100+ Free MAFP/icFRACGP Part 1 Practice Questions

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Key Facts: MAFP/icFRACGP Part 1 Exam

RM 1,000

Processing Fee

AFPM

176

Total Questions

150 AKT + 26 KFP

6.5 hrs

Exam Duration

Two papers

4 years

Experience Required

Clinical GP

Lifelong

Credential Validity

NSR Specialist

Angoff

Standard Setting

Criterion-based

The Conjoint MAFP/icFRACGP Part 1 exam is a written assessment for family medicine specialization in Malaysia. It consists of the Applied Knowledge Test (AKT) and Key Feature Problems (KFP). Administered by the Academy of Family Physicians of Malaysia (AFPM) in partnership with the RACGP, passing this exam is a mandatory step toward registration as a Family Medicine Specialist on the National Specialist Register (NSR).

Sample MAFP/icFRACGP Part 1 Practice Questions

Try these sample questions to test your MAFP/icFRACGP Part 1 exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A 48-year-old asymptomatic Malay man is found to have a fasting plasma glucose (FPG) of 7.4 mmol/L during a routine health screening. He has no significant past medical history. Which of the following is the most appropriate next step to confirm the diagnosis of Type 2 Diabetes Mellitus in this patient according to the Malaysian CPG 2020?

A.Perform a repeat fasting plasma glucose or an HbA1c on another day.

B.Diagnose him with diabetes immediately and start Metformin.

C.Admit him for an oral glucose tolerance test (OGTT) as an inpatient.

D.Advise lifestyle modification and repeat screening in 1 year.

Explanation: According to the Malaysian Clinical Practice Guidelines (CPG) on the Management of Type 2 Diabetes Mellitus (2020), in an asymptomatic patient with an initial abnormal screening result (FPG >= 7.0 mmol/L or random glucose >= 11.1 mmol/L or HbA1c >= 6.3%), a second confirmatory test (FPG, HbA1c, or OGTT) must be performed on another day to establish the diagnosis. Initiating treatment immediately without a confirmatory test is inappropriate in an asymptomatic patient. Inpatients do not require OGTT for routine diagnosis unless indicated by special circumstances (e.g., pregnancy). Waiting 1 year is unsafe as he has already crossed the diagnostic threshold.

2A 55-year-old Chinese woman with a 10-year history of Type 2 Diabetes Mellitus presents to the primary care clinic for her quarterly review. Her current medications are Metformin 1g BD and Gliclazide 80mg BD. Her HbA1c is 8.2%. She has no history of cardiovascular disease, but her eGFR is 42 mL/min/1.73m2. According to the Malaysian CPG 2020, which of the following is the most appropriate modification to her therapy?

A.Add a Sodium-Glucose Co-transporter 2 (SGLT2) inhibitor (e.g., Dapagliflozin).

B.Increase Gliclazide to 160mg BD.

C.Initiate basal insulin at bedtime.

D.Stop Metformin and start Pioglitazone.

Explanation: According to the Malaysian T2DM CPG 2020, in patients with established chronic kidney disease (eGFR < 60 mL/min/1.73m2), SGLT2 inhibitors with proven renal benefits (such as Dapagliflozin or Empagliflozin) are recommended as add-on therapy to reduce the risk of kidney disease progression and cardiovascular events, provided the eGFR is above the initiation threshold (usually >= 30 mL/min/1.73m2). Increasing Gliclazide to 160mg BD exceeds the standard maximum dose and increases hypoglycemia risk without kidney protection. Bedtime basal insulin is an option but does not address the target-organ protective benefits of SGLT2 inhibitors in CKD. Metformin does not need to be stopped at eGFR 42 mL/min/1.73m2; it only requires dosage reduction (maximum 1g daily) and monitoring when eGFR is between 30 and 44 mL/min/1.73m2.

3A 32-year-old primigravida at 24 weeks of gestation undergoes a routine 75g Oral Glucose Tolerance Test (OGTT) at a government health clinic (Klinik Kesihatan). Her results show a fasting plasma glucose of 5.3 mmol/L and a 2-hour post-load glucose of 7.6 mmol/L. According to the Malaysian CPG on Management of Diabetes in Pregnancy (2017/2020 updates), which of the following is the correct diagnosis?

