and post-micturition symptoms affecting the lower urinary tract. LUTS can significantly reduce men's quality of life and may point to serious problems in the urogenital tract. The pathogenesis of LUTS is multifactorial and can include one or several diagnoses, commonly benign prostatic obstruction, nocturnal polyuria (polynocturia) and detrusor muscle instability. LUTS are common and not necessarily a reason for suspecting prostate cancer. In this episode, Dr Roger Henderson gives an overview of male LUTS, including investigations, referral criteria and treatment options.

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Scabies is a condition that can cause significant distress due to the intense itching associated with the condition and concerns about social stigma. In this episode, Dr Kate Chesterman discusses the risk factors for contracting scabies, the signs and symptoms associated with the condition, preferred treatment options and indications for involving secondary care.

Access episode show notes containing key references and take-home points at:

https://gpnotebook.com/en-GB/podcasts/dermatology/ep-175-scabies.

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Acute cholecystitis is often seen in primary care patients and is a major complication of cholelithiasis. Symptomatic gallstones occur in up to 10% of patients before developing cholecystitis. Patients typically present with pain and localised tenderness, with or without guarding, in the upper right quadrant. In this episode, Dr Roger Henderson provides an overview of this common problem, looking at its risk factors, causes, symptoms, investigations and the treatment options available, as well as the prognosis and advice to give our patients to help prevent recurrence.

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Abdominal aortic aneurysms (AAAs) are potentially life-threatening and have a poor prognosis if ruptured. Arterial aneurysms are defined as a permanent localised dilatation of the vessel, enlarging significantly compared to a relatively normal diameter of the adjacent artery. An AAA is characterised by abnormal focal dilation of the abdominal aorta that is often detected incidentally or only at the time of rupture. In this episode, Dr Roger Henderson looks at AAA risk factors, clinical presentations, diagnostic investigations, screening, treatments and prognosis.

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Keloid scars are a form of abnormal scarring that occur in susceptible individuals and often appear to be more common in darker skin types. Often observed between the ages of 10 and 30 years, and associated with skin trauma or inflammation, their diagnosis is a clinical one. Unfortunately, no definitive treatment is currently available, but options include injectable preparations and cryotherapy, as well as surgery and radiotherapy. In this episode, Dr Roger Henderson looks at the aetiology, epidemiology and presentation of keloid scars as well as the efficacy of current treatments.

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What if one of the most misunderstood diagnoses of the past is now one of the most manageable chronic conditions? How can GPs play a pivotal role in tackling stigma, increasing testing and improving outcomes for people living with HIV?

Dr James Waldron is joined by Dr Grace Bottoni (HIV and Hepatitis C GP Champion, Lewisham) for a series of podcasts about HIV. Together, they explore a range of topics with experts in the field. In this third episode, they talk with Dr Emily Mabonga (Consultant in HIV Medicine, London) about pre-exposure prophylaxis (PrEP...

Aortic stenosis (AS) is an obstruction of blood flow from the left ventricle into the aorta due to narrowing at the level of the aortic valve. In Europe, it is the most common valvular disease requiring treatment and is the second most frequent cause for cardiac surgery. By the age of 80, it occurs in almost 10% of adults and has a mortality rate of about 50% at 2 years unless the outflow obstruction is relieved. In this episode, Dr Roger Henderson looks at the aetiology, pathophysiology, clinical presentation, diagnostic evaluation, treatment options and prognosis associated with this common condition usually seen in...

Shin splints are a common type of leg pain caused by repetitive stress on the bones and muscles in the lower leg, particularly around the tibia. The condition, also known as medial tibial stress syndrome (MTSS), is characterised by pain and tenderness along the inner or front of the lower leg. It is often triggered by activities like running, jumping or other high-impact sports. In this episode, Dr Roger Henderson looks at risk factors, how to diagnose it, typical treatment options and prognosis.

