GPnotebook Podcast

In this episode, Dr Roger Henderson explores the growing clinical challenge of anabolic–androgenic steroid (AAS) misuse, a condition increasingly seen in everyday practice. Here, we examine how AAS use has shifted toward appearance-driven motivations, the role of muscle dysmorphia and the influence of gym culture and online communities. This episode highlights key pathophysiological effects, including hypogonadism, cardiovascular risk and neuropsychiatric complications. It also reviews how AAS misuse presents in real-world clinical settings, often through indirect signs rather than disclosure. Finally, it covers practical approaches to recognition, withdrawal management and long-term care, equipping GPs to better identify and support patients affected by this evolving, multi-system disorder.

Access episode show notes containing key references and take-home points at:

https://gpnotebook.com/en-GB/podcasts/general-information/ep-209-anabolic-steroid-misuse

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In this episode, Dr Roger Henderson explores the pathophysiology, clinical features and management of myasthenia gravis, an autoimmune disorder affecting the neuromuscular junction. It highlights how antibodies, most commonly against acetylcholine receptors, impair neuromuscular transmission, leading to fatigable weakness that worsens with activity and improves with rest. The discussion emphasises key clinical presentations, including ocular, bulbar and proximal limb weakness, alongside the risk of life-threatening myasthenic crisis. Diagnostic approaches are reviewed, focusing on antibody testing and electrophysiological studies. Management strategies include symptomatic treatment with acetylcholinesterase inhibitors, immunosuppression and thymectomy in selected patients.

Access episode show notes containing key references and take-home points at:

https://gpnotebook.com/en-GB/podcasts/neurology/ep-208-myasthenia-gravis

Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

In this episode, Dr Roger Henderson looks at one of the most time-sensitive diagnoses in general practice: the transient ischaemic attack, or TIA. Often underestimated because symptoms resolve quickly, a TIA is in fact a powerful warning sign of an impending ischaemic stroke. For GPs, recognising and responding to this brief neurological event can make the difference between prevention and long-term disability. Here we break down the modern tissue-based definition of TIA, highlighting how it differs from older time-based concepts and why that matters in our clinical practice. We also explore the importance of sudden focal symptoms and discuss why the first 48 hours carry the greatest risk. We also look at key causes and outline practical approaches to urgent evaluation, risk stratification and management.

Access episode show notes containing key references and take-home points at:

https://gpnotebook.com/en-GB/podcasts/neurology/ep-207-transient-ischaemic-attack

Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

In this episode, Dr Roger Henderson explores hypertensive disorders of pregnancy – one of the most important and potentially life-threatening conditions encountered in obstetric care. Affecting up to one in 10 pregnancies, these disorders range from mild hypertension to severe complications such as preeclampsia, eclampsia and HELLP (haemolysis, elevated liver enzymes and low platelets) syndrome. Despite advances in prenatal monitoring and management, they remain a leading cause of maternal and foetal morbidity worldwide. Here, we look at the underlying mechanisms, risk factors, clinical features and current management strategies, with a focus on practical insights to support clinical decision-making and improve outcomes for both mother and baby.

Access episode show notes containing key references and take-home points at:

https://gpnotebook.com/en-GB/podcasts/obstetrics/ep-206-hypertensive-disorders-of-pregnancy

Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Liver disease is often overlooked in primary care, yet it is one of the fastest-growing causes of morbidity and mortality in the UK. Metabolic dysfunction-associated steatotic liver disease (MASLD), previously known as non-alcoholic fatty liver disease (NAFLD), now affects around one-third of the UK population, with prevalence rising and all-cause mortality worsening over time. In this second episode of a series on hepatology and hepatitis, Dr James Waldron is joined by Dr Rik Fijten (GP Partner, Hepatitis C GP Champion for Bexley and GP Clinical Fellow in Gastroenterology) to explore why MASLD matters to GPs, why it is so common and why primary care is central to identifying disease early and preventing progression. They discuss why clinicians need to raise this often “silent” disease proactively and how it should be considered alongside diabetes, hypertension and weight management. The conversation covers how to approach abnormal liver function tests, how to assess fibrosis risk using simple non-invasive tools and how MASLD fits into the wider cardio–renal–metabolic model of long-term condition care. The episode also looks ahead to emerging treatments and what the future may hold for patients.

