In this episode, Dr Kate Chesterman talks to Dr Briony Arrowsmith, who is a Consultant Paediatrician at the Haven, a sexual assault referral centre in London. They discuss the many and varied ways that sexual abuse can present, as well as the considerations surrounding who the abuse should be disclosed to. They talk through the physical health concerns that need to be addressed and the role of the sexual assault referral centre in the care of abused children and their families. Finally, they dis...
Apr 28, 2023•29 min•Ep. 73
In this episode, which has been recorded for Chronic Conditions Month 2023, Dr Yassir Javaid (GP with a Specialist Interest in Cardiology) discusses auscultation of the heart sounds. Auscultation is an important aspect of the cardiac examination and can give an indication of significant underlying structural heart disease – particularly valve disease, which is becoming increasingly prevalent as the population ages. But which patients should be auscultated and what specifically should clinicians ...
Apr 21, 2023•15 min•Ep. 72
The call to adventure is felt by many and general practice is a career that can take you there! As GPs grow their portfolios, they look for interesting and unusual ways to forge their own paths. This can take them all round the world (and back again). In the first episode in a two-part series, Drs James and Rebecca Waldron discuss adventure and expedition medicine, finding inspiration and opportunities, preparing oneself and getting started on the journey. Rebecca recently returned from a 3-mont...
Apr 14, 2023•20 min•Ep. 71
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 n...
Mar 31, 2023•13 min•Ep. 70
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 ...
Mar 24, 2023•20 min•Ep. 69
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 vitami...
Mar 17, 2023•13 min•Ep. 68
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 ...
Mar 10, 2023•16 min•Ep. 67
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 containi...
Mar 03, 2023•19 min•Ep. 66
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 ...
Feb 24, 2023•16 min•Ep. 65
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 h...
Feb 17, 2023•28 min•Ep. 64
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 ...
Feb 10, 2023•16 min•Ep. 63
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/podcast...
Jan 27, 2023•16 min•Ep. 62
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-pr...
Jan 16, 2023•34 min•Ep. 61
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 th...
Dec 21, 2022•12 min•Ep. 60
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 heal...
Dec 08, 2022•23 min•Ep. 59
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 reference...
Nov 11, 2022•16 min•Ep. 58
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-chro...
Oct 05, 2022•21 min•Ep. 57
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...
Sep 23, 2022•15 min•Ep. 56
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 track...
Sep 12, 2022•14 min•Ep. 55
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...
Aug 19, 2022•18 min•Ep. 54
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-practi...
Aug 12, 2022•23 min•Ep. 53
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 expl...
Aug 08, 2022•21 min•Ep. 52
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-ho...
Jul 28, 2022•18 min•Ep. 51
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-pract...
Jul 22, 2022•11 min•Ep. 50
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 . Di...
Jul 15, 2022•12 min•Ep. 49
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, yo...
Jul 07, 2022•15 min•Ep. 48
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 ben...
May 03, 2022•21 min•Ep. 47
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...
May 02, 2022•23 min•Ep. 46
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 containi...
Apr 30, 2022•21 min•Ep. 45
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 k...
Apr 29, 2022•22 min•Ep. 44