Most Repeated SMLE MCQs by Subject

The SMLE draws most heavily from Medicine and Pediatrics, with General Surgery and Psychiatry also carrying real weight — together these four domains account for the bulk of HighYield's SMLE question bank. Below is a sample across each, in the same vignette style you'll see on exam day.

Medicine

1. Charcot's triad — right upper quadrant pain, fever, and jaundice — is classically associated with:

• A) Acute cholecystitis
• B) Ascending cholangitis ✅
• C) Acute pancreatitis
• D) Choledocholithiasis alone

2. Virchow's triad describes the three mechanisms predisposing to:

• A) Cardiac tamponade
• B) Venous thromboembolism ✅
• C) Raised intracranial pressure
• D) Anaphylaxis

Pediatrics

3. The most common cause of bacterial meningitis in neonates under one month of age is:

• A) Neisseria meningitidis
• B) Group B Streptococcus ✅
• C) Haemophilus influenzae
• D) Streptococcus pneumoniae

4. Febrile seizures most commonly occur in children within which age range?

• A) 0–6 months
• B) 6 months–5 years ✅
• C) 5–10 years
• D) 10–15 years

General Surgery

5. Maximal tenderness in acute appendicitis is classically located at:

• A) Murphy's point
• B) McBurney's point ✅
• C) Hesselbach's triangle
• D) The epigastrium

6. In blunt abdominal trauma, the bedside imaging test used to rapidly screen for free intraperitoneal fluid is:

• A) Plain abdominal X-ray
• B) FAST scan ✅
• C) Barium study
• D) MRI abdomen

Psychiatry

7. Which class of medication is first-line pharmacotherapy for major depressive disorder?

• A) Benzodiazepines
• B) Selective serotonin reuptake inhibitors ✅
• C) Typical antipsychotics
• D) Tricyclic antidepressants as first choice

8. Auditory hallucinations and persecutory delusions lasting more than six months are most consistent with:

• A) Brief psychotic disorder
• B) Schizophrenia ✅
• C) Delirium
• D) Major depressive disorder with psychotic features

Why These Four Carry the Most Weight

Medicine and Pediatrics together make up well over half of HighYield's SMLE bank by question count, which is why candidates who under-revise Pediatrics specifically — often treating it as a subset of Medicine — tend to lose marks disproportionately on exam day.

HighYield's SMLE question bank covers all four of these subjects alongside Internal Medicine, Ob/Gyn, Ethics and every other domain on the blueprint, with every question explained. For the full eligibility and syllabus breakdown, see our SMLE Exam Full Guide. Your first 20 questions are free, no sign-in required.