Sample KFP questions

 

Sample KFP questions

 

Education > FRACGP exams > Fellowship exams > Applied Knowledge Test (AKT) and Key Feature Problem (KFP) exams > Sample KFP questions
Last updated 16 February 2026

Paul Holt, aged 56 years, has noticed mild pain gradually increasing in his left scrotum over the last two weeks. He has increased pain when sitting. He has not had any penile discharge but has noticed mild stinging at the end of urination. He married his wife Michelle four months ago. He has never had sex with men.

Examination findings: 

  • Temperature is 37.6oC 
  • Heart rate 83/min regular 
  • Blood pressure 135/90 mmHg 
  • Scrotal examination; normal position of the testes with tenderness at the superior pole of the left testis. Normal cremasteric reflex

You commence Paul on appropriate dosages of paracetamol and ibuprofen. What are the MOST appropriate next steps? Select four (4) from the following list. 

  1. Ceftriaxone 500mg in 2ml of 1% lignocaine intramuscularly
  2. Doppler ultrasound of the scrotum
  3. Doxycycline 100 mg twice daily for 14 days
  4. First void urine for chlamydia and gonorrhoea PCR
  5. Indometacin 100mg rectally as a single dose
  6. Manually externally rotate the left testis
  7. Prostate specific antigen
  8. Reassure that symptoms are likely to settle without treatment
  9. Refer to urologist for scrotal exploration
  10. Refer urgently to the Emergency Department
  11. Tapentadol controlled-release 50mg twice daily
  12. Trimethoprim 300 mg daily for 14 days
  13. Urethral swab for herpes simplex virus PCR
  14. Urethral swab microscopy, culture and sensitivity
  15. Urine microscopy, culture and sensitivity

A. Ceftriaxone 500mg in 2ml of 1% lignocaine intramuscularly (Score: 1) 
C. Doxycycline 100 mg twice daily for 14 days (Score: 1) 
D. First void urine for chlamydia and gonorrhoea PCR (Score: 1)
O. Urine microscopy, culture and sensitivity (Score: 1)

This is a four answer multiple selection question with a mixture of investigations and management options. This patient presents with two weeks of worsening scrotal pain, low grade fever, superior pole tenderness of one testis and mild dysuria, in the setting of a heterosexual relationship. The most likely presenting complaint in this setting is epididymo-orchitis. In sexually active men of any age, Chlamydia trachomatis and Neisseria gonorrhoea are the most likely causative organisms. It is appropriate to commence empirical treatment whilst awaiting the results of investigations. A urine microscopy and culture is appropriate to determine if the cause is non-sexually transmitted. The stem describes his pain as mild and he is unlikely to need analgesia other than paracetamol and ibuprofen.

He has had this pain for more than 48 hours making acute torsion unlikely. His degree of pain is also not severe. He has a low-grade fever and dysuria which makes appendix torsion also less likely.  

Urgent steps such as a doppler ultrasound, surgical input, or emergency department review is not required at this stage. Reassurance that symptoms will settle, which may be appropriate in testicular appendix torsion, would not be appropriate here.

Clare Parker, aged 4 years, presents for her routine scheduled immunisations with her mother Heather. Clare has had a persistent cough for ten days. She also had a runny nose and fever when the cough started, however these symptoms have now settled. Clare has vomited several times after episodes of coughing but is eating and drinking normally.

Clare last had her routine childhood immunisations at age 18 months. She attends daycare two days a week.

Examination findings: 

  • Appears well although has frequent spasms of coughing 
  • Temperature 36.9oC 
  • Heart rate 90/min regular 
  • Respiratory rate 20/min 
  • Oxygen saturation 99% on room air 
  • Respiratory examination; chest auscultation is unremarkable 

You arrange appropriate investigation of Clare’s cough which confirms the most likely diagnosis.

What is the MOST appropriate management for Clare? Select three (3) from the following list.

  1. Advise Clare can return to daycare after 5 days of treatment
  2. Advise Clare can return to daycare tomorrow
  3. Advise Clare must not return to daycare until her symptoms are resolved
  4. Advise Clare should delay her routine immunisations for two weeks
  5. Advise Clare’s mother should contact the relevant public health unit
  6. Advise to avoid lactose for four weeks
  7. Advise to proceed with routine immunisations
  8. Amoxicillin-clavulanate 22.5mg/3.2mg/kg/dose 12 hourly for 14 days
  9. Clarithromycin liquid 7.5mg/kg/dose 12 hourly for 7 days
  10. Oral rehydration solution 10mL/kg/hour
  11. Prednisolone 1mg/kg/dose once daily for 5 days
  12. Salbutamol 100mcg/dose 6 puffs via spacer and mask 4 hourly as required

A. Advise Clare can return to daycare after 5 days of treatment (Score: 1)
G. Advise to proceed with routine immunisations (Score: 1)
I. Clarithromycin liquid 7.5mg/kg/dose 12 hourly for 7 days (Score: 1)

This is a three answer multiple selection question with a mixture of pharmacological and non-pharmacological management options. Candidates need to first identify that the most likely diagnosis is whooping cough (pertussis). As the cough has been present for less than 14 days, appropriate antibiotic treatment is indicated to reduce the risk of transmission to others. Exclusion from daycare is required until 5 days of therapy has been received, or if coughing has been ongoing for more than 21 days. Children should still complete the pertussis immunisation schedule if they contract whooping cough.

