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Two potentially practice changing pearls in one episode: we tackle obesity & weight management in pregnancy: how to raise it sensitively, what to do with BMI at booking, how to handle GLP‑1s pre‑conception, and what to say about folate, vitamin D, diet and activity. Then we demystify perianal masses: the red flags, and why the clock is ticking for thrombosed haemorrhoids. Plus a much needed best intentions story to put a smile on your face. Press play as we make your life easier and reignite your passion for primary care. 

Useful Links

For more detail on safe use of medications related to obesity during breastfeeding, see Specialist Pharmacy Service: UK Drugs in Lactation Advisory Service – safety in breastfeeding

GP Trainee Essentials support package information, and the Red Whale Calendar

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Disclaimer: We make every effort to ensure the information in this podcast is accurate and correct at the date of publication, but it is of necessity of a brief and general nature, and this should not replace your own good clinical judgement, or be regarded as a substitute for taking professional advice in appropriate circumstances. In particular, check drug doses, side-effects and interactions with the British National Formulary. Save insofar as any such liability cannot be excluded at law, we do not accept any liability for loss of any type caused by reliance on the information in this podcast.

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This time Fiona and Nik serve up two “don’t miss” clinical challenges: precocious puberty—what’s normal vs red flags, who warrants urgent paediatric referral, and how to use the RCPCH puberty growth charts.

And bullous pemphigoid—how to spot it fast, common drug links and when to phone dermatology today: when was the last time you did that?

Useful Links

Growth charts from the Royal College of Paediatrics and Child Health (RCPCH) with ‘puberty lines’ that show the normal age limits for phases of puberty:  

1. RCPCH - growth charts: girls childhood and puberty close monitoring 
2. RCPCH - growth charts: boys childhood and puberty close monitoring 

GP Trainee Essentials support package information, and the Red Whale Calendar

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Sign up to receive Pearls here. Pearls are available for 3 months from publish date. After this, you can get access them plus 100s more articles when you buy a one-day online course from Red Whale OR sign up to Red Whale Unlimited.  Find out more here.

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Disclaimer: We make every effort to ensure the information in this podcast is accurate and correct at the date of publication, but it is of necessity of a brief and general nature, and this should not replace your own good clinical judgement, or be regarded as a substitute for taking professional advice in appropriate circumstances. In particular, check drug doses, side-effects and interactions with the British National Formulary. Save insofar as any such liability cannot be excluded at law, we do not accept any liability for loss of any type caused by reliance on the information in this podcast.

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Grief touches every consulting room. In this episode we gently unpick how to support people after loss, using the RCGP framework “A Compassionate Bereavement Response”. Practical language you can use tomorrow, how to recognise prolonged grief disorder (including in children) and when to refer. The overlap with PTSD, and realistic ways we can look after ourselves as clinicians.

Then we change gear for an update on NICE’s 2024 guideline covering bacterial meningitis and meningococcal disease: the red flag combination that demands 999, when prehospital antibiotics are (and aren’t) advised, the easy to miss early signs, and robust safety netting. 

Press play for compassionate care, sharper suspicions, and help to make the right clinical decisions when under pressure. 

Useful links

Grief

Good Grief Festival (free events, YouTube Channel and curated resources)

RCGP framework “A Compassionate Bereavement Response”

Bacterial meningitis and meningococcal disease

Meningitis Now

GP Trainee Essentials support package information, and the Red Whale Calendar

Send us your feedback [email protected] or send a voice message

Sign up to receive Pearls here. Pearls are available for 3 months from publish date. After this, you can get access them plus 100s more articles when you buy a one-day online course from Red Whale OR sign up to Red Whale Unlimited.  Find out more here.

Follow us:  Facebook, Instagram, LinkedIn

Disclaimer: We make every effort to ensure the information in this podcast is accurate and correct at the date of publication, but it is of necessity of a brief and general nature, and this should not replace your own good clinical judgement, or be regarded as a substitute for taking professional advice in appropriate circumstances. In particular, check drug doses, side-effects and interactions with the British National Formulary. Save insofar as any such liability cannot be excluded at law, we do not accept any liability for loss of any type caused by reliance on the information in this podcast.

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Fiona and Nik break down the latest evidence on menopause, HRT and cognition so you can feel confident when patients ask, “Should I be worried?”

Plus: in our second Pearl in this episode,  practical tips for behaviour change that actually sticks, including how to spot those golden moments and use the STOP IT model to turn advice into action.

Tune in for clear answers and real‑world support for primary care.

Perfect for anyone in primary care who wants to feel informed, confident and ready for the inevitable “I saw this in the news...” conversation.

Useful Links

British Menopause Society: Menopause linked to loss of grey matter in the brain, poorer mental health and sleep disturbance

GP Trainee Essentials support package information, and the Red Whale Calendar

Send us your feedback [email protected] or send a voice message

Sign up to receive Pearls here. Pearls are available for 3 months from publish date. After this, you can get access them plus 100s more articles when you buy a one-day online course from Red Whale OR sign up to Red Whale Unlimited.  Find out more here.

Follow us:  Facebook, Instagram, LinkedIn

Disclaimer: We make every effort to ensure the information in this podcast is accurate and correct at the date of publication, but it is of necessity of a brief and general nature, and this should not replace your own good clinical judgement, or be regarded as a substitute for taking professional advice in appropriate circumstances. In particular, check drug doses, side-effects and interactions with the British National Formulary. Save insofar as any such liability cannot be excluded at law, we do not accept any liability for loss of any type caused by reliance on the information in this podcast.

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Domestic abuse affects patients and colleagues, yet it’s often unseen- so in this compassionate, practical episode Fiona and Nik walk you through what primary care can do right now:

1. How to spot warning signs
2. How we should use clinical inquiry (not universal screening)
3. How to respond to a disclosure with the LIVES framework
4. How to document safely in the electronic medical record

You’ll also hear why children and young people are recognised as victims in their own right, and how to notice and support a colleague who may be affected. 

Do you know about the 999 “Silent Solution”?

All this is so you can feel more prepared, confident and informed in your next clinic. 

Press play: the right conversation at the right moment can change a life.

Useful Links

Domestic abuse  

Doctors Association UK offers resources and research on domestic abuse in healthcare, including: 

• Resources for doctors and health professionals experiencing domestic abuse
• Resources for NHS employers to support staff affected by domestic abuse
• Research and guidance on domestic abuse in healthcare professionals

TED Talk: Why domestic violence victims don't leave 

Silent Solution 

Mr Right and Mr Wrong

GP Trainee Essentials support package information, and the Red Whale Calendar

Send us your feedback [email protected] or send a voice message

Sign up to receive Pearls here. Pearls are available for 3 months from publish date. After this, you can get access them plus 100s more articles when you buy a one-day online course from Red Whale OR sign up to Red Whale Unlimited.  Find out more here.

Follow us:  Facebook, Instagram, LinkedIn

Disclaimer: We make every effort to ensure the information in this podcast is accurate and correct at the date of publication, but it is of necessity of a brief and general nature, and this should not replace your own good clinical judgement, or be regarded as a substitute for taking professional advice in appropriate circumstances. In particular, check drug doses, side-effects and interactions with the British National Formulary. Save insofar as any such liability cannot be excluded at law, we do not accept any liability for loss of any type caused by reliance on the information in this podcast.

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Have you heard of Alpha-gal syndrome? It was new for nearly all of us at Red Whale too.

Kick off the year with some free CPD as Fi and Nik share what you need to know in this week’s round-up of Red Whale Pearls.

They discuss:

1. What Alpha-gal syndrome is and how it affects patients
2. The serious consequences of this rare, tick-borne allergy to red meat
3. How it manifests as urticaria occurring 2–6 hours after ingesting mammal products
4. How repeated exposure can increase sensitivity and risk of anaphylaxis.

And because we love a smile, we’ve included a best intentions story: when two should have been one!

Listen as soon as you can to ensure you have full access to all the free resources. 

Further Pearls from December will be covered next time

Useful Links

Alpha-gal  

Patients may need specific dietetic device to support them in this. Anaphylaxis UK has produced a patient information leaflet with more details:
https://www.anaphylaxis.org.uk/fact-sheet/alpha-gal/ 

UKHSA: Tips and tricks to stay safe from ticks

Video:
https://www.redwhale.co.uk/bytes/did-you-know-alpha-gal-syndrome
(You'll need to sign in, or sign up to a free Red Whale account to view the video byte above!) 

