,Chapter 01: Introduction to Preliminary Diagnosis of Oral LesionsIbsen
v v v v v v v v v
: Oral Pathology for the Dental Hygienist, 7th Edition
v v v v v v v v
MULTIPLEvCHOICE
1. Whichvdescriptivevtermvisvdescribedvasvavsegmentvthatvisvpartvofvthevwhole?
a. Bulla
b. Vesicle
c. Lobule
d. Pustule
ANS:v C
Avlobulevisvdescribedvasvavsegmentvorvlobevthatvisvpartvofvavwhole.vAvbullavisvavlarge,velevatedvlesi
onvthatvcontainsvserousvfluidvandvmayvlookvlikevavblister.vAvvesiclevisvavsmall,velevatedvlesionvthat
vcontainsvserousvfluid.vPustulesvarevcircumscribed velevationsvcontainingvpus.
REF:v Vocabulary,vClinicalvofvSoftvTissuevLesions,vpagev1 OBJ:v 1
2. Avlesionvwithvavsessilevbasevisvdescribedvas
a. anvulcer.
b. stemlike.
c. pedunculated.
d. flatvandvbroad.
ANS:v D
Sessilevdescribesvthevbasevofvavlesionvthatvisvflatvandvbroad.vAnvulcervisvavbreakvinvthevsurfacevepit
helium.vAvstemlikevlesionvisvreferredvtovasvpedunculated.vAvpedunculatedvlesionvisvstemlikevorvsta
lk-basedv(similarvtovavmushroom).
REF:vVocabulary,vClinicalvAppearancevofvSoftvTissuevLesions,vpagev1vO
BJ:v 1
3. Whichvconditionvisvnotvdiagnosedvthroughvclinicalvappearance?
a. Mandibularvtori
b. Fordycevgranules
c. Blackvhairyvtongue
d. Compoundvodontoma
ANS:v D
Thevcompoundvodontomavisvinitiallyvidentifiedvradiographicallyvasvavradiopaquevareavinvwhichvto
othvstructurevcanvbevidentified.vNovclinicalvcomponentvexists.vMandibularvtorivarevidentifiedvclin
icallyvasvareasvofvexostosisvonvthevlingualvaspectsvofvmandibularvpremolars.vFordycevgranulesvar
evyellowvclustersvofvectopicvsebaceousvglandsvdiagnosedvthroughvclinicalvappearance.vBlackvhai
ryvtonguevisvdiagnosedvclinically.vThevfiliformvpapillaevonvthevdorsalvtonguevelongatevandvbeco
mevbrownvorvblack.vCausesvincludevtobacco,valcohol,vhydrogenvperoxide,vchemicalvrinses,vantib
iotics,vandvantacids.
REF:v RadiographicvDiagnosis,vpagev9 OBJ:v 3
4. Anothervnamevforvgeographicvtonguevis
, a. medianvrhomboidvglossitis.
b. benignvmigratoryvglossitis.
c. fissuredvtongue.
d. blackvhairyvtongue.
ANS:v B
Benignvmigratoryvglossitisvisvanothervnamevforvgeographicvtongue.vResearchvsuggestsvthatvmedi
anvrhomboidvglossitisvisvassociatedvwithvavchronicvfungalvinfectionvfromvCandidavalbicans.vSo
metimesvthevconditionvresolvesvwithvantifungalvtherapy.vFissuredvtonguevisvseenvinv5%vofvthevpo
pulation.vItvisvavvariantvofvnormal.vGeneticvfactorsvarevtypicallyvassociatedvwithvthevcondition.vBl
ackvhairyvtonguevisvcausedvbyvavreactionvtovchemicals,vtobacco,vhydrogenvperoxide,vorvantacids.v
Thevfiliformvpapillaevonvthevdorsalvtonguevbecomevelongatedvandvarevdarkvbrownvtovblack.
REF:v GeographicvTongue,vpagev24 OBJ:v 7
5. Thisvbonyvhardvstructurevinvthevmidlinevofvthevhardvpalatevisvgeneticvinvoriginvandvinheritedvinva
nvautosomalvdominantvmanner.vThevdiagnosisvisvmadevthroughvclinicalvappearance.vWhichvco
nditionvisvsuspected?
a. Palatalvcyst
b. Torusvpalatinus
c. Mixedvtumor
d. Ranula
ANS:v B
Avtorusvpalatinusvisvdevelopmentalvandvbonyvhardvandvisvfoundvonvthevmidlinevofvthevpalate.vDia
gnosisvisvmadevonvthevbasisvofvclinicalvappearance.vAvpalatalvcystvappearsvradiolucentvonvavradio
graphicvexaminationvandvisvnotvdiagnosedvthroughvclinicalvappearance.vAvmixedvtumorvorvpleom
orphicvadenomavisvavbenignvtumorvofvsalivaryvglandvorigin,vfoundvunilaterallyvoffvthevmidlinevofv
thevhardvpalate.vItvisvcomposedvofvtumorvtissuevthatvisvnotvbonyvhardvtovpalpation.