A.Gestational Diabetes Mellitus (GDM)

B.Impaired Fasting Glucose (IFG) of pregnancy

C.Normal OGTT in pregnancy

D.Overt Diabetes Mellitus in pregnancy

Explanation: In Malaysia, the diagnostic criteria for Gestational Diabetes Mellitus (GDM) using a 75g OGTT are: Fasting plasma glucose (FPG) >= 5.1 mmol/L, or 2-hour post-load glucose >= 7.8 mmol/L. Since her fasting plasma glucose is 5.3 mmol/L (which is >= 5.1 mmol/L), she is diagnosed with GDM. Malaysia uses these stringent thresholds to optimize maternal and fetal outcomes. There is no category named 'Impaired Fasting Glucose of pregnancy' in clinical practice. The test is abnormal, so it is not a normal OGTT. Overt diabetes requires an FPG >= 7.0 mmol/L or random/post-load glucose >= 11.1 mmol/L.

4A 40-year-old newly diagnosed Type 2 Diabetes Mellitus patient with no other comorbidities or risk factors is discussing glycemic targets with you. According to the Malaysian CPG 2020, what is the recommended general target for HbA1c in this patient to prevent microvascular and macrovascular complications?

A.< 6.5%

B.< 7.0%

C.< 6.0%

D.< 7.5%

Explanation: The Malaysian T2DM CPG 2020 recommends a general target HbA1c of < 6.5% for most adult patients, particularly those who are younger, newly diagnosed, and have no significant cardiovascular disease or risk of severe hypoglycemia. For older patients, those with a history of severe hypoglycemia, multiple comorbidities, or long-standing diabetes, a less stringent target of < 7.0% or 7.0-8.0% may be appropriate. A target of < 6.0% is not routinely recommended due to the high risk of hypoglycemia without clear additional macrovascular benefits. A target of < 7.5% is too lax for a young, newly diagnosed patient with no comorbidities.

5Which of the following is the diagnostic threshold for HbA1c to confirm diabetes mellitus in a non-pregnant, asymptomatic adult in Malaysia according to the Malaysian CPG 2020?

A.>= 6.3%

B.>= 6.5%

C.>= 6.0%

D.>= 5.6%

Explanation: The Malaysian Clinical Practice Guidelines (CPG) on the Management of Type 2 Diabetes Mellitus (2020) specifies an HbA1c of >= 6.3% as the diagnostic threshold for diabetes in Malaysia. This threshold was selected based on local validation studies demonstrating its sensitivity and specificity within the Malaysian population. The international standard (ADA) uses >= 6.5%, but Malaysian guidelines specifically mandate >= 6.3%. An HbA1c between 5.6% and 6.2% is classified as pre-diabetes (impaired glucose regulation) in Malaysia.

6A 62-year-old Indian man with Type 2 Diabetes Mellitus and established ischemic heart disease is currently on Metformin 1g BD. His HbA1c is 7.9% and his eGFR is 55 mL/min/1.73m2. According to the Malaysian CPG 2020, which of the following is the most appropriate next step in his pharmacological management?

A.Add an SGLT2 inhibitor or a GLP-1 receptor agonist.

B.Add Gliclazide 80mg OD.

C.Add Sitagliptin 100mg OD.

D.Add Pioglitazone 15mg OD.

Explanation: According to the Malaysian T2DM CPG 2020, in patients with Type 2 Diabetes and established atherosclerotic cardiovascular disease (ASCVD) or heart failure, either a Sodium-Glucose Co-transporter 2 (SGLT2) inhibitor or a Glucagon-Like Peptide-1 (GLP-1) receptor agonist with proven cardiovascular benefit should be added, independent of the baseline HbA1c. These agents have been shown to reduce secondary major cardiovascular events and hospitalization for heart failure. While Gliclazide, Sitagliptin, and Pioglitazone will lower glucose, they do not offer the same high-level secondary cardiovascular protection as SGLT2 inhibitors or GLP-1 receptor agonists, and Pioglitazone is contraindicated in patients with heart failure.

