General Practice Clinical Sessions Podcast

Protecting the feet in people with diabetes Professor Stephen Twigg

Professor Stephen Twigg addresses the critical issue of preventing diabetes-related foot diseases, emphasizing the need for effective prevention strategies due to their severe consequences, including ulceration and amputation. He discusses the prevalence of peripheral neuropathy and its implications, illustrating diagnostic complexities with a case vignette. The lecture highlights the importance of integrated care models and specialized foot services, along with patient education for self-management. Professor Twigg concludes with a call for interdisciplinary collaboration and proactive monitoring to enhance foot health outcomes in individuals with diabetes.

You already know how powerful learning by podcast can be.

No travel.

No sitting in lecture theatres.

No giving up another weekend.

Just practical education from leading clinicians, ready whenever you have time to listen.

That's exactly what ArmchairMedical.tv gives you.

Unlock hundreds of Australia's leading GP conferences and listen while you're driving to work, exercising, walking the dog or relaxing at home. When you want the full experience, simply switch to video and follow along with synchronised presentation slides.

Stay clinically up to date without putting your life on hold.

Spend less time travelling to conferences.

Spend more time with your friends and family and less time in auditoriums.

Learn more https://www.armchairmedical.tv/podcasts

-------------------------------------------------------------------------------

If you are a General Practitioner who gets invited to dozens of webinars a month. The General Practice Clinical Sessions Podcast is designed for you.

Instead of giving up an evening with your family for a live webinar or your weekend for a conference, you can listen to it here whenever it's convenient, in half the time and while you are commuting, exercising or even walking the dog.

It's the same education, without interrupting your life.

GPs can also earn CPD hours.

Earn Educational Activity (EA) CPD without sacrificing time with your family.

Listen to your Clinical Sessions Podcasts on your commute or while you exercise. Then each week, calculate the amount of time you invest listening and count that as self claimed Educational Activities (EA).

Earn Reviewing Performance (RP) CPD without sacrificing time with your family.

After each podcast, pause for a few minutes and identify and summarise 3 key points relevant to your scope of practice.

• Identify the key clinical learnings that may be incorporated into the clinical assessment, work-up and/or management plan for appropriate patients.
• If relevant, would you change any of your management strategies for those patients identified by appropriate screening, examination and investigation.

Invest 10 minutes per podcast mentally reviewing your practice. When you listen to 6 podcasts per week, you have earned an hour of Reviewing Performance CPD you can self claim.

Remember to document your learning!

Earn Measuring Outcomes (MO) CPD without sacrificing time with your family.

To claim MO, you need:

• A baseline measurement
• A change in practice
• A re-measurement
• Reflection on the outcome

1. Identify a measurable change. After the podcast, ask:

“What will I do differently on Monday?”

Example:

• Start using a screening tool
• Change prescribing habits
• Increase documentation of a risk factor

2. Measure your baseline (quick audit). Do a small, realistic audit

Examples:

• Review last 10 patients with condition X
• % who had guideline-based management
• % with documented counselling

3. Implement the change. Apply the idea from the podcast for 2–4 weeks

• Could be as simple as a checklist, template, or reminder

4. Re-measure. Repeat the same audit:

• Same sample size
• Same criteria

5. Reflect & Document:

• What changed?
• Did outcomes improve?
• What will you keep doing?

If you enjoy learning through podcasts and video podcasts then you can also access thousands of premium podcasts with PowerPoint Slides at https://www.armchairmedical.tv/podcasts

⭐ Rate this episode

➕ Follow the podcast

💬 Share it with a colleague who’d value conference learning without the time away

Disclaimer: Content is for health professionals and general educational purposes only. It is not medical advice or a substitute for independent clinical judgement. Always consult current guidelines, product information and local protocols. Views expressed are those of the presenters and not necessarily ArmchairMedical. ArmchairMedical accepts no responsibility or liability for any loss or harm resulting from reliance on the information provided.

Visit https://www.armchairmedical.tv/podcasts for more information.

Host: Michelle Odayan (My Health Academy) Guest Expert: Dr. Nicholas Mehan (Urological Surgeon specializing in prostate cancer, robotic surgery, and laser ablation)

Episode Summary

Dr. Nicholas Mehan provides an overview of how prostate cancer care has evolved over the past two decades. The discussion covers the shift away from broad PSA screening toward targeted early detection, modern diagnostic tools (mpMRI and transperineal biopsy), updated Australian clinical guidelines (PCFA & RACGP Red Book), and harm-minimizing treatments like focal laser ablation and robotic surgery.

Key Discussion Topics & Highlights

• The PSA Screening Dilemma & Historical ContextPre-PSA Era: Before blood testing in the 1990s, prostate cancer was typically detected at late, metastatic stages with high mortality.
• Overdiagnosis & Overtreatment: The introduction of PSA testing increased early detection but led to 20–40% overdiagnosis of indolent, low-risk cancers, subjecting many men to aggressive treatments that caused incontinence and erectile dysfunction.
• Guideline Re-evaluation: Confusion following the 2012 US Preventive Services Task Force (USPSTF) recommendation against PSA testing led to long-term trial analyses that confirmed the value of targeted early detection.
• Diagnostic Breakthroughs (The Past 10 Years)Multiparametric MRI (mpMRI): Used as a triage tool before biopsy. Federally funded in Australia since 2018, allowing ~50% of low-risk men to safely avoid biopsy altogether.
• Transperineal (TP) Biopsy: Replaced transrectal (TRUS) biopsies, reducing post-procedure sepsis risk from up to 2–5% down to ~1 in 1,000.
• Active Surveillance: Standard of care for low-risk (Grade Group 1) disease, with ~90% of eligible Australian men choosing monitoring over immediate surgery or radiation.
• Updated Clinical Guidelines (PCFA & RACGP 10th Edition Red Book)Risk-Based Approach: Recommends baseline PSA testing from age 45–49 for high-risk men (family history, BRCA2 gene mutation, Black ancestry).
• Routine Testing: Recommended every 2 years for well-informed men aged 50–69 (with re-testing triggered at PSA > 3.0).
• Digital Rectal Exam (DRE): No longer recommended for routine screening in asymptomatic men.
• Treatment Innovations & Harm MinimizationFocal Therapy (Organ Preservation): Targets the MRI-visible "index lesion" while preserving surrounding prostate tissue, resulting in 0% incontinence and low erectile dysfunction rates. Dr. Mehan highlights Nepean Hospital’s ProFocal laser ablation trial, which achieved an 84% cancer-free rate in treated areas.
• Robotic Surgery: Robotic-assisted radical prostatectomy reduces blood loss, complication rates, pain, and hospital stays compared to open surgery.
• Radiotherapy & Hydrogel Spacers: Stereotactic body radiation (SBRT over 5 days) combined with hydrogel spacers (e.g., SpaceOAR) protects the rectum from collateral radiation damage.
• Advanced Disease: PSMA PET scans enable precise staging and recurrence tracking, while novel anti-androgens significantly extend survival in castrate-resistant disease.

