Board Review Radiology and Pathology

A.Occlusal trauma RATIONALE: Condensing osteitis, or root resorption, is a factor in occlusal trauma that appears radiographically radiopaque and is associated with endo-periapical lesions. Also indicative of occlusal trauma as a cause for condensing osteitis, her exam results were positive for pathology and radiographically appear radiopaque. This pathology is not an odontoma, which is an odontogenic tumor composed of tooth structures, enamel, dentin, and pulp. While an odontoma is radiopaque, as is condensing osteitis, an odontoma is surrounded by a radiolucent halo. Neither is this lesion a periapical cemento-ossdeous dysplasia (cementoma), a condition that is associated with vital teeth that are asymptomatic. Cementoma most frequently occurs in the mandibular anterior region and occurs in middle aged Africa American women 70% of the time. Although periapical abcesses also occur at the root apex, radiographically they typically appear radiolucent.

A 49-year-old white female client reports intermittent sensitivity in her right mandibular first molar. The tooth has no restoration, and the vitalometer test results are positive (indicating a nonvital pulp) for pathology. A current radiograph shows a radiopaque area at the apex of the distal root of this tooth. This condition has been diagnosed as condensing osteitis. Which of the following is MOST likely responsible for this condition? A.Occlusal trauma B.Odontoma C.Periapical cemento-osseous dysplasia D.Periapical abcess

C.Lipoma RATIONALE: A lipoma is a benign tumor consisting of adipose tissue or mature fat cells. The remaining selections are also benign in nature. A hemangioma is a proliferation of capillaries whereas a fibroma is a mass of fibrous tissue. As the name implies, a lymphangioma is a tumor consisting of lymphatic vessels.

A benign tumor consisting of adipose tissue is referred to as which of the following lesions? A.Hemangioma B.Fibroma C.Lipoma D.Lymphangioma

C.teratogen. RATIONALE: A teratogen is a chemical, biological or physical agent that can disturb the development of an embryo or fetus whereas a carcinogen is a cancer causing substance or agent. Known to cause both teratogens and carcinogens, a free radical is an atom or group of atoms that has at least one unpaired electron and is therefore unstable and highly reactive. Gestation refers to the period of development in utero from conception to birth.

A chemical, biologic, or physical agent that causes birth defects is known as a A.gestation. B.carcinogen. C.teratogen. D.free radical.

C.pyogenic granuloma. RATIONALE: Based upon the signs and symptoms, this lesion is a pyogenic granuloma. Pyogenic granulomas present as a benign mass containing numerous blood-filled small blood vessel and capillaries. They are tender and bleed easily. This lesion more commonly forms on maxillary labial gingiva than on mandibular gingiva, but can occur on the lips, tongue, and buccal mucosa. Pyogenic granulomas are exophytic masses (outward growing) with pedunculated, sessile, or lobulated base. Lesions range from a few millimeters to several centimeters in size. Lipomas rarely occur in the oral cavity and most frequently form in individuals over 40 years. While it can be lobulated, and have a sessile or pedunculated base, the surface is covered with normal colored oral mucosa. Central giant cell granuloma (CGCG) is a central lesion which means it forms within bone. This painless expansion of cortical plates is typically asymptomatic and is thought to form as a reaction to trauma or an irritation. Chronic hyperplastic pulpitis, also called pulpal granuloma and pulp polyp, occurs in children and young adults with no gender predilection. It most often occurs in primary molars of permanent first molars and is associated with large, open, carious lesions.

A fifteen year old female presents with a benign mass containing numerous blood-filled small blood vessel and capillaries. The area is tender and bleeds easily. The lesion is located on her maxillary labial gingiva, but the pathologist notes that it can also occur on the lips, tongue, and buccal mucosa. It has an exophytic (outward growing), lobulated base. There is no history of trauma or irritation. There is no evidence of carious lesions in the area. The lesion measures 8 mm in size. Based upon this description, this lesion is MOST likely a A.lipoma. B.central giant cell granuloma (CGCG). C.pyogenic granuloma. D.chronic hyperplastic pulpitis.

C.gingival abscess. RATIONALE: A gingival abscess is a localized purulent infection involving the marginal gingiva or interdental papilla that does not involve the underlying periodontium. There may be a bluish hue. Note that abscesses can occur in most tissues within the body. Ludwig's angina is diffuse bilateral cellulitis of the floor of the mouth and neck that rapidly spreads. Predisposing factors are infected molars and a thin lingual cortical mandibular plate. Osteomyelitis is an infection of bone or bone marrow. Small, inflamed, pus-filled, blister-like lesions on the skin surface are called pustules.

A localized purulent infection involving the marginal gingiva or interdental papilla that does not involve the underlying periodontium is called A.Ludwig's angina. B.osteomyelitis. C.gingival abscess. D.pustule.

B.metaplasia. RATIONALE: Metaplasia is a microscopic change in which cells of one type are transformed or replaced by cells not normally found in that area. Hyperplasia is enlargement of a tissue or organ resulting from an increase in number of normal cells whereas hypoplasia is a failure of full development of an organ or tissue. Dysplasia, as indicated by its prefix "dys" represents dysfunctional development manifested as an alteration in size, shape, and organization of adult cells.

A microscopic change in which cells of one type are transformed or replaced by cells of another type that normally would not be in that area is referred to as A.hyperplasia. B.metaplasia. C.hypoplasia. D.dysplasia.

D.Globulomaxillary cyst RATIONALE: A globulomaxillary cyst is a pear-shaped radiolucency located between the roots of the maxillary lateral and canine teeth. This cyst is currently thought to arise from odontogenic epithelium (previously considered a fissural cyst). Median palatine cysts are located at the midline of the hard palate. Nasopalatine duct cysts are located within or adjacent to the nasopalatine canal or incisive papilla and may appear heart-shaped. Median mandibular cysts are rare and located at the midline of the mandible.

A periapical examination reveals an inverted pear-shaped radiolucency between the roots of the maxillary lateral and canine teeth. The client is asymptomatic, and the adjacent teeth are vital. What is the correct diagnosis for this pathologic condition? A.Median palatal cyst B.Nasopalatine duct cyst C.Median mandibular cyst D.Globulomaxillary cyst

C.The first statement is TRUE, the second is FALSE. RATIONALE: A pyogenic granuloma, is a benign mass containing blood-filled small blood vessels and capillaries. It appears on the gingiva as an exuberant tissue response to trauma or chronic irritants (plaque biofilm, calculus, poor restorative margins, hormonal levels). Note that this lesion does not form within bone; it most commonly occurs on the maxillary gingiva but can occur on the lips, tongue, and buccal mucosa.

A pyogenic granuloma is an inflammatory tumor that occurs more commonly on the maxilla than on the mandible. A pyogenic granuloma occurs in the bone and appears as a swelling or bulge resulting from the expansion of cortical plates. 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.

D.dentigerous cyst. RATIONALE: A dentigerous cyst, also called a follicular cyst, forms around the crown of unerupted or developing teeth. This cyst is most frequently located in the mandibular third molar area where it may enlarge to extend high into the ramus. If a dentigerous cyst occurs in the maxillary canine region it may compromise the maxillary sinus. A primordial cyst is believed to aris from degeneration of the tooth germ during development. The cyst represents the remnants of the enamel organ. A primordial cyst develops in place of a tooth. Note that a periapical granuloma, also called an apical granuloma or chronic apical periodontitis, is associated with a nonvital tooth and is most often asymptomatic. Residual cysts have the distinction of developing after tooth removal. They represent the remainder or "residual" portion of a previously established periapical cyst.

A radiolucency around the crown of an unerupted tooth is referred to as a A.primordial cyst. B.periapical granuloma. C.residual cyst. D.dentigerous cyst.

C.bring the area to the attention of the patient to learn any relevant history. RATIONALE: The hygienist should first show the area to the patient to learn her awareness of its origin and history. After documentation by the hygienist, the dentist should examine the lesion and determine the appropriate treatment or referral. A biopsy, whether excisional or incisional, may be indicated at this appointment or in the near future if the area does not heal on its own.

A red, raised nodule is noted on the posterior lateral border of the tongue. The first appropriate first step is to A.excise the entire area and perform a biopsy. B.perform an incisional biopsy of both the questionable area and adjacent normal area. C.bring the area to the attention of the patient to learn any relevant history. D.have the dentist exam the lesion.