Ranulavisvavtermvusedvforvavmucocele-
likevlesionvthatvformsvunilaterallyvonvthevfloorvofvthevmouth.
REF:v TorusvPalatinus,vpagev21 OBJ:v 4
6. Thevgray-
whitevopalescentvfilmvseenvonvthevbuccalvmucosavofv85%vofvblackvadultsvisvavvariantvofvnormalvt
hatvrequiresvnovtreatmentvandvisvtermed
a. lineavalba.
b. leukoedema.
c. leukoplakia.
d. whitevspongevnevus.
ANS:v B
Leukoedemavisvavdiffusevopalescencevmostvcommonlyvseenvonvthevbuccalvmucosavinvblackvindiv
iduals.vLineavalbavisvav“whitevline”vthatvextendsvanteroposteriorlyvonvthevbuccalvmucosavalongvth
evocclusalvplane.vItvisvmostvprominentvinvpatientsvwhovhavevavclenchingvorvgrindingvhabit.vLeuko
plakiavisvavclinicalvtermvforvavwhitevlesion,vthevcausevofvwhichvisvunknown.vWhitevspongevnevusvi
svavgeneticv(autosomalvdominant)vtrait.vClinically,vitvisvcharacterizedvbyvavsoftvwhite,vfoldedv(orvc
orrugated)voralvmucosa.vAvthickvlayervofvkeratinvproducesvthevwhitening.
REF:v Leukoedema,vpagev23 OBJ:v 8
, 7. Whichvconditionvmostvlikelyvrespondsvtovtherapeuticvdiagnosis?
a. Angularvcheilitis
b. Amelogenesisvimperfecta
c. Pagetvdisease
d. Stafnevbonevcyst
ANS:v A
Angularvcheilitisvmostvcommonlyvrespondsvtovantifungalvtherapyvoncevnutritionalvdeficienciesvh
avevbeenvruledvout.vAmelogenesisvimperfectavisvavgeneticvconditionvassociatedvwithvabnormalvde
velopmentvofvthevenamel.vPagetvdiseasevisvavchronicvmetabolicvbonevdisease.vAvhighlyvelevatedvs
erumvalkalinevphosphatasevlevelvcontributesvsignificantlyvtovthevdiagnosis.vAvStafnevbonevcystvis
vdeterminedvthroughvsurgicalvdiagnosisvinvwhichventrappedvsalivaryvglandvtissuevisvidentified.
REF:v TherapeuticvDiagnosis,vpagev18 OBJ:v 3
8. Thevgingivalvenlargementvinvthisvpatientvwasvcausedvbyvavcalciumvchannelvblocker.v
Whichvmedicationvisvthevlikelyvcause?
a. Dilantin
b. Nifedipine
c. Quinidine
d. Clozapine
ANS:v B
Nifedipinevisvavcalciumvchannelvblocker.vDilantinvisvanvanticonvulsantvusedvtovpreventvorvcontrolv
seizures.vQuinidinevisvanvantiarrhythmicvagentvusedvtovtreatvcardiacvarrhythmias.vClozapinevisva
nvantipsychoticvusedvinvthevmanagementvofvpsychoticvsymptomsvinvschizophrenia.
REF:v HistoricalvDiagnosis,vFig.v1.38,vpagev17 OBJ:v 3
9. Radiographicvfeatures,vincludingvcotton-
woolvradiopacitiesvandvhypercementosis,varevespeciallyvhelpfulvinvthevdiagnosisvof
a. Pagetvdisease.
b. dentinogenesisvimperfecta.
c. anemia.
d. diabetes.
ANS:v A
Pagetvdiseasevisvavchronicvmetabolicvbonevdisease.vRadiographically,vcotton-
woolvradiopacitiesvandvhypercementosisvarevcharacteristicvfeatures.vDentinogenesisvimperfectavi
svavgeneticvconditionvinvolvingvavdefectvinvthevdevelopmentvofvdentin.vAnemia,vavdecreasevinvred
vbloodvcells,vrequires vbloodvtestsvtovdeterminevthevetiologicvfactors.vDiabetesvisvavchronicvdisord
ervofvcarbohydratevmetabolismvcharacterizedvbyvabnormallyvhighvbloodvglucosevlevels.