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In the UK, ectopic pregnancy is diagnosed in approximately 11 out of every 1,000 pregnancies and typically presents 6–8 weeks after the last normal menstrual period but can be earlier or later. The risk of ectopic pregnancy increases with prior ectopic pregnancy, tubal surgery, history of sexually transmitted infections, smoking, in vitro fertilisation or if the woman is pregnant despite intrauterine device usage. Classical symptoms and signs of ectopic pregnancy are pain, vaginal bleeding and amenorrhoea. Haemodynamic instability and cervical motion tenderness may indicate rupture or imminent rupture of an ectopic pregnancy. In this episode, Dr Roger Henderson gives an overview of ho...

Acute pancreatitis is an inflammatory condition of the pancreas, most commonly caused by bile stones or excessive use of alcohol. It is one of the most common diseases of the gastrointestinal tract leading to hospital admission. In most patients, the disease takes a mild course, where moderate fluid resuscitation, management of pain and nausea and early oral feeding result in rapid clinical improvement. The severe form is life-threatening, with mortality rates of up to 30%. In this episode, Dr Roger Henderson looks at how to quickly diagnose acute pancreatitis, what the common risk factors are, the treatment options and prognosis.<...

Hand–arm vibration syndrome is a chronic, progressive disorder of the upper limbs resulting from prolonged exposure to vibration. It encompasses vascular, neurological and musculoskeletal injury, often presenting with a combination of symptoms that may severely impact daily functioning and quality of life. This condition was historically observed among forestry workers and miners but now affects people in a broad range of industries, including construction, engineering, vehicle maintenance and utilities. In this episode, Dr Roger Henderson looks at how to recognise the condition in patients, as well as diagnostic tests, treatment options and prognosis.

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In the second part of a two-episode series on chronic kidney disease (CKD), Dr Hannah Rosa is joined again by Dr Will Hinchliffe, a Consultant in Renal and General Medicine working in the North East and North Cumbria. They discuss the management options for CKD that can be initiated in primary care. They first look at how to empower patients with lifestyle and dietary advice, then the medical treatment options we have for CKD and when to start them, before finishing with holistic care, especially with regards to cardiovascular disease. This episode is mainly based on the NICE assessment...

Cauda equina syndrome (CES) is caused by compression of the lumbosacral nerve roots that extend below the spinal cord. The most common cause is disc prolapse at the L4/5 or L5/S1 level and stenosis of the spinal canal. Less commonly, compression may be due to pathology in a higher disc or to a tumour, infection or trauma. Typical symptoms and signs of CES include leg and/or back pain, together with one or more of: bladder or bowel dysfunction; altered perianal, perineal or genital sensation; motor weakness affecting both legs; sexual dysfunction. It is a medical emergency and...

In the first of a two-episode series on chronic kidney disease (CKD), Dr Hannah Rosa is joined by Dr Will Hinchliffe, a Consultant in Renal and General Medicine working in the North East and North Cumbria. They discuss which people are at risk of CKD, how to test for it and diagnose it and, lastly, which patients require a referral to secondary care. This episode is mostly based on the NICE guideline on assessment and management of CKD and aims to help you to improve the lives of your patients by diagnosing CKD earlier and referring those who may...

Ankylosing spondylitis (AS) is a chronic, immune-mediated inflammatory disorder that predominantly targets the axial skeleton, especially the spine and sacroiliac joints. This condition evolves insidiously, often beginning in young adulthood, and gradually imposes limitations on spinal mobility, eventually leading to fusion in advanced cases. Beyond its skeletal manifestations, AS can also extend its reach to various extra-articular organs, emphasising the systemic nature of the disease. In this episode, Dr Roger Henderson looks at its clinical presentation, how to diagnose it, the treatment options available and its prognosis.

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Post-herpetic neuralgia (PHN) is the most common complication following an episode of shingles and can affect up to one in five people. Pain is typically described as burning or like an electric shock and is often associated with allodynia and hyperalgesia. It can have significant effects on both physical and psychological well-being, with sleep disturbance and depression being frequently described. PHN is notoriously difficult to treat, with a significant number of patients achieving only a modest reduction in their symptoms despite combinations of analgesic agents. In this episode, Dr Kate Chesterman explores the treatment options available in primary care.<...

