GPnotebook Podcast

GPnotebook

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.

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27 episodes
weekly
Avg 17 min
English

Episodes 27

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Thursday · 19 min
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 discomfort, while identifying those patients who require urgent investigation and treatment. The episode covers the underlying pathophysiology, the clinical features that should raise suspicion and the role of the electrocardiogram and high-sensitivity troponin in contemporary diagnosis. It also explores risk stratification, antiplatelet and anticoagulant therapy, symptom management, indications for invasive assessment and secondary prevention. Most importantly, it considers how careful clinical reasoning can help GPs identify high-risk patients early and avoid missing alternative life-threatening diagnoses. Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/cardiovascular-medicine/ep-224-unstable-angina. Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.
September 10 · 15 min
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 targeted therapies. The episode covers the underlying genetics and pathophysiology, the multisystem nature of the disease and key features of diagnosis and management, along with the revolutionary impact of cystic fibrosis transmembrane conductance regulator modulators. It also considers the continuing importance of holistic, multidisciplinary care and what the future may hold for patients living with cystic fibrosis. Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/respiratory-and-chest-medicine/ep-223-cystic-fibrosis. Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.
September 3 · 11 min
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 traditional management of sleep disorders. Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/nutrition/ep-222-magnesium-and-sleep. Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.
August 27 · 15 min
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 psychological consequences that extend far beyond the ovaries. In this episode, Dr Roger Henderson explores the underlying pathophysiology of PMOS, including the central role of insulin resistance and hyperandrogenism, as well as the diverse ways patients present in clinical practice. He also reviews the current diagnostic approach, important differential diagnoses and evidence-based management, from lifestyle intervention and pharmacological therapy to fertility treatment and long-term metabolic surveillance. Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/gynaecology/ep-221-polyendocrine-metabolic-ovarian-syndrome. Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.
August 20 · 13 min
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 suspicion and the diagnostic criteria are discussed, along with why asking patients how many days each month they take headache medication is often the most important question in the consultation. This episode also examines the proposed mechanisms underlying MOH, practical approaches to diagnosis and evidence-based management, including medication withdrawal, preventive therapy and patient education. By recognising MOH early, GPs can often achieve substantial improvements in headache control and quality of life without simply prescribing another acute treatment. Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/neurology/ep-220-medication-overuse-headache. Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.
August 13 · 7 min
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 episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/dermatology/ep-219-keratosis-pilaris. Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.
August 6 · 21 min
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 context with a quick quiz. Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/diabetes-and-endocrinology/ep-218-hypercalcaemia. Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.
July 30 · 17 min
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 specialist settings, frequently seeking answers for symptoms that may be minimal or entirely absent. Recognising the condition is important, as repeated investigations alone rarely alleviate distress and can contribute to unnecessary healthcare utilisation. This episode explores the clinical features, risk factors, diagnostic criteria, differential diagnosis and evidence-based management of IAD. It also discusses practical strategies for building therapeutic relationships and supporting these patients in a compassionate and effective manner. Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/psychiatry/ep-217-illness-anxiety-disorder. Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.
July 23 · 17 min
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, ranging from temporary and reversible conditions to forms of permanent scarring hair loss; for GPs, distinguishing between these types is essential for accurate diagnosis, timely intervention and effective management. The episode covers the major categories of alopecia, reviews key clinical features and diagnostic approaches, and explores current treatment strategies. It also considers the important psychosocial effects of hair loss and the role GPs play in supporting affected patients. Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/dermatology/ep-216-alopecia. Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.
July 16 · 14 min
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 causes needing to be considered. In this episode, Dr Kate Chesterman discusses the investigation and management of hiccups. Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/general-practice/ep-215-hiccups. Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.
July 9 · 14 min
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 discusses the microbiology and clinical manifestations of pneumococcal disease, reviews the immunological principles behind current vaccines and examines why the UK is transitioning towards the use of the 20-valent pneumococcal conjugate vaccine, or PCV20. It also looks at the wider public health implications of these policy changes and considers how evolving serotype epidemiology continues to shape vaccination strategy in modern clinical practice. Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/infectious-disease/ep-214-pneumococcal-disease. Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.
