Free MRCGP Applied Knowledge Test (AKT) Practice Questions

Sample Practice Questions

Try these 10 sample questions from the MRCGP Applied Knowledge Test (AKT) practice bank. Each includes the answer and explanation. Continue with the interactive practice above to review the full question set.

1. 1A 52-year-old has repeatedly raised clinic blood pressure. Home readings are being used to help assess hypertension. Which average home reading is the usual diagnostic threshold?

   1. A.120/80 mmHg
   2. B.135/85 mmHgCorrect answer: B
   3. C.140/90 mmHg
   4. D.150/90 mmHg

   Explanation: The NHS states: "135/85 or higher when checked at home" The home threshold is lower than the clinic threshold of 140/90 mmHg. The question asks for the threshold, not whether a higher reading also qualifies.

   Reference: NHS: High blood pressure — What your blood pressure reading means

2. 2When arranging an intimate examination, a GP needs an impartial chaperone. Who is the usual appropriate choice?

   1. A.A trained practice nurseCorrect answer: A
   2. B.The patient's adult partner
   3. C.The patient's adult sibling
   4. D.The patient's accompanying friend

   Explanation: The GMC states: "A chaperone should usually be a health professional" The usual chaperone is a trained health professional able to act impartially. A friend or relative may support the patient but does not usually replace this role.

   Reference: GMC: Intimate examinations and chaperones — Paragraph 17

3. 3A GP reviews waiting-time data with a few very long delays creating a strongly right-skewed distribution. Which summary is usually preferred to describe the typical waiting time?

   1. A.Arithmetic mean
   2. B.MedianCorrect answer: B
   3. C.Standard deviation
   4. D.Range

   Explanation: The source states: "median for skewed data" The median is less affected by extreme long waits. The mean is pulled towards them; standard deviation and range describe spread rather than the typical value.

   Reference: RCGP: Understanding research data, Professor Michael Harris — 05:35, Descriptive studies

4. 4A GP detects an irregular pulse in a patient with intermittent palpitations and wants a recording of the heart's electrical rhythm. Which investigation should be arranged?

   1. A.Echocardiography
   2. B.Chest radiography
   3. C.ElectrocardiographyCorrect answer: C
   4. D.Coronary angiography

   Explanation: The NHS states: "an electrocardiogram (ECG)" An ECG records cardiac electrical activity and is the appropriate rhythm investigation. An echo images cardiac structure, a chest X-ray images the thorax, and angiography images coronary vessels.

   Reference: NHS: Atrial fibrillation — Tests for atrial fibrillation

5. 5A chaperone is present throughout an intimate examination. Which chaperone-specific details should the GP record in the patient's medical record?

   1. A.The chaperone's identity and role.Correct answer: A
   2. B.The chaperone's registration date and qualification.
   3. C.The chaperone's shift times and line manager.
   4. D.The chaperone's postal address and telephone number.

   Explanation: The GMC requires a note of the chaperone’s "identity and role". These identify who was present and in what capacity. Qualifications, staffing details and personal contact details are genuine record categories but do not replace the required examination record.

   Reference: GMC: Intimate examinations and chaperones — Paragraph 23

6. 6A trial reports an adverse outcome in 18% of controls and 12% of treated patients over the same year. What is the number needed to treat for one year, rounded appropriately?

   1. A.3 patients
   2. B.6 patients
   3. C.9 patients
   4. D.17 patientsCorrect answer: D

   Explanation: The source states: "NNT = 1/ARR Where ARR = CER (Control Event Rate) – EER (Experimental Event Rate). NNTs are always rounded up to the nearest whole number." ARR = 0.18−0.12 = 0.06. NNT = 1/0.06 = 16.67, rounded up to 17 patients treated for one year. Three uses the reciprocal of relative risk reduction (1/(0.06/0.18)); six mistakes the 6 percentage-point ARR for the NNT; nine uses 1/0.12 and rounds up.

   Reference: University of Oxford CEBM: Number Needed to Treat — Calculation

7. 7A patient develops suspected acute myocardial infarction in the surgery. Emergency help has been summoned. There is no aspirin allergy or other contraindication. What single aspirin dose should the GP give while awaiting help?

   1. A.75 mg
   2. B.150 mg
   3. C.300 mgCorrect answer: C
   4. D.600 mg

   Explanation: The NHS states: "Take aspirin (300mg) if you have any – do not give aspirin to someone who has an aspirin allergy." The immediate dose is 300 mg. Lower antiplatelet maintenance doses and a higher analgesic dose do not match the acute dose requested.

   Reference: NHS: Heart attack — What to do while waiting for help

8. 8An adult with a history of schizophrenia attends to discuss a treatment decision. What starting position should the GP take on decision-making capacity?

   1. A.Presume capacity unless assessment shows otherwise.Correct answer: A
   2. B.Presume incapacity until a psychiatrist confirms capacity.
   3. C.Assume capacity only if the family agrees with the choice.
   4. D.Assume incapacity while any psychiatric diagnosis remains.

   Explanation: The GMC states: "every adult patient has capacity" A psychiatric diagnosis alone does not remove the presumption of capacity. Capacity is assessed for the particular decision rather than inferred from the diagnostic label.

   Reference: GMC: Decision making and consent — Paragraph 81

9. 9A GP appraises a diagnostic study using a valid reference standard. Of 40 patients with the disease, 32 test positive. Of 160 without it, 16 test positive. What is sensitivity?

   1. A.20%
   2. B.66.7%
   3. C.80%Correct answer: C
   4. D.90%

   Explanation: The source states: "Sensitivity refers to how often the test is positive when the condition of interest is present" Sensitivity = true positives / all with disease = 32/40 ×100 = 80%. Twenty percent is the false-negative rate (8/40); 66.7% is PPV (32/(32+16)); 90% is specificity (144/160).

   Reference: FDA: Statistical guidance on diagnostic test studies — Appendix 7.1

10. 10A patient with established heart failure develops troublesome fluid retention. Which medicine specifically increases urine output to relieve this congestion?

    1. A.Enalapril
    2. B.Candesartan
    3. C.Bisoprolol
    4. D.FurosemideCorrect answer: D

    Explanation: The NHS states: "make you pee more to reduce fluid build-up in your body (diuretics), such as furosemide" Furosemide is the diuretic. The other medicines are established heart failure therapies but do not constitute the loop-diuretic treatment of congestion requested.

    Reference: NHS: Heart failure — Treatment for heart failure, Medicines