Test Bank Oral Pathology for the Dental Hygienist, 7th Edition Ibsen ISBN: 9780323400626

Oral Pathology for the Dental Hygienist, 7th Edition Ibsen Test Bank ISBN: 0626. Chapter 01: Introduction to Preliminary Diagnosis of Oral Lesions Ibsen: Oral Pathology for the Dental Hygienist, 7th Edition It has been suggested that Candida albicans is associated with which condition? a. Median rhomboid glossitis b. Linea alba c. Leukoedema d. Retrocuspid papillae ANS: A Research has suggested that median rhomboid glossitis may be associated with Candida albicans. Linea alba is a variant of normal. Leukoedema is a variant of normal. Retrocuspid papillae are developmental and found on the gingiva of the lingual aspect of mandibular canine teeth. REF: Median Rhomboid Glossitis, page 23 OBJ: 7 25. Which term is used to describe a radiographic lesion with borders that are specifically defined, revealing the exact margins and extent of the lesion? a. Unilocular b. Well circumscribed c. Diffuse d. Multilocular ANS: B Well circumscribed defines a lesion with borders that are specifically defined and in which one can see the exact margins and extent of the lesion. Unilocular means having one compartment or unit that is well defined (as in a radicular cyst). Diffuse describes a lesion with borders that are not well defined. Multilocular lesions are described radiographically as resembling “soap bubbles” (i.e., a lesion with many lobes beyond the confines of one distinct area). REF: Vocabulary, Radiographic Terms Used to Describe Lesions in Bone, page 5 OBJ: 1 26. Fordyce granules a. are ectopic sebaceous glands. b. are seen on the dorsal surface of the tongue. c. require antibiotic treatment. d. are lesions that require biopsy for diagnosis. ANS: A Fordyce granules are ectopic sebaceous glands. Fordyce granules are seen on the buccal and labial mucosa, not the dorsal tongue. Fordyce granules require no treatment. Fordyce granules are diagnosed through clinical appearance. Biopsy is not necessary. REF: Fordyce Granules, page 20 OBJ: 4 27. The base of this lesion is correctly described as a. pedunculated. b. lobule. c. bulla. d. sessile. ANS: D The base of this lesion is sessile, or broad and flat. A pedunculated lesion has a stemlike base similar to that of a mushroom stem. A lobule is a segment or lobe that is part of the whole. A bulla usually contains serous fluid and looks like a blister. REF: Vocabulary, Clinical Appearance of Soft Tissue Lesions, Fig. 1.5, A, pages 1, 3 OBJ: 1 28. This torus palatinus is correctly described as a. bullous. b. papular. c. lobulated. d. nodular. ANS: C This torus palatinus is lobulated (i.e., lobes that are fused together). Bullous lesions contain serous fluid and resemble blisters. A papule is a soft tissue lesion that is elevated above the surface of normal surrounding tissue. A nodule is a palpable solid lesion found in soft tissue. REF: Vocabulary, Clinical Appearance of Soft Tissue Lesions, Fig. 1.1, pages 1, 2 OBJ: 1 29. Another term for an amalgam tattoo is a a. melanoma. b. focal argyrosis. c. nevus. d. multiple myeloma. ANS: B Focal argyrosis is a synonym for amalgam tattoo. A melanoma is a malignant tumor. A nevus is a benign overgrowth of melanocytes. Multiple myeloma is a malignant proliferation of plasma cells. REF: Clinical Diagnosis, page 7 OBJ: 2 30. Which finding is not apparent in leukoedema? a. Intracellular edema in the spinous cells b. Acanthosis of the epithelium c. Generalized opalescence of the buccal mucosa d. A white diffuse material on the buccal mucosa that can be wiped off ANS: D A white diffuse material that can be wiped off is significant in diagnosing pseudomembranous candidiasis. Intracellular edema in the spinous cells is found in leukoedema. Acanthosis of the epithelium is found in leukoedema. Generalized opalescence of the buccal mucosa is seen in leukoedema. REF: Leukoedema, page 23 OBJ: 8 31. Which term best describes an elevated, 5-mm soft tissue lesion containing serous fluid? a. Macule b. Vesicle c. Lobule d. Pustule ANS: B A vesicle is a small (less than 1 cm in diameter), elevated lesion that contains serous fluid. A macule is a flat area usually distinguished by a color different from the surrounding tissue. A lobule is described as a segment or lobe that is part of a whole. A pustule is a circumscribed elevation containing pus. REF: Vocabulary, Clinical Appearance of Soft Tissue Lesions, page 1 OBJ: 1 32. A lesion with a pedunculated base is best described as a. an ulcer. b. stemlike. c. pallor. d. broad and flat. ANS: B A stemlike lesion is referred to as pedunculated. An ulcer is a break in the surface epithelium. Pallor is a paleness of the skin or mucosal tissues. Broad and flat describes the base of a sessile lesion. REF: Vocabulary, Clinical Appearance of Soft Tissue Lesions, page 1 OBJ: 1 33. The following lesions can be identified radiographically except one. Which one is the exception? a. Root resorption b. Fordyce granules c. Interproximal dental caries d. Compound odontoma ANS: B Fordyce granules are yellow clusters of ectopic sebaceous glands that are diagnosed through clinical appearance. Root resorption is identified radiographically when the apex of the tooth appears shortened or blunted. Interproximal dental caries are seen as radiographic radiolucencies. A compound odontoma is initially identified radiographically as a radiopaque area in which tooth structure can be identified. REF: Clinical Diagnosis, page 7 | Fordyce Granules, page 20 OBJ: 3 34. These reddish-purple clusters observed on the ventral surface of the tongue and diagnosed through clinical observation are referred to as which variants of normal conditions? a. Palatal cyst b. Mandibular tori c. Lingual varicosities d. Ranula ANS: C Lingual varicosities are prominent lingual veins usually observed on the ventral and lateral surfaces of the tongue. A palatal cyst is radiolucent and not diagnosed through clinical appearance. Mandibular tori are outgrowths of hard dense bone and found on the lingual aspect of the mandible. Ranula is a term used to describe a mucocele-like lesion that forms unilaterally on the floor of the mouth. REF: Lingual Varicosities, page 22 OBJ: 4 35. An elevated serum alkaline phosphate level, significant in the diagnosis of Paget disease, is determined from which diagnostic category? a. Laboratory b. Therapeutic c. Clinical d. Surgical ANS: A Laboratory tests, including blood chemistries, can provide information that contributes to a diagnosis. Therapeutic testing applies the principle of diagnosis based on clinical and historical information with confirmation by the response of the condition to therapy. Clinical diagnosis suggests that the strength of the diagnosis comes from the clinical appearance of the lesion. Surgical diagnosis is based on information about a lesion gained during surgical intervention. REF: Laboratory Diagnosis, page 16 OBJ: 2 36. The following conditions most likely respond to therapeutic diagnosis except one. Which one is the exception? a. Angular cheilitis b. Necrotizing ulcerative gingivitis c. Nutritional deficiencies d. Stafne bone cyst ANS: D Stafne bone cyst, in which entrapped salivary gland tissue is identified, is diagnosed through surgical examination. Angular cheilitis commonly responds to antifungal therapy once nutritional deficiencies have been ruled out. Necrotizing ulcerative gingivitis responds to hydrogen peroxide rinses. Nutritional deficiencies are common conditions diagnosed by therapeutic means. REF: Surgical Diagnosis, page 18 OBJ: 3 37. The variant of normal coloration seen on the mandibular gingival surface is termed a. lingual varicosities. b. leukoedema. c. melanin pigmentation. d. linea alba. ANS: C Melanin pigmentation is most commonly seen in dark-skinned individuals and gives color to the oral mucosa and gingiva. Lingual varicosities are prominent lingual veins observed on the ventral and lateral surfaces of the tongue. Leukoedema is a generalized opalescence imparted to the buccal mucosa. Linea alba is a white line that extends anteroposteriorly on the buccal mucosa along the occlusal plane of the teeth. REF: Melanin Pigmentation, Fig. 1.50, pages 21-22 OBJ: 6 38. A white lesion that cannot be rubbed off and cannot be diagnosed on the basis of clinical characteristics alone is termed a. leukoplakia. b. dentinogenesis imperfecta. c. erythroplakia. d. squamous cell carcinoma. ANS: A Leukoplakia is a clinical term for a white lesion that cannot be rubbed off and cannot be diagnosed on the basis of clinical characteristics alone. Dentinogenesis imperfecta is a genetic condition involving a defect in the development of dentin. Erythroplakia is a clinical term for a red lesion that cannot be diagnosed on the basis of clinical features alone. Squamous cell carcinoma is diagnosed by microscopic evaluation and does not refer to all white lesions that cannot be rubbed off. REF: Microscopic Diagnosis, page 18 OBJ: 9 39. The radiographic appearance of a simple radicular cyst is best described as a. coalescence. b. diffuse. c. multilocular. d. unilocular. ANS: D Unilocular means having one compartment or unit that is well defined. This term is often used to describe a radicular cyst. Coalescence refers to the process by which parts of a whole join together, or fuse, to make one. Diffuse describes a lesion with ill-defined borders, making it impossible to detect the exact parameters of the lesion. A multilocular lesion has also been described as “soap bubble”–like; the lobes