7A 45-year-old female patient with newly diagnosed Type 2 Diabetes Mellitus presents to your primary care clinic. According to the Malaysian CPG 2020, when should screening for diabetic microvascular complications (specifically retinopathy and nephropathy) be initiated in this patient?

A.At the time of diagnosis.

B.5 years after diagnosis.

C.Only when clinical symptoms (e.g., visual changes, frothy urine) develop.

D.1 year after starting glucose-lowering therapy.

Explanation: For patients newly diagnosed with Type 2 Diabetes Mellitus, screening for microvascular complications (diabetic retinopathy via funduscopy, and nephropathy via urine albumin-creatinine ratio and eGFR) must be conducted at the time of diagnosis. This is because Type 2 Diabetes often has a long asymptomatic phase before detection, meaning complications may already be present at diagnosis. In contrast, for Type 1 Diabetes, screening is initiated 5 years after diagnosis. Relying on clinical symptoms is inappropriate, as early stages of retinopathy and nephropathy are silent and treatable.

8A 28-year-old female presenting at her first antenatal booking at 8 weeks gestation is identified as high-risk for Gestational Diabetes Mellitus (GDM) because her pre-pregnancy BMI was 31 kg/m2. What is the recommended screening protocol for this patient in a Malaysian primary care clinic?

A.Perform a 75g Oral Glucose Tolerance Test (OGTT) as soon as possible at booking.

B.Screen with an HbA1c at 24 weeks gestation.

C.Perform a standard 75g OGTT at 24–28 weeks gestation only.

D.Screen with random capillary blood glucose measurements at every antenatal clinic visit.

Explanation: According to the Malaysian guidelines, pregnant women with high-risk factors for GDM (such as obesity with BMI > 27 kg/m2, maternal age >= 35, history of GDM, macrosomia, or first-degree relative with diabetes) must undergo a 75g OGTT as soon as possible at booking. If the booking OGTT is negative, a repeat 75g OGTT must be performed at 24–28 weeks gestation. Waiting until 24–28 weeks for the initial screening in a high-risk patient is incorrect because early onset GDM or pre-existing diabetes must be identified and managed early in pregnancy. HbA1c is not recommended as the primary tool for GDM screening.

9A 50-year-old Malay man with Type 2 Diabetes Mellitus is taking Metformin 1g BD and Glimepiride 2mg OD. He complains of frequent episodes of sweating, shakiness, and palpitations in the late morning, which resolve after taking sweet drinks. His HbA1c is 6.1%. Which of the following is the most appropriate action?

A.Reduce or discontinue Glimepiride.

B.Reduce Metformin to 500mg BD.

C.Advise him to eat larger meals.

D.Discontinue Metformin and start Gliclazide.

Explanation: The patient is experiencing symptomatic hypoglycemia, likely caused by the sulfonylurea (Glimepiride) in the setting of tight glycemic control (HbA1c 6.1%). Sulfonylureas increase insulin secretion independently of blood glucose levels. The most appropriate step is to reduce or discontinue the sulfonylurea to prevent further hypoglycemia. Metformin does not cause hypoglycemia when used as monotherapy, so reducing it will not resolve the issue and might worsen insulin sensitivity. Advising larger meals to match the drug dose is inappropriate and counterproductive to weight and metabolic control.

10A 60-year-old diabetic patient presents with painful burning sensations in both feet, which are worse at night. The physical examination reveals reduced vibration sense up to the ankles. What is the most cost-effective first-line pharmacological treatment for this patient's diabetic peripheral neuropathy in a Malaysian public health clinic?

