Episodes

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 a...

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...

The National Osteoporosis Guideline Group (NOGG) clinical guideline for osteoporosis was updated in December 2024. In this episode, Dr Hannah Rosa shares 10 things she learnt from the updated guideline about how to prevent and treat osteoporosis. Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/musculoskeletal-medicine/ep-144-osteoporosis-key-learnings-from-the-nogg-2024-clinical-guideline. Did you know? With GPnotebook Pro, yo...

Irritable bowel syndrome (IBS) is a chronic condition characterised by abdominal pain associated with bowel dysfunction and is one of the most common gastroenterology presentations in primary care. The pain is often relieved by defecation and is sometimes accompanied by abdominal bloating, with no structural abnormalities to explain the pain. IBS occurs in up to 20% of the adult population, and its aetiology is multi-factorial. In this episode, Dr Roger Henderson looks at the diagnosis of IBS al...

Colorectal cancer (CRC) is the fourth most common malignancy in the UK and a major cause of morbidity and mortality. It refers to malignancies that arise from the caecum to the rectum and can be detected on screening, on imaging or endoscopy, or following presentation with change in bowel habit, iron deficiency anaemia or bowel obstruction. Its management depends on the stage of the disease and patient factors, with treatment options including surgical resection, chemotherapy and radiotherapy. I...

Hidradenitis suppurativa (HS) is a chronic inflammatory dermatosis that typically affects areas of pilosebaceous gland-containing skin. In HS, patients often suffer recurrent attacks of discharging and painful lesions that can require multiple courses of antibiotics or surgical drainage. The condition causes significant morbidity, distress and sometimes long-term scarring. In this episode, Dr Roger Henderson looks at the disease process, classification and classical features of HS as well as con...

Seasonal affective disorder (SAD) is a form of depression that occurs at specific times of the year, most commonly during the autumn and winter months when daylight hours are shorter. Characterised by symptoms such as persistent sadness, fatigue and changes in appetite or sleep patterns, SAD is more than just the "winter blues." It is a clinically recognised but often underdiagnosed condition that can significantly impact an individual's quality of life. In this episode, Dr Roger Henderson looks...

Perinatal mental health (PNMH) problems affect one in five women and one in ten men. They can present in several ways, including depression and anxiety, but also post-traumatic stress disorder, adjustment disorder, obsessive-compulsive disorder and psychosis. In the third episode of the perinatal mental health series, Dr James Waldron and Dr Jenny Barnes (GP and Perinatal Mental Health Champion, Warwickshire) discuss what to do in clinical practice when PNMH issues are suspected. Prevention is b...

Morton’s neuroma is a common condition that results in forefoot pain. It is a condition that can often be diagnosed in primary care and managed with simple changes in footwear and over-the-counter treatments. In this episode, Dr Kate Chesterman discusses the classic presentation of Morton’s neuroma, considers the need for any investigations, and updates us on appropriate self-care advice that can be given to patients. Access episode show notes containing key references and take-home points at: ...

The 6–8-week postnatal check is a chance to better support mental health in new parents. In this second episode in a series on perinatal mental health, Dr James Waldron speaks with Dr Jenny Barnes – a GP in Warwickshire and perinatal mental health champion – about making the most of this critical opportunity. This episode discusses addressing mental health in both mothers and partners, the hidden toll of social media and understanding associated conditions such as obsessive-compulsive disorder a...

In this episode, Dr Hannah Rosa invites you to join her in the first ever GPnotebook quiz of the year. The GPnotebook education team have been reflecting upon all that they have learnt over the past 12 months, in both their day-to-day clinical work and through delivering GPnotebook Study Group events. The quiz is based on the facts that the team have found most useful, interesting and sometimes surprising. So, have a pen and a piece of paper ready, and give it a go! Access episode show notes co...

Tinnitus can be frustrating for both patients and clinicians as there is some misinformation and misunderstanding about its aetiology and treatment options. For some people with tinnitus there is significant distress and a reduced quality of life that may not always be appreciated by healthcare professionals. Fortunately, most cases of tinnitus can be treated successfully, and there are a number of management techniques that can reduce its impact, including sound therapy, stress reduction and tr...

One in six UK males will be diagnosed with prostate cancer in their lifetime. In the UK prostate cancer is the most common male cancer, with over 55,000 new cases diagnosed every year. There has been much discussion in the media recently regarding whether men under the age of 50 should have access to prostate-specific antigen (PSA) testing, particularly if they have a strong family history of prostate cancer. In this episode, Dr Roger Henderson takes a look at prostate cancer, including guidance...