Key Audience Q&A

• Does a prostate biopsy cause cancer to spread? No. Prostate biopsy utilizes a closed true-cut needle system and is completely safe.
• Focal Therapy Modalities (NanoKnife vs. Laser vs. HIFU): Different energy sources (electrical pulses, laser thermal heat, ultrasound) are chosen based on the lesion's specific anatomical location inside the prostate.
• Post-Surgical Erectile Dysfunction Management: Treated using daily low-dose PDE5 inhibitors (tadalafil), vacuum pumps, intracavernosal injections, or penile implants.

Continuing Professional Development (CPD): Australian general practitioners can obtain CPD points for listening to this episode from our education partner, My Health Academy.

Myhealth Academy Link: https://lms-academy.myhealth.net.au/login/index.php?tenant=MHAC01

Access your favourite conferences by podcast: https://www.armchairmedical.tv/podcasts

⭐ Rate this episode

➕ Follow the podcast

💬 Share it with a colleague who’d value conference learning without the time away

Disclaimer: Content is for health professionals and general educational purposes only. It is not medical advice or a substitute for independent clinical judgement. Always consult current guidelines, product information and local protocols. Views expressed are those of the presenters and not necessarily ArmchairMedical. ArmchairMedical accepts no responsibility or liability for any loss or harm resulting from reliance on the information provided.

Visit https://www.armchairmedical.tv/podcasts for more information.

-------------------------------------------------------------------------------

If you are a General Practitioner who gets invited to dozens of webinars a month. The General Practice Clinical Sessions Podcast is designed for you.

Instead of giving up an evening with your family for a live webinar or your weekend for a conference, you can listen to it here whenever it's convenient, in half the time and while you are commuting, exercising or even walking the dog.

It's the same education, without interrupting your life.

GPs can also earn CPD hours.

Earn Educational Activity (EA) CPD without sacrificing time with your family.

Listen to your Clinical Sessions Podcasts on your commute or while you exercise. Then each week, calculate the amount of time you invest listening and count that as self claimed Educational Activities (EA).

Earn Reviewing Performance (RP) CPD without sacrificing time with your family.

After each podcast, pause for a few minutes and identify and summarise 3 key points relevant to your scope of practice.

• Identify the key clinical learnings that may be incorporated into the clinical assessment, work-up and/or management plan for appropriate patients.
• If relevant, would you change any of your management strategies for those patients identified by appropriate screening, examination and investigation.

Invest 10 minutes per podcast mentally reviewing your practice. When you listen to 6 podcasts per week, you have earned an hour of Reviewing Performance CPD you can self claim.

Remember to document your learning!

Earn Measuring Outcomes (MO) CPD without sacrificing time with your family.

To claim MO, you need:

• A baseline measurement
• A change in practice
• A re-measurement
• Reflection on the outcome

1. Identify a measurable change. After the podcast, ask:

“What will I do differently on Monday?”

Example:

• Start using a screening tool
• Change prescribing habits
• Increase documentation of a risk factor

2. Measure your baseline (quick audit). Do a small, realistic audit

Examples:

• Review last 10 patients with condition X
• % who had guideline-based management
• % with documented counselling

3. Implement the change. Apply the idea from the podcast for 2–4 weeks

• Could be as simple as a checklist, template, or reminder

4. Re-measure. Repeat the same audit:

• Same sample size
• Same criteria

5. Reflect & Document:

• What changed?
• Did outcomes improve?
• What will you keep doing?

If you enjoy learning through podcasts and video podcasts then you can also access thousands of premium podcasts with PowerPoint Slides at https://www.armchairmedical.tv/podcasts

First Trimester & Screening

• Host/Speaker: Dr. Jackie Chua (Director, Queensland Ultrasound for Women)
• Episode Summary: Early pregnancy scans involve far more than checking for a heartbeat. Dr. Jackie Chua breaks down why the first trimester offers a crucial diagnostic window for pregnancy dating, risk assessment, and mother-baby wellness.
• In This Episode, You'll Discover:
• The Dating Dilemma: Why relying on a last menstrual period can be misleading and when an ultrasound crown-rump length measurement should officially change an estimated due date.
• Diagnostic Red Flags: The specific ultrasound thresholds required to accurately diagnose early pregnancy loss without jumping to premature conclusions.
• Scar & Ectopic Emergencies: Why Caesarean section scar pregnancies are on the rise and how early transvaginal imaging catches them before severe complications occur.
• Beyond Chromosomes: Why Non-Invasive Prenatal Testing (NIPT) cannot replace a detailed structural anatomy scan or preeclampsia risk evaluation

Continuing Professional Development (CPD): Australian general practitioners can obtain CPD points for listening to this episode from our education partner, My Health Academy.

Myhealth Academy Link: https://lms-academy.myhealth.net.au/login/index.php?tenant=MHAC01

-------------------------------------------------------------------------------

If you are a General Practitioner who gets invited to dozens of webinars a month. The General Practice Clinical Sessions Podcast is designed for you.

Instead of giving up an evening with your family for a live webinar or your weekend for a conference, you can listen to it here whenever it's convenient, in half the time and while you are commuting, exercising or even walking the dog.

It's the same education, without interrupting your life.

GPs can also earn CPD hours.

Earn Educational Activity (EA) CPD without sacrificing time with your family.

Listen to your Clinical Sessions Podcasts on your commute or while you exercise. Then each week, calculate the amount of time you invest listening and count that as self claimed Educational Activities (EA).

Earn Reviewing Performance (RP) CPD without sacrificing time with your family.

After each podcast, pause for a few minutes and identify and summarise 3 key points relevant to your scope of practice.

• Identify the key clinical learnings that may be incorporated into the clinical assessment, work-up and/or management plan for appropriate patients.
• If relevant, would you change any of your management strategies for those patients identified by appropriate screening, examination and investigation.

Invest 10 minutes per podcast mentally reviewing your practice. When you listen to 6 podcasts per week, you have earned an hour of Reviewing Performance CPD you can self claim.

Remember to document your learning!

Earn Measuring Outcomes (MO) CPD without sacrificing time with your family.

To claim MO, you need:

• A baseline measurement
• A change in practice
• A re-measurement
• Reflection on the outcome

1. Identify a measurable change. After the podcast, ask:

“What will I do differently on Monday?”

Example:

• Start using a screening tool
• Change prescribing habits
• Increase documentation of a risk factor

2. Measure your baseline (quick audit). Do a small, realistic audit

Examples:

• Review last 10 patients with condition X
• % who had guideline-based management
• % with documented counselling

3. Implement the change. Apply the idea from the podcast for 2–4 weeks

• Could be as simple as a checklist, template, or reminder

4. Re-measure. Repeat the same audit:

• Same sample size
• Same criteria

5. Reflect & Document:

• What changed?
• Did outcomes improve?
• What will you keep doing?

