,Chapter 01: Introduction to Preliminary Diagnosis of Oral
ss ss ss ss ss ss ss
Lesions Ibsen: Oral Pathology for the Dental Hygienist, 7th
ss u ss ss ss ss ss ss ss
Edition
ss
MULTIPLE ssCHOICE
1. Which ssdescriptive s s term ss is ssdescribed s s as ss a ss segment ss that ssis s s part s s of ssthe ss whole?
a. Bulla
b. Vesicle
c. Lobule
d. Pustule
ANS: s s C
Asslobule ssis ssdescribed ssas ssa sssegment ssor sslobe ssthat ssis sspart ssof ssa sswhole.ssAssbulla ssis ssa sslarge,
sselevated l esion ssthat sscontains ssserous ssfluid ssand ssmay sslook sslike ssa ssblister. ssA ssvesicle ssis ssa
u
sssmall, sselevated sslesion ssthat sscontains ssserous ssfluid. ssPustules ssare sscircumscribed sselevations
sscontaining sspus.
REF: Vocabulary, ssClinical ssof ssSoft ssTissue ssLesions, sspage ss1 OBJ: 1
2. Asslesion s s with s s a sssessile s s base ss is s s described s s as
a. an ssulcer.
b. stemlike.
c. pedunculated.
d. flat ssand s s broad.
ANS: s s D
Sessile s s describes s s the s s base s s of s s a s s lesion s s that s s is s s flat s s and s s broad. s s An s s ulcer s s is s s a
s s break s s in s s the sssurface ssepithelium. ssAssstemlike sslesion ssis ssreferred ssto ssas sspedunculated. ssA
sspedunculated sslesion ssis ssstemlikeor ssstalk-based ss(similar ssto ssa ssmushroom).
REF: ssVocabulary, ssClinical ssAppearance ssof ssSoft ssTissue ssLesions,
sspage ss1OBJ: s s 1
3. Which sscondition ssis ssnot ss diagnosed ss through s s clinical s s appearance?
a. Mandibular sstori
b. Fordyce s s granules
c. Black s s hairy s s tongue
d. Compound ss odontoma
ANS: s s D
The sscompound ssodontoma ssis ssinitially ssidentified ssradiographically ssas ssa ssradiopaque ssarea ssin
sswhich tooth ssstructure sscan ssbe ssidentified. ssNo ssclinical sscomponent ssexists. ssMandibular sstori
uu
ssare ssidentified ssclinically ssas ssareas ssof ssexostosis sson ssthe sslingual ssaspects ssof ssmandibular
sspremolars. ssFordyce s s granules s s are s s yellow s s clusters s s of s s ectopic s s sebaceous s s glands
s s diagnosed s s through ssclinical ssappearance. ssBlack sshairy sstongue ssis ssdiagnosed ssclinically.
ssThe ssfiliform sspapillae sson ssthe ssdorsal sstongue sselongate ssand ssbecome ssbrown ssor ssblack.
ssCauses ssinclude sstobacco, ssalcohol, sshydrogen ssperoxide, sschemical ssrinses, ssantibiotics, ssand
ssantacids.
REF: Radiographic ssDiagnosis, s s page s s 9 OBJ: 3
4. Another s s name ssfor ss geographic sstongue ss is
, a. median ssrhomboid ssglossitis.
b. benign ssmigratory ssglossitis.
c. fissured sstongue.
d. black ss hairy s s tongue.
ANS: s s B
Benign ssmigratory ssglossitis ssis ssanother ssname ssfor ssgeographic sstongue. ssResearch sssuggests
ssthat ssmedian ssrhomboid ssglossitis ssis ssassociated sswith ssa sschronic ssfungal ssinfection ssfrom
ssCandida ssalbicans. ssSometimes ssthe sscondition ssresolves sswith ssantifungal sstherapy. ssFissured
sstongue ssis ssseen ssin 5% ssof ssthe sspopulation. ssIt ssis ssa ssvariant ssof ssnormal. ssGenetic ssfactors ssare
uu
sstypically ssassociated sswith ssthe sscondition. ssBlack sshairy sstongue ssis sscaused ssby ssa ssreaction ssto
sschemicals, sstobacco, sshydrogen ssperoxide, ssor ssantacids. ssThe ssfiliform sspapillae sson ssthe
ssdorsal sstongue ssbecome s s elongated ssand ssare ssdark ssbrown ssto ssblack.
