Free SMLE Exam Flashcards
Memorize 50 essential terms and definitions for the Saudi Medical Licensure Examination (SMLE). See the term, recall the definition, then flip to check yourself.
Can a normal resting ECG exclude acute coronary syndrome?
No. NICE CG95 requires ongoing assessment when ACS is suspected; a normal ECG can occur with ACS.
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About These SMLE Flashcards
These 50 flashcards are designed to help you memorize key terms and definitions for the Saudi Medical Licensure Examination (SMLE). Each card shows a term on the front and its definition on the back—the classic flashcard format for vocabulary memorization. Use these alongside our practice questions to build both recall and comprehension.
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Review every term in this set. Open any term to reveal its definition.
Can a normal resting ECG exclude acute coronary syndrome?
No. NICE CG95 requires ongoing assessment when ACS is suspected; a normal ECG can occur with ACS.
Does an elevated troponin alone establish ACS?
No. Reassess for other causes of myocardial injury, such as myocarditis or pulmonary embolism, before confirming ACS (NICE CG95).
Should every patient with suspected ACS receive oxygen?
No. NICE CG95 advises monitoring oxygen saturation and giving oxygen when indicated by hypoxaemia; patients at risk of hypercapnic respiratory failure need a different target.
What confirms suspected atrial fibrillation after an irregular pulse is found?
A 12-lead ECG. An irregular pulse prompts testing; pulse palpation alone does not establish AF (NICE NG196).
Does apparently resolved AF automatically justify stopping anticoagulation?
No. NICE NG196 says to reassess stroke and bleeding risk and discuss preferences rather than stopping solely because AF is no longer detectable.
In NICE's adult suspected-PE pathway, what test follows a likely two-level Wells score?
Immediate CTPA if possible. Assess a ventilation/perfusion scan as an alternative when contrast allergy, severe renal impairment or radiation risk makes CTPA unsuitable.
Does a positive D-dimer confirm DVT in NICE's DVT-unlikely pathway?
No. It triggers proximal leg-vein ultrasound. D-dimer is part of the diagnostic pathway, not a stand-alone confirmation of a clot.
What evidence supports confirming suspected asthma under BTS/NICE/SIGN guidance?
A suggestive clinical history plus a supporting objective test. Record suspected asthma until confirmed; acutely unwell patients need immediate treatment.
What must accompany a SABA prescription for asthma under BTS/NICE/SIGN guidance?
A concomitant inhaled corticosteroid (ICS) prescription. A short-acting beta2 agonist alone does not address the guideline's anti-inflammatory treatment requirement.
Which two measurements classify adult CKD risk under NICE?
GFR category and urine albumin:creatinine ratio (ACR) category. Both contribute to risk; interpreting filtration alone misses albuminuria.
Why does NICE prefer urine ACR over PCR for initial proteinuria testing?
ACR is more sensitive for low levels of albuminuria. Use the recommended confirmation pathway for abnormal results.
What first-line serology does NICE recommend for suspected coeliac disease in adults?
Total IgA plus IgA tissue transglutaminase (tTG). IgA deficiency changes test selection; testing requires ongoing gluten ingestion during the diagnostic process.
What time course should raise suspicion of delirium in an at-risk adult?
Recent changes or fluctuations over hours to days in attention, cognition, perception or behaviour. Hypoactive withdrawal can also be delirium (NICE CG103).
Can age or BMI alone exclude type 1 diabetes in an adult?
No. NICE NG17 warns against diagnosing or excluding type 1 diabetes from age or BMI alone; consider the full presentation and further testing when uncertain.
What can abrupt antidepressant discontinuation cause?
Withdrawal symptoms, including dizziness, altered sensations and mood changes. NICE NG222 recommends clinician-guided staged reduction; new symptoms are not automatically relapse.
Is proteinuria essential for diagnosing pre-eclampsia under NICE?
No. New hypertension after 20 weeks can qualify with proteinuria, new maternal organ dysfunction or uteroplacental dysfunction (NICE NG133).
How urgently does NICE treat severe hypertension in obstetric critical care?
Immediately, during pregnancy or after birth, with an appropriate antihypertensive and monitoring of response and adverse effects.
