ORAL PATHOLOGY EXAM 5 |DENTAL
HYGIENIST STUDENT | LATEST 2025-2026
QUESTION AND CORRECT ANSWER WITH
EXPLANATION WEST COAST UNIVERSITY
1. A 62-year-old smoker presents with a non-healing ulcer on the lateral
tongue with induration and mild bleeding. What is the most appropriate
next step?
A. Prescribe antifungal rinse
B. Observe for 2 weeks
C. Incisional biopsy
D. Start antiviral therapy
Correct Answer: C
Rationale: Any persistent indurated ulcer in a high-risk patient requires
biopsy.
2. A patient presents with bilateral white striations and burning sensation.
Lesions worsen with stress. Histology shows basal cell degeneration.
Most likely diagnosis?
A. Leukoplakia
B. Candidiasis
C. Oral Lichen Planus
D. Frictional keratosis
Correct Answer: C
Rationale: Classic clinical + histologic features of lichen planus.
3. A diabetic patient presents with necrotic gingiva, halitosis, and
papillary cratering. What is the primary etiologic mechanism?
A. Viral infection
B. Autoimmune destruction
C. Anaerobic bacterial overgrowth in immunocompromised host
D. Fungal invasion
Correct Answer: C
Rationale: NUG is polymicrobial with anaerobic dominance.
,4. A radiograph shows multilocular radiolucency with root resorption in
the posterior mandible. Most likely diagnosis?
A. Dentigerous cyst
B. Periapical granuloma
C. Ameloblastoma
D. Fibroma
Correct Answer: C
Rationale: Soap bubble pattern + root resorption = ameloblastoma.
5. A patient presents with xerostomia, parotid enlargement, and dry eyes.
Which systemic complication is most likely?
A. Osteosarcoma
B. Liver failure
C. Sjogren Syndrome
D. Hyperthyroidism
Correct Answer: C
Rationale: Classic sicca syndrome.
6. A bluish compressible lesion enlarges when dependent and partially
blanches. Diagnosis?
A. Fibroma
B. Papilloma
C. Venous Malformation
D. Leukoplakia
Correct Answer: C
Rationale: Positional vascular change indicates venous lesion.
7. A patient presents with painful oral erosions and positive Nikolsky sign.
Target antigen is most likely:
A. Collagen type IV
B. Desmoglein-3
C. Keratin
D. Elastin
, Correct Answer: B
Rationale: Pemphigus vulgaris targets desmoglein.
8. A lesion shows sunburst radiographic pattern and paresthesia.
Diagnosis?
A. Ameloblastoma
B. Fibrous dysplasia
C. Osteosarcoma
D. Cyst
Correct Answer: C
Rationale: Sunburst + nerve involvement = malignancy.
9. A smoker presents with a white patch that cannot be wiped off and
shows dysplasia. Diagnosis?
A. Candidiasis
B. Lichen planus
C. Leukoplakia
D. Frictional keratosis
Correct Answer: C
Rationale: Leukoplakia is diagnosis of exclusion with malignant potential.
10. A patient presents with macroglossia and waxy skin changes.
Diagnosis?
A. Diabetes
B. Cushing syndrome
C. Amyloidosis
D. Hyperthyroidism
Correct Answer: C
Rationale: Amyloid deposition causes tissue enlargement.
11. A red-white lesion with irregular borders in a smoker is most
concerning for:
A. Candidiasis
HYGIENIST STUDENT | LATEST 2025-2026
QUESTION AND CORRECT ANSWER WITH
EXPLANATION WEST COAST UNIVERSITY
1. A 62-year-old smoker presents with a non-healing ulcer on the lateral
tongue with induration and mild bleeding. What is the most appropriate
next step?
A. Prescribe antifungal rinse
B. Observe for 2 weeks
C. Incisional biopsy
D. Start antiviral therapy
Correct Answer: C
Rationale: Any persistent indurated ulcer in a high-risk patient requires
biopsy.
2. A patient presents with bilateral white striations and burning sensation.
Lesions worsen with stress. Histology shows basal cell degeneration.
Most likely diagnosis?
A. Leukoplakia
B. Candidiasis
C. Oral Lichen Planus
D. Frictional keratosis
Correct Answer: C
Rationale: Classic clinical + histologic features of lichen planus.
3. A diabetic patient presents with necrotic gingiva, halitosis, and
papillary cratering. What is the primary etiologic mechanism?
A. Viral infection
B. Autoimmune destruction
C. Anaerobic bacterial overgrowth in immunocompromised host
D. Fungal invasion
Correct Answer: C
Rationale: NUG is polymicrobial with anaerobic dominance.
,4. A radiograph shows multilocular radiolucency with root resorption in
the posterior mandible. Most likely diagnosis?
A. Dentigerous cyst
B. Periapical granuloma
C. Ameloblastoma
D. Fibroma
Correct Answer: C
Rationale: Soap bubble pattern + root resorption = ameloblastoma.
5. A patient presents with xerostomia, parotid enlargement, and dry eyes.
Which systemic complication is most likely?
A. Osteosarcoma
B. Liver failure
C. Sjogren Syndrome
D. Hyperthyroidism
Correct Answer: C
Rationale: Classic sicca syndrome.
6. A bluish compressible lesion enlarges when dependent and partially
blanches. Diagnosis?
A. Fibroma
B. Papilloma
C. Venous Malformation
D. Leukoplakia
Correct Answer: C
Rationale: Positional vascular change indicates venous lesion.
7. A patient presents with painful oral erosions and positive Nikolsky sign.
Target antigen is most likely:
A. Collagen type IV
B. Desmoglein-3
C. Keratin
D. Elastin
, Correct Answer: B
Rationale: Pemphigus vulgaris targets desmoglein.
8. A lesion shows sunburst radiographic pattern and paresthesia.
Diagnosis?
A. Ameloblastoma
B. Fibrous dysplasia
C. Osteosarcoma
D. Cyst
Correct Answer: C
Rationale: Sunburst + nerve involvement = malignancy.
9. A smoker presents with a white patch that cannot be wiped off and
shows dysplasia. Diagnosis?
A. Candidiasis
B. Lichen planus
C. Leukoplakia
D. Frictional keratosis
Correct Answer: C
Rationale: Leukoplakia is diagnosis of exclusion with malignant potential.
10. A patient presents with macroglossia and waxy skin changes.
Diagnosis?
A. Diabetes
B. Cushing syndrome
C. Amyloidosis
D. Hyperthyroidism
Correct Answer: C
Rationale: Amyloid deposition causes tissue enlargement.
11. A red-white lesion with irregular borders in a smoker is most
concerning for:
A. Candidiasis
