GPnotebook Podcast

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.

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.

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.

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.

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.

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.

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.

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.DisclaimerThis 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.

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 James Waldron is joined by Dr Mark Graham (GP from Nottingham with experience in dermatology) to explore how to invest time initially to achieve the right diagnosis. The discussion considers differential diagnoses, clinical examination and management.Access episode show notes containing key references and take-home points at:https://gpnotebook.com/en-GB/podcasts/cardiovascular-medicine/ep-204-red-legs.DisclaimerThis 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.

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 essential anatomy of the oral cavity, clarify how it differs from the oropharynx and examine the major risk factors driving disease development, including tobacco, alcohol, human papillomavirus (HPV) and immunosuppression. We also discuss clinical presentation, red-flag features, diagnostic pathways, staging principles and current management strategies. Most importantly, we focus on the role GPs play in early detection, timely referral and multidisciplinary care.Access episode show notes containing key references and take-home points at:https://gpnotebook.com/en-GB/podcasts/ear-nose-and-throat/ep-203-oral-mucosal-cancer.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

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 closely resemble more serious neurological pathology, including posterior circulation stroke, making accurate assessment essential in both primary and acute care settings. This episode examines the underlying causes, key clinical features, important differentials and evidence-based treatment strategies. It aims to refine our diagnostic reasoning, avoid common pitfalls and strengthen confidence when evaluating patients presenting with acute vertigo, hearing loss and associated neuro-otological symptoms in everyday general practice.Access episode show notes containing key references and take-home points at:https://gpnotebook.com/en-GB/podcasts/ear-nose-and-throat/ep-202-labyrinthitis.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

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 key references and take-home points at:https://gpnotebook.com/en-GB/podcasts/dermatology/ep-201-pityriasis-rosea.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

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 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 hepatitis C matters to primary care now more than ever. Together, they discuss who should be tested, how to interpret results, what happens after diagnosis and the central role GPs play in the NHS Hepatitis C Elimination Programme. This practical, confidence-building conversation focuses on normalising testing, reducing stigma and being curious, helping primary-care clinicians identify patients who could benefit from life-changing treatment.Access episode show notes containing key references and take-home points at:https://gpnotebook.com/en-GB/podcasts/infectious-disease/ep-200-hepatitis-c.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

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 modern approaches in diagnosis, staging and treatment. He also explores why outcomes differ so dramatically across regions, how molecular insights are reshaping its therapy and what this disease continues to teach us about prevention and early detection.Access episode show notes containing key references and take-home points at:https://gpnotebook.com/en-GB/podcasts/gastroenterology/ep-199-gastric-cancer.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

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 lead to significant local destruction, functional impairment and disfigurement. In this episode, Dr Roger Henderson takes a closer look at BCC beyond the surface, exploring its clinical variability, underlying biology and evolving management strategies.Access episode show notes containing key references and take-home points at:https://gpnotebook.com/en-GB/podcasts/oncology/ep-198-basal-cell-cancer.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

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 where pressure remains normal. He considers diagnostic strategies, including tonometry and visual field testing, and emphasises the importance of early detection. Finally, he covers glaucoma management, from pharmacologic therapy and laser procedures to surgical interventions and minimally invasive options, highlighting individualised approaches for each subtype.Access episode show notes containing key references and take-home points at:https://gpnotebook.com/en-GB/podcasts/ophthalmology/ep-197-glaucoma.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

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 hoarseness and vocal fatigue to dry cough, and discuss red flags that signal more serious pathology. We also consider infectious and non-infectious causes, management strategies and the subtle ways patient behaviour and environment can influence recovery.Access episode show notes containing key references and take-home points at:https://gpnotebook.com/en-GB/podcasts/ear-nose-and-throat/ep-196-acute-laryngitis.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

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 manifestations, diagnostic tools and management strategies. In this episode, Dr Roger Henderson discusses how chronic insults from viral hepatitis, alcohol or metabolic disease lead to progressive fibrosis, the development of portal hypertension and multisystem involvement.Access episode show notes containing key references and take-home points at:https://gpnotebook.com/en-GB/podcasts/gastroenterology/ep-195-liver-cirrhosis.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

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 include abnormal foot biomechanics, limited ankle dorsiflexion, posterior chain tightness, obesity and prolonged weight-bearing. In this episode, Dr Roger Henderson looks at the epidemiology and pathophysiology of plantar fasciitis, reviews key clinical features and examination findings, discusses differential diagnoses and appropriate investigations, and outlines evidence-based management strategies, with a focus on practical guidance for primary-care clinicians.Access episode show notes containing key references and take-home points at:https://gpnotebook.com/en-GB/podcasts/musculoskeletal-medicine/ep-194-plantar-fasciitis.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

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 how chronic reflux reshapes the oesophageal lining, who is at greatest risk and how modern surveillance and endoscopic therapies have transformed management. He also discusses evolving guidelines, emerging technologies and practical implications for everyday clinical practice.Access episode show notes containing key references and take-home points at:https://gpnotebook.com/en-GB/podcasts/gastroenterology/ep-193-barretts-oesophagus.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

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, alongside management strategies, prognosis and indications for surgical intervention, with particular attention to patients with diabetes and endocrine disorders who experience more severe and prolonged disease.Access episode show notes containing key references and take-home points at:https://gpnotebook.com/en-GB/podcasts/musculoskeletal-medicine/ep-192-adhesive-capsulitis.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

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 symmetrical erythema that may progress to maceration, fissures, discharge and secondary infection. The diagnosis is mainly clinical, with cultures or potassium hydroxide testing when needed. Management focuses on reducing moisture and friction, treating infections and using gentle barrier protection. In this episode, Dr Roger Henderson looks at how to identify and manage this condition, which is commonly seen in primary care.Access episode show notes containing key references and take-home points at:https://gpnotebook.com/en-GB/podcasts/dermatology/ep-191-intertrigo.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

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 clinical evaluation supported by imaging (especially magnetic resonance imaging) to assess cartilage integrity and patellar alignment. Most patients improve with long-term conservative therapy focused on quadriceps strengthening, hip stabilisation and activity modification. Surgical intervention is reserved for persistent, symptomatic cases or significant maltracking. Early recognition helps prevent progression to patellofemoral osteoarthritis. In this episode, Dr Roger Henderson looks at how best to recognise the condition in our surgeries and the best plan of action for our patients.Access episode show notes containing key references and take-home points at:https://gpnotebook.com/en-GB/podcasts/musculoskeletal-medicine/ep-190-chondromalacia-patella.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

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. Management focuses on cardiovascular risk reduction, smoking cessation, supervised exercise therapy, antiplatelet treatment and statins. Revascularisation is considered only when symptoms continue to limit lifestyle despite optimal therapy. Although limb loss is uncommon, cardiovascular mortality is high, making systemic risk management essential. In this episode, Dr Roger Henderson gives an overview of the condition and looks at how best to diagnose and manage it.Access episode show notes containing key references and take-home points at:https://gpnotebook.com/en-GB/podcasts/cardiovascular-medicine/ep-189-intermittent-claudication.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

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 references and take-home points at:https://gpnotebook.com/en-GB/podcasts/dermatology/ep-188-pityriasis-versicolor.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.