If you enjoy learning through podcasts and video podcasts then you can also access thousands of premium podcasts with PowerPoint Slides at https://www.armchairmedical.tv/podcasts

⭐ Rate this episode

➕ Follow the podcast

💬 Share it with a colleague who’d value conference learning without the time away

Disclaimer: Content is for health professionals and general educational purposes only. It is not medical advice or a substitute for independent clinical judgement. Always consult current guidelines, product information and local protocols. Views expressed are those of the presenters and not necessarily ArmchairMedical. ArmchairMedical accepts no responsibility or liability for any loss or harm resulting from reliance on the information provided.

Visit https://www.armchairmedical.tv/podcasts for more information.

Plant based diet in diabetes Vivien Yiu

In this podcast, Vivian Yiu explores the prevention and management of Type 2 diabetes through plant-based eating. She presents evidence-based strategies, emphasizing the benefits of plant-based diets, including improved insulin sensitivity and weight management. Yiu categorizes these diets and discusses their nutritional advantages, highlighting the importance of fiber and whole foods in diabetes management. She presents data linking plant-based eating to reduced diabetes risk and dispels myths regarding nutrients typically associated with animal products. Practical tips for transitioning to plant-based diets are provided, with an overall call for healthcare professionals to promote these dietary changes as a means to enhance patient health.

You already know how powerful learning by podcast can be.

No travel.

No sitting in lecture theatres.

No giving up another weekend.

Just practical education from leading clinicians, ready whenever you have time to listen.

That's exactly what ArmchairMedical.tv gives you.

Unlock hundreds of Australia's leading GP conferences and listen while you're driving to work, exercising, walking the dog or relaxing at home. When you want the full experience, simply switch to video and follow along with synchronised presentation slides.

Stay clinically up to date without putting your life on hold.

Spend less time travelling to conferences.

Spend more time with your friends and family and less time in auditoriums.

Learn more https://www.armchairmedical.tv/podcasts

-------------------------------------------------------------------------------

If you are a General Practitioner who gets invited to dozens of webinars a month. The General Practice Clinical Sessions Podcast is designed for you.

Instead of giving up an evening with your family for a live webinar or your weekend for a conference, you can listen to it here whenever it's convenient, in half the time and while you are commuting, exercising or even walking the dog.

It's the same education, without interrupting your life.

GPs can also earn CPD hours.

Earn Educational Activity (EA) CPD without sacrificing time with your family.

Listen to your Clinical Sessions Podcasts on your commute or while you exercise. Then each week, calculate the amount of time you invest listening and count that as self claimed Educational Activities (EA).

Earn Reviewing Performance (RP) CPD without sacrificing time with your family.

After each podcast, pause for a few minutes and identify and summarise 3 key points relevant to your scope of practice.

• Identify the key clinical learnings that may be incorporated into the clinical assessment, work-up and/or management plan for appropriate patients.
• If relevant, would you change any of your management strategies for those patients identified by appropriate screening, examination and investigation.

Invest 10 minutes per podcast mentally reviewing your practice. When you listen to 6 podcasts per week, you have earned an hour of Reviewing Performance CPD you can self claim.

Remember to document your learning!

Earn Measuring Outcomes (MO) CPD without sacrificing time with your family.

To claim MO, you need:

• A baseline measurement
• A change in practice
• A re-measurement
• Reflection on the outcome

1. Identify a measurable change. After the podcast, ask:

“What will I do differently on Monday?”

Example:

• Start using a screening tool
• Change prescribing habits
• Increase documentation of a risk factor

2. Measure your baseline (quick audit). Do a small, realistic audit

Examples:

• Review last 10 patients with condition X
• % who had guideline-based management
• % with documented counselling

3. Implement the change. Apply the idea from the podcast for 2–4 weeks

• Could be as simple as a checklist, template, or reminder

4. Re-measure. Repeat the same audit:

• Same sample size
• Same criteria

5. Reflect & Document:

• What changed?
• Did outcomes improve?
• What will you keep doing?

If you enjoy learning through podcasts and video podcasts then you can also access thousands of premium podcasts with PowerPoint Slides at https://www.armchairmedical.tv/podcasts

⭐ Rate this episode

➕ Follow the podcast

💬 Share it with a colleague who’d value conference learning without the time away

Disclaimer: Content is for health professionals and general educational purposes only. It is not medical advice or a substitute for independent clinical judgement. Always consult current guidelines, product information and local protocols. Views expressed are those of the presenters and not necessarily ArmchairMedical. ArmchairMedical accepts no responsibility or liability for any loss or harm resulting from reliance on the information provided.

Visit https://www.armchairmedical.tv/podcasts for more information.ion.

Gestational Weight Gain Why is it Important Dr Robyn Barnes

The podcast examines the importance of gestational weight gain in managing gestational diabetes mellitus (GDM), highlighting medical nutrition therapy (MNT) as the primary treatment. The speaker emphasizes the need for balanced carbohydrate intake, suggesting a requirement of 185 to 210 grams daily to support maternal and fetal health. A systematic review indicates dietary modifications significantly improve GDM management, reducing blood glucose levels and medication needs.

The discussion also covers the interplay between maternal weight gain and pregnancy outcomes, stressing the need for tailored weight gain targets and early intervention strategies. Ultimately, the lecture advocates for a compassionate approach to GDM care that incorporates weight management while supporting nutritional requirements.

You already know how powerful learning by podcast can be.

No travel.

No sitting in lecture theatres.

No giving up another weekend.

Just practical education from leading clinicians, ready whenever you have time to listen.

That's exactly what ArmchairMedical.tv gives you.

Unlock hundreds of Australia's leading GP conferences and listen while you're driving to work, exercising, walking the dog or relaxing at home. When you want the full experience, simply switch to video and follow along with synchronised presentation slides.

Stay clinically up to date without putting your life on hold.

Spend less time travelling to conferences.

Spend more time with your friends and family and less time in auditoriums.

Learn more https://www.armchairmedical.tv/podcasts

-------------------------------------------------------------------------------

If you are a General Practitioner who gets invited to dozens of webinars a month. The General Practice Clinical Sessions Podcast is designed for you.

Instead of giving up an evening with your family for a live webinar or your weekend for a conference, you can listen to it here whenever it's convenient, in half the time and while you are commuting, exercising or even walking the dog.

It's the same education, without interrupting your life.

GPs can also earn CPD hours.

Earn Educational Activity (EA) CPD without sacrificing time with your family.

Listen to your Clinical Sessions Podcasts on your commute or while you exercise. Then each week, calculate the amount of time you invest listening and count that as self claimed Educational Activities (EA).

Earn Reviewing Performance (RP) CPD without sacrificing time with your family.

After each podcast, pause for a few minutes and identify and summarise 3 key points relevant to your scope of practice.

