In this final episode of a four-part series on HIV and primary care, Dr James Waldron is joined again by Dr Grace Bottoni (HIV and Hepatitis C GP Champion, Lewisham) and special guest Darren Knight (CEO of George House Trust). Together, they explore the importance of language in healthcare and how reducing HIV-related stigma is key to increasing engagement with primary care, improving lives and helping to prevent HIV transmission. This conversation brings together clinical insight, lived experience and practical strategies for making HIV care truly inclusive.Access episode show notes containing key references and take-home points at:https://gpnotebook.com/en-GB/podcasts/infectious-disease/ep-180-rethinking-hiv-reducing-hiv-related-stigma (https://gpnotebook.com/en-GB/podcasts/infectious-disease/ep-180-rethinking-hiv-reducing-hiv-related-stigma).Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more (https://gpnotebook.com/en-GB/gpnotebook-pro).

Paraesthesia is an indication of an abnormality that impacts the sensory pathways at any point from the peripheral sensory nervous system right up to the sensory cortex. The essential tool for the diagnosis of this condition is obtaining a concise patient history. This history must accurately reflect the patient's experience, including the provoking and alleviating factors, along with any existing concurrent conditions, such as diabetes and all treatments that might potentially lead to neuropathies. Treatment is based on the relevant diagnosis and mechanism to address the cause. In this episode, Dr Roger Henderson discusses paraesthesia, covering its causes, investigations and treatment.Access episode show notes containing key references and take-home points at:https://gpnotebook.com/en-GB/podcasts/neurology/ep-179-paraesthesia (https://gpnotebook.com/en-GB/podcasts/neurology/ep-179-paraesthesia).Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more (https://gpnotebook.com/en-GB/gpnotebook-pro).

A tremor is defined as an involuntary rhythmic oscillation of one or more body parts, mediated by alternating contractions of reciprocally acting muscles. Tremors typically affect the upper extremities but can also affect the head, chin, voice or legs. Although some tremors may be mild and cause little impact to quality of life, requiring no treatment, others may impair activities of daily living or occupation, which may lead to embarrassment and social withdrawal. In this episode, Dr Roger Henderson gives an overview of the different types of tremor, looking at ways of distinguishing them and how each is usually managed.Access episode show notes containing key references and take-home points at:https://gpnotebook.com/en-GB/podcasts/neurology/ep-178-tremor (https://gpnotebook.com/en-GB/podcasts/neurology/ep-178-tremor).Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more (https://gpnotebook.com/en-GB/gpnotebook-pro).

Postnasal drip is a condition where excess mucus from the nose and sinuses accumulates and flows down the back of the throat. This can lead to symptoms such as throat clearing, coughing, a scratchy or sore throat, hoarseness and bad breath. Common causes include allergies, colds, sinus infections, weather changes, acid reflux and irritants such as smoke. Treatment typically involves managing the underlying cause through medications such as antihistamines, decongestants and nasal sprays, as well as maintaining proper hydration. If symptoms persist for more than 10 days or are accompanied by fever or discoloured mucus, medical evaluation is recommended to rule out infections or other issues. In this episode, Dr Roger Henderson provides an overview of these areas to help us easily diagnose this common problem in our surgeries.Access episode show notes containing key references and take-home points at:https://gpnotebook.com/en-GB/podcasts/ear-nose-and-throat/ep-177-postnasal-drip (https://gpnotebook.com/en-GB/podcasts/ear-nose-and-throat/ep-177-postnasal-drip).Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more (https://gpnotebook.com/en-GB/gpnotebook-pro).

Lower urinary tract symptoms (LUTS) are storage, voiding and post-micturition symptoms affecting the lower urinary tract. LUTS can significantly reduce men's quality of life and may point to serious problems in the urogenital tract. The pathogenesis of LUTS is multifactorial and can include one or several diagnoses, commonly benign prostatic obstruction, nocturnal polyuria (polynocturia) and detrusor muscle instability. LUTS are common and not necessarily a reason for suspecting prostate cancer. In this episode, Dr Roger Henderson takes an overview of male LUTS, including investigations, referral criteria and treatment options.Access episode show notes containing key references and take-home points at:https://gpnotebook.com/en-GB/podcasts/urology/ep-176-lower-urinary-tract-symptoms-in-men (https://gpnotebook.com/en-GB/podcasts/urology/ep-176-lower-urinary-tract-symptoms-in-men).Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more (https://gpnotebook.com/en-GB/gpnotebook-pro).

