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