appear to fuse together to make up the lesion. REF: Vocabulary, Radiographic Terms Used to Describe Lesions in Bone, Fig. 1.13, pages 5, 6 OBJ: 1 40. A pathologic lesion found frequently in 30-year-old black women that requires a radiographic image and historical data for diagnosis is termed a. verrucous vulgaris. b. necrotizing ulcerative gingivitis. c. periapical cemento-osseous dysplasia. d. amalgam tattoo. ANS: C Periapical cemento-osseous dysplasia requires a radiograph, specific patient history, and a pulp test to evaluate tooth vitality. It is frequently found in black women in the third decade of life. Verrucous vulgaris is diagnosed on the basis of its clinical and microscopic appearance and does not require a radiograph. Necrotizing ulcerative gingivitis requires clinical and historical data for diagnosis and does not require a radiograph. An amalgam tattoo relies on clinical and historical data for diagnosis and does not require a radiograph. REF: Historical Diagnosis, page 16 OBJ: 5 41. Leukoedema is a generalized opalescence appearing on the buccal mucosa; linea alba is a dark pigmented line appearing on the buccal mucosa. a. Both statements are true. b. Both statements are false. c. The first statement is true, and the second statement is false. d. The first statement is false, and the second statement is true. ANS: C The first statement is true, and the second statement is false. Leukoedema is a generalized opalescence appearing on the buccal mucosa, as stated, but linea alba is not a dark pigmented line. The statement that leukoedema is a generalized opalescence appearing on the buccal mucosa is true; the statement that linea alba is a dark pigmented line is false. (Linea alba is a white line.) Leukoedema is a generalized opalescence appearing on the buccal mucosa, but linea alba is not a dark pigmented line. REF: Leukoedema, Fig. 1.54, page 23 | Linea Alba, Fig. 1.53, page 23 OBJ: 8 42. Each condition is considered a variant of normal except one. Which is the exception? a. Melanin pigmentation b. Linea alba c. Geographic tongue d. Retrocuspid papilla ANS: C Geographic tongue is characterized by diffuse areas devoid of filiform papillae. It is not a variant of normal. Melanin pigmentation is commonly seen in dark-skinned individuals and is considered a variant of normal. Linea alba is located on the buccal mucosa along the occlusal plane. It is most prominent in patients who have a clenching or bruxism habit. It is so common that it is considered a variant of normal. Retrocuspid papilla is a sessile nodule on the gingival margin of the lingual aspect of the mandibular cuspids and is considered a variant of normal. REF: Geographic Tongue, page 24 | Variants of Normal, pages 20-23 OBJ: 6 43. The term erythroplakia is best used in which context? a. Microscopic b. Laboratory c. Surgical d. Clinical ANS: D Erythroplakia is a descriptive clinical term for a red lesion. Microscopic diagnosis requires a biopsy. Laboratory diagnosis involves the use of clinical laboratory tests, including blood chemistries and urinalysis. Surgical diagnosis requires surgical intervention. REF: Vocabulary, Color of Lesion, page 2 OBJ: 9 44. The pathologic lesion seen on the dorsal surface of the tongue is characteristic of a. fissured tongue. b. hairy tongue. c. median rhomboid glossitis. d. migratory glossitis. ANS: C Median rhomboid glossitis appears as a flat or slightly raised oval or rectangular erythematous area in the midline of the dorsal surface of the tongue. Fissured tongue is characterized by deep fissures or grooves. Hairy tongue has the appearance of white, elongated filiform papillae. Migratory glossitis is another name for geographic tongue and appears as patches on the lateral and dorsal surfaces of the tongue. REF: Median Rhomboid Glossitis, page 23 | Fig. 1.20, page 8 OBJ: 7 45. Each condition is considered benign and of unknown cause except one. Which one is the exception? a. Hairy tongue b. Amelogenesis imperfecta c. Migratory glossitis d. Fissured tongue ANS: B Amelogenesis imperfecta represents a group of inherited conditions affecting the enamel of teeth. Hairy tongue is a benign condition of unknown cause. Migratory glossitis is a benign condition of unknown cause. Fissured tongue is a benign condition of unknown cause. REF: Historical Diagnosis, page 15 OBJ: 7 46. A medical history of a patient prescribed a calcium channel blocker may reveal which condition? a. Gingival enlargement b. Cementoma c. Paget disease d. Ulcerative colitis ANS: A A patient taking a calcium channel blocker may exhibit gingival enlargement. A cementoma is not a result of a patient taking a calcium channel blocker. An elevated serum alkaline phosphatase level is significant for Paget disease but not