D.2.0 seconds. RATIONALE: The 30 milliamperes per second (mAs) is calculated by multiplying the milliamperes (10 mA) by the exposure time (3 seconds). If any component of this calculation is altered and the goal is to maintain the same density in the exposed radiograph, the same total milliamperes per second (mAs) must be retained. In this case, after increasing the mA to 15, the time (s) must be decreased to 2 seconds in order to retain 30 mAs. (15 mA × 2 s = 30 mAs). It follows that the remaining selections are incorrect. Note that milliamperes represent the amount of electrical current applied to the cathode and affects the number of x-rays produced in the exposure.

A setting of 10 milliamperes (mA) with an exposure time of 3 seconds results in 30 mAs (milliamperes per second) of radiation exposure. To maintain the same density of the exposed radiograph when the mA is increased to 15, the time of exposure must be reduced to A.0.5 second. B.1.0 seconds. C.1.5 seconds. D.2.0 seconds.

D.Frequently becomes malignant with slight pain RATIONALE: Inflammatory papillary hyperplasia of the palate is most often associated with partial or complete dentures; it is considered a type of denture stomatitis. Inflammatory papillary hyperplasia of the palate is also called palatal papillomatosis. It presents with varying degrees of inflammation; typically has a rounded, smooth, glistening red surface and is granular in appearance. Inflammatory papillary hyperplasia of the palate is a benign asymptomatic condition.

All of the following accurately describe aspects of inflammatory papillary hyperplasia of the palate EXCEPT one. Which one is the EXCEPTION? A.Most often associated with partial or complete denture B.Also called palatal papillomatosis C.Varying degrees of inflammation D.Frequently becomes malignant with slight pain

D.Exposure to white light RATIONALE: Exposure of radiographic film to white light alters the silver halide crystals within the emulsion. As the damaged film is processed, the developer will reduce exposed silver halide crystals to black, creating a completely black image. Another potential error, decreasing the kilovoltage, results in an x-ray beam that is less penetrating. This causes underexposure because the x-ray photons are attenuated by the structures the beam must pass through before reaching the film. Hence, decreased kilovoltage delivers less radiation and results in an image that is too light. Also causing light radiographic images is the tendency to increase the distance between the open end of the PID and the film packet. The x-ray beam loses intensity the farther it must travel to reach the film. Reversing the film packet placement in the oral cavity causes the lead foil within the packet to attenuate (block) a portion of the beam. The resultant image will appear too light due to a decrease in beam intensity.

All of the following items may result in radiographic images that are too light, EXCEPT one. Which one is the EXCEPTION? A.Decreased kilovoltage setting B.Increased distance between open end of the PID and the film packet C.Reversed film packet placement in the oral cavity D.Exposure to white light

A.Large focal spot RATIONALE: Image appearance is improved with a smaller focal spot size; the smaller the focal spot size, the sharper the image. By contrast, the longest source-to-object distance (focal spot to tooth) enhances image appearance. Also enhancing radiographic image are 1) the shortest object-to-receptor distance (tooth to receptor) and parallel object (tooth) and receptor relationship.

All of the following would improve the visual appearance of the radiographic image, EXCEPT one. Which one is the EXCEPTION? A.Large focal spot B.Long focal spot to object distance C.Short object to film distance D.Parallel object and film relationship

C.The first statement is true, the second is false. RATIONALE: Over time, ionizing radiation accumulates in the cells, tissues, and organs. Accumulated damage that the body cannot repair is called the cumulative effect. The somatic effect refers to injury occurring in the person exposed to the ionizing radiation that does not involve reproductive tissue. By contrast, the genetic effect refers to exposure of reproductive tissues that result in injury to future generations.

Although tissues have the capacity to repair some degree of damage from ionizing radiation, accumulated unrepaired damage is called the cumulative effect.The somatic effect of ionizing radiation refers to exposure resulting in injury to future generations. 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.

D.filter the low-energy, nonpenetrating x-rays from the beam. RATIONALE: Aluminum filters, a component of the radiographic machine's anode, are placed in the path of the x-ray beam to filter and selectively remove the low-energy, nonpenetrating x-rays from the beam. Note that it is the lead collimator (positioned next to the aluminum filter) that restricts the size and shape of the x-ray beam.

Aluminum filters, a portion of the radiographic machine's anode, are placed in the path of the x-ray beam to A.restrict the size and shape of the x-ray beam. B.enhance the size and shape of the x-ray beam . C.filter the high-energy, penetrating x-rays from the beam. D.filter the low-energy, nonpenetrating x-rays from the beam.

A.Bremsstrahlung RATIONALE: General radiation, also called braking or bremsstrahlung radiation , is produced by the slowing- down process of an accelerating electron as it passes near the nucleus of the target atom. Bremsstrahlung or general/braking radiation results in a transference of the electron's kinetic energy into x-ray energy. Characteristic radiation accounts for a small portion of x-rays produced by dental x-ray machines and can only occur at levels of 70kVp or higher with a tungsten target. Characteristic radiation occurs when an electron removes an orbital electron from the target atom. Electromagnetic radiation, a form of ionizing radiation, propagates wave-like energy through space without mass. Particulate radiation is a type of ionizing radiation; examples include protons, neutrons, alpha and beta particles.

An x-ray produced by the slowing down of an accelerating electron as it passes near the nucleus of the target atom is called A.Bremsstrahlung B.Characteristic C.Electromagnetic D.Particulate

B.Panoramic RATIONALE: The panoramic radiograph is ideal for assessing growth and development and is the survey film of choice of the third molar area of this 17-year-old client. The cephalometric radiograph, although ideal for assessing growth and development, is more often indicated for evaluation for orthodontic intervention. In addition, the superimposition of the right and left sides of the skull, created by the cephalometric radiograph, would make individual third molar observation difficult. Topographical occlusal radiographs may be used to image large areas of possible pathology. Occlusal radiographs demonstrate large anatomic regions or the entire arch and are usually exposed in conjunction with other intraoral radiograph.

Based on the FDA selection criteria guidelines, which of the following would be the BEST projection to recommend for imaging a 17-year-old client who complains of pain in the region of his unerupted third molars? A.Cephalometric B.Panoramic C.Topographical occlusal D.Transcranial

C.Onset is acute with fever, rash, spleen, and lymph node involvement RATIONALE: Acute (sudden and intense) onset is a characteristic of the juvenile type of rheumatoid arthritis. It is correctly stated that etiology of adult type rheumatoid arthritis varies and may be unknown. Theories include autoimmunity, hereditary or psychosomatic factors, and infection. Signs and symptoms within the fingers, hands, and knees occur prior to TMJ symptoms. Signs and symptoms of rheumatoid arthritis (adult type) include fatigue, loss of appetite, low-grade fever, migratory joint pain and swelling, and stiffness after periods of inactivity.

Characteristics of rheumatoid arthritis (adult type) include each of the following EXCEPT one. Which one is the EXCEPTION? A.Etiology varies; it may be unknown B.Signs and symptoms within the TMJ occur later than within the fingers C.Onset is acute with fever, rash, spleen, and lymph node involvement D.Signs and symptoms include fatigue, loss of appetite, and low-grade fever

D.Centering the film in the x-ray beam RATIONALE: If the film packet is not centered within the beam of x-radiation, a portion of the film will remain unexposed. The edge of the PID or "cone" will appear to define the edge where the image and the clear portion of the unexposed film meet—hence, the term "cone-cut error." A packet placement error will not result in cone cutting, but will instead result in the structure of interest not being imaged. This can occur even if both vertical and horizontal angulation as well as centering of the beam is correct. Also not resulting in cone cutting are errors in vertical angulation which cut off the image of the incisal and occlusal edges of the teeth (excessive vertical angulation) or cut off the image of the root apices of the teeth (inadequate vertical angulation). When using the paralleling technique, vertical angulation errors result in foreshortening of the image (excessive vertical angulation) or elongation of the image (inadequate vertical angulation). An error made when determining the horizontal angulation will result in either overlapping of the proximal surfaces of the teeth or superimposition of the adjacent structures.

Cone cutting results from an error in one of the following steps. Which one of the following steps is related to this error? A.Packet placement B.Vertical angulation C.Horizontal angulation D.Centering the film in the x-ray beam

C.chronic hyperplastic pulpitis. RATIONALE: Chronic hyperplastic pulpitis, also called pulp polyp, manifests intraorally as a benign red to pink outgrowth of pulp tissue protruding from the occlusal surface. It occurs most commonly in females (15:1) and in African Americans (70%). Cementoma is a benign fibro-osseous lesion adjacent to or surrounding the apices of teeth. Cementoma mainly occurs in the anterior mandible; it is rare in the maxilla, and is of unknown etiology. Neither periapical abscess pulpitis nor periapical granuloma exhibit a mass of tissue protruding from the crown of a tooth.