Scabies is a condition that can cause significant distress due to the intense itching associated with the condition and concerns about social stigma. In this episode, Dr Kate Chesterman discusses the risk factors for contracting scabies, the signs and symptoms associated with the condition, preferred treatment options and indications for involving secondary care.Access episode show notes containing key references and take-home points at:https://gpnotebook.com/en-GB/podcasts/dermatology/ep-175-scabies (https://gpnotebook.com/en-GB/podcasts/dermatology/ep-175-scabies).Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more (https://gpnotebook.com/en-GB/gpnotebook-pro).

Acute cholecystitis is often seen in primary care patients and is a major complication of cholelithiasis. Symptomatic gallstones occur in up to 10% of patients before developing cholecystitis. Patients typically present with pain and localised tenderness, with or without guarding, in the upper right quadrant. In this episode, Dr Roger Henderson provides an overview of this common problem, looking at its risk factors, causes, symptoms, investigations and the treatment options available, as well as the prognosis and advice to give our patients to help prevent recurrence.Access episode show notes containing key references and take-home points at:https://gpnotebook.com/en-GB/podcasts/gastroenterology/ep-174-acute-cholecystitis (https://gpnotebook.com/en-GB/podcasts/gastroenterology/ep-174-acute-cholecystitis).Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more (https://gpnotebook.com/en-GB/gpnotebook-pro).

Abdominal aortic aneurysms (AAAs) are potentially life-threatening and have a poor prognosis if ruptured. Arterial aneurysms are defined as a permanent localised dilatation of the vessel, enlarging significantly compared to a relatively normal diameter of the adjacent artery. An AAA is characterised by abnormal focal dilation of the abdominal aorta that is often detected incidentally or only at the time of rupture. In this episode, Dr Roger Henderson looks at AAA risk factors, clinical presentations, diagnostic investigations, screening, treatments and prognosis.Access episode show notes containing key references and take-home points at:https://gpnotebook.com/en-GB/podcasts/cardiovascular-medicine/ep-173-abdominal-aortic-aneurysm (https://gpnotebook.com/en-GB/podcasts/cardiovascular-medicine/ep-173-abdominal-aortic-aneurysm).Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more (https://gpnotebook.com/en-GB/gpnotebook-pro).

Keloid scars are a form of abnormal scarring that occur in susceptible individuals and often appear to be more common in darker skin types. Often observed between the ages of 10 and 30 years, and associated with skin trauma or inflammation, their diagnosis is a clinical one. Unfortunately, no definitive treatment is currently available, but options include injectable preparations and cryotherapy, as well as surgery and radiotherapy. In this episode, Dr Roger Henderson looks at the aetiology, epidemiology and presentation of keloid scars as well as the efficacy of current treatments.Access episode show notes containing key references and take-home points at:https://gpnotebook.com/en-GB/podcasts/dermatology/ep-172-keloid-scars (https://gpnotebook.com/en-GB/podcasts/dermatology/ep-172-keloid-scars).Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more (https://gpnotebook.com/en-GB/gpnotebook-pro).

What if one of the most misunderstood diagnoses of the past is now one of the most manageable chronic conditions? How can GPs play a pivotal role in tackling stigma, increasing testing and improving outcomes for people living with HIV?Dr James Waldron is joined by Dr Grace Bottoni (HIV and Hepatitis C GP Champion, Lewisham) for a series of podcasts about HIV. Together, they explore a range of topics with experts in the field. In this third episode, they talk with Dr Emily Mabonga (Consultant in HIV Medicine, London) about pre-exposure prophylaxis (PrEP): who it is for, how to start the conversation and practicalities around access and dosing.Access episode show notes containing key references and take-home points at:https://gpnotebook.com/en-GB/podcasts/infectious-disease/ep-171-rethinking-hiv-prevention-and-pre-exposure-prophylaxis (https://gpnotebook.com/en-GB/podcasts/infectious-disease/ep-171-rethinking-hiv-prevention-and-pre-exposure-prophylaxis).Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more (https://gpnotebook.com/en-GB/gpnotebook-pro).

