Chapter 01: Introduction to Preliminary Diagnosis of Oral Lesions
Ibsen: Oral Pathology for the Dental Hygienist, 7th Edition
MULTIPLE CHOICE
1. Which descriptive term is described as a segment that is part of the whole?
a. Bulla
b. Vesicle
c. Lobule
d. Pustule
ANS: C
A lobule is described as a segment or lobe that is part of a whole. A bulla is a large, elevated
lesion that contains serous fluid and may look like a blister. A vesicle is a small, elevated
lesion that contains serous fluid. Pustules are circumscribed elevations containing pus.
REF: Vocabulary, Clinical of Soft Tissue Lesions, page 1 OBJ: 1
2. A lesion with a sessile base is described as
a. an ulcer.
b. stemlike.
c. pedunculated.
d. flat and broad.
ANS: D
Sessile describes the base of a lesion that is flat and broad. An ulcer is a break in the surface
epithelium. A stemlike lesion is referred to as pedunculated. A pedunculated lesion is stemlike
or stalk-based (similar to a mushroom).
REF: Vocabulary, Clinical Appearance of Soft Tissue Lesions, page 1
OBJ: 1
3. Which condition is not diagnosed through clinical appearance?
a. Mandibular tori
b. Fordyce granules
c. Black hairy tongue
d. Compound odontoma
ANS: D
The compound odontoma is initially identified radiographically as a radiopaque area in which
tooth structure can be identified. No clinical component exists. Mandibular tori are identified
clinically as areas of exostosis on the lingual aspects of mandibular premolars. Fordyce
granules are yellow clusters of ectopic sebaceous glands diagnosed through clinical
appearance. Black hairy tongue is diagnosed clinically. The filiform papillae on the dorsal
tongue elongate and become brown or black. Causes include tobacco, alcohol, hydrogen
peroxide, chemical rinses, antibiotics, and antacids.
REF: Radiographic Diagnosis, page 9 OBJ: 3
4. Another name for geographic tongue is
, a. median rhomboid glossitis.
b. benign migratory glossitis.
c. fissured tongue.
d. black hairy tongue.
ANS: B
Benign migratory glossitis is another name for geographic tongue. Research suggests that
median rhomboid glossitis is associated with a chronic fungal infection from Candida
albicans. Sometimes the condition resolves with antifungal therapy. Fissured tongue is seen in
5% of the population. It is a variant of normal. Genetic factors are typically associated with
the condition. Black hairy tongue is caused by a reaction to chemicals, tobacco, hydrogen
peroxide, or antacids. The filiform papillae on the dorsal tongue become elongated and are
dark brown to black.
REF: Geographic Tongue, page 24 OBJ: 7
5. This bony hard structure in the midline of the hard palate is genetic in origin and inherited in
an autosomal dominant manner. The diagnosis is made through clinical appearance. Which
condition is suspected?
a. Palatal cyst
b. Torus palatinus
c. Mixed tumor
d. Ranula
ANS: B
A torus palatinus is developmental and bony hard and is found on the midline of the palate.
Diagnosis is made on the basis of clinical appearance. A palatal cyst appears radiolucent on a
radiographic examination and is not diagnosed through clinical appearance. A mixed tumor or
pleomorphic adenoma is a benign tumor of salivary gland origin, found unilaterally off the
midline of the hard palate. It is composed of tumor tissue that is not bony hard to palpation.
Ranula is a term used for a mucocele-like lesion that forms unilaterally on the floor of the
mouth.
REF: Torus Palatinus, page 21 OBJ: 4
6. The gray-white opalescent film seen on the buccal mucosa of 85% of black adults is a variant
of normal that requires no treatment and is termed
a. linea alba.
b. leukoedema.
c. leukoplakia.
d. white sponge nevus.
ANS: B
Leukoedema is a diffuse opalescence most commonly seen on the buccal mucosa in black
individuals. Linea alba is a “white line” that extends anteroposteriorly on the buccal mucosa
along the occlusal plane. It is most prominent in patients who have a clenching or grinding
habit. Leukoplakia is a clinical term for a white lesion, the cause of which is unknown. White
sponge nevus is a genetic (autosomal dominant) trait. Clinically, it is characterized by a soft
white, folded (or corrugated) oral mucosa. A thick layer of keratin produces the whitening.
