ORAL PATHOLOGY EXAM 2 |DENTAL
HYGIENIST STUDENT | LATEST 2025-2026
QUESTION AND CORRECT ANSWER WITH
EXPLANATION WEST COAST UNIVERSITY
1. A 58-year-old patient with a 30-year history of tobacco and alcohol use
presents with a painless white lesion on the lateral border of the tongue
that has persisted for 5 weeks. The lesion is non-wipeable and slightly
indurated. What is the most appropriate next step?
A. Prescribe antifungal therapy
B. Reassure and monitor for 2 weeks
C. Incisional Biopsy
D. Initiate topical corticosteroids
Correct Answer: C
Rationale: A persistent, non-wipeable lesion in a high-risk patient and
high-risk location requires immediate biopsy to rule out dysplasia or
malignancy.
2. A 42-year-old female presents with bilateral white reticular lesions on
the buccal mucosa and reports intermittent burning. She has a history of
autoimmune disease. Which mechanism best explains this condition?
A. Fungal overgrowth
B. Viral epithelial proliferation
C. T-cell mediated immune response
D. Bacterial toxin production
Correct Answer: C
Rationale: Oral lichen planus is a T-cell mediated autoimmune condition
targeting basal epithelial cells.
3. A patient presents with multiple vesicles on keratinized gingiva that
rupture into painful ulcers. The patient reports prodromal tingling. Which
diagnosis is most likely?
A. Primary Herpetic Gingivostomatitis
B. Recurrent Herpes Simplex
C. Aphthous Ulcer
D. Pemphigus Vulgaris
,Correct Answer: B
Rationale: Recurrent HSV occurs on keratinized tissue with prodrome
and vesicle formation, unlike aphthous ulcers which occur on non-
keratinized mucosa.
4. A radiograph reveals a unilocular radiolucency surrounding the crown
of an unerupted mandibular third molar. The lesion is asymptomatic.
What is the most likely diagnosis?
A. Dentigerous Cyst
B. Ameloblastoma
C. Radicular Cyst
D. Periapical Abscess
Correct Answer: A
Rationale: Dentigerous cysts classically surround the crown of impacted
teeth and are often asymptomatic.
5. A patient with poorly controlled diabetes presents with angular fissures
at the corners of the mouth and white plaques intraorally. What is the
most appropriate combined management?
A. Antibiotics only
B. Topical antifungal agents and glycemic control
C. Surgical excision
D. Antiviral therapy
Correct Answer: B
Rationale: Angular cheilitis with candidiasis requires antifungal
treatment and correction of underlying systemic factors such as diabetes.
6. A 65-year-old patient presents with a red lesion on the floor of the
mouth. The lesion is velvety and asymptomatic. Which feature makes this
lesion more concerning than leukoplakia?
A. Color
B. Location
C. Erythroplakia histologic dysplasia rate
D. Patient age
, Correct Answer: C
Rationale: Erythroplakia has a significantly higher rate of severe
dysplasia or carcinoma compared to leukoplakia.
7. A patient reports dry mouth, dry eyes, and difficulty swallowing.
Which diagnostic test would help confirm the suspected condition?
A. Blood glucose test
B. Salivary Flow Rate Test
C. Biopsy of fibroma
D. Radiograph of mandible
Correct Answer: B
Rationale: Xerostomia evaluation via salivary flow testing helps assess
conditions like Sjögren syndrome.
8. A patient presents with a rapidly enlarging painful swelling in the
mandible with paresthesia. What is the most concerning diagnosis?
A. Osteosarcoma
B. Fibroma
C. Mucocele
D. Cyst
Correct Answer: A
Rationale: Rapid growth, pain, and nerve involvement suggest
malignancy such as osteosarcoma.
9. A 30-year-old patient presents with recurrent ulcers triggered by stress.
Which underlying mechanism is most likely?
A. Bacterial invasion
B. Viral latency
C. Immune dysregulation
D. Mechanical trauma
Correct Answer: C
Rationale: Recurrent aphthous ulcers are linked to immune dysregulation
and stress triggers.