During intraoral examination of the occlusal surface of the mandibular first right premolar, a carious lesion with a mass of reddish tissue protruding from the large cavity is observed. The patient is a 35 year old female and has no symptoms. The mass of tissue is called A.a cementoma. B.periapical abscess pulpitis. C.chronic hyperplastic pulpitis. D.a periapical granuloma.

C.Elongated RATIONALE: Insufficient vertical angulation causes the tooth to appear elongated while excessive vertical angulation causes foreshortening. Correct horizontal angulation results in open contacts whereas overlapped contacts are the result of incorrect horizontal angulation.

During radiographic exposure, if the vertical angulation of the PID is too little or insufficient, the image on the film becomes distorted. Which of the following terms BEST describes the appearance of the tooth? A.Foreshortened B.Overlapped C.Elongated D.Open contacts

B.Middle stage (osteoblastic stage) RATIONALE: The middle stage (osteoblastic stage) of a periapical cemento-osseous dysplasia (cementoma) appears radiographically as a mixed radiolucent/radiopaque lesion; indicative of calcification of connective tissue. The early stage (osteolytic stage) this lesion appears as a radiolucent and cannot be differentiated from other apical pathology. The end-stage, also known as the mature stage, of a periapical cemento-osseous dysplasia (cementoma) radiographically appears uniformly radiopaque throughout with a radiolucent rim; the periodontal ligament remains intact.

During which stage does a periapical cemento-osseous dysplasia (cementoma) radiographically appear as a mixed a mixed radiolucent/radiopaque lesion? A.Early stage (osteolytic stage) B.Middle stage (osteoblastic stage) C.End stage D.Mature stage

C.Increase exposure time RATIONALE: Increasing the distance between the source of radiation and the receptor will decrease beam intensity. Increasing kVp, mA, and exposure time will increase beam intensity.

Each of the following adjustments to an X-ray machine will increase beam intensity EXCEPT one. Which one is the EXCEPTION? A.Increase kVp B.Increase mA C.Increase exposure time D.Increase distance

D.Involves paralysis in muscles, this occurs after bone formation is complete,

Each of the following descriptions apply to Fetal alcohol syndrome (FASD) EXCEPT one. Which one is the EXCEPTION? A.A leading preventable cause of mental impairments and birth defects B.Associated with premature and/or postnatal growth retardation C.Associated with craniofacial dysmorphia D.Involves paralysis in muscles, this occurs after bone formation is complete,

D.Systemic effects are unusual RATIONALE: Although presentation of localized accumulation of exudate occurs in the pocket, the patient remains at risk for systemic effects of the infection. Periodontal abcesses and endodontic-periodontal lesions most frequently occur in existing periodontal pockets. The most common microbiologic isolate microbiologic is Streptococcus viridans; this isolate is similar to that found in deeper pockets.

Each of the following is a feature of periodontal abcesses and endodontic-periodontal lesions EXCEPT one. Which selection is the EXCEPTION? A.Most frequently occur in periodontal pockets B.Most common microbiologic isolate is Streptococcus viridans C.Microbiologic isolate is similar to that found in deeper pockets D.Systemic effects are unusual

A.The traditional x-ray machine is no longer required RATIONALE: Both indirect and direct digital imaging processes use a traditional x-ray machine. Indirect digital imagine differs from direct in that the intraoral sensor for indirect is a reusable imaging plate coated with phosphors (often termed PSP plate). This sensor is thin and flexible, similar to an intraoral film packet. After exposure, the plate is scanned to convert the information into electronic files. Indirect imaging is less rapid than direct digital imagining because of the laser scanning step.

Each of the following is an accurate statement regarding indirect digital radiographic imaging EXCEPT one. Which one is the EXCEPTION? A.The traditional x-ray machine is no longer required B.The intraoral sensor is a reusable imaging plate coated with phosphors C.The imaging plates are reusable D. Indirect imaging is less rapid than direct digital imagining because of the laser scanning step

A.Frequently occurs intraorally

Each of the following is true of verruca vulgaris EXCEPT one. Which one is the EXCEPTION? A.Frequently occurs intraorally B.Etiology is the papilloma virus (HPV) C.Lips are most common oral site D.It is also called the common wart

B.Hyperkeratosis RATIONALE: Hyperkeratosis, associated with salivary glandular or ductal tissue, presents as a painless white, grayish white, or yellowish white patch or plaque that varies from simple localized lesions to diffuse lesions with broad coverage. Surfaces are smooth to rough and elevated to flat. Mucoceles, necrotizing sialometaplasia, and ranulas form in response to injuries or trauma to soft tissues that are associated with salivary glandular tissues.

Each of the following oral lesions results from injury to soft tissues that involve major or minor salivary glands and/or their ducts EXCEPT one. Which one is the EXCEPTION? A.Mucocele B.Hyperkeratosis C.Necrotizing sialometaplasia D.Ranula

D.Peripheral giant cell granulomas usually arise from the periodontal ligament RATIONALE: Peripheral giant cell granulomas usually arise from the periodontal ligament and are characterized histologically by the presence of multinucleated giant cells. Osteoblasts are bone-forming cells and are not a component of peripheral giant cell granulomas. Remnants of enamel and cementum are not components of peripheral giant cell granulomas.

Each of the following statements EXCEPT one correctly describes peripheral giant cell granulomas. Which one is the EXCEPTION? A.Peripheral giant cell granulomas are characterized histologically by the presence of single nucleated giant cells B.Osteoblasts are a component of peripheral giant cell granulomas C.Remnants of enamel and cementum are components of peripheral giant cell granulomas D.Peripheral giant cell granulomas usually arise from the periodontal ligament

D.May be caused by hyperglycemia RATIONALE: Shock can occur for many reasons. Individuals with diabetes can experience insulin shock if too much insulin is present in their body. This is called hypoglycemia (too much insulin remains in body cells and is not appropriately transferred to the blood stream). In any form of shock respiration may be increased and body temperature may be decreased. Acute adrenal insufficiency, also known as adrenal crisis, is a life-threatening situation that can result in shock and/or cardiac arrest.

Each of the following statements regarding shock is accurate EXCEPT one. Which one is the EXCEPTION? A.Respiration may be increased B.Body temperature may be decreased C.May be caused by acute adrenal insufficiency D.May be caused by hyperglycemia

D.Herpes simplex RATIONALE: Although considerable research and testing is in progress, there is no vaccine currently available for the prevention of the herpes simplex virus. Vaccines are partly responsible for the reduction in the incidence of measles, mumps, and chicken pox.

Effective vaccines have been partly responsible for a reduction in the incidence of all of the following EXCEPT one. Which one is the EXCEPTION? A.Measles B.Mumps C.Chicken pox D.Herpes simplex

B.Foreshortening RATIONALE: Excess vertical angulation results in foreshortened images whereas insufficient vertical angulation results in elongation results. Another error, incorrect horizontal angulation, results in overlapping of teeth and structures. A cone-cut occurs when a portion of the film has not been exposed to the x-ray beam. Contrast is the difference in the degrees of darkness between adjacent areas on an image.

Excessive vertical angulation during radiographic exposure results in which of the following? A.Increased contrast B.Foreshortening C.Elongation D.Overlapping

A.Both the statement and reason are correct and related. RATIONALE: If excess orthodontic forces cause teeth to move too quickly, external root resorption may occur. Osteoclasts are giant multinucleate cells that contain powerful lysosomal enzymes that destroy bone matrix (resorption). Note that osteoblasts are bone-forming cells found in all bone surfaces.

External root resorption can occur as a result of orthodontic treatment because excess forces caused by tooth movement can stimulate osteoclasts. A.Both the statement and reason are correct and related. B.Both the statement and reason are correct but NOT related. C.The statement is correct, but the reason is NOT. D.The statement is NOT correct, but the reason is correct.

