GPnotebook Podcast

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...

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...

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...

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...

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...

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,...

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...

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...

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...

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...

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...

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. Acces...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...