Clinical Update

Asthma and COPD may be the ‘bread and butter’ of the respiratory conditions seen in primary care, but other respiratory conditions, such as bronchiectasis, will also be seen. 

In this episode of the MIMS Learning Clinical Update podcast, MIMS Learning editors Dawn and Pat survey the wide range of respiratory conditions seen in primary care that are not COPD or asthma. They look at the diagnosis of bronchiectasis, improvements in managing cystic fibrosis, the rising incidence of tuberculosis (TB), and how the NHS Lung Cancer Screening Programme is enabling earlier diagnosis.

Educational objectives

After listening to this podcast, healthcare professionals should be better able to: 

• Describe the pathophysiology of bronchiectasis
• Review how developments in screening and management has improved outcomes in cystic fibrosis
• Discuss which socioeconomic groups are at increased risk of tuberculosis
• Recall the number of lung cancers detected through the NHS lung cancer screening programme

You can access the website version of this podcast, along with a list of key learning points, on MIMS Learning - and make notes for your appraisal. MIMS Learning offers hundreds of hours of CPD for healthcare professionals, along with a handy CPD organiser.

Please note: this podcast is presented by medical editors and discusses educational content written or presented by doctors, nurses and other healthcare professionals on the MIMS Learning website and at live events.

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Bronchiectasis: clinical review

Cystic fibrosis: clinical review

Inflammatory bowel disease mimics

Lung cancer: presentation and referral

Podcast: advanced nurse practitioner Beverley Bostock on asthma and COPD

Podcast bonus episode: Dr Steve Holmes on asthma in pregnancy and childhood wheeze

MIMS

Early start to flu season prompts warning for healthcare professionals

Influenza vaccines 2025/2026

Influenza vaccines, which vaccine to offer

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Pancreatic cancer is the deadliest common cancer, with more than half of people dying within three months of diagnosis and 80% of people diagnosed at a late stage.

In this episode of the Clinical Update podcast, part of MIMS Learning's ‘Patient, Presentation, Pathway for Cancer’ campaign, Rhiannon speaks to Rachel Richardson, a pancreatic cancer specialist nurse at Pancreatic Cancer UK.

During their discussion, they consider the common but often vague symptoms patients may experience, including abdominal/back pain, unexplained weight loss, and new-onset diabetes. 

Rachel says: ‘Research does highlight that over 90% of pancreatic cancer patients will actually visit their GP with relevant symptoms in the 2 years before they're diagnosed. So really this represents such a crucial window of opportunity for earlier detection.’

The discussion also covers key risk factors, the important link between pancreatic cancer and type 3c diabetes, and new diagnostic tools in development – such as breath and blood tests – that could help GPs detect pancreatic cancer earlier.

Educational objectives

After listening to this podcast, healthcare professionals should be better able to:

• Recall the common, but often vague symptoms, of pancreatic cancer
• Identify key risk factors, including age, family history, smoking, obesity and pancreatic cysts
• Understand the link between type 3c diabetes and pancreatic cancer
• Recognise the challenges in diagnosis, including late presentation and non-specific symptoms
• Describe promising new diagnostic tools in development, such as breath and blood tests

You can access the website version of this podcast, along with a list of key learning points, on MIMS Learning - and make notes for your appraisal.

MIMS Learning offers hundreds of hours of CPD for healthcare professionals, along with a handy CPD organiser.

Please note: this podcast is presented by medical editors and discusses educational content written or presented by doctors, nurses and other healthcare professionals on the MIMS Learning website and at live events.

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Podcast: Professor Willie Hamilton on cancer risk assessment tools

Podcast: Dr Patrick Holmes on identifying type 3c diabetes in primary care

Pancreatic cancer - red flag symptoms

Other resources

Pancreatic Cancer UK. Health professionals page.

Pancreatic Cancer UK. Family history checker

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In this episode of the Clinical Update podcast, MIMS Learning medical editors Sangeeta and Dawn discuss the management of thyroid and hypertensive disorders during the antenatal period, including latest guidelines and prescribing recommendations. 

