How child health is examined
The AKT is 150 single-best-answer questions in a four-hour paper sitting. In the 2026.1 sitting, 1,117 candidates sat the exam and 80.6% passed, with a pass mark of 67.1% set by the modified Angoff method. The RACGP notes that questions can have between five and ten options, that more than one option may be plausible, and that you must choose the most appropriate one for the scenario.
Topics in recent reports include developmental milestones, hypospadias, parvovirus infection and pulled elbow, and two of the worked cases candidates found hardest were childhood asthma and atopic dermatitis.
Childhood asthma
- The RACGP 2026.1 report noted that, ideally, spirometry should be performed before starting regular preventer therapy in a school-aged child.
- Children 6 and over with frequent symptoms: low-dose inhaled corticosteroid; montelukast is an alternative for some.
- Every child needs a written asthma action plan and a spacer.
- Acute attacks: salbutamol by spacer, oral prednisolone for moderate to severe attacks, and transfer if severe or life-threatening.
Atopic dermatitis and skin
- Daily emollients and soap substitutes; topical corticosteroids of appropriate strength for flares, used enough and long enough.
- Wet dressings help restore moisture and settle itch in moderate to severe flares, an option the 2026.1 report highlighted.
- Oral prednisolone is not recommended for eczema flares.
- Infected eczema: treat staphylococcal infection; eczema herpeticum needs urgent antiviral treatment.
Growth and development
| Age | Milestone |
|---|---|
| 6 weeks | Social smile |
| 6 to 8 months | Sits unsupported |
| 12 months | First words, pincer grip |
| 18 months | Walks (refer if not); check CK in boys |
| 2 years | 50 words, two-word phrases |
| 4 years | Clear speech in sentences |
Regression at any age, no pointing or babbling by 12 months, and hand preference before 18 months need referral. Always test hearing in speech delay.
Common childhood problems
| Problem | GP management |
|---|---|
| Pulled elbow | Reduce with supination-flexion or hyperpronation; no X-ray needed if the history fits and the child uses the arm afterwards |
| Hypospadias | Refer to paediatric urology; do not circumcise |
| Parvovirus (slapped cheek) | Self-limiting; advise pregnant contacts to seek testing |
| Acute otitis media | Analgesia and watchful waiting in most children over 6 months; antibiotics for higher risk |
| Bronchiolitis | Supportive care only |
| Constipation | Macrogol, toilet routine and months of maintenance |
Child protection and safety
- Mandatory reporting applies to doctors in every state and territory.
- Bruising in a non-mobile infant needs assessment for abuse.
- Safe sleeping, car restraints, pool fencing and poison storage are part of anticipatory guidance.
Adolescent consultations
- See the young person alone for part of the consultation and explain confidentiality and its limits.
- Use the HEADSS assessment: home, education or employment, activities, drugs, sexuality, suicide and mood.
- A mature minor can consent to their own treatment, including contraception.
- Young people can get their own Medicare card from 15.
Worked examples
Worked example 1 · Asthma
An 8-year-old boy has wheeze and cough at night 3 times a week and uses salbutamol most days. He has never had lung function tested. What is the most appropriate next step?
- A Start a long-acting beta agonist
- B Arrange spirometry
- C Prescribe oral prednisolone for 5 days
- D Refer for allergy testing only
- E Increase salbutamol use
Show the reasoning
Answer B. Reflecting the RACGP 2026.1 exam report, spirometry should ideally be performed to confirm asthma before starting regular preventer therapy in a school-aged child. A LABA alone is unsafe, and steroid bursts do not address ongoing control.
Worked example 2 · Eczema
A 5-year-old has a widespread itchy flare of atopic dermatitis despite daily emollient and topical corticosteroid. There is no infection. What is the most appropriate additional treatment?
- A Oral prednisolone
- B Wet dressings over emollient and corticosteroid
- C Oral antibiotics
- D Stop all topical corticosteroids
- E Strict elimination diet
Show the reasoning
Answer B. Wet dressings help restore moisture and reduce itch in a flare. Oral prednisolone is not recommended for eczema, antibiotics are only for infection, and elimination diets are not first-line.
