Oral Pathology for Dental Hygienist | Ibsen &
Phelan 7th Edition | Comprehensive Examination
- Chapters 1-10
Instructions: Select the single best answer for each question. Each question is worth one
point. Mark your answers on the provided answer sheet.
Section 1: Chapter 01 – Introduction to Preliminary Diagnosis of
Oral Lesions (12 questions)
Q1: A 32-year-old patient presents with multiple small, yellowish papules on the buccal
mucosa bilaterally. The lesions are asymptomatic and have been present since adolescence.
Which of the following is the most appropriate preliminary diagnosis?
A. Fordyce granules
B. Mucoceles
C. Leukoedema
D. Linea alba
Correct Answer: A
Rationale: Fordyce granules are ectopic sebaceous glands appearing as yellowish papules on
the buccal mucosa, commonly bilateral and asymptomatic, representing a normal anatomic
variant rather than a pathologic condition (Ibsen & Phelan, 7th Ed., Ch. 1).
Q2: During a routine intraoral examination, a dental hygienist observes a diffuse, grayish-
white, milky film on the buccal mucosa that disappears when the tissue is stretched. This
finding is most consistent with:
A. Leukoplakia
B. Leukoedema
C. Lichen planus
D. Candidiasis
,Correct Answer: B
Rationale: Leukoedema presents as a grayish-white, milky opalescence of the buccal
mucosa that diminishes or disappears upon stretching, distinguishing it from leukoplakia
which does not disappear with stretching (Ibsen & Phelan, 7th Ed., Ch. 1).
Q3: A 45-year-old male patient presents with a white, adherent plaque on the lateral border
of the tongue that cannot be scraped off. The patient reports a 20-year history of tobacco
use. Which of the following is the MOST significant concern regarding this lesion?
A. It is a manifestation of candidiasis
B. It may represent a premalignant lesion
C. It is a normal anatomic variation
D. It indicates vitamin B12 deficiency
Correct Answer: B
Rationale: A white, adherent plaque that cannot be scraped off is consistent with
leukoplakia, which is a premalignant lesion. The patient's history of tobacco use increases
the risk of dysplasia or malignant transformation. Biopsy is indicated (Ibsen & Phelan, 7th
Ed., Ch. 1).
Q4: Which of the following describes the correct order of the clinical examination process?
A. Inspection, palpation, percussion, auscultation
B. Palpation, inspection, auscultation, percussion
C. Inspection, auscultation, percussion, palpation
D. Auscultation, inspection, palpation, percussion
Correct Answer: A
Rationale: The systematic examination process follows a logical sequence: inspection (visual
examination), palpation (feeling tissues), percussion (tapping), and auscultation (listening).
This sequence ensures a thorough and organized clinical assessment (Ibsen & Phelan, 7th
Ed., Ch. 1).
Q5: A dental hygienist notes a bilateral, white, thickened line along the occlusal plane on the
buccal mucosa of a patient. This finding is most consistent with:
A. Fordyce granules
B. Leukoedema
,C. Linea alba
D. Nicotine stomatitis
Correct Answer: C
Rationale: Linea alba is a bilateral, white, thickened line along the occlusal plane on the
buccal mucosa, typically caused by chronic cheek biting or frictional irritation. It is a
common finding and is considered a normal variation (Ibsen & Phelan, 7th Ed., Ch. 1).
Q6: When examining the floor of the mouth, which of the following techniques is MOST
appropriate for visualizing sublingual structures?
A. Ask the patient to extend the tongue fully
B. Ask the patient to lift the tongue to the palate
C. Use a dental mirror to retract the tongue laterally
D. Ask the patient to swallow while observing
Correct Answer: B
Rationale: Asking the patient to lift the tongue to the palate (or touch the roof of the
mouth) allows for optimal visualization of the floor of the mouth and sublingual structures.
This maneuver elevates the tongue and provides clear access (Ibsen & Phelan, 7th Ed., Ch.
1).