Aortic stenosis (AS) is an obstruction of blood flow from the left ventricle into the aorta due to narrowing at the level of the aortic valve. In Europe, it is the most common valvular disease requiring treatment and is the second most frequent cause for cardiac surgery. By the age of 80, it occurs in almost 10% of adults and has a mortality rate of about 50% at 2 years unless the outflow obstruction is relieved. In this episode, Dr Roger Henderson looks at the aetiology, pathophysiology, clinical presentation, diagnostic evaluation, treatment options and prognosis associated with this common condition usually seen in our elderly patients.Access episode show notes containing key references and take-home points at:https://gpnotebook.com/en-GB/ (https://gpnotebook.com/en-GB/podcasts/cardiovascular-medicine/ep-170-aortic-stenosis)podcasts/cardiovascular-medicine/ep-170-aortic-stenosis (https://gpnotebook.com/en-GB/podcasts/cardiovascular-medicine/ep-170-aortic-stenosis).Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more (https://gpnotebook.com/en-GB/gpnotebook-pro).

Shin splints are a common type of leg pain caused by repetitive stress on the bones and muscles in the lower leg, particularly around the tibia. The condition, also known as medial tibial stress syndrome (MTSS), is characterised by pain and tenderness along the inner or front of the lower leg. It is often triggered by activities like running, jumping or other high-impact sports. In this episode, Dr Roger Henderson looks at risk factors, how to diagnose it, typical treatment options and prognosis.Access episode show notes containing key references and take-home points at:https://gpnotebook.com/en-GB/podcasts/musculoskeletal-medicine/ep-169-shin-splints-medial-tibial-stress-syndrome.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more (https://gpnotebook.com/en-GB/gpnotebook-pro).

In the UK, ectopic pregnancy is diagnosed in approximately 11 out of every 1,000 pregnancies and typically presents 6–8 weeks after the last normal menstrual period but can be earlier or later. The risk of ectopic pregnancy increases with prior ectopic pregnancy, tubal surgery, history of sexually transmitted infections, smoking, in vitro fertilisation or if the woman is pregnant despite intrauterine device usage. Classical symptoms and signs of ectopic pregnancy are pain, vaginal bleeding and amenorrhoea. Haemodynamic instability and cervical motion tenderness may indicate rupture or imminent rupture of an ectopic pregnancy. In this episode, Dr Roger Henderson gives an overview of how to accurately diagnose an ectopic pregnancy, the management pathway involved and the risks of recurrence.Access episode show notes containing key references and take-home points at:Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more (https://gpnotebook.com/en-GB/gpnotebook-pro).

Acute pancreatitis is an inflammatory condition of the pancreas, most commonly caused by bile stones or excessive use of alcohol. It is one of the most common diseases of the gastrointestinal tract leading to hospital admission. In most patients, the disease takes a mild course, where moderate fluid resuscitation, management of pain and nausea and early oral feeding result in rapid clinical improvement. The severe form is life-threatening, with mortality rates of up to 30%. In this episode, Dr Roger Henderson looks at how to quickly diagnose acute pancreatitis, what the common risk factors are, the treatment options and prognosis.Access episode show notes containing key references and take-home points at:https://gpnotebook.com/en-GB/podcasts/gastroenterology/ep-167-acute-pancreatitis (https://gpnotebook.com/en-GB/podcasts/gastroenterology/ep-167-acute-pancreatitis).Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more (https://gpnotebook.com/en-GB/gpnotebook-pro).

Hand–arm vibration syndrome is a chronic, progressive disorder of the upper limbs resulting from prolonged exposure to vibration. It encompasses vascular, neurological and musculoskeletal injury, often presenting with a combination of symptoms that may severely impact daily functioning and quality of life. This condition was historically observed among forestry workers and miners but now affects people in a broad range of industries, including construction, engineering, vehicle maintenance and utilities. In this episode, Dr Roger Henderson looks at how to recognise the condition in patients, as well as diagnostic tests, treatment options and prognosis.Access episode show notes containing key references and take-home points at:https://gpnotebook.com/en-GB/podcasts/musculoskeletal-medicine/ep-168-hand-arm-vibration-syndrome (https://gpnotebook.com/en-GB/podcasts/musculoskeletal-medicine/ep-168-hand-arm-vibration-syndrome).Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more (https://gpnotebook.com/en-GB/gpnotebook-pro).