What if one of the most misunderstood diagnoses of the past is now one of the most manageable chronic conditions? How can GPs play a pivotal role in tackling stigma, increasing testing and improving outcomes for people living with HIV?

Dr James Waldron is joined by Dr Grace Bottoni (HIV and Hepatitis C GP Champion, Lewisham) for a series of podcasts about HIV. Together, they explore a range of topics with experts in the field. In this second episode, they talk with Dr Mel Rosenvinge (Consultant HIV Specialist, Lewisham and Greenwich NHS Trust) about...

Baker’s cysts commonly present in primary care. In this episode, Dr Kate Chesterman discusses the pathophysiology, underlying aetiology and management options for this condition, describing possible differential diagnoses and indications for investigations. She also explains the self-care options for those with minimal symptoms and how to escalate treatment, as well as when to consider a referral.

Access episode show notes containing key references and take-home points at:

http://gpnotebook.com/en-GB/podcasts/musculoskeletal-medicine/ep-159-bakers-cyst.

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A rotator cuff injury is an event that causes pain in the shoulder. This can be due to a tear, inflammation or narrowing of the space within the shoulder joint. The rotator cuff muscles interlock to work as a unit. They help to stabilise the shoulder joint and also help with shoulder joint movement. In this episode, Dr Roger Henderson takes a specific look at tears to the rotator cuff – a problem often seen in primary care. The episode covers causes, diagnosis and treatment, including conservative approaches and surgical options.

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Ganglion cysts, also sometimes referred to as synovial cysts, are the most common benign soft-tissue masses of the hand and wrist. These cysts arise from the synovial lining of joints or tendon sheaths and are filled with a gelatinous, mucin-rich fluid. Despite their benign nature, ganglion cysts can cause discomfort, restrict motion and cause neurovascular compression (requiring medical intervention in some cases). In this episode, Dr Roger Henderson looks at epidemiology, pathophysiology, clinical presentation, diagnostic modalities, differential diagnoses and treatment options.

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Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy, primarily affecting the median nerve at the level of the wrist. The condition results from compression of the median nerve within the carpal tunnel, leading to sensory and motor impairments in the affected hand. There are a range of causes for the condition, and treatments range from simple conservative measures to surgery. In this episode, Dr Roger Henderson looks at how to recognise the condition, some of the clinical and diagnostic tests available, when to refer to secondary care and management options including both surgical and non-surgical measures.

Temporal arteritis, also known as giant cell arteritis, is an inflammatory condition that affects the large- and medium-sized arteries, primarily those in the head. It most commonly occurs in adults over 50, particularly women. The exact cause is unknown, but it is believed to be an autoimmune response that leads to inflammation and narrowing of the arteries, reducing blood flow. Symptoms include severe headaches, scalp tenderness, jaw pain when chewing and, in severe cases, sudden vision loss. Diagnosis typically involves blood tests, imaging and a temporal artery biopsy. Early detection is crucial to avoid permanent damage and blindness. In this...

Febrile seizures are common in the first 5 years of life, and many factors that increase the risk of such seizures occurring have been identified. Initial evaluation should determine whether features of a complex seizure are present, as well as identifying the source of fever. In this episode, Dr Roger Henderson provides an overview of febrile seizures in childhood and also looks at risk factors, referral criteria, treatment options and prognosis.

Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/paediatrics/ep-154-febrile-seizures

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In this episode, Dr Hannah Rosa continues looking at the new asthma guideline from the British Thoracic Society (BTS), NICE and SIGN, which was published in 2024. This guideline, based on the latest research, contains some big changes, which will hopefully help you to improve the lives of your patients living with asthma. In the first episode in the series (episode 146), Dr Rosa covered suspected asthma, asthma diagnosis and treatment in people aged 12 and over. In this second episode, she focuses on pharmacological treatment in children aged 11 and under, as well as monitoring asthma control and self-management.