GP Trainee Essentials support package information, and the Red Whale Calendar

Send us your feedback [email protected] or send a voice message

Sign up to receive Pearls here. Pearls are available for 3 months from publish date. After this, you can get access them plus 100s more articles when you buy a one-day online course from Red Whale OR sign up to Red Whale Unlimited.  Find out more here.

Follow us:  Facebook, Instagram, LinkedIn

Disclaimer: We make every effort to ensure the information in this podcast is accurate and correct at the date of publication, but it is of necessity of a brief and general nature, and this should not replace your own good clinical judgement, or be regarded as a substitute for taking professional advice in appropriate circumstances. In particular, check drug doses, side-effects and interactions with the British National Formulary. Save insofar as any such liability cannot be excluded at law, we do not accept any liability for loss of any type caused by reliance on the information in this podcast.

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Grab your trainers, your dog lead, or even shake your jingle bells, and join us for some free CPD as we have another relaxed round up of recent Red Whale primary care Pearls of wisdom. In the second of two episodes this month, Fi and Nik discuss: 

1. It’s beginning to look a lot like…flu season. There’s been a LOT of media coverage on seasonal influenza over the past few weeks. But aside from flu jabs, are you confident in where we would use antivirals? We look at the criteria for giving antivirals: for treatment, for prophylaxis, and the evidence behind it.
2. “I would like a blood test to check I am well…” What do you do with this request? We share a handy framework to help, and think about how ‘just ticking a box’ could cause a lot of work down the line!

Listen as soon as you can to ensure you have full access to all the free resources. 

Useful Links

UKHSA guideline (2025): treatment and prophylaxis of influenza

GP Trainee Essentials support package information, and the Red Whale Calendar

Send us your feedback [email protected] or send a voice message

Sign up to receive Pearls here. Pearls are available for 3 months from publish date. After this, you can get access them plus 100s more articles when you buy a one-day online course from Red Whale OR sign up to Red Whale Unlimited.  Find out more here.

Follow us:  Facebook, Instagram, LinkedIn

Disclaimer: We make every effort to ensure the information in this podcast is accurate and correct at the date of publication, but it is of necessity of a brief and general nature, and this should not replace your own good clinical judgement, or be regarded as a substitute for taking professional advice in appropriate circumstances. In particular, check drug doses, side-effects and interactions with the British National Formulary. Save insofar as any such liability cannot be excluded at law, we do not accept any liability for loss of any type caused by reliance on the information in this podcast.

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Grab your trainers, your dog lead, or even shake your jingle bells, and join us for some free CPD as we have another relaxed round up of recent Red Whale primary care Pearls of wisdom.  In the first of two episodes this month, Fi and Nik discuss : 

1. Spotting adrenal crisis. Adrenal insufficiency and Addison’s disease can be easy to miss. We've recently updated our article on this, so we thought we’d share it as a Pearl, distilling the 2024 NICE guidance for you.
2. Recurrent bacterial vaginosis: time to consider partner treatment? Bacterial vaginosis is the commonest cause of pathological vaginal discharge in women of reproductive age. But it’s not an easy diagnosis for us to confirm – although we can suspect it clinically and manage empirically.  We’ll give you a refresher on BV infection and diagnosis in primary care and then think about managing recurrent BV, where there’s a new development.

Listen as soon as you can to ensure you have full access to all the free resources. 

Further Pearls from November will be covered next time.

Useful Links

Adrenal insufficiency and Addison’s disease

For professionals:

• The Society of Endocrinology – adrenal crisis

For patients:

• Addison’s Disease Self-help Group (include sections on emergency kits and sick day rules; there doesn’t appear to be a patient group for other forms of adrenal insufficiency)

GP Trainee Essentials support package information, and the Red Whale Calendar

Send us your feedback [email protected] or send a voice message

Sign up to receive Pearls here. Pearls are available for 3 months from publish date. After this, you can get access them plus 100s more articles when you buy a one-day online course from Red Whale OR sign up to Red Whale Unlimited.  Find out more here.

