Chronic Disease & Conditions

This module begins with the anatomy, role and function of the thyroid gland and outlines common conditions. Primary and secondary hypo and hyperthyroidism are discussed including risk factors, primary causes, symptoms, examinations, investigations, diagnosis, management and complications if untreated. The main types of thyroid cancer are outlined including papillary, follicular, medullary, anaplastic and hurtle cell carcinoma. Risk factors, symptoms, signs, diagnosis, investigations and management are discussed. Three patient cases outline different clinical presentations and guides the practitioner through each case. Steps include patient history and medications then discusses examinations, investigations, results, whether to scan, management and follow-up. Treatment and monitoring thyroid conditions are long term, even lifelong.   

This module commences with the description and epidemiology of asthma. The history, pathogenesis and a range of risk factors are outlined. An overview of the diagnosis and evaluation of patients with asthma also includes mimics of asthma symptoms. Diagnosis and management for adolescents and adults including diagnostic tools are outlined then moves to the diagnosis, diagnostic tools and management of asthma in infants and children. Red flags to look for are described. The module concludes with information on thunderstorm asthma, asthma emergencies, acute asthma in primary care, vaccination and lists available asthma resources.     

Arthritis is an umbrella term for over 100 diseases and conditions affecting the bones, muscles and joints. More than 30 of these are inflammatory rheumatic diseases. The steps of early assessment and diagnosis are outlined commencing with symptoms, patient history and test options. This information is supported by two clinical cases. The first case considers septic arthritis and the second case discusses polymyalgia rheumatica. Inflammatory arthritis aetiologies are outlined before discussing gout and pseudogout in detail.  

The module then considers rheumatoid arthritis covering the facts, aetology, history, stages, tests, clinical features and extra-articular manifestations. A case study is included. Pharmacotherapy, DMARDS, non-pharmacological options and complications are outlined. Information is provided on Rheumatoid arthritis (RA) and pregnancy, and RA and vaccination. 

Unit five discusses ankylosing spondylitis and psoriatic arthritis in detail including aetiology, symptoms, investigations, tests to assist with diagnosis, differential diagnoses and management information.    

This module focuses on the papulosquamous disorders of psoriasis, lichen planus and pityriasis rosea. The first section of the module focuses on identifying the different types of psoriasis and their distinguishing features. It also explains the nine categories of psoriasis, steps taken to make a diagnosis and outlines treatment options. The next topic focuses on recognising the different variations of lichen planus and pityriasis rosea. It explains the six Ps and skin variants of lichen planus, including selecting appropriate treatment options. The diagnosis, including when to biopsy, and the management of pityriasis rosea is outlined including treatment options. Clinical images are featured throughout the module.   

This module commences by describing osteoporosis and related statistics. Bone physiology and determinants of bone density are revisited and modifiable risk factors outlined. Fracture risk factors independent of Bone mineral density (BMD) are outlined and two calculators for assessing fracture risk are included. Recommendations for identifying patients to investigate for osteoporosis and bone mineral density testing are outlined. The management of osteoporosis is discussed from a non-pharmacological, lifestyle and pharmacological perspective. The module then discusses osteoporosis in men including risk factors. The module concludes with focussing on osteoporosis in young people including chronic diseases associated with lowered BMD, assessment and the principles of treatment of osteoporosis in children and adolescents.   

The primary burden of disease in children and young people has shifted from infectious diseases to chronic conditions. Definitions, demographic and incident data are discussed. Tooth decay is very common in children and information is provided for the medical practitioner encountering this issue. Primary, secondary and tertiary stages of care are listed. The GP role is to listen, support, diagnosis, communicate/educate, coordinate and advocate for the patient and their family. The role of allied health support for the clinician is recognised and discussed. Key consultation strategies and considerations are covered. These include aims, communication, curve balls, breaking bad news, family considerations, non-compliance, medico-legal, child protection, mental health, adolescence and palliation. Consultation frameworks are provided. Following the FAMILY guide, five case examples are provided in managing children with asthma, ASD, school and social media influence, food allergy and spina bifida. Information about the GP’s self-care is mentioned.    

Atrial fibrillation (AF) is the most common recurrent adult arrhythmia worldwide. AF is a supraventricular tachyarrhythmia characterised by uncoordinated, irregular, ineffective atrial contractions. Statistics, epidemiology and health concerns are introduced. Pathophysiology and risk factors are outlined before moving into the classification and the relevance of screening. Clinical features, evaluation, diagnostic work-up and a collaborative approach are a focus of module content.  Information around AF management includes the CHA2DS2-VASc score and HAS-BLED score tools applied to clinical practice. Oral anticoagulants (OAC) contraindications and comparisons are covered including OAC choices. Decisions between rhythm vs Rate control are considered in depth.  

The aim of this module is to consider patients who have symptoms where it is difficult to make a firm diagnosis, but who still need care, support and in some instances, symptomatic treatment. Content commences with the challenges facing a practitioner when dealing with these patients. These patient presentations are common, and symptoms are variable.  Information is provided in how to manage these patients including cultural factors, common symptoms, syndromes, the patient perspective and diagnoses. Information on electromagnetic hypersensitivity is detailed.   

A patient centred approach aims to combine evidence-based diagnosis and treatment with what patients’ experience. Six components of patient centred care are outlined. Treatment should aim to establish an effective physician-patient relationship, help develop strategies for coping and encourage patients to lead a normal work/social life. History, examinations, investigations and self-help strategies are discussed.  Unit five discusses three patient cases.