B.Bilateral, white keratinized linear elevations on the buccal mucosa at the height of the occlusal table. RATIONALE: The white elevations that the patient noticed during self-examination are called linea alba, which means "white line." It is considered a nonpathologic deviation from normal and should be monitored, but does not require a dental examination. Any lesion present for more than 2 weeks warrants further evaluation. A prime example is the patchy, white vestibular covering described in conjunction with a history of spit tobacco. Individuals who use snuff and spit tobacco are prone to squamous cell carcinomas at or near the site where the tobacco is held. Any change in the vermilion border of the lip is suggestive of a cancerous lesion, particularly if the patient has risk factors for cancer such as a history of frequent or extended exposure to ultraviolet rays, failure to wear sunscreen, or past history of skin cancer.

Extraoral and intraoral findings on a client:Face/neck markings: an 8 × 1-mm scar between the borders of the philtrum.TMJ: 20-mm maximum opening.Lymph nodes: within normal limits.Lips: dry and cracked.Buccal mucosa: linea alba.Tongue: geographic.Palate: small (1-mm) red spots scattered throughout.Oropharyngeal area: right palatine tonsil enlarged.Frena: within normal limits.Salivary glands: prominent palatal duct openings.During oral cancer self-examination, each of the following conditions indicate a significant deviation from normal that warrants an examination by a dental professional EXCEPT one. Which one is the EXCEPTION? A.A 2 × 3-mm round ulceration that has been present for 3 weeks. B.Bilateral, white keratinized linear elevations on the buccal mucosa at the height of the occlusal table. C.A white, patchy covering on the left buccal mucosa in the vestibule area, adjacent to teeth #19 to #22 in a person reporting daily spit tobacco use. D.A loss of distinction of the vermilion border of the labium inferius.

D.The first statement is false, the second is true. RATIONALE: Fever is considered a systemic sign of inflammation. However, erythema, defined as redness of the skin or mucous membranes, is considered a local sign of inflammation. Pain, swelling, and edema are considered local signs of inflammation. Note that pain, swelling, and edema have the potential to become systemic.

Fever and erythema are considered systemic signs of inflammation.Pain, swelling, and edema are considered local signs of inflammation. 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.

C.18 months. RATIONALE: For adolescent recare patients with clinical caries or increased risk for caries it is recommended that posterior bitewing examination be prescribed at a six to eighteen month interval. Note that the same criteria for a child would prompt a recommended prescription at a to 12 month interval.

For an adult recare patient with clinical caries or an increased risk for caries, posterior bitewing examination is recommended every A.6 to 12 months. B.12 months. C.18 months. D.6 to 18 months.

C.Vitamin C deficiency

Frictional keratosis can be caused by each of the following EXCEPT one. Which one is the EXCEPTION? A.Constant, low-grade irritation B.Tongue chewing C.Vitamin C deficiency D.Cheek biting

C.purulent. RATIONALE: Purulent refers to an exudate containing pus. Catarrhal refers to exudate containing mucous whereas an exudate that contains fibrin is described by the adjective fibrinous. Serous refers to exudate containing thin liquid from blood.

If an exudate contains a large amount of pus, it is classified as A.catarrhal. B.fibrinous. C.purulent. D.serous.

D.16-inch circular RATIONALE: The additional length of the 16-inch circular PID makes it the best selection for decreasing patient radiation exposure. In general, a longer PID (position indicating device) lessens divergence of the primary x-ray beam. This decreases patient radiation exposure. Rectangular PIDs expose the patient to less radiation than circular PIDs do. The very short closed-ended, 4-inch pointed PID is commonly called a cone. It significantly increases the patient's radiation exposure and should not be used.

If you wanted to decrease patient radiation exposure, which of the following PIDs (position-indicating devices or cones) would you choose? A.4-inch pointed B.8-inch circular C.12-inch circular D.16-inch circular

D.Inverted Y RATIONALE: This radiopaque intersection created by the intersection of the lateral wall of the nasal cavity and the anterior portion of the maxillary sinus is known as the inverted "Y." Nutrient canals appear as thin radiolucent lines; the anterior nasal spine is a radiopacity adjacent and superior to the incisive foramen; and the radiopaque zygomatic process is located superior to the maxillary posterior teeth.

In a dental radiograph which of the following appears as a radiopaque intersection of the lateral wall of the nasal cavity and the anterior portion of the maxillary sinus? A.Nutrient canal B.Anterior nasal spine C.Zygomatic process D.Inverted Y

C.Anterior teeth appear blurred and magnified in size ANS RATIONALE: While exposing a panoramic radiograph a focal trough positioning error will result in blurring and magnification in size of anterior teeth. This occurs because the dental arches are positioned too far back (posterior). A Frankfort plane positioning error produces numerous areas of distortion including: an exaggerated smile line, mandibular incisor region appears blurred, and condyles may not be visible.

In a panoramic radiograph which of the following is the result a focal trough positioning error? A.An exaggerated smile line appears on the image B.Mandibular incisor region appears blurred C.Anterior teeth appear blurred and magnified in size ANS D.Condyles may not be visible

A.Both statements are TRUE. RATIONALE: Interpretation involves formulation of explanation of what is visible on a radiograph. Diagnosis, whether by examination or analysis of findings from a physical examination, interview or diagnostic data such as radiographs, refers to the identification of disease, state of health, contributing deficiency/excess or perceived problem.

In dental radiography, interpretation refers to an explanation of what is viewed on a radiograph.The term diagnosis refers to the identification of a problem, deficiency/excess, or disease by examination or analysis. 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.

D.time between exposure and symptoms RATIONALE: The latent period is the period of time interposed between exposure to radiation and appearance of the first observable clinical symptoms. Period of injury is the time span in which a variety of cellular injuries may occur. During the recovery period some damage subsides; not all cellular radiation injuries are permanent. Cumulative effect is the result of repeated exposures.

In radiology the latent period is the A.period of injury. B.recovery period. C.cumulative effect. D.time between exposure and symptoms

C.IgM RATIONALE: IgM is the immunoglobulin produced first after a bacterial challenge. This is because it activates the complement system (an organization of serum proteins that is the primary mediator of antigen-antibody reactions). Although IgG is the principal immunoglobulin of the secondary immune response, it is not produced first. IgD is thought to active the B cells, the precursors of plasma cells that produce antibodies. IgD is not the first immunoglobulin following a bacterial challenge to the periodontium. IgA, the principal immunoglobulin in external secretions of mucosal surfaces, tear, saliva, bile, urine, and colostrum, is not the first to arrive after a bacterial challenge to the periodontium.

In the inflammatory process, which one of the following immunoglobulins is produced first, following a bacterial challenge to the periodontium? A.IgG B.IgD C.IgM D.IgA

B.Epstein-Barr virus. RATIONALE: Infectious mononucleosis is caused by the Epstein-Barr virus. Hence, it is not caused by any type of bacteria or any type of fungus.

Infectious mononucleosis is caused by A.gram-negative bacteria. B.Epstein-Barr virus. C.thermophilic fungus. D.gram-positive bacteria.

B.destruction of the heart valves. RATIONALE: Plaque growths on the heart valves can entrap microorganisms, which can cause heart valve destruction. Infective endocarditis is not directly associated with heart enlargement, altered blood vessel elasticity, or increased arterial flow.

Infective endocarditis (bacterial endocarditis) is a life-threatening disease because microorganisms that colonize the endocardium may cause A.enlargement of the heart. B.destruction of the heart valves. C.increased blood vessel elasticity. D.increased arterial flow.

D.Palatal Papillomatosis RATIONALE: Palatal papillomatosis, also called papillary hyperplasia of the palate is most often associated with a complete maxillary or partial denture and is considered a type of denture stomatitis. Contributing factors include chronic irritation and poor denture hygiene. Irritation caused by an ill-fitting denture is called denture-induced inflammatory fibrous hyperplasia (also called epulis fissuratum and inflammatory hyperplasia). This irritation occurs along the border edge of the denture flange within the mandible or maxillary vestibule and/or along the alveolar ridge adjacent to the denture border.

Inflammatory hyperplasia along a denture border or flange is referred to as each of the following EXCEPT one. Which one is the EXCEPTION? A.Epulis fissuratum B.Denture-Induced inflammatory fibrous hyperplasia C.Inflammatory papillary hyperplasia D.Palatal Papillomatosis

C.Leukocytes RATIONALE: Leukocytes provide the first line of defense during bacterial invasion of the periodontium. They are essential for the control of bacterial infections. Although not part of the initial response to bacterial invasion, erythrocytes are the most numerous of the circulating blood cells and take part in red blood cell development. Thrombocytes (platelets), found in blood and extremely important in the formation of a clot, also arrive later in the immune response. Plasma cells, seen in chronic inflammation, are principal carriers of antibodies. Neither plasma cells, nor plasma, the liquid part of the blood, are part of the initial response to bacterial invasion.

