Oral Pathology PDF Past Paper

Oral Pathology Q1: The congenital absence of six or more teeth is known as: A. hypodontia B. oligodontia C. diphyodontia D. anodontia Answer: oligodontia Q2: Which type of dentinogenesis imperfecta features multiple pulp exposures, periapical radiolucencies, and a variable radiographic appear...

Oral Pathology Q1: The congenital absence of six or more teeth is known as: A. hypodontia B. oligodontia C. diphyodontia D. anodontia Answer: oligodontia Q2: Which type of dentinogenesis imperfecta features multiple pulp exposures, periapical radiolucencies, and a variable radiographic appearance? A. Type I B. Type II C. Type III Answer: Type III Q3: The permanent maxillary centrals in the x-ray below are vital. What is the most probable interpretation of the condition illustrated? A. mesiodens B. concrescence C. fusion D. dens in dente Answer: mesiodens Q4: All of the following are differential diagnoses for hypercementosis EXCEPT one. Which one is the EXCEPTION? A. cemento-osseous dysplasia B. cementoblastoma C. condensing osteitis D. odontogenic keratocyst Answer: odontogenic keratocyst Q5: An enamel defect resulting from the incomplete formation of the enamel matrix is called: A. enamel pearls B. enamel hypocalcification C. enamel hypoplasia D. regional odontodysplasia Answer: enamel hypoplasia Q6: A new patient presents to your office and on examination, you notice an abnormally wide maxillary incisor and a total of three maxillary incisors instead of four. The condition is most likely due to which of the following anomalies? A. gemination B. twinning C. concrescence D. fusion Answer: fusion Q7: All of the following statements concerning amelogenesis imperfecta are true EXCEPT one. Which one is the EXCEPTION? A. it is an inherited condition that is transmitted as a dominant trait B. because of the enamel malformation, the teeth of individuals with amelogenesis imperfecta are often discolored, sensitive to temperature changes, and painful to brush C. it only affects the permanent teeth D. it causes the enamel to be soft and thin E. the teeth appear yellow because the dentin is visible through the thin enamel F. the teeth are easily damaged and susceptible to decay Answer: it only affects the permanent teeth Q8: The abnormal loss of tooth structure due to non-masticatory physical friction is referred to as: A. erosion B. abfraction C. attrition D. abrasion Answer: abrasion Q9: Erythropoietic porphyria–related discoloration is a type of extrinsic dental stain. The tooth stain in congenital erythropoietic porphyria is red-brown in color. A. both statements are true B. both statements are false C. the first statement is true, the second is false D. the first statement is false, the second is true Answer: the first statement is false, the second is true Q10: All of the following statements regarding internal root resorption are true EXCEPT one. Which one is the EXCEPTION? A. is usually accompanied by pain and swelling B. radiograph shows uniform radiolucent pulp canal enlargement C. is carried out by multinucleated giant cells near the pulp granulation tissue D. is rare as compared to external root resorption Answer: is usually accompanied by pain and swelling Q11: Your patient has been diagnosed with amelogenesis imperfecta. His teeth demonstrate enamel that varies from thin and smooth to normal thickness with grooves, furrows, and pits. This patient's hereditary condition is an example of the _____ defect. A. type I (hypoplastic) B. type II (hypomaturation) C. type III (hypocalcified) Answer: type I (hypoplastic) Q12: In Type I dentin dysplasia, roots appear extremely short, and pulps are: A. normal B. somewhat smaller C. extremely large D. completely obliterated Answer: completely obliterated Q13: Where does leukemia form in the body and which type is mostly commonly found in children? A. lymph nodes, ALL B. bone marrow, AML C. lymph nodes, AML D. bone marrow, ALL Answer: bone marrow, ALL Q14: A 48-year-old female patient walks into your office. She states that she has been diagnosed with some disease, the name of which she can't remember. Her physician wants her to follow up with your office regularly to watch out for cancer of the tongue and throat. She also has a bald tongue, and states that her fingernails "look funny." What disease does she have? A. aplastic anemia B. Plummer-Vinson syndrome C. pernicious anemia D. Cushing syndrome Answer: Plummer-Vinson syndrome Q15: All of the following are characteristics of sickle cell anemia EXCEPT one. Which one is the EXCEPTION? A. crescent shaped RBC B. production of hemoglobin S C. more common in females D. RBC lifespan of 120 days E. loss of trabeculae evident in radiographs F. valine for glutamic acid substitution G. muscle and joint pain are common Answer: RBC lifespan of 120 days Q16: All of the following are true of acute leukemias EXCEPT one. Which one is the EXCEPTION? A. slow onset and progression B. characterized by the appearance of immature, abnormal cells in the bone marrow and peripheral blood and frequently in the liver, spleen, lymph nodes, and other parenchymatous organs C. marked by the effects of anemia, which are usually severe (fatigue, malaise), an absence of functioning granulocytes (prone to infection and inflammation), and thrombocytopenia (hemorrhagic diathesis) D. moderate enlargement of the spleen, liver, and lymph nodes. Fever and very high ESR E. leukocyte counts vary greatly from patient to patient Answer: slow onset and progression Q17: Which type of purpura is characterized by a low platelet count that is caused by abnormal thrombosis in terminal arterioles? A. thrombocytopenic purpura B. thrombotic thrombocytopenic purpura C. both of the above D. neither of the above Answer: thrombotic thrombocytopenic purpura Q18: You have a dental patient who mentions during his health history that he has an "overactive thyroid." You ask him about his medications and he states that he doesn't know what he takes now, but at one time he took methimazole. He had to stop that because it "really tore up my gums and the roof of my mouth and I got a lot of infections." Which condition of the blood is most commonly caused as a reaction to medication that could have caused these symptoms? A. thrombocytopenic purpura B. agranulocytosis C. sickle cell anemia D. Peutz-Jegher syndrome Answer: agranulocytosis Q19: A dentist is often consulted first by a patient with pernicious anemia for relief of: A. denuded gingiva B. glossitis C. edematous buccal mucosa D. severe gingivitis Answer: glossitis Q20: In your office, you see a 6-month-old child whose first teeth are erupting and whose mother is concerned about the color. The mandibular incisors do show a brownish-blue hue. You are going to ask the mother about which of the following conditions during her pregnancy: A. sickle cell anemia B. erythroblastosis fetalis C. patent ductus arteriosus D. low-weight preterm birth Answer: erythroblastosis fetalis Q21: Which of the following statements are false regarding chronic leukemias? A. they have a delayed onset and progression B. the clinical course is less devastating than that of an acute leukemia C. they constitute 75% of all leukemias D. they are characterized by proliferations of lymphoid or hematopoietic cells that are more mature than those of the acute leukemias Answer: they constitute 75% of all leukemias Q22: Leukemias are evenly split between the acute and chronic forms, but among children, one form accounts for about two-thirds of cases. This one form is: A. acute lymphocytic leukemia (ALL) B. acute myeloid leukemia (AML) C. chronic lymphocytic leukemia (CLL) D. chronic myeloid leukemia leukemia (CML) Answer: acute