Common traps
- Starting preventers without confirming the diagnosis where possible.
- Using oral steroids for eczema.
- Ordering X-rays for a typical pulled elbow.
- Circumcising a boy with hypospadias.
- Not seeing an adolescent alone.
Free sample children and adolescents questions
Questions from our GP AKT bank. Choose your answer, then open the explanation.
A 6-week-old baby has a temperature of 38.3 C. She is feeding a little less but looks well. What is the most appropriate management?
- AArrange a urine test through the local laboratory tomorrow
- BReassure, as fever is common with teething
- COral amoxicillin for a presumed ear or urine infection
- DParacetamol and review in 48 hours if the fever persists
- ESame-day hospital assessment
Show answer and explanation
Answer E. Fever of 38 C or more in an infant under 3 months needs urgent hospital assessment, because serious bacterial infection (urinary tract infection, bacteraemia, meningitis) is more common and signs are subtle. Infants under 1 month usually need a full septic screen.
Learning point: Fever 38 C or more under 3 months: same-day hospital assessment.
A 15-year-old comes alone asking for contraception. She seems mature and understands the risks and benefits. There are no concerns about abuse. What is appropriate?
- AReport to child protection because she is under 16
- BRefuse until a parent attends
- CCall her parents before prescribing
- DPrescribe only condoms and nothing else
- EAssess maturity and provide care confidentially
Show answer and explanation
Answer E. A young person who demonstrates sufficient maturity and understanding (often called Gillick competence) can consent to their own treatment, including contraception, and is entitled to confidentiality, with exceptions for serious risk of harm. Use a HEADSS assessment to screen for risk, including abuse.
Learning point: Mature minors can consent to contraception confidentially; screen with HEADSS for risk.
A 9-year-old girl has asthma symptoms 3 nights a week despite using salbutamol. Spirometry confirmed asthma last month. What is the most appropriate preventer?
- ANebulised salbutamol four times a day every day
- BLow-dose inhaled corticosteroid via a spacer
- CA long-acting beta agonist inhaler used on its own
- DAntibiotics during each wheezy episode for 5 days
- EOral prednisolone 3 days each week as maintenance
Show answer and explanation
Answer B. Children 6 and over with frequent symptoms need a regular preventer. Low-dose inhaled corticosteroid via a spacer is first-line, with a written asthma action plan and inhaler technique check. A LABA should never be used without an ICS.
Learning point: School-age asthma with frequent symptoms: low-dose ICS via spacer plus an action plan.
Practise more children and adolescents questions free
Every children and adolescents subtopic in our bank
The bank holds 30 children and adolescents questions across 30 subtopics. You can filter by any of them, build a custom block and track your accuracy subtopic by subtopic.
- Acute otitis media1
- Adolescent contraception and consent1
- Adolescent depression1
- Bronchiolitis1
- Childhood asthma preventer1
- Constipation in a child1
- Cows milk protein allergy1
- Croup in general practice1
- Developmental dysplasia of the hip1
- Developmental red flags1
- Eczema in infants1
- Enuresis1
- Food allergy introduction1
- Gastroenteritis in children1
- Head lice1
- HEADSS assessment1
- Hypospadias in a newborn1
- Infant fever1
- Infant reflux1
- Infant sleep safety1
- Iron deficiency from cow's milk1
- Iron deficiency in toddlers1
- Kawasaki disease1
- Measles vaccination timing1
- Pulled elbow1
- Short stature1
- Slapped cheek and pregnancy1
- Sun protection for children1
- Undescended testis1
- Youth confidentiality1
Common questions
Which paediatric topics appear in the AKT?
Recent RACGP reports list developmental milestones, hypospadias, parvovirus and pulled elbow, and highlighted childhood asthma and atopic dermatitis as areas candidates found difficult.
Which paediatric guideline should I use?
The Royal Children's Hospital Melbourne clinical practice guidelines, the Australian Asthma Handbook and the Australian Immunisation Handbook.
Can a 15-year-old consent to treatment?
Yes, if they understand the treatment and its consequences, under the mature minor principle.
Sources
Clinical content is summarised from current Australian guidance at the date above. Guidelines change, so always check the latest edition.