Educational objectives

After listening to this podcast, healthcare professionals should be better able to:

• Recall the target TSH level for women who are pregnant or trying to conceive
• Understand the increased thyroxine demand during pregnancy and practical steps for adjusting levothyroxine doses in women with hypothyroidism
• Identify and manage subclinical and overt hypothyroidism in the context of pregnancy and fertility
• Choose appropriate anti-thyroid medication based on the trimester, considering the risks associated with these medications
• Recall the features of pre-eclampsia and when to refer
• Diagnose and manage hypertensive disorders of pregnancy
• Recall the target blood pressure range for pregnant women
• Know which antihypertensive medications are to be avoided in pregnancy owing to teratogenicity risk

You can access the website version of this podcast, along with a list of key learning points, on MIMS Learning - and make notes for your appraisal. MIMS Learning offers hundreds of hours of CPD for healthcare professionals, along with a handy CPD organiser.

Please note: this podcast is presented by medical editors and discusses educational content written or presented by doctors, nurses and other healthcare professionals on the MIMS Learning website and at live events.

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Practice on a page: hypertensive disorders of pregnancy

Understanding and managing fertility and pregnancy in thyroid disease

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Pat from MIMS Learning speaks to GP Dr Pipin Singh about diagnosis, management and referral in this episode of the Clinical Update podcast.

Dr Pipin Singh presents a way through the diagnostic maze, emphasising the need to distinguish between acute and chronic presentations, and the importance of taking time to get to the bottom of chronic symptoms.

His thorough discussion of this topic emphasises the importance of continuity of care in conducting examinations and investigations, the myriad of possible causes to consider, and how to approach lifestyle measures and prescribing medication. 

Educational objectives

After listening to this podcast, healthcare professionals should be better able to: 

• Understand the prevalence and potential impact of lower urinary tract symptoms (LUTS)
• Take a history from patients presenting with LUTS, and conduct examinations
• Undertake relevant investigations, using tools such as a bladder diary or the International Prostate Symptom Score
• Recall possible urological and non-urological causes including benign prostatic enlargement (BPE), detrusor overactivity, ‘ketamine bladder’, malignancy and acute infections
• Recommend lifestyle measures and initiate medication for BPE and other causes
• Review and follow up, referring to urology if appropriate

You can access the website version of this podcast, along with a list of key learning points, on MIMS Learning - and make notes for your appraisal. MIMS Learning offers hundreds of hours of CPD for healthcare professionals, along with a handy CPD organiser.

Please note: this podcast is presented by medical editors and discusses educational content written or presented by doctors, nurses and other healthcare professionals on the MIMS Learning website and at live events.

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Benign prostatic hyperplasia: clinical review

Lower urinary tract symptoms in men - red flag symptoms

Lower urinary tract symptoms: a clue to underlying diseases

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Dementia is a major challenge for the NHS, with one in six people in their eighties developing the condition. For many people, fear and stigma surrounds the condition, so the GP's role as the first port of call is crucial.

In this episode of the Clinical Update podcast, MIMS Learning’s Rhiannon and Sangeeta draw on the expertise of MIMS Learning’s professional clinical writers and speakers to discuss how primary care can approach the initial assessment process, key differentials such as delirium and depression, and important modifiable risk factors, including hearing loss.

This episode also covers the challenge of 'therapeutic nihilism', latest research on antipsychotic use, and practical approaches to polypharmacy in patients with cognitive impairment.

Educational objectives

After listening to this podcast, healthcare professionals should be better able to:

• Describe the GP's role in the initial assessment of suspected dementia, including history taking and cognitive assessment tools.
• Distinguish presentations of dementia from key differentials, including delirium and depression.
• Recall key modifiable risk factors for dementia, such as smoking, social isolation, and unmanaged hearing loss.
• Understand the risks associated with antipsychotic use in people with dementia and NICE recommendations for their use.
• Recognise 'therapeutic nihilism' and how primary care can support patients and carers through positive language and use of social prescribing.
• Apply a structured approach to medication reviews for patients with dementia.

Presenters

Rhiannon Ashman

Deputy editor, MIMS Learning

Sangeeta Krishnan

Medical editor, MIMS Learning

You can access the website version of this podcast, along with a list of key learning points, on MIMS Learning - and make notes for your appraisal. MIMS Learning offers hundreds of hours of CPD for healthcare professionals, along with a handy CPD organiser.

Please note: this podcast is presented by medical editors and discusses educational content written or presented by doctors, nurses and other healthcare professionals on the MIMS Learning website and at live events.

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Guidance update: SIGN guidelines for support of people with dementia and their carers

Delirium: clinical review

Case series: polypharmacy in older people with mental health conditions

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‘Alcohol use disorder is very, very prevalent and the harm occurs long before people have physical dependence,’ Dr Steve Brinksman says in this episode of the MIMS Learning Clinical Update podcast.

He adds that if patients are concerned that they are drinking too much, they may hesitate to raise the issue with their GP because they might fear being told to stop drinking completely, and GPs may feel ‘uncomfortable’ about asking people how much they drink because alcohol misuse is ‘a common problem’ within the profession. 

Dr Brinksman, who worked as a GP for 30 years, says that GPs should encourage colleagues to seek help if they feel they have problems, and can encourage many patients to cut down rather than cut out alcohol completely. ‘If you are drinking 50 or 60 units a week, then you reduce your harm by cutting down even to 40 units a week,’ he explains.

The episode also reviews how to assess alcohol misuse, how to advise patients to cut down, and how to support patients with severe dependence.  

You can access the website version of this podcast, along with a list of key learning points, on MIMS Learning — and make notes for your appraisal. MIMS Learning offers hundreds of hours of CPD for healthcare professionals, along with a handy CPD organiser.

Educational objectives

After listening to this podcast, healthcare professionals should be better able to: 

• Assess alcohol misuse with a validated screening tool, and keep talking to patients about their drinking over time
• Support patients to cut down their consumption, to benefit their health and prevent them from moving on to more harmful drinking
• Provide brief interventions, which have good evidence of effectiveness 
• Understand the need for oral thiamine supplementation in people with severe alcohol dependence
• Discuss the medications used during a medically-assisted withdrawal
• Understand what steps to take if they feel a colleague has alcohol use disorder
• Follow safeguarding procedures if a patient or colleague poses a risk to others because of their alcohol use

Please note: this podcast is presented by medical editors and discusses educational content written or presented by doctors, nurses and other healthcare professionals on the MIMS Learning website and at live events.

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Abnormal liver function tests: case-based discussion

Foetal alcohol spectrum disorder

Smoking cessation for people with mental illness

Smoking, alcohol and psoriasis

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Thiamine

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In this episode of the Clinical Update podcast, MIMS Learning editor Pat Anderson and deputy editor Rhiannon Ashman discuss chickenpox and shingles, their prevention, diagnosis and management.

This podcast draws on the expertise of MIMS Learning’s professional clinical writers and speakers, to bring you key learning points on prevention, diagnosis and management.  

Educational objectives

After listening to this podcast, healthcare professionals should be better able to: 

• Recall changes to the NHS childhood vaccination programme taking place from January 2026
• Understand why the routine childhood chickenpox vaccination programme is being introduced, and the potential benefits for children and parents
• Know how to advise parents on the management of childhood chickenpox, and which children are at higher risk of severe disease
• Reflect on the management of chickenpox in pregnancy, and which pregnant individuals may be more likely to contract chickenpox
• Recall changes to the shingles vaccination programme which came into effect in September 2025
• Diagnose and manage shingles in primary care, and choose effective pain relief options

You can access the website version of this podcast, along with a list of key learning points, on MIMS Learning - and make notes for your appraisal. MIMS Learning offers hundreds of hours of CPD for healthcare professionals, along with a handy CPD organiser.

Please note: this podcast is presented by medical editors and discusses educational content written or presented by doctors, nurses and other healthcare professionals on the MIMS Learning website and at live events.

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Chickenpox clinical review

Chickenpox in pregnancy

Shingles and post-herpetic neuralgia clinical review

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In this episode of the Clinical Update podcast, guests from Future Dreams and Breast Cancer Now talk to MIMS Learning deputy editor Rhiannon Ashman. In the first section of this podcast, you'll learn about the varied presentations of breast cancer and how to sensitively approach consultations with breast cancer survivors. In the second section, the podcast focuses on signs and symptoms of secondary breast cancer, with insights into patient experience.

Part 1: 1.13 – 25.09: lead clinical nurse specialist Jackie Wright, and Amanda – who was diagnosed with breast cancer at the age of 42 – consider how to encourage people to open up conversations with family about medical history, and discuss access to genetic testing.

They also offer tips on self-checking, and how to support patients. Speaking about the health anxiety many patients with a history of cancer feel, and the importance of compassion from primary care, Amanda says, ‘I just feel that that understanding is priceless’. 

Part 2: 25.09 – 56.59: Catherine Priestley, senior clinical nurse specialist for secondary breast cancer, and Laura Price, author of the novel Single Bald Female, who is living with secondary breast cancer, discuss signs and symptoms of secondary (metastatic) breast cancer. They remind GPs that ‘low risk is not no risk’, and that secondary breast cancer can occur decades after the original diagnosis. 

Laura draws on her experiences to provide some useful insights into how GPs can gather information on, and prioritise, often vague collections of symptoms, and on taking seriously patients’ concerns without being swayed if a patient ‘self-diagnoses something that's actually much less serious than the thing that it could be’.  

Educational objectives

After listening to this podcast, healthcare professionals should be better able to: 

• Understand signs and symptoms of breast cancer and how to effectively educate patients on self-checking
• Discuss who is at risk of secondary breast cancer, and the most common locations of metastasis
• Identify signs and symptoms of secondary breast cancer 
• Understand proactive steps primary care can take to support patients with a history of cancer 
• Appreciate patient anxiety in healthcare settings following a diagnosis of cancer
• Advise patients on breast cancer risk factors

Please note: this podcast is presented by medical editors and discusses educational content written or presented by doctors, nurses and other healthcare professionals on the MIMS Learning website and at live events.

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Breast cancer: clinical review

Guidance update: pembrolizumab plus chemotherapy in locally advanced or metastatic triple negative breast cancer

Fear of cancer recurrence

Podcast: interview with oncologist Dr Jay Naik

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In this episode of the Clinical Update podcast, MIMS Learning’s medical editor Sangeeta Krishnan and editor Pat Anderson discuss neurodiversity and how to approach consultations with neurodivergent patients.

This podcast, which includes excerpts from a MIMS Learning interview with Dr Heidi Philips, founder of the British Association for Neurodiversity, discusses common neurodivergent conditions like autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD).

Educational objectives

After listening to this podcast, healthcare professionals should be better able to:

• Understand the definitions of neurodiversity and neurodivergence
• Appreciate the prevalence of neurodivergence in the general population
• Recognise the common presentations and comorbidities of ASD and ADHD
• Approach consultations with neurodivergent patients with sensitivity and compassion
• Explain why a ‘neurodiversity-affirming’ perspective can lead to better patient outcomes

You can access the website version of this podcast, along with a list of key learning points, on MIMS Learning - and make notes for your appraisal. MIMS Learning offers hundreds of hours of CPD for healthcare professionals, along with a handy CPD organiser.

Please note: this podcast is presented by medical editors and discusses educational content written or presented by doctors, nurses and other healthcare professionals on the MIMS Learning website and at live events.

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Thinking neurodiversity in general practice with Dr Heidi Phillips

Test your knowledge of neurodiversity

Guidance update: latest NICE guidelines on neurological conditions

Guidance update: latest NICE guidelines on mental health problems in people with learning disabilities

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One in five children and young people have a diagnosable mental health condition. In this episode of the Clinical Update podcast, GP DrAmina Al-Yassin, clinical lead for Children’s Services in the London borough of Brent, talks to medical editor Sangeeta Krishnan about why prevalence is increasing, key risk factors, the importance of early intervention, and practical tools GPs can use to support their young patients.

Dr Al-Yassin also looks at the effect of the COVID-19 pandemic and early childhood experiences, especially the crucial early period of life, on mental health in young people. 

After listening to this podcast, healthcare professionals should be better able to:

• Discuss the increasing prevalence of mental health conditions in adolescents and the factors that contribute to this rise
• Understand the importance of early intervention, particularly during the first 1,000 days of life, and the role of attachment in a child's mental well-being
• Apply practical consultation tools to conduct a comprehensive assessment of adolescents
• Recognise the key differences between managing cases in primary care and referring to specialist services
• Identify red flags for serious mental health conditions, including suicidality and eating disorders

You can access the website version of this podcast on MIMS Learning to make notes for your appraisal. MIMS Learning offers hundreds of hours of CPD for healthcare professionals, along with a handy CPD organiser.

THIS PODCAST IS INTENDED FOR HEALTHCARE PROFESSIONALS. IF YOU ARE EXPERIENCING THOUGHTS OF SELF-HARM OR SUICIDAL IDEATION, PLEASE SEEK HELP FROM THESE RESOURCES:

• National Suicide Prevention Helpline UK
• Young Minds
• Samaritans

Please note: this podcast is presented by medical editors and discusses educational content written or presented by doctors, nurses and other healthcare professionals on the MIMS Learning website and at live events.

MIMS Learning

Self-harm in children and young people

OCD in children and adolescents: clinical review

Eating disorders: clinical review

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Mental health technologies

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