lymphocytic leukemia (ALL) Q23: You have a new patient in your dental office who has just moved from Denver. He says his doctor told him that he has some disease caused by living at a high altitude. When conducting an intraoral exam, you find that his tongue is a deep purple and his gingiva bleed easily. What disease is a likely cause of these findings? A. polycythemia vera (primary) B. secondary polycythemia C. hemophilia B D. thalassemia major E. porphyria Answer: secondary polycythemia Q24: The translocation from chromosome 22 to chromosome 9 is a finding of which leukemia? A. acute lymphocytic leukemia (ALL) B. chronic myeloid leukemia (CML) C. acute myeloid leukemia (AML) D. chronic lymphocytic leukemia (CLL) Answer: chronic myeloid leukemia (CML) Q25: Which of the following is an encapsulated mass that presents as an asymptomatic lump? A. neurofibroma B. traumatic neuroma C. neurilemmoma D. nodular fasciitis Answer: neurilemmoma Q26: While in the OR on a general surgery rotation, a 3-month-old is brought in with a large (20 cm) fluid- filled mass on her neck. The diagnosis is a cystic hygroma. This lesion is under which umbrella of lesions, which also contains enlarged tissue on the posterior and lateral border of the tongue? A. angiomas B. lymphangiomas C. schwannomas D. fibrosarcomas Answer: lymphangiomas Q27: A 24-year-old female patient comes into your office complaining of 14-mm exophytic, red mass present on the gingiva between teeth 5 and 6. A health history reveals that she is a smoker and is 3 months pregnant. Her oral hygiene is poor. A likely diagnosis of the mass is: A. epulis granulomatosa B. pyogenic granuloma C. peripheral ossifying fibroma D. peripheral giant cell granuloma Answer: pyogenic granuloma Q28: A patient presents to your clinic with multiple exophytic masses covering the buccal mucosa, tongue, and lips. A biopsy reveals that these are mucosal neuromas. The most important reason this patient should be referred to a physician is because of the risk of related: A. squamous cell carcinoma of the tongue B. pituitary hyperplasia C. medullary carcinoma of the thyroid D. Sipple syndrome Answer: medullary carcinoma of the thyroid Q29: Which of the following statements are true regarding neurofibroma? Select all that apply. A. a benign nerve sheath tumor B. an encapsulated tumor C. seen as interlacing bundles of spindle cells D. can be treated with medication Answer: a benign nerve sheath tumor, seen as interlacing bundles of spindle cells Q30: Von Recklinghausen disease displays all of the following characteristics EXCEPT one. Which one is the EXCEPTION? A. autosomal dominant B. axillary freckling C. café au lait macules D. iris hamartomas E. Optic gliomas F. due to a mutation of the tumor suppressor gene NF3 Answer: due to a mutation of the tumor suppressor gene NF3 Q31: A 55-year-old patient comes into your office for a routine dental cleaning. You see that he has a tooth fracture (due to decay) of tooth #31. A smooth, firm, asymptomatic lesion is noted on the lateral border of the tongue adjacent to the sharp enamel of tooth #31. The patient states that the lesion has been there for years and is annoying because sometimes he will bite it accidentally. Name this most frequently encountered intraoral benign neoplasm of connective tissue origin. A. a leiomyosarcoma B. a fibroma C. a leiomyoma D. a rhabdomyoma Answer: a fibroma Q32: Systemic sclerosis (scleroderma) is a systemic disease that affects many organ systems. What is usually the first sign of the disease? A. lung fibrosis B. Raynaud's phenomenon C. microstomia D. hypertension Answer: Raynaud's phenomenon Q33: A newborn girl was delivered via cesarean section due to airway patency concerns. During ultrasound, there was the discovery of a tumor of the oral cavity. On delivery, the pink, compressible tumor of the anterior maxilla was deemed to be a congenital epulis of the newborn. This lesion is composed of cells that are identical to those of the: A. traumatic neuroma B. schwannoma C. granular cell tumor D. lipoma Answer: granular cell tumor Q34: An emergency patient walks into your office with swelling of the left submandibular space. He says his lower left molar recently "broke down" and has been very painful, especially when something cold hits it or when he chews on it. What is the most likely etiology of this swelling? A. orthodontics B. trauma C. infection of the pulp of the tooth D. periodontal disease Answer: infection of the pulp of the tooth Q35: A healthy patient comes into your office for an initial exam. On the full mouth series of radiographs, you see a radiopaque lesion periapical to tooth #19. Tooth #19 has a deep amalgam restoration with recurrent decay underneath. Though the lesion is not separated from the apex, you can see the entire outline of the mesial root of tooth #19. The radiopaque lesion does not have a radiolucent rim. What is the most likely diagnosis of the lesion? A. condensing osteitis B. cementoblastoma C. focal cemento-osseous dysplasia D. idiopathic osteosclerosis Answer: condensing osteitis Q36: All forms of osteomyelitis are much more commonly seen in the mandible. Unless the inflammatory process has been present for more than 1 week, radiographic evidence of acute osteomyelitis is usually not present. A. both statements are true B. both statements are false C. the first statement is true, the second is false D. the first statement is false, the second is true Answer: both statements are true Q37: Cleft palate usually occurs starting in the _____ week of embryonic life whereas cleft lip usually occurs starting in the _____ week. A. 8th week, 6th week B. 10th week, 8th week C. 6th week, 8th week D. 8th week, 10th week Answer: 8th week, 6th week Q38: Achondroplasia is an autosomal dominant disorder caused by a mutation in the __________ gene. A. TRPS1 B. COL10A1 C. FGFR3 D. FLNB Answer: FGFR3 Q39: Type I dentinogenesis imperfecta is associated with which genetic disease? A. osteogenesis imperfecta B. Marfan syndrome C. Ehlers-Danlos D. cystic fibrosis Answer: osteogenesis imperfect Q40: Hypophosphatasia is a genetic metabolic disorder of bone mineralization caused by a deficiency in: A. acid phosphatase B. vitamin K C. alkaline phosphatase D. phosphorus Answer: alkaline phosphatase Q41: Pituitary adenoma in a 9-year-old will most likely lead to: A. gigantism B. acromegaly C. achondroplasia D. dwarfism Answer: gigantism Q42: A new 6-year-old pediatric patient walks into your operatory with her mother. Your initial physical assessment notes a prominent forehead and flattened nose. The patient initially seems to have no eyebrows but you later realize that the hair is just very fine and sparse. When you shake her hand and she smiles, you also notice that she is missing teeth and the ones she has are cone shaped. What is her most likely systemic condition? A. Pierre Robin syndrome B. ectodermal dysplasia C. cleidocranial dysplasia D. Peutz-Jeghers syndrome E. osteopetrosis Answer: ectodermal dysplasia Q43: A 65-year old Caucasian male presents to your office with ill-fitting dentures. Radiographic and clinical exam lead you to believe the patient has Paget disease. Which of the following would support this diagnosis? Select all that apply. A. hypercementosis B. enlarged cranium C. bone of decreased density D. headaches E. hearing loss Answer: hypercementosis, enlarged cranium, headaches, hearing loss Q44: Cherubism is a benign, autosomal dominant condition exhibiting all of the following characteristics EXCEPT one. Which one is the EXCEPTION? A. radiographically shows multilocular radio-opacities B. histologically close to central giant cell granuloma C. clinically presents as