REF: Geographic ssTongue, sspage ss24 OBJ: 7
5. This ssbony sshard ssstructure ssin ssthe ssmidline ssof ssthe sshard sspalate ssis ssgenetic ssin ssorigin ssand
ssinherited s s in an ssautosomal ssdominant ssmanner. ssThe ssdiagnosis ssis ssmade ssthrough ssclinical
uu
ssappearance. ssWhich sscondition ssis sssuspected?
a. Palatal s s cyst
b. Torus sspalatinus
c. Mixed s s tumor
d. Ranula
ANS: s s B
A sstorus sspalatinus ssis ssdevelopmental ssand ssbony sshard ssand ssis ssfound sson ssthe ssmidline ssof ssthe
sspalate. s s Diagnosis ssis ssmade sson ssthe ssbasis ssof ssclinical ssappearance. ssA sspalatal sscyst ssappears
ssradiolucent sson s s a s s radiographic s s examination s s and s s is s s not s s diagnosed s s through
s s clinical s s appearance. ssA ssmixed sstumor s s orpleomorphic s s adenoma s s is s s a s s benign s s tumor
s s of s s salivary s s gland s s origin, s s found ssunilaterally s s off s s the s s midline s s of s s the s s hard s s palate.
s s It s s is s s composed s s of s s tumor s s tissue s s that s s is s s not ssbony sshard ssto sspalpation.
Ranula ssis ssa ssterm ssused ssfor ssa ssmucocele-like sslesion ssthat ssforms ssunilaterally sson ssthe ssfloor
ssof ssthemouth.
REF: Torus ss Palatinus, sspage ss21 OBJ: 4
6. The ssgray-white ssopalescent ssfilm ssseen sson ssthe ssbuccal ssmucosa ssof ss85% ssof ssblack ssadults
ss is ssa ssvariant of ssnormal ssthat ssrequires ssno sstreatment ssand ssis sstermed
uu
a. linea ss alba.
b. leukoedema.
c. leukoplakia.
d. white s s sponge ssnevus.
ANS: s s B
Leukoedema ssis ssa ssdiffuse ssopalescence ssmost sscommonly ssseen sson ssthe ssbuccal ssmucosa ssin
ssblack ssindividuals. ssLinea ssalba ssis ssa ss―white ssline‖ ssthat ssextends ssanteroposteriorly sson ssthe
ssbuccal ssmucosa ssalong ssthe ssocclusal ssplane. ssIt ssis ssmost ssprominent ssin sspatients sswho sshave ssa
ssclenching ssor ssgrinding sshabit. ssLeukoplakia ssis ssa ssclinical ssterm ssfor ssa sswhite sslesion, ssthe
sscause ssof sswhich ssis ssunknown. ssWhitesponge ssnevus ssis ssa ssgenetic ss(autosomal ssdominant)
sstrait. ssClinically, ssit ssis sscharacterized ssby ssa sssoft sswhite, ssfolded ss(or sscorrugated) ssoral
ssmucosa. ssAthick sslayer ssof sskeratin ssproduces ssthe sswhitening.
REF: Leukoedema, ss page s s 23 OBJ: 8
, 7. Which sscondition ssmost s s likely ss responds ss to sstherapeutic ss diagnosis?
a. Angular sscheilitis
b. Amelogenesis ssimperfecta
c. Paget ssdisease
d. Stafne s s bone sscyst
ANS: s s A
Angular sscheilitis ssmost sscommonly ssresponds ssto ssantifungal sstherapy ssonce ssnutritional
s s deficiencies sshave ssbeen ssruled ssout.sAmelogenesis ssimperfecta ssis ssa ssgenetic sscondition
ssassociated sswith ssabnormal development ssof ssthe ssenamel. ssPaget ssdisease ssis ssa sschronic
u
ssmetabolic ssbone ssdisease. ssA sshighly sselevated ssserum ssalkaline ssphosphatase sslevel
sscontributes sssignificantly ssto ssthe ssdiagnosis. ssA ssStafne ssbone sscyst ssis ssdetermined ssthrough
sssurgical ssdiagnosis ssin sswhich ssentrapped sssalivary ssgland sstissue ssis i dentified. u
REF: Therapeutic ss Diagnosis, sspage ss 18 OBJ: 3
8. The ssgingival ssenlargement ssin ssthis sspatient sswas sscaused ssby ssa sscalcium sschannel
blocker. ssWhich medication ssis ssthe sslikely sscause?
