In this episode of Synapse, we tackle one of the most common presentations in Australian primary care: the headache. We provide a clear guide to cut through the complexity, starting with how to take a representative history and spot crucial red flags with the SNOOP4 mnemonic. We then demystify the approach to neuroimaging and provide clinical pearls for managing common primary headaches like migraine and TTH , as well as can't-miss secondary causes like Giant Cell Arteritis.

Support the show

Podcast: Unlocking TMJ: Pain, Popping, and Pathways to Relief

Is it a dull ache in your face, a painful click in your jaw, a tension headache you can't shake, or a persistent earache? You might be dealing with temporomandibular dysfunction, or TMD. Affecting millions of people, especially women in their 20s and 30s, this complex condition is one of the most common causes of non-dental facial pain.

In this episode, we separate fact from fiction and provide a clear guide to understanding your jaw pain. We break down the two main culprits: pain from the hardworking muscles of mastication and problems from within the temporomandibular joint (TMJ) itself.

Join us to learn:

• The common symptoms of TMD, from jaw discomfort and popping sounds to referred pain like headaches and earaches.
• The surprising links between TMD, stress, anxiety, and parafunctional habits like teeth clenching and bruxism.
• How TMD is diagnosed, and why a detailed history and physical exam are often more important than imaging.
• The most effective first-line conservative treatments, including patient education, self-care strategies, and the role of physical therapy.
• A straightforward look at medications, from which ones are recommended for initial treatment to those that should be used with caution.
• When to consider other options like occlusal splints or a referral to a specialist.

The good news is that for the vast majority of patients, symptoms resolve with simple, non-invasive therapies. Tune in to find out how you can manage your symptoms and find relief.

Podcast based on the following articles:

• TMJ dysfunction AFP .pdf
• TMJ dysfunction Article .pdf
• AJGP-04-2018-Clinical-Lomas-Temperomandibular.pdf

Keywords: Temporomandibular Dysfunction (TMD); Orofacial Pain; Myofascial Pain; Articular Disc Displacement; Bruxism (Teeth Grinding); Masticatory Muscles; Jaw Clicking & Popping; Headache and TMJ; Conservative Management; Cognitive Behavioural Therapy (CBT) and TMJ; Physiotherapy and TMJ; Occlusal Splints for TMJD.

Support the show

Is it a ringing, a buzzing, a hissing, or a hum? Tinnitus is one of the most common symptoms people experience, but it's widely misunderstood. More than just an annoyance, persistent tinnitus can significantly affect mood, sleep, and overall quality of life.

In this episode, we cut through the noise to bring you a clear, evidence-based guide to tinnitus. We explore what's really happening in your auditory system when you perceive a sound that isn't there.

Join us as we discuss:

• The crucial difference between pulsatile and nonpulsatile tinnitus, and why it matters for your health.
• The "red flag" symptoms, like unilateral (one-sided) tinnitus, that warrant a specialist referral.
• Why a formal hearing test is the essential first step for almost every patient.
• Effective management strategies that go beyond "just live with it," including the proven benefits of hearing aids, sound therapy, and Cognitive Behavioural Therapy (CBT) to help you regain control.
• Why most medications are not recommended and what you should focus on instead.

Whether you're personally affected by tinnitus or are a clinician looking for a clear approach, this episode provides the essential information you need to understand the causes, appropriate investigations, and most effective management pathways.

Podcast based on the following articles:

• AFP Approach to Tinnitus .pdf
• Apprach to Tinnitus NEW .pdf
• AJGP-04-2018-Clinical-Esmaili-Tinnitus.pdf

Support the show

This episode offers a concise clinical review of Overactive Bladder (OAB) syndrome for practitioners. We cover the essential steps in diagnosis, from taking a focused history and ruling out red flags to the importance of urinalysis and post-void residual measurement.

The core of the discussion is the stepwise management framework:

• First-line: A review of foundational conservative therapies, including lifestyle advice and structured bladder training.
• Second-line: A comparison of pharmacotherapy options, focusing on the mechanisms and differing side-effect profiles of antimuscarinics versus the beta-3 agonist, mirabegron.
• Third-line: An overview of specialist treatments for refractory OAB, including intravesical botulinum toxin A and sacral neuromodulation.

Tune in for a practical update to guide your clinical management of OAB.

Keywords: Overactive Bladder (OAB) management; Urinary urgency diagnosis; Nocturia and frequency treatment; Antimuscarinics for OAB; Mirabegron Australia; Beta-3 agonists bladder; First-line OAB treatment; Bladder training and pelvic floor; Refractory OAB options; OAB in elderly patients; Australian General Practice guidelines; Urge incontinence vs OAB-wet; GP review of incontinence; Bladder diary use; Medical student urology.

Support the show

GPA ref 11: Androgen deficiency in older men

This episode focuses on the evidence-based approach to diagnosing and managing androgen deficiency in older men13. We summarise the AJGP article "Androgen deficiency in older men," providing a practical guide for GPs. This information is taken directly from the Australian Journal of General Practice, Vol. 48, No. 7, July 201914.

Article Link: https://www.racgp.org.au/ajgp/2019/july/androgen-deficiency-older-men

Support the show

GPA ref 10: The diabetic foot ulcer

This episode provides a practical guide to the assessment, management, and prevention of diabetic foot ulcers in the general practice setting11. We summarise the AJGP article "The diabetic foot ulcer". This information is taken directly from the Australian Journal of General Practice, Vol. 49, No. 5, May 202012.

Article Link: https://www.racgp.org.au/ajgp/2020/may/diabetic-foot-ulcer

Support the show

Article Summary: Hyperglycaemia in Type 2 Diabetes

This episode explores the assessment and management of various hyperglycaemic presentations in patients with type 2 diabetes9. We summarise the AJGP article "Hyperglycaemic presentations in type 2 diabetes," providing a practical guide for GPs. This information is taken directly from the Australian Journal of General Practice, Vol. 48, No. 5, May 201910.

Article Link: https://www.racgp.org.au/ajgp/2019/may/hyperglycaemic-presentations

Support the show

GPA ref 48: Patient-delivered partner therapy

This episode explores the options for patient-delivered partner therapy for the management of sexual partners of patients diagnosed with chlamydia7. We summarise the AJGP article "Patient-delivered partner therapy - options for management of sexual partners of a patient diagnosed with chlamydia". This information is taken directly from the Australian Journal of General Practice, Vol. 51, No. 6, June 20228.

Article Link: https://www.racgp.org.au/ajgp/2022/june/patient-delivered-partner-therapy