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