Initial response to bacterial invasion in periodontitis is carried out by what type of cells? A.Erythrocytes B.Thrombocytes C.Leukocytes D.Plasma

B.produces particulate radiation. RATIONALE: Ionizing radiation, produced by the process by which radiant energy removes an orbital electron from an atom is capable of producing two types of ions: particulate and electromagnetic. Examples of particulate radiation include neutrons, protons, alpha and beta particles. Please note, these particles are produced by ionizing radiation, they are not destroyed. Similarly, ionizing radiation does NOT originate from ionizing radiation; ionizing radiations produces electromagnetic energy.

Ionizing radiation, produced by the process by which radiant energy removes an orbital electron from an atom A.is capable of producing three types of ions. B.produces particulate radiation. C.destroys neutrons and protons. D.originates from electromagnetic radiation.

B.Both statements are FALSE. RATIONALE: Kilovoltage peak (kVp) controls the current passing from the cathode to the anode. Milliamperage allows for warming of the cathode filament and determines the number of electrons available for x-ray production. Increasing the mA increases the heat within the filament resulting in a greater number of available electrons.

Milliamperage (mA) controls the current passing from the cathode to the anode.Increasing the amperage increases the force that moves the electrons along an electrical conductor. 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.

D.radiographically appear as unilocular or multi-locular radiolucency; may have a "honeycomb" or "soap bubble" appearance. RATIONALE: Radiographically an odontogenic myxoma appears as a unilocular or multi-locular radiolucency; they may have a "honeycomb" or "soap bubble" appearance. Odontogenic myxoma most often form in young adults, ages 10 to 30 years with no gender predilection. These lesions are located in the mandiblemore frequently than in the maxilla. Odontogenic myxoma are benign, but aggressive lesions within bone; small lesions are asymptomatic, larger lesions cause expansion of bone. Displacement of resorption of adjacent teeth may occur with odontogenic myxoma.

Odontogenic myxoma, an odontogenic neoplasm that originates from mesenchymal tissue of tooth germ A.form in postmenopausal women and men over age 60 B.are located in the maxilla more frequently than in the mandible. C.are aggressive malignant lesions within bone D.radiographically appear as unilocular or multi-locular radiolucency; may have a "honeycomb" or "soap bubble" appearance.

B.have an increased risk for root caries. RATIONALE: Older adults have many complicating factors in their lives. Dental hygienists, dentists and support personnel can be helpful by finding the most appropriate appointment times for the older adult patient. Most prefer shorter, midmorning appointments. Older adult patients have an increased risk for root caries due to more extensive gingival recession, self-care challenges, and altered dietary selections. These same factors present an increased risk for xerostomia, but medications pose an even more serious threat to soft and hard tissues. Older adults - for financial, social, and familial reasons - have an increased risk for depression.

Older adults need special consideration in many areas. Dental personnel can be helpful by understanding that older adults A.often prefer early morning appointments. B.have an increased risk for root caries. C.have a decreased risk for xerostomia. D.have a decreased risk for depression.

C.globulomaxillary cyst. RATIONALE: Classified as a developmental cyst, the pear-shaped globulomaxillary cyst arises from odontogenic epithelium between the maxillary lateral incisor and canine. Globulomaxillary cysts were previously called fissural cysts. Note that like many cysts, the globulomaxillary is named based upon its location. Keratocystic odontogenic tumors most frequently form in the posterior of the mandible. Ranulas cause blockage or obstruction in ducts of major salivary glands. Most frequently ranulas are caused by a salivary "stone" (referred to as a sialolith). Ranula is a term reserved and used for a mucocele that occurs in the floor of the mouth.

On x-ray examination, a radiolucent, pear-shaped lesion is found distal to a patient's maxillary right lateral incisor causing divergence of the lateral and canine roots. The lesion is likely a(an) A.keratocystic odontogenic tumor. B.ranula. C.globulomaxillary cyst. D.sialolith.

B.Ionizing RATIONALE: Ionizing radiation is defined as particulate and electromagnetic radiation with sufficient energy to cause ionization of atoms or to remove orbital electrons from atoms. Electronic radiation is produced by the interactions that occur when high-speed electrons strike a target material. Note that the term kinetic does not refer to a type of radiation, but rather to a type of energy. Radioactive radiation is the spontaneous emission of radiation from the nucleus of an unstable atom or element in an effort to attain a more balanced nuclear state.

Particulate and electromagnetic radiation with sufficient energy to remove orbital electrons from atoms is referred to as what type of radiation? A.Electronic B.Ionizing C.Ionizing D.Radioactive

B.a malignancy that occurs in middle age. RATIONALE: Periapical cemento-osseous dysplasia is also referred to as cementoma. While this fibro-osseous lesion does occur in middle age, it is a benign nonneoplastic type of dysplasia. Periapical cemento-osseous dysplasia rarely occurs in the maxilla; it most frequently occurs in the anterior mandibular area near the apices. It is asymptomatic, localized and teeth in the affected area are vital.

Periapical cemento-osseous dysplasia is A.also referred to as cementoma. B.a malignancy that occurs in middle age. C.frequently found in the maxilla. D.symptomatic with frequent tenderness and pressure.

B.indirect. RATIONALE: Damage to DNA macromolecules that is caused by radiolysis of intracellular water (H2O) to hydrogen peroxide (H2O2) is called indirect damage. Radiolysis is defined as the dissociation of molecules by radiation. The term indirect damage refers to the damage to DNA caused by a free radical. A direct effect of radiolysis involves the actual transfer of ionizing energy directlyfrom the x-ray to the DNA. Collimation is the mechanism within a PID that restricts the cross-sectional area of the X-ray beam. Free radicals are involved in radiolysis; indeed, free radical damage to DNA occurs as a result of exposure to radiation, including ionizing and UV radiation.

Radiation damage from the radiolysis of water to hydrogen peroxide within DNA macromolecules is referred to as A.direct. B.indirect. C.collimation. D.free radical.

D.Cementomas RATIONALE: Although cementomas are detected radiographically, the most reliable factors for diagnosis are the age, gender, and race of the patient, plus the fact that the associated teeth are vital. Internal resorption can only be seen radiographically. Odontoma is evaluated radiographically. Unerupted supernumerary teeth are best diagnosed from a radiograph.

Radiographic diagnosis contributes significantly to the final diagnosis of all the following EXCEPT one. Which one is the EXCEPTION? A.Internal resorption B.Odontoma C.Unerupted supernumerary teeth D.Cementomas

B.taurodontism. RATIONALE: Taurodontism is a term used to describe a developmental dental anomaly in which the teeth exhibit elongated, large pulp chambers and short roots. It is identified by its characteristic radiographic appearance. Not applicable to development of teeth is gigantism, due to excess hormone production by the anterior pituitary gland during development before closure of the long bones. Microdontia is a developmental anomaly in which one or more teeth in a dentition is smaller than normal while macrodontia is an uncommon developmental anomaly in which one or more teeth in a dentition are larger than normal. Anodontia is the congenital lack of teeth.

Radiographically, a tooth has a normal shape and size crown but the roots are short, the body is elongated, and there is a longitudinally enlarged pulp chamber. This abnormality is referred to as A.anodontia. B.taurodontism. C.microdontia. D.macrodontia.

D.chickenpox. RATIONALE: Chickenpox and shingles represent different forms of infection by the same agent, the herpes zoster varicella virus. Cold sore is a layman term for herpes labialis which is caused by the herpes simplex virus. Mononucleosis is caused by the Epstein-Barr virus whereas both mumps and measles are caused by the paramyxovirus.

Shingles is caused by the same virus that causes A.cold sores. B.mononucleosis. C.mumps. D.chickenpox.

C.No 3 size film - 27x54 mm. RATIONALE: Standard radiographic film size is No 2 size which is 24x41 mm. No 1 size film is 24x40 mm. No 3 size film is 27x54 mm. No 4 size film is 57x76 mm. Also available, No 0 size film is 22x35 mm.

Standard radiographic film size for intraoral dental radiography is A.No. 1 size film - 24x40 mm. B.No 2 size film - 31x41 mm. C.No 3 size film - 27x54 mm. D.No 34 size film - 57x76 mm.

