Clinical Rounds, the GPAtlas podcast

Clinical Rounds is reviewed and updated by practising UK GPs. Each episode takes a single presentation as it arrives in a surgery and works through the decision that actually matters, with the guidance behind it named.

Every episode

• Endometriosis: the normal scan that proves nothing Women's Health 20 min

  Hannah, aged 26, misses work each month with period pain, has deep pain during sex and a normal scan, and wants to be believed.

• Knee osteoarthritis: before anyone talks about a new knee Musculoskeletal (MSK) 17 min

  Linda, aged 68, has aching, stiff knees and asks for an X-ray and a referral.

• Diabetic nerve pain: the codeine in his coat pocket Neurology 17 min

  Mr Hussain, aged 67, has type 2 diabetes and burning feet, worse at night, and asks for something stronger than co-codamol.

• Palliative cough: find the cause, then skip the codeine Palliative Care 18 min

  Ray, aged 74, has metastatic lung cancer and a dry, hacking cough every night; his wife Jean asks for more codeine linctus.

• Bipolar disorder: the high hidden inside depression Mental Health (MH) 18 min

  Leah, aged 26, a staff nurse on rotating nights, has low mood not helped by her second antidepressant and asks for a dose increase.

• Acute otitis media: the bulge, not the blush ENT 19 min

  Isla, aged 16 months, has had a cold for three days, then fever, right ear-tugging and a sleepless night, and her mum wants antibiotics.

• Heart disease risk: why the calculator is just the start Cardiovascular 20 min

  Amar, aged 42, brings his Health Check letter showing a ten-year cardiovascular risk score of 8 and asks whether he is fine.

• Type 1 diabetes: ignore the age and look for ketones Endocrinology 19 min

  Joanne, aged 52, comes for her blood results: glycated haemoglobin (HbA1c) 71, thirst, nocturia, recurrent thrush and nearly a stone lost without trying.

• PMOS, the new name for PCOS: the scan you don't need Women's Health 21 min

  A girl aged 15, two years after menarche, has irregular periods, acne and chin hair, and her mother asks for an ultrasound.

• Lipids and statins: two targets and a three-month recheck Cardiovascular 19 min

  Mr Nowak, aged 62, takes atorvastatin after a heart attack 14 months ago, and comes in about his knee.

• Epilepsy and valproate: both sexes, under fifty-five Neurology 20 min

  A man aged 34, stable on sodium valproate for years, has a repeat request for it on the Friday prescribing list.

• Miscarriage: the rule that changed in June Pregnancy & Antenatal Care 19 min

  A woman seven weeks pregnant rings on a Saturday with bleeding since overnight and cramping, and asks whether to wait and see.

• Menopause and HRT: change the route, not the decision Women's Health 19 min

  Karen, aged 52, has flushes, poor sleep and a short temper, and assumes her weight, migraines and mother's clot rule out hormone replacement therapy (HRT).

• Chest pain: timing, not typicality Cardiovascular 19 min

  Mr Osei, aged 58, a smoker, had 40 minutes of chest tightness carrying shopping yesterday evening and thinks Gaviscon proved it was indigestion.

• Raised ferritin: what to do with six hundred Haematology 19 min

  Mr Bianchi, aged 51, had a tiredness screen. His ferritin is 620, everything else is normal and he feels no different.

• Breastfeeding problems: the instinct that makes it worse Pregnancy & Antenatal Care 18 min

  A first-time mother, aged 29, has cracked, painful nipples, feeds her three-week-old about two-hourly, says she has no milk and is considering formula.

• Methotrexate and DMARDs: the routine prescription that could kill Musculoskeletal (MSK) 19 min

  Mrs Whelan, aged 58, takes methotrexate for rheumatoid arthritis and rings on Monday morning with burning on passing urine and frequency.

• Bowel cancer and the FIT test: two tests with the same name Malignancy & Cancer 18 min

  Mrs Ferreira, aged 63, has two months of looser stools and some blood she blames on piles, and says her screening kit was fine.

• Sciatica: the questions you ask every time Musculoskeletal (MSK) 19 min

  Dev, aged 44, who does deliveries, has two weeks of left leg pain worse than back pain and asks for a scan and stronger painkillers.

• Delirium: the quiet one is the worry Mental Health (MH) 20 min

  Mrs Cole, aged 84, lives alone; a home visit is requested because she is not herself, sleepy and off her food.

• Contraception: when oestrogen is the wrong answer Sexual Health 19 min

  Chloe, aged 26, gets migraines and asks to restart Microgynon, the combined pill she took without problems years ago.

• Palliative care: the conversation you're having too late Palliative Care 19 min

  Mr Doyle, aged 79, has lung cancer and has had his last chemotherapy; his wife rings asking whether he should have his flu jab.

• Ovarian cancer: CA125 is no longer one number Malignancy & Cancer 19 min

  A woman aged 63 has had four months of bloating, a change in bowel habit and early fullness when she eats.

• Heart failure: under-treated, not optimised Cardiovascular 19 min

  A man aged 71 with heart failure with reduced ejection fraction feels fine on furosemide 40 mg, ramipril 2.5 mg and bisoprolol 1.25 mg.

• Fatty liver (MASLD): the normal ALT that isn't Gastroenterology (GIT) 20 min

  A man aged 54 attends about his knee, with normal alanine aminotransferase (ALT), body mass index 33 and probable fatty liver on a two-year-old ultrasound.

• Type 2 diabetes: two drugs on day one Endocrinology 18 min

  A man aged 52, overweight with no heart or kidney disease, attends a medication review and is newly diagnosed: glycated haemoglobin (HbA1c) 58 millimoles per mole.

• Asthma: the end of the blue inhaler first Respiratory 18 min

  A woman aged 19 attends her asthma review on a twice-daily brown preventer, uses her blue reliever about three times a week and feels fine.

• Polycystic kidney disease: high blood pressure in a young adult Renal 18 min

  A woman aged 34 books in about her pill and feels well, but the healthcare assistant records a blood pressure of 152 over 96.