A bite-sized, regular chat for all healthcare professionals working in primary care. Episodes cover clinical tips and hot topics. New episodes published every Thursday or Friday.
Episodes
Ep 231 – Nasopharyngeal cancer
In this episode, Dr Roger Henderson focuses on nasopharyngeal carcinoma, an uncommon head and neck malignancy in many parts of the world, but one with distinctive epidemiology, biology and patterns of presentation. It has a strong association with Epstein–Barr virus (EBV), occurs with striking geographical and ethnic variation, and often presents with cervical lymphadenopathy rather than obvious s
Ep 230 – Hepatitis B
In this episode, Dr James Waldron is joined by Dr Rik Fijten, a GP with an extended role in gastroenterology, to discuss hepatitis B, the third instalment in a four-part hepatology series. Why are emergency departments (EDs) finding so much hepatitis B through opt-out blood-borne virus testing? Who is most at risk and why is hepatitis B such an important health inequalities issue? The discussion c
Ep 229 – Continuous glucose monitoring
Continuous glucose monitoring (CGM) has moved from being a specialist technology used mainly in type 1 diabetes to becoming one of the most important developments in modern glucose management. What began as a way of collecting more frequent glucose measurements has evolved into a platform capable of displaying trends, predicting future glucose changes and, when integrated with insulin pumps, autom
Ep 228 – Infectious mononucleosis
In this episode, Dr Roger Henderson discusses infectious mononucleosis, a common viral illness that can present a surprisingly complex diagnostic and clinical challenge. Most often associated with Epstein–Barr virus (EBV), infectious mononucleosis is particularly familiar in adolescents and young adults, where fever, pharyngitis, lymphadenopathy and fatigue can create a classic clinical picture. B
Ep 227 – Parasomnia
In this episode, Dr Roger Henderson explores a fascinating and sometimes unsettling area of clinical practice: parasomnias. Sleep is something everyone experiences, but for some patients it is far from quiet or predictable: they may walk, shout, experience vivid nightmares or even physically act out their dreams, leaving both them and their partners confused, frightened or concerned about what the
Ep 226 – Gallstones
In this episode, Dr Roger Henderson discusses gallstone disease, one of the most common disorders affecting the biliary system and a frequent cause of abdominal pain, emergency presentations and gastrointestinal complications. He examines how gallstones develop, focusing on the metabolic, hormonal, genetic and environmental factors that contribute to their formation. The discussion then follows th
Ep 225 – Carotid artery stenosis
In this episode, Dr Roger Henderson explores carotid artery stenosis and its role in the prevention of ischaemic stroke. Carotid disease is common, but managing it effectively is far from straightforward. The key clinical questions are not simply how narrow the artery is, but whether the stenosis is responsible for the patient's neurological symptoms, what mechanism is causing cerebral ischaemia,
Ep 224 – Unstable angina
In this episode, Dr Roger Henderson discusses unstable angina and its place within the spectrum of acute coronary syndrome. Although advances in high-sensitivity troponin testing mean that unstable angina is diagnosed less frequently than in the past, recognising the clinical syndrome remains essential. For GPs, the challenge is distinguishing acute myocardial ischaemia from other causes of chest
Ep 223 – Cystic fibrosis
In this episode, Dr Roger Henderson explores cystic fibrosis, a condition that has undergone one of the most remarkable transformations in modern medicine. Once considered almost exclusively a life-limiting childhood disease, cystic fibrosis is now increasingly recognised as a chronic condition extending well into adult life, thanks to major advances in diagnosis, multidisciplinary care and target
Ep 222 – Magnesium and sleep
The role of magnesium supplements in improving sleep duration and quality has received a great deal of interest, particularly on social media, but why might additional magnesium improve sleep, and is there evidence that it does? In this episode, Dr Kate Chesterman explores these questions and considers whether magnesium supplements could be recommended as an additional option alongside the traditi
Ep 221 – Polyendocrine metabolic ovarian syndrome