B.lymphatic RATIONALE: Lymphatic tissues, composed of lymphatic cellular components, are the MOST radiosensitive (a cell that is sensitive to radiation effects). Also radiosensitive are erythrocytes and reproductive cells. Cells of the nervous system are the most radioresistant - resistant to effects of radiation.

The MOST radiosensitive structure is composed of which cell type? A.reproductive B.lymphatic C.erythrocyte D.nervous

C.pulp cavity. RATIONALE: The pulp cavity is relatively radiolucent (dark). Enamel is radiopaque. Dentin is less radiopaque than enamel. Alveolar bone, composed of both cancellous and cortical bone, is radiopaque.

The anatomical portion of teeth that is least radiopaque is theThe anomaly that is often mistaken as dental calculus on a radiograph but is actually a small globule of tooth structure in the roots of a molar is A.enamel. B.dentin. C.pulp cavity. D.alveolar bone.

A.single-stranded RNA. RATIONALE: The causative agent of Hepatitis A virus (HAV) is a single-stranded RNA (ribonucleic acid) that does not possess an envelope. The causative agent of Hepatitis A virus (HAV) is neither double-stranded nor does it have DNA configuration.

The causative agent of the Hepatitis A virus (HAV) is A.single-stranded RNA. B.double-stranded RNA. C.single-stranded DNA. D.double-stranded DNA.

A.Acceleration of electrons RATIONALE: The kilovoltage control, NOT the milliamperage control, regulates the acceleration of electrons from the cathode to the anode. The milliamperage allows for warming of the cathode filament, determines the number of electrons available for x-ray production, and regulates the step-down transfer.

The milliamperage control regulates all of the following, EXCEPT one. Which one is the EXCEPTION? A.Acceleration of electrons B.Heating of the filament C.Quantity of electrons produced D.Step-down transformer

C.6 feet. RATIONALE: Ideally the radiographer should stand behind a structural wall or shield. If this is not available, a distance of six feet is considered the minimum safe distance from the source of radiation. The remaining selections represent too little or too much distance.

The minimum distance the operator should stand from the tubehead while exposing films is A.2 feet. B.4 feet. C.6 feet. D.9 feet.

C.erythrocytes. RATIONALE: Erythrocytes are the most numerous type of red blood cell (RBC). Leukocytes, both granular and nongranular, are white blood cells. Platelets are cell fragments of a specific cell type found in bone marrow; they have no nuclei. Plasma is the liquid portion of the blood.

The most numerous type of red blood cell is/are the A.leukocytes. B.platelets. C.erythrocytes. D.plasma.

B.mA. RATIONALE: The mA (milliamperage) control regulates the quantity of electrons; therefore, increasing the mA setting will produce an increase in available electrons. Millamperage also regulates the step-down transformer and heating of the filament. Increasing the kilovoltage will increase the beam's ability to penetrate objects because the kVp controls the current passing from the cathode to the anode. An increase in the length of the PID (position-indicating device) increases the distance the x-ray photons must travel to reach the object.

The number of x-ray photons generated can be increased by increasing the A.kVp. B.mA. C.current from cathode to anode. D.PID length.

C.Physical injury of the primary maxillary central incisor RATIONALE: A physical injury of the primary maxillary central incisor can cause a hypoplastic defect in the permanent maxillary central incisor due to the trauma inflicted onto the permanent tooth during its development. A dietary deficiency would most likely cause an anomaly on both permanent maxillary central incisors whereas the absence of the primary mandibular central incisor has no direct association to a hypoplastic defect found on the maxillary central incisor. Neonatal hypoplasia of the primary anterior teeth would not directly cause hypoplastic defect on the permanent incisors.

The only hypoplastic defect in a patient's dentition is located on the facial surface of a permanent maxillary central incisor. What is the MOST likely cause of this defect? A.A dietary deficiency during tooth formation B.Absence of the primary mandibular central incisor C.Physical injury of the primary maxillary central incisor D.Neonatal hypoplasia of the primary anterior teeth

A.Primary radiation RATIONALE: The penetrating beam produced at the target anode is referred to as primary radiation. It is also termed primary or useful beam. Secondary radiation results from the interaction of primary radiation and matter. A subtype of secondary radiation, classified as scatter radiation, occurs when the travel of the primary radiation is altered with matter. The photoelectric effect results from an incident photon colliding with a tightly bound inner-shell electron. This collision causes ionization by ejecting the electron.

The penetrating beam produced at the target anode is referred to as A.Primary radiation B.Secondary radiation C.Scatter radiation D.Photoelectric effect

D.tungsten target. RATIONALE: Within the anode is a tungsten target that serves as a focal spot and converts bombarding electrons into x-ray photons. Note also, within the anode is a tungsten plate that is fixed to a copper arm. The kilovoltage (kVp) control, also found within the anode, regulates the step-up transformer and speed of electrons.

The portion of the anode that serves as a focal spot and converts bombarding electrons into x-ray photons is called the A.copper arm. B.positive electrode. C.kilovoltage (kVp) control. D.tungsten target.

A.incisive foramen. RATIONALE: The incisive foramen is the radiographic anatomic landmark of the maxilla that appears as a hole in bone found at the midline of the anterior portion of the hard palate. It appears as an oval radiolucency located between the maxillary central incisors. The lateral fossa (canine fossa) appears as a diffuse radiolucency located between the maxillary lateral incisor and the canine. The nasal fossae (nasal cavity) consists of two paired radiolucent compartments superior to the maxillary central incisors; it is outlined by the floor of the nasal cavity. The inferior nasal conchae appear as radiopaque curved plates of bone extending from the lateral walls of the nasal cavity.

The radiographic anatomic landmark of the maxilla that appears as a hole in bone found at the midline of the anterior portion of the hard palate is the A.incisive foramen. B.lateral fossa. C.nasal fossae. D.inferior nasal conchae.

C.hamulus. RATIONALE: The hamulus is the radiopaque spine located on the medial pterygoid plate that is radiographically visible posterior to the maxillary tuberosity. The zygomatic process of the maxilla is the J- or U-shaped radiopacity that appears superior to the maxillary posterior teeth. The maxillary tuberosity is the rounded prominence of bone that appears as a radiopaque bulge in the most posterior region of the maxilla. The lateral pterygoid plate is the radiopaque extension of sphenoid bone; distinguished as separate from the maxillary tuberosity.

The radiopaque spine located on the medial pterygoid plate that appears posterior to the maxillary tuberosity is the A.zygomatic process of the maxilla. B.maxillary tuberosity. C.hamulus. D.lateral pterygoid plate.

C.The first statement is true, the second is false. RATIONALE: The speed of dental radiographic film is determined by the size of the silver halide crystals in the emulsion. Larger crystals result in a faster film. However, this faster film produces a grainy image with less detail and sharpness. To solve this dilemma, manufacturers have altered the shape of the silver halide crystals to produce images with higher contrast and increased sharpness.

The silver halide crystals in the emulsion of radiographic film determine the speed of the film.Larger silver halide crystals in the emulsion of dental radiographic film result in slower film but a more detailed, high contrast image. 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.

C.as a variety of shapes - nodular, lobulated, smooth (flat), spindle. RATIONALE: Torus palatinus appears as a variety of shapes - nodular, lobulated, smooth (flat), and/or spindle. It appears as a hard protuberance of bone in the midline of the hard palate. Torus palatinus is usually seen by the age of puberty; rarely observed in children, peak incidence occurs before 30 years; more common in females. This benign protuberance of bone appears as a dense radiopacity (radiopaque) in radiographs.

Torus palatinus, an inherited, autosomal dominant condition appears A.at the junction of the hard and soft palates. B.in middle age, typically around aged 50. C.as a variety of shapes - nodular, lobulated, smooth (flat), spindle. D.radiolucent and malignant in radiographs.

C.Restricts the size and shape of the x-ray beam RATIONALE: The purpose of the lead collimator is to restrict the size and shape of the x-ray beam. The collimator does not filter out wavelengths, whether short or long, nor does it block gamma rays.

What is the purpose of the lead collimator on radiology equipment? A.Filters out shorter wavelength x-rays B.Filters out longer wavelength x-rays C.Restricts the size and shape of the x-ray beam D.Blocks out the gamma rays

B.surround the crown of an unerupted or impacted tooth. RATIONALE: Radiographically a dentigerous cyst appears as a smooth, unilocular radiolucency associated with the crown of unerupted teeth. The radiolucency encircles the tooth crown down to the cemento-enamel junction (CEJ). The radiolucent area of a dentigerous cyst (follicular cyst) forms around the crown of an unerupted or developing tooth. A dentigerous cyst is not found in place of a tooth and does not surround any portion of the root.