non-tender swellings D. treatment is frequent monitoring E. most cases occur in mandible F. affects males more than females Answer: radiographically shows multilocular radio-opacities Q45: A deficiency of parathyroid hormone can be treated with: A. vitamin A B. vitamin C C. vitamin D D. vitamin K Answer: vitamin D Q46: Graves disease is the most acute and severe form of hyperthyroidism caused by the autoimmune disease targeting which receptor? A. MSH receptor B. TSH receptor C. GH receptor D. PTH receptor Answer: TSH receptor Q47: Severe hypothyroidism is called _____ in children, whereas it is called _____ in adults. A. Hashimoto disease, cretinism B. cretinism, Graves disease C. myxedema, dwarfism D. cretinism, myxedema Answer: cretinism, myxedema Q48: The clinical features of the primary form of which disease is classically described as "stones, bones, groans, and moans?" A. Paget disease B. hypophosphatasia C. hyperparathyroidism D. hyperthyroidism Answer: hyperparathyroidism Q49: On a hospital rotation you see an infant who displays bowed legs and muscular weakness. On dental examination you notice a delayed eruption pattern. The child has rickets, which is a deficiency in which vitamin? A. vitamin A B. vitamin D C. vitamin C D. vitamin E Answer: vitamin D Q50: Which of the following conditions may be seen in a patient with cerebral palsy? Select all that apply. A. difficulty with mastication and swallowing B. higher incidence of periodontal disease and caries C. attrition of the teeth D. multilocular radiolucencies of the jaws Answer: difficulty with mastication and swallowing, higher incidence of periodontal disease and caries, attrition of the teeth Q51: Which of the following diseases is associated with a decrease in caries? A. Sjögren syndrome B. cystic fibrosis C. cerebral palsy D. Down syndrome Answer: cystic fibrosis Q52: You are listening to a story about oyster fishing from a fellow classmate concerning his trip to the East Coast. He mentions that he got sick and had to be taken to the ER where he was told he had hepatitis. He is fine now. Which hepatitis is the most likely culprit in your colleague? A. hepatitis A B. hepatitis B C. hepatitis C D. hepatitis D Answer: hepatitis A - also called infectious, viral or short-incubation hepatitis Q53: Which of the following is the most common reason for liver transplant in the United States and has been linked to a higher incidence of hepatocellular carcinoma? A. hepatitis A B. hepatitis B C. hepatitis C D. hepatitis D Answer: hepatitis C Q54: Which of the following aid in wound healing? Select all that apply. A. highly vascular areas (i.e., tongue) B. hyperthermia C. younger age D. cortisone E. hypothermia Answer: highly vascular areas (i.e., tongue), hyperthermia, younger age Q55: In which one of the following cases is an incisional biopsy indicated? A. 3 x 3 mm well-encapsulated fibroma B. necrotizing sialometaplasia of the hard palate C. 2 x 2 mm papilloma of left commissure of lips D. 3 x 2 mm melanotic macule Answer: necrotizing sialometaplasia of the hard palate Q56: Epstein-Barr virus (EBV) is associated with all of the following EXCEPT one. Which one is the EXCEPTION? A. nasopharyngeal carcinoma B. oral hairy leukoplakia C. Burkitt lymphoma D. Koplik spots E. infectious mononucleosis Answer: Koplik spots Q57: Epithelioid cells and giant cells are derived from macrophages and are important in the development of: A. initial inflammation B. granulomatous inflammation C. acute inflammation D. subacute inflammation Answer: granulomatous inflammation Q58: A patient you saw yesterday had minor swelling of the submandibular space associated with a carious #31. You prescribed amoxicillin and sent him home. He called today to say the swelling has gotten worse. You squeeze him into the schedule and notice that he has trouble breathing. You call an ambulance to escort him to the ER and tell the paramedics that he has Ludwig's angina. Ludwig angina is a severe and spreading infection that involves the: A. submental and sublingual spaces only B. submandibular, submental, and sublingual spaces unilaterally C. submandibular and sublingual spaces only D. submandibular, submental, and sublingual spaces bilaterally Answer: submandibular, submental, and sublingual spaces bilaterally Q59: ESR rises with all of the following EXCEPT one. Which one is the EXCEPTION? A. inflammation B. administration of hydrocortisone C. necrosis D. suppuration E. pregnancy Answer: administration of hydrocortisone Q60: Your 2-year-old nephew tells you he feels sick and then proceeds to vomit on the kitchen floor. You rush him to the bathroom where you notice toothpaste everywhere and his "SpongeBob" toothpaste tube completely empty. Your aunt asks you, "What is the estimated toxic dose for fluoride ingestion"? Your answer to her is: A. 1-2 mg/kg B. 5-10 mg/kg C. 8-10 mg/kg D. 12-15 mg/kg Answer: 5-10 mg/kg Q61: The most common cause of xerostomia is: A. hereditary B. medications C. tooth decay D. mouth breathing Answer: medications Q62: Hereditary gingival fibromatosis is a benign condition affecting both arches. Microscopically, hereditary gingival fibromatosis resembles fibrous hyperplasia. A. both statements are true B. both statements are false C. the first statement is true, the second is false D. the first statement is false, the second is true Answer: both statements are true Q63: Radiographically, traumatic bone cysts present as a: A. well-defined unilocular or multilocular radiolucency with scalloping around the roots B. poorly circumscribed radiopaque lesion which may have a "ground-glass" appearance C. saucer-shaped radiopaque lesion D. poorly defined multilocular radiolucency with a "pear-shaped" appearance between the maxillary central incisors Answer: well-defined unilocular or multilocular radiolucency with scalloping around the roots Q64: Where in the oral cavity is malignant melanoma most commonly found? A. tongue and mandibular alveolar ridge B. buccal mucosa and pharyngeal pillars C. palate and maxillary gingiva D. mucobuccal fold of lower lip Answer: palate and maxillary gingiva Q66: A 62-year-old African American patient comes into your office complaining of his loose lower molars. The health history reveals recent lower back pain. On a hunch, you send him down the hall to the orthodontist to take a lateral skull radiograph that reveals "punched-out" radiolucencies. You will refer this patient to the physician suspecting a diagnosis of: A. non-Hodgkin's lymphoma B. Hodgkin's lymphoma C. multiple myeloma D. Langerhan's cell disease Answer: multiple myeloma Q67: The least common type of malignant melanoma is: A. superficial spreading melanoma B. lentigo maligna melanoma C. acral-lentiginous melanoma D. nodular melanoma Answer: acral-lentiginous melanoma Q68: Which of the following grades of oral epithelial dysplasia shows marked pleomorphism and abnormal proliferation of basal layer cells into the upper third of epithelium? A. grade-1 B. grade-2 C. grade-3 D. grade-1 and grade-2 Answer: grade-3 Q69: The most common site of squamous cell carcinoma of the tongue is the: A. dorsum B. ventral surface C. tip D. posterior lateral border Answer: posterior lateral border Q70: Of the following types of squamous cell carcinomas, which is the least common? A. squamous cell carcinoma of the nasopharynx B. squamous cell carcinoma of the oropharynx C. squamous cell carcinoma of the maxillary sinus Answer: squamous cell carcinoma of the nasopharynx Q71: At which growth stage is metastasis most likely for malignant melanoma? A. "horizontal" growth phase B. "circular" growth phase C. "vertical" growth phase D. "radial" growth phase Answer: "vertical" growth phase Q72: Cancer