))
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.
…
continue reading
Jeep Legend Rick Péwé and the crew of Gone-Gpn discuss everything related to Willys and Jeep. We're All Jeep All The Time! Lockers Before Lightbars - Fan Q & A Willys -vs- Wrangler - Rick faces off with the new guys in the Jeep industry Toolbox Talk - Jeep tech, tips and tricks Trail Side - Favorite trails, places we want to go and trail reports. Special guests and product reviews!
…
continue reading
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 nig…
…
continue reading
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 appen…
…
continue reading
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 …
…
continue reading
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 aetiolo…
…
continue reading
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 t…
…
continue reading
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 mi…
…
continue reading
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 diagn…
…
continue reading
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 n…
…
continue reading
Emollients are moisturisers that help soothe, hydrate and protect the skin by forming an occlusive barrier to lock in moisture. They are commonly used to treat dry, rough and scaly skin conditions such as eczema, psoriasis and dermatitis, and work by softening and smoothing the skin, reducing water loss and improving the skin's natural barrier func…
…
continue reading
Many children have additional needs, and occupational therapy can play an important role in helping these children take part in everyday activities as well as in supporting their families and carers. In this episode, Dr James Waldron talks with Dr Naomi Fox, a paediatric occupational therapist, about ways to improve care and consultations for child…
…
continue reading
Echocardiography is an essential tool in a wide range of clinical scenarios. Appropriate use of an echocardiogram ("echo" scan) can improve clinical outcomes by increasing diagnostic accuracy, providing non-invasive or minimally invasive assessment of disease status and risk stratification and enabling real-time monitoring and guidance of intervent…
…
continue reading
The term goitre refers to an abnormal enlargement of the thyroid gland, typically caused by iodine deficiency or autoimmune diseases such as Graves' disease or Hashimoto's thyroiditis, as well as hormonal changes, thyroid nodules or thyroid cancer. Symptoms include a visible neck swelling, throat tightness, coughing, hoarseness and difficulty swall…
…
continue reading
Global travel offers many opportunities for adventure – but some come with medical considerations. An infrequent but important consultation is altitude medicine for people planning to travel to areas high above sea level. In episode 80, Dr James Waldron and Dr Rashbal Ghattaora talked about how to approach a travel consultation, with notes on relev…
…
continue reading
1
Ep 117 – Improving early diagnosis of type 2 diabetes: addressing the challenge of undiagnosed cases
22:01
Undiagnosed type 2 diabetes is an increasing and concerning trend in the UK, particularly among Black and Asian ethnic groups and in areas of high deprivation. Early diagnosis and management are crucial, particularly in younger adults and underserved populations. Therefore, education, screening, and tailored treatment pathways are needed, but reach…
…
continue reading
Transient loss of consciousness (TLoC) affects nearly half the population of the UK at some point in their lives and is not an uncommon presentation in primary care. In this episode, Dr Kate Chesterman discusses the initial assessment of these patients and the factors that will help to differentiate between vasovagal syncope, cardiac syncope and ep…
…
continue reading
Polycystic ovary syndrome (PCOS) is the most common endocrinopathy in women of reproductive age, as well as being a major cause of infertility and pregnancy complications. It includes symptoms of hyperandrogenism, the presence of hyperandrogenaemia, oligo-ovulation or anovulation and polycystic ovarian morphology on ultrasound. It is strongly assoc…
…
continue reading
In this episode, Dr Hannah Rosa discusses erectile dysfunction. Using the latest guidelines, this episode takes you through everything to consider when first reviewing a patient with erectile dysfunction, including key points to cover in the history and examination and which investigations to order. A four-step approach to management is discussed, …
…
continue reading
Quitting smoking is the single most important thing a smoker can do to improve their health, and with the right combination of support, medication and determination, individuals can successfully overcome their nicotine addiction and enjoy a smoke-free life. For many, quitting smoking completely can be a challenge due to the addictive nature of nico…
…
continue reading
In this episode, Dr Hannah Rosa discusses a condition that affects 95% of people aged 11–30 to some extent: acne. The 2021 NICE guideline on acne vulgaris is explored in detail, and broken down into four steps: Getting the diagnosis of acne right, including how to grade its severity What constitutes good general skin-care advice Management options …
…
continue reading
Testicular torsion is a urological emergency that usually affects young men, and a high index of suspicion is vital to ensure prompt diagnosis and management. A history and physical examination consistent with testicular torsion requires immediate surgical assessment for scrotal exploration – and if the initial examination suggests testicular torsi…