When reviewing a dentigerous cyst on a radiograph, the radiolucent area will A.be found in a place of a tooth. B.surround the crown of an unerupted or impacted tooth. C.surround the root apex of a fully erupted tooth. D.surround the root apex of an impacted tooth.

A.The reducing agent (hydroquinone and elon) RATIONALE: The reducing agent (hydroquinone and elon) reduces the exposed silver halide crystals to black metallic silver. The alkalizer (sodium carbonate) softens and swells the gelatin of the emulsion to allow the reducing agent to reach the silver halide crystals. The preservative (sodium sulfite) slows the oxidation of the solution to prolong its lifespan. The restrainer (potassium bromide) slows down the action of chemicals.

Which component of the radiographic developer solutions reduces the exposed silver halide crystals to black metallic silver? A.The reducing agent (hydroquinone and elon) B.The alkalizer (sodium carbonate) C.The preservative (sodium sulfite) D.The restrainer (potassium bromide)

A.Primary radiation RATIONALE: Primary radiation is more detrimental to both the patient and operator than either secondary or scatter radiation. Note that scatter radiation is a type of secondary radiation that occurs when the useful beam, not an actual form of radiation, intercepts any object, causing some x-rays to be scattered. An important concept, the larger the amount of tissue the beam is allowed to irradiate, the more scatter radiation is produced. Rectangular collimation greatly reduces the amount of scatter radiation.

Which form of the x-ray beam is MOST detrimental to the patient and the operator? A.Primary radiation B.Secondary radiation C.Scatter radiation D.Useful beam

C.Ulcerated, craterlike, papillary gingival lesions RATIONALE: NUG is characterized by painful papillary gingival lesions that are ulcerated and craterlike. Note that NUG is typically not involved with periodontal pocket formation, but is typically confined to the free gingival margin, crest of the gingiva, and the interdental papillae. NUG is characterized by a foul (fetid) mouth odor as well as intense gingival pain, spontaneous gingivgival bleeding and bad taste.

Which of the following clinical signs and symptoms is characteristic of necrotizing ulcerative gingivitis (NUG)? A.Lack of pain B.Periodontal pocket formation C.Ulcerated, craterlike, papillary gingival lesions D.Sweet mouth odor

B.Removes the less-penetrating x-rays from the beam RATIONALE: Filtration, an integral component of safe equipment, removes the less penetrating, longer x-rays from the beam. Another safety feature of radiation equipment is collimation which reduces scatter radiation and image fog. A PID (position-indicating device) is critical to safety as it restricts the area of radiation exposure to no more than the size of the receptor.

Which of the following describes the function of filtration in a dental x-ray tubehead? A.Reduces scatter radiation exposure B.Removes the less-penetrating x-rays from the beam C.Reduces image fog D.Restricts client radiation exposure to the size of the receptor.

C.Ionization RATIONALE: Ionization is the radiographic process (x-radiant) by which an orbital electron is removed from an atom to yield an ion pair. Ionizing radiation produces two types of ions: electromagnetic radiation and particulate radiation. Electromagnetic radiation is the propagation of wave-like energy without mass through space. Particulate radiation involves neutrons, protons, alpha, and beta particles that have both mass and energy. These tiny particles travel in straight lines at high speeds. Bremsstrahlung radiation involves an accelerating electron that passes near the nucleus of the target atom and the slowing-down process that transfers kinetic energy. Also called general or braking radiation, Bremsstrahlung radiation produces 70% of x-ray photons by dental x-ray machines.

Which of the following describes the process by which x-radiant energy removes an orbital electron from an atom to yield an ion pair? A.Electromagnetic radiation B.Particulate radiation C.Ionization D.Bremsstrahlung radiation

A.Most commonly form during mixed dentition and teen years RATIONALE: Radicular cysts, also called apical cyst and periapical cysts, can occur at any age, but most commonly occur between ages 30 to 60 years. Contributing factors include dental caries, trauma, deep restorations causing irreversible pulpitis, and pulp necrosis. Radicular cysts develop as a response to inflammation associated with nonvital teeth. They develop at the apex of a tooth or lateral to the tooth root (accessory lateral pulp canals).

Which of the following does NOT correctly describe a radicular cyst? A.Most commonly form during mixed dentition and teen years B.Contributing factors include dental caries and trauma C.Develop as a response to inflammation associated with nonvital teeth D.May develop in an accessory lateral pulp canal

D.X-rays and gamma rays RATIONALE: The wavelengths of rays and gamma rays are shorter than the wavelengths of radio waves, infrared waves, and/or ultraviolet waves.

Which of the following forms of electromagnetic radiation has the shortest wavelength? A.Radio waves B.Infrared waves C.Ultraviolet waves D.X-rays and gamma rays

B.Photoelectric effect RATIONALE: Of the four interactions of x-ray photons and matter that occur during production of radiation, the photoelectric effect results from an incident photon colliding with a tightly bound inner-shell electron and accounts for approximately 30% of such interactions. Compton scatter results from an incident photon colliding with a loosely bound outer-shell electron and accounts for 62% of such photon/matter interactions. Radiolysis of water describes a mechanism of radiation injury that yields free radicals that combine to form hydrogen peroxide (H202). Coherent scatter results from the interaction of an incident photon passing near an outer-shell electron and being scattered without energy loss. Coherent scatter accounts for approximately 8% of such interactions.

Which of the following interactions of x-ray photons and matter results from an incident photon colliding with a tightly bound inner-shell electron and accounts for approximately 30% of such interactions? A.Compton scatter B.Photoelectric effect C.Radiolysis of water D.Coherent scatter

A.Renal surgery RATIONALE: Renal surgery is not a treatment for acute leukemia. Maintenance of optimal oral hygiene, chemotherapy and antibiotics are among treatments recommended for acute leukemia. Transfusions with platelets or packed RBCs are also recommended as are bone marrow or stem cell transplants.

Which of the following interventions is NOT a treatment for acute leukemia? A.Renal surgery B.Optimal oral hygiene C.Chemotherapy D.Antibiotics

A.Liver tissue RATIONALE: Liver tissue is considered radioresistant (resistant to effects of radiation), whereas lymphatic tissue (most sensitive), erythrocytes, and reproductive cells are radiosensitive (sensitive to effects of radiation).

Which of the following is the LEAST radiosensitive area of the cell? A.Liver tissue B.Lymphatic tissue C.Erythrocytes D.Reproductive cells

C.Tobacco RATIONALE: Tobacco is the greatest single risk factor for nicotine stomatitis. Commonly called "pipe smoker's palate", nicotine stomatitis is most common in male smokers over 40 years of age. It initially presents with erythema and inflammation. Although alcohol abuse increases risk of nicotine stomatitis, it is not the greatest risk factor. In comparison to tobacco use, genetics and diet are not significant risk factors.

Which of the following is the greatest risk factor for nicotine stomatitis? A.Alcohol B.Genetics C.Tobacco D.Diet

B.Neutrophil RATIONALE: The neutrophil (or polymorphonuclear leukocyte PMN), a type of white blood cell (leukocyte), is the first cell to emigrate to the site of injury and is the primary cell involved in acute inflammation. The monocyte, which later becomes a macrophage, is the next leukocyte to arrive. Plasma cells (and lymphocytes) arrive later as they are more common during chronic inflammation.

Which of the following is the primary cell involved in an acute inflammatory reaction? A.Monocyte B.Neutrophil C.Macrophage D.Plasma cell

D.Lipoma RATIONALE: The term lipoma describes a benign soft tissue lesion composed of fat cells. Note that the origin of this term is lipid. Inflammatory papillary hyperplasia, most often associated with complete maxillary or partial denture (considered a type of denture stomatitis), is a chronic irritation to the hard palate. Also triggered by the inflammatory response to chronic irritants or trauma, a pyogenic granuloma is a benign mass containing numerous blood-filled small blood vessels and capillaries. More common on maxillary labial gingiva than mandibular gingiva, pyogenic granulomas can occur on the lips, tongue, and buccal mucosa. The common wart (verruca vulgaris), due to the human papilloma virus (HPV), is a common skin lesion most frequently seen on the lips. Common warts are not normally observed intraorally.

