Oral Pathology Section - NB

All the following are a variation of the fungal infection candidiasis EXCEPT one. Which one is the EXCEPTION? a. Chronic Hyperplastic b. Pseudomembranous c. Chronic Atrophic d. Acute Hyperplastic

Acute Hyperplastic

This is a reactive cyst that may occur in the mandible often from trauma, rupturing a blood vessel and blood accumulates outside the wall or from an arteriovenous shunt. May cause some tenderness, pain on movement, and may also limit mobility.

Aneurysmal bone cyst

All of the following describe the appearance of dentin dysplasia EXCEPT one, which one is the EXCEPTION? a. Short roots b. Obliteration of pulp on radiographs c. Blue to brown appearance in color of teeth d. Abnormal root dentin

Blue to brown appearance in color of teeth

Erythema multiforme is noted for the characteristic bull's eye lesion; oral lesions associated with this condition are usually ulcerative on the lateral borders on the tongue. a. The first statement is TRUE, the second statement if FALSE b. The first statement is FALSE, the second statement is TRUE c. Both statements are TRUE d. Both statements are FALSE

Both statements are TRUE

The condition where an individual has a sensitivity to protein glutens is called a. Agranulocytosis b. Behcet's syndrome c. Celiac sprue d. None of the above

Celiac sprue

The union of roots of two or more normal teeth caused by the fusion of cementum is called: a. Concrescence b. Germination c. Fusion d. Dilacerations

Concrescence

In the oral cavity this cyst is located at the midline of the floor of the mouth, often present at birth or in young children. Clinical features include a doughlike consistency.

Dermoid cyst

Pain is the cardinal sign of inflammation that is known in Latin as a. Rubor b. Calor c. Tumor d. Pallor e. Dolor

Dolor

The most likely cause of hairy leukoplakia in patients with HIV infection or AIDS is: a. Epstein- Barr virus b. Candidiasis c. Human herpesvirus 8 d. Herpes simplex virus e. Squamous cell carcinoma

Epstein- Barr virus

All of the following are considered to be physical injuries to oral tissues EXCEPT one. Which one is the EXCEPTION? a. Abfraction b. Erosion c. Attrition d. Bruxism

Erosion -loss of tooth structure

A 14-year-old young man has a very sore mouth. He has multiple ulcers on his _____ tongue and buccal mucosa, and bleeding lips. He also has "bull's eye" lesions on the palms of the hands. He developed chickenpox last week. Which is the best diagnosis?

Erythema multiforme is an acute, self-limiting disease that is noted for its characteristic bull's eye lesion associated with skin and mucosal tissue. EM is quite common in young adult males. Most cases are usually self-limiting and not life threatening

Your 8-year-old patient cannot sit still. He is having difficulty learning to read, _____ and is enrolled in a special education class at school. He has small close-set eyes and an indistinct philtrum. Which is the best diagnosis?

Fetal alcohol syndrome results from excessive alcohol exposure during pregnancy. Problems include: physical deformities, mental retardation, vision problems, and learning disabilities.

Your 13-year-old patient has large irregular bony-hard masses at the angles of the _____ mandible. She has numerous impacted teeth, and there are many supernumerary teeth also. She has a family history of colon cancer. Which is the best diagnosis?

Gardner syndrome is a rare disorder often first discovered by the dental professional due to its intraoral manifestations. Gardner syndrome is considered o be part of a spectrum of diseases characterized by familial colorectal polyposis. Up to 90% of the patients demonstrate skeletal abnormalities, the most common being osteomas. Most patients show one or several epidermoid cysts of the skin. Dental abnormalities include increased prevalence of odontomas, supernumerary teeth and impacted teeth. There is a high rate of malignant transformation of bowel polyps into invasive adenocarcinoma. By age 30 about 50% of patients with Gardner syndrome will develop colorectal carcinoma. Prophylactic colectomy is usually recommended.

The lateral periodontal cyst that is located between the maxillary lateral and central incisor and used to be considered a fissural cyst is termed a/an a. Median palatine cyst b. Stafne bone cyst c. Globulomaxillary cyst d. Dermoid cyst

Globulomaxillary cyst

A stage three syphyllis lesion appears as a localized lesion called a/an a. Gumma b. Mucous patch c. Chancre d. Perleche

Gumma -A mucous patch is a second stage lesion and a chancre is a primary stage lesion. Perleche is the inflammation of the sides of the lips (or the corners of the mouth) following a fungal or a bacterial infection

A patient with the following clinical features is most likely suffering from what disorder? • Exophthalmos • Nervousness • Hypertension • Sweating • Tachycardia • Weight loss • Insomnia a. Hyperthyroidism b. Addison's disease c. Hyperparathyroidism d. Hypothyroidism

