ORAL PATHOLOGY EXAM 6 |DENTAL
HYGIENIST STUDENT | LATEST 2025-2026
QUESTION AND CORRECT ANSWER WITH
EXPLANATION WEST COAST UNIVERSITY
1. A 69-year-old smoker presents with a non-healing ulcer on the
ventrolateral tongue. It is indurated, irregular, and bleeds on contact. The
lesion has persisted for 5 months. What is the MOST appropriate next
step?
A. Prescribe chlorhexidine rinse and reassess in 2 weeks
B. Start empiric antifungal therapy
C. Incisional biopsy
D. Schedule routine cleaning and observe
Correct Answer: C
Rationale: Persistent indurated ulcer in a high-risk patient requires
immediate biopsy.
2. A patient presents with bilateral white striations and erosive areas on
buccal mucosa. Symptoms worsen with stress. Histology shows basal cell
liquefaction and band-like lymphocytic infiltrate. Most likely diagnosis?
A. Leukoplakia
B. Candidiasis
C. Oral Lichen Planus
D. Frictional keratosis
Correct Answer: C
Rationale: Classic histopathology and stress association confirm lichen
planus.
3. A diabetic patient presents with severe necrosis of interdental papillae,
halitosis, and spontaneous bleeding. What is the primary underlying
mechanism?
A. Viral epithelial infection
B. Autoimmune collagen destruction
C. Anaerobic bacterial proliferation in immunocompromised periodontal
tissues
D. Fungal invasion of gingiva
,Correct Answer: C
Rationale: Necrotizing periodontal disease is polymicrobial anaerobic
infection.
4. A radiograph shows multilocular radiolucency with root resorption and
cortical expansion in the posterior mandible. Most likely diagnosis?
A. Dentigerous cyst
B. Periapical granuloma
C. Ameloblastoma
D. Fibroma
Correct Answer: C
Rationale: Soap-bubble appearance + root resorption = ameloblastoma.
5. A patient presents with xerostomia, parotid enlargement, and dry eyes.
Which complication is MOST likely long-term?
A. Osteosarcoma
B. Liver cirrhosis
C. Sjogren Syndrome
D. Hyperthyroidism
Correct Answer: C
Rationale: Sicca syndrome leads to chronic oral and ocular
complications.
6. A bluish oral lesion enlarges when dependent and partially compresses
under pressure. Diagnosis?
A. Fibroma
B. Papilloma
C. Venous Malformation
D. Leukoplakia
Correct Answer: C
Rationale: Venous lesions are compressible and gravity-dependent.
, 7. A patient presents with painful oral erosions and positive Nikolsky sign.
The immunologic target is:
A. Basement membrane collagen
B. Desmoglein-3
C. Keratin
D. Elastin
Correct Answer: B
Rationale: Pemphigus vulgaris targets desmoglein-3.
8. A sunburst radiographic pattern with paresthesia suggests:
A. Ameloblastoma
B. Fibrous dysplasia
C. Osteosarcoma
D. Cyst
Correct Answer: C
Rationale: Sunburst pattern + nerve involvement = aggressive
malignancy.
9. A smoker presents with a non-wipeable white plaque showing
epithelial dysplasia. Diagnosis?
A. Candidiasis
B. Lichen planus
C. Leukoplakia
D. Frictional keratosis
Correct Answer: C
Rationale: Leukoplakia is a diagnosis of exclusion with malignant
potential.
10. A patient presents with macroglossia and waxy skin changes.
Underlying pathology?
A. Diabetes mellitus
B. Cushing syndrome
C. Amyloidosis
D. Hyperthyroidism
HYGIENIST STUDENT | LATEST 2025-2026
QUESTION AND CORRECT ANSWER WITH
EXPLANATION WEST COAST UNIVERSITY
1. A 69-year-old smoker presents with a non-healing ulcer on the
ventrolateral tongue. It is indurated, irregular, and bleeds on contact. The
lesion has persisted for 5 months. What is the MOST appropriate next
step?
A. Prescribe chlorhexidine rinse and reassess in 2 weeks
B. Start empiric antifungal therapy
C. Incisional biopsy
D. Schedule routine cleaning and observe
Correct Answer: C
Rationale: Persistent indurated ulcer in a high-risk patient requires
immediate biopsy.
2. A patient presents with bilateral white striations and erosive areas on
buccal mucosa. Symptoms worsen with stress. Histology shows basal cell
liquefaction and band-like lymphocytic infiltrate. Most likely diagnosis?
A. Leukoplakia
B. Candidiasis
C. Oral Lichen Planus
D. Frictional keratosis
Correct Answer: C
Rationale: Classic histopathology and stress association confirm lichen
planus.
3. A diabetic patient presents with severe necrosis of interdental papillae,
halitosis, and spontaneous bleeding. What is the primary underlying
mechanism?
A. Viral epithelial infection
B. Autoimmune collagen destruction
C. Anaerobic bacterial proliferation in immunocompromised periodontal
tissues
D. Fungal invasion of gingiva
,Correct Answer: C
Rationale: Necrotizing periodontal disease is polymicrobial anaerobic
infection.
4. A radiograph shows multilocular radiolucency with root resorption and
cortical expansion in the posterior mandible. Most likely diagnosis?
A. Dentigerous cyst
B. Periapical granuloma
C. Ameloblastoma
D. Fibroma
Correct Answer: C
Rationale: Soap-bubble appearance + root resorption = ameloblastoma.
5. A patient presents with xerostomia, parotid enlargement, and dry eyes.
Which complication is MOST likely long-term?
A. Osteosarcoma
B. Liver cirrhosis
C. Sjogren Syndrome
D. Hyperthyroidism
Correct Answer: C
Rationale: Sicca syndrome leads to chronic oral and ocular
complications.
6. A bluish oral lesion enlarges when dependent and partially compresses
under pressure. Diagnosis?
A. Fibroma
B. Papilloma
C. Venous Malformation
D. Leukoplakia
Correct Answer: C
Rationale: Venous lesions are compressible and gravity-dependent.
, 7. A patient presents with painful oral erosions and positive Nikolsky sign.
The immunologic target is:
A. Basement membrane collagen
B. Desmoglein-3
C. Keratin
D. Elastin
Correct Answer: B
Rationale: Pemphigus vulgaris targets desmoglein-3.
8. A sunburst radiographic pattern with paresthesia suggests:
A. Ameloblastoma
B. Fibrous dysplasia
C. Osteosarcoma
D. Cyst
Correct Answer: C
Rationale: Sunburst pattern + nerve involvement = aggressive
malignancy.
9. A smoker presents with a non-wipeable white plaque showing
epithelial dysplasia. Diagnosis?
A. Candidiasis
B. Lichen planus
C. Leukoplakia
D. Frictional keratosis
Correct Answer: C
Rationale: Leukoplakia is a diagnosis of exclusion with malignant
potential.
10. A patient presents with macroglossia and waxy skin changes.
Underlying pathology?
A. Diabetes mellitus
B. Cushing syndrome
C. Amyloidosis
D. Hyperthyroidism
