How this area 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.
Recent reports list contraception, dysmenorrhoea and postmenopausal bleeding among examined topics. Questions are practical: choosing a contraceptive for a specific woman, timing antenatal tests, investigating abnormal bleeding, and counselling about PSA or erectile dysfunction.
Contraception
- Long-acting reversible contraception (implant, hormonal and copper IUDs) is the most effective and should be offered first to most women.
- Use UKMEC categories: migraine with aura, smoking over 35, recent VTE and some cardiovascular risks rule out oestrogen.
- Emergency contraception: copper IUD within 5 days is most effective; ulipristal is more effective than levonorgestrel orally.
- Medical termination with mifepristone and misoprostol can be prescribed in general practice by registered prescribers.
Pregnancy care in general practice
- Pre-conception: folic acid 0.5 mg (5 mg if higher risk) and iodine 150 micrograms daily, vaccines, medicine review.
- First visit bloods, aneuploidy screening options, morphology ultrasound at 18 to 20 weeks, OGTT at 24 to 28 weeks.
- Vaccines in pregnancy: influenza and pertussis, plus RSV protection.
- Postnatal: contraception, EPDS screening and the 6-week check for mother and baby.
Gynaecological problems
| Presentation | Key steps |
|---|---|
| Heavy menstrual bleeding | FBC, iron studies, pelvic ultrasound; LNG-IUD first-line if no structural cause |
| Dysmenorrhoea | NSAIDs and hormonal contraception; consider endometriosis if refractory |
| Postmenopausal bleeding | Transvaginal ultrasound; endometrium over 4 mm or persistent bleeding needs biopsy |
| Menopausal symptoms | MHT for vasomotor symptoms; progestogen needed with a uterus; non-hormonal options available |
| Pelvic pain with discharge | Test for chlamydia and gonorrhoea; treat PID promptly |
Men's health
- PSA testing: not a population screening program; offer informed decision-making about benefits and harms. Men with a strong family history may start earlier.
- Erectile dysfunction: a marker of cardiovascular risk; assess CVD risk, diabetes and medicines; PDE5 inhibitors are contraindicated with nitrates.
- Testicular lump: urgent ultrasound and urology referral.
- Lower urinary tract symptoms: assess with a symptom score, check urine and renal function; alpha-blockers for symptomatic BPH.
- Male infertility and hypogonadism: semen analysis, morning testosterone repeated before diagnosing low testosterone.
Sexual health
- Offer STI testing based on risk: chlamydia and gonorrhoea NAAT, syphilis and HIV serology.
- Treat chlamydia with doxycycline 7 days (azithromycin in pregnancy) and arrange partner notification.
- Syphilis rates have risen in Australia, including congenital syphilis; test in pregnancy as recommended.
- Offer HIV pre-exposure prophylaxis to people at higher risk; GPs can prescribe it.
Worked examples
Worked example 1 · Contraception
A 36-year-old woman who smokes 15 cigarettes a day wants contraception and has heavy periods. What is the most appropriate option?
- A Combined oral contraceptive pill
- B Levonorgestrel intrauterine device
- C Combined vaginal ring
- D Copper IUD
- E Condoms only
Show the reasoning
Answer B. Smoking over age 35 makes combined hormonal methods unsafe. The levonorgestrel IUD is highly effective contraception and also reduces heavy menstrual bleeding.
Worked example 2 · PSA
A 55-year-old man with no symptoms asks whether he should have a PSA test. His father was diagnosed with prostate cancer at 78. What is the most appropriate response?
- A Order the test, as all men over 50 should be screened
- B Refuse, as PSA testing is not recommended
- C Discuss benefits and harms so he can make an informed decision
- D Refer to a urologist for biopsy
- E Arrange an MRI prostate
Show the reasoning
Answer C. Australian guidance supports informed decision-making for PSA testing in men without symptoms. A father diagnosed at 78 does not place him in a high-risk group. Discuss false positives, overdiagnosis and treatment harms alongside potential benefit.