ss u
a. Dilantin
b. Nifedipine
c. Quinidine
d. Clozapine
ANS: s s B
Nifedipine ssis ssa sscalcium sschannel ssblocker. ssDilantin ssis ssan ssanticonvulsant ssused ssto ssprevent
ssorcontrol ssseizures. ssQuinidine ssis ssan ssantiarrhythmic ssagent ssused ssto sstreat sscardiac
ssarrhythmias. ssClozapine ssis ssan ssantipsychotic ssused ssin ssthe ssmanagement ssof sspsychotic
sssymptoms ssin ssschizophrenia.
REF: Historical s s Diagnosis, s s Fig. s s 1.38, sspage ss17 OBJ: 3
9. Radiographic ssfeatures, ssincluding sscotton-wool ssradiopacities ssand
ss hypercementosis, ssareespecially sshelpful ssin ssthe ssdiagnosis ssof
a. Paget ssdisease.
b. dentinogenesis ssimperfecta.
c. anemia.
d. diabetes.
ANS: s s A
Paget ssdisease ssis ssa sschronic ssmetabolic ssbone ssdisease. ssRadiographically, sscotton-wool
ssradiopacities and sshypercementosis ssare sscharacteristic ssfeatures. ssDentinogenesis ssimperfecta
u
ssis ssa ssgenetic s s condition s s involving s s a s s defect s s in s s the s s development s s of s s dentin.
s s Anemia, s s a s s decrease s s in ssred ssblood sscells, ssrequires ssblood sstests ssto ssdetermine ssthe
ssetiologic ssfactors. ssDiabetes ssis ssa sschronic ssdisorder s s of s s carbohydrate s s metabolism
sscharacterized s s by ssabnormally s s high s s blood s s glucose sslevels.
REF: Laboratory ss Diagnosis, s s Fig. ss 1.40, s s pages s s 16, s s 18 OBJ: 3
10. In ssinternal s s resorption, ssthe ss radiolucency s s seen sson ssradiographic ssexamination ssis ssusually
a. well ss circumscribed.
b. diffuse.
ss ss ss ss ss ss ss
Lesions Ibsen: Oral Pathology for the Dental Hygienist, 7th
ss u ss ss ss ss ss ss ss
Edition
ss
MULTIPLE ssCHOICE
1. Which ssdescriptive s s term ss is ssdescribed s s as ss a ss segment ss that ssis s s part s s of ssthe ss whole?
a. Bulla
b. Vesicle
c. Lobule
d. Pustule
ANS: s s C
Asslobule ssis ssdescribed ssas ssa sssegment ssor sslobe ssthat ssis sspart ssof ssa sswhole.ssAssbulla ssis ssa sslarge,
sselevated l esion ssthat sscontains ssserous ssfluid ssand ssmay sslook sslike ssa ssblister. ssA ssvesicle ssis ssa
u
sssmall, sselevated sslesion ssthat sscontains ssserous ssfluid. ssPustules ssare sscircumscribed sselevations
sscontaining sspus.
REF: Vocabulary, ssClinical ssof ssSoft ssTissue ssLesions, sspage ss1 OBJ: 1
2. Asslesion s s with s s a sssessile s s base ss is s s described s s as
a. an ssulcer.
b. stemlike.
c. pedunculated.
d. flat ssand s s broad.
ANS: s s D
Sessile s s describes s s the s s base s s of s s a s s lesion s s that s s is s s flat s s and s s broad. s s An s s ulcer s s is s s a
s s break s s in s s the sssurface ssepithelium. ssAssstemlike sslesion ssis ssreferred ssto ssas sspedunculated. ssA
sspedunculated sslesion ssis ssstemlikeor ssstalk-based ss(similar ssto ssa ssmushroom).
REF: ssVocabulary, ssClinical ssAppearance ssof ssSoft ssTissue ssLesions,
sspage ss1OBJ: s s 1
3. Which sscondition ssis ssnot ss diagnosed ss through s s clinical s s appearance?
a. Mandibular sstori
b. Fordyce s s granules
c. Black s s hairy s s tongue
d. Compound ss odontoma
ANS: s s D
The sscompound ssodontoma ssis ssinitially ssidentified ssradiographically ssas ssa ssradiopaque ssarea ssin
sswhich tooth ssstructure sscan ssbe ssidentified. ssNo ssclinical sscomponent ssexists. ssMandibular sstori
uu
ssare ssidentified ssclinically ssas ssareas ssof ssexostosis sson ssthe sslingual ssaspects ssof ssmandibular
sspremolars. ssFordyce s s granules s s are s s yellow s s clusters s s of s s ectopic s s sebaceous s s glands
s s diagnosed s s through ssclinical ssappearance. ssBlack sshairy sstongue ssis ssdiagnosed ssclinically.
ssThe ssfiliform sspapillae sson ssthe ssdorsal sstongue sselongate ssand ssbecome ssbrown ssor ssblack.
ssCauses ssinclude sstobacco, ssalcohol, sshydrogen ssperoxide, sschemical ssrinses, ssantibiotics, ssand
ssantacids.
REF: Radiographic ssDiagnosis, s s page s s 9 OBJ: 3
4. Another s s name ssfor ss geographic sstongue ss is
, a. median ssrhomboid ssglossitis.
b. benign ssmigratory ssglossitis.
c. fissured sstongue.
d. black ss hairy s s tongue.
ANS: s s B
Benign ssmigratory ssglossitis ssis ssanother ssname ssfor ssgeographic sstongue. ssResearch sssuggests
ssthat ssmedian ssrhomboid ssglossitis ssis ssassociated sswith ssa sschronic ssfungal ssinfection ssfrom
ssCandida ssalbicans. ssSometimes ssthe sscondition ssresolves sswith ssantifungal sstherapy. ssFissured
sstongue ssis ssseen ssin 5% ssof ssthe sspopulation. ssIt ssis ssa ssvariant ssof ssnormal. ssGenetic ssfactors ssare
uu
sstypically ssassociated sswith ssthe sscondition. ssBlack sshairy sstongue ssis sscaused ssby ssa ssreaction ssto
sschemicals, sstobacco, sshydrogen ssperoxide, ssor ssantacids. ssThe ssfiliform sspapillae sson ssthe
ssdorsal sstongue ssbecome s s elongated ssand ssare ssdark ssbrown ssto ssblack.
REF: Geographic ssTongue, sspage ss24 OBJ: 7
5. This ssbony sshard ssstructure ssin ssthe ssmidline ssof ssthe sshard sspalate ssis ssgenetic ssin ssorigin ssand
ssinherited s s in an ssautosomal ssdominant ssmanner. ssThe ssdiagnosis ssis ssmade ssthrough ssclinical
uu
ssappearance. ssWhich sscondition ssis sssuspected?
a. Palatal s s cyst
b. Torus sspalatinus
c. Mixed s s tumor
d. Ranula
ANS: s s B
A sstorus sspalatinus ssis ssdevelopmental ssand ssbony sshard ssand ssis ssfound sson ssthe ssmidline ssof ssthe
sspalate. s s Diagnosis ssis ssmade sson ssthe ssbasis ssof ssclinical ssappearance. ssA sspalatal sscyst ssappears
ssradiolucent sson s s a s s radiographic s s examination s s and s s is s s not s s diagnosed s s through
s s clinical s s appearance. ssA ssmixed sstumor s s orpleomorphic s s adenoma s s is s s a s s benign s s tumor
s s of s s salivary s s gland s s origin, s s found ssunilaterally s s off s s the s s midline s s of s s the s s hard s s palate.
s s It s s is s s composed s s of s s tumor s s tissue s s that s s is s s not ssbony sshard ssto sspalpation.
Ranula ssis ssa ssterm ssused ssfor ssa ssmucocele-like sslesion ssthat ssforms ssunilaterally sson ssthe ssfloor
ssof ssthemouth.
REF: Torus ss Palatinus, sspage ss21 OBJ: 4
6. The ssgray-white ssopalescent ssfilm ssseen sson ssthe ssbuccal ssmucosa ssof ss85% ssof ssblack ssadults
ss is ssa ssvariant of ssnormal ssthat ssrequires ssno sstreatment ssand ssis sstermed
uu
a. linea ss alba.
b. leukoedema.
c. leukoplakia.
d. white s s sponge ssnevus.