of which oral cavity structure is most commonly associated with mortality? A. lip B. Tongue C. floor of mouth D. buccal mucosa Answer: tongue Q73: A 47-year-old HIV+ patient is referred from his physician to your office because of an exophytic growth in the maxillary left mucobuccal fold. Unable to find anodontogenic source, a biopsy was done. A starry-sky morphology was found and a dismal diagnosis of Burkitt's lymphoma was made. Which virus is thought to be responsible for this lymphoma? A. herpes virus B. Epstein-Barr virus C. cytomegalovirus D. human papillomavirus Answer: Epstein-Barr virus Q74: Ewing's sarcoma most often presents radiographically as: A. multiple radiolucent/radiopaque lesions resembling "cotton ball" or "cotton wool" appearance B. multiple "punched-out" radiolucencies C. ill-defined lytic lesion with an onionskin parosteal reaction in the long bones D. ill-defined radiolucent lesion resembling "ground glass" Answer: ill-defined lytic lesion with an onionskin parosteal reaction in the long bones Q75: A 15-year-old patient presents to his physician because of localized pain in his right femur and rapidly enlarging swelling. A radiograph of the area shows a "sun-ray" appearance. Which is a likely diagnosis for this patient based on incidence? A. chondrosarcoma B. osteosarcoma C. scleroderma D. chronic osteomyelitis Answer: osteosarcoma Q76: While doing a dental mission trip in Ethiopia, you notice purplish-brown nodules on the hard palate of a 32-year-old female patient. You notice more of these spots on her arms and legs. Given that HIV infection has an almost 5% prevalence in urban Addis Ababa, for what neoplasm are you suspicious of? A. nicotinic stomatitis B. hemangioma C. Kaposi sarcoma D. leukemia Answer: Kaposi sarcoma Q77: The ___________ presents as a movable, painless submucosal nodule with a yellowish-pink discoloration most commonly in the floor of the mouth. A. lipoma B. ranula C. lymphoma D. oral lymphoepithelial cyst Answer: Oral lymphoepithelial cyst Q78: Which of the following statements concerning metastatic tumors of the jaws are correct. Select all that apply. A. they may be completely asymptomatic B. the patient is usually aware of slight discomfort or pain C. the maxilla is affected far more frequently than the mandible D. the molar region is predominantly involved Answer: they may be completely asymptomatic, the patient is usually aware of slight discomfort or pain, the molar region is predominantly involved Q79: What is the stage for an oral cavity carcinoma with TNM designation T1, N2c, M1? A. stage I B. stage III C. stage IVa D. stage IVb E. stage IVc Answer: stage IVc Q80: A 65-year-old patient of East Indian origin presents to your clinic with a complaint of a lesion on the maxillary alveolar tuberosity. The lesion is a thick white, exophytic mass with a cauliflower appearance. A social history reveals that this woman has been chewing a betel nut concoction from her native India for over 40 years. What is the likely diagnosis of this lesion? A. papilloma B. erythroplakia C. verrucous carcinoma D. hyperkeratosis Answer: verrucous carcinoma Q81: A 73-year-old patient presents to your office with complaint of a lasting ulceration on the right side of his tongue. He has a history of hypertension and high cholesterol and a 40-year pack history of smoking. The patient takes antihypertensives and antilipidemics and has no allergies. You cannot find any sources of trauma. After 2 weeks, the ulcer has grown in size. What is the likely diagnosis of this most common malignancy of the oral cavity? A. adenoid cystic carcinoma B. mucoepidermoid carcinoma C. basal cell carcinoma D. squamous cell carcinoma Answer: squamous cell carcinoma Q82: While attempting to give an inferior alveolar nerve block, if you inject the anesthetic solution into the capsule of the parotid gland, you may cause a Bell's palsy-like feeling for the patient by anesthetizing the: A. trigeminal nerve B. glossopharyngeal nerve C. hypoglossal nerve D. facial nerve Answer: facial nerve Q83: A 25-year-old college student comes into your office complaining that, when she wakes up, she has trouble opening her mouth. When conducting a TMJ exam, you note tenderness of the right lateral pterygoid and nonreciprocal clicking of the right TMJ. What is the most likely cause of the patient's myofacial pain? A. trauma B. muscle spasm C. periodontal disease D. tumor Answer: muscle spasm Q84: A 53-year-old patient comes to your office and notes that, sometimes when he swallows, he gets a sharp "jolt" on the right side of his throat. He says the pain is severe and he can even feel it in his ear. The most likely diagnosis is: A. postherpetic neuralgia B. orolingual paresthesia C. Frey syndrome D. glossopharyngeal neuralgia Answer: glossopharyngeal neuralgia Q85: Which of the following is a relatively rare autoimmune disorder of peripheral nerves in which antibodies form against acetylcholine (ACh) nicotinic post-synaptic receptors at the myoneural junction? A. myasthenia gravis B. myelofibrosis C. multiple sclerosis D. Graves disease Answer: myasthenia gravis Q86: A 34-year-old dentophobe is your patient for the morning. After getting a very hesitant health history, you decide to begin your oral exam. As you reach toward her face, she immediately flinches and puts her hands up. She lets you know that if you touch a particular point above her lip, she gets sharp, stabbing jolts of pain. You let her know that a neurologist can work her up for: A. glossopharyngeal neuralgia B. trigeminal neuralgia C. postherpetic neuralgia D. diabetic neuralgia Answer: trigeminal neuralgia Q87: Which of the following are typically within soft tissue and may mimic inflammatory lesions of odontogenic origin? A. median palatal cyst B. traumatic bone cyst C. nasolabial cyst D. nasopalatine cyst Answer: nasolabial cyst Q88: Which of the following cysts are congenital? Select all that apply. A. thyroglossal duct cyst B. branchial cyst C. stafne bone cyst D. dermoid cyst Answer: thyroglossal duct cyst, branchial cyst, dermoid cyst Q89: Which of the following cysts are developmental (or fissural)? Select all that apply. A. nasopalatine duct (canal) B. nasolabial (nasoalveolar) C. branchiogenic D. median palatal E. median alveolar Answer: nasopalatine duct (canal), nasolabial (nasoalveolar), median palatal, median alveolar Q90: A nasopalatine duct cyst is the most common nonodontogenic oral cyst. A nasopalatine duct cyst is derived from embryonic epithelial remnants of paired nasopalatine ducts. A. both statements are true B. both statements are false C. the first statement is true, the second is false D. the first statement is false, the second is true Answer: both statements are true Q91: The soft tissue, and far less common, variant of the nasopalatine canal cyst is the: A. median mandibular cyst B. nasolabial cyst C. cyst of the incisive papilla D. aneurysmal bone cyst Answer: cyst of the incisive papilla Q92: An 8-year-old girl, who looks like she is 14 years old, comes with her father into your office. Her father states during the health history that she has McCune-Albright syndrome. Which of the following would you expect the patient to have? Select all that apply. A. congenital heart defects B. polyostotic fibrous dysplasia C. café au lait spots D. endocrine dysfunction Answer: polyostotic fibrous dysplasia, café au lait spots, endocrine dysfunction Q93: An 8-year-old child has complained of pain on the left side of his head for 5 weeks. There are no abnormal findings on physical examination. A pan reveals multiple radiolucent lesions on the left side of the maxilla. The lesions give the appearance of teeth that are "floating