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What if one of the most misunderstood diagnoses of the past is now one of the most manageable chronic conditions? How can GPs play a pivotal role in tackling stigma, increasing testing and improving outcomes for people living with HIV?

Dr James Waldron is joined by Dr Grace Bottoni (HIV and Hepatitis C GP Champion, Lewisham) for the first episode in an insightful series that dives into the evolving landscape of HIV care. Together, they will explore a range of topics with experts in the field. In this episode, they talk with Dr Mel Rosenvinge (Consultant HIV...

Dupuytren’s disease is a chronic, progressive condition that primarily affects the palmar and digital fascia of the hand. Over time, fibrous cords form under the skin, thickening and contracting, which can cause the fingers (most often the ring and little fingers) to curl inward. This results in Dupuytren’s contracture, limiting hand function and impacting daily activities. It often starts with the formation of painless nodules in the palm. As the disease progresses, these nodules develop into cords that restrict finger movement. While the condition is not life-threatening, it can significantly affect a person’s quality of life and is...

Roseola infantum is a viral infection primarily affecting infants and young children, most commonly between the ages of 6 and 12 months. It accounts for 10–45% of febrile illnesses in infants, and cases tend to peak in the spring and autumn seasons. Diagnosing roseola is almost always clinical, and for patients with the classic presentation a clinical diagnosis can be made based on physical examination findings and history alone. In this episode, Dr Roger Henderson looks at the causes and typical symptoms of roseola, along with illnesses that may mimic it, treatment options and possible complications of the illness.

Raynaud's phenomenon is a relatively common condition seen in primary care (especially during the autumn and winter months) that is characterised by vasospasm. This causes digits to change colour to white due to a lack of blood flow, usually brought on by cold temperatures. Affected areas subsequently turn blue due to deoxygenation and red due to reperfusion. The most common type is primary (idiopathic) Raynaud’s, affecting around 90% of people with the condition. Secondary Raynaud’s is often the initial manifestation of an associated underlying connective tissue disease. Both primary and secondary Raynaud’s can be painful, but secondary Raynau...

Sickle cell anaemia is a disease of red blood cells, caused by an autosomal recessive single gene defect in the beta-chain of haemoglobin, which results in production of sickle cell haemoglobin. Sickle cells can obstruct blood flow and break down prematurely, and they are associated with varying degrees of anaemia. A common presentation of sickle cell disease (SCD) is a painful sickle crisis, caused by obstruction of small blood capillaries. Treatment includes symptom control (including pain management) and prevention and management of complications. Until now, haematopoietic stem-cell transplantation has been the only potentially curative treatment option, but a new...

Paronychia is a common condition affecting the proximal and lateral nail folds of the hands or feet. In this episode, Dr Kate Chesterman discusses the differences between acute and chronic paronychia and the thinking around the causes and treatment of each. She also gives some tips that we can pass on to our patients regarding self-management and prevention.

Access episode show notes containing key references and take-home points at:

https://gpnotebook.com/en-GB/podcasts/dermatology/ep-147-paronychia.

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In this episode, Dr Hannah Rosa discusses the new asthma guideline from the British Thoracic Society (BTS), NICE and SIGN, which was published in 2024. This guideline, based on the latest research, contains some big changes, which will hopefully help you to improve the lives of your patients living with asthma. In this first part of a two-episode series, topics covered include when to suspect asthma, how to confirm an asthma diagnosis and the pharmacological treatment pathway in people aged 12 and over. The second part of the series, which will be released later in the year, covers pharmacological treatment in...

Around 0.5% of the adult population in England experience problems gambling, 3.8% are at elevated risk of gambling harms and an estimated 7% are negatively affected by someone else’s gambling. NICE has published NG248 – its first recommendations on gambling, covering the identification, assessment and treatment of people over the age of 18 who are experiencing gambling-related harms. The recommendations are also for people of any age affected by someone close to them who is experiencing gambling that harms. In this episode, Dr Roger Henderson looks at some of the key points in the guideline as well as the pharmacological options that are reco...