REF:v LaboratoryvDiagnosis,vFig.v1.40,vpagesv16,v18 OBJ:v 3
10. Invinternalvresorption,vthevradiolucencyvseenvonvradiographicvexaminationvisvusually
a. wellvcircumscribed.
b. diffuse.
v v v v v v v v v
: Oral Pathology for the Dental Hygienist, 7th Edition
v v v v v v v v
MULTIPLEvCHOICE
1. Whichvdescriptivevtermvisvdescribedvasvavsegmentvthatvisvpartvofvthevwhole?
a. Bulla
b. Vesicle
c. Lobule
d. Pustule
ANS:v C
Avlobulevisvdescribedvasvavsegmentvorvlobevthatvisvpartvofvavwhole.vAvbullavisvavlarge,velevatedvlesi
onvthatvcontainsvserousvfluidvandvmayvlookvlikevavblister.vAvvesiclevisvavsmall,velevatedvlesionvthat
vcontainsvserousvfluid.vPustulesvarevcircumscribed velevationsvcontainingvpus.
REF:v Vocabulary,vClinicalvofvSoftvTissuevLesions,vpagev1 OBJ:v 1
2. Avlesionvwithvavsessilevbasevisvdescribedvas
a. anvulcer.
b. stemlike.
c. pedunculated.
d. flatvandvbroad.
ANS:v D
Sessilevdescribesvthevbasevofvavlesionvthatvisvflatvandvbroad.vAnvulcervisvavbreakvinvthevsurfacevepit
helium.vAvstemlikevlesionvisvreferredvtovasvpedunculated.vAvpedunculatedvlesionvisvstemlikevorvsta
lk-basedv(similarvtovavmushroom).
REF:vVocabulary,vClinicalvAppearancevofvSoftvTissuevLesions,vpagev1vO
BJ:v 1
3. Whichvconditionvisvnotvdiagnosedvthroughvclinicalvappearance?
a. Mandibularvtori
b. Fordycevgranules
c. Blackvhairyvtongue
d. Compoundvodontoma
ANS:v D
Thevcompoundvodontomavisvinitiallyvidentifiedvradiographicallyvasvavradiopaquevareavinvwhichvto
othvstructurevcanvbevidentified.vNovclinicalvcomponentvexists.vMandibularvtorivarevidentifiedvclin
icallyvasvareasvofvexostosisvonvthevlingualvaspectsvofvmandibularvpremolars.vFordycevgranulesvar
evyellowvclustersvofvectopicvsebaceousvglandsvdiagnosedvthroughvclinicalvappearance.vBlackvhai
ryvtonguevisvdiagnosedvclinically.vThevfiliformvpapillaevonvthevdorsalvtonguevelongatevandvbeco
mevbrownvorvblack.vCausesvincludevtobacco,valcohol,vhydrogenvperoxide,vchemicalvrinses,vantib
iotics,vandvantacids.
REF:v RadiographicvDiagnosis,vpagev9 OBJ:v 3
4. Anothervnamevforvgeographicvtonguevis
, a. medianvrhomboidvglossitis.
b. benignvmigratoryvglossitis.
c. fissuredvtongue.
d. blackvhairyvtongue.
ANS:v B
Benignvmigratoryvglossitisvisvanothervnamevforvgeographicvtongue.vResearchvsuggestsvthatvmedi
anvrhomboidvglossitisvisvassociatedvwithvavchronicvfungalvinfectionvfromvCandidavalbicans.vSo
metimesvthevconditionvresolvesvwithvantifungalvtherapy.vFissuredvtonguevisvseenvinv5%vofvthevpo
pulation.vItvisvavvariantvofvnormal.vGeneticvfactorsvarevtypicallyvassociatedvwithvthevcondition.vBl
ackvhairyvtonguevisvcausedvbyvavreactionvtovchemicals,vtobacco,vhydrogenvperoxide,vorvantacids.v
Thevfiliformvpapillaevonvthevdorsalvtonguevbecomevelongatedvandvarevdarkvbrownvtovblack.
REF:v GeographicvTongue,vpagev24 OBJ:v 7
5. Thisvbonyvhardvstructurevinvthevmidlinevofvthevhardvpalatevisvgeneticvinvoriginvandvinheritedvinva
nvautosomalvdominantvmanner.vThevdiagnosisvisvmadevthroughvclinicalvappearance.vWhichvco
nditionvisvsuspected?
a. Palatalvcyst
b. Torusvpalatinus
c. Mixedvtumor
d. Ranula
ANS:v B
Avtorusvpalatinusvisvdevelopmentalvandvbonyvhardvandvisvfoundvonvthevmidlinevofvthevpalate.vDia
gnosisvisvmadevonvthevbasisvofvclinicalvappearance.vAvpalatalvcystvappearsvradiolucentvonvavradio
graphicvexaminationvandvisvnotvdiagnosedvthroughvclinicalvappearance.vAvmixedvtumorvorvpleom
orphicvadenomavisvavbenignvtumorvofvsalivaryvglandvorigin,vfoundvunilaterallyvoffvthevmidlinevofv
thevhardvpalate.vItvisvcomposedvofvtumorvtissuevthatvisvnotvbonyvhardvtovpalpation.