The child in this case is still eating and drinking normally, therefore oral rehydration is not required. As pertussis is a notifiable disease it is the GP’s responsibility to notify the Public Health unit. Other distractors relate to incorrect diagnoses (such as asthma, gastroenteritis or protracted bacterial bronchitis).

Sharon Edge, aged 47 years, presents to your clinic in tears. Her husband of 23 years passed away last month from multiple myeloma. While his death was not unexpected, she is having difficulty coming to terms with this.  

Since her husband’s death, Sharon has felt flat and sad, and has had difficulties sleeping. She often lies awake for an hour or two at night before being able to sleep through until morning. Her sister and mother live nearby and are a good support for Sharon. She has been able to talk to them about her concerns and does not think she needs other people to talk to. She has not had any thoughts of self-harm. 

Sharon experienced mild anxiety many years ago, however, is usually happy and settled. She continues to work as an accountant at her long-term workplace but is finding it difficult to concentrate and she is worried about making mistakes at work. 

You provide brief counselling and support today.  

What are the MOST appropriate next steps? Select two (2) from the following list.   

  1. Amitriptyline 25 mg at night 
  2. Escitalopram 10 mg daily 
  3. Mental health care plan 
  4. Offer a GP follow up appointment in one week
  5. Provide Centrelink medical certificate 
  6. Provide medical certificate for bereavement leave
  7. Refer to psychologist for cognitive behavioural therapy 
  8. Refer to psychiatrist  
  9. Temazepam 10 mg at night for 2 weeks 

D. Offer a GP follow up appointment in one week (Score: 1) 
F. Provide medical certificate for bereavement leave (Score: 1) 

This is a two answer multiple selection question with pharmacological and non-pharmacological management options. This question is designed to explore a candidate’s competency with managing a patient presenting during a normal grieving process. Normal grief is not a mental health disorder and does not necessarily require medication or formal psychological care. Sharon would benefit from some time away from work given her concern about making mistakes however is unlikely to require a prolonged period of leave and Centrelink support. It is appropriate to offer ongoing GP support however she does not require intensive psychological therapy at this stage. 

Anti-depressant medications are not appropriate as she does not display features of major depressive disorder. She is not suitable for a mental health care plan as she does not have a formal mental health diagnosis at this stage. There may be benefit to her seeing a psychologist in the future, however she states that she has enough support at this time, so this is not currently required.  

While she has some difficulties getting to sleep, she can sleep through the night and does not require hypnotic medication.

Danielle Martin, aged 24 years, presents with three days of bloody vaginal discharge and pelvic pain. She reports one new male partner with whom she has had penetrative sex in the past two months. She has also noticed intermenstrual vaginal bleeding but thought this was due to her etonogestrel 68 mg implant which was inserted five months ago. She did a home pregnancy test last night which was negative. 

Past medical history: 

  • Nil 

Medications:

  • Etonogestrel 68mg implant 

Examination findings: 

  • Temperature 36.9oC 
  • Heart rate 89/min regular 
  • Respiratory rate 16/min 
  • Blood pressure 122/79 mmHg 
  • Abdominal examination; lower abdominal tenderness, no guarding or rigidity 
  • Speculum examination; bloody mucopurulent discharge from the external cervical os 
  • Bimanual examination; cervical motion tenderness 

What is the MOST appropriate pharmacological management? Select three (3) from the following list. 

  1. Amoxicillin-Clavulanate 875 mg/125 mg twice daily   
  2. Benzathine benzylpenicillin 2.4 million units intramuscularly as a single dose  
  3. Cefotaxime 2 g intravenously as a single dose  
  4. Ceftriaxone 500 mg intramuscularly as a single dose
  5. Ciprofloxacin 500 mg twice daily  
  6. Clindamycin 2% vaginal cream 1 applicatorful intravaginally at night  
  7. Doxycycline 100 mg twice daily
  8. Imiquimod 5% cream topically three times weekly 
  9. Metronidazole 400 mg daily
  10. Probenecid 1 g as a single dose  
  11. Trimethoprim-Sulfamethoxazole 160 mg/800 mg twice daily  
  12. Ulipristal 30 mg as a single dose  

