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