SMLE Study Guide 2026
Everything you need to pass the SMLE exam in one place: the exam format, every topic to study, real practice questions with explanations, flashcards, and full-length practice tests. Free, no sign-up needed.
📋 SMLE Exam Format at a Glance
📚 SMLE Topics to Study (37)
✍️ Sample SMLE Questions & Answers
1. A patient with gout is prescribed allopurinol. What is its mechanism of action?
Allopurinol is a xanthine oxidase inhibitor that blocks the conversion of hypoxanthine to xanthine and xanthine to uric acid, thereby reducing uric acid production. It should not be started during an acute gout attack as it can worsen the flare.
2. A 55-year-old male with a 30-pack-year smoking history presents with painless gross haematuria. Cystoscopy reveals a papillary mass in the bladder. What is the most likely histological type?
Transitional cell carcinoma (urothelial carcinoma) is the most common type of bladder cancer, strongly associated with cigarette smoking. It typically presents as a papillary lesion on cystoscopy.
3. A patient is prescribed gentamicin for a serious gram-negative infection. Which two adverse effects require monitoring?
Aminoglycosides (gentamicin, tobramycin, amikacin) require monitoring for nephrotoxicity (elevated creatinine, reduced GFR) and ototoxicity (vestibular and cochlear damage causing dizziness and hearing loss). Trough and/or peak levels guide dosing to minimise toxicity.
4. A 6-year-old child presents with polydipsia, polyuria, weight loss, and a blood glucose of 22 mmol/L. Blood pH is 7.15 and ketones are strongly positive. What is the immediate priority in management?
In paediatric diabetic ketoacidosis, the immediate priority is IV fluid resuscitation with 0.9% normal saline to correct dehydration and restore circulation. IV insulin infusion (NOT bolus) is started after the first hour of fluid resuscitation to avoid cerebral oedema.
5. A patient on isoniazid for tuberculosis develops peripheral neuropathy. Which vitamin deficiency is responsible and what supplement prevents this?
Isoniazid inhibits pyridoxal phosphokinase and competes with pyridoxal phosphate (active form of vitamin B6), leading to pyridoxine deficiency. This manifests as peripheral neuropathy. Prophylactic pyridoxine (10-25 mg/day) prevents this complication.
6. A 55-year-old male presents with a change in bowel habit, rectal bleeding, and a palpable mass on digital rectal examination at 6 cm from the anal verge. What is the most likely diagnosis?
A palpable rectal mass with change in bowel habit and rectal bleeding in a patient over 50 is rectal carcinoma until proven otherwise. Digital rectal examination can detect low rectal tumours, and further assessment with rigid sigmoidoscopy and biopsy is essential.
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What Practice Test Geeks adds beyond an AI chat for SMLE
An AI chatbot can quiz you, but it can't reproduce the exam conditions or keep your record. Here you get:
- A timed, full-length SMLE mock exam — 200 questions in 270 minutes with a 50% pass mark, modeled on the official exam's question count and time limit, followed by a score report broken down by exam domain.
- A fixed SMLE question bank: the same test every attempt, so your score is comparable from one try to the next instead of changing with every regenerated quiz.
- Progress saved on your device: completed tests, scores and missed questions stay in My Progress, so you can retake only what you got wrong.
- A printable SMLE cheat sheet you can print or save as a PDF.
- SMLE flashcards built from the same question bank.
- Free SMLE practice tests with the correct answer shown after each question.
How this page was made: written with AI tools and published by Nathan Beja, founder of Practice Test Geeks, who is responsible for its content. Exam facts are checked against the official sources listed below. Not reviewed by a subject-matter expert. Editorial policy
Sources & references
Exam facts on this page (fees, format, dates, passing scores) are checked against these official sources; the date is our last check. Editorial policy
- scfhs.org.sa — Test dates, test delivery, eligibility, passing score, retake policy, score release, fees · verified Oct 2026