Polyendocrine metabolic ovarian syndrome (PMOS) is one of the most common endocrine disorders affecting women of reproductive age, yet it remains widely misunderstood. Although traditionally viewed as primarily a reproductive condition and known as polycystic ovary syndrome, PMOS is now recognised as a complex multisystem disorder with important metabolic, endocrine, dermatological and psychologic
Ep 220 – Medication overuse headache
Medication overuse headache (MOH) is a common but frequently overlooked cause of chronic daily headache, particularly in people with migraine. In this episode, Dr Roger Henderson explores how regular use of acute headache medications can paradoxically drive increasing headache frequency, creating a cycle of persistent pain and escalating medication use. Clinical features that should raise suspicio
Ep 219 – Keratosis pilaris
Keratosis pilaris is a common and harmless condition that can, nevertheless, cause distress in some people due to its appearance. In this episode, Dr Kate Chesterman considers the pathophysiology and diagnostic features of keratosis pilaris, before discussing self-care advice and treatment options that can be recommended to try to reduce the rough, bumpy and dry appearance of this condition.Access
Ep 218 – Hypercalcaemia
In this episode, Dr Hannah Rosa discusses hypercalcaemia and how it can be managed in five steps. She reviews when to suspect hypercalcaemia and the most common causes of a raised calcium. She also covers further investigations that can be undertaken in primary care, management in secondary care and follow-up in primary care. At the end, there is a chance to put the learning into a clinical contex
Ep 217 – Illness anxiety disorder
In this episode, Dr Roger Henderson discusses illness anxiety disorder (IAD), a condition that presents unique challenges for both patients and healthcare professionals. Formerly known as hypochondriasis, IAD is characterised by a persistent fear of having or developing a serious medical illness despite appropriate evaluation and reassurance. These patients often present in primary care and specia
Ep 216 – Alopecia
In this episode, Dr Roger Henderson provides an overview of alopecia, one of the most common yet often misunderstood conditions encountered in clinical practice. While hair loss is rarely life-threatening, it can have a profound impact on a patient’s psychological wellbeing, self-esteem and quality of life. Alopecia is not a single disease but a clinical sign with numerous underlying causes, rangi
Ep 215 – Hiccups
Hiccups are a common symptom, with short-lived episodes usually being a source of amusement rather than distress. For these acute episodes, simple nonpharmacologic techniques are often effective. However, persistent hiccups greatly affect quality of life and can be difficult to manage. There is often significant diagnostic dilemma, with potentially serious and even life-threatening underlying caus
Ep 214 – Pneumococcal disease
In this episode, Dr Roger Henderson explores pneumococcal disease and the major changes coming to the UK pneumococcal vaccination programme in 2026. Although often overshadowed by other infectious diseases, Streptococcus pneumoniae remains a leading cause of preventable morbidity and mortality worldwide, particularly among older adults, young children and immunocompromised patients. This episode d
Ep 213 – Polymyalgia rheumatica
In this episode, Dr Roger Henderson explores polymyalgia rheumatica (PMR), a common but often underestimated inflammatory condition affecting older adults. Although many clinicians recognise the classic presentation of shoulder and hip girdle stiffness, PMR is far more than a simple musculoskeletal complaint. Its overlap with giant cell arteritis (GCA), the challenges of long-term steroid manageme
Ep 212 – Herpes zoster
In this episode, Dr Roger Henderson looks at a condition every GP recognises, but not always in its earliest or most subtle form: shingles. Also known as herpes zoster, it is far more than just a painful rash – it’s the reactivation of a neurotropic virus that may have been lying dormant for decades within the nervous system. Here, we explore how and why that reactivation occurs and what clinical
Ep 211 – Mumps
In this episode, Dr Roger Henderson looks at a condition that many clinicians associate with pre-vaccine paediatrics, yet which still occurs: mumps. While its incidence has dramatically declined since the introduction of the measles, mumps and rubella vaccine, it has not disappeared. Here, we walk through why mumps still matters clinically, from its systemic viral nature and characteristic parotit
Ep 210 – Bacterial meningitis and meningococcal disease