in air.''The lesions are sharply circumscribed with a punched-out appearance. Which of the following is the most likely diagnosis? A. Langerhans cell disease B. hyperparathyroidism C. cherubism D. Paget disease Answer: Langerhans cell disease Q94: Which of the following are true regarding central giant cell granulomas? Select all that apply. A. appear more frequently than peripheral giant cell granulomas B. found predominantly in children and young adults C. affects females more than males D. present almost exclusively in the small bones of the hands and feet Answer: found predominantly in children and young adults, affects females more than males Q95: A 21-year-old male patient is home from college and came to you because his "bite seems off."A quick physical assessment seems to indicate that his chin is deviated to the right. Taking a panoramic x- ray and comparing to the previous panoramic radiographs you have in his chart, you notice that the left condylar neck seems to have elongated. What condition does this patient most likely have? A. condylar agenesis B. condylar hyperplasia C. condylar hypoplasia D. hemifacial microsomia Answer: condylar hyperplasia Q96: A 6-year-old boy is a patient in your practice who has been hospitalized multiple times for broken bones. During routine lab tests, it was noted that his alkaline phosphatase levels were quite high. If this patient has a form of fibrous dysplasia, which radiographic feature may you find? A. the lesions are usually radiolucent, well-circumscribed, and may have a "cotton wool" appearance B. the lesions are usually a saucer-shaped radiolucency C. the lesions are usually radiopaque, not well-circumscribed, and may have a "ground-glass" appearance D. the lesions are usually well-demarcated unilocular or multilocular radiolucencies Answer: the lesions are usually radiopaque, not well-circumscribed, and may have a "ground- glass" appearance Q97: Mandibular tori most often appear: A. in the retromolar pad region B. on the lingual surface of the mandible, most often in the premolar region C. on the lingual surface of the mandible, inferior to the mylohyoid ridge D. along the midline of the hard palate Answer: on the lingual surface of the mandible, most often in the premolar region Q98: All of the following are features of an ossifying fibroma EXCEPT one. Which one is the EXCEPTION? A. slow growing expansile lesion B. more often in maxilla C. asymptomatic D. common in young adults around 35 years of age E. more common in females Answer: more often in maxilla Q99: A 17-year-old patient of yours comes in for a routine examination. A head and neck examination reveals multiple cysts of the skin. Her panoramic exams have always shown multiple impacted teeth. Today, her panoramic exam shows multiple radiopacities of the jaws, especially at the angle of the mandible. You suspect Gardner syndrome. What is the most serious complication she should be concerned with when consulting her physician? A. odontomas B. osteomas C. epidermoid cysts D. multiple polyps that affect the large intestine Answer: multiple polyps that affect the large intestine Q100: A 10-year-old boy comes with his mother to the dental office because of a painless swelling of his maxilla. Radiographic exam reveals an irregularly shaped radiopaque mass with a ground-glass appearance. No other bulges have been noted by the mother. A biopsy reveals fibrous tissue in the bone. What is the most likely diagnosis? A. monostotic fibrous dysplasia B. polyostotic fibrous dysplasia C. Albright syndrome D. Jaffe syndrome Answer: monostotic fibrous dysplasia Q101: A new patient walks into your office. Your initial physical assessment reveals that his eyes are set wide and that he has multiple lesions of the skin. When shaking his hand, you notice that the skin of his palm is very thick and has palmer pitting. When doing a health history, he reveals that he sees a neurologist and that he has some calcified structures "in his brain." A panoramic radiograph may likely reveal: A. osteomas B. keratocystic odontogenic tumors C. odontomas D. dentigerous cysts Answer: keratocystic odontogenic tumors Q102: A mother brings her 2-year-old boy into the dental office because of a "swelling" on his alveolar ridge. Your exam reveals a smooth-surfaced bluish lesion with fluctuance where tooth #K will be erupting. The most likely diagnosis of this is: A. dentigerous cyst B. eruption cyst C. hematoma D. hemangioma Answer: eruption cyst Q103: Upon viewing a panorex of a 14-year-old patient, you see a well-defined radiolucency with scalloping around the roots on the left side of the mandible apical to the canine and first premolar. No clinical symptoms are present. Teeth are not carious and respond normally to vitality tests. Medical history is unremarkable. On opening the area, no fluid or tissue is evident. What is the most probable diagnosis? A. dentigerous cyst B. traumatic (simple) bone cyst C. primordial cyst D. residual cyst E. Stafne (static) bone defect Answer: traumatic (simple) bone cyst Q104: A healthy 19-year-old patient presents to your office for a routine exam. Taking a panoramic radiograph, you see a well-corticated, unilocular radiolucency surrounding the crown of impacted tooth #17. The lesion is asymptomatic. What is the most likely diagnosis? A. keratocystic odontogenic tumor B. dentigerous cyst C. cystic ameloblastoma D. central ossifying fibroma Answer: dentigerous cyst - or Follicular cyst Q105: The odontogenic keratocyst (or keratocystic odontogenic tumor) is derived from which of the following: A. Hertwig's epithelial root sheath B. the reduced enamel epithelium C. remnants of the dental lamina D. a preexisting osteoma Answer: remnants of the dental lamina Q106: Which of the following most commonly appears radiographically as a well-circumscribed radiolucency with corticated margins, located laterally to a vital mandibular canine? A. lateral periodontal cyst B. dentigerous cyst C. keratocystic odontogenic tumor D. all of the above Answer: lateral periodontal cyst Q107: A dental granuloma and a radicular cyst can be differentiated: A. based on symptoms B. radiographically C. histologically D. by an electric pulp tester Answer: histologically - and only histologically Q108: A 37-year-old patient comes into your office with the complaint of a slow-growing, painless swelling of his lower left jaw. A panoramic shows a multilocular radiolucency with well-defined and sclerotic margins along the left mandibular molar-ramus area. All teeth test as vital. A biopsy showed the lesion to be an ameloblastoma. It is most likely to be which type of ameloblastoma? A. solid (multicystic or polycystic) B. unicystic C. extraosseous (peripheral) Answer: solid (multicystic or polycystic) Q109: A 30-year-old patient comes into your office complaining of a painless swelling of his lower left jaw. A panoramic radiograph shows a well-circumscribed multilocular radiolucency with a "honeycomb" pattern at the location of the lower left molars. The teeth have been displaced. The pathology report calls this an odontogenic myxoma. This tumor: A. is composed of large polyhedral, neoplastic, epithelial cells B. is composed of neoplastic epithelium and mesenchyme C. arises from odontogenic ectomesenchyme D. is composed of spindle-shaped mesenchymal cells and aggregates of multinucleated giant cells Answer: arises from odontogenic ectomesenchyme Q110: The cementoblastoma is more often seen: A. in the mandible than in the maxilla, and more often in the posterior than in the anterior regions B. in the mandible than in the maxilla, and more often in the anterior than in the posterior regions C. in the maxilla than in the mandible, and