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In this episode, Dr Roger Henderson discusses infectious mononucleosis, a common viral illness that can present a surprisingly complex diagnostic and clinical challenge. Most often associated with Epstein–Barr virus (EBV), infectious mononucleosis is particularly familiar in adolescents and young adults, where fever, pharyngitis, lymphadenopathy and fatigue can create a classic clinical picture. But recognising the syndrome is only the beginning. Similar presentations can occur with other infections, including acute HIV and cytomegalovirus, while complications such as airway obstruction and splenic rupture, although uncommon, require careful attention. Here, he explores how EBV infection presents, how to approach diagnosis and differential diagnosis, what evidence-based supportive management involves, and the key advice GPs should give patients about activity, recovery and potential complications. Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/infectious-disease/ep-228-infectious-mononucleosis 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 a fascinating and sometimes unsettling area of clinical practice: parasomnias. Sleep is something everyone experiences, but for some patients it is far from quiet or predictable: they may walk, shout, experience vivid nightmares or even physically act out their dreams, leaving both them and their partners confused, frightened or concerned about what these behaviours might mean. For GPs, recognising the pattern is crucial. Is the episode occurring early or late in the night? Is the patient confused or fully alert afterwards? Do they remember what happened, and could medication, another sleep disorder or an underlying neurological condition be contributing? Here, we cover the key clinical features of non-rapid eye movement (NREM) parasomnias, nightmare disorder and rapid eye movement (REM) sleep behaviour disorder, and discuss practical approaches to their assessment, differential diagnosis and management. Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/neurology/ep-227-parasomnia 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 discusses gallstone disease, one of the most common disorders affecting the biliary system and a frequent cause of abdominal pain, emergency presentations and gastrointestinal complications. He examines how gallstones develop, focusing on the metabolic, hormonal, genetic and environmental factors that contribute to their formation. The discussion then follows the clinical progression from asymptomatic cholelithiasis and biliary colic to acute cholecystitis, choledocholithiasis, ascending cholangitis and gallstone pancreatitis. Dr Henderson reviews the role of ultrasound, laboratory investigations, magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography in diagnosis, before considering current approaches to management, including laparoscopic cholecystectomy and endoscopic intervention. Finally, he highlights important complications and clinical red flags, providing a concise framework for recognising and managing gallstone disease in everyday medical practice. Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/gastroenterology/ep-226-gallstones 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 carotid artery stenosis and its role in the prevention of ischaemic stroke. Carotid disease is common, but managing it effectively is far from straightforward. The key clinical questions are not simply how narrow the artery is, but whether the stenosis is responsible for the patient's neurological symptoms, what mechanism is causing cerebral ischaemia, and whether revascularisation offers greater benefit than modern medical therapy. The episode explores the differences between symptomatic and asymptomatic carotid stenosis, the evidence supporting carotid endarterectomy, the importance of timing after transient ischaemic attack or stroke, and the evolving role of carotid stenting. It also considers plaque vulnerability, contemporary medical therapy and how these factors influence decisions about intervention in everyday clinical practice. Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/cardiovascular-medicine/ep-225-carotid-artery-stenosis 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 discusses unstable angina and its place within the spectrum of acute coronary syndrome. Although advances in high-sensitivity troponin testing mean that unstable angina is diagnosed less frequently than in the past, recognising the clinical syndrome remains essential. For GPs, the challenge is distinguishing acute myocardial ischaemia from other causes of chest discomfort, while identifying those patients who require urgent investigation and treatment. The episode covers the underlying pathophysiology, the clinical features that should raise suspicion and the role of the electrocardiogram and high-sensitivity troponin in contemporary diagnosis. It also explores risk stratification, antiplatelet and anticoagulant therapy, symptom management, indications for invasive assessment and secondary prevention. Most importantly, it considers how careful clinical reasoning can help GPs identify high-risk patients early and avoid missing alternative life-threatening diagnoses. Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/cardiovascular-medicine/ep-224-unstable-angina 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 cystic fibrosis, a condition that has undergone one of the most remarkable transformations in modern medicine. Once considered almost exclusively a life-limiting childhood disease, cystic fibrosis is now increasingly recognised as a chronic condition extending well into adult life, thanks to major advances in diagnosis, multidisciplinary care and targeted therapies. The episode covers the underlying genetics and pathophysiology, the multisystem nature of the disease and key features of diagnosis and management, along with the revolutionary impact of cystic fibrosis transmembrane conductance regulator modulators. It also considers the continuing importance of holistic, multidisciplinary care and what the future may hold for patients living with cystic fibrosis. Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/respiratory-and-chest-medicine/ep-223-cystic-fibrosis Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