• Identify the key clinical learnings that may be incorporated into the clinical assessment, work-up and/or management plan for appropriate patients.
• If relevant, would you change any of your management strategies for those patients identified by appropriate screening, examination and investigation.

Invest 10 minutes per podcast mentally reviewing your practice. When you listen to 6 podcasts per week, you have earned an hour of Reviewing Performance CPD you can self claim.

Remember to document your learning!

Earn Measuring Outcomes (MO) CPD without sacrificing time with your family.

To claim MO, you need:

• A baseline measurement
• A change in practice
• A re-measurement
• Reflection on the outcome

1. Identify a measurable change. After the podcast, ask:

“What will I do differently on Monday?”

Example:

• Start using a screening tool
• Change prescribing habits
• Increase documentation of a risk factor

2. Measure your baseline (quick audit). Do a small, realistic audit

Examples:

• Review last 10 patients with condition X
• % who had guideline-based management
• % with documented counselling

3. Implement the change. Apply the idea from the podcast for 2–4 weeks

• Could be as simple as a checklist, template, or reminder

4. Re-measure. Repeat the same audit:

• Same sample size
• Same criteria

5. Reflect & Document:

• What changed?
• Did outcomes improve?
• What will you keep doing?

If you enjoy learning through podcasts and video podcasts then you can also access thousands of premium podcasts with PowerPoint Slides at https://www.armchairmedical.tv/podcasts

⭐ Rate this episode

➕ Follow the podcast

💬 Share it with a colleague who’d value conference learning without the time away

Disclaimer: Content is for health professionals and general educational purposes only. It is not medical advice or a substitute for independent clinical judgement. Always consult current guidelines, product information and local protocols. Views expressed are those of the presenters and not necessarily ArmchairMedical. ArmchairMedical accepts no responsibility or liability for any loss or harm resulting from reliance on the information provided.

Visit https://www.armchairmedical.tv/podcasts for more information.

Co-Hosts: Professor Nicholas Zwar (Executive Dean & GP) & Dr. Alexander Sweetman (Senior Research Fellow & Sleep Psychologist) and Michelle Odayan (MyHealth Academy)

Episode Overview

While up to 10–15% of Australian adults suffer from chronic insomnia, primary care has historically relied on sedative-hypnotics, writing prescriptions in up to 90% of insomnia presentations. In this episode, Prof. Nicholas Zwar and Dr. Alexander Sweetman unpack the critical clinical shift toward Cognitive Behavioral Therapy for Insomnia (CBT-I), the global gold-standard first-line treatment.

They discuss the massive barrier to accessing CBT-I (only 1% of chronic sufferers currently receive it) and reveal how a free, Australian-developed digital program called Bedtime Window is giving GPs an effective, evidence-based pathway to cure insomnia and support elegant de-prescribing.

Key Clinical Takeaways for GPs

Insomnia is a Chronic Disorder, Not Just a Symptom: Chronic insomnia is defined as sleep dissatisfaction occurring 3+ nights a week for 3+ months. It is highly comorbid with depression, anxiety, chronic pain, and cardiovascular diseases, and is a significant predictor of future depressive episodes.

CBT-I is the First-Line Cure, Not Sleep Hygiene: Standard sleep hygiene advice (e.g., avoiding caffeine, regular wake times) rarely resolves chronic insomnia. CBT-I is a multicomponent therapy heavily focused on behavioral techniques like stimulus control and bedtime restriction therapy.

The Power of Digital CBT-I: To bypass the severe shortage and cost of trained sleep psychologists, GPs can utilize Bedtime Window, a free, 5-session digital CBT-I program that uses personalized algorithms and clinician-led videos to achieve a 90% mild-to-normal sleep remission rate for completers.

An Elegant De-Prescribing Helper: Digital CBT-I is highly effective whether patients are actively taking sleeping pills or not. In a trial of 950 patients referred by GPs, 45% of patients completely stopped using sedative-hypnotics by the end of the Bedtime Window program.

Navigating Patient Resistance & Stigmas:

• The "It's Not in My Head" Objection: If patients reject "psychological" help, reframe CBT-I as a practical, behavioral routine program (like physical rehab for sleep) rather than talk therapy.
• The Tapering Tussle: Do not make medication cessation a prerequisite to starting CBT-I. Run them concurrently; as behavioral therapy fixes the sleep architecture, patients naturally find their medications become redundant.

Medicare Eligibility: GPs can initiate an Australian Medicare Mental Health Treatment Plan using chronic insomnia disorder as the primary mental health diagnosis.

Resources for Your Practice

Refer Patients to Active Trials:

• The Sleep Drive Trial (for metropolitan/urban GPs): Offers immediate, free patient access to Bedtime Window. https://www.bedtimewindow.com/contact-us
• The Rest Up Trial (for regional/rural GPs in MM 2–7): Investigates GP-assisted digital CBT-I with clinical practice and patient reimbursements. https://bond.qualtrics.com/jfe/form/SV_ea089FomERd5pkO

Screening & Assessment Tools: Visit the Australasian Sleep Association's "Sleep Central" portal to access sleep diaries and screening tools like the Insomnia Severity Index (ISI) and OSA-50. https://sleepcentral.org.au/Central/Contents/GP/GP-landing.aspx

Up-Skill in CBT-I: GPs and clinical psychologists can access a 6-hour online training course on the Australian Psychological Society website. https://psychology.org.au/event/24371

Bedtime Window: https://www.bedtimewindow.com/

Continuing Professional Development (CPD): Australian general practitioners can obtain CPD points for listening to this episode from our education partner, My Health Academy.

Myhealth Academy Link: https://lms-academy.myhealth.net.au/login/index.php?tenant=MHAC01

Access your favourite conferences by podcast: https://www.armchairmedical.tv/podcasts

⭐ Rate this episode

➕ Follow the podcast

💬 Share it with a colleague who’d value conference learning without the time away

Disclaimer: Content is for health professionals and general educational purposes only. It is not medical advice or a substitute for independent clinical judgement. Always consult current guidelines, product information and local protocols. Views expressed are those of the presenters and not necessarily ArmchairMedical. ArmchairMedical accepts no responsibility or liability for any loss or harm resulting from reliance on the information provided.

Visit https://www.armchairmedical.tv/podcasts for more information.

Management, medications and role of CGM Assoc Professor Tang Wong

In this lecture, Assoc Professor Tang Wong, an endocrinologist at the Bankstown-Lidcombe Diabetes Centre, provides an in-depth analysis of gestational diabetes (GDM) management, highlighting the importance of early intervention for both mothers and infants. He discusses the historical context behind GDM treatment, the complications arising from maternal hyperglycemia, and the long-term health implications for mothers and children. Key studies like the A-Choice and MFMU are reviewed, reinforcing the benefits of GDM treatment in reducing adverse outcomes. Assoc Professor Tang Wong advocates for a multidisciplinary care approach, emphasizing tailored dietary strategies and the possible role of continuous glucose monitoring (CGM) technology in improving patient management. He concludes by stressing the necessity of ongoing care that addresses the broader metabolic health of women, aiming to mitigate long-term risks associated with GDM.