Q7: A patient presents with multiple, small, red lesions on the soft palate that blanch when
pressure is applied. The patient reports a recent upper respiratory infection. The most likely
diagnosis is:
A. Erythroplakia
B. Petechiae
C. Hemangioma
D. Kaposi's sarcoma
Correct Answer: B
Rationale: Petechiae are small, red, non-elevated lesions that blanch with pressure and are
often associated with trauma, infection (such as upper respiratory infections), or bleeding
disorders. They are not considered pathologic in isolation (Ibsen & Phelan, 7th Ed., Ch. 1).
Q8: Which of the following terms describes a lesion that is flat and cannot be felt with a
gloved finger?
, A. Papule
B. Nodule
C. Macule
D. Vesicle
Correct Answer: C
Rationale: A macule is a flat, circumscribed area of color change that is not palpable.
Papules, nodules, and vesicles are all elevated lesions that can be palpated (Ibsen & Phelan,
7th Ed., Ch. 1).
Q9: A 28-year-old patient presents with a painless, fluctuant swelling on the lower lip that
has a bluish hue. The patient reports the lesion appeared after accidentally biting the lip 3
days ago. The most likely diagnosis is:
A. Fibroma
B. Mucocele
C. Hemangioma
D. Pyogenic granuloma
Correct Answer: B
Rationale: A mucocele is a mucous extravasation cyst that commonly occurs on the lower
lip following trauma to minor salivary glands. It presents as a painless, fluctuant swelling
with a bluish hue (Ibsen & Phelan, 7th Ed., Ch. 1).
Q10: Which of the following characteristics is MOST suggestive of a malignant lesion?
A. Painless, slow-growing, well-defined borders
B. Rapid growth, fixed to underlying structures, ulceration
C. Soft, compressible, blanches with pressure
D. Symmetrical, bilateral, asymptomatic
Correct Answer: B
Rationale: Malignant lesions often exhibit rapid growth, fixation to underlying structures
(indicating invasion), ulceration, and irregular borders. Painless slow growth and well-
defined borders are characteristic of benign lesions (Ibsen & Phelan, 7th Ed., Ch. 1).
Q11: During palpation of the cervical lymph nodes, a dental hygienist notes a firm, fixed,
non-tender lymph node. This finding is MOST concerning for:
Phelan 7th Edition | Comprehensive Examination
- Chapters 1-10
Instructions: Select the single best answer for each question. Each question is worth one
point. Mark your answers on the provided answer sheet.
Section 1: Chapter 01 – Introduction to Preliminary Diagnosis of
Oral Lesions (12 questions)
Q1: A 32-year-old patient presents with multiple small, yellowish papules on the buccal
mucosa bilaterally. The lesions are asymptomatic and have been present since adolescence.
Which of the following is the most appropriate preliminary diagnosis?
A. Fordyce granules
B. Mucoceles
C. Leukoedema
D. Linea alba
Correct Answer: A
Rationale: Fordyce granules are ectopic sebaceous glands appearing as yellowish papules on
the buccal mucosa, commonly bilateral and asymptomatic, representing a normal anatomic
variant rather than a pathologic condition (Ibsen & Phelan, 7th Ed., Ch. 1).
Q2: During a routine intraoral examination, a dental hygienist observes a diffuse, grayish-
white, milky film on the buccal mucosa that disappears when the tissue is stretched. This
finding is most consistent with:
A. Leukoplakia
B. Leukoedema
C. Lichen planus
D. Candidiasis
,Correct Answer: B
Rationale: Leukoedema presents as a grayish-white, milky opalescence of the buccal
mucosa that diminishes or disappears upon stretching, distinguishing it from leukoplakia
which does not disappear with stretching (Ibsen & Phelan, 7th Ed., Ch. 1).
Q3: A 45-year-old male patient presents with a white, adherent plaque on the lateral border
of the tongue that cannot be scraped off. The patient reports a 20-year history of tobacco
use. Which of the following is the MOST significant concern regarding this lesion?
A. It is a manifestation of candidiasis
B. It may represent a premalignant lesion
C. It is a normal anatomic variation
D. It indicates vitamin B12 deficiency
Correct Answer: B
Rationale: A white, adherent plaque that cannot be scraped off is consistent with
leukoplakia, which is a premalignant lesion. The patient's history of tobacco use increases
the risk of dysplasia or malignant transformation. Biopsy is indicated (Ibsen & Phelan, 7th
Ed., Ch. 1).