The role of magnesium supplements in improving sleep duration and quality has received a great deal of interest, particularly on social media, but why might additional magnesium improve sleep, and is there evidence that it does? In this episode, Dr Kate Chesterman explores these questions and considers whether magnesium supplements could be recommended as an additional option alongside the traditional management of sleep disorders. Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/nutrition/ep-222-magnesium-and-sleep Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Polyendocrine metabolic ovarian syndrome (PMOS) is one of the most common endocrine disorders affecting women of reproductive age, yet it remains widely misunderstood. Although traditionally viewed as primarily a reproductive condition and known as polycystic ovary syndrome, PMOS is now recognised as a complex multisystem disorder with important metabolic, endocrine, dermatological and psychological consequences that extend far beyond the ovaries. In this episode, Dr Roger Henderson explores the underlying pathophysiology of PMOS, including the central role of insulin resistance and hyperandrogenism, as well as the diverse ways patients present in clinical practice. He also reviews the current diagnostic approach, important differential diagnoses and evidence-based management, from lifestyle intervention and pharmacological therapy to fertility treatment and long-term metabolic surveillance. Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/gynaecology/ep-221-polyendocrine-metabolic-ovarian-syndrome Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Medication overuse headache (MOH) is a common but frequently overlooked cause of chronic daily headache, particularly in people with migraine. In this episode, Dr Roger Henderson explores how regular use of acute headache medications can paradoxically drive increasing headache frequency, creating a cycle of persistent pain and escalating medication use. Clinical features that should raise suspicion and the diagnostic criteria are discussed, along with why asking patients how many days each month they take headache medication is often the most important question in the consultation. This episode also examines the proposed mechanisms underlying MOH, practical approaches to diagnosis and evidence-based management, including medication withdrawal, preventive therapy and patient education. By recognising MOH early, GPs can often achieve substantial improvements in headache control and quality of life without simply prescribing another acute treatment. Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/neurology/ep-220-medication-overuse-headache Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Keratosis pilaris is a common and harmless condition that can, nevertheless, cause distress in some people due to its appearance. In this episode, Dr Kate Chesterman considers the pathophysiology and diagnostic features of keratosis pilaris, before discussing self-care advice and treatment options that can be recommended to try to reduce the rough, bumpy and dry appearance of this condition. Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/dermatology/ep-219-keratosis-pilaris 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 Hannah Rosa discusses hypercalcaemia and how it can be managed in five steps. She reviews when to suspect hypercalcaemia and the most common causes of a raised calcium. She also covers further investigations that can be undertaken in primary care, management in secondary care and follow-up in primary care. At the end, there is a chance to put the learning into a clinical context with a quick quiz. Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/diabetes-and-endocrinology/ep-218-hypercalcaemia 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 discusses illness anxiety disorder (IAD), a condition that presents unique challenges for both patients and healthcare professionals. Formerly known as hypochondriasis, IAD is characterised by a persistent fear of having or developing a serious medical illness despite appropriate evaluation and reassurance. These patients often present in primary care and specialist settings, frequently seeking answers for symptoms that may be minimal or entirely absent. Recognising the condition is important, as repeated investigations alone rarely alleviate distress and can contribute to unnecessary healthcare utilisation. This episode explores the clinical features, risk factors, diagnostic criteria, differential diagnosis and evidence-based management of IAD. It also discusses practical strategies for building therapeutic relationships and supporting these patients in a compassionate and effective manner. Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/psychiatry/ep-217-illness-anxiety-disorder 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 provides an overview of alopecia, one of the most common yet often misunderstood conditions encountered in clinical practice. While hair loss is rarely life-threatening, it can have a profound impact on a patient’s psychological wellbeing, self-esteem and quality of life. Alopecia is not a single disease but a clinical sign with numerous underlying causes, ranging from temporary and reversible conditions to forms of permanent scarring hair loss; for GPs, distinguishing between these types is essential for accurate diagnosis, timely intervention and effective management. The episode covers the major categories of alopecia, reviews key clinical features and diagnostic approaches, and explores current treatment strategies. It also considers the important psychosocial effects of hair loss and the role GPs play in supporting affected patients. Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/dermatology/ep-216-alopecia Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

Hiccups are a common symptom, with short-lived episodes usually being a source of amusement rather than distress. For these acute episodes, simple nonpharmacologic techniques are often effective. However, persistent hiccups greatly affect quality of life and can be difficult to manage. There is often significant diagnostic dilemma, with potentially serious and even life-threatening underlying causes needing to be considered. In this episode, Dr Kate Chesterman discusses the investigation and management of hiccups. Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/general-practice/ep-215-hiccups 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 pneumococcal disease and the major changes coming to the UK pneumococcal vaccination programme in 2026. Although often overshadowed by other infectious diseases, Streptococcus pneumoniae remains a leading cause of preventable morbidity and mortality worldwide, particularly among older adults, young children and immunocompromised patients. This episode discusses the microbiology and clinical manifestations of pneumococcal disease, reviews the immunological principles behind current vaccines and examines why the UK is transitioning towards the use of the 20-valent pneumococcal conjugate vaccine, or PCV20. It also looks at the wider public health implications of these policy changes and considers how evolving serotype epidemiology continues to shape vaccination strategy in modern clinical practice. Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/infectious-disease/ep-214-pneumococcal-disease Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.