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100+ Free RACGP KFP Practice Questions

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2026 Statistics

Key Facts: RACGP KFP Exam

70 questions

The KFP comprises 70 individual multiple-selection questions, each its own scenario

RACGP - AKT and KFP guide

Cycle 2025.2

Format changed from handwritten short answers to multiple-selection questions

RACGP AGPT Program update, November 2024

2 to 6 options

Each KFP question asks candidates to select a stated number of correct options

RACGP - AKT and KFP guide

Four hours

KFP exam duration: a 3.5-hour exam plus a 30-minute universal allowance

RACGP - AKT and KFP guide

64.59% cut score

Pass mark set by standard setting for cycle 2025.2 of the KFP

RACGP - 2025.2 KFP public exam report

79.57% pass rate

Proportion of the 1,160 candidates who passed the 2025.2 KFP

RACGP - 2025.2 KFP public exam report

1.43% per question

Each KFP question contributes equally (1/70) to the final mark with no negative marking

RACGP - General exam delivery information

100

Free original case-based practice questions in this bank

OpenExamPrep

The RACGP Key Feature Problem (KFP) exam assesses clinical reasoning and decision-making for unsupervised Australian general practice. From cycle 2025.2 it consists of 70 scenario-based multiple-selection questions (MSQs), each independent, in which candidates select a stated number of correct options (usually 2 to 6) about history, examination, diagnosis, investigation or management. The exam runs for four hours and is marked from paper answer sheets, with each question worth about 1.43% of the score and no negative marking. There is no fixed pass mark; in 2025.2 the cut score was 64.59% with a 79.57% pass rate from 1,160 candidates. This 100-question bank provides original case vignettes modelled on the new MSQ format and grounded in Australian guidelines.

Sample RACGP KFP Practice Questions

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

1A 58-year-old man presents to your GP clinic with 40 minutes of central crushing chest pain radiating to his left arm, diaphoresis and nausea. He looks unwell. After giving aspirin and arranging an ambulance, what is the single most important immediate investigation to perform in the clinic?
A.12-lead ECG
B.Chest X-ray
C.Troponin point-of-care test
D.Exercise stress test
Explanation: In suspected acute coronary syndrome, an immediate 12-lead ECG is the critical first investigation because it identifies ST-elevation MI, which requires urgent reperfusion and changes management within minutes. It can and should be done in the clinic while awaiting transfer.
2A 24-year-old woman develops widespread urticaria, lip swelling and wheeze within minutes of eating at a restaurant. She is anxious, has a respiratory rate of 28 and a blood pressure of 88/54 mmHg. What is the single most important immediate management step?
A.Oral antihistamine
B.Intramuscular adrenaline 0.5 mg (1:1000)
C.Intravenous hydrocortisone
D.Nebulised salbutamol
Explanation: This is anaphylaxis (skin, airway and circulatory involvement). Intramuscular adrenaline into the anterolateral thigh is the first-line, life-saving treatment and must be given immediately; it reverses bronchospasm, vasodilation and angioedema.
3A 70-year-old man with a history of hypertension reports three weeks of increasing exertional breathlessness, orthopnoea and bilateral ankle swelling. On examination he has bibasal crackles, a raised JVP and a displaced apex beat. Which single investigation is most useful to confirm the most likely diagnosis?
A.D-dimer
B.Echocardiogram
C.Spirometry
D.Coronary angiography
Explanation: The picture is congestive heart failure. A transthoracic echocardiogram is the key investigation: it confirms the diagnosis, quantifies ejection fraction and guides whether it is heart failure with reduced or preserved ejection fraction, directing therapy.
4A 65-year-old man has an irregularly irregular pulse at 110 bpm found on routine review. He is asymptomatic and haemodynamically stable. An ECG confirms atrial fibrillation. Beyond rate control, which single assessment is most important to guide his ongoing management?
A.CHA2DS2-VA stroke risk score
B.Exercise tolerance test
C.Holter monitor for 7 days
D.Serum troponin
Explanation: In atrial fibrillation the critical decision is stroke prevention. Calculating the CHA2DS2-VA score determines whether anticoagulation is indicated, which is the single most important determinant of long-term outcome in AF.
5A 30-year-old woman presents with sudden-onset pleuritic chest pain and breathlessness three days after a long-haul flight. She has unilateral calf swelling and tenderness. Heart rate is 105, oxygen saturation 93%. What is the most appropriate first-line investigation given she is haemodynamically stable?
A.CT pulmonary angiogram
B.D-dimer
C.Chest X-ray only
D.V/Q scan as first-line
Explanation: With a high clinical probability of pulmonary embolism (Wells score raised by signs of DVT, tachycardia and recent travel), a D-dimer is unhelpful because a negative result would not exclude PE. CT pulmonary angiogram is the appropriate first-line confirmatory imaging.
6A 19-year-old man with known asthma presents acutely with severe wheeze. He can speak only in short phrases, has a respiratory rate of 32, heart rate 130 and oxygen saturation of 91% on room air. What is the single most important immediate treatment?
A.Oral prednisolone alone
B.Continuous nebulised salbutamol with oxygen
C.Antibiotics
D.Inhaled corticosteroid increase
Explanation: This is a severe acute asthma exacerbation. The immediate priority is high-dose inhaled bronchodilator (salbutamol, repeated or continuous) with controlled supplemental oxygen to relieve bronchospasm and correct hypoxia. Systemic steroids are added but bronchodilation is the urgent step.
7A 68-year-old man who smokes has a chronic productive cough and worsening breathlessness over years. Spirometry shows a post-bronchodilator FEV1/FVC ratio of 0.58 with limited reversibility. What is the single most effective intervention to slow disease progression?
A.Inhaled corticosteroid
B.Smoking cessation
C.Oral theophylline
D.Long-term oral antibiotics
Explanation: The diagnosis is COPD. Smoking cessation is the single most effective intervention to slow the accelerated decline in lung function and improve survival; no pharmacological therapy matches its impact on disease progression.
8A 45-year-old man has a clinic blood pressure of 158/96 mmHg on three separate visits. He has no end-organ symptoms. Before starting medication, which single investigation best confirms whether he has sustained hypertension rather than white-coat effect?
A.24-hour ambulatory blood pressure monitoring
B.Echocardiogram
C.Renal artery Doppler
D.Serial in-clinic readings only
Explanation: Australian guidelines recommend confirming the diagnosis of hypertension with ambulatory (or home) blood pressure monitoring, as it distinguishes sustained hypertension from white-coat hypertension and better predicts cardiovascular risk before committing to lifelong therapy.
9A 75-year-old woman with type 2 diabetes presents with vague fatigue and breathlessness but no chest pain. ECG shows new ST depression in the lateral leads. What is the most likely diagnosis you must not miss?
A.Anxiety
B.Atypical (silent) acute coronary syndrome
C.Gastro-oesophageal reflux
D.Costochondritis
Explanation: Older patients, women and people with diabetes frequently present with atypical or 'silent' acute coronary syndrome lacking classic chest pain. New ischaemic ECG changes mandate treating this as ACS until proven otherwise.
10A 22-year-old previously well man presents with sudden sharp left-sided pleuritic chest pain and breathlessness at rest. He is tall and thin. On examination there are reduced breath sounds and hyper-resonance on the left. He is stable with saturation 95%. What is the most likely diagnosis?
A.Primary spontaneous pneumothorax
B.Pneumonia
C.Pulmonary embolism
D.Pericarditis
Explanation: A tall, thin young man with sudden pleuritic pain, unilateral reduced breath sounds and hyper-resonance has a primary spontaneous pneumothorax. A chest X-ray confirms it, and management depends on size and symptoms.