REF: Leukoedema, page 23 OBJ: 8
, 7. Which condition most likely responds to therapeutic diagnosis?
a. Angular cheilitis
b. Amelogenesis imperfecta
c. Paget disease
d. Stafne bone cyst
ANS: A
Angular cheilitis most commonly responds to antifungal therapy once nutritional deficiencies
have been ruled out. Amelogenesis imperfecta is a genetic condition associated with abnormal
development of the enamel. Paget disease is a chronic metabolic bone disease. A highly
elevated serum alkaline phosphatase level contributes significantly to the diagnosis. A Stafne
bone cyst is determined through surgical diagnosis in which entrapped salivary gland tissue is
identified.
REF: Therapeutic Diagnosis, page 18 OBJ: 3
8. The gingival enlargement in this patient was caused by a calcium channel blocker. Which
medication is the likely cause?
a. Dilantin
b. Nifedipine
c. Quinidine
d. Clozapine
ANS: B
Nifedipine is a calcium channel blocker. Dilantin is an anticonvulsant used to prevent or
control seizures. Quinidine is an antiarrhythmic agent used to treat cardiac arrhythmias.
Clozapine is an antipsychotic used in the management of psychotic symptoms in
schizophrenia.
REF: Historical Diagnosis, Fig. 1.38, page 17 OBJ: 3
9. Radiographic features, including cotton-wool radiopacities and hypercementosis, are
especially helpful in the diagnosis of
a. Paget disease.
b. dentinogenesis imperfecta.
c. anemia.
d. diabetes.
ANS: A
Paget disease is a chronic metabolic bone disease. Radiographically, cotton-wool radiopacities
and hypercementosis are characteristic features. Dentinogenesis imperfecta is a genetic
condition involving a defect in the development of dentin. Anemia, a decrease in red blood
cells, requires blood tests to determine the etiologic factors. Diabetes is a chronic disorder of
carbohydrate metabolism characterized by abnormally high blood glucose levels.
REF: Laboratory Diagnosis, Fig. 1.40, pages 16, 18 OBJ: 3
10. In internal resorption, the radiolucency seen on radiographic examination is usually
a. well circumscribed.
b. diffuse.
, c. multilocular.
d. unilocular.
ANS: B
Diffuse borders are ill defined, making it impossible to detect the exact parameters of the
lesion. Therefore treatment is more difficult. Well circumscribed describes borders that are
specifically defined. Exact margins of the lesion are identified. Multilocular has also been
described as resembling “soap bubbles”; lobes seem to fuse together to make up the lesion.
This term has been used to describe the odontogenic keratocyst. Unilocular means having one
compartment or unit that is well defined. This term is often used to describe the radicular cyst.
REF: Vocabulary, Radiographic Terms Used to Describe Lesions in Bone, page 5
OBJ: 1
11. Which condition is diagnosed through clinical appearance?
a. Fordyce granules
b. Unerupted mesiodens
c. Periapical cemento-osseous dysplasia
d. Traumatic bone cyst
ANS: A
Fordyce granules are diagnosed on the basis of their clinical appearance. They are ectopic
sebaceous glands seen on the lips and buccal mucosa. Clinically, they appear as yellow
lobules in clusters and are considered a variant of normal. Unerupted mesiodens requires a
radiographic image for diagnosis. Periapical cemento-osseous dysplasia requires a
radiographic image, specific patient history, and a pulp test to evaluate tooth vitality.
Traumatic bone cyst requires a radiographic image and surgical intervention to establish a
diagnosis.
REF: Clinical Diagnosis, page 7 | Fordyce Granules, page 20 OBJ: 3
12. Retrocuspid papillae are located on the
a. palate.
b. floor of the mouth.
c. gingival margin of the lingual aspect of mandibular cuspids.
d. canine eminence.
ANS: C
Retrocuspid papillae are located on the gingival margin of the lingual aspect of mandibular
cuspids. Retrocuspid papillae are not located on the palate. Retrocuspid papillae are not
located on the floor of the mouth. Retrocuspid papillae are not located on the canine
eminence.