for use of a calcium channel blocker. Ulcerative colitis may contribute to oral lesions but not gingival enlargement. REF: Historical Diagnosis, Fig. 1.38, B, pages 16, 17 OBJ: 3 47. Urticaria is an example of a(n) a. genetic disorder. b. developmental disturbance. c. immediate response to an allergen. d. immunodeficiency response. ANS: C Urticaria is an immediate response to an allergen. Urticaria is not the result of a genetic disorder. Urticaria is not the result of a developmental disturbance. Urticaria is not a result of immunodeficiency. REF: Historical Diagnosis, page 16 OBJ: 3 48. Which term describes a lesion in which parts of a whole are joined together, or fused, to make one? a. Fissured b. Coalescence c. Diffuse d. Multilocular ANS: B Coalescence describes the process by which parts of a whole join together, or fuse, to make one. Fissured describes a cleft or groove, normal or otherwise, showing prominent depth. Diffuse describes a lesion with borders that are not well defined. Multilocular lesions are described radiographically as “soap bubbles” (i.e., a lesion with many lobes beyond the confines of one distinct area). REF: Vocabulary, Radiographic Terms Used to Describe Lesions in Bone, page 3 OBJ: 1 49. While obtaining diagnostic information from a patient, the dental hygienist learns that the appearance of this patient’s teeth is familial. The correct diagnosis is a. tetracycline staining. b. pulpal dysplasia. c. extrinsic staining. d. dentinogenesis imperfecta. ANS: D Dentinogenesis imperfecta is a pathologic condition in which the family history plays a significant role in the diagnosis. Tetracycline staining is not a familial condition. Pulpal dysplasia is not a pathologic familial condition. Extrinsic staining is not a familial condition. REF: Historical Diagnosis, Fig. 1.37, pages 15, 16 OBJ: 3 50. The eight categories that provide information leading to a definitive diagnosis are as follows: microscopic, clinical, laboratory, surgical, differential findings, radiographic, therapeutic, and a. etiology. b. historical. c. chief complaint. d. treatment. ANS: B Historical information reveals past experiences that may be relevant to the diagnosis. Etiology is not a component of the definitive or final diagnosis. The chief complaint may be helpful in understanding the patient’s perspective but is not considered a diagnostic tool. Treatment is decided after the definitive or final diagnosis is made, and it is not part of the information leading to the diagnosis. REF: Making a Diagnosis, page 6 OBJ: 3 51. What is the radiographic appearance of periapical cemento-osseous dysplasia in its earliest stage? a. Radiolucent b. Radiopaque c. Radiolucent and radiopaque d. Cotton-wool radiolucencies ANS: A In stage I of periapical cemento-osseous dysplasia, the appearance is radiolucent. Radiopacities are not seen in the early stage of perioapical cemento-osseous dysplasia. In stage II, the appearance is radiolucent and radiopaque. Cotton-wool radiopacities are seen in patients with Paget disease. REF: Vocabulary, Radiographic Terms Used to Describe Lesions in Bone, page 3 OBJ: 5 52. All conditions are associated with lingual varicosities except one. Which is the exception? a. Red to purple enlarged vessels b. May be associated with varicosities in the legs c. Age-related condition d. May swell during eating ANS: D Lingual varicosities do not swell during the eating process. Red to purple enlarged vessels are seen with lingual varicosities. Lingual varicosities may be associated with varicosities in the legs. Lingual varicosities are considered an age-related condition, often seen in individuals over the age of 60. REF: Variants of Normal, pages 22-23 OBJ: 4 53. Various sizes of circumscribed elevations that contain pus are termed a. vesicles. b. pustules. c. papules d. lobules ANS: B Pustules are variously sized circumscribed elevations containing pus. Vesicles are elevated lesions that contain serous fluid. Papules are elevated lesions that protrude above the surface of normal surrounding tissue. Lobules are segments or lobes that are part of the whole. REF: Vocabulary, Clinical Appearance of Soft Tissue Lesions, page 1 OBJ: 1 54. Studies have linked the presence of a lingual thyroid in association with the following life events except one. Which is the exception? a. Pregnancy b. Infancy c. Menopause d. Puberty ANS: B Infancy is not associated with the presence of a lingual thyroid. The emergence of a lingual thyroid is linked to hormonal changes, such as pregnancy. The emergence of a lingual thyroid is linked to hormonal changes, such as menopause. The emergence of a lingual thyroid is linked to hormonal changes, such as puberty. REF: Benign Conditions of Unknown Cause, page 23 OBJ: 11