GPnotebook Podcast

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.

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.