GPnotebook Podcast

In this episode, Kevin discusses the case of Louise, a 19-year-old who has been living with type 1 diabetes for the last 12 years and hypothyroidism for the last 8 years. She presents to us in primary care with a history of recurring unexplained hypoglycaemic episodes despite proactive adjustments to her insulin regimen. In addition to her insulin, she is taking levothyroxine 150 μg/day. She has n...

n this episode, which has been recorded for Chronic Conditions Month 2021, Dr Peter Bagshaw (Clinical Lead in Dementia and Mental Health, South Gloucestershire CCG) and Dr Rob Hampton (Portfolio GP, Leicester) explore the use of opioids for musculoskeletal pain and examine alternative approaches to treatment. Do opioids have a role in managing musculoskeletal pain? How are guidelines in this area...

In this episode, which has been recorded for Chronic Conditions Month 2021, Dr Yassir Javaid (Cardiovascular and Diabetes Clinical Lead, Nene CCG) and Dr Kevin Fernando (GP Partner at North Berwick Health Centre and Education Director for GPnotebook Education) discuss the detection of chronic kidney disease in primary care. What do the different tests tell us? What are the most up-to-date guidelin...

In this episode, which has been recorded for Chronic Conditions Month 2021, Dr Steve Holmes (Clinical Respiratory Lead for NHS Somserset) and Dr Peter Bagshaw (Clinical Lead in Dementia and Mental Health, South Gloucestershire CCG) explore the impact that COVID-19 has had on mental health, including among people who have not been infected. How has self-isolation and shielding affected different pe...

In this episode, which has been recorded for Chronic Conditions Month 2021, Dr Steve Holmes (Clinical Respiratory Lead for NHS Somserset) and Dr Anthony Cunliffe (National Lead GP Adviser at Macmillan Cancer Support) discuss cancer as a long-term condition from a primary care perspective. How is the landscape of cancer care changing, with respect to the role of primary care clinicians? Why is accu...

In this episode, which has been recorded for Chronic Conditions Month 2021, Dr Peter Bagshaw (Clinical Lead in Dementia and Mental Health, South Gloucestershire CCG) and Dr Kevin Fernando (GP Partner at North Berwick Health Centre and Education Director for GPnotebook Education) discuss the interplay between diabetes and severe mental illness (SMI). What exactly is meant by SMI? How prevalent is m...

In this epsiode, which has been recorded for Chronic Conditions Month 2021, Dr Peter Bagshaw (Clinical Lead in Dementia and Mental Health, South Gloucestershire CCG) and Dr Yassir Javaid (Cardiovascular and Diabetes Clinical Lead, Nene CCG) discuss the management of palpitations in primary care. How can we identify those patients with palpitations who have a significant cardiac abnormality or are...

Steroids are prescribed for a range of health conditions. In this podcast, which has been recorded for Chronic Conditions Month 2021, Dr Steve Holmes (Clinical Respiratory Lead for NHS Somserset) and Dr Kevin Fernando (GP Partner at North Berwick Health Centre and Education Director for GPnotebook Education) discuss the factors that primary care clinicians need to be aware of when prescribing thes...

In her first podcast for GPnotebook, Dr Kate Chesterman discusses new evidence on the management of children with non-blanching rashes with Dr Edward Snelson. Dr Snelson is a Consultant Emergency Paediatrician at Sheffield Children’s Hospital and is the author of the blog GPpaedstips. Should we be treating every non-blanching rash as meningococcal disease, and if not, why not? What important diffe...

In this episode, Kevin Fernando discusses the case of Lyndsey: a 44-year-old lady who presents to us in primary care with recurrent dizzy episodes over the last month. Lyndsey feels like her head is spinning. She feels nauseated with these episodes, but there is no history of vomiting. Lyndsey can walk unaided but feels very unsteady on her feet during these episodes. The dizziness can last for ho...

In this episode, Dr Kevin Fernando discusses thrombocytosis in the context of suspected cancer. How should an unexplained high platelet count be interpreted and managed in primary care? Which cancers are most commonly associated with thrombocytosis? Aside from underlying malignancy, what are the other possible causes? What further investigations and referrals should we consider, and when? Access e...