REF: Retrocuspid Papilla, page 22 OBJ: 3
13. Which condition is not considered a variant of normal?
a. Fordyce granules
b. Leukoedema
c. Linea alba
d. Pyogenic granuloma
ANS: D
Ibsen: Oral Pathology for the Dental Hygienist, 7th Edition
MULTIPLE CHOICE
1. Which descriptive term is described as a segment that is part of the whole?
a. Bulla
b. Vesicle
c. Lobule
d. Pustule
ANS: C
A lobule is described as a segment or lobe that is part of a whole. A bulla is a large, elevated
lesion that contains serous fluid and may look like a blister. A vesicle is a small, elevated
lesion that contains serous fluid. Pustules are circumscribed elevations containing pus.
REF: Vocabulary, Clinical of Soft Tissue Lesions, page 1 OBJ: 1
2. A lesion with a sessile base is described as
a. an ulcer.
b. stemlike.
c. pedunculated.
d. flat and broad.
ANS: D
Sessile describes the base of a lesion that is flat and broad. An ulcer is a break in the surface
epithelium. A stemlike lesion is referred to as pedunculated. A pedunculated lesion is stemlike
or stalk-based (similar to a mushroom).
REF: Vocabulary, Clinical Appearance of Soft Tissue Lesions, page 1
OBJ: 1
3. Which condition is not diagnosed through clinical appearance?
a. Mandibular tori
b. Fordyce granules
c. Black hairy tongue
d. Compound odontoma
ANS: D
The compound odontoma is initially identified radiographically as a radiopaque area in which
tooth structure can be identified. No clinical component exists. Mandibular tori are identified
clinically as areas of exostosis on the lingual aspects of mandibular premolars. Fordyce
granules are yellow clusters of ectopic sebaceous glands diagnosed through clinical
appearance. Black hairy tongue is diagnosed clinically. The filiform papillae on the dorsal
tongue elongate and become brown or black. Causes include tobacco, alcohol, hydrogen
peroxide, chemical rinses, antibiotics, and antacids.
REF: Radiographic Diagnosis, page 9 OBJ: 3
4. Another name for geographic tongue is
, a. median rhomboid glossitis.
b. benign migratory glossitis.
c. fissured tongue.
d. black hairy tongue.
ANS: B
Benign migratory glossitis is another name for geographic tongue. Research suggests that
median rhomboid glossitis is associated with a chronic fungal infection from Candida
albicans. Sometimes the condition resolves with antifungal therapy. Fissured tongue is seen in
5% of the population. It is a variant of normal. Genetic factors are typically associated with
the condition. Black hairy tongue is caused by a reaction to chemicals, tobacco, hydrogen
peroxide, or antacids. The filiform papillae on the dorsal tongue become elongated and are
dark brown to black.
REF: Geographic Tongue, page 24 OBJ: 7
5. This bony hard structure in the midline of the hard palate is genetic in origin and inherited in
an autosomal dominant manner. The diagnosis is made through clinical appearance. Which
condition is suspected?
a. Palatal cyst
b. Torus palatinus
c. Mixed tumor
d. Ranula
ANS: B
A torus palatinus is developmental and bony hard and is found on the midline of the palate.
Diagnosis is made on the basis of clinical appearance. A palatal cyst appears radiolucent on a
radiographic examination and is not diagnosed through clinical appearance. A mixed tumor or
pleomorphic adenoma is a benign tumor of salivary gland origin, found unilaterally off the
midline of the hard palate. It is composed of tumor tissue that is not bony hard to palpation.
Ranula is a term used for a mucocele-like lesion that forms unilaterally on the floor of the
mouth.
REF: Torus Palatinus, page 21 OBJ: 4
6. The gray-white opalescent film seen on the buccal mucosa of 85% of black adults is a variant
of normal that requires no treatment and is termed
a. linea alba.
b. leukoedema.
c. leukoplakia.
d. white sponge nevus.
ANS: B
Leukoedema is a diffuse opalescence most commonly seen on the buccal mucosa in black
individuals. Linea alba is a “white line” that extends anteroposteriorly on the buccal mucosa
along the occlusal plane. It is most prominent in patients who have a clenching or grinding
habit. Leukoplakia is a clinical term for a white lesion, the cause of which is unknown. White
sponge nevus is a genetic (autosomal dominant) trait. Clinically, it is characterized by a soft
white, folded (or corrugated) oral mucosa. A thick layer of keratin produces the whitening.