A.Amitriptyline

B.Pregabalin

C.Methylcobalamin

D.Diclofenac sodium

Explanation: According to the Malaysian T2DM CPG 2020, amitriptyline is a highly effective, widely available, and cost-effective first-line agent for the management of painful diabetic neuropathy. While Pregabalin is also a first-line option, it is significantly more expensive and often reserved for patients who do not tolerate or have contraindications to amitriptyline (e.g., cardiac conduction defects, severe glaucoma, or urinary retention). Methylcobalamin (vitamin B12) is commonly prescribed but lacks strong evidence of efficacy for symptom relief in patients without established B12 deficiency. NSAIDs like Diclofenac are ineffective for neuropathic pain and carry risks of nephrotoxicity and gastrointestinal bleeding.

About the MAFP/icFRACGP Part 1 Exam

The Conjoint MAFP/icFRACGP Part 1 is the written exam for family medicine specialist accreditation in Malaysia. It consists of the Applied Knowledge Test (AKT) and Key Feature Problems (KFP).

Questions

176 scored questions

Time Limit

6 hours 30 minutes

Passing Score

Criterion-referenced

Exam Fee

RM 1,000 processing fee (Academy of Family Physicians of Malaysia (AFPM))

MAFP/icFRACGP Part 1 Exam Content Outline

25%

Chronic Disease Management

Primary care management of diabetes, hypertension, asthma, and COPD based on Malaysian CPGs.

25%

Primary Care Medicine & Therapeutics

Evidence-based pharmacology, cardiovascular medicine, gastroenterology, and primary care dermatology.

20%

Maternal & Child Health

Antenatal screening, contraception, neonatal jaundice, and the National Immunisation Programme.

15%

Infectious Diseases & Tropical Medicine

Management of Dengue, Tuberculosis, Leptospirosis, and other locally endemic infectious diseases.

15%

Professionalism, Ethics & Psychiatry

Malaysian Medical Council (MMC) guidelines on consent, confidentiality, and management of depression/anxiety.

How to Pass the MAFP/icFRACGP Part 1 Exam

What You Need to Know

Passing score: Criterion-referenced
Exam length: 176 questions
Time limit: 6 hours 30 minutes
Exam fee: RM 1,000 processing fee

Keys to Passing

Complete 500+ practice questions
Score 80%+ consistently before scheduling
Focus on highest-weighted sections
Use our AI tutor for tough concepts

MAFP/icFRACGP Part 1 Study Tips from Top Performers

1Focus heavily on Malaysian Clinical Practice Guidelines (CPGs) for chronic diseases like diabetes, hypertension, and dyslipidemia.

2Practice the Key Feature Problems (KFP) format, ensuring precise and concise clinical answers.

3Understand the National Immunisation Programme (NIP) and prolonged neonatal jaundice management protocols.

4Review common tropical infectious diseases in Malaysia, including Dengue warning signs and Tuberculosis treatment.

5Ensure familiarity with MMC guidelines on consent, confidentiality, and medical record retention.

Frequently Asked Questions

What is the Conjoint MAFP/icFRACGP Part 1 exam?

It is the written portion of the conjoint postgraduate assessment conducted by the Academy of Family Physicians of Malaysia (AFPM) and the RACGP. It includes the Applied Knowledge Test (AKT) and Key Feature Problems (KFP), serving as the pathway for GPs to become credentialed Family Medicine Specialists in Malaysia.

What is the difference between the AKT and KFP?

The Applied Knowledge Test (AKT) is a 3.5-hour exam consisting of 150 single-best-answer MCQs that test breadth of clinical knowledge. The Key Feature Problems (KFP) is a 3-hour case-based exam assessing clinical reasoning, decision-making, and diagnostic prioritization.

How is the passing score determined?

The passing score is determined using a criterion-referenced standard-setting process (such as the modified Angoff method) set by the Conjoint Board of Examiners. It represents the score a minimally competent family physician should achieve, rather than a fixed percentage.

What are the eligibility requirements?

Candidates must be active members of the AFPM, have completed the GCFM or equivalent training program, hold a valid MMC Annual Practising Certificate, and have a minimum of 4 years of clinical experience in general practice.

How should I prepare for the KFP component?

The KFP is highly challenging and tests clinical application rather than recall. Candidates should study Malaysian Clinical Practice Guidelines (CPGs), focus on key features of patient presentations, prioritize diagnostic steps, and practice with RACGP/AFPM sample papers.