,Chapter 01: Introduction to Preliminary Diagnosis of Oral
pw pw pw pw pw pw pw
LesionsIbsen: Oral Pathology for the Dental Hygienist, 7th Edition
pw p
w pw pw pw pw pw pw pw pw
MULTIPLE CHOICE pw
1. Which descriptive term is described as a segment that is part of the whole?
pw pw pw pw pw pw pw pw pw pw pw pw pw
a. Bulla
b. Vesicle
c. Lobule
d. Pustule
ANS: C p w
A lobule is described as a segment or lobe that is part of a whole. A bulla is a large,
pw pw pw pw pw pw pw pw pw pw pw pw pw pw pw pw pw pw pw
elevatedlesion that contains serous fluid and may look like a blister. A vesicle is a small,
pw w
p pw pw pw pw pw pw pw pw pw pw pw pw pw pw pw
elevated lesion that contains serous fluid. Pustules are circumscribed elevations containing
pw pw pw pw pw pw pw pw pw pw pw
pus.
pw
REF: p w Vocabulary, Clinical of Soft Tissue Lesions, page 1 pw pw pw pw pw pw pw OBJ: 1 pw
2. A lesion with a sessile base is described as
pw pw pw pw pw pw pw pw
a. an ulcer. pw
b. stemlike.
c. pedunculated.
d. flat and broad. pw pw
ANS: D p w
Sessile describes the base of a lesion that is flat and broad. An ulcer is a break in the surface
pw pw pw pw pw pw pw pw pw pw pw pw pw pw pw pw pw pw pw
epithelium. A stemlike lesion is referred to as pedunculated. A pedunculated lesion is
pw pw pw pw pw pw pw pw pw pw pw pw pw
stemlikeor stalk-based (similar to a mushroom).
pw w
p pw pw pw pw pw
REF: Vocabulary, Clinical Appearance of Soft Tissue Lesions, page
pw pw pw pw pw pw pw pw
1OBJ: 1
pw pw pw
3. Which condition is not diagnosed through clinical appearance?
pw pw pw pw pw pw pw
a. Mandibular tori pw
b. Fordyce granules pw
c. Black hairy tongue pw pw
d. Compound odontoma pw
ANS: D p w
The compound odontoma is initially identified radiographically as a radiopaque area in
pw pw pw pw pw pw pw pw pw pw pw
whichtooth structure can be identified. No clinical component exists. Mandibular tori are
pw w
p pw pw pw pw pw pw pw pw pw pw pw
identified clinically as areas of exostosis on the lingual aspects of mandibular premolars.
pw pw pw pw pw pw pw pw pw pw pw pw pw
Fordyce granules are yellow clusters of ectopic sebaceous glands diagnosed through clinical
pw pw pw pw pw pw pw pw pw pw pw pw
appearance. Black hairy tongue is diagnosed clinically. The filiform papillae on the dorsal
pw pw pw pw pw pw pw pw pw pw pw pw pw
tongue elongate and become brown or black. Causes include tobacco, alcohol, hydrogen
pw pw pw pw pw pw pw pw pw pw pw pw
peroxide, chemical rinses, antibiotics, and antacids.
pw pw pw pw pw pw
REF: p w Radiographic Diagnosis, page 9 pw pw pw OBJ: p w 3
4. Another name for geographic tongue is pw pw pw pw pw
, a. median rhomboid glossitis. pw pw
b. benign migratory glossitis. pw pw
c. fissured tongue. pw
d. black hairy tongue. pw pw
ANS: B p w
Benign migratory glossitis is another name for geographic tongue. Research suggests that
pw pw pw pw pw pw pw pw pw pw pw
median rhomboid glossitis is associated with a chronic fungal infection from Candida
pw pw pw pw pw pw pw pw pw pw pw pw
albicans. Sometimes the condition resolves with antifungal therapy. Fissured tongue is seen
pw pw pw pw pw pw pw pw pw pw pw pw
in5% of the population. It is a variant of normal. Genetic factors are typically associated with
pw pw pw pw pw pw pw pw pw pw pw pw pw pw pw pw pw
the condition. Black hairy tongue is caused by a reaction to chemicals, tobacco, hydrogen
pw pw pw pw pw pw pw pw pw pw pw pw pw pw
peroxide, or antacids. The filiform papillae on the dorsal tongue become elongated and are
pw pw pw pw pw pw pw pw pw pw pw pw pw pw
dark brown to black.
pw pw pw pw
REF: p w Geographic Tongue, page 24 pw pw pw OBJ: 7 pw
5. This bony hard structure in the midline of the hard palate is genetic in origin and inherited
pw pw pw pw pw pw pw pw pw pw pw pw pw pw pw pw
inan autosomal dominant manner. The diagnosis is made through clinical appearance.
pw pw pw pw pw pw pw pw pw pw pw pw
Which condition is suspected?
pw pw pw pw
a. Palatal cyst pw
b. Torus palatinus pw
c. Mixed tumor pw
d. Ranula
ANS: B p w
A torus palatinus is developmental and bony hard and is found on the midline of the palate.
pw pw pw pw pw pw pw pw pw pw pw pw pw pw pw pw
Diagnosis is made on the basis of clinical appearance. A palatal cyst appears radiolucent on a
pw pw pw pw pw pw pw pw pw pw pw pw pw pw pw pw
radiographic examination and is not diagnosed through clinical appearance. A mixed tumor
pw pw pw pw pw pw pw pw pw pw pw pw
orpleomorphic adenoma is a benign tumor of salivary gland origin, found unilaterally off the
pw pw pw pw pw pw pw pw pw pw pw pw pw pw pw
midline of the hard palate. It is composed of tumor tissue that is not bony hard to palpation.
pw pw pw pw pw pw pw pw pw pw pw pw pw pw pw pw pw pw
Ranula is a term used for a mucocele-like lesion that forms unilaterally on the floor of
pw pw pw pw pw pw pw pw pw pw pw pw pw pw pw
themouth.
pw pw
REF: p w Torus Palatinus, page 21 pw pw pw OBJ: 4 pw
6. The gray-white opalescent film seen on the buccal mucosa of 85% of black adults is a
pw pw pw pw pw pw pw pw pw pw pw pw pw pw pw
variantof normal that requires no treatment and is termed
pw w
p pw pw pw pw pw pw pw pw
a. linea alba. pw
b. leukoedema.
c. leukoplakia.
d. white sponge nevus. pw pw
ANS: B p w
Leukoedema is a diffuse opalescence most commonly seen on the buccal mucosa in black pw pw pw pw pw pw pw pw pw pw pw pw pw
individuals. Linea alba is a ―white line‖ that extends anteroposteriorly on the buccal mucosa
pw pw pw pw pw pw pw pw pw pw pw pw pw pw
along the occlusal plane. It is most prominent in patients who have a clenching or grinding
pw pw pw pw pw pw pw pw pw pw pw pw pw pw pw pw
habit. Leukoplakia is a clinical term for a white lesion, the cause of which is unknown.
pw pw pw pw pw pw pw pw pw pw pw pw pw pw pw pw
Whitesponge nevus is a genetic (autosomal dominant) trait. Clinically, it is characterized by a
pw w
p pw pw pw pw pw pw pw pw pw pw pw pw pw
soft white, folded (or corrugated) oral mucosa. A thick layer of keratin produces the
pw pw pw pw pw pw pw pw pw pw pw pw pw pw
whitening.
pw
REF: p w Leukoedema, page 23 pw pw OBJ: 8 pw
, 7. Which condition most likely responds to therapeutic diagnosis?
pw pw pw pw pw pw pw
a. Angular cheilitis pw
b. Amelogenesis imperfecta pw
c. Paget disease pw
d. Stafne bone cyst pw pw
ANS: A p w
Angular cheilitis most commonly responds to antifungal therapy once nutritional deficiencies
pw pw pw pw pw pw pw pw pw pw
have been ruled out. Amelogenesis imperfecta is a genetic condition associated with
pw pw pw pw pw pw pw pw pw pw pw pw
abnormaldevelopment of the enamel. Paget disease is a chronic metabolic bone disease. A
pw w
p pw pw pw pw pw pw pw pw pw pw pw pw
highly elevated serum alkaline phosphatase level contributes significantly to the diagnosis. A
pw pw pw pw pw pw pw pw pw pw pw pw
Stafne bone cyst is determined through surgical diagnosis in which entrapped salivary gland
pw pw pw pw pw pw pw pw pw pw pw pw pw
tissue isidentified.
pw pw w
p
REF: p w Therapeutic Diagnosis, page 18 pw pw pw OBJ: 3 pw
8. The gingival enlargement in this patient was caused by a calcium channel
pw pw pw pw pw pw pw pw pw pw pw
blocker.Which medication is the likely cause?
pw w
p pw pw pw pw pw
a. Dilantin
b. Nifedipine
c. Quinidine
d. Clozapine
ANS: B p w
Nifedipine is a calcium channel blocker. Dilantin is an anticonvulsant used to prevent orcontrol
pw pw pw pw pw pw pw pw pw pw pw pw pw pw
seizures. Quinidine is an antiarrhythmic agent used to treat cardiac arrhythmias. Clozapine is
pw pw pw pw pw pw pw pw pw pw pw pw pw
an antipsychotic used in the management of psychotic symptoms in schizophrenia.
pw pw pw pw pw pw pw pw pw pw pw
REF: p w Historical Diagnosis, Fig. 1.38, page 17 pw pw pw pw pw OBJ: 3 pw
9. Radiographic features, including cotton-wool radiopacities and hypercementosis, pw pw pw pw pw pw
areespecially helpful in the diagnosis of
pw pw pw pw pw pw pw
a. Paget disease. pw
b. dentinogenesis imperfecta. pw
c. anemia.
d. diabetes.
ANS: A p w
Paget disease is a chronic metabolic bone disease. Radiographically, cotton-wool
pw pw pw pw pw pw pw pw pw
radiopacitiesand hypercementosis are characteristic features. Dentinogenesis imperfecta is a
pw w
p pw pw pw pw pw pw pw pw
genetic condition involving a defect in the development of dentin. Anemia, a decrease in red
pw pw pw pw pw pw pw pw pw pw pw pw pw pw pw
blood cells, requires blood tests to determine the etiologic factors. Diabetes is a chronic
pw pw pw pw pw pw pw pw pw pw pw pw pw pw
disorder of carbohydrate metabolism characterized by abnormally high blood glucose levels.
pw pw pw pw pw pw pw pw pw pw pw
REF: p w Laboratory Diagnosis, Fig. 1.40, pages 16, 18 pw pw pw pw pw pw OBJ: 3 pw
10. In internal resorption, the radiolucency seen on radiographic examination is usually
pw pw pw pw pw pw pw pw pw pw
a. well circumscribed. pw
b. diffuse.
pw pw pw pw pw pw pw
LesionsIbsen: Oral Pathology for the Dental Hygienist, 7th Edition
pw p
w pw pw pw pw pw pw pw pw
MULTIPLE CHOICE pw
1. Which descriptive term is described as a segment that is part of the whole?
pw pw pw pw pw pw pw pw pw pw pw pw pw
a. Bulla
b. Vesicle
c. Lobule
d. Pustule
ANS: C p w
A lobule is described as a segment or lobe that is part of a whole. A bulla is a large,
pw pw pw pw pw pw pw pw pw pw pw pw pw pw pw pw pw pw pw
elevatedlesion that contains serous fluid and may look like a blister. A vesicle is a small,
pw w
p pw pw pw pw pw pw pw pw pw pw pw pw pw pw pw
elevated lesion that contains serous fluid. Pustules are circumscribed elevations containing
pw pw pw pw pw pw pw pw pw pw pw
pus.
pw
REF: p w Vocabulary, Clinical of Soft Tissue Lesions, page 1 pw pw pw pw pw pw pw OBJ: 1 pw
2. A lesion with a sessile base is described as
pw pw pw pw pw pw pw pw
a. an ulcer. pw
b. stemlike.
c. pedunculated.
d. flat and broad. pw pw
ANS: D p w
Sessile describes the base of a lesion that is flat and broad. An ulcer is a break in the surface
pw pw pw pw pw pw pw pw pw pw pw pw pw pw pw pw pw pw pw
epithelium. A stemlike lesion is referred to as pedunculated. A pedunculated lesion is
pw pw pw pw pw pw pw pw pw pw pw pw pw
stemlikeor stalk-based (similar to a mushroom).
pw w
p pw pw pw pw pw
REF: Vocabulary, Clinical Appearance of Soft Tissue Lesions, page
pw pw pw pw pw pw pw pw
1OBJ: 1
pw pw pw
3. Which condition is not diagnosed through clinical appearance?
pw pw pw pw pw pw pw
a. Mandibular tori pw
b. Fordyce granules pw
c. Black hairy tongue pw pw
d. Compound odontoma pw
ANS: D p w
The compound odontoma is initially identified radiographically as a radiopaque area in
pw pw pw pw pw pw pw pw pw pw pw
whichtooth structure can be identified. No clinical component exists. Mandibular tori are
pw w
p pw pw pw pw pw pw pw pw pw pw pw
identified clinically as areas of exostosis on the lingual aspects of mandibular premolars.
pw pw pw pw pw pw pw pw pw pw pw pw pw
Fordyce granules are yellow clusters of ectopic sebaceous glands diagnosed through clinical
pw pw pw pw pw pw pw pw pw pw pw pw
appearance. Black hairy tongue is diagnosed clinically. The filiform papillae on the dorsal
pw pw pw pw pw pw pw pw pw pw pw pw pw
tongue elongate and become brown or black. Causes include tobacco, alcohol, hydrogen
pw pw pw pw pw pw pw pw pw pw pw pw
peroxide, chemical rinses, antibiotics, and antacids.
pw pw pw pw pw pw
REF: p w Radiographic Diagnosis, page 9 pw pw pw OBJ: p w 3
4. Another name for geographic tongue is pw pw pw pw pw
, a. median rhomboid glossitis. pw pw
b. benign migratory glossitis. pw pw
c. fissured tongue. pw
d. black hairy tongue. pw pw
ANS: B p w
Benign migratory glossitis is another name for geographic tongue. Research suggests that
pw pw pw pw pw pw pw pw pw pw pw
median rhomboid glossitis is associated with a chronic fungal infection from Candida
pw pw pw pw pw pw pw pw pw pw pw pw
albicans. Sometimes the condition resolves with antifungal therapy. Fissured tongue is seen
pw pw pw pw pw pw pw pw pw pw pw pw
in5% of the population. It is a variant of normal. Genetic factors are typically associated with
pw pw pw pw pw pw pw pw pw pw pw pw pw pw pw pw pw
the condition. Black hairy tongue is caused by a reaction to chemicals, tobacco, hydrogen
pw pw pw pw pw pw pw pw pw pw pw pw pw pw
peroxide, or antacids. The filiform papillae on the dorsal tongue become elongated and are
pw pw pw pw pw pw pw pw pw pw pw pw pw pw
dark brown to black.
pw pw pw pw
REF: p w Geographic Tongue, page 24 pw pw pw OBJ: 7 pw
5. This bony hard structure in the midline of the hard palate is genetic in origin and inherited
pw pw pw pw pw pw pw pw pw pw pw pw pw pw pw pw
inan autosomal dominant manner. The diagnosis is made through clinical appearance.
pw pw pw pw pw pw pw pw pw pw pw pw
Which condition is suspected?
pw pw pw pw
a. Palatal cyst pw
b. Torus palatinus pw
c. Mixed tumor pw
d. Ranula
ANS: B p w
A torus palatinus is developmental and bony hard and is found on the midline of the palate.
pw pw pw pw pw pw pw pw pw pw pw pw pw pw pw pw
Diagnosis is made on the basis of clinical appearance. A palatal cyst appears radiolucent on a
pw pw pw pw pw pw pw pw pw pw pw pw pw pw pw pw
radiographic examination and is not diagnosed through clinical appearance. A mixed tumor
pw pw pw pw pw pw pw pw pw pw pw pw
orpleomorphic adenoma is a benign tumor of salivary gland origin, found unilaterally off the
pw pw pw pw pw pw pw pw pw pw pw pw pw pw pw
midline of the hard palate. It is composed of tumor tissue that is not bony hard to palpation.
pw pw pw pw pw pw pw pw pw pw pw pw pw pw pw pw pw pw
Ranula is a term used for a mucocele-like lesion that forms unilaterally on the floor of
pw pw pw pw pw pw pw pw pw pw pw pw pw pw pw
themouth.
pw pw
REF: p w Torus Palatinus, page 21 pw pw pw OBJ: 4 pw
6. The gray-white opalescent film seen on the buccal mucosa of 85% of black adults is a
pw pw pw pw pw pw pw pw pw pw pw pw pw pw pw
variantof normal that requires no treatment and is termed
pw w
p pw pw pw pw pw pw pw pw
a. linea alba. pw
b. leukoedema.
c. leukoplakia.
d. white sponge nevus. pw pw
ANS: B p w
Leukoedema is a diffuse opalescence most commonly seen on the buccal mucosa in black pw pw pw pw pw pw pw pw pw pw pw pw pw
individuals. Linea alba is a ―white line‖ that extends anteroposteriorly on the buccal mucosa
pw pw pw pw pw pw pw pw pw pw pw pw pw pw
along the occlusal plane. It is most prominent in patients who have a clenching or grinding
pw pw pw pw pw pw pw pw pw pw pw pw pw pw pw pw
habit. Leukoplakia is a clinical term for a white lesion, the cause of which is unknown.
pw pw pw pw pw pw pw pw pw pw pw pw pw pw pw pw
Whitesponge nevus is a genetic (autosomal dominant) trait. Clinically, it is characterized by a
pw w
p pw pw pw pw pw pw pw pw pw pw pw pw pw
soft white, folded (or corrugated) oral mucosa. A thick layer of keratin produces the
pw pw pw pw pw pw pw pw pw pw pw pw pw pw
whitening.
pw
REF: p w Leukoedema, page 23 pw pw OBJ: 8 pw
, 7. Which condition most likely responds to therapeutic diagnosis?
pw pw pw pw pw pw pw
a. Angular cheilitis pw
b. Amelogenesis imperfecta pw
c. Paget disease pw
d. Stafne bone cyst pw pw
ANS: A p w
Angular cheilitis most commonly responds to antifungal therapy once nutritional deficiencies
pw pw pw pw pw pw pw pw pw pw
have been ruled out. Amelogenesis imperfecta is a genetic condition associated with
pw pw pw pw pw pw pw pw pw pw pw pw
abnormaldevelopment of the enamel. Paget disease is a chronic metabolic bone disease. A
pw w
p pw pw pw pw pw pw pw pw pw pw pw pw
highly elevated serum alkaline phosphatase level contributes significantly to the diagnosis. A
pw pw pw pw pw pw pw pw pw pw pw pw
Stafne bone cyst is determined through surgical diagnosis in which entrapped salivary gland
pw pw pw pw pw pw pw pw pw pw pw pw pw
tissue isidentified.
pw pw w
p
REF: p w Therapeutic Diagnosis, page 18 pw pw pw OBJ: 3 pw
8. The gingival enlargement in this patient was caused by a calcium channel
pw pw pw pw pw pw pw pw pw pw pw
blocker.Which medication is the likely cause?
pw w
p pw pw pw pw pw
a. Dilantin
b. Nifedipine
c. Quinidine
d. Clozapine
ANS: B p w
Nifedipine is a calcium channel blocker. Dilantin is an anticonvulsant used to prevent orcontrol
pw pw pw pw pw pw pw pw pw pw pw pw pw pw
seizures. Quinidine is an antiarrhythmic agent used to treat cardiac arrhythmias. Clozapine is
pw pw pw pw pw pw pw pw pw pw pw pw pw
an antipsychotic used in the management of psychotic symptoms in schizophrenia.
pw pw pw pw pw pw pw pw pw pw pw
REF: p w Historical Diagnosis, Fig. 1.38, page 17 pw pw pw pw pw OBJ: 3 pw
9. Radiographic features, including cotton-wool radiopacities and hypercementosis, pw pw pw pw pw pw
areespecially helpful in the diagnosis of
pw pw pw pw pw pw pw
a. Paget disease. pw
b. dentinogenesis imperfecta. pw
c. anemia.
d. diabetes.
ANS: A p w
Paget disease is a chronic metabolic bone disease. Radiographically, cotton-wool
pw pw pw pw pw pw pw pw pw
radiopacitiesand hypercementosis are characteristic features. Dentinogenesis imperfecta is a
pw w
p pw pw pw pw pw pw pw pw
genetic condition involving a defect in the development of dentin. Anemia, a decrease in red
pw pw pw pw pw pw pw pw pw pw pw pw pw pw pw
blood cells, requires blood tests to determine the etiologic factors. Diabetes is a chronic
pw pw pw pw pw pw pw pw pw pw pw pw pw pw
disorder of carbohydrate metabolism characterized by abnormally high blood glucose levels.
pw pw pw pw pw pw pw pw pw pw pw
REF: p w Laboratory Diagnosis, Fig. 1.40, pages 16, 18 pw pw pw pw pw pw OBJ: 3 pw
10. In internal resorption, the radiolucency seen on radiographic examination is usually
pw pw pw pw pw pw pw pw pw pw
a. well circumscribed. pw
b. diffuse.