You already know how powerful learning by podcast can be.

No travel.

No sitting in lecture theatres.

No giving up another weekend.

Just practical education from leading clinicians, ready whenever you have time to listen.

That's exactly what ArmchairMedical.tv gives you.

Unlock hundreds of Australia's leading GP conferences and listen while you're driving to work, exercising, walking the dog or relaxing at home. When you want the full experience, simply switch to video and follow along with synchronised presentation slides.

Stay clinically up to date without putting your life on hold.

Spend less time travelling to conferences.

Spend more time with your friends and family and less time in auditoriums.

Learn more https://www.armchairmedical.tv/podcasts

-------------------------------------------------------------------------------

If you are a General Practitioner who gets invited to dozens of webinars a month. The General Practice Clinical Sessions Podcast is designed for you.

Instead of giving up an evening with your family for a live webinar or your weekend for a conference, you can listen to it here whenever it's convenient, in half the time and while you are commuting, exercising or even walking the dog.

It's the same education, without interrupting your life.

GPs can also earn CPD hours.

Earn Educational Activity (EA) CPD without sacrificing time with your family.

Listen to your Clinical Sessions Podcasts on your commute or while you exercise. Then each week, calculate the amount of time you invest listening and count that as self claimed Educational Activities (EA).

Earn Reviewing Performance (RP) CPD without sacrificing time with your family.

After each podcast, pause for a few minutes and identify and summarise 3 key points relevant to your scope of practice.

• Identify the key clinical learnings that may be incorporated into the clinical assessment, work-up and/or management plan for appropriate patients.
• If relevant, would you change any of your management strategies for those patients identified by appropriate screening, examination and investigation.

Invest 10 minutes per podcast mentally reviewing your practice. When you listen to 6 podcasts per week, you have earned an hour of Reviewing Performance CPD you can self claim.

Remember to document your learning!

Earn Measuring Outcomes (MO) CPD without sacrificing time with your family.

To claim MO, you need:

• A baseline measurement
• A change in practice
• A re-measurement
• Reflection on the outcome

1. Identify a measurable change. After the podcast, ask:

“What will I do differently on Monday?”

Example:

• Start using a screening tool
• Change prescribing habits
• Increase documentation of a risk factor

2. Measure your baseline (quick audit). Do a small, realistic audit

Examples:

• Review last 10 patients with condition X
• % who had guideline-based management
• % with documented counselling

3. Implement the change. Apply the idea from the podcast for 2–4 weeks

• Could be as simple as a checklist, template, or reminder

4. Re-measure. Repeat the same audit:

• Same sample size
• Same criteria

5. Reflect & Document:

• What changed?
• Did outcomes improve?
• What will you keep doing?

If you enjoy learning through podcasts and video podcasts then you can also access thousands of premium podcasts with PowerPoint Slides at https://www.armchairmedical.tv/podcasts

⭐ Rate this episode

➕ Follow the podcast

💬 Share it with a colleague who’d value conference learning without the time away

Disclaimer: Content is for health professionals and general educational purposes only. It is not medical advice or a substitute for independent clinical judgement. Always consult current guidelines, product information and local protocols. Views expressed are those of the presenters and not necessarily ArmchairMedical. ArmchairMedical accepts no responsibility or liability for any loss or harm resulting from reliance on the information provided.

Visit https://www.armchairmedical.tv/podcasts for more information.

1. Episode Overview and the Strategic Imperative

In the current digital landscape, cybersecurity has shifted from a backend technical luxury to a non-negotiable "must-have survival factor" for general practices. As patient records become increasingly digitized, the protection of this data is no longer just an IT task—it is a fundamental business imperative. This episode provides a strategic roadmap for clinic owners to safeguard their operations against a rising tide of professionalized cybercrime.

Speaker Profile: Henry McLaughlin Henry McLaughlin is a veteran IT and cybersecurity specialist with over 20 years of experience specifically supporting the medical industry. As the Managing Director of Green Umbrella Technology.

Core Directive The goal of this session is to transform dense technical cybersecurity concepts into actionable business strategies. It aims to empower clinic managers and owners to treat digital defense as a core pillar of business continuity, rather than an optional expense.

Understanding the gravity of this challenge begins with recognizing why general practices have become the premier target for global criminal syndicates.

2. Healthcare: The High-Value Target

Healthcare is not merely an incidental target; it is the most targeted sector in Australia. This risk profile is a strategic reality confirmed by the Office of the Australian Information Commissioner (OAIC).

Data Vulnerability Analysis According to OAIC notifiable data breach reports, healthcare consistently ranks as the #1 targeted industry. The reason is the "complete patient identity profile" found in clinical records. Unlike a credit card that can be canceled, a clinical record contains permanent data points:

• Full names and residential addresses.
• Dates of birth.
• Medicare card numbers.
• Sensitive, often blackmail-worthy, medical histories.

On the dark web, this "goldmine" of data is used to facilitate sophisticated identity theft, fraudulent financial accounts, and targeted extortion. Because these identity markers cannot be changed, their value to criminals remains high indefinitely.

The Invisible Threat Cyberattacks are no longer the work of lone hackers; they are industrialized. Henry McLaughlin observes that when a new system is connected to the internet, it is subjected to thousands of automated hacking attempts within minutes. These attacks occur 24/7, invisible to the staff but relentless in probing for a single vulnerability.

The "So What?" Layer: Business Survival The impact of a breach is often terminal for a practice. Beyond the immediate technical failure, the compounding effects of legal liability, massive regulatory fines, and the irreparable loss of patient trust can force a clinic to close. McLaughlin warns that for many practices, their cybersecurity strategy over the next 12 months will be the sole determining factor in whether the business continues to exist.

To combat these high-stakes threats, practices must adopt the standardized framework used by the Australian Department of Defence.

3. The Essential Eight: An International Standard for Defense

The "Essential Eight" is a defense-in-depth strategy developed by the Australian Signals Directorate (ASD). This framework serves as the baseline for securing any professional computer network.

Framework Evolution The ASD originally issued 32 recommendations. To prevent "analysis paralysis" among organizations, they distilled these into eight core pillars. This framework is now recognized as an international standard for cybersecurity excellence.

The Eight Pillars

1. Application control: Whitelisting only approved software.
2. Patch applications: Keeping software (like Best Practice or MS Office) updated.
3. Office macro settings: Blocking unvetted or malicious macros.
4. User application hardening: Restricting high-risk browser and office functions.
5. Restrict administrative privileges: Limiting "god-mode" access to only necessary IT staff.
6. Patch operating systems: Ensuring Windows or macOS is always current.
7. Multi-Factor Authentication (MFA): Requiring a second form of ID to log in.
8. Regular backups: Ensuring a reliable safety net for recovery.

