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