In the second part of a two-episode series on chronic kidney disease (CKD), Dr Hannah Rosa is joined again by Dr Will Hinchliffe, a Consultant in Renal and General Medicine working in the North East and North Cumbria. They discuss the management options for CKD that can be initiated in primary care. They first look at how to empower patients with lifestyle and dietary advice, then the medical treatment options we have for CKD and when to start them, before finishing with holistic care, especially with regards to cardiovascular disease. This episode is mainly based on the NICE assessment and management guideline for CKD, but it also draws on other recent guidelines from Kidney Disease Improving Global Outcomes (KDIGO) and the International Society of Nephrology as it aims to help you to improve the lives of your patients with CKD.Access episode show notes containing key references and take-home points at:https://gpnotebook.com/en-GB/podcasts/renal-medicine/ep-165-chronic-kidney-disease-among-adults-in-primary-care-testing-diagnosis-and-referral (https://gpnotebook.com/en-GB/podcasts/renal-medicine/ep-165-chronic-kidney-disease-among-adults-in-primary-care-testing-diagnosis-and-referral).Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more (https://gpnotebook.com/en-GB/gpnotebook-pro).

Cauda equina syndrome (CES) is caused by compression of the lumbosacral nerve roots that extend below the spinal cord. The most common cause is disc prolapse at the L4/5 or L5/S1 level and stenosis of the spinal canal. Less commonly, compression may be due to pathology in a higher disc or to a tumour, infection or trauma. Typical symptoms and signs of CES include leg and/or back pain, together with one or more of: bladder or bowel dysfunction; altered perianal, perineal or genital sensation; motor weakness affecting both legs; sexual dysfunction. It is a medical emergency and a missed diagnosis can have devastating consequences. In this episode, Dr Roger Henderson covers the anatomy and causes of CES, its presentation, diagnosis and treatment pathway.Access episode show notes containing key references and take-home points at:https://gpnotebook.com/en-GB/podcasts/neurology/ep-164-cauda-equina-syndrome (https://gpnotebook.com/en-GB/podcasts/neurology/ep-164-cauda-equina-syndrome).Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more (https://gpnotebook.com/en-GB/gpnotebook-pro).

In the first of a two-episode series on chronic kidney disease (CKD), Dr Hannah Rosa is joined by Dr Will Hinchliffe, a Consultant in Renal and General Medicine working in the North East and North Cumbria. They discuss which people are at risk of CKD, how to test for it and diagnose it and, lastly, which patients require a referral to secondary care. This episode is mostly based on the NICE guideline on assessment and management of CKD and aims to help you to improve the lives of your patients by diagnosing CKD earlier and referring those who may benefit from specialist input sooner.Access episode show notes containing key references and take-home points at:https://gpnotebook.com/en-GB/podcasts/renal-medicine/ep-163-chronic-kidney-disease-among-adults-in-primary-care-testing-diagnosis-and-referral (https://gpnotebook.com/en-GB/podcasts/renal-medicine/ep-163-chronic-kidney-disease-among-adults-in-primary-care-testing-diagnosis-and-referral).Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more (https://gpnotebook.com/en-GB/gpnotebook-pro).

Ankylosing spondylitis (AS) is a chronic, immune-mediated inflammatory disorder that predominantly targets the axial skeleton, especially the spine and sacroiliac joints. This condition evolves insidiously, often beginning in young adulthood, and gradually imposes limitations on spinal mobility, eventually leading to fusion in advanced cases. Beyond its skeletal manifestations, AS can also extend its reach to various extra-articular organs, emphasising the systemic nature of the disease. In this episode, Dr Roger Henderson looks at its clinical presentation, how to diagnose it, the treatment options available and its prognosis.Access episode show notes containing key references and take-home points at:https://gpnotebook.com/en-GB/podcasts/rheumatology/ep-162-ankylosing-spondylitis (https://gpnotebook.com/en-GB/podcasts/rheumatology/ep-162-ankylosing-spondylitis).Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more (https://gpnotebook.com/en-GB/gpnotebook-pro).

Post-herpetic neuralgia (PHN) is the most common complication following an episode of shingles and can affect up to one in five people. Pain is typically described as burning or like an electric shock and is often associated with allodynia and hyperalgesia. It can have significant effects on both physical and psychological well-being, with sleep disturbance and depression being frequently described. PHN is notoriously difficult to treat, with a significant number of patients achieving only a modest reduction in their symptoms despite combinations of analgesic agents. In this episode, Dr Kate Chesterman explores the treatment options available in primary care.Access episode show notes containing key references and take-home points at:Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more (https://gpnotebook.com/en-GB/gpnotebook-pro).