more often in the posterior than in the anterior regions D. in the maxilla than in the mandible, and more often in the anterior than in the posterior regions Answer: in the mandible than in the maxilla, and more often in the posterior than in the anterior regions Q111: All of the following are true regarding periapical cemento-osseous dysplasia EXCEPT one. Which one is the EXCEPTION? A. appears in middle age B. mandible is affected more than maxilla C. a predilection for middle-aged black women D. no treatment is usually required E. teeth are non-vital Answer: teeth are non-vital Q112: The most common location for a Pindborg tumor (calcifying epithelial odontogenic tumor [CEOT]) is the: A. tuberosity area B. maxillary anterior area C. mandibular premolar area D. posterior mandible Answer: posterior mandible Q113: The ameloblastic fibroma and ameloblastic fibro-odontoma appear to be variations of the same process. These neoplasms occur predominantly in: A. adults with a mean age of 40 B. elderly people with a mean age of 75 C. young adults with a mean age of 25 D. children and young adults Answer: children and young adults Q114: Odontoma is a tumor of odontogenic origin with completely differentiated odontogenic epithelium and ectomesenchyme. Complex odontomas are morphologically similar to normal teeth. A. both statements are true B. both statements are false C. the first statement is true, the second is false D. the first statement is false, the second is true Answer: the first statement is true, the second is false Q115: A 45-year-old African-American female presents to your office for a routine exam. Periapicals of the mandibular incisors show multiple radioopacities with radiolucent rims. Teeth #23 through #26 test as vital. There is no pain on percussion or palpation. Treatment for these lesions should be: A. do nothing (observe) B. RCT treatment for teeth #23 through #26 C. surgical excision of lesions D. none of the above Answer: do nothing (observe) Q116: A 5-year-old boy presents with his mother for his first dental exam. Your exam reveals a normally developing dentition, but you notice multiple "freckles" on his lower lip and on the buccal mucosa. For what condition should you be concerned? A. Gorlin-Goltz syndrome B. Gardner syndrome C. Peutz-Jeghers syndrome D. Cleidocranial dysplasia Answer: Peutz-Jeghers syndrome Q117: The bluish discoloration of the gingiva, as visible in the picture below, is most likely to be diagnosed as: A. melanocytic nevus B. amalgam tattoo C. melanotic macule D. oral melanoacanthoma Answer: amalgam tattoo Q118: The most common location for an intraoral congenital nevi (birthmark) is the: A. buccal mucosa B. tongue C. hard palate D. alveolar mucosa Answer: hard palate Q119: Which of the following conditions demonstrate pigmentation of the intraoral mucous membranes. Select all that apply. A. Addison disease B. McCune-Albright syndrome C. Cushing syndrome D. Peutz-Jeghers syndrome Answer: Addison's disease, McCune-Albright syndrome, Peutz-Jeghers syndrome Q120: A 40-year-old patient presents to his physician with complaints of muscle weakness and loss of appetite. He has noticed a loss of weight and also that his skin has started to "bronze." His labs show lowered blood glucose and sodium and increased potassium. One condition likely to be causing this is: A. Peutz-Jeghers syndrome B. Cushing syndrome C. Addison disease D. Albright syndrome Answer: Addison disease Q121: Focal melanosis is a common circumstance in which brownish areas of pigmentation occur in the oral cavity. Once properly diagnosed: A. surgical excision is required B. radiation is required C. no treatment is necessary D. antibiotics are required Answer: no treatment is necessary Q122: The intraoral nevus is usually a/an: A. intradermal nevus B. compound nevus C. junctional nevus D. blue nevus E. intramucosal nevus Answer: intramucosal nevus Q123: A patient presents with an asymptomatic, elongated, erythematous patch of atrophic mucosa of the mid-dorsal surface of the tongue due to a chronic Candida albicans infection. The most likely diagnosis is: A. thyroglossal duct cyst B. lymphangioma C. hemangioma D. median rhomboid glossitis Answer: median rhomboid glossitis Q124: A 13-year-old patient presents with his father to your dental clinic for a routine examination. From the health history, you gather that the patient has frequent nosebleeds, just like his father. Upon intraoral examination, you notice multiple red spots on the patient's lower lip and tongue. The father states that he has these same marks on his tongue, palate, hands, and eyes. What condition do you suspect the child has? A. Wegener granulomatosis B. hereditary hemorrhagic telangiectasia (HHT) C. Sturge-Weber angiomatosis D. juvenile nasopharyngeal angiofibroma Answer: hereditary hemorrhagic telangiectasia (HHT) - aka Rendu-Osler-Weber syndrome Q125: A clinical term defined as a red patch that cannot be clinically or pathologically diagnosed as any other condition is called: A. leukoedema B. psoriasis C. erythroplakia D. white sponge nevus Answer: erythroplakia Q126: Which of the following statements is not true about pyogenic granuloma? A. fast growing, tumor-like growth formed after an exaggerated conditioned response to mild trauma B. most commonly seen on gingiva, although can be seen anywhere in the mucous membrane C. lesions bleed easily when probed due to pronounced vascularity D. older pyogenic granulomas are more vascular than younger lesions Answer: older pyogenic granulomas are more vascular than younger lesions Q127: Peripheral giant cell granulomas are seen exclusively in the: A. buccal mucosa B. alveolar mucosa C. bone D. gingiva Answer: gingiva Q128: The picture below shows a benign, soft, moderately well-circumscribed, painless mass which is deep red or blue-red in coloration. The most likely diagnosis is: A. lymphangioma B. hemangioma C. blue nevus D. melanotic macule Answer: hemangioma Q129: Tumors of the salivary glands are: A. uncommon and represent 2-4% of head and neck neoplasms B. common and represent 75-80% of head and neck neoplasms C. uncommon and represent 25-30% of head and neck neoplasms D. common and represent 95-98% of head and neck neoplasms Answer: uncommon and represent 2-4% of head and neck neoplasms Q130: Which lesion below presents itself as a deep-seated palatal ulcer with clinical and histologic features mimicking those of a malignant neoplasm? A. white sponge nevus B. lichen planus C. necrotizing sialometaplasia D. focal hyperkeratosis Answer: necrotizing sialometaplasia Q131: In a small Amish community, there is an infectious outbreak. Multiple children are coming down with symptoms including fever and malaise. Commonly, there is swelling of the parotid glands. Given that this community does not receive vaccinations, what is a likely diagnosis for the condition? A. measles B. mumps C. rubella D. chickenpox Answer: mumps Q132: The Stafne bone defect is a developmental anomaly represented by a bone concavity usually containing: A. parotid gland tissue B. submandibular gland tissue C. sublingual gland tissue D. all of the above Answer: submandibular gland tissue Q133: A 53-year-old woman comes into the dental clinic with bilaterally enlarged parotid glands. It was discovered that she had recently been to the African continent and had contracted tuberculosis. What is the name of the autoimmune disease associated with enlarged salivary glands in association with a secondary disease? A. Sjögren syndrome B. Mikulicz disease C. Gorlin-Goltz syndrome D. Pierre Robin syndrome E. Apert syndrome Answer: Mikulicz disease Q134: A 33-year-old patient comes into your office for a routine maintenance