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Chapter 01: Introduction to Preliminary Diagnosis of Oral Lesions
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Ibsen: Oral Pathology for the Dental Hygienist, 8th Edition
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MULTIPLE CHOICE b
1. Which descriptive term is described as a segment that is part of the whole?
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a. Bulla
b. Vesicle
c. Lobule
d. Pustule
ANS: C b
A lobule is described as a segment or lobe that is part of a whole. A bulla is a large, elevated
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lesion that contains serous fluid and may look like a blister. A vesicle is a small, elevated
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lesion that contains serous fluid. Pustules are circumscribed elevations containing pus.
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REF: b Vocabulary, Clinical of Soft Tissue Lesions, page 1 b b b b b b b OBJ: 1 b
2. A lesion with a sessile base is described as
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a. an ulcer. b
b. stemlike.
c. pedunculated.
d. flat and broad. b b
ANS: D b
Sessile describes the base of a lesion that is flat and broad. An ulcer is a break in the surface
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epithelium. A stemlike lesionNi sUrRefSeI
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edGtK
o Ia sNpGe.
b d uCnOcuMl a t e d. A pedunculated lesion is
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stemlike or stalk-based (similar to a mushroom).
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REF: Vocabulary, Clinical Appearance of Soft Tissue Lesions, page 1
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OBJ: 1
b b
3. Which condition is not diagnosed through clinical appearance?
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a. Mandibular tori b
b. Fordyce granules b
c. Black hairy tongue b b
d. Compound odontoma b
ANS: D b
The compound odontoma is initially identified radiographically as a radiopaque area in which
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tooth structure can be identified. No clinical component exists. Mandibular tori are identified
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clinically as areas of exostosis on the lingual aspects of mandibular premolars. Fordyce
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granules are yellow clusters of ectopic sebaceous glands diagnosed through clinical
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appearance. Black hairy tongue is diagnosed clinically. The filiform papillae on the dorsal
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tongue elongate and become brown or black. Causes include tobacco, alcohol, hydrogen
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peroxide, chemical rinses, antibiotics, and antacids.
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REF: b Radiographic Diagnosis, page 9 b b b OBJ: 3 b
4. Another name for geographic tongue is b b b b b
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a. median rhomboid glossitis. b b
b. benign migratory glossitis. b b
c. fissured tongue. b
d. black hairy tongue. b b
ANS: B b
Benign migratory glossitis is another name for geographic tongue. Research suggests that
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median rhomboid glossitis is associated with a chronic fungal infection from Candida
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albicans. Sometimes the condition resolves with antifungal therapy. Fissured tongue is seen in
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5% of the population. It is a variant of normal. Genetic factors are typically associated with
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the condition. Black hairy tongue is caused by a reaction to chemicals, tobacco, hydrogen
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peroxide, or antacids. The filiform papillae on the dorsal tongue become elongated and are
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dark brown to black.
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REF: b Geographic Tongue, page 24 b b b OBJ: 7 b
5. This bony hard structure in the midline of the hard palate is genetic in origin and inherited in
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an autosomal dominant manner. The diagnosis is made through clinical appearance. Which
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condition is suspected?
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a. Palatal cyst b
b. Torus palatinus b
c. Mixed tumor b
d. Ranula
ANS: B b
A torus palatinus is developmental and bony hard and is found on the midline of the palate.
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Diagnosis is made on the basis of clinical appearance. A palatal cyst appears radiolucent on a
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radiographic examination and is not diagnosed through clinical appearance. A mixed tumor or
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pleomorphic adenoma is a benign tumor of salivary gland origin, found unilaterally off the
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midline of the hard palate. It is composed of tumor tissue that is not bony hard to palpation.
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Ranula is a term used for a mucocele-like lesion that forms unilaterally on the floor of the
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mouth.
b
REF: b Torus Palatinus, page 21 b b b OBJ: 4 b
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6. The gray-white opalescent film seen on the buccal mucosa of 85% of black adults is a variant
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of normal that requires no treatment and is termed
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a. linea alba. b
b. leukoedema.
c. leukoplakia.
d. white sponge nevus. b b
ANS: B b
Leukoedema is a diffuse opalescence most commonly seen on the buccal mucosa in black
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individuals. Linea alba is a ―white line‖ that extends anteroposteriorly on the buccal mucosa
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balong the occlusal plane. It is most prominent in patients who have a clenching or grinding
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bhabit. Leukoplakia is a clinical term for a white lesion, the cause of which is unknown. White
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bsponge nevus is a genetic (autosomal dominant) trait. Clinically, it is characterized by a soft
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bwhite, folded (or corrugated) oral mucosa. A thick layer of keratin produces the whitening.
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REF: b Leukoedema, page 23 b b OBJ: 8 b
7. Which condition most likely responds to therapeutic diagnosis?
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a. Angular cheilitis b
b. Amelogenesis imperfecta b
c. Paget disease b
d. Stafne bone cyst b b
ANS: A b
Angular cheilitis most commonly responds to antifungal therapy once nutritional deficiencies
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have been ruled out. Amelogenesis imperfecta is a genetic condition associated with abnormal
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development of the enamel. Paget disease is a chronic metabolic bone disease. A highly
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elevated serum alkaline phospNhUatRa S
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n tG
b ri .
b uCteOs Msignificantl y to the diagnosis. A
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Stafne
b
bone cyst is determined through surgical diagnosis in which entrapped salivary gland tissue is
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identified.
b
REF: b Therapeutic Diagnosis, page 18 b b b OBJ: 3 b
8. The gingival enlargement in this patient was caused by a calcium channel blocker. Which
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medication is the likely cause?
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a. Dilantin
b. Nifedipine
c. Quinidine
d. Clozapine
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