Syphilis is a sexually transmitted infection caused by the bacterium Treponema pallidum. Known for its varied symptoms and potential to progress through multiple stages, syphilis can have serious health consequences if left untreated, affecting organs like the heart, brain and nerves. The infection spreads primarily through direct contact with syphilitic sores, which typically occur on the genital, anal or oral areas. Though syphilis was once thought to be largely under control, its prevalence h...

In this episode, Dr Hannah Rosa reflects upon the changing relationship between young people and alcohol. She examines the latest statistics before discussing the Chief Medical Officer for England’s guideline on alcohol consumption for children and young people. The focus then moves on to the harms that we now know that alcohol can cause to young people, especially to the developing brain, before finishing with emphasising the role that professionals in primary care play in supporting these youn...

Perinatal mental health (PNMH) issues refer to the period from the point of conception to a child’s first birthday. It encompasses several different mental health conditions and components far beyond the traditional understanding of post-natal depression and has an important impact on families and society. In part, the huge burden and associated cost is driven by how common PNMH problems are for both men and women. PNMH issues are more common than any physical health problem in pregnancy, so the...

Croup is a respiratory condition typically affecting children, characterised by a distinctive barking cough, hoarseness and difficulty breathing. Caused primarily by viral infections, especially the parainfluenza virus, it inflames the larynx, trachea and bronchi, leading to swelling and obstruction in the airway. Croup symptoms often worsen at night and can be triggered by environmental factors such as cold air. Treatment ranges from home remedies like humidified air and hydration to medical in...

Acute appendicitis is a medical emergency characterised by the sudden onset of inflammation in the appendix. As one of the leading causes of abdominal pain that necessitates surgical intervention, appendicitis can occur at any age, though it is most common in adolescents and young adults. The condition is primarily caused by a blockage in the appendix, which leads to bacterial infection, swelling and increased pressure. If left untreated, acute appendicitis can progress to life-threatening compl...

Breast pain affects around 70% of women at some point in their lives and is a common reason for referral to breast clinics. It is often a cause of anxiety for women who may be concerned that their pain might be associated with breast cancer. In this episode, Dr Kate Chesterman discusses the assessment of the patient presenting with breast pain and explains the lack of association between breast cancer and breast pain in those with a normal clinical examination. She considers cyclical, non-cyclic...

Fibromyalgia is a condition characterised by chronic widespread pain together with multiple muscular tender points or associated fatigue, sleep disturbance or cognitive dysfunction in the absence of a well-defined underlying organic disease. The majority of patients present with both tender points and associated symptoms, although the exact aetiology of fibromyalgia is unknown. In this episode, Dr Roger Henderson takes a look at possible triggers, diagnostic approaches, possible treatments (incl...

In this episode, Dr Hannah Rosa reflects upon the poor lung cancer survival rates in the UK. She asks whether we are doing enough chest X-rays in primary care and whether we could be detecting lung cancers earlier. She delves further into this by exploring why diagnosing lung cancer is challenging, reviewing the guidelines and latest research and then discussing when we should continue to investigate for lung cancer even if the patient has had a normal chest X-ray. She finishes by reviewing the ...

Generalised anxiety disorder (GAD) is a common condition defined as chronic, excessive worry for at least 6 months that causes distress or impairment, and is hard to control. It is in part a diagnosis of exclusion: physical examination and laboratory studies are generally normal if no co-existing physical or mental health conditions or substance misuse issues exist. Treatment is primarily with psychotherapy (usually cognitive behavioural therapy), serotonergic antidepressants or a combination of...

Ovarian cancer is a common female malignancy. Patients often present with vague, non-specific symptoms such as abdominal bloating, early satiety and dyspepsia (suggestive of upper abdominal disease). Other symptoms are more suggestive of pelvic disease, such as pelvic pain, abdominal or pelvic pressure, low back pain and urinary urgency. Late diagnosis has a significantly adverse impact on survival rates, so prompt diagnosis and treatment is crucial. In this episode, Dr Roger Henderson looks at ...

In episode 121, care and consultations for children with additional needs, and how to help these children and their families, were discussed. In this episode, Dr James Waldron is again joined by Dr Naomi Fox. Here, they look at harnessing the power of proprioception to improve behaviour and sleep and reduce stress in children. Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/paediatrics/ep-123-proprioception-and-sleep-for-childre...