appointment. While doing an intraoral exam, the hygienist discovers a bluish lesion of the lower lip. The patient relates a history of biting this area last week when he had a sinus infection. What is the most likely diagnosis of this lesion? A. ranula B. infectious sialadenitis C. maxillary sinus retention cyst D. mucocele Answer: mucocele Q135: What is the most probable diagnosis for a lesion that presents as a translucent, bluish, well- rounded, smooth-surfaced bulge that protrudes from one side of the floor of the mouth? A. adenoid carcinoma B. squamous cell carcinoma C. a ranula D. a lymphangioma Answer: a ranula Q136: A patient comes to your office complaining of pain when eating and even sometimes when thinking about food. Your intraoral exam reveals a small, hard swelling in the floor of the mouth. A mandibular occlusal radiograph shows a pea-sized radiopacity with "onion-skin" thickening lingual to the right mandibular border. Name the likely diagnosis: A. sialometaplasia B. sialadenitis C. sialolith D. sialosis Answer: sialolith Q137: Of the neoplasms affecting the major or minor glands, the ____________ is the most common. A. basal cell adenoma B. sebaceous adenoma C. pleomorphic adenoma D. ductal papilloma Answer: pleomorphic adenoma Q138: Which of the following disorders should be included in your differential diagnosis of parotid gland enlargement. Select all that apply. A. sarcoidosis B. Mikulicz disease C. Sjögren syndrome D. hypothyroidism E. diabetes mellitus F. malnutrition/starvation G. dehydration H. cystic fibrosis Answer: sarcoidosis, mikulicz disease, sjögren syndrome, diabetes mellitus, malnutrition/starvation, dehydration, cystic fibrosis Q139: The acinic cell carcinoma is derived from serous acinar cells and is found almost exclusively in the: A. submandibular gland B. parotid gland C. minor glands of the palate D. sublingual gland Answer: parotid gland Q140: ________ is the most common salivary gland malignancy and makes up between 5% and 9% of all salivary gland neoplasms. A. adenoid cystic carcinoma B. mucoepidermoid carcinoma C. acinic cell carcinoma D. polymorphous low-grade adenocarcinoma Answer: mucoepidermoid carcinoma Q141: Which autoimmune disease is associated with the increase in caries? A. Lupus erythematosus B. Sjögren syndrome C. Sarcoidosis D. Crohn disease Answer: Sjögren syndrome Q142: The _____ salivary gland presents with the most number of tumors and _____carcinoma is the most common malignant salivary gland neoplasm. A. parotid, acinic cell B. parotid, mucoepidermoid C. sublingual, mucoepidermoid D. sublingual, acinic cell Answer: parotid, mucoepidermoid Q143: Oncocytomas are _______ tumors that constitute about _______of benign epithelial salivary gland neoplasms. A. common; 50% B. common; 75% C. rare; 2% D. rare; 15% Answer: rare; 2% Q144: A 65-year-old patient comes to your office complaining of a slowly growing enlargement of the jaw. You palpate the angle of his right ramus and find an encapsulated mass that is nontender and firm. Your oral pathologist defines it as a glandular and cystic tumor lined by a bilayered (inner columnar oncocytic and outer basal) epithelium with a lymphoid stroma. Name this second most common benign neoplasm of the parotids. A. pleomorphic adenoma B. Warthin tumor C. fibroadenoma D. monomorphic adenoma Answer: Warthin tumor Q145: A 40-year-old female comes to your clinic with the complaint of a lesion on the lower lip that has been increasing slowly during the past 2 years. On examining, the subcutaneous growth is nontender, soft, and mobile. A biopsy taken to confirm the type of lesion reveals a yellow lobulated cut surface. The lesion being localized and slow growing is suggestive of a malignant tumor. The cells in benign tumors are always well differentiated, resembling their normal cells of origin. A. both statements are true B. both statements are false C. the first statement is true, the second is false D. the first statement is false, the second is true Answer: the first statement is false, the second is true Q146: An overgrowth of normal tissues in a place where that tissue is not normally found is referred to as a: A. teratoma B. choristoma C. hamartoma D. none of the above Answer: choristoma Q147: Malignant neoplasms range from well-differentiated to undifferentiated. Malignant neoplasms composed of undifferentiated cells are said to be: A. metaplastic B. hyperplastic C. anaplastic D. dysplastic Answer: anaplastic Q148: Metaplasia most commonly occurs by replacement of ________ by _______. A. cuboidal cells; columnar cells B. columnar cells; stratified squamous epithelium C. columnar cells; pseudostratified columnar cells D. cuboidal cells; stratified squamous epithelium Answer: columnar cells; stratified squamous epithelium Q149: A 25-year-old dental student has been cramming for his dental physiology and pharmacology final exams. He is sleep deprived but otherwise healthy. When flossing, he notices a 3-mm ulceration on the inner surface of his lower lip. He can find no other instances of this lesion and remembers that he had one a long time ago in undergraduate clinic, which went away. What is the most likely diagnosis? A. recurrent aphthous minor B. recurrent aphthous major C. recurrent herpetiform aphthous D. recurrent herpetic stomatitis Answer: recurrent aphthous minor Q150: Which of the following make up the triad of Stevens-Johnson syndrome (SJS)? A. stomatitis B. lesions of the eye C. genital lesions D. maculopapular rash Answer: stomatitis, lesions of the eye, genital lesions Q151: The picture below showcases a solitary small whitish sore with a red border measuring 2-5 mm in diameter. The patient is a 14-year-old female with a history of its recurrent appearance beginning two months ago. Each time the lesion heals on its own within 10 days. It begins as a reddish area with a burning or tingling sensation. The most likely diagnosis is: A. recurrent minor aphthous ulcers B. recurrent major aphthous ulcers C. pemphigous D. recurrent herpetiform ulceration Answer: recurrent minor aphthous ulcers Q153: A 43-year-old man presents to the ER with a purple lump of the jaw that is painful. He has an extraoral sinus tract presenting with yellowish crust. The ER places the individual on a long-term penicillin regimen. What was the most likely diagnosis? A. coccidioidomycosis B. histoplasmosis C. tuberculosis D. actinomycosis E. scarlet fever Answer: actinomycosis Q154: Treponema pallidum is the infectious organism of which disease? A. syphilis B. gonorrhea C. chlamydia D. tuberculosis Answer: syphilis Q155: All of the following are the features of Hutchinson triad which are pathognomonic of congenital syphilis EXCEPT one. Which one is the EXCEPTION? A. eighth nerve deafness B. interstitial keratitis C. screwdriver-shaped central incisor D. multiple fibroma Answer: multiple fibroma Q156: Which of the following fungal infections is most commonly associated with diabetes mellitus? A. coccidioiodomycosis B. mucormycosis C. aspergillosis D. none of the above Answer: mucormycosis Q152: Erythema multiforme (EM) is an acute self-limited eruption characterized by a distinctive clinical eruption, the hallmark of which is the: A. chronic desquamative gingivitis B. petechial hemorrhage C. iris or target lesion D. mucocutaneous rash Answer: iris or target lesion - appears as a central lesion surrounded by concentric rings of pallor and redness over the dorsal aspect of the hands and forearms Q157: A 4-year-old patient comes with her mother for a routine appointment. The mother states that her daughter just started not feeling well and had a mild fever earlier in the day. The daughter has been having trouble swallowing. An