Hyperthyroidism is a condition in which the thyroid gland makes too much thyroid hormone, features include increased thyroid hormones and increased metabolic rate, exophthalmos (bulging eyes) and diffuse goiter

What term denotes the adaptive change in which there is an increase in cell size? a. Atrophy b. Hypertrophy c. Metaplasia d. Hyperplasia

Hypertrophy

What is the most common cause of cell injury and death? a. Mutations b. Radiation exposure c. Hypoxia d. Trauma

Hypoxia

All of the following are characteristic of papillary hyperplasia EXCEPT one. Which one is the EXCEPTION? a. Associated with secondary fungal infection or bacterial infections b. Displays a pebble-like appearance c. The great majority of cases are seen beneath ill-fitting dentures d. It is a benign overgrowth of fibrous connective tissue

It is a benign overgrowth of fibrous connective tissue -Benign overgrowth of connective tissue is called a fibroma

The type of cyst usually associated with mandibular canines or premolars that is located middistance between the apex and cervix of the tooth is called a/an a. Lateral periodontal cyst b. Dentigerous cyst c. Eruption cyst d. Keratocyst

Lateral periodontal cyst

A 48 year-old African American patient has a grayish-white area with a coarsely wrinkled appearance, found bilaterally on the buccal mucosa. When the buccal mucosa is retracted the lesion somewhat disappears, this lesion mostly likely is: a. Leukoedema b. Lichen planus c. Candidiasis d. Leukoplakia

Leukoedema is located on the buccal mucosa and appears as a gray-white film giving the mucosa an opalescent appearance, most commonly found in African-American ethnic group

Your 45 year-old patient gets often painful 10 mm lacey-looking ulcers on the _____ buccal mucosa, vestibules, or lateral tongue. Usually only a few may appear at a time. This happens a couple times a year, especially when she is under stress. Which is the best diagnosis?

Lichen planus exhibits clinically white inter-lacy lines or ulcerations called Wickham's Striae commonly found on the tongue, buccal mucosa, vestibule, and gingiva, usually bilateral.

This cyst develops from the epithelial remnants of the embryonic brachial arches, and intraoral clinical features include a pink to yellowish color movable mass often found at the lateral borders of the posterior tongue.

Lymphoepithelial cyst

Which of the following is an acute systemic disease characterized primarily by inflammation, necrosis, and suppuration, initially involving paranasal sinuses, orbit, bronchi or intestines? a. Actinomycosis b. Histoplasmosis c. Coccidoiodomycosis d. Mucormycosis

Mucormycosis

Your 18-year-old female patient is tall and skinny. Inside her mouth, there are _____ clustered soft smooth-surfaced lesions around the commissures and anterior tongue. Her blood pressure is very high. She has a family history of thyroid cancer, and her calcitonin levels are high. Which is the best diagnosis?

Multiple Endocrine Neoplasia MEN III is an autosomal-dominant trait caused by a mutation with a defect in the neuroectodermal tissue. This syndrome consists of medullary carcinoma of the thyroid, pheochromocytoma of the adrenal, and mucosal neuromas. Early detection of this syndrome is important because of 50% survival rate for 5 years. Average age of death is early 20's

Your 46-year-old patient is deaf because of Schwannomas on both acoustic _____ nerves. She has numerous firm smooth nodules on her skin as well as café-au-lait spots. Her eyes have Lisch nodules and she has rough pigmented lesions (Crowe sign) in her armpits. Which is the best diagnosis?

Neurofibromatosis is a relatively common disorder with approximately 50% of the cases inherited. This condition is caused by a mutation in the tumor suppressor gene. A complication is the development of cancer, malignant schwanoma reported in 5 % of the cases

Which of the following diseases is related to a human herpes virus? a. Oral hairy leukoplakia b. Verruca vulgaris c. Squamous papilloma d. Condyloma acuminatum

Oral hairy leukoplakia

Your 61 year-old male patient looks like he has terrible dandruff in large flakes _____ in many areas of his scalp. He also has white scaly lesions on his elbows and knees. When the scales are peeled off they leave pinpoint bleeding. Which is the best diagnosis?

Psoriasis is a common skin disorder also involving the scalp, and may be chronic with remissions male to female ratio is equal, often starts in the teens. Skins lesions may appear as red macules or plaques, or silvery scales leaving pinpoint bleeding (Auspitz's sign). On the scalp may look like very severe dandruff

A progressive autoimmune disease that affects the skin and mucous membranes and is characterized by intraepithelial blister formation in the epidermis is called a. Angular cheilitis b. Pagets' disease c. Pemphigus vulgaris d. Erythema multiforme

Pemphigus vulgaris

Which periapical dental lesion contains pus? a. Periapical abscess b. Periapical granuloma c. Periapical cyst d. Condensing osteitis

Periapical abscess

Your 27-year-old patient has many pigmented macules on his face, clustered _____ around his mouth, eyes and nostrils. There are also numerous pigmented macules inside his mouth. He recently had colon surgery because of a bowel obstruction, caused by a bowel polyp. Which is the best diagnosis?