In this episode, Dr Hannah Rosa discusses bacterial meningitis and meningococcal disease, with a focus on the NICE guideline that was published in 2024. She reviews how to recognise bacterial meningitis and meningococcal disease and answers the key question: when to give antibiotics outside of hospital? At the end of this episode, there is a chance to put the learning into a clinical context with
Ep 209 – Anabolic steroid misuse
In this episode, Dr Roger Henderson explores the growing clinical challenge of anabolic–androgenic steroid (AAS) misuse, a condition increasingly seen in everyday practice. Here, we examine how AAS use has shifted toward appearance-driven motivations, the role of muscle dysmorphia and the influence of gym culture and online communities. This episode highlights key pathophysiological effects, inclu
Ep 208 – Myasthenia gravis
In this episode, Dr Roger Henderson explores the pathophysiology, clinical features and management of myasthenia gravis, an autoimmune disorder affecting the neuromuscular junction. It highlights how antibodies, most commonly against acetylcholine receptors, impair neuromuscular transmission, leading to fatigable weakness that worsens with activity and improves with rest. The discussion emphasises
Ep 207 – Transient ischaemic attack
In this episode, Dr Roger Henderson looks at one of the most time-sensitive diagnoses in general practice: the transient ischaemic attack, or TIA. Often underestimated because symptoms resolve quickly, a TIA is in fact a powerful warning sign of an impending ischaemic stroke. For GPs, recognising and responding to this brief neurological event can make the difference between prevention and long-te
Ep 206 – Hypertensive disorders of pregnancy
In this episode, Dr Roger Henderson explores hypertensive disorders of pregnancy – one of the most important and potentially life-threatening conditions encountered in obstetric care. Affecting up to one in 10 pregnancies, these disorders range from mild hypertension to severe complications such as preeclampsia, eclampsia and HELLP (haemolysis, elevated liver enzymes and low platelets) syndrome. D
Ep 205 – Metabolic dysfunction-associated steatotic liver disease and hepatitis
Liver disease is often overlooked in primary care, yet it is one of the fastest-growing causes of morbidity and mortality in the UK. Metabolic dysfunction-associated steatotic liver disease (MASLD), previously known as non-alcoholic fatty liver disease (NAFLD), now affects around one-third of the UK population, with prevalence rising and all-cause mortality worsening over time. In this second epis
Ep 204 – Red legs
Red legs are frequently seen in primary care but are often misdiagnosed. With a need for antimicrobial stewardship, it is important to identify the cause, rather than automatically rely on antibiotic prescription. Importantly, all that is red is not cellulitis; venous or varicose eczema is a common cause of swollen and red legs and requires a different management approach. In this episode, Dr Jame
Ep 203 – Oral mucosal cancer
In this episode, Dr Roger Henderson explores an important and often overlooked area of head and neck oncology: oral mucosal cancer. As GPs, we frequently encounter oral lesions in primary care, and they are also often seen in dental practice, emergency settings and specialist clinics; however, distinguishing benign conditions from early malignancy can be challenging. Here, we break down the essent
Ep 202 – Labyrinthitis
In this episode, Dr Roger Henderson explores labyrinthitis from a GP’s perspective, moving beyond the textbook definition to focus on practical diagnosis, pathophysiology and management. Although often grouped broadly under causes of acute vertigo, true labyrinthitis is a distinct inflammatory condition of the inner ear that combines vestibular and auditory dysfunction. Its presentation can closel
Ep 201 – Pityriasis rosea
Pityriasis rosea is a common and self-limiting condition, but it can cause significant anxiety and distress for patients. In this episode, Dr Kate Chesterman discusses the expected course and clinical findings that are associated with this condition, as well as exploring possible differentials, treatment options, potential complications and referral criteria.Access episode show notes containing ke
Ep 200 – Hepatitis C
Hepatitis C was once considered a chronic, life-limiting condition with difficult treatments and significant stigma. Today, it is one of the great success stories of modern medicine: curable in the vast majority of patients with short courses of well-tolerated oral therapy. Yet, thousands of people in the UK remain undiagnosed. In this first episode of a series on hepatology and hepatitis, Dr Jame
Ep 199 – Gastric cancer
