GENERAL AND ORAL PATHOLOGY FOR
DENTAL HYGIENE PRACTICE
AUTHOR(S)MYERS, SANDRA; CURRAN,
ALICE
TEST BANK
1
Reference
Ch. 1 — OVERVIEW OF ORAL AND MAXILLOFACIAL PATHOLOGY
Question Stem
A 58-year-old patient presents with a 3-month history of a
slowly enlarging, painless, firm swelling on the lateral border of
the tongue. Based on pathologic principles, which attribute
most strongly suggests that this lesion requires prompt biopsy
rather than observation?
Options
A. Patient reports occasional irritation when eating spicy foods
B. Lesion has been present for less than 2 weeks
C. Lesion is firm, fixed to deeper tissues, and progressively
,enlarging over months
D. Lesion is fluctuant and compressible with palpation
Correct Answer
C
Rationales
• Correct (C): Progressive enlargement, firmness, fixation to
deeper tissues, and a months-long timeline raise concern
for neoplastic processes; these features support biopsy for
definitive diagnosis.
• Incorrect (A): Occasional irritation is nonspecific and does
not by itself justify immediate invasive diagnostics.
• Incorrect (B): A lesion present for less than 2 weeks is
often observed for spontaneous resolution unless other
concerning signs exist.
• Incorrect (D): A fluctuant, compressible lesion suggests a
cystic or vascular lesion and may be evaluated differently
(e.g., aspiration, imaging) rather than immediate excisional
biopsy.
Teaching Point
Progressive, firm, fixed oral lesions merit biopsy to exclude
malignancy.
Citation
Myers, S., & Curran, A. (2023). General and Oral Pathology for
Dental Hygiene Practice (3rd Ed.). Ch. 1.
,2
Reference
Ch. 1 — The Practice of Oral and Maxillofacial Pathology
Question Stem
A general dentist identifies an unusual white patch on the
buccal mucosa and asks you whether to order an exfoliative
cytology or refer for incisional biopsy. Which principle of oral
and maxillofacial pathology should guide your
recommendation?
Options
A. Exfoliative cytology always replaces biopsy for definitive
diagnosis
B. Incisional biopsy is preferred when the lesion’s clinical
features are suspicious for dysplasia or carcinoma
C. Cytology is indicated only for pigmented lesions
D. Referral is unnecessary if lesion is asymptomatic
Correct Answer
B
Rationales
• Correct (B): When clinical features suggest dysplasia or
malignancy (e.g., nonhomogeneous white patch,
induration), incisional biopsy provides tissue architecture
necessary for definitive diagnosis.
, • Incorrect (A): Exfoliative cytology can be adjunctive but
does not always replace biopsy due to limited ability to
assess tissue architecture.
• Incorrect (C): Cytology is not limited to pigmented lesions;
pigment evaluation often requires biopsy.
• Incorrect (D): Asymptomatic lesions can still be malignant;
absence of symptoms does not preclude referral or biopsy
when suspicious features exist.
Teaching Point
Incisional biopsy is required for lesions clinically suspicious for
dysplasia or carcinoma.
Citation
Myers, S., & Curran, A. (2023). General and Oral Pathology for
Dental Hygiene Practice (3rd Ed.). Ch. 1.
3
Reference
Ch. 1 — Assessment of Oral Pathologic Lesions
Question Stem
During an oral examination you note an exophytic lesion with a
pedunculated base on the gingiva. Which descriptive terms
most precisely guide a differential diagnosis?
Options
A. Endophytic, indurated, flat
DENTAL HYGIENE PRACTICE
AUTHOR(S)MYERS, SANDRA; CURRAN,
ALICE
TEST BANK
1
Reference
Ch. 1 — OVERVIEW OF ORAL AND MAXILLOFACIAL PATHOLOGY
Question Stem
A 58-year-old patient presents with a 3-month history of a
slowly enlarging, painless, firm swelling on the lateral border of
the tongue. Based on pathologic principles, which attribute
most strongly suggests that this lesion requires prompt biopsy
rather than observation?
Options
A. Patient reports occasional irritation when eating spicy foods
B. Lesion has been present for less than 2 weeks
C. Lesion is firm, fixed to deeper tissues, and progressively
,enlarging over months
D. Lesion is fluctuant and compressible with palpation
Correct Answer
C
Rationales
• Correct (C): Progressive enlargement, firmness, fixation to
deeper tissues, and a months-long timeline raise concern
for neoplastic processes; these features support biopsy for
definitive diagnosis.
• Incorrect (A): Occasional irritation is nonspecific and does
not by itself justify immediate invasive diagnostics.
• Incorrect (B): A lesion present for less than 2 weeks is
often observed for spontaneous resolution unless other
concerning signs exist.
• Incorrect (D): A fluctuant, compressible lesion suggests a
cystic or vascular lesion and may be evaluated differently
(e.g., aspiration, imaging) rather than immediate excisional
biopsy.
Teaching Point
Progressive, firm, fixed oral lesions merit biopsy to exclude
malignancy.
Citation
Myers, S., & Curran, A. (2023). General and Oral Pathology for
Dental Hygiene Practice (3rd Ed.). Ch. 1.
,2
Reference
Ch. 1 — The Practice of Oral and Maxillofacial Pathology
Question Stem
A general dentist identifies an unusual white patch on the
buccal mucosa and asks you whether to order an exfoliative
cytology or refer for incisional biopsy. Which principle of oral
and maxillofacial pathology should guide your
recommendation?
Options
A. Exfoliative cytology always replaces biopsy for definitive
diagnosis
B. Incisional biopsy is preferred when the lesion’s clinical
features are suspicious for dysplasia or carcinoma
C. Cytology is indicated only for pigmented lesions
D. Referral is unnecessary if lesion is asymptomatic
Correct Answer
B
Rationales
• Correct (B): When clinical features suggest dysplasia or
malignancy (e.g., nonhomogeneous white patch,
induration), incisional biopsy provides tissue architecture
necessary for definitive diagnosis.
, • Incorrect (A): Exfoliative cytology can be adjunctive but
does not always replace biopsy due to limited ability to
assess tissue architecture.
• Incorrect (C): Cytology is not limited to pigmented lesions;
pigment evaluation often requires biopsy.
• Incorrect (D): Asymptomatic lesions can still be malignant;
absence of symptoms does not preclude referral or biopsy
when suspicious features exist.
Teaching Point
Incisional biopsy is required for lesions clinically suspicious for
dysplasia or carcinoma.
Citation
Myers, S., & Curran, A. (2023). General and Oral Pathology for
Dental Hygiene Practice (3rd Ed.). Ch. 1.
3
Reference
Ch. 1 — Assessment of Oral Pathologic Lesions
Question Stem
During an oral examination you note an exophytic lesion with a
pedunculated base on the gingiva. Which descriptive terms
most precisely guide a differential diagnosis?
Options
A. Endophytic, indurated, flat
