GPnotebook

Continuous glucose monitoring reveals trends rather than isolated measurements and supports automated insulin delivery. Forecasts remain uncertain, backup finger-prick testing is necessary, and increasing data availability introduces challenges involving interpretation, privacy, access and clinical workload.

Fever, sore throat and profound fatigue suggest infectious mononucleosis, but a negative Monospot cannot exclude Epstein–Barr virus. Acute HIV and other infections remain important alternatives, while management requires supportive care, recognition of complications and advice about splenic injury and prolonged fatigue.

Sleepwalking, sleep terrors, nightmares and REM sleep behaviour disorder differ in timing, awareness and recall. Witness accounts help distinguish them, while adult-onset symptoms, injuries and dream enactment warrant assessment for contributing medicines, sleep disorders or neurological disease.

Gallstone disease ranges from incidental stones to biliary colic, cholecystitis, cholangitis and pancreatitis. Symptoms, inflammatory features and stone location guide investigation, while biliary infection with persistent obstruction requires decompression rather than antibiotics alone.

Carotid stenosis management depends on linking the neurological event to the lesion, then considering severity, timing and procedural risk; severe symptomatic disease may benefit from early endarterectomy, while asymptomatic disease requires more selective risk assessment.

Unstable angina remains acute myocardial ischaemia without demonstrable infarction, requiring interpretation of changing symptoms, serial ECGs and high-sensitivity troponins together; normal investigations between episodes do not automatically exclude acute coronary syndrome.

CFTR dysfunction drives thick airway secretions, infection, inflammation, bronchiectasis and multisystem disease; later presentations still occur, while mutation-specific modulators improve outcomes without replacing airway clearance, nutritional treatment, surveillance or lifelong multidisciplinary care.

Magnesium has plausible roles in sleep-related neuronal signalling and circadian physiology, but supplementation studies remain small and inconsistent; dietary assessment, risk factors for low magnesium, formulation, gastrointestinal adverse effects and cautious interpretation of modest reported benefits all matter.

Irregular cycles, hyperandrogenic symptoms and metabolic dysfunction can occur at any body mass index. Diagnosis integrates clinical features while excluding mimics; management follows reproductive goals and requires long-term surveillance for metabolic, cardiovascular, psychological and endometrial complications.

Medication overuse headache should be considered when a previously episodic primary headache occurs on at least 15 days each month. Count treatment days, not tablets: 10 days for triptans, opioids or combination analgesics, and 15 for simple analgesics, sustained for more than three months.