Q4: Which of the following describes the correct order of the clinical examination process?
A. Inspection, palpation, percussion, auscultation
B. Palpation, inspection, auscultation, percussion
C. Inspection, auscultation, percussion, palpation
D. Auscultation, inspection, palpation, percussion
Correct Answer: A
Rationale: The systematic examination process follows a logical sequence: inspection (visual
examination), palpation (feeling tissues), percussion (tapping), and auscultation (listening).
This sequence ensures a thorough and organized clinical assessment (Ibsen & Phelan, 7th
Ed., Ch. 1).
Q5: A dental hygienist notes a bilateral, white, thickened line along the occlusal plane on the
buccal mucosa of a patient. This finding is most consistent with:
A. Fordyce granules
B. Leukoedema
,C. Linea alba
D. Nicotine stomatitis
Correct Answer: C
Rationale: Linea alba is a bilateral, white, thickened line along the occlusal plane on the
buccal mucosa, typically caused by chronic cheek biting or frictional irritation. It is a
common finding and is considered a normal variation (Ibsen & Phelan, 7th Ed., Ch. 1).
Q6: When examining the floor of the mouth, which of the following techniques is MOST
appropriate for visualizing sublingual structures?
A. Ask the patient to extend the tongue fully
B. Ask the patient to lift the tongue to the palate
C. Use a dental mirror to retract the tongue laterally
D. Ask the patient to swallow while observing
Correct Answer: B
Rationale: Asking the patient to lift the tongue to the palate (or touch the roof of the
mouth) allows for optimal visualization of the floor of the mouth and sublingual structures.
This maneuver elevates the tongue and provides clear access (Ibsen & Phelan, 7th Ed., Ch.
1).
Q7: A patient presents with multiple, small, red lesions on the soft palate that blanch when
pressure is applied. The patient reports a recent upper respiratory infection. The most likely
diagnosis is:
A. Erythroplakia
B. Petechiae
C. Hemangioma
D. Kaposi's sarcoma
Correct Answer: B
Rationale: Petechiae are small, red, non-elevated lesions that blanch with pressure and are
often associated with trauma, infection (such as upper respiratory infections), or bleeding
disorders. They are not considered pathologic in isolation (Ibsen & Phelan, 7th Ed., Ch. 1).
Q8: Which of the following terms describes a lesion that is flat and cannot be felt with a
gloved finger?
, A. Papule
B. Nodule
C. Macule
D. Vesicle
Correct Answer: C
Rationale: A macule is a flat, circumscribed area of color change that is not palpable.
Papules, nodules, and vesicles are all elevated lesions that can be palpated (Ibsen & Phelan,
7th Ed., Ch. 1).
Q9: A 28-year-old patient presents with a painless, fluctuant swelling on the lower lip that
has a bluish hue. The patient reports the lesion appeared after accidentally biting the lip 3
days ago. The most likely diagnosis is:
A. Fibroma
B. Mucocele
C. Hemangioma
D. Pyogenic granuloma
Correct Answer: B
Rationale: A mucocele is a mucous extravasation cyst that commonly occurs on the lower
lip following trauma to minor salivary glands. It presents as a painless, fluctuant swelling
with a bluish hue (Ibsen & Phelan, 7th Ed., Ch. 1).
Q10: Which of the following characteristics is MOST suggestive of a malignant lesion?
A. Painless, slow-growing, well-defined borders
B. Rapid growth, fixed to underlying structures, ulceration
C. Soft, compressible, blanches with pressure
D. Symmetrical, bilateral, asymptomatic
Correct Answer: B
Rationale: Malignant lesions often exhibit rapid growth, fixation to underlying structures
(indicating invasion), ulceration, and irregular borders. Painless slow growth and well-
defined borders are characteristic of benign lesions (Ibsen & Phelan, 7th Ed., Ch. 1).
Q11: During palpation of the cervical lymph nodes, a dental hygienist notes a firm, fixed,
non-tender lymph node. This finding is MOST concerning for:
