RACGP KFP Exam – 102 Exam Topics

Based on the RACGP public exam reports from 2016-2024, here is a summary of the likelihood of appearances for various medical conditions in a typical 26-appearance RACGP KFP exam. The estimates are derived from the frequency reflected in past exam reports. You will note a reasonably good match to the BEACH data.

Summary of Expected Questions by System and Medical Condition

System	Condition	Probability (%)	System Probability (%)
Cardiovascular	Acute Coronary Syndrome (ACS)	83	209
Cardiovascular	Hypertension	40	209
Cardiovascular	Heart Failure	35	209
Cardiovascular	Atrial Fibrillation	29	209
Cardiovascular	Endocarditis	22	209
Musculoskeletal	Osteoarthritis	41	134
Musculoskeletal	Rheumatoid Arthritis	29	134
Musculoskeletal	Low Back Pain	23	134
Musculoskeletal	Osteoporosis	23	134
Musculoskeletal	Gout	18	134
Psychiatry	Depression	35	129
Psychiatry	Anxiety Disorders	29	129
Psychiatry	Substance Use Disorders	18	129
Psychiatry	Bipolar Disorder	17	129
Psychiatry	Eating Disorders	16	129
Psychiatry	Schizophrenia	14	129
Gastrointestinal	Liver Diseases (e.g., Hepatitis, NAFLD)	47	118
Gastrointestinal	Gastroesophageal Reflux Disease (GERD)	29	118
Gastrointestinal	Jaundice	24	118
Gastrointestinal	Irritable Bowel Syndrome (IBS)	18	118
Respiratory	Chronic Obstructive Pulmonary Disease (COPD)	41	117
Respiratory	Asthma	35	117
Respiratory	Pneumonia	23	117
Respiratory	Pulmonary Embolism	18	117
Endocrine	Diabetes Mellitus	53	111
Endocrine	Thyroid Disorders (Hyperthyroidism, Hypothyroidism)	35	111
Endocrine	Hyperlipidemia	23	111
Infectious Diseases	Urinary Tract Infections (UTIs)	29	98
Infectious Diseases	Sexually Transmitted Infections (STIs)	23	98
Infectious Diseases	Hepatitis	21	98
Infectious Diseases	AIDS	13	98
Infectious Diseases	Tuberculosis (TB)	12	98
Neurological	Stroke	29	95
Neurological	Dementia	25	95
Neurological	Epilepsy	18	95
Neurological	Migraine	12	95
Neurological	Multiple Sclerosis	11	95
Dermatological	Skin Infections (e.g., Cellulitis, Impetigo)	29	71
Dermatological	Psoriasis	23	71
Dermatological	Dermatitis	19	71
Dermatological	Eczema (Atopic Dermatitis)	18	71
Hematological	Anemia (e.g., Iron Deficiency, B12 Deficiency)	29	62
Hematological	Coagulopathies	18	62
Hematological	Melanoma	15	62
Other	General Preventive Health	29	52
Other	Pediatric Conditions	23	52
Ophthalmology	Conjunctivitis	18	42
Ophthalmology	Glaucoma	12	42
Ophthalmology	Diabetic Retinopathy	12	42

Common Focus Areas by System and Medical Condition

Cardiovascular System:

1. Acute Coronary Syndrome (ACS):
   • Diagnosis using ECG and cardiac markers (troponins).
   • Risk stratification and decisions regarding percutaneous coronary intervention (PCI) or thrombolysis
   • Acute management, including reperfusion therapy.
   • Management protocols (MONA: Morphine, Oxygen, Nitrates, Aspirin).
   • Recognition of complications (arrhythmias, heart failure).
   • Long-term secondary prevention (antiplatelets, statins, beta-blockers).
2. Hypertension:
   • Diagnosis and classification (primary vs. secondary hypertension).
   • Management, including lifestyle changes and pharmacological therapy.
   • Monitoring for complications such as stroke, myocardial infarction, and renal damage.
3. Heart Failure:
   • Differentiation between heart failure with reduced ejection fraction (HFrEF) and preserved ejection fraction (HFpEF).
   • Pharmacological management (ACE inhibitors, beta-blockers, diuretics).
   • Monitoring and managing exacerbations and comorbidities.
4. Atrial Fibrillation:
   • Rate vs. rhythm control strategies.
   • Stroke risk assessment (CHA₂DS₂-VASc score) and anticoagulation options.
   • Acute management of new-onset AF.
5. Endocarditis:
   • Diagnosis using Duke criteria.
   • Empirical antibiotic therapy and indications for surgical intervention.
   • Identifying and managing complications (heart failure, embolic events).

Musculoskeletal System:

1. Osteoarthritis:
   • Non-pharmacological management (exercise, weight loss).
   • Pharmacological treatments (NSAIDs, acetaminophen).
   • Indications for surgical interventions (joint replacement).
2. Rheumatoid Arthritis:
   • Early diagnosis and initiation of DMARDs (disease-modifying antirheumatic drugs).
   • Monitoring for disease progression and extra-articular manifestations.
   • Managing complications (osteoporosis, cardiovascular risk).
3. Low Back Pain:
   • Differentiating between mechanical vs. red-flag conditions.
   • Initial management with analgesics and physiotherapy.
   • Indications for imaging and referral to specialist care.
4. Osteoporosis:
   • Screening and diagnosis (DEXA scan).
   • Pharmacological management (bisphosphonates, calcium, vitamin D).
   • Lifestyle modifications and fall prevention strategies.
5. Gout:
   • Acute management with NSAIDs, colchicine, or corticosteroids.
   • Long-term urate-lowering therapy (allopurinol, febuxostat).
   • Dietary advice and lifestyle modification.

Psychiatry:

1. Depression:
   • Diagnosis using criteria such as DSM-5.
   • Management options (SSRIs, cognitive-behavioral therapy).
   • Recognizing and managing treatment-resistant depression.
2. Anxiety Disorders:
   • Differentiation between generalized anxiety disorder, panic disorder, PTSD.
   • First-line treatment with SSRIs/SNRIs and cognitive-behavioral therapy.
   • Management of acute anxiety episodes.
3. Substance Use Disorders:
   • Recognition of withdrawal syndromes.
   • Treatment approaches (detoxification, maintenance therapy, behavioural interventions).
   • Harm reduction strategies.
4. Bipolar Disorder:
   • Differentiating between Bipolar I and II.
   • Acute management of manic and depressive episodes.
   • Long-term mood stabilization (lithium, valproate, antipsychotics).
5. Eating Disorders:
   • Recognition and diagnosis (anorexia nervosa, bulimia nervosa).
   • Multidisciplinary management, including nutritional support and psychotherapy.
   • Monitoring for medical complications (electrolyte imbalances, cardiac issues).
6. Schizophrenia:
   • Diagnosis and differentiation from other psychotic disorders.
   • Management with antipsychotic medications and psychosocial interventions.
   • Addressing comorbidities (substance use, cardiovascular risk).

Gastrointestinal System:

1. Liver Diseases (e.g., Hepatitis, NAFLD):
   • Diagnosis and differentiation of hepatitis types (viral, alcoholic, NAFLD).
   • Management of liver cirrhosis and its complications (ascites, varices, encephalopathy).
   • Screening for hepatocellular carcinoma.
2. Gastroesophageal Reflux Disease (GERD):
   • Diagnosis based on clinical symptoms.
   • Management with lifestyle modifications and pharmacotherapy (PPIs, H2 blockers).
   • Indications for referral for endoscopy.
3. Jaundice:
   • Differentiating between pre-hepatic, hepatic, and post-hepatic causes.
   • Diagnostic workup (LFTs, imaging).
   • Management based on underlying etiology.
4. Irritable Bowel Syndrome (IBS):
   • Diagnosis based on Rome criteria.
   • Management with dietary modifications (low FODMAP diet), fibre supplements, and antispasmodics.
   • Identifying and managing psychological comorbidities.

Respiratory System:

1. Chronic Obstructive Pulmonary Disease (COPD):
   • Diagnosis using spirometry.
   • Management with bronchodilators, corticosteroids, and oxygen therapy.
   • Exacerbation prevention and pulmonary rehabilitation.
2. Asthma:
   • Diagnosis and management using stepwise guidelines (GINA).
   • Management of acute exacerbations.
   • Monitoring and patient education on inhaler use.
3. Pneumonia:
   • Differentiation between community-acquired and hospital-acquired pneumonia.
   • Empirical antibiotic selection based on local guidelines.
   • Criteria for hospitalization and severity assessment.
4. Pulmonary Embolism:
   • Diagnosis using Wells score, D-dimer, and imaging (CTPA).
   • Acute management with anticoagulation.
   • Long-term risk reduction strategies.

Endocrine System:

1. Diabetes Mellitus:
   • Diagnosis and classification (type 1, type 2, gestational).
   • Management of hyperglycemia and complications (retinopathy, nephropathy, neuropathy).
   • Lifestyle modification and education.
2. Thyroid Disorders (Hyperthyroidism, Hypothyroidism):
   • Diagnosis based on thyroid function tests.
   • Management with antithyroid drugs, levothyroxine.
   • Indications for surgical intervention or radioactive iodine therapy.
3. Hyperlipidemia:
   • Risk assessment (e.g., ASCVD risk score).
   • Pharmacological management (statins, ezetimibe).
   • Lifestyle modifications (diet, exercise).

Infectious Diseases:

1. Urinary Tract Infections (UTIs):
   • Diagnosis and differentiation (cystitis vs. pyelonephritis).
   • Management with antibiotics based on local resistance patterns.
   • Prevention strategies for recurrent UTIs.
2. Sexually Transmitted Infections (STIs):
   • Diagnosis and management of common STIs (chlamydia, gonorrhea, syphilis).
   • Partner notification and treatment.
   • Preventive strategies (condom use, vaccination for HPV).
3. Hepatitis:
   • Differentiation of hepatitis types (A, B, C, D, E).
   • Management with antiviral therapy and liver function monitoring.
   • Preventive measures (vaccination, harm reduction).
4. AIDS:
   • Diagnosis and management of HIV with antiretroviral therapy (ART).
   • Monitoring for opportunistic infections and HIV-related comorbidities.
   • Counselling and preventive strategies.
5. Tuberculosis (TB):
   • Diagnosis using Mantoux test, IGRA, and chest X-ray.
   • Management with first-line antitubercular drugs.
   • Public health measures (contact tracing, DOTS).

Neurological System:

1. Stroke:
   • Recognition of symptoms and rapid assessment (FAST).
   • Acute management (thrombolysis, thrombectomy).
   • Secondary prevention (antiplatelets, statins, lifestyle modification).
2. Dementia:
   • Diagnosis and differentiation from other cognitive disorders.
   • Management with cholinesterase inhibitors and NMDA receptor antagonists.
   • Supportive care for patients and caregivers.
3. Epilepsy:
   • Diagnosis and classification of seizure types.
   • Management with antiepileptic drugs and lifestyle modifications.
   • Counselling on safety (driving, pregnancy).
4. Migraine:
   • Diagnosis based on clinical criteria.
   • Acute management (NSAIDs, triptans).
   • Prophylactic treatment options.
5. Multiple Sclerosis:
   • Diagnosis using MRI and CSF analysis.
   • Management of relapses (corticosteroids) and long-term disease-modifying therapies.
   • Symptomatic management (spasticity, fatigue).

Dermatological System:

1. Dermatitis:
   • Differentiating between types (contact dermatitis, atopic dermatitis, seborrheic dermatitis).
   • Management with avoidance of triggers, topical steroids, and emollients.
   • Use of immunomodulators (e.g., tacrolimus) for chronic or severe cases.
2. Eczema (Atopic Dermatitis):
   • Identification and management of triggers (allergens, irritants, stress).
   • Maintenance with moisturizers, treatment with topical corticosteroids, and calcineurin inhibitors.
   • Education on skin care routines and infection prevention (e.g., treating secondary bacterial infections).
3. Skin Infections (e.g., Cellulitis, Impetigo):
   • Recognition and differentiation of bacterial skin infections.
   • Management with appropriate antibiotics (topical or oral).
   • Prevention of recurrence through hygiene education and treatment of underlying conditions (e.g., eczema).
4. Psoriasis:
   • Diagnosis based on clinical presentation and family history.
   • Management with topical treatments (steroids, vitamin D analogs), phototherapy, and systemic therapies (methotrexate, biologics).
   • Screening for comorbidities (e.g., psoriatic arthritis, cardiovascular risk).
5. Melanoma:
   • Early detection using ABCDE criteria (Asymmetry, Border, Color, Diameter, Evolving).
   • Surgical excision with margin control.
   • Follow-up for recurrence or metastasis and patient education on UV protection.

Hematological System:

1. Anemia (e.g., Iron Deficiency, B12 Deficiency):
   • Identification of type (iron deficiency, B12 deficiency, anemia of chronic disease) via blood tests (CBC, iron studies, B12 levels).
   • Management with appropriate supplementation (iron, vitamin B12).
   • Investigation and treatment of underlying causes (e.g., gastrointestinal bleeding, malabsorption).
2. Coagulopathies:
   • Diagnosis of bleeding disorders (e.g., hemophilia, von Willebrand disease).
   • Management with specific factor replacement, desmopressin, or anticoagulants.
   • Preoperative planning and bleeding risk management in surgical patients.

Preventive Health and Pediatric System:

1. General Preventive Health:
   • Counselling on lifestyle modifications (diet, exercise, smoking cessation).
   • Implementing screening programs (e.g., cancer screening, cardiovascular risk assessment).
   • Administration of immunizations according to national guidelines.
2. Pediatric Conditions:
   • Management of common pediatric conditions (e.g., asthma, otitis media, failure to thrive).
   • Monitoring growth and development milestones.
   • Nutritional counselling and management of pediatric obesity.

Ophthalmological System:

1. Conjunctivitis:
   • Differentiation between bacterial, viral, and allergic conjunctivitis.
   • Appropriate treatment with antibiotics, antihistamines, or lubricating eye drops.
   • Patient education on hygiene practices to prevent transmission.
2. Glaucoma:
   • Diagnosis using tonometry (intraocular pressure measurement), visual field testing, and optic nerve evaluation.
   • Management with medications (e.g., beta-blockers, prostaglandin analogs) and surgical options (e.g., laser trabeculoplasty).
   • Regular monitoring to prevent progression to blindness.
3. Diabetic Retinopathy:
   • Regular screening for all diabetic patients (fundoscopy, retinal photography).
   • Management with optimal glycemic control, laser therapy, and intravitreal injections (anti-VEGF agents).
   • Referral to ophthalmology for advanced or sight-threatening retinopathy.

Analysis of Question Focus Areas in KFP Exams

1. History:

• Prevalence: High
• Typical Focus:
  • Questions related to history-taking are very common in the KFP exams, reflecting the importance of obtaining a comprehensive patient history to guide diagnosis and management.
  • They often test the candidate’s ability to identify key historical details relevant to the presenting complaint, such as symptom duration, risk factors, past medical history, medications, family history, and social context.
• Common Scenarios:
  • Eliciting a detailed history to differentiate between similar presenting symptoms (e.g., differentiating chest pain due to cardiac causes from gastrointestinal or musculoskeletal causes).
  • Identifying red flags or warning signs in a patient’s history that may indicate a serious underlying condition (e.g., weight loss, night sweats, hemoptysis).
  • Asking for the key questions to ask in specific scenarios (e.g., a patient with acute shortness of breath or abdominal pain).

2. Differential Diagnosis:

• Prevalence: High
• Typical Focus:
  • Questions about differential diagnosis test the candidate’s ability to consider all possible diagnoses that fit the presenting symptoms and history.
  • Emphasis is placed on identifying both common and serious conditions, prioritizing life-threatening or urgent diagnoses that must be ruled out first.
• Common Scenarios:
  • Developing a differential diagnosis for nonspecific symptoms (e.g., fatigue, dizziness, weight loss).
  • Prioritizing differentials based on the most likely causes or those requiring immediate intervention (e.g., chest pain could be ACS, pulmonary embolism, aortic dissection).
  • Differentiating between multiple potential diagnoses based on clinical clues and patient context.

3. Most Likely Diagnosis:

• Prevalence: Very High
• Typical Focus:
  • Questions that focus on the most likely diagnosis are among the most common in the KFP exams. They require the candidate to use clinical reasoning to determine which diagnosis best fits the clinical presentation, patient history, and examination findings.
  • These questions often assess knowledge of diagnostic criteria and key clinical features that distinguish one condition from another.
• Common Scenarios:
  • Selecting the most likely diagnosis based on a set of symptoms, signs, and patient background (e.g., identifying a myocardial infarction in a patient with chest pain, diaphoresis, and risk factors).
  • Differentiating the most probable diagnosis among multiple possibilities after considering clinical findings (e.g., differentiating between iron deficiency anemia and anemia of chronic disease).

4. Examination:

• Prevalence: Moderate
• Typical Focus:
  • Examination-focused questions test the candidate’s understanding of which physical examinations are most relevant to the presenting symptoms and how to interpret findings.
  • They often assess the ability to perform a targeted examination, identify abnormal findings, and correlate those findings with potential diagnoses.
• Common Scenarios:
  • Choosing the most appropriate physical examination maneuvers for a given presentation (e.g., lung auscultation for dyspnea, abdominal palpation for right upper quadrant pain).
  • Interpreting examination findings and correlating them with possible diagnoses (e.g., identifying signs of heart failure on physical examination such as jugular venous distention, rales, and peripheral edema).
  • Identifying examination red flags that require immediate action or referral (e.g., neurological deficits in a stroke or signs of meningism in suspected meningitis).

5. Investigation:

• Prevalence: Very High
• Typical Focus:
  • Investigation-related questions are also highly prevalent in the KFP exams. They assess the candidate’s ability to choose the most appropriate tests to confirm or rule out suspected diagnoses and guide further management.
  • These questions often emphasize evidence-based testing, cost-effectiveness, and appropriateness of the investigations.
• Common Scenarios:
  • Selecting initial investigations based on the clinical presentation (e.g., ordering a chest X-ray and D-dimer in suspected pulmonary embolism).
  • Deciding on second-line or more specific tests after initial results (e.g., troponin and ECG for chest pain, MRI for a suspected brain tumor).
  • Interpreting investigation results (e.g., blood test abnormalities, imaging findings) and understanding their implications for diagnosis and management.

6. Management:

• Prevalence: Very High
• Typical Focus:
  • Management questions are a cornerstone of the KFP exams and cover a wide range of topics, including general, non-pharmacological, and pharmacological management.
  • These questions test the candidate’s ability to formulate a comprehensive management plan that integrates various modalities of care.
• Common Scenarios:
  • Developing a management plan that includes both immediate (e.g., acute management of myocardial infarction) and long-term strategies (e.g., lifestyle changes and secondary prevention).
  • Choosing appropriate pharmacological treatments, including first-line and second-line medications, dosing, and monitoring for side effects.
  • Identifying non-pharmacological management strategies, such as patient education, lifestyle modification, and supportive care (e.g., dietary changes for diabetes, physical therapy for osteoarthritis).

7. Follow-Up:

• Prevalence: Moderate
• Typical Focus:
  • Follow-up questions assess the candidate’s ability to plan appropriate follow-up care, including the timing and nature of follow-up, monitoring for complications, and adjusting treatment as necessary.
  • These questions emphasize the importance of continuity of care, monitoring treatment effectiveness, and preventing complications.
• Common Scenarios:
  • Determining the appropriate follow-up interval after initiating or changing treatment (e.g., follow-up in two weeks after starting antihypertensives).
  • Identifying necessary monitoring for potential side effects of medications (e.g., regular blood tests for a patient on methotrexate or warfarin).
  • Planning follow-up imaging or lab tests to assess treatment response (e.g., follow-up ultrasound for a patient with a resolving deep vein thrombosis).

Summary of the Focus Areas in KFP Exams:

• Most Likely Diagnosis and Investigation questions are among the most frequently asked, reflecting their critical role in clinical decision-making.
• Management (both general and pharmacological) is also very commonly tested, as it encompasses a broad range of scenarios and assesses comprehensive care.
• History and Differential Diagnosis are frequently examined, given their importance in forming the basis for subsequent diagnostic and management steps.
• Examination and Follow-Up questions are moderately common, often integrated within broader questions that require a holistic understanding of patient care.

Implications for Exam Preparation:

• Focus on developing strong clinical reasoning skills to accurately identify the most likely diagnosis, choose appropriate investigations, and develop comprehensive management plans.
• Practice structured approaches to history-taking, formulating differential diagnoses, and performing physical examinations.
• Understand the principles of evidence-based medicine and apply them in selecting both pharmacological and non-pharmacological management strategies.
• Be familiar with follow-up protocols, monitoring for complications, and adjusting treatment plans accordingly.