Follow us:  Facebook, Instagram, LinkedIn

Disclaimer: We make every effort to ensure the information in this podcast is accurate and correct at the date of publication, but it is of necessity of a brief and general nature, and this should not replace your own good clinical judgement, or be regarded as a substitute for taking professional advice in appropriate circumstances. In particular, check drug doses, side-effects and interactions with the British National Formulary. Save insofar as any such liability cannot be excluded at law, we do not accept any liability for loss of any type caused by reliance on the information in this podcast.

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Grab your trainers, your dog lead, or your drink of choice and join us for some free CPD as we have another relaxed round up of recent Red Whale primary care Pearls of wisdom. In the second of two episodes this month, Fi and Nik discuss: 

• Genital warts: spotting, treating and referring. Are you confident to diagnose? Do you know what additional screening should be offered? Are you comfortable with what can be managed in primary care and what should be referred?
• Addictive behaviours. The word ‘addiction’ conjures specific images for each of us. Perhaps it is a person struggling to stop smoking, or a person who uses IV drugs? Or perhaps it is a behaviour more ‘normalised’ and ubiquitous in our society – alcohol or social media use? All can impact health. We share our article on addictive behaviours, and consider: 
  • The difference between addiction and impulse control. 
  • How we can identify addictive behaviour. 
  • Factors that make individuals more susceptible. 

Listen as soon as you can to ensure you have full access to all the free resources. 

Links:

Genital warts

BASHH - genital warts

Red Whale byte: HPV and genital warts 

Problematic social media use or addiction?

UK Rehab – social media addiction (includes a free 24/7 helpline)

Boggled Docs episode covering "The Social Dilemma" on Netflix 

GP Trainee Essentials support package information, and the Red Whale Calendar

Send us your feedback [email protected] or send a voice message

Sign up to receive Pearls here. Pearls are available for 3 months from publish date. After this, you can get access them plus 100s more articles when you buy a one-day online course from Red Whale OR sign up to Red Whale Unlimited.  Find out more here.

Follow us:  Facebook, Instagram, LinkedIn

Disclaimer: We make every effort to ensure the information in this podcast is accurate and correct at the date of publication, but it is of necessity of a brief and general nature, and this should not replace your own good clinical judgement, or be regarded as a substitute for taking professional advice in appropriate circumstances. In particular, check drug doses, side-effects and interactions with the British National Formulary. Save insofar as any such liability cannot be excluded at law, we do not accept any liability for loss of any type caused by reliance on the information in this podcast.

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Grab your trainers, your dog lead, or your drink of choice and join us for some free CPD as we have another relaxed round up of recent Red Whale primary care Pearls of wisdom.  In the first of two episodes this month, Fi and Nik have special guest Lucy Cox, the Red Whale women’s health course lead to discuss : 

• Managing menopause after breast cancer. A diagnosis of breast cancer is life-changing at any age. Women in this situation will commonly seek our advice and we really want to help them at this vulnerable time, but for pre- and perimenopausal women conflicting media coverage over the safety of different menopause treatment options after breast cancer have created a recipe for confusion and frustration for patients and clinicians alike... 
• We'll also briefly cover ultra-processed food. Joe Wicks’ recent documentary ‘Licensed to Kill’ has brought this topic back into the spotlight. While the scare-tactic language in the title and promo are perhaps not the best way to support people to make sustained change, the programme contained some important points and may well result in questions coming primary care’s way. We have an exclusive clip of Nik talking to Hussain all about this on Boggled Docs.  

Listen as soon as you can to ensure you have full access to all the free resources. 

Further Pearls from October will be covered next time.

Links:

Boggled Docs: Ultra-processed food: licensed to kill?

GP Trainee Essentials support package information, and the Red Whale Calendar

Send us your feedback [email protected] or send a voice message

Sign up to receive Pearls here. Pearls are available for 3 months from publish date. After this, you can get access them plus 100s more articles when you buy a one-day online course from Red Whale OR sign up to Red Whale Unlimited.  Find out more here.

Follow us:  Facebook, Instagram, LinkedIn

Disclaimer: We make every effort to ensure the information in this podcast is accurate and correct at the date of publication, but it is of necessity of a brief and general nature, and this should not replace your own good clinical judgement, or be regarded as a substitute for taking professional advice in appropriate circumstances. In particular, check drug doses, side-effects and interactions with the British National Formulary. Save insofar as any such liability cannot be excluded at law, we do not accept any liability for loss of any type caused by reliance on the information in this podcast.