Ranulavisvavtermvusedvforvavmucocele-
likevlesionvthatvformsvunilaterallyvonvthevfloorvofvthevmouth.
REF:v TorusvPalatinus,vpagev21 OBJ:v 4
6. Thevgray-
whitevopalescentvfilmvseenvonvthevbuccalvmucosavofv85%vofvblackvadultsvisvavvariantvofvnormalvt
hatvrequiresvnovtreatmentvandvisvtermed
a. lineavalba.
b. leukoedema.
c. leukoplakia.
d. whitevspongevnevus.
ANS:v B
Leukoedemavisvavdiffusevopalescencevmostvcommonlyvseenvonvthevbuccalvmucosavinvblackvindiv
iduals.vLineavalbavisvav“whitevline”vthatvextendsvanteroposteriorlyvonvthevbuccalvmucosavalongvth
evocclusalvplane.vItvisvmostvprominentvinvpatientsvwhovhavevavclenchingvorvgrindingvhabit.vLeuko
plakiavisvavclinicalvtermvforvavwhitevlesion,vthevcausevofvwhichvisvunknown.vWhitevspongevnevusvi
svavgeneticv(autosomalvdominant)vtrait.vClinically,vitvisvcharacterizedvbyvavsoftvwhite,vfoldedv(orvc
orrugated)voralvmucosa.vAvthickvlayervofvkeratinvproducesvthevwhitening.
REF:v Leukoedema,vpagev23 OBJ:v 8
, 7. Whichvconditionvmostvlikelyvrespondsvtovtherapeuticvdiagnosis?
a. Angularvcheilitis
b. Amelogenesisvimperfecta
c. Pagetvdisease
d. Stafnevbonevcyst
ANS:v A
Angularvcheilitisvmostvcommonlyvrespondsvtovantifungalvtherapyvoncevnutritionalvdeficienciesvh
avevbeenvruledvout.vAmelogenesisvimperfectavisvavgeneticvconditionvassociatedvwithvabnormalvde
velopmentvofvthevenamel.vPagetvdiseasevisvavchronicvmetabolicvbonevdisease.vAvhighlyvelevatedvs
erumvalkalinevphosphatasevlevelvcontributesvsignificantlyvtovthevdiagnosis.vAvStafnevbonevcystvis
vdeterminedvthroughvsurgicalvdiagnosisvinvwhichventrappedvsalivaryvglandvtissuevisvidentified.
REF:v TherapeuticvDiagnosis,vpagev18 OBJ:v 3
8. Thevgingivalvenlargementvinvthisvpatientvwasvcausedvbyvavcalciumvchannelvblocker.v
Whichvmedicationvisvthevlikelyvcause?
a. Dilantin
b. Nifedipine
c. Quinidine
d. Clozapine
ANS:v B
Nifedipinevisvavcalciumvchannelvblocker.vDilantinvisvanvanticonvulsantvusedvtovpreventvorvcontrolv
seizures.vQuinidinevisvanvantiarrhythmicvagentvusedvtovtreatvcardiacvarrhythmias.vClozapinevisva
nvantipsychoticvusedvinvthevmanagementvofvpsychoticvsymptomsvinvschizophrenia.
REF:v HistoricalvDiagnosis,vFig.v1.38,vpagev17 OBJ:v 3
9. Radiographicvfeatures,vincludingvcotton-
woolvradiopacitiesvandvhypercementosis,varevespeciallyvhelpfulvinvthevdiagnosisvof
a. Pagetvdisease.
b. dentinogenesisvimperfecta.
c. anemia.
d. diabetes.
ANS:v A
Pagetvdiseasevisvavchronicvmetabolicvbonevdisease.vRadiographically,vcotton-
woolvradiopacitiesvandvhypercementosisvarevcharacteristicvfeatures.vDentinogenesisvimperfectavi
svavgeneticvconditionvinvolvingvavdefectvinvthevdevelopmentvofvdentin.vAnemia,vavdecreasevinvred
vbloodvcells,vrequires vbloodvtestsvtovdeterminevthevetiologicvfactors.vDiabetesvisvavchronicvdisord
ervofvcarbohydratevmetabolismvcharacterizedvbyvabnormallyvhighvbloodvglucosevlevels.
REF:v LaboratoryvDiagnosis,vFig.v1.40,vpagesv16,v18 OBJ:v 3
10. Invinternalvresorption,vthevradiolucencyvseenvonvradiographicvexaminationvisvusually
a. wellvcircumscribed.
b. diffuse.
