SMLE Dermatology & Ophthalmology MCQs: Practice Questions With Explanations

Sample SMLE MCQs from Dermatology and Ophthalmology — 70 questions each in HighYield's SMLE bank and still without a dedicated practice post — covering classic sign-based diagnoses, each with the correct answer explained.

Dermatology and Ophthalmology are 70-question subjects each in HighYield's SMLE bank — smaller than Medicine or Pediatrics, but still a meaningful share of the exam, and neither has had a dedicated practice post until now. Below is a sample set of Dermatology and Ophthalmology MCQs in the same one-line clinical-vignette format as the real exam.

Dermatology

1. A positive Nikolsky sign, where gentle lateral pressure on normal-appearing skin causes the epidermis to shear off, is characteristic of:

A) Bullous pemphigoid
B) Pemphigus vulgaris ✅
C) Dermatitis herpetiformis
D) Erythema multiforme

2. Pinpoint bleeding points appearing after a psoriatic scale is scraped away is known as the:

A) Koebner phenomenon
B) Auspitz sign ✅
C) Nikolsky sign
D) Darier sign

3. The appearance of new psoriatic or lichen planus lesions at a site of skin trauma is called:

A) Auspitz sign
B) Koebner phenomenon ✅
C) Wickham's striae
D) Dermatographism

4. A skin lesion that fluoresces coral-red under Wood's lamp examination is most consistent with:

A) Tinea versicolor
B) Erythrasma ✅
C) Vitiligo
D) Pityriasis rosea

5. Six or more café-au-lait macules larger than 5 mm in a child is a diagnostic criterion for:

A) Tuberous sclerosis
B) Neurofibromatosis type 1 ✅
C) McCune-Albright syndrome
D) Sturge-Weber syndrome

Ophthalmology

6. A pupil that constricts poorly to direct light but constricts normally when light is swung from the healthy eye (paradoxical dilation) indicates a:

A) Horner pupil
B) Relative afferent pupillary defect ✅
C) Adie tonic pupil
D) Argyll Robertson pupil

7. A "cherry red spot" at the macula on fundoscopy is classically seen in:

A) Central retinal vein occlusion
B) Central retinal artery occlusion ✅
C) Retinal detachment
D) Diabetic retinopathy

8. Progressive cupping of the optic disc, with an increased cup-to-disc ratio, is the hallmark fundoscopic finding in:

A) Papilledema
B) Glaucoma ✅
C) Optic neuritis
D) Central retinal artery occlusion

9. A pupil that accommodates normally but fails to constrict to light, seen in neurosyphilis, is called an:

A) Adie tonic pupil
B) Argyll Robertson pupil ✅
C) Marcus Gunn pupil
D) Hutchinson pupil

10. A visible layer of pus in the anterior chamber of the eye, seen with severe intraocular inflammation or infection, is called:

A) Hyphema
B) Hypopyon ✅
C) Chemosis
D) Synechiae

Why These Deserve Dedicated Revision

With Medicine, Surgery, Pediatrics and Obstetrics & Gynecology already covered, Dermatology and Ophthalmology round out the sign-based, pattern-recognition side of the SMLE blueprint — both reward the same skill of matching a described finding to a named sign, which is exactly what repeated MCQ drilling builds.

HighYield's SMLE question bank covers Dermatology and Ophthalmology alongside Medicine, Surgery, Pediatrics, Obstetrics & Gynecology and every other SCFHS domain, with every question explained. For the full exam picture, see our SMLE Exam Guide. Start with your first questions free, no sign-in required.