Peutz-Jegher's Syndrome is a relatively rare but well recognized condition characterized by freckle like lesions of the hands, perioral skin, and oral mucosa in conjunction with intestinal polyposis predisposition to develop cancer

Your 35 year-old female patient is having a hard time opening her mouth because _____ her face is so stiff. Radiographs reveal generalized widening of the periodontal ligament spaces. She also has been suffering from Raynaud's Phenomenon. Which is the best diagnosis?

Scleroderma also called Systemic sclerosis, an autoimmune disease with a very poor prognosis affecting more females in the reproductive years. Extra collagen is deposited in the skin and organs causing fibrosis in the lungs and GI, loss of function causing mask-like face with limited mobility, arthritis and sclerodactyly, and cardiovascular and renal problems as disease progresses. Radiographically loss of bone at the angle of the mandible and symmetrical widening of the PDL are seen on dental x-rays. Only 80% 5-year survival rate

Prodromal symptoms of pain and burning at the site where a lesion is about to occur are representative of which of the following? a. Primary syphilis b. Secondary syphilis c. Infectious mononucleosis d. Secondary herpes

Secondary herpes

Your patient is 56 year-old male who just moved to town. He has pretty healthy teeth and gums. His last prophy was 4 months; at that appointment he was scheduled for a follow-up visit with the dentist, which he did not keep. Upon examination today you notice a red mucosal lesion on the lateral border of the posterior tongue, which appears to be a possible cancerous lesion. Your patient admits to heavy drinking and smoking for many years. The patient's medical history reveals he gets quite a bit of stomach pain and takes over the counter medications to alleviate his stomach pain. His vitals today are BP 124/80 RASIT and pulse 92 bpm. I. The red mucosal lesion noted on the lateral border of the tongue based on the above history most likely is: a. Kaposi's sarcoma b. Hyperkeratosis c. Pyogenic granuloma d. Squamous cell carcinoma Which of the following contributes to the increased risk for oral cancer for this patient? a. Alcohol and smoking usage b. Use of antacids for stomach pain c. High pulse rate

Squamous cell carcinoma, the lateral border of the tongue is the # 1 area, most frequent site for oral cancer Heavy alcohol and smoking

All of the following are viral infections that affect the oral cavity EXCEPT one. Which one is the EXCEPTION? a. Epstein Barr b. Herpes Simplex c. Human Papilloma d. Syphilis

Syphilis -caused by the bacteria Treponema pallidum

A 40-year-old female has a rash across her cheeks and nose. She also gets ulcers _____ on sun-exposed skin and in her oral cavity. She has recently been diagnosed with kidney disease and a heart murmur. Which is the best diagnosis?

Systemic lupus erythematosus is an autoimmune disease affecting females of reproductive years . Skin lesions are usually mild exhibiting a butterfly-shaped malar rash on sun-exposed skin (lesions are photosensitive). No scarring present when lesions heal. SLE involves multiple organs in the body such as: heart (pericarditis, myocarditis), blood (anemias), joints (polyarthritis), and kidney disease with being the #1 cause of death. 75% 15 - year survival rate

Which forms of anemia produce a "hair-on-end" pattern of bone formation on the flat bones of the skull, with a thickened diploe and course trabeculae? a. Iron deficiency anemia b. Thalassemia (Mediterranean Disease) c. Sickle cell anemia d. All of the above e. b and c

Thalassemia (Mediterranean Disease) Sickle cell anemia

An insufficient production of corticosteroids from the adrenal gland is termed Paget disease. This corticosteroid insufficiency can cause chronic infections and increased melanin production. a. The first statement is TRUE, the second statement if FALSE b. The first statement is FALSE, the second statement is TRUE c. Both statements are TRUE d. Both statements are FALSE

The first statement is FALSE, the second statement is TRUE -Addison's disease is the result of an underactive adrenal gland

This developmental cyst originates in the embryonic thyroglossal tract. Features include: asymptomatic, painless, movable swelling, located at midline of the neck.

Thyroglossal tract cyst

Which of the following lesions may occur within the jaw bone? a. adenoid cystic carcinoma b. polymorphous low-grade adenocarcinoma c. acinic cell adenocarcinoma d. mucoepidermoid carcinoma

mucoepidermoid carcinoma