General and Oral Pathology for Dental
Hygiene Practice
Author(s)Myers, Sandra; Curran, Alice
TEST BANK
1
Reference: Ch. 1 — Terminology Used in Describing Oral
Pathologic Lesions — Lesion Morphology
Question stem: A 45-year-old patient presents with a 6-mm,
slightly raised, well-demarcated white lesion on the buccal
mucosa that is flat across the surface but rises less than 5 mm
from surrounding tissue. Which descriptive term best fits this
lesion?
A. Macule
B. Papule
C. Plaque
D. Nodule
Correct answer: C. Plaque
,Rationales:
• C (Correct): A plaque is a slightly raised, flat-topped lesion
with surface area larger than its height; this matches a
small, slightly raised white lesion on buccal mucosa.
(Myers & Curran discuss plaques as elevated, broad
lesions.)
• A: A macule is a flat, nonpalpable change in color (e.g.,
freckle); this lesion is raised, so macule is incorrect.
• B: A papule is a small, dome-shaped raised lesion typically
less than 5 mm in diameter and with vertical prominence
— the described lesion is broad and flat.
• D: A nodule is a larger, deeper, often spherical lesion that
extends into connective tissue; the lesion here is
superficial and flat-topped.
Teaching point: Plaques are flat-topped, slightly elevated
lesions with surface area exceeding height.
Tags: Interpretation of Findings | Application
Citation: Myers, S., & Curran, A. (2023). General and Oral
Pathology for Dental Hygiene Practice. Ch. 1.
2
Reference: Ch. 1 — Assessment of Oral Pathologic Lesions —
Patient Assessment and History
,Question stem: A 62-year-old smoker reports a painless ulcer
on the lateral tongue for 8 weeks that has not healed. On exam
the ulcer has a firm, indurated base. What is the most
appropriate next step?
A. Prescribe topical corticosteroid and review in 2 weeks
B. Obtain an incisional biopsy of the ulcer margin and base
C. Order antifungal rinse and follow up in 1 week
D. Reassure patient and chart as traumatic ulcer
Correct answer: B. Obtain an incisional biopsy of the ulcer
margin and base
Rationales:
• B (Correct): A persistent (>2 weeks), painless ulcer with
induration on the lateral tongue in an older smoker is
suspicious for squamous cell carcinoma; incisional biopsy
of the lesion margin and deep base is the diagnostic
standard.
• A: Topical steroids are for inflammatory/immune lesions;
using them risks delay of cancer diagnosis.
• C: Antifungal therapy is for suspected candidiasis and
would not be appropriate for a firm, indurated ulcer
suspicious for malignancy.
• D: Traumatic ulcers should heal after elimination of
trauma; this lesion is persistent and indurated —
reassurance alone is unsafe.
, Teaching point: Any persistent, indurated oral ulcer (>2 weeks)
requires prompt biopsy.
Tags: Clinical Application | Analysis
Citation: Myers, S., & Curran, A. (2023). General and Oral
Pathology for Dental Hygiene Practice. Ch. 1.
3
Reference: Ch. 1 — Supplemental Diagnostic Aides — Biopsy
Types and Indications
Question stem: A 1.2-cm, well-circumscribed white lesion on
the lower lip is clinically suspicious but small and accessible.
Which biopsy approach best balances diagnosis and treatment?
A. Incisional biopsy sampling the lesion edge only
B. Excisional biopsy removing the entire lesion with margin
C. Brush cytology and observation for 4 weeks
D. Defer biopsy and treat empirically with antifungal
Correct answer: B. Excisional biopsy removing the entire lesion
with margin
Rationales:
• B (Correct): For small, accessible lesions (<1–2 cm) that
can be removed entirely without significant morbidity,
excisional biopsy provides diagnostic tissue and is
therapeutic.
Hygiene Practice
Author(s)Myers, Sandra; Curran, Alice
TEST BANK
1
Reference: Ch. 1 — Terminology Used in Describing Oral
Pathologic Lesions — Lesion Morphology
Question stem: A 45-year-old patient presents with a 6-mm,
slightly raised, well-demarcated white lesion on the buccal
mucosa that is flat across the surface but rises less than 5 mm
from surrounding tissue. Which descriptive term best fits this
lesion?
A. Macule
B. Papule
C. Plaque
D. Nodule
Correct answer: C. Plaque
,Rationales:
• C (Correct): A plaque is a slightly raised, flat-topped lesion
with surface area larger than its height; this matches a
small, slightly raised white lesion on buccal mucosa.
(Myers & Curran discuss plaques as elevated, broad
lesions.)
• A: A macule is a flat, nonpalpable change in color (e.g.,
freckle); this lesion is raised, so macule is incorrect.
• B: A papule is a small, dome-shaped raised lesion typically
less than 5 mm in diameter and with vertical prominence
— the described lesion is broad and flat.
• D: A nodule is a larger, deeper, often spherical lesion that
extends into connective tissue; the lesion here is
superficial and flat-topped.
Teaching point: Plaques are flat-topped, slightly elevated
lesions with surface area exceeding height.
Tags: Interpretation of Findings | Application
Citation: Myers, S., & Curran, A. (2023). General and Oral
Pathology for Dental Hygiene Practice. Ch. 1.
2
Reference: Ch. 1 — Assessment of Oral Pathologic Lesions —
Patient Assessment and History
,Question stem: A 62-year-old smoker reports a painless ulcer
on the lateral tongue for 8 weeks that has not healed. On exam
the ulcer has a firm, indurated base. What is the most
appropriate next step?
A. Prescribe topical corticosteroid and review in 2 weeks
B. Obtain an incisional biopsy of the ulcer margin and base
C. Order antifungal rinse and follow up in 1 week
D. Reassure patient and chart as traumatic ulcer
Correct answer: B. Obtain an incisional biopsy of the ulcer
margin and base
Rationales:
• B (Correct): A persistent (>2 weeks), painless ulcer with
induration on the lateral tongue in an older smoker is
suspicious for squamous cell carcinoma; incisional biopsy
of the lesion margin and deep base is the diagnostic
standard.
• A: Topical steroids are for inflammatory/immune lesions;
using them risks delay of cancer diagnosis.
• C: Antifungal therapy is for suspected candidiasis and
would not be appropriate for a firm, indurated ulcer
suspicious for malignancy.
• D: Traumatic ulcers should heal after elimination of
trauma; this lesion is persistent and indurated —
reassurance alone is unsafe.
, Teaching point: Any persistent, indurated oral ulcer (>2 weeks)
requires prompt biopsy.
Tags: Clinical Application | Analysis
Citation: Myers, S., & Curran, A. (2023). General and Oral
Pathology for Dental Hygiene Practice. Ch. 1.
3
Reference: Ch. 1 — Supplemental Diagnostic Aides — Biopsy
Types and Indications
Question stem: A 1.2-cm, well-circumscribed white lesion on
the lower lip is clinically suspicious but small and accessible.
Which biopsy approach best balances diagnosis and treatment?
A. Incisional biopsy sampling the lesion edge only
B. Excisional biopsy removing the entire lesion with margin
C. Brush cytology and observation for 4 weeks
D. Defer biopsy and treat empirically with antifungal
Correct answer: B. Excisional biopsy removing the entire lesion
with margin
Rationales:
• B (Correct): For small, accessible lesions (<1–2 cm) that
can be removed entirely without significant morbidity,
excisional biopsy provides diagnostic tissue and is
therapeutic.