Which anticonvulsant does NICE recommend for an eclamptic fit in critical care?
Intravenous magnesium sulfate. It treats the seizure problem; blood-pressure management remains a separate part of care.
Does absence of known risk factors exclude ectopic pregnancy?
No. Consider ectopic pregnancy in a compatible early-pregnancy presentation even without known risk factors (NICE NG126).
Can serum hCG determine the location of a pregnancy of unknown location?
No. NICE NG126 uses hCG trends to guide subsequent management, not to establish location; changing clinical symptoms require reassessment.
Is one early ultrasound always sufficient to diagnose miscarriage?
No. Very early scans can be inconclusive. NICE NG126 requires measurement- and scan-specific repeat assessment or a second opinion when indicated.
Which blood tests does NICE offer at the first face-to-face antenatal appointment?
A full blood count, blood group and rhesus D status (NICE NG201).
What baseline blood test does NICE recommend for all women with heavy menstrual bleeding?
A full blood count, in parallel with treatment, to assess the haematological effect of bleeding.
Does heavy menstrual bleeding alone require thyroid hormone testing under NICE?
No. Test when other signs or symptoms of thyroid disease are present rather than routinely for isolated heavy menstrual bleeding.
Which bowel-pain pattern should suggest endometriosis?
Period-related or cyclical painful bowel movements, especially with other compatible pelvic symptoms (NICE NG73).
Can a normal pelvic examination and ultrasound exclude endometriosis?
No. NICE NG73 says endometriosis may still be present and referral may still be necessary despite normal findings.
How does U.S. MEC 2024 classify combined hormonal contraception in migraine with aura?
Category 4: an unacceptable health risk. This applies to combined pill, patch and ring; assess other contraceptive methods separately.
In CDC's PID guidance, must all three pelvic tenderness findings be present before presumptive treatment?
No. In an STI-risk patient with pelvic/lower abdominal pain and no better cause identified, one or more of cervical-motion, uterine or adnexal tenderness meets the minimum clinical criteria.
What clinical sequence supports bronchiolitis in a baby or young child?
A coryzal prodrome followed by persistent cough, tachypnoea or chest recession, and wheeze or crackles (NICE NG9).
Why does NICE avoid routine chest X-rays in typical bronchiolitis?
Radiographic changes can mimic pneumonia and lead to inappropriate antibiotic decisions. Consider imaging for specific indications, such as proposed intensive care.
Do antibiotics treat uncomplicated bronchiolitis?
No. NICE NG9 does not recommend antibiotics for bronchiolitis. A separate suspected bacterial infection needs its own assessment.
What does NICE require for visible jaundice in the first 24 hours after birth?
Urgent serum bilirubin measurement within 2 hours and urgent medical review to exclude pathological causes. Use age-specific treatment thresholds.
Can visual inspection quantify a newborn's bilirubin level?
No. NICE CG98 says not to estimate bilirubin from appearance alone; appropriate measurement is required, and pigmentation can make jaundice harder to see.
Is sunlight an accepted treatment for neonatal hyperbilirubinaemia under NICE?
No. When indicated, use phototherapy with a controlled artificial light source and the baby's age-specific treatment thresholds.
How does NICE classify a temperature of 38°C or higher in an infant younger than 3 months?
A high-risk feature for serious illness. This age-temperature combination needs prompt clinical assessment, even if no localising symptoms are obvious.
Do antipyretics prevent febrile seizures?
No. NICE NG143 says not to use them specifically to prevent febrile convulsions; symptom relief and assessment of the illness are separate goals.
Does absent neck stiffness exclude bacterial meningitis in an infant?
No. Classic findings such as neck stiffness, a bulging fontanelle and a high-pitched cry are often absent in infants (NICE NG143).
What serious infection should be considered in a child with fever and a non-blanching rash?
Meningococcal disease, particularly when the child is ill-appearing or the rash is purpuric. NICE NG143 treats this as a high-risk presentation.
What does NICE recommend for suspected UTI in a baby younger than 3 months?
Refer to paediatric specialist care and send urine for urgent microscopy and culture. Apply the young-infant fever assessment pathway.
When should urine be collected relative to antibiotics in a child with suspected UTI?