Implementation Strategy These pillars are "must-do" items. They are not optional tasks for when time permits; they are the mandatory foundation of clinical IT infrastructure.

The first line of defense in this framework focuses on the most common point of failure: human-managed access.

4. Defensive Fundamentals: Passwords, Managers, and MFA

Human-managed passwords are the weakest link in any security chain. Three in five cyber breaches begin with a compromised or stolen password, often obtained through phishing or "brute-force" attacks.

The Human Element: A Cautionary Tale The risk is often internal and accidental. McLaughlin recounts an instance at a medical center where a nurse, returning from leave, found her password expired. To solve the immediate problem, the clinic called a doctor on holiday and wrote his credentials on a sticky note for the nurse to use. This "credential sharing" creates massive security holes that attackers exploit with ease.

Brute-Force Comparison Table The strength of a password is a matter of mathematics. Modern computers can guess simple passwords almost instantly.

The Password Manager Solution "If you can remember your password, it is too simple and, therefore, unsafe." It is impossible for the human brain to memorize unique, 16-character passwords for every account. A Password Manager is a digital vault that generates and stores these complex keys, allowing the user to only remember one "master" key.

Secondary Defenses (MFA) Multi-Factor Authentication (MFA) is your insurance policy. Even if a criminal steals a password from a sticky note, they cannot enter the system without the second factor (usually a code sent to a mobile device).

Actionable Check: Have I Been Pwned? Visit haveibeenpwned.com and enter your professional email.

• If Compromised: This means your data is being sold on the dark web. Immediately change the password for that service and any other site where you reused that password.

The "So What?" Layer Shifting from memory-based passwords to vault-based management moves a practice's risk profile from "vulnerable" to "resilient," effectively closing the front door to three-fifths of all potential attacks.

Protecting access is vital, but we must also control what "work" is allowed to happen once the door is open.

5. Beyond Antivirus: The Shift to Application Control

Legacy antivirus is no longer sufficient. It relies on "blacklisting", recognizing a virus that has been seen before. In an era of custom-coded malware, if the "mugshot" isn't in the database, the antivirus lets it through.

The Bouncer Analogy

• Antivirus (Blacklisting): A bouncer with a book of known troublemakers. If a new troublemaker isn't in the book, they get in.
• Application Control (Whitelisting): A bouncer with a guestlist. If your name (the software) isn't on the list, you don't get in.

Operational Impact Application Whitelisting ensures that only explicitly approved programs (e.g., Best Practice, Medical Director) can run. Even if a staff member accidentally downloads ransomware, the system will block its execution because it is not on the "guestlist."

As we harden our internal "guestlists," criminals are turning to emerging technology to find the cracks we haven't patched yet.

6. The AI Arms Race and the Five Eyes Warning

Artificial Intelligence is "supercharging" cybercrime, shifting the threat from targeted hacking to industrialized exploitation. Criminals now use AI to scan thousands of systems simultaneously, finding loopholes at a speed that manual security cannot match.

The Unprecedented Warning The "Five Eyes" security agencies (Australia, Canada, New Zealand, UK, and US) issued a rare collective warning stating that AI-driven threats require immediate defensive action. Manual or legacy security methods are officially obsolete against AI-powered exploits.

This rapid evolution of threats makes prevention difficult, which is why the "Yang" to cybersecurity’s "Ying" is recovery.

7. Disaster Recovery (DR): Planning for the Inevitable

Disaster Recovery (DR) focuses on business continuity—how quickly you can resume seeing patients after a breach or system failure. Cybersecurity is about prevention; DR is about survival after the "unthinkable" happens.

Debunking "Wishful Thinking" A backup log that says "Successful" is not a guarantee of safety. It is merely "wishful thinking." A backup is only valid if it has been successfully restored and tested. Furthermore, modern ransomware is now designed to "hunt out" and encrypt backups if they are connected to the main network, rendering legacy systems (like removable disks) useless.

Critical Recovery Metrics As a clinic owner, you must define your RTO and RPO:

1. Recovery Time Objective (RTO): How long can the practice afford to be offline? (15 minutes? 4 days?)
2. Recovery Point Objective (RPO): How much data are you willing to lose? (The last hour of bookings? The last week?)

Modern vs. Legacy Comparison The 3CX software breach, where a legitimate software update was compromised, proves that even "safe" software can be a Trojan horse. You need a system that can recover from such events in minutes.

8. Practical Action Checklist for General Practices

The urgency of the current threat environment requires immediate movement from awareness to implementation. To ensure your business exists tomorrow, take these four steps today:

1. Implement a Password Manager: Move away from memory-based passwords. Ensure every single account has a unique, 16+ character password.
2. Activate Multi-Factor Authentication (MFA): Turn on MFA for every possible system, starting with your email and clinical software.
3. Audit Credentials: Check all professional and personal emails on haveibeenpwned.com and change passwords for any compromised accounts.
4. Initiate a High-Level IT Consultation: Specifically ask your provider about your status regarding the Essential Eight and Application Whitelisting. Demand a demonstration of your RTO (Recovery Time Objective).

Final Statement Cybersecurity is no longer a technical expense; it is business continuity insurance. Being prepared today by hardening your defenses and testing your recovery systems is the only way to ensure your practice remains viable in an increasingly hostile digital world.

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If you are a General Practitioner who gets invited to dozens of webinars a month. The General Practice Clinical Sessions Podcast is designed for you.

Instead of giving up an evening with your family for a live webinar or your weekend for a conference, you can listen to it here whenever it's convenient, in half the time and while you are commuting, exercising or even walking the dog.

It's the same education, without interrupting your life.

GPs can also earn CPD hours.

Earn Educational Activity (EA) CPD without sacrificing time with your family.

Listen to your Clinical Sessions Podcasts on your commute or while you exercise. Then each week, calculate the amount of time you invest listening and count that as self claimed Educational Activities (EA).

Earn Reviewing Performance (RP) CPD without sacrificing time with your family.

After each podcast, pause for a few minutes and identify and summarise 3 key points relevant to your scope of practice.

• Identify the key clinical learnings that may be incorporated into the clinical assessment, work-up and/or management plan for appropriate patients.
• If relevant, would you change any of your management strategies for those patients identified by appropriate screening, examination and investigation.

Invest 10 minutes per podcast mentally reviewing your practice. When you listen to 6 podcasts per week, you have earned an hour of Reviewing Performance CPD you can self claim.

Remember to document your learning!

Earn Measuring Outcomes (MO) CPD without sacrificing time with your family.

To claim MO, you need:

• A baseline measurement
• A change in practice
• A re-measurement
• Reflection on the outcome

1. Identify a measurable change. After the podcast, ask:

“What will I do differently on Monday?”