Common traps
- Prescribing combined pills to women with migraine with aura or who smoke over 35.
- Missing an ectopic pregnancy.
- Ordering PSA without counselling.
- Forgetting cardiovascular assessment in erectile dysfunction.
- Treating an STI without partner notification.
Free sample women's and men's health questions
Questions from our GP AKT bank. Choose your answer, then open the explanation.
A 32-year-old woman had a cervical screening test 5 years ago: HPV not detected. She has no symptoms. What should be offered?
- AScreening only if she has a new sexual partner since her last test
- BCytology every 2 years
- CNo further screening until age 50
- DA repeat HPV test now
- EColposcopy at this visit
Show answer and explanation
Answer D. People with a cervix aged 25 to 74 who have ever been sexually active are offered an HPV-based cervical screening test every 5 years if HPV is not detected. Self-collection is an option for everyone eligible.
Learning point: Cervical screening: HPV test every 5 years, ages 25 to 74; self-collection is an option.
A 21-year-old asymptomatic man asks for an STI check. What is the recommended test for chlamydia and gonorrhoea?
- ANo test without symptoms
- BUrethral culture only
- CFirst-pass urine NAAT
- DBlood serology for chlamydia
- EMidstream urine culture
Show answer and explanation
Answer C. First-pass urine (the first 20 to 30 mL) NAAT is the recommended test for chlamydia and gonorrhoea in men. Women can use a self-collected vaginal swab. Testing is recommended annually for sexually active young people under 30.
Learning point: Chlamydia/gonorrhoea: first-pass urine NAAT in men; self-collected vaginal swab in women.
A 58-year-old woman has a single episode of vaginal bleeding 6 years after her last period. She takes no hormones. What is the most appropriate first investigation?
- AReassure her because the bleeding was a single episode
- BRepeat cervical screening in 5 years as scheduled
- CCT of the abdomen and pelvis with contrast
- DStart combined menopausal hormone therapy now
- ETransvaginal ultrasound for endometrial thickness
Show answer and explanation
Answer E. Postmenopausal bleeding needs assessment for endometrial cancer. Transvaginal ultrasound measures endometrial thickness; more than 4 mm, or persistent bleeding, needs endometrial sampling or hysteroscopy. Examine the cervix and check cervical screening is up to date.
Learning point: Postmenopausal bleeding: transvaginal ultrasound; sample if endometrium over 4 mm.
Practise more women's and men's health questions free
Every women's and men's health subtopic in our bank
The bank holds 30 women's and men's health questions across 30 subtopics. You can filter by any of them, build a custom block and track your accuracy subtopic by subtopic.
- Breast lump in a young woman1
- Breast pain1
- Cervical screening interval1
- Chlamydia testing1
- Combined pill contraindications1
- Emergency contraception1
- Endometriosis1
- Erectile dysfunction1
- Erectile dysfunction with nitrates1
- Gestational diabetes screening1
- Gonorrhoea treatment1
- Heavy menstrual bleeding1
- HPV 16/18 detected1
- Hyperemesis gravidarum1
- Male hypogonadism1
- Male infertility initial test1
- Menopausal hormone therapy1
- Menopause symptoms with uterus1
- Missed combined pills1
- Polycystic ovary syndrome1
- Postmenopausal bleeding1
- Postnatal check1
- Pregnancy folic acid1
- Primary dysmenorrhoea1
- Prostate cancer testing1
- Recurrent urinary tract infection1
- Syphilis in pregnancy1
- Testicular lump1
- Urinary incontinence1
- Vasectomy counselling1
Common questions
Does the AKT test contraception?
Yes. Contraception is a recurring AKT topic, including choosing methods for women with medical conditions.
Is PSA screening part of the AKT?
PSA counselling and informed decision-making appear in general practice exams. Know why there is no population screening program.
What is first-line for heavy menstrual bleeding?
The levonorgestrel intrauterine device, when there is no structural cause needing other treatment.
Sources
Clinical content is summarised from current Australian guidance at the date above. Guidelines change, so always check the latest edition.