REF: Leukoedema, page 23 OBJ: 8
, 7. Which condition most likely responds to therapeutic diagnosis?
a. Angular cheilitis
b. Amelogenesis imperfecta
c. Paget disease
d. Stafne bone cyst
ANS: A
Angular cheilitis most commonly responds to antifungal therapy once nutritional deficiencies
have been ruled out. Amelogenesis imperfecta is a genetic condition associated with abnormal
development of the enamel. Paget disease is a chronic metabolic bone disease. A highly
elevated serum alkaline phosphatase level contributes significantly to the diagnosis. A Stafne
bone cyst is determined through surgical diagnosis in which entrapped salivary gland tissue is
identified.
REF: Therapeutic Diagnosis, page 18 OBJ: 3
8. The gingival enlargement in this patient was caused by a calcium channel blocker. Which
medication is the likely cause?
a. Dilantin
b. Nifedipine
c. Quinidine
d. Clozapine
ANS: B
Nifedipine is a calcium channel blocker. Dilantin is an anticonvulsant used to prevent or
control seizures. Quinidine is an antiarrhythmic agent used to treat cardiac arrhythmias.
Clozapine is an antipsychotic used in the management of psychotic symptoms in
schizophrenia.
REF: Historical Diagnosis, Fig. 1.38, page 17 OBJ: 3
9. Radiographic features, including cotton-wool radiopacities and hypercementosis, are
especially helpful in the diagnosis of
a. Paget disease.
b. dentinogenesis imperfecta.
c. anemia.
d. diabetes.
ANS: A
Paget disease is a chronic metabolic bone disease. Radiographically, cotton-wool radiopacities
and hypercementosis are characteristic features. Dentinogenesis imperfecta is a genetic
condition involving a defect in the development of dentin. Anemia, a decrease in red blood
cells, requires blood tests to determine the etiologic factors. Diabetes is a chronic disorder of
carbohydrate metabolism characterized by abnormally high blood glucose levels.
REF: Laboratory Diagnosis, Fig. 1.40, pages 16, 18 OBJ: 3
10. In internal resorption, the radiolucency seen on radiographic examination is usually
a. well circumscribed.
b. diffuse.
, c. multilocular.
d. unilocular.
ANS: B
Diffuse borders are ill defined, making it impossible to detect the exact parameters of the
lesion. Therefore treatment is more difficult. Well circumscribed describes borders that are
specifically defined. Exact margins of the lesion are identified. Multilocular has also been
described as resembling “soap bubbles”; lobes seem to fuse together to make up the lesion.
This term has been used to describe the odontogenic keratocyst. Unilocular means having one
compartment or unit that is well defined. This term is often used to describe the radicular cyst.
REF: Vocabulary, Radiographic Terms Used to Describe Lesions in Bone, page 5
OBJ: 1
11. Which condition is diagnosed through clinical appearance?
a. Fordyce granules
b. Unerupted mesiodens
c. Periapical cemento-osseous dysplasia
d. Traumatic bone cyst
ANS: A
Fordyce granules are diagnosed on the basis of their clinical appearance. They are ectopic
sebaceous glands seen on the lips and buccal mucosa. Clinically, they appear as yellow
lobules in clusters and are considered a variant of normal. Unerupted mesiodens requires a
radiographic image for diagnosis. Periapical cemento-osseous dysplasia requires a
radiographic image, specific patient history, and a pulp test to evaluate tooth vitality.
Traumatic bone cyst requires a radiographic image and surgical intervention to establish a
diagnosis.
REF: Clinical Diagnosis, page 7 | Fordyce Granules, page 20 OBJ: 3
12. Retrocuspid papillae are located on the
a. palate.
b. floor of the mouth.
c. gingival margin of the lingual aspect of mandibular cuspids.
d. canine eminence.
ANS: C
Retrocuspid papillae are located on the gingival margin of the lingual aspect of mandibular
cuspids. Retrocuspid papillae are not located on the palate. Retrocuspid papillae are not
located on the floor of the mouth. Retrocuspid papillae are not located on the canine
eminence.
REF: Retrocuspid Papilla, page 22 OBJ: 3
13. Which condition is not considered a variant of normal?
a. Fordyce granules
b. Leukoedema
c. Linea alba
d. Pyogenic granuloma
ANS: D
