,Chapter 01: Introduction to Preliminary Diagnosis of Oral
ff ff ff ff ff ff ff
Lesions Ibsen: Oral Pathology for the Dental Hygienist, 7th Edition
ff u 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
Alobule is described as a segment or lobe that is part of a whole. Abulla is a large,
f ff ff ff ff ff ff ff ff ff ff ff ff ff f f ff ff ff
elevated lesion that contains serous fluid and may look like a blister. A vesicle is a small,
ff u ff ff ff ff ff ff ff ff ff ff ff ff ff ff ff
elevated lesion that contains serous fluid. Pustules are circumscribed elevations
ff ff ff ff ff ff ff ff ff ff
containing pus.
ff ff
REF: Vocabulary, Clinical of Soft Tissue Lesions, page 1 ff ff ff ff ff ff ff OBJ: 1
2. Alesion with a sessile base is described as
f 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
ff ff ff ff ff ff ff ff ff ff ff ff ff ff ff ff
ffin the surface epithelium. Astemlike lesion is referred to as pedunculated. Apedunculated
ff ff ff f f ff ff ff ff ff ff f f
lesion is stemlikeor stalk-based (similar to a mushroom).
ff ff ff ff ff ff ff ff
REF: Vocabulary, Clinical Appearance of Soft Tissue Lesions,
ff ff ff ff ff ff ff
page 1OBJ: 1
ff ff f f
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
ff ff ff ff ff ff ff ff ff ff ff
which tooth structure can be identified. No clinical component exists. Mandibular tori are
ff uu 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
ff ff ff f f ff ff ff ff ff ff
ffthrough clinical appearance. Black hairy tongue is diagnosed clinically. The filiform
ff ff ff ff ff ff ff ff ff ff
papillae on the dorsal tongue elongate and become brown or black. Causes include
ff ff ff ff ff ff ff ff ff ff ff ff ff
tobacco, alcohol, hydrogen peroxide, chemical rinses, antibiotics, and antacids.
ff ff ff ff ff ff ff ff ff
REF: Radiographic Diagnosis, page 9 ff ff ff OBJ: 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
ff ff ff ff ff ff ff ff ff ff ff
seen in 5% of the population. It is a variant of normal. Genetic factors are typically
ff ff uu ff ff ff ff ff ff ff ff ff ff ff ff ff
associated with the condition. Black hairy tongue is caused by a reaction to chemicals,
ff ff ff ff ff ff ff ff ff ff ff ff ff ff
tobacco, hydrogen peroxide, or antacids. The filiform papillae on the dorsal tongue
ff ff ff ff ff ff ff ff ff ff ff ff
become elