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