Before antibiotics when feasible. For a child at high risk of serious illness, do not delay treatment if a urine sample cannot be obtained (NICE NG224).
If hair must be removed before surgery, what method does NICE prefer?
Electric clippers with a single-use head on the day of surgery. Avoid routine removal and razors, which increase surgical-site infection risk.
Does clean surgery involving an implant receive antibiotic prophylaxis under NICE?
Yes. Clean surgery with a prosthesis or implant is an indication; routine prophylaxis is not recommended for clean, uncomplicated non-prosthetic surgery.
When should suspected tension pneumothorax be decompressed before imaging under NICE?
When there is haemodynamic instability or severe respiratory compromise. A trained emergency team acts immediately in that setting.
What does NICE recommend when direct pressure fails to control life-threatening traumatic limb bleeding?
A tourniquet. Start with simple dressings and direct pressure; use a tourniquet for uncontrolled life-threatening haemorrhage after major limb trauma.
How long does NICE emphasise compartment-syndrome surveillance after a tibial fracture or fixation?
Maintain awareness for 48 hours with documented serial clinical assessments. Consider continuous pressure monitoring when signs cannot be reliably assessed.
Which risk scores does NICE use before and after endoscopy for acute upper GI bleeding in over-16s?
Blatchford at first assessment; full Rockall after endoscopy. They are used at different stages of the bleeding evaluation.
When does NICE recommend endoscopy for an unstable patient with severe acute upper GI bleeding?
Immediately after resuscitation. Stabilisation and urgent endoscopic management belong to the same emergency pathway.
Are prophylactic antimicrobials recommended for acute pancreatitis under NICE?
No. Do not offer antimicrobials solely to prevent infection in acute pancreatitis; suspected or established infection requires separate evaluation.
What is required if testicular torsion cannot be confidently excluded in a child?
Urgent surgical review. The Royal Children's Hospital guideline treats suspected torsion as requiring immediate surgical assessment.
Does a negative FAST exclude abdominal or retroperitoneal bleeding after major trauma?
No. NICE NG39 warns that a negative FAST does not exclude intraperitoneal or retroperitoneal haemorrhage; imaging and intervention depend on clinical stability.
Frequently Asked Questions
How many questions and how much testing time does the current SMLE have?
The currently linked SCFHS 2026 guideline specifies two parts of 100 questions, each lasting 120 minutes, plus a scheduled 30-minute break. Up to 10% may be pilot questions. The 50 flashcards here are a study-set count, not the real exam length.
What is the SMLE passing score?
SCFHS's current content guideline states 560 on a reporting scale of 200–800. This is a scaled score, not a raw percentage or a guaranteed number of correct answers.
How are these cards distributed?
SCFHS publishes Medicine 30%, OB-GYN 25%, Pediatrics 25% and Surgery 20%. This independent 50-card selection uses 15, 13, 12 and 10 cards respectively, with the rounding tie assigned to OB-GYN. It is a selective recall aid, not a complete syllabus or an official question set.
Who can apply for the SMLE?
The current SCFHS guide lists a recognised MBBS or equivalent degree, commencement of internship training, or being a student one year away from graduation. Saudi university/college students may sit during their final undergraduate year. SCFHS must approve eligibility and issue a scheduling permit before booking.
How many attempts and what retake wait apply?
SCFHS publications differ: its licensure-exams hub grants two additional attempts after an unsuccessful first attempt and says opportunities may renew one year from that first attempt; the currently linked SMLE 2026 PDF says up to four attempts a year from the first attempt. The PDF prohibits two sittings in one testing window. Confirm the opportunities and dates in your current Mumaris+ eligibility with SCFHS; these sources do not establish a universal fixed-day wait.
What SMLE pass rate should I use?
SCFHS's university-performance reporting uses passing attempts divided by all attempts during the academic year, including repeat attempts. Institution and reporting-period results do not predict an individual candidate's result; no universal current rate is asserted here.
Are these clinical recommendations Saudi treatment protocols?
These are independent exam-learning cards. Where a recommendation depends on a guideline, the card names NICE, BTS/NICE/SIGN, CDC U.S. MEC or the Royal Children's Hospital. Apply current Saudi guidance, local protocols and the patient's circumstances in clinical practice.
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