Gastric cancer is often described as a disease in decline, yet it remains one of the deadliest malignancies worldwide. For many GPs, it is a diagnosis that still arrives late, cloaked in vague symptoms and missed opportunities for early intervention. In this episode, Dr Roger Henderson takes a deep, clinically focused look at gastric cancer, from its evolving epidemiology and underlying biology to
Ep 198 – Basal cell cancer
Basal cell carcinoma (BCC) is a diagnosis most GPs encounter regularly, yet its familiarity often disguises its true impact. As the most common cancer in humans, BCC shapes clinical workload, healthcare costs and patient quality of life far more than its low mortality rate suggests. Although it is frequently described as slow growing and low risk, delayed recognition or inadequate treatment can le
Ep 197 – Glaucoma
Glaucomas are a leading cause of irreversible vision loss worldwide. They encompass a range of disorders, including primary open-angle, angle-closure, normal-tension and secondary glaucomas, each with distinct pathophysiology, risk factors and clinical presentations. In this episode, Dr Roger Henderson looks at how elevated intraocular pressure drives optic nerve damage and also examines cases whe
Ep 196 – Acute laryngitis
In this episode, Dr Roger Henderson looks at acute laryngitis, a condition that is both common and deceptively complex. Often dismissed as a simple cold-related voice change, acute laryngitis actually offers GPs insights into airway physiology, vocal mechanics and clinical reasoning. Understanding the nuances of this condition is essential. We look at its typical presentation, from sudden hoarsene
Ep 195 – Liver cirrhosis
Cirrhosis represents the end stage of chronic liver injury, characterised by fibrosis and regenerative nodules that disrupt normal liver architecture. While the liver can compensate for years, patients often remain asymptomatic until complications such as ascites, variceal bleeding or hepatic encephalopathy arise. Understanding cirrhosis involves exploring its pathophysiology, systemic manifestati
Ep 194 – Plantar fasciitis
Plantar fasciitis is a common cause of heel pain, accounting for up to 15% of foot complaints requiring professional care and affecting both athletic and sedentary populations. It is best understood as a mechanically driven, degenerative condition resulting from repetitive loading that exceeds the plantar fascia’s capacity for repair, rather than a purely inflammatory process. Key risk factors inc
Ep 193 – Barrett’s oesophagus
Barrett’s oesophagus sits at the crossroads of gastroesophageal reflux disease and oesophageal cancer, making it a condition every clinician should understand. Although most patients with Barrett’s will never develop malignancy, it remains the only identifiable precursor to oesophageal adenocarcinoma, a cancer with rising incidence and high mortality. In this episode, Dr Roger Henderson looks at h
Ep 192 – Adhesive capsulitis
In this episode, Dr Roger Henderson looks at adhesive capsulitis, commonly known as a frozen shoulder, reviewing its epidemiology, risk factors and underlying pathophysiology, as well as typical clinical presentations, disease staging and key examination findings that aid diagnosis in primary care. Diagnostic challenges, differential diagnoses and the role of imaging and injections are covered, al
Ep 191 – Intertrigo
Intertrigo is an inflammatory condition of opposing skin surfaces, driven by friction, heat and moisture that weaken the skin barrier and invite secondary infections, especially Candida and bacteria. It affects all ages, from infants with diaper dermatitis to older adults with limited mobility. It is more common in hot climates and in patients with obesity or diabetes. Clinically, it presents with
Ep 190 – Chondromalacia patella
Chondromalacia patella (CMP), sometimes called “runner’s knee”, is a degenerative condition involving softening and breakdown of the patellar articular cartilage, most often due to abnormal patellofemoral mechanics, muscular imbalance or repetitive micro-trauma. It commonly presents with anterior knee pain worsened by stair descent, squatting, running or prolonged sitting. Diagnosis relies on clin
Ep 189 – Intermittent claudication
Intermittent claudication is a hallmark symptom of peripheral arterial disease and reflects widespread atherosclerosis. It presents as predictable exertional leg pain caused by inadequate blood flow during exercise. The pain location helps localise arterial stenosis and diagnosis relies on history, examination and the ankle–brachial index, with imaging reserved for intervention planning. Managemen
Ep 188 – Pityriasis versicolor
Pityriasis versicolor is a fungal condition caused by overgrowth of Malassezia – a yeast that is commonly found on the skin in most people. In this episode, Dr Kate Chesterman discusses the clinical findings that become visible when there is overgrowth of this yeast and explores the treatment options available to manage initial and recurrent episodes.Access episode show notes containing key refere
Ep 187 – Quiz of the year 2025
In this episode, Dr Hannah Rosa, Dr Kate Chesterman and Dr Roger Henderson invite you to join them for the annual GPnotebook quiz. 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 meetings. This quiz is based on the facts that they have found the most usefu
Ep 186 – Olecranon bursitis
Olecranon bursitis is the inflammation of the bursa overlying the olecranon process, presenting as localised, fluctuating posterior elbow swelling that necessitates clinical differentiation between aseptic (traumatic, crystalline) and septic aetiologies for appropriate management. In this episode, Dr Kate Chesterman discusses the risk factors for olecranon bursitis as well as its diagnostic featur
Ep 185 – Lung cancer
Lung cancer is the leading cause of cancer-related death worldwide and is classified into two main types: non-small cell lung cancer (NSCLC), which accounts for most cases and the more aggressive small cell lung cancer (SCLC). Early detection is crucial for improving outcomes, but symptoms often emerge late in the disease course. In episode 126, Dr Hannah Rosa looked at the challenges of diagnosis
Ep 184 – Parvovirus B19
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 si
Ep 183 – Post-traumatic stress disorder
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
Ep 182 – Melanoma
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
Ep 181 – Management of hyperkalaemia in primary care
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
Ep 180 – Rethinking HIV: reducing HIV-related stigma
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 he
Ep 179 – Paraesthesia
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
Ep 178 – Tremor
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
Ep 177 – Postnasal drip
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 u
Ep 176 – Lower urinary tract symptoms in men
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 detru
Ep 175 – Scabies
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 containin
Ep 174 – Acute cholecystitis
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
Ep 173 – Abdominal aortic aneurysm
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 th
Ep 172 – Keloid scars
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,
Ep 171 – Rethinking HIV: prevention and pre-exposure prophylaxis
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 topi
Ep 170 – Aortic stenosis
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 obstruct
Ep 169 – Shin splints (medial tibial stress syndrome)
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, D
Ep 168 – Ectopic pregnancy
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 intrauter
Ep 167 – Acute pancreatitis
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 improv
Ep 166 – Hand–arm vibration syndrome
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 p
Ep 165 – Chronic kidney disease among adults in primary care: management
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 trea
Ep 164 – Cauda equina syndrome
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 wit
Ep 163 – Chronic kidney disease among adults in primary care: testing, diagnosis and referral
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 guidel
Ep 162 – Ankylosing spondylitis
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
Ep 161– Post-herpetic neuralgia
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 describe
Ep 160 – Rethinking HIV: dealing with a positive test result
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 topi
Ep 159 – Baker’s cyst
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.
Ep 158 – Rotator cuff tears
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
Ep 157 – Ganglion cysts
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 intervent
Ep 156 – Carpal tunnel syndrome
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
Ep 155 – Temporal arteritis
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
Ep 154 – Febrile seizures
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,
Ep 153 – Asthma treatment, monitoring and self-management: what's changed in the 2024 BTS, NICE and SIGN guideline?
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
Ep 152 – Rethinking HIV: from testing to transformation
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
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