HYGIENIST STUDENT | LATEST 2025-2026
QUESTION AND CORRECT ANSWER WITH
EXPLANATION WEST COAST UNIVERSITY
1. A 58-year-old patient with a 30-year history of tobacco and alcohol use
presents with a painless white lesion on the lateral border of the tongue
that has persisted for 5 weeks. The lesion is non-wipeable and slightly
indurated. What is the most appropriate next step?
A. Prescribe antifungal therapy
B. Reassure and monitor for 2 weeks
C. Incisional Biopsy
D. Initiate topical corticosteroids
Correct Answer: C
Rationale: A persistent, non-wipeable lesion in a high-risk patient and
high-risk location requires immediate biopsy to rule out dysplasia or
malignancy.
2. A 42-year-old female presents with bilateral white reticular lesions on
the buccal mucosa and reports intermittent burning. She has a history of
autoimmune disease. Which mechanism best explains this condition?
A. Fungal overgrowth
B. Viral epithelial proliferation
C. T-cell mediated immune response
D. Bacterial toxin production
Correct Answer: C
Rationale: Oral lichen planus is a T-cell mediated autoimmune condition
targeting basal epithelial cells.
3. A patient presents with multiple vesicles on keratinized gingiva that
rupture into painful ulcers. The patient reports prodromal tingling. Which
diagnosis is most likely?
A. Primary Herpetic Gingivostomatitis
B. Recurrent Herpes Simplex
C. Aphthous Ulcer
D. Pemphigus Vulgaris
,Correct Answer: B
Rationale: Recurrent HSV occurs on keratinized tissue with prodrome
and vesicle formation, unlike aphthous ulcers which occur on non-
keratinized mucosa.
4. A radiograph reveals a unilocular radiolucency surrounding the crown
of an unerupted mandibular third molar. The lesion is asymptomatic.
What is the most likely diagnosis?
A. Dentigerous Cyst
B. Ameloblastoma
C. Radicular Cyst
D. Periapical Abscess
Correct Answer: A
Rationale: Dentigerous cysts classically surround the crown of impacted
teeth and are often asymptomatic.
5. A patient with poorly controlled diabetes presents with angular fissures
at the corners of the mouth and white plaques intraorally. What is the
most appropriate combined management?
A. Antibiotics only
B. Topical antifungal agents and glycemic control
C. Surgical excision
D. Antiviral therapy
Correct Answer: B
Rationale: Angular cheilitis with candidiasis requires antifungal
treatment and correction of underlying systemic factors such as diabetes.
6. A 65-year-old patient presents with a red lesion on the floor of the
mouth. The lesion is velvety and asymptomatic. Which feature makes this
lesion more concerning than leukoplakia?
A. Color
B. Location
C. Erythroplakia histologic dysplasia rate
D. Patient age
, Correct Answer: C
Rationale: Erythroplakia has a significantly higher rate of severe
dysplasia or carcinoma compared to leukoplakia.
7. A patient reports dry mouth, dry eyes, and difficulty swallowing.
Which diagnostic test would help confirm the suspected condition?
A. Blood glucose test
B. Salivary Flow Rate Test
C. Biopsy of fibroma
D. Radiograph of mandible
Correct Answer: B
Rationale: Xerostomia evaluation via salivary flow testing helps assess
conditions like Sjögren syndrome.
8. A patient presents with a rapidly enlarging painful swelling in the
mandible with paresthesia. What is the most concerning diagnosis?
A. Osteosarcoma
B. Fibroma
C. Mucocele
D. Cyst
Correct Answer: A
Rationale: Rapid growth, pain, and nerve involvement suggest
malignancy such as osteosarcoma.
9. A 30-year-old patient presents with recurrent ulcers triggered by stress.
Which underlying mechanism is most likely?
A. Bacterial invasion
B. Viral latency
C. Immune dysregulation
D. Mechanical trauma
Correct Answer: C
Rationale: Recurrent aphthous ulcers are linked to immune dysregulation
and stress triggers.