July 2 · 15 min· Video
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 management and the importance of recognising red-flag symptoms make it a condition that requires careful clinical judgement. Join us as we walk through the typical patient presentation, discuss the underlying inflammatory mechanisms, review current diagnostic approaches and explore practical management strategies, including relapse prevention and steroid-sparing therapies. Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/rheumatology/ep-213-polymyalgia-rheumatica. Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.
June 25 · 18 min· Video
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 clues can help you identify the condition even before the rash appears. We walk through the typical and atypical presentations, highlight key complications and discuss why early treatment can make a meaningful difference to patient outcomes. We also consider high-risk groups, including older adults and immunocompromised patients, where the disease burden is greatest. Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/infectious-disease/ep-212-herpes-zoster. Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.
June 18 · 14 min
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 parotitis, to less obvious presentations like orchitis and aseptic meningitis. We also explore why vaccinated populations can still be affected, how diagnosis is confirmed in practice and what clinicians need to remember about public health reporting. Although usually self-limiting, mumps remains a notifiable disease with important implications for outbreak control and patient counselling in everyday clinical work. Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/infectious-disease/ep-211-mumps. Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.
June 11 · 17 min
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 some clinical scenarios. Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/infectious-disease/ep-210-bacterial-meningitis-and-meningococcal-disease. Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.
June 4 · 16 min
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, including hypogonadism, cardiovascular risk and neuropsychiatric complications. It also reviews how AAS misuse presents in real-world clinical settings, often through indirect signs rather than disclosure. Finally, it covers practical approaches to recognition, withdrawal management and long-term care, equipping GPs to better identify and support patients affected by this evolving, multi-system disorder. Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/general-information/ep-209-anabolic-steroid-misuse. Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.
May 28 · 19 min
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 key clinical presentations, including ocular, bulbar and proximal limb weakness, alongside the risk of life-threatening myasthenic crisis. Diagnostic approaches are reviewed, focusing on antibody testing and electrophysiological studies. Management strategies include symptomatic treatment with acetylcholinesterase inhibitors, immunosuppression and thymectomy in selected patients. Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/neurology/ep-208-myasthenia-gravis. Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.
May 21 · 19 min
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-term disability. Here we break down the modern tissue-based definition of TIA, highlighting how it differs from older time-based concepts and why that matters in our clinical practice. We also explore the importance of sudden focal symptoms and discuss why the first 48 hours carry the greatest risk. We also look at key causes and outline practical approaches to urgent evaluation, risk stratification and management. Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/neurology/ep-207-transient-ischaemic-attack. Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.
May 14 · 15 min
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. Despite advances in prenatal monitoring and management, they remain a leading cause of maternal and foetal morbidity worldwide. Here, we look at the underlying mechanisms, risk factors, clinical features and current management strategies, with a focus on practical insights to support clinical decision-making and improve outcomes for both mother and baby. Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/obstetrics/ep-206-hypertensive-disorders-of-pregnancy. Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.
May 7 · 24 min
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 episode of a series on hepatology and hepatitis, Dr James Waldron is joined by Dr Rik Fijten (GP Partner, Hepatitis C GP Champion for Bexley and GP Clinical Fellow in Gastroenterology) to explore why MASLD matters to GPs, why it is so common and why primary care is central to identifying disease early and preventing progression. They discuss why clinicians need to raise this often “silent” disease proactively and how it should be considered alongside diabetes, hypertension and weight management. The conversation covers how to approach abnormal liver function tests, how to assess fibrosis risk using simple non-invasive tools and how MASLD fits into the wider cardio–renal–metabolic model of long-term condition care. The episode also looks ahead to emerging treatments and what the future may hold for patients. Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/infectious-disease/ep-205-metabolic-dysfunction-associated-steatotic-liver-disease-and-hepatitis. Disclaimer This content is for medical education purposes only and does not constitute clinical advice. While specific drugs and dosages may be discussed, clinicians should always refer to local protocols and official prescribing information before administering medication. Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

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