Example:

• Start using a screening tool
• Change prescribing habits
• Increase documentation of a risk factor

2. Measure your baseline (quick audit). Do a small, realistic audit

Examples:

• Review last 10 patients with condition X
• % who had guideline-based management
• % with documented counselling

3. Implement the change. Apply the idea from the podcast for 2–4 weeks

• Could be as simple as a checklist, template, or reminder

4. Re-measure. Repeat the same audit:

• Same sample size
• Same criteria

5. Reflect & Document:

• What changed?
• Did outcomes improve?
• What will you keep doing?

If you enjoy learning through podcasts and video podcasts then you can also access thousands of premium podcasts with PowerPoint Slides at https://www.armchairmedical.tv/podcasts

⭐ Rate this episode

➕ Follow the podcast

💬 Share it with a colleague who’d value conference learning without the time away

Disclaimer: Content is for health professionals and general educational purposes only. It is not medical advice or a substitute for independent clinical judgement. Always consult current guidelines, product information and local protocols. Views expressed are those of the presenters and not necessarily ArmchairMedical. ArmchairMedical accepts no responsibility or liability for any loss or harm resulting from reliance on the information provided.

Visit https://www.armchairmedical.tv/podcasts for more information.

GLP 1 and Other Incretin Analogues Assoc Professor Samantha Hocking

In this lecture, Sam Hocking focuses on incretin-based therapies for managing cardiometabolic diseases, particularly obesity and type 2 diabetes. He discusses the roles of GLP-1 and GIP in insulin regulation and appetite control, and highlights their potential beyond diabetes, including benefits for heart failure and chronic kidney disease.

Hocking evaluates the effectiveness of agents like semaglutide and tizepatide, showcasing significant improvements in glycemic control and weight loss from clinical trials. He also addresses the cardiovascular benefits of these therapies, alongside practical considerations for clinicians in managing side effects and economic accessibility. The lecture concludes with a call for the clinical application of incretin therapies to enhance patient health outcomes.

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If you are a General Practitioner who gets invited to dozens of webinars a month. The General Practice Clinical Sessions Podcast is designed for you.

Instead of giving up an evening with your family for a live webinar or your weekend for a conference, you can listen to it here whenever it's convenient, in half the time and while you are commuting, exercising or even walking the dog.

It's the same education, without interrupting your life.

GPs can also earn CPD hours.

Earn Educational Activity (EA) CPD without sacrificing time with your family.

Listen to your Clinical Sessions Podcasts on your commute or while you exercise. Then each week, calculate the amount of time you invest listening and count that as self claimed Educational Activities (EA).

Earn Reviewing Performance (RP) CPD without sacrificing time with your family.

After each podcast, pause for a few minutes and identify and summarise 3 key points relevant to your scope of practice.

• Identify the key clinical learnings that may be incorporated into the clinical assessment, work-up and/or management plan for appropriate patients.
• If relevant, would you change any of your management strategies for those patients identified by appropriate screening, examination and investigation.

Invest 10 minutes per podcast mentally reviewing your practice. When you listen to 6 podcasts per week, you have earned an hour of Reviewing Performance CPD you can self claim.

Remember to document your learning!

Earn Measuring Outcomes (MO) CPD without sacrificing time with your family.

To claim MO, you need:

• A baseline measurement
• A change in practice
• A re-measurement
• Reflection on the outcome

1. Identify a measurable change. After the podcast, ask:

“What will I do differently on Monday?”

Example:

• Start using a screening tool
• Change prescribing habits
• Increase documentation of a risk factor

2. Measure your baseline (quick audit). Do a small, realistic audit

Examples:

• Review last 10 patients with condition X
• % who had guideline-based management
• % with documented counselling

3. Implement the change. Apply the idea from the podcast for 2–4 weeks

• Could be as simple as a checklist, template, or reminder

4. Re-measure. Repeat the same audit:

• Same sample size
• Same criteria

5. Reflect & Document:

• What changed?
• Did outcomes improve?
• What will you keep doing?

If you enjoy learning through podcasts and video podcasts then you can also access thousands of premium podcasts with PowerPoint Slides at https://www.armchairmedical.tv/podcasts

⭐ Rate this episode

➕ Follow the podcast

💬 Share it with a colleague who’d value conference learning without the time away

Disclaimer: Content is for health professionals and general educational purposes only. It is not medical advice or a substitute for independent clinical judgement. Always consult current guidelines, product information and local protocols. Views expressed are those of the presenters and not necessarily ArmchairMedical. ArmchairMedical accepts no responsibility or liability for any loss or harm resulting from reliance on the information provided.

Visit https://www.armchairmedical.tv/podcasts for more information.

Host: Michelle Odayan (My Health Academy)

Guest Speaker: Dr. Clinton Colaco (Infectious Diseases & Consultant Physician)

Watch the video version with slides at Spotify https://open.spotify.com/episode/4fOSlJ5aLu2ijIKhmlGTZg

Episode Overview

Join us as Sydney infectious diseases physician Dr. Clinton Colaco shares clinical pearls and fascinating case studies from his time completing the prestigious Gorgas Course in Clinical Tropical Medicine in Lima, Peru. While these cases originate in South America, their diagnostic lessons are highly relevant for any primary care clinician treating travelers, immigrants, or dealing with local tropical pathogens.

From navigating the diagnostic pitfalls of syphilis testing to removing botfly larvae, this episode equips general practitioners (GPs) with the essential skills to spot overlooked tropical diseases and ask the right social and travel questions.

High-Yield Chapter Markers

[00:00] Introduction

• Host Michelle Odayan introduces Dr. Clinton Colaco and his background.

[05:30] Case 1: Syphilis, HIV, & The "Prozone Effect"

• A 41-year-old male presents with a widespread psoriasiform rash and a negative RPR test. Dr. Colaco explains the prozone effect—how an excess of antigen-antibody complexes can cause false-negative serology in secondary syphilis—and how to overcome it with serum dilution.

[09:15] Case 2: Cryptococcal Meningitis & Bedside Eye Ultrasound

• A 26-year-old law student presents with severe headaches, seizures, and an astronomical lumbar puncture opening pressure of 136 cm H₂O. Learn how point-of-care ultrasound (POCUS) over the eye can detect optic nerve sheath thickening to screen for raised intracranial pressure.

[14:40] Case 3: Hydatid Lung Cysts (Echinococcus)

• A 20-year-old from the Bolivian border presents with hemoptysis and a massive fluid-filled cavity in his lung. Dr. Colaco outlines the Echinococcus lifecycle, its link to livestock and dogs, and the surgical management of hydatid disease.

[18:10] Case 4: Myiasis (Botflies in the Skin)

• A patient presents with painful, non-healing skin nodules. Using real-time bedside ultrasound, the team visualizes moving botfly larvae (Dermatobia hominis) beneath the skin, requiring occlusion with Vaseline to force the maggot to emerge for extraction.

