In this episode, Dr Hannah Rosa reflects upon the changing relationship between young people and alcohol. She examines the latest statistics before discussing the Chief Medical Officer for England’s guideline on alcohol consumption for children and young people. The focus then moves on to the harms that we now know that alcohol can cause to young people, especially to the developing brain, before finishing with emphasising the role that professionals in primary care play in supporting these young people and their families.

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Perinatal mental health (PNMH) issues refer to the period from the point of conception to a child’s first birthday. It encompasses several different mental health conditions and components far beyond the traditional understanding of post-natal depression and has an important impact on families and society. In part, the huge burden and associated cost is driven by how common PNMH problems are for both men and women. PNMH issues are more common than any physical health problem in pregnancy, so there is a need for GPs to look for and manage them to ensure the best outcomes for families and children. In this episode, Dr James Waldron welcomes Dr Jenny Barnes (GP, Warwickshire) to discuss PNMH problems and help raise awareness of the risks and impact, as well as simple ideas to support families in clinical practice.

Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/mental-health/ep-131-perinatal-mental-health-awareness-risks-and-impacts.

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Croup is a respiratory condition typically affecting children, characterised by a distinctive barking cough, hoarseness and difficulty breathing. Caused primarily by viral infections, especially the parainfluenza virus, it inflames the larynx, trachea and bronchi, leading to swelling and obstruction in the airway. Croup symptoms often worsen at night and can be triggered by environmental factors such as cold air. Treatment ranges from home remedies like humidified air and hydration to medical interventions, such as corticosteroids or nebulised epinephrine, depending on the severity of the condition. While most cases resolve within a few days, severe instances can lead to hospitalisation. In this episode, Dr Roger Henderson looks at how best to diagnose it, whether scoring systems are useful, and principles of effective management – including when to consider hospital referral.

Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/respiratory-and-chest-medicine/ep-130-croup.

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Acute appendicitis is a medical emergency characterised by the sudden onset of inflammation in the appendix. As one of the leading causes of abdominal pain that necessitates surgical intervention, appendicitis can occur at any age, though it is most common in adolescents and young adults. The condition is primarily caused by a blockage in the appendix, which leads to bacterial infection, swelling and increased pressure. If left untreated, acute appendicitis can progress to life-threatening complications such as perforation, peritonitis and sepsis. Due to the non-specific symptoms, particularly in the early stages, diagnosing appendicitis can be challenging. Prompt recognition and treatment, typically through surgical removal of the appendix, are critical to preventing complications and ensuring a swift recovery. In this episode, Dr Roger Henderson looks at the clinical presentation, diagnosis and management of acute appendicitis, highlighting its significance as a common yet potentially dangerous medical condition.

Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/gastroenterology/ep-129-acute-appendicitis.

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Breast pain affects around 70% of women at some point in their lives and is a common reason for referral to breast clinics. It is often a cause of anxiety for women who may be concerned that their pain might be associated with breast cancer. In this episode, Dr Kate Chesterman discusses the assessment of the patient presenting with breast pain and explains the lack of association between breast cancer and breast pain in those with a normal clinical examination. She considers cyclical, non-cyclical and extra-mammary pain and discusses the causes and management options for these, as well as considering when referral to secondary care would be appropriate.

Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/gynaecology/ep-128-mastalgia-breast-pain.

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Fibromyalgia is a condition characterised by chronic widespread pain together with multiple muscular tender points or associated fatigue, sleep disturbance or cognitive dysfunction in the absence of a well-defined underlying organic disease. The majority of patients present with both tender points and associated symptoms, although the exact aetiology of fibromyalgia is unknown. In this episode, Dr Roger Henderson takes a look at possible triggers, diagnostic approaches, possible treatments (including non-pharmacological methods) and the prognosis for patients with this often poorly understood and underdiagnosed condition.

Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/neurology/ep-127-fibromyalgia

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In this episode, Dr Hannah Rosa reflects upon the poor lung cancer survival rates in the UK. She asks whether we are doing enough chest X-rays in primary care and whether we could be detecting lung cancers earlier. She delves further into this by exploring why diagnosing lung cancer is challenging, reviewing the guidelines and latest research and then discussing when we should continue to investigate for lung cancer even if the patient has had a normal chest X-ray. She finishes by reviewing the targeted lung health check programme that is currently being rolled out across England.

Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/oncology/ep-126-are-we-doing-enough-chest-x-rays-in-primary-care.

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Generalised anxiety disorder (GAD) is a common condition defined as chronic, excessive worry for at least 6 months that causes distress or impairment, and is hard to control. It is in part a diagnosis of exclusion: physical examination and laboratory studies are generally normal if no co-existing physical or mental health conditions or substance misuse issues exist. Treatment is primarily with psychotherapy (usually cognitive behavioural therapy), serotonergic antidepressants or a combination of these approaches. In this episode, Dr Roger Henderson looks at how best to diagnose GAD, what treatment options should be considered, possible differential diagnoses and the long-term outlook for patients.

Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/mental-health/ep-125-generalised-anxiety-disorder.

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