D. Ceftriaxone 500 mg intramuscularly as a single dose (Score: 1) 
G. Doxycycline 100 mg twice daily (Score: 1) 
I. Metronidazole 400 mg daily (Score: 1) 

This is a three answer multiple selection question with pharmacological management options. This question presents a patient with non-severe pelvic inflammatory disease (PID), which is usually caused by either sexually transmitted infections or vaginal flora.  Answers relate to pharmacological management and require knowledge of best practice guidelines. It is recommended to begin treatment immediately once the provisional diagnosis is made, without waiting for investigation results. Intramuscular ceftriaxone, metronidazole and doxycycline are first line treatment options for non-severe pelvic inflammatory disease. Intravenous cefotaxime is used for treatment of severe pelvic inflammatory disease. 

Amoxicillin-clavulanate is used for postprocedural pelvic infection or pyelonephritis.  

Trimethoprim-sulfamethoxazole is used for postprocedural pelvic infection for those who have hypersensitivity to penicillins. Ciprofloxacin is used for pyelonephritis in adults with penicillin hypersensitivity. Intramuscular benzathine benzylpenicillin is used for treatment of early syphilis. Imiquimod cream is used for treatment of genital warts. Probenecid forms part of the treatment for gonococcal urethritis in areas where penicillin-resistant gonorrhoeae is less common, such as remote areas of northern and central Australia. 

It is unlikely that Danielle is pregnant so ulipristal as emergency contraception is less appropriate. 

Molly Larson, aged 59 years, presents with three months of dry and red hands. She has been applying hydrocortisone acetate 0.5% cream topically daily for the past three months. She thinks the cream has stopped working as her hands always feel itchy and dry. She washes her hands any chance she gets with soap and water because they feel dirty all the time. She always takes gloves and hand sanitiser with her when she goes out, fearing that she will not be able to wash her hands. She tells you that she developed this habit during the COVID-19 pandemic. 

Examination findings: 

  • Both hands; dry rash with erythema, scaling and fissuring, worse on the dorsal surfaces and between the fingers 

You provide appropriate advice regarding reducing hand washing frequency and avoiding soap. 

What is the MOST appropriate further management? Select four (4) from the following list. 

  1. Agomelatine 25 mg daily 
  2. Ceramide based cream as required  
  3. Cognitive behavioural therapy  
  4. Diazepam 5 mg daily as required 
  5. Eye movement desensitisation and reprocessing therapy 
  6. Fluoxetine 20 mg daily  
  7. Imiquimod 5% cream topically once daily for six weeks  
  8. Mometasone furoate 0.1% ointment topically once daily until skin is clear 
  9. Mupirocin 2% ointment topically twice daily for five days  
  10. Prednisolone 25mg daily for five days 
  11. Pregabalin 25 mg twice daily  
  12. Promethazine 25 mg at night 
  13. Single session psychological debriefing regarding the COVID-19 pandemic 
  14. Sorbolene lotion as required 
  15. Suvorexant 15 mg daily   
  16. Terbinafine 1% cream topically twice daily for 14 days 

B. Ceramide based cream as required (Score: 1) 
C. Cognitive behavioural therapy (Score: 1) 
F. Fluoxetine 20 mg daily (Score: 1) 
H. Mometasone furoate 0.1% ointment topically once daily until skin is clear (Score: 1) 

This is a four answer multiple selection question with pharmacological and non-pharmacological management options. This question presents a woman with a provisional diagnosis of obsessive-compulsive disorder, with compulsive hand washing resulting in hand dermatitis. Management options address both aspects of the diagnosis and include pharmacological and non-pharmacological options.  

First line treatment of obsessive-compulsive disorder includes cognitive behavioural therapy and exposure and response prevention, and selective serotonin reuptake inhibitors. Treatment of her hand washing dermatitis includes use of emollients and short courses of topical corticosteroids. Ceramide-based emollients are likely to be more effective than sorbolene cream given the provided history. Molly has already tried hydrocortisone acetate 0.5% topically, so a more potent topical corticosteroid is indicated. Oral corticosteroids may be needed in severe cases however in the given scenario it is reasonable to trial a more potent topical corticosteroid first. 

There are no strong features of depression or neuropathic pain, and Molly has not described difficulty sleeping, therefore agomelatine, pregabalin, promethazine and suvorexant are not indicated. Diazepam is not recommended first-line in obsessive compulsive disorder. Eye movement desensitisation and reprocessing therapy is used in post-traumatic stress disorder, which is a less likely diagnosis given the key features. Single session psychological debriefing is not appropriate in this case. 

Imiquimod cream is used in treatment of warts and solar keratoses. Mupirocin is used in bacterial skin infections. Terbinafine is used in fungal skin infections.