intraoral exam reveals multiple 1-mm to 2- mm vesiculopapular lesions of the nasopharynx and soft palate. Your working diagnosis is: A. herpangina B. hand-Foot-and-Mouth disease C. herpes simplex infection D. pemphigus vulgaris Answer: herpangina Q158: Which type of herpes virus is associated with the lesion on the lower lip? A. HSV-1 B. HSV-2 C. HSV-3 D. HSV-4 Answer: HSV-1 Q159: The dormancy state with latency in the trigeminal ganglion is associated with which form of herpes? A. Cytomegalovirus B. Epstein-Barr virus C. Herpes simplex virus type 1 D. Herpes simplex virus type 2 Answer: Herpes simplex virus type 1 Q160: A 65-year-old man presents to your clinic in regards to upper dentures. When getting his health history, you ask about history of infectious diseases. He mentions that a year ago, his eldest son died and later he broke out in blisters on only half of his back. He says he doesn't remember what the doctor called it, but he remembers the physician saying it "stopped at the midline." What is the most likely diagnosis? A. herpes zoster B. herpangina C. recurrent herpes D. chickenpox Answer: herpes zoster Q161: Over 90% of primary herpes simplex viral infections are: A. manifested as ANUG B. associated with HIV C. subclinical D. characterized by severe lymphadenopathy and acute dermatitis Answer: subclinical Q162: After the initial primary attack during the early childhood period, the herpes simplex virus remains inactive most commonly in the: A. geniculate ganglion B. ciliary ganglion C. trigeminal ganglion D. pterygopalatine ganglion Answer: trigeminal ganglion Q163: A 49-year-old patient of Ashkenazi heritage presents to your office complaining of "blisters in her mouth." Your intraoral exam shows ulcers present on multiple areas of mucosa. She also related to you that, while getting out of the car earlier, the skin of her arm rubbed against the car door and tore. Known as Nikolsky sign, this phenomenon is associated with which disease? A. herpes zoster B. lupus erythematosus C. lichen planus D. pemphigus Answer: pemphigus Q164: The oral lesions of benign mucous membrane pemphigoid most commonly present as a: A. candidiasis B. hairy leukoplakia C. desquamative gingivitis D. hemorrhagic mass Answer: desquamative gingivitis Q165: The common wart or verruca vulgaris is caused by the: A. human papillomavirus B. adenovirus C. Epstein-Barr virus D. Human parvovirus Answer: human papillomavirus Q166: A 45-year-old female walks into your office complaining of a "wart" on her gums that has been there for years. Your exam reveals an asymptomatic, well circumscribed, slightly raised, papillomatous lesion on the buccal gingiva of tooth #5. A likely diagnosis of this is: A. fibrosarcoma B. neurosarcoma C. lipoma D. Verruciform xanthoma Answer: verruciform xanthoma Q167: A 63-year-old completely edentulous patient comes into your office because her dentures have "finally gotten too bothersome to wear." Her health history consists of COPD and cigarette 40-year pack history. Your intraoral exam reveals a noxious odor and an ill-fitting upper denture. When you remove the upper denture you note multiple red, papillary projections of the hard palate. Your patient states she does not remove her dentures at night or between meals. After reviewing denture hygiene instructions, you give her the diagnosis of: A. epulis fissuratum B. inflammatory papillary hyperplasia C. nicotinic stomatitis D. Kaposi sarcoma Answer: inflammatory papillary hyperplasia Q168: A 54-year-old African-American female presents to your clinic for an initial exam. She has a history of hypertension controlled with beta-blockers but no other contributory health findings. Your intraoral exam reveals a bilateral filmy opalescence of the buccal mucosa. When stretching out her cheeks, this white hue disappears. Your most likely diagnosis is: A. Squamous cell carcinoma B. Fordyce granulation C. Leukoedema D. Leukoplakia Answer: Leukoedema Q169: A 67-year-old Caucasian male comes into your office for a routine check-up. He relates to you that he just got back from Florida where he goes for the fall and winter months. He enjoys taking his boat out with his wife. Your extraoral exam shows chapped lips, but his lower lip also presents with grayish-white plaques. There is a blurring of the vermilion border. Which of the following would you make your diagnosis: A. actinic keratosis B. actinic cheilitis C. actinic dermatitis D. solar lentigo Answer: actinic cheilitis Q170: An incisional biopsy is indicated for which of the following lesions? A. a 0.2-cm exostosis of the hard palate B. a 0.2-cm area of Fordyce granules of the cheek C. a 0.3-cm hemangioma of the tongue D. a 0.3-cm area of leukoplakia of the soft palate Answer: a 0.3-cm area of leukoplakia of the soft palate Q171: You are conducting a routine exam on a 54-year-old patient with diabetes mellitus type 2 and a 20- year pack history of smoking. You see a white patch on the floor of the mouth. The lesion cannot be wiped off and the patient denies a history of trauma or allergies. Which of the following would be your diagnosis? A. squamous cell carcinoma B. lichen planus C. erythroplakia D. leukoplakia Answer: leukoplakia Q172: A 75-year-old patient comes to your office wanting a new set of dentures. She hasn't been wearing her old dentures for about 2 years. She has a collapsed vertical dimension of occlusion and her physician is concerned about her iron deficiency. The corners of her mouth are fissured, dry, and erythematous. Which of the following conditions is the likely diagnosis? A. squamous cell carcinoma B. angular cheilitis C. verruca vulgaris D. stomatitis nicotina Answer: angular cheilitis - also called perlèche Q173: A 34-year-old male comes into the clinic for an initial exam. Your health history is noncontributory. The patient presents with bilateral asymptomatic, white, folded and spongy tissue on the buccal mucosa. There is no history of cheek biting, and the patient recalls that the lesions have been present as long as he can remember. Your diagnosis is: A. hyperkeratosis B. leukoplakia C. epidermolysis bullosa D. white sponge nevus Answer: white sponge nevus Q174: Hairy tongue is a condition characterized by hypertrophy of the: A. filiform papillae B. fungiform papillae C. circumvallate papillae D. foliate papillae Answer: filiform papillae Q175: A 62-year-old African-American female patient presents to your clinic for routine dental work. Your intraoral exam reveals white, lace-like webbing on the buccal mucosa. Your patient has never noticed these and they have never caused her a problem. You suspect the following: A. lupus erythematosus B. erythema multiforme C. pemphigus vulgaris D. lichen planus Answer: lichen planus Q176: A white patch that, when scraped or removed from the oral mucosa, leaves a raw surface most likely is: A. leukoplakia B. white sponge nevus C. candidiasis D. lichen planus Answer: candidiasis Q177: Identify the white patch seen below in a 65-year-old male patient, who is a long-time smoker. A. leukoplakia B. leukoedema C. mucosal burn D. nicotine stomatitis Answer: leukoplakia Q178: A 35-year-old healthy female presents to your office for a routine cleaning. While completing the scaling on the LL quadrant, you notice that her tongue has multiple irregularly shaped red lesions that have a white border. You make a note in her chart. When she returns 2 weeks later for the restorative work on the LR quadrant with the dentist, he notes that there are still lesions, but in different locations on the tongue with different shapes. What is your diagnosis? A. fissured tongue B. macroglossia C. geographic tongue D. hairy tongue Answer: geographic tongue