About the RACGP KFP Exam

The Key Feature Problem (KFP) exam is one of three RACGP Fellowship examinations and is designed to assess clinical decision-making and clinical reasoning in Australian general practice. From cycle 2025.2 the KFP was converted from handwritten short-answer responses to 70 scenario-based multiple-selection questions (MSQs), a format similar to the Applied Knowledge Test. Each question begins with a clinical vignette describing a realistic GP presentation, examination findings and sometimes investigation results, then asks the candidate to select a stated number of correct options from a list. Questions test the critical 'key feature' actions of a case - the focused history, examination, differential diagnoses, investigations or management that most influence the outcome - rather than rewarding breadth of recall. It remains a paper-based exam marked from computer-readable answer sheets, with each question contributing equally to the final mark.

Assessment

70 individual multiple-selection questions, each based on its own clinical scenario. Each question presents a vignette and asks candidates to select a stated number of correct options (usually 2 to 6) covering history, examination, differential diagnosis, investigation or management. Questions are independent of one another.

Time Limit

Four hours on exam day: a 3.5-hour exam plus a universal additional 30-minute allowance. The exam starts at 11am local time at each venue.

Passing Score

No fixed percentage. The pass mark is determined by standard setting for each sitting. In cycle 2025.2 the cut score was 64.59%, the mean was 70.98% and the pass rate was 79.57% from 1,160 candidates.

Exam Fee

Approximately A$2,721 for the 2026 cycle (each written exam was A$2,555 in 2024). Fees are set per cycle by the RACGP; confirm the current fee on the official enrolment page. (Royal Australian College of General Practitioners (RACGP))

RACGP KFP Exam Content Outline

22%

Cardiovascular, respiratory and emergency presentations

Acute coronary syndromes, chest pain assessment, heart failure, hypertension, atrial fibrillation, asthma and COPD exacerbations, anaphylaxis, sepsis and other can't-miss emergencies. Practice focuses on recognising the critical action - immediate management, the right first investigation or a red flag - in time-critical GP scenarios.

16%

Acute abdomen, gastrointestinal and genitourinary

Acute abdominal pain, appendicitis, biliary and pancreatic disease, dyspepsia, GORD, inflammatory bowel disease, colorectal red flags, urinary tract infection, pyelonephritis, renal colic and the acute scrotum, emphasising the most appropriate next step in primary care.

