ORAL PATHOLOGY EXAM 3 |DENTAL
HYGIENIST STUDENT | LATEST 2025-2026
QUESTION AND CORRECT ANSWER WITH
EXPLANATION WEST COAST UNIVERSITY
1. A 61-year-old patient with a history of tobacco and alcohol use
presents with a mixed red-and-white lesion on the lateral tongue. The
lesion is asymptomatic and non-wipeable. What is the most appropriate
next step?
A. Prescribe antifungal therapy
B. Monitor for 2 weeks
C. Incisional biopsy
D. Start corticosteroids
Correct Answer: C
Rationale: Mixed red and white lesions (erythroleukoplakia) in high-risk
patients require immediate biopsy due to high dysplasia risk.
2. A patient presents with chronic bilateral white striations and episodic
erosive lesions on the buccal mucosa. The lesions worsen during stress.
Which condition is most likely?
A. Oral Lichen Planus
B. Leukoplakia
C. Candidiasis
D. Frictional Keratosis
Correct Answer: A
Rationale: Bilateral Wickham striae with episodic erosion and stress
correlation are classic for lichen planus.
3. A 45-year-old patient presents with a rapidly enlarging mandibular
lesion with pain and paresthesia. Radiographs show ill-defined borders.
What is the most likely diagnosis?
A. Osteosarcoma
B. Ameloblastoma
C. Dentigerous Cyst
D. Fibrous Dysplasia
,Correct Answer: A
Rationale: Rapid growth, pain, and paresthesia strongly indicate
malignancy.
4. A patient presents with diffuse erythema under a maxillary denture.
The patient reports no pain. Which management is most appropriate?
A. Antibiotics
B. Topical antifungal therapy and denture hygiene improvement
C. Surgical removal
D. Biopsy immediately
Correct Answer: B
Rationale: Denture stomatitis is typically Candida-related and managed
conservatively.
5. A lesion on the ventral tongue appears as a small, red, velvety patch.
The patient denies trauma. What is the most concerning diagnosis?
A. Erythroplakia
B. Candidiasis
C. Fibroma
D. Mucocele
Correct Answer: A
Rationale: Red lesions without clear cause are highly suspicious for
severe dysplasia or carcinoma.
6. A patient presents with desquamative gingivitis. Which two conditions
must be primarily differentiated?
A. Pemphigus Vulgaris and Mucous Membrane Pemphigoid
B. Fibroma and papilloma
C. Mucocele and cyst
D. Leukoplakia and keratosis
Correct Answer: A
Rationale: Both present similarly but differ in level of epithelial
separation.
, 7. A patient presents with a non-healing ulcer that becomes painful only
in later stages. What does this progression suggest?
A. Benign lesion
B. Tumor invasion of nerve tissue
C. Fungal infection
D. Viral replication
Correct Answer: B
Rationale: Malignant lesions often become painful after nerve
involvement.
8. A radiograph shows a multilocular “soap bubble” lesion in the
posterior mandible. The patient has no pain. What is the most likely
diagnosis?
A. Ameloblastoma
B. Abscess
C. Fibroma
D. Granuloma
Correct Answer: A
Rationale: Classic radiographic pattern of ameloblastoma.
9. A patient presents with white plaques that do not wipe off and show
dysplasia on biopsy. What is the diagnosis?
A. Leukoplakia
B. Candidiasis
C. Lichen Planus
D. Frictional Keratosis
Correct Answer: A
Rationale: Leukoplakia is defined clinically and may show dysplasia
histologically.
10. A patient presents with a rapidly bleeding gingival lesion during
pregnancy. What is the most likely diagnosis?
A. Pyogenic Granuloma
B. Fibroma
HYGIENIST STUDENT | LATEST 2025-2026
QUESTION AND CORRECT ANSWER WITH
EXPLANATION WEST COAST UNIVERSITY
1. A 61-year-old patient with a history of tobacco and alcohol use
presents with a mixed red-and-white lesion on the lateral tongue. The
lesion is asymptomatic and non-wipeable. What is the most appropriate
next step?
A. Prescribe antifungal therapy
B. Monitor for 2 weeks
C. Incisional biopsy
D. Start corticosteroids
Correct Answer: C
Rationale: Mixed red and white lesions (erythroleukoplakia) in high-risk
patients require immediate biopsy due to high dysplasia risk.
2. A patient presents with chronic bilateral white striations and episodic
erosive lesions on the buccal mucosa. The lesions worsen during stress.
Which condition is most likely?
A. Oral Lichen Planus
B. Leukoplakia
C. Candidiasis
D. Frictional Keratosis
Correct Answer: A
Rationale: Bilateral Wickham striae with episodic erosion and stress
correlation are classic for lichen planus.
3. A 45-year-old patient presents with a rapidly enlarging mandibular
lesion with pain and paresthesia. Radiographs show ill-defined borders.
What is the most likely diagnosis?
A. Osteosarcoma
B. Ameloblastoma
C. Dentigerous Cyst
D. Fibrous Dysplasia
,Correct Answer: A
Rationale: Rapid growth, pain, and paresthesia strongly indicate
malignancy.
4. A patient presents with diffuse erythema under a maxillary denture.
The patient reports no pain. Which management is most appropriate?
A. Antibiotics
B. Topical antifungal therapy and denture hygiene improvement
C. Surgical removal
D. Biopsy immediately
Correct Answer: B
Rationale: Denture stomatitis is typically Candida-related and managed
conservatively.
5. A lesion on the ventral tongue appears as a small, red, velvety patch.
The patient denies trauma. What is the most concerning diagnosis?
A. Erythroplakia
B. Candidiasis
C. Fibroma
D. Mucocele
Correct Answer: A
Rationale: Red lesions without clear cause are highly suspicious for
severe dysplasia or carcinoma.
6. A patient presents with desquamative gingivitis. Which two conditions
must be primarily differentiated?
A. Pemphigus Vulgaris and Mucous Membrane Pemphigoid
B. Fibroma and papilloma
C. Mucocele and cyst
D. Leukoplakia and keratosis
Correct Answer: A
Rationale: Both present similarly but differ in level of epithelial
separation.
, 7. A patient presents with a non-healing ulcer that becomes painful only
in later stages. What does this progression suggest?
A. Benign lesion
B. Tumor invasion of nerve tissue
C. Fungal infection
D. Viral replication
Correct Answer: B
Rationale: Malignant lesions often become painful after nerve
involvement.
8. A radiograph shows a multilocular “soap bubble” lesion in the
posterior mandible. The patient has no pain. What is the most likely
diagnosis?
A. Ameloblastoma
B. Abscess
C. Fibroma
D. Granuloma
Correct Answer: A
Rationale: Classic radiographic pattern of ameloblastoma.
9. A patient presents with white plaques that do not wipe off and show
dysplasia on biopsy. What is the diagnosis?
A. Leukoplakia
B. Candidiasis
C. Lichen Planus
D. Frictional Keratosis
Correct Answer: A
Rationale: Leukoplakia is defined clinically and may show dysplasia
histologically.
10. A patient presents with a rapidly bleeding gingival lesion during
pregnancy. What is the most likely diagnosis?
A. Pyogenic Granuloma
B. Fibroma