ANS: s s B
Leukoedema ssis ssa ssdiffuse ssopalescence ssmost sscommonly ssseen sson ssthe ssbuccal ssmucosa ssin
ssblack ssindividuals. ssLinea ssalba ssis ssa ss―white ssline‖ ssthat ssextends ssanteroposteriorly sson ssthe
ssbuccal ssmucosa ssalong ssthe ssocclusal ssplane. ssIt ssis ssmost ssprominent ssin sspatients sswho sshave ssa
ssclenching ssor ssgrinding sshabit. ssLeukoplakia ssis ssa ssclinical ssterm ssfor ssa sswhite sslesion, ssthe
sscause ssof sswhich ssis ssunknown. ssWhitesponge ssnevus ssis ssa ssgenetic ss(autosomal ssdominant)
sstrait. ssClinically, ssit ssis sscharacterized ssby ssa sssoft sswhite, ssfolded ss(or sscorrugated) ssoral
ssmucosa. ssAthick sslayer ssof sskeratin ssproduces ssthe sswhitening.
REF: Leukoedema, ss page s s 23 OBJ: 8
, 7. Which sscondition ssmost s s likely ss responds ss to sstherapeutic ss diagnosis?
a. Angular sscheilitis
b. Amelogenesis ssimperfecta
c. Paget ssdisease
d. Stafne s s bone sscyst
ANS: s s A
Angular sscheilitis ssmost sscommonly ssresponds ssto ssantifungal sstherapy ssonce ssnutritional
s s deficiencies sshave ssbeen ssruled ssout.sAmelogenesis ssimperfecta ssis ssa ssgenetic sscondition
ssassociated sswith ssabnormal development ssof ssthe ssenamel. ssPaget ssdisease ssis ssa sschronic
u
ssmetabolic ssbone ssdisease. ssA sshighly sselevated ssserum ssalkaline ssphosphatase sslevel
sscontributes sssignificantly ssto ssthe ssdiagnosis. ssA ssStafne ssbone sscyst ssis ssdetermined ssthrough
sssurgical ssdiagnosis ssin sswhich ssentrapped sssalivary ssgland sstissue ssis i dentified. u
REF: Therapeutic ss Diagnosis, sspage ss 18 OBJ: 3
8. The ssgingival ssenlargement ssin ssthis sspatient sswas sscaused ssby ssa sscalcium sschannel
blocker. ssWhich medication ssis ssthe sslikely sscause?
ss u
a. Dilantin
b. Nifedipine
c. Quinidine
d. Clozapine
ANS: s s B
Nifedipine ssis ssa sscalcium sschannel ssblocker. ssDilantin ssis ssan ssanticonvulsant ssused ssto ssprevent
ssorcontrol ssseizures. ssQuinidine ssis ssan ssantiarrhythmic ssagent ssused ssto sstreat sscardiac
ssarrhythmias. ssClozapine ssis ssan ssantipsychotic ssused ssin ssthe ssmanagement ssof sspsychotic
sssymptoms ssin ssschizophrenia.
REF: Historical s s Diagnosis, s s Fig. s s 1.38, sspage ss17 OBJ: 3
9. Radiographic ssfeatures, ssincluding sscotton-wool ssradiopacities ssand
ss hypercementosis, ssareespecially sshelpful ssin ssthe ssdiagnosis ssof
a. Paget ssdisease.
b. dentinogenesis ssimperfecta.
c. anemia.
d. diabetes.
ANS: s s A
Paget ssdisease ssis ssa sschronic ssmetabolic ssbone ssdisease. ssRadiographically, sscotton-wool
ssradiopacities and sshypercementosis ssare sscharacteristic ssfeatures. ssDentinogenesis ssimperfecta
u
ssis ssa ssgenetic s s condition s s involving s s a s s defect s s in s s the s s development s s of s s dentin.
s s Anemia, s s a s s decrease s s in ssred ssblood sscells, ssrequires ssblood sstests ssto ssdetermine ssthe
ssetiologic ssfactors. ssDiabetes ssis ssa sschronic ssdisorder s s of s s carbohydrate s s metabolism
sscharacterized s s by ssabnormally s s high s s blood s s glucose sslevels.
REF: Laboratory ss Diagnosis, s s Fig. ss 1.40, s s pages s s 16, s s 18 OBJ: 3
10. In ssinternal s s resorption, ssthe ss radiolucency s s seen sson ssradiographic ssexamination ssis ssusually
a. well ss circumscribed.
b. diffuse.