14%

Mental health, neurology and substance use

Depression and anxiety, acute psychosis, suicide and self-harm risk, dementia, delirium, headache and red-flag neurology, stroke and TIA, seizures, and alcohol and other drug presentations, with a focus on safe prioritisation and escalation.

12%

Women's, men's, sexual and reproductive health

Antenatal and postnatal care, abnormal uterine bleeding, contraception, the National Cervical Screening Program, sexually transmitted infections, ectopic pregnancy, menopause and prostate disease, applying current Australian screening and treatment guidelines.

10%

Paediatrics and child health

The febrile and unwell child, infant feeding and growth, paediatric rashes, asthma and bronchiolitis, developmental surveillance, immunisation and recognition of the seriously ill or at-risk child, prioritising safe assessment and disposition.

9%

Endocrine, metabolic and renal

Type 2 diabetes and its complications, thyroid disease, electrolyte and acid-base disturbance, osteoporosis, lipid and cardiovascular risk and obesity, set within Australian preventive-health and chronic-disease frameworks.

10%

Dermatology, musculoskeletal and ENT/eyes

Skin cancer and common dermatoses, the acute and chronic joint, back pain and fractures, the acute red eye, otitis media and externa, and other ear, nose and throat presentations that hinge on a single focused decision.

7%

Preventive care, aged care and population health

Health assessments and chronic-disease management, immunisation, Aboriginal and Torres Strait Islander health, polypharmacy and frailty, and ethical, medicolegal and patient-safety considerations such as consent, capacity and mandatory reporting.

How to Pass the RACGP KFP Exam

What You Need to Know

  • Passing score: No fixed percentage. The pass mark is determined by standard setting for each sitting. In cycle 2025.2 the cut score was 64.59%, the mean was 70.98% and the pass rate was 79.57% from 1,160 candidates.
  • Assessment: 70 individual multiple-selection questions, each based on its own clinical scenario. Each question presents a vignette and asks candidates to select a stated number of correct options (usually 2 to 6) covering history, examination, differential diagnosis, investigation or management. Questions are independent of one another.
  • Time limit: Four hours on exam day: a 3.5-hour exam plus a universal additional 30-minute allowance. The exam starts at 11am local time at each venue.
  • Exam fee: Approximately A$2,721 for the 2026 cycle (each written exam was A$2,555 in 2024). Fees are set per cycle by the RACGP; confirm the current fee on the official enrolment page.

Keys to Passing

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

RACGP KFP Study Tips from Top Performers

1Practise identifying the single most critical next step in each scenario - the most likely diagnosis, the first investigation or the immediate management - because the KFP rewards focused, prioritised decisions, not exhaustive lists.
2Read the lead-in and the requested number of answers carefully; selecting more options than asked for incurs a penalty, so commit to exactly the number requested.
3Ground every answer in current Australian guidelines - Therapeutic Guidelines, the RACGP Red Book, the Australian Medicines Handbook and national screening programs - rather than overseas practice.
4Drill the can't-miss emergencies (anaphylaxis, sepsis, acute coronary syndrome, ectopic pregnancy, the unwell child, stroke) until red-flag recognition and first-line management are automatic.
5Work the official RACGP practice exam and public KFP exam reports to learn the question style, then time yourself to reach the 35th question by the two-hour mark.
6Review your wrong answers for the clinical-reasoning error behind them - over-investigating, under-prioritising or missing a red flag - because technique often matters more than knowledge gaps in the KFP.

Frequently Asked Questions

What format is the RACGP KFP exam in 2026?

Since cycle 2025.2 the KFP is a paper-based exam of 70 scenario-based multiple-selection questions (MSQs). Each question gives a clinical vignette and asks you to select a stated number of correct options, usually between 2 and 6, from a list. Handwritten short answers were removed.

How many questions are on the KFP and how is it marked?

There are 70 independent questions, each contributing equally (about 1.43%) to your final mark. There is no negative marking, but if you shade more options than requested a small penalty (0.35% per extra option) is deducted from your overall paper score, so select exactly the number asked for.

How long is the KFP exam?

The KFP runs for four hours on exam day - a 3.5-hour exam plus a universal additional 30-minute allowance. It starts at 11am local time at each venue, and candidates are advised to reach at least the 35th question by the halfway point.

What is the pass mark for the KFP?

There is no fixed pass percentage; the cut score is set by standard setting for each sitting. In cycle 2025.2 the pass mark was 64.59%, the mean score was 70.98% and the pass rate was 79.57% from 1,160 candidates.

What does the KFP assess?

The KFP assesses clinical reasoning and decision-making in Australian general practice. It rewards identifying the critical 'key feature' actions of a case - the focused history, examination, diagnosis, investigation or management that most affect the outcome - rather than breadth of recall.

Are these official RACGP KFP questions?

No. These are original OpenExamPrep questions modelled on the new MSQ format and grounded in Australian guidelines such as Therapeutic Guidelines and the RACGP Red Book. The RACGP provides an official practice exam and public exam reports separately.