Which of the following is the term used for a benign soft tissue lesion composed of fat cells? A.Inflammatory papillary hyperplasia B.Pyogenic granuloma C.Common wart D.Lipoma

C.Ulceration RATIONALE: Ulcerations are oval or round in shape with distinct border. The center of the ulcer has a yellowish to white fibrinous surface and is surrounded by an erythematous (red) halo. A macule is a flat, nonpalpable, circumscribed lesion. With slightly different characteristics, a papule is a raised palpable, firm, circumscribed lesion.

Which of the following lesions has a yellowish to white center and is surrounded by an erythematous (red) halo?? A.Macule B.Papule C.Ulceration D.Vesicle

B.Rem RATIONALE: There are numerous terms describing amounts of different aspect of radiation. Dose equivalent, called rem, is the measure of biologic effects produced by different types of radiation. RAD describes the amount of radiation absorbed by a tissue; radiation absorbed dose. . Gray, or gy, is the International System of Units (SI) unit for radiation absorbed dose. The roentgen is the traditional unit for radiation exposure more generally. Finally, Roentgen, named after Wilhelm Roentgen who discovered the x-ray in 1895, is the traditional unit of exposure that is the measurement of ionization in air produced by x-rays.

Which of the following measurements is used to compare the biologic effects of different types of radiation? A.RAD B.Rem C.Gy D.Roentgen

B.Selected periapical views supplemented with occlusal views RATIONALE: a full-mouth intraoral radiographic examination is preferred when the patient has clinical evidence of generalized dental disease or a history of extensive dental treatment. Bitewing radiographs do not display periapical areas. Selected periapical views are indicated for situations with more limited indication of disease.

Which of the following radiographic prescription is preferred for an adolescent patient who exhibits clinical evidence of generalized dental disease in a permanent dentition? A.Posterior bitewings with panoramic examination B.Selected periapical views supplemented with occlusal views C.A full-mouth intraoral radiographic examination D.Panoramic examination supplemented with selected periapical views

B.Rem RATIONALE: Rem is the traditional unit of measurement for dose equivalent. The dose equivalent is the measure of biologic effects produced by different types of radiation. Rad is the traditional unit of measurement for the amount of radiation absorbed by a tissue. Traditional unit is the radiation absorbed dose (rad). Gray (Gy), another unit of measure, is the SI (System Internationale) unit. Note that the International System of Units, adopted to the Metre Convention is abbreviated as SI. Roentgen is the traditional unit of measurement for exposure.

Which of the following refers to the measurement of dose equivalent? A.Rad B.Rem C.Gray D.Roentgen

C.The thickness of the emulsion is partially responsible for film speed RATIONALE: Film speed, the amount of radiation needed to produce an image with standard density, is determined by the thickness of the emulsion, the size of silver halide crystals in the emulsion, and the presence of radiosensitive dyes. While gelatin is a component within the emulsion, it does not determine film speed. Speed ranges in dental radiography are designated from "D" (slowest) to "F" (fastest). E-speed intraoral film requires only 50% of the exposure of D-speed intraoral film. F-speed film requires only 77% of the exposure of E-speed film.

Which of the following statements correctly describes film speed? A.Determined by the density of the gelatin within the emulsion B.Speed ranges in dental radiography are designated from "A" (slowest) to "F" (fastest) C.The thickness of the emulsion is partially responsible for film speed D.E-speed intraoral film requires only 25% of the exposure of D-speed intraoral film

A.Fusion RATIONALE: Fusion results from the union of two normally separated adjacent tooth germs. Germination is a developmental anomaly that occurs when a single tooth germ attempting to divide results in the incomplete formation of two teeth. Gemination means paired or occurring in twos. Concrescence is the fusion of tooth roots by cementum only. Dilaceration describes an abnormal curve or angle in the root of a tooth.

Which of the following terms refers to the developmental anomaly that arises from the union of two normally separated adjacent tooth germs? A.Fusion B.Gemination C.Concrescence D.Dilaceration

B.Lymphatic RATIONALE: Lymphatic tissue is the most sensitive to ionizing radiation; radiosensitive is the term that describes a cell that is sensitive to radiation effects. Also radiosensitive are erythrocytes and reproductive cells/tissues. Radioresistant cells/tissues include nerve (most resistant), liver, and muscle.

Which of the following tissues is the MOST susceptible to ionizing radiation? A.Nervous B.Lymphatic C.Liver D.Reproductive

B.Lymphatic RATIONALE: Lymphatic, reproductive, and erythrocyte cells are the most radiosensitive (sensitive to radiation effects). Lymphatic is the most radiosensitive cell type. The most radioresistant cell type is nerve cell. Also radioresistant are liver and muscle cells.

Which of the following types of cells/tissues is MOST radiosensitive? A.Nerve B.Lymphatic C.Erythrocyte D.Reproductive cells

D.Topographical occlusal RATIONALE: Topographical occlusal radiographs are ideal for imaging large areas with one film. In addition, the occlusal film technique works well with children and with other clients who may have difficulty opening the mouth or limited tolerance to film packet placement. In this case, periapical radiographs may not provide a large enough image, especially if the lateral incisors are impacted and have migrated well out of normal position. Also, the age of the patient may make placement of the film packet difficult. Bitewing radiographs, whether horizontal or vertical, image the coronal portion of the teeth of both maxillary and mandibular arches and would not provide the necessary root imagery of this area. Although the occlusal radiograph is the ideal choice in this case (maxillary anterior region), the cross-sectional occlusal radiograph is best suited to imaging of the mandible, particularly the soft tissue in the lingual area.

Which of the following would be the BEST projection to image the developing permanent maxillary lateral incisors of a 7-year-old child? A.Periapical B.Horizontal bitewing C.Vertical bitewing D.Topographical occlusal

A.Infection RATIONALE: Whereas edema and erythema are classic signs of the body's primary repair mechanism known as inflammation, infection is not a sign of healing. This complication should be prioritized.

Which of the following wound complications should be given first consideration? A.Infection B.Edema C.Inflammation D.Erythema

A.Hairy leukoplakia RATIONALE: Hairy leukoplakia is due to Epstein-Barr virus. In an HIV-infected patient hairy leukoplakia is a strong indicator that AIDS will develop within 2 years. In contrast, erythema migrans, also called geographic tongue and benign migratory glossitis, is considered an abnormality of unknown etiology that tends to run in families.

Which one of the following is due to Epstein-Barr virus? A.Hairy leukoplakia B.Erythema migrans C.Benign migratory glossitis D.Geographic tongue

D.Tertiary-gumma RATIONALE: The tertiary stage of syphilis is associated with gummas. These inflammatory granulomatous lesions have a central zone of necrosis. Chancres are characteristic lesions in the primary stage of syphilis. Rashes appear in the secondary stage of syphilis. The primary stage of syphilis is associated with chancres, not gummas.

Which one of the following stages of syphilis is properly matched with the clinical manifestation? A.Primary-rash B.Secondary-chancre C.Primary-gumma D.Tertiary-gumma

A.Neutrophils and monocytes RATIONALE: Neutrophils and monocytes combat inflammation and infection through the process of phagocytosis. Eosinophils combat the effects of histamine in allergic reactions. Concentrations of eosinophils increase in the presence of allergies and parasites. Basophils develop into mast cells that liberate heparin, histamine, and serotonin in allergic reactions that intensify the inflammatory process. Note that white blood cells, also called leukocytes, are cells that exist in the blood, the lymphatic system, and tissues as a key player in the body's defense system.

Which white blood cells (leukocytes) combat inflammation by phagocytosis? A.Neutrophils and monocytes B.Eosinophils C.Basophils D.Mast cells

C.herpes simplex virus. RATIONALE: The herpes simplex virus (HSV-1) generally occurs above the waist and is usually found in and around the mouth. Herpes labialis, commonly known as cold sores (fever blister), is a type of infection by the herpes simplex virus that primarily affects the lip. The varicella-zoster virus (VZV) causes both chickenpox and shingles. The Epstein-Barr virus causes infectious mononucleosis. The papilloma virus causes warts.

Your client has arrived for her appointment and has a 6-mm, slightly elevated encrusted lesion on her lower lip. She says that it has been there for approximately 1 week. You find that she has a history of "cold sores" on her chart. The infectious agent responsible for this infection is the A.varicella-zoster virus. B.Epstein-Barr virus. C.herpes simplex virus. D.papillomavirus.