General-practice and mental-health clinicians get a practical approach to persistent fear of serious disease despite appropriate assessment. Validation, scheduled review, careful limits on repeat investigation and cognitive behavioural therapy are used to reduce reassurance cycles without dismissing genuine symptoms.

Dermatology and general-practice clinicians get a structured approach to patchy hair loss, diffuse shedding and progressive recession. The central distinction is scarring versus non-scarring alopecia, supported by follicular openings, perifollicular scale, hair pattern, recent triggers, dermoscopy and targeted investigation, with prompt specialist assessment when permanent follicular loss is possible.

General practice, gastroenterology and palliative-care clinicians get a structured approach to acute, persistent and intractable hiccups. Duration, sleep disturbance, nutrition, medication triggers and gastrointestinal, cardiopulmonary, neurological or metabolic features guide focused examination, investigation and escalation.

Primary-care, respiratory and infectious-diseases clinicians get a practical pneumococcal disease update. It covers capsule biology, serotype diversity, invasive pneumococcal disease, pneumonia, sepsis, meningitis, adult risk groups and the 2026 UK shift towards PCV20 for adults aged 65 years and over and clinically at-risk groups.

General practice, rheumatology and geriatric medicine teams get a practical PMR review for adults over 50 with rapid-onset shoulder, neck and hip girdle stiffness. Functional limitation, preserved true power, inflammatory markers, corticosteroid response, relapse, bone protection and repeated giant cell arteritis screening are kept together.

General practice, infectious diseases and dermatology teams get a practical review of unilateral dermatomal pain and vesicular rash. The episode highlights prodromal neuropathic pain, early antiviral treatment, pain control and urgent assessment for ophthalmic zoster, Ramsay Hunt syndrome, disseminated disease or neurological complications.

A primary-care and infectious-diseases update for fever, parotid swelling, jaw pain or outbreak exposure. It covers notification, laboratory confirmation, isolation and supportive care, while keeping orchitis, testicular torsion, aseptic meningitis, encephalitis and hearing change within the safety-net.

Infertility, gynaecomastia, erectile dysfunction, acne, new hypertension or mood change can be the presentation of anabolic androgenic steroid misuse. The useful consultation skill is neutral language about training goals, body image, substances, route and duration.

Resolved neurological symptoms can still mark a time-critical TIA. This review keeps the focus on sudden focal symptoms, common mimics, early aspirin when appropriate, urgent imaging, vascular assessment, ECG and mechanism-based prevention.

Raised blood pressure after 20 weeks is not settled by one reading or absent proteinuria. The pregnancy hypertension item is useful for repeated measurement, severe thresholds, headache, visual symptoms, right upper abdominal pain, HELLP syndrome, fetal surveillance and postpartum safety-netting.