[21:25] Cases 5 & 6: Pulmonary Tuberculosis vs. Bilateral Psoas Abscesses

• Why is Peru a hotbed for TB? Hint: it's all about overcrowded public transit. Dr. Colaco contrasts classic pulmonary tuberculosis with a rare presentation of bilateral psoas abscesses and spinal discitis in a non-compliant HIV patient.

[25:50] Case 7: Leprosy (Hansen’s Disease)

• A sibling pair presenting with severe facial disfigurement and thickened nerves. Dr. Colaco explains how to perform a quick slit skin smear to identify acid-fast bacilli and reviews the three-drug combination therapy.

[29:10] Case 8: Cutaneous Leishmaniasis

• How to approach a non-healing, crater-like ulcer. The key diagnostic takeaway: perform a punch biopsy on the active, raised border of the lesion (not the necrotic center) to successfully find amastigotes.

[32:45] Case 9: Leptospirosis Meningoencephalitis

• A patient with high viral load HIV presents with severe neurological symptoms linked to river exposure and rodent droppings. Discover the two-step diagnostic testing process (screening serology followed by the Microscopic Agglutination Test, or MAT).

[35:20] Case 10: Paragonimiasis (Lung Flukes)

• A school teacher presenting with chronic cough and peripheral nodules after eating ceviche. Learn why coastal, saltwater ceviche is safe, whereas inland freshwater ceviche (made with freshwater crabs or crayfish) carries a major risk for lung flukes.

[38:15] Case 11: Fascioliasis (Liver Flukes) & Watercress

• A patient presenting with epigastric pain and a massive blood eosinophil count of 10. Dr. Colaco details the lifecycle of Fasciola hepatica contracted from contaminated watercress, showing dramatic ERCP footage of living worms being extracted from the common bile duct.

[41:30] Case 12: Pelvic Actinomycosis & Lost IUDs

• A woman presenting with chronic yellow vaginal discharge and a cervical mass. The culprit? A copper intrauterine device (IUD) left in situ for 30 years, resulting in a tumor-mimicking actinomycosis infection showing the classic Splendore-Hoeppli phenomenon on pathology.

[44:55] Case 13: Neurocysticercosis (Brain Tapeworm)

• A young fisherman presenting with seizures. Dr. Colaco discusses the diverse presentations of tapeworm cysts in the brain and why treatment with albendazole or praziquantel must be highly customized depending on the location of the scolex.

[48:20] Q&A: Practical Advice for Travel Consults

• Dr. Colaco answers critical questions regarding:
• Overcoming "vaccine fatigue" and the high cost of pre-travel vaccines (e.g., Yellow Fever, Japanese Encephalitis).
• The highly cost-effective strategy of getting rabies vaccinations overseas ($100/shot in Peru vs. $500/shot in Australia) and the updated 2-dose recommendation.
• The role of doxycycline as post-exposure prophylaxis (PEP) for leptospirosis after fresh-water swimming.
• Pitfalls of the Interferon-Gamma Release Assay (IGRA/QuantiFERON-Gold) and how fish tank exposures (Mycobacterium marinum) can trigger a false-positive tuberculosis test.

5 Quick Clinical Pearls for Your Practice

1. Test Syphilis Thoroughly: If you strongly suspect secondary syphilis but the RPR is negative, request the laboratory to perform serial dilutions to bypass the prozone effect.
2. Biopsy the Border: When performing a punch biopsy for suspected Cutaneous Leishmaniasis, always biopsy the active, raised border of the ulcer rather than the central necrotic tissue to maximize amastigote yield.
3. Ask About Watercress: An unexplained, sky-high eosinophil count paired with right upper quadrant pain should prompt you to ask about raw watercress consumption (suspect Fasciola hepatica).
4. Mind the Fish Tank: A positive QuantiFERON-Gold test in a patient with low TB risk could be a false positive triggered by Mycobacterium marinum (often contracted from cleaning domestic aquariums).
5. Check Old IUDs: Long-term retention of copper IUDs (e.g., decades-long use) can lead to pelvic actinomycosis, which clinically and radiologically mimics advanced pelvic malignancies.

Continuing Professional Development (CPD): Australian general practitioners can obtain CPD points for listening to this episode from our education partner, My Health Academy.

Myhealth Academy Link: https://lms-academy.myhealth.net.au/login/index.php?tenant=MHAC01

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-------------------------------------------------------------------------------

If you are a General Practitioner who gets invited to dozens of webinars a month. The General Practice Clinical Sessions Podcast is designed for you.

Instead of giving up an evening with your family for a live webinar or your weekend for a conference, you can listen to it here whenever it's convenient, in half the time and while you are commuting, exercising or even walking the dog.

It's the same education, without interrupting your life.

GPs can also earn CPD hours.

Earn Educational Activity (EA) CPD without sacrificing time with your family.

Listen to your Clinical Sessions Podcasts on your commute or while you exercise. Then each week, calculate the amount of time you invest listening and count that as self claimed Educational Activities (EA).

Earn Reviewing Performance (RP) CPD without sacrificing time with your family.

After each podcast, pause for a few minutes and identify and summarise 3 key points relevant to your scope of practice.

• Identify the key clinical learnings that may be incorporated into the clinical assessment, work-up and/or management plan for appropriate patients.
• If relevant, would you change any of your management strategies for those patients identified by appropriate screening, examination and investigation.

Invest 10 minutes per podcast mentally reviewing your practice. When you listen to 6 podcasts per week, you have earned an hour of Reviewing Performance CPD you can self claim.

Remember to document your learning!

Earn Measuring Outcomes (MO) CPD without sacrificing time with your family.

To claim MO, you need:

• A baseline measurement
• A change in practice
• A re-measurement
• Reflection on the outcome

1. Identify a measurable change. After the podcast, ask:

“What will I do differently on Monday?”

Example:

• Start using a screening tool
• Change prescribing habits
• Increase documentation of a risk factor

2. Measure your baseline (quick audit). Do a small, realistic audit

Examples:

• Review last 10 patients with condition X
• % who had guideline-based management
• % with documented counselling

3. Implement the change. Apply the idea from the podcast for 2–4 weeks

• Could be as simple as a checklist, template, or reminder

4. Re-measure. Repeat the same audit:

• Same sample size
• Same criteria

5. Reflect & Document:

• What changed?
• Did outcomes improve?
• What will you keep doing?

If you enjoy learning through podcasts and video podcasts then you can also access thousands of premium podcasts with PowerPoint Slides at https://www.armchairmedical.tv/podcasts

⭐ Rate this episode

➕ Follow the podcast

💬 Share it with a colleague who’d value conference learning without the time away

Disclaimer: Content is for health professionals and general educational purposes only. It is not medical advice or a substitute for independent clinical judgement. Always consult current guidelines, product information and local protocols. Views expressed are those of the presenters and not necessarily ArmchairMedical. ArmchairMedical accepts no responsibility or liability for any loss or harm resulting from reliance on the information provided.

Visit https://www.armchairmedical.tv/podcasts for more information.