In this episode, Dr Kevin Fernando looks at common questions around non-visible haematuria (NVH) – the condition formerly known as microscopic haematuria. Should we be screening for NVH? What follow-up investigations should we do for people with asymptomatic NVH? Should we change our approach for patients taking aspirin, warfarin or direct-acting oral anticoagulants (DOACs)? Finally, who should we...

In this episode, Kevin examines some common questions regarding vitamin B12 deficiency. In whom should we suspect it? What investigations should be carried out in primary care? How is it associated with folate deficiency? Once a deficiency in vitamin B12 is detected, how should it be managed? Finally, what approach should be taken during the current COVID-19 pandemic, when intramuscular administra...

In the first episode in a new season of the podcast, Kevin discusses helpful guidance on the corrected QT interval in the context of primary care prescribing. Why should we be concerned about prolongation of the QT interval? Which medications can affect QT interval? What other risk factors for QT prolongation should be considered? And for which patients should we recommend electrocardiogram monito...

Kevin is joined by Drs Patrick Holmes, Amrit Lamba and Amar Puttanna to discuss the key take-home points from last week’s American Diabetes Association Virtual Scientific Sessions congress. Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/diabetes-and-endocrinology/diabetes-special-round-up-from-the-ada-2020-virtual-congress . Did y...

Kevin discusses the findings of NHS research on COVID-19 in people with diabetes with study author Professor Partha Kar, National Specialty Advisor – Diabetes with NHS England. Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/diabetes-and-endocrinology/diabetes-and-covid-19-related-mortality-in-england-an-interview-with-partha-kar ....

In the first episode in a new season of the podcast, Kevin discusses helpful guidance on the corrected QT interval in the context of primary care prescribing. Why should we be concerned about prolongation of the QT interval? Which medications can affect QT interval? What other risk factors for QT prolongation should be considered? And for which patients should we recommend electrocardiogram monito...

Kevin discusses some helpful and important clinical guidance on the prevention of adrenal crisis during the pandemic. Notably, this includes not only those patients with primary adrenal insufficiency but also all of those patients on long-term steroid treatment. Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/diabetes-and-endocrino...

Kevin summarises recommendations from the Faculty of Sexual and Reproductive Healthcare to help support women with contraceptive requirements as primary care cuts back on non-essential face-to-face contact to reduce viral transmission. Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/covid-19/effective-contraception-provision-during...

Kevin covers recently updated guidance from the British Society for Haematology on managing vitamin B12 supplementation in primary care within the context of the pandemic. Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/covid-19/vitamin-b12-supplementation-during-the-covid-19-pandemic . Did you know? With GPnotebook Pro, you can ea...

Kevin covers helpful BSR guidance including a risk stratification and scoring grid for those with rheumatological conditions who are receiving immunosuppressive therapies, and considers which patients should be advised to practice shielding. Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/covid-19/british-society-for-rheumatology-g...

Kevin discusses evidence-based practical advice to potentially reduce transmission of coronavirus, in the form of nasal irrigation and gargling with saline solution. Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/infectious-disease/ep-10-covid-19-could-nasal-irrigation-reduce-transmission-and-is-there-a-role-for-anosmia-in-screeni...

Kevin considers the challenges related to managing osteoporosis in the context of conflicting clinical guidelines, including who to assess for fracture risk, who to treat (and with what agent) and how long to treat individuals for. Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/rheumatology/tips-hacks-on-the-diagnosing-managing-os...

Dr Kevin Fernando explains why the thinking around gout needs to change, along with common questions in relation to its management in primary care. What lifestyle advice should be given? When should urate-lowering therapy be offered, and what options are available? For those with a history of gout, how can future episodes be avoided? Access episode show notes containing key references and take-hom...

Dr Kevin Fernando provides a practical overview of the utility of sodium–glucose cotransporter 2 inhibitors, focusing on dosing, cardiovascular and renal safety and the management of adverse events, including dehydration and genital infections. Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/diabetes-and-endocrinology/appropriate-u...