Access episode show notes containing key references and take-home points at:

https://gpnotebook.com/en-GB/podcasts/infectious-disease/ep-205-metabolic-dysfunction-associated-steatotic-liver-disease-and-hepatitis

Disclaimer

This content is for medical education purposes only and does not constitute clinical advice. While specific drugs and dosages may be discussed, clinicians should always refer to local protocols and official prescribing information before administering medication.

Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Red legs are frequently seen in primary care but are often misdiagnosed. With a need for antimicrobial stewardship, it is important to identify the cause, rather than automatically rely on antibiotic prescription. Importantly, all that is red is not cellulitis; venous or varicose eczema is a common cause of swollen and red legs and requires a different management approach. In this episode, Dr James Waldron is joined by Dr Mark Graham (GP from Nottingham with experience in dermatology) to explore how to invest time initially to achieve the right diagnosis. The discussion considers differential diagnoses, clinical examination and management.

Access episode show notes containing key references and take-home points at:

https://gpnotebook.com/en-GB/podcasts/cardiovascular-medicine/ep-204-red-legs

Disclaimer

This content is for medical education purposes only and does not constitute clinical advice. While specific drugs and dosages may be discussed, clinicians should always refer to local protocols and official prescribing information before administering medication.

Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

In this episode, Dr Roger Henderson explores an important and often overlooked area of head and neck oncology: oral mucosal cancer. As GPs, we frequently encounter oral lesions in primary care, and they are also often seen in dental practice, emergency settings and specialist clinics; however, distinguishing benign conditions from early malignancy can be challenging. Here, we break down the essential anatomy of the oral cavity, clarify how it differs from the oropharynx and examine the major risk factors driving disease development, including tobacco, alcohol, human papillomavirus (HPV) and immunosuppression. We also discuss clinical presentation, red-flag features, diagnostic pathways, staging principles and current management strategies. Most importantly, we focus on the role GPs play in early detection, timely referral and multidisciplinary care.

Access episode show notes containing key references and take-home points at:

https://gpnotebook.com/en-GB/podcasts/ear-nose-and-throat/ep-203-oral-mucosal-cancer

Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

In this episode, Dr Roger Henderson explores labyrinthitis from a GP’s perspective, moving beyond the textbook definition to focus on practical diagnosis, pathophysiology and management. Although often grouped broadly under causes of acute vertigo, true labyrinthitis is a distinct inflammatory condition of the inner ear that combines vestibular and auditory dysfunction. Its presentation can closely resemble more serious neurological pathology, including posterior circulation stroke, making accurate assessment essential in both primary and acute care settings. This episode examines the underlying causes, key clinical features, important differentials and evidence-based treatment strategies. It aims to refine our diagnostic reasoning, avoid common pitfalls and strengthen confidence when evaluating patients presenting with acute vertigo, hearing loss and associated neuro-otological symptoms in everyday general practice.

Access episode show notes containing key references and take-home points at:

https://gpnotebook.com/en-GB/podcasts/ear-nose-and-throat/ep-202-labyrinthitis

Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Pityriasis rosea is a common and self-limiting condition, but it can cause significant anxiety and distress for patients. In this episode, Dr Kate Chesterman discusses the expected course and clinical findings that are associated with this condition, as well as exploring possible differentials, treatment options, potential complications and referral criteria.

Access episode show notes containing key references and take-home points at:

https://gpnotebook.com/en-GB/podcasts/dermatology/ep-201-pityriasis-rosea

Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Hepatitis C was once considered a chronic, life-limiting condition with difficult treatments and significant stigma. Today, it is one of the great success stories of modern medicine: curable in the vast majority of patients with short courses of well-tolerated oral therapy. Yet, thousands of people in the UK remain undiagnosed. In this first episode of a series on hepatology and hepatitis, Dr James Waldron is joined by Dr Rik Fijten (GP Partner, Hepatitis C GP Champion for Bexley and GP Clinical Fellow in Gastroenterology) to explore why hepatitis C matters to primary care now more than ever. Together, they discuss who should be tested, how to interpret results, what happens after diagnosis and the central role GPs play in the NHS Hepatitis C Elimination Programme. This practical, confidence-building conversation focuses on normalising testing, reducing stigma and being curious, helping primary-care clinicians identify patients who could benefit from life-changing treatment.

Access episode show notes containing key references and take-home points at:

https://gpnotebook.com/en-GB/podcasts/infectious-disease/ep-200-hepatitis-c

Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.