Breast pain can be commonly seen in primary care and although rare inflammatory breast cancer can mimic the signs and symptoms of mastitis. Learn more about recognising the different causes of breast pain in non-lactating women and how to manage them. Read the article then take the multiple choice assessment.                          

Anabolic steroid use has a number of long term health risks and it is important to identify patients who may be using them so you can encourage cessation and monitor them for complications. Read the article then take the multiple choice assessment.

Itching in the perianal area, pruritus ani, causes substantial discomfort with an uncontrollable desire to scratch. Patients are often embarrassed to talk about it. Read the article on this subject then take the multiple choice assessment.                         

Snoring occurs in 8% to 15% of children, while obstructive sleep apnoea occurs in 1% to 4%. The spectrum of sleep disordered breathing extends from normal breathing and uncomplicated snoring through to obstructive sleep apnoea, with increasing degrees of airway obstruction. Parents are often concerned about snoring, the disordered breathing and behaviour changes that sometimes accompany it, and the possibility of an underlying medical cause. This first consultation will help to discriminate obstructive sleep apnoea from uncomplicated snoring. Read the article on this subject then take the[...]

Learning outcomes After completing this module you should know: how to identify patients at high risk of type 2 diabetes and what to advise them regarding lifestyle measures to reduce the risk when to consider medication to reduce diabetes risk which drugs can increase the risk of diabetes and the implications for rational prescribing. 

Learning outcomes Upon completion of this module you should know: How to assess ongoing risk of fracture in a patient who is taking bone sparing medication for osteoporosis The red flag symptoms that might suggest an osteoporotic vertebral fracture How to help patients weigh up the benefits and drawbacks of having a break from bisphosphonate treatment (a “drug holiday”).                                                        [...]

Prolonged grief disorder (PGD) should be considered in people with continued separation distress beyond the first six to 12 months of bereavement. PGD occurs in approximately 10% of bereaved individuals, with an increased risk of occurring following the death of a partner or child and loss to unnatural or violent circumstances, and among people vulnerable to mental health conditions. Read the article on this subject then take the multiple choice assessment.                                  [...]

Learning outcomes Upon completion of this module you should: Know the common causes of foot drop and how to assess for them clinically Feel confident about managing peroneal neuropathy in primary care Know which investigations are useful to confirm the diagnosis of peroneal neuropathy Understand the indications for referral in a patient with foot drop.

Learning outcomes Upon completion of this module you should know: How cataract typically presents and when to refer How to advise patients on the complications of cataract surgery and appropriate postoperative care How to recognise signs of more serious conditions that require urgent referral including age related macular degeneration, giant cell arteritis, and retinal detachment How fundoscopy findings relate to different diagnoses in patients presenting with visual disturbances.

Learning outcomes Upon completion of this module you should know: Antihypertensive medications that you can consider using in pregnancy, and drugs that need to be stopped How to correctly measure blood pressure when assessing a woman who is pregnant with chronic hypertension The risks of uncontrolled hypertension in pregnancy How to monitor postnatally, and antihypertensive medications that can be considered or need to be avoided in breast feeding.

Learning outcomes Upon completion of this module you should know: When nipple discharge is a red flag warranting a two-week referral to a breast clinic under the 2015 NICE referral criteria for suspected cancer How to manage nipple discharge, whether unilateral or bilateral Which drugs can cause galactorrhoea as a side-effect The significance of eczematous changes in the breasts.

Learning outcomes Upon completion of this module you should know: How to assess for an Achilles tendon rupture How to manage an Achilles tendon rupture Drugs which can be associated with tendinopathy How to assess for Achilles tendinopathy The management options for Achilles tendinopathy, and when to expect improvement in symptoms.

Learning outcomes   After completing this module you should: Know the symptoms and signs of osteoarthritis of the base of the thumb Know some of the common differential diagnoses in someone presenting with pain in the carpometacarpal joint and how to distinguish them Know when investigation is and isn’t indicated in a patient with pain at the base of the thumb Know which treatments can be carried out in primary care and when referral is indicated.

Learning outcomes Upon completion of this module you should know: Which symptoms and examination findings are red flags that warrant urgent referral The symptoms and signs of endometriosis A rational approach to investigating and treating dysmenorrhoea in primary care The indications for, and limitations of, laparoscopy in the investigation of chronic pelvic pain.