…
continue reading
Disclosing sexual violence is a difficult and emotional prospect for a patient and the way a GP responds can set the course of that person’s journey. It is important we get it right, but it is a complex topic. In this second part of our series on sexual violence, Dr James Waldron is joined again by Hayley Wilson (Consent and Sexual Violence Develop…
…
continue reading
Hypothyroidism, or an underactive thyroid gland, is increasingly common as people get older, but it may often be undiagnosed or diagnosed late due to the insidious nature of some of its symptoms. These include fatigue, weight gain, sensitivity to cold, constipation, dry skin, hair loss and depression. Common causes of hypothyroidism include autoimm…
…
continue reading
Restless leg syndrome (RLS) is prevalent in around 5–10% of the population and can result in an impact on quality of life that is comparable to conditions such as type 2 diabetes and osteoarthritis. It can result in significant impairments in sleep, energy, daily activities and behaviour and is associated with anxiety and depression in those who ex…
…
continue reading
Benign prostatic hyperplasia (BPH) is an extremely common condition seen in clinical practice, and one which can cause considerable difficulties in older men. Common symptoms include frequent urination, difficulty starting urination, weak urine stream or the need to urinate during the night – all of which significantly impact on quality of life. Tr…
…
continue reading
Understanding sexual violence is vitally important in primary care. A GP may be the first (or only) individual spoken to by a person who has experienced sexual violence. But how often does the experience disclosed represent the full scope of the issue? How much sexual violence goes unreported? What has changed about our understanding of sexual viol…
…
continue reading
In this episode, Dr Hannah Rosa discusses a topic which is at the heart of good clinical care: empathy. Research has shown that empathy decreases as medical students progress through medical school and that in society empathy levels have fallen over recent decades. But what does this mean for us working in primary care? What are the benefits that i…
…
continue reading
Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disorder that primarily affects the joints. Causing joint pain, stiffness, swelling and reduced joint motion, its exact cause is still unknown, but is believed to involve a combination of factors. In this episode, Dr Roger Henderson looks at the aetiology of RA, diagnostic testing and t…
…
continue reading
In this episode, which has been recorded for Chronic Conditions Month 2024, Dr Yassir Javaid (GP with a Specialist Interest in Cardiology) examines the role of the QRISK3 calculator in the primary prevention of cardiovascular disease. He considers the development of the tool, the differences between QRISK2 and QRISK3 (including the additional risk …
…
continue reading
Diverticular disease is a condition characterised by the presence of small pouches, called diverticula, in the wall of the colon (large intestine). These pouches can develop when weak spots in the colon's muscular wall give way under pressure. Diverticular disease encompasses two main conditions: diverticulosis and diverticulitis. In this episode, …
…
continue reading
Coeliac disease (CD) is a chronic autoimmune disorder that primarily affects the small intestine and is triggered by the consumption of gluten, a protein found in wheat, barley, rye and sometimes oats. When individuals with CD ingest gluten, their immune system responds by damaging the lining of the small intestine. This damage impairs the absorpti…
…
continue reading
In this episode, Dr Hannah Rosa takes a look around the world at some of the different strategies that are being used to try to reduce the health complications caused by alcohol. She then looks at the latest research which links alcohol as a primary cause of a variety of cancers, before finishing with a consideration of the economic cost. Access ep…
…
continue reading
Obesity is a medical condition characterised by excessive accumulation of body fat, to the point where it may have adverse effects on health. Its incidence is steadily rising in both young people and adults. It is typically measured using BMI, but this has limitations and may not always accurately represent the level of obesity. While genetics and …
…
continue reading
Recurrent vulvovaginal candidiasis is reported in 6% of women of reproductive age. It has a significant impact on an individual’s quality of life that is comparable to conditions such as asthma and migraine. Appropriate management of the acute infection and subsequent maintenance treatment can help to reduce the burden of this condition. In this ep…
…
continue reading
The most common cause of peptic ulcers (gastric and duodenal) is infection with Helicobacter pylori (H. pylori) or the long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs). Other factors such as excessive alcohol consumption, smoking, stress and certain medical conditions may also contribute to the development of peptic ulcers. Symptoms o…
…
continue reading
Dysphagia refers to difficulty swallowing. It can occur at any age and may be caused by various conditions, including neurological disorders, muscular disorders, structural abnormalities, or even psychological factors. Dysphagia can range from mild to severe, and it can lead to complications such as malnutrition, dehydration and aspiration pneumoni…
…
continue reading
Trigeminal neuralgia (TN) is a condition characterised by severe, shooting pain in the face, along the trigeminal nerve. The pain can be triggered by even mild stimulation of the face, such as brushing teeth, touching the face or eating. It is often described as one of the most excruciating pains known to medicine and it can significantly impact a …
…
continue reading
Anal fissures are small tears or cracks in the lining of the anus which can cause pain, bleeding and discomfort, particularly during bowel movements. They are quite common and can be caused by various factors such as constipation, diarrhoea, childbirth or anal trauma. Treatment often involves keeping the stool soft and avoiding straining during bow…
…
continue reading
Haemorrhoids are a very common finding in the Western world and are often seen in our surgeries. They are frequently under-reported so their exact incidence can be difficult to quantify; however, estimates are that 50% of the population experience them by the age of 50. Because many people attribute symptoms of more serious pathology to haemorrhoid…
…
continue reading
We live in an age of increasing digital connectivity where technology plays an ever-prominent role in peoples’ lives. While social media can provide a platform for support and connection, we are all susceptible to the negative effects of overuse or misuse, particularly on our sleeping patterns and our mental health. In this episode, the second in a…
…
continue reading
Lateral hip pain is a common presenting complaint in primary care. It can result in significant morbidity with reduction in activity levels and associated implications for leisure activities, employment and overall wellbeing. In this episode, Dr Kate Chesterman reviews the likely differential diagnoses, including some key questions to consider when…
…
continue reading
We are constantly connected to the web! You are likely connected right now, trying to decide what podcast to listen to! In this episode, Dr James Waldron interviews Dr Alex Lai of the WorkWell Doctors in the first of a series about staying well in an increasingly digital world. How do we check in with our use of digital tools? What impact might it …
…
continue reading
Bowen's disease, also known as squamous cell carcinoma in situ, is a type of skin disorder characterised by the presence of precancerous or intra-epidermal squamous cell carcinoma. It was named after John T. Bowen, the dermatologist who first described the condition in 1912. Bowen's disease primarily affects the outermost layer of the skin (epiderm…
…
continue reading
Obsessive–compulsive disorder (OCD) is a prevalent mental health condition characterised by persistent, intrusive thoughts (obsessions) and repetitive behaviours or mental acts (compulsions) aimed at alleviating anxiety. Individuals with OCD often find themselves trapped in a distressing cycle, as compulsions provide only temporary relief, perpetua…
…
continue reading
NICE published its last guideline on depression in 2009. Since that time, the prevalence of depression has increased, especially among vulnerable adults during the COVID-19 pandemic. NICE published a new guideline in June 2022 to reflect this. In this episode, Dr Roger Henderson looks at the new recommendations on managing depression in primary car…
…
continue reading
Many pathology tests are ordered unnecessarily in primary care and this can include testing for inflammatory markers. The most common examples of tests typically ordered are for erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels, with occasional requests for plasma viscosity (PV) too. Although such tests can be useful in givin…
…
continue reading
Sweating is a crucial way to reduce our body temperature, such as when doing strenuous physical activity or when in a hot environment. Hyperhidrosis is defined as excessive sweating beyond what is physiologically required or normal. It can be categorised as primary (idiopathic), secondary to other conditions, or as a side effect of some medications…
…
continue reading
Testosterone deficiency (TD) is an increasingly common problem with significant health implications, but the diagnosis and management of this condition may present problems in primary care. Low levels of testosterone in men are associated with increased risk of incident type 2 diabetes mellitus, worse outcomes in chronic kidney disease and COVID-19…
…
continue reading
Dry skin is an extremely common condition that occurs in all skin colours and ethnic groups; however, differences in skin colour can cause significant differences in the incidence, presentation and treatment of different skin conditions. Although dry skin may cause similar symptoms among different skin tones, the appearance may make it more challen…
…
continue reading
Although pityriasis capitis (dandruff) is not a serious medical condition, it causes significant embarrassment and self-esteem issues in many people who suffer from it. It is extremely common, affecting up to half the global adult population, and its recurring nature is often a source of frustration. It can impact on primary care workload and can a…
…
continue reading
Lyme disease can present a number of particular difficulties in primary care, and these are often linked to clinical findings and the availability and timing of testing. In this podcast, Dr Roger Henderson discusses those and looks at Lyme disease’s three stages — early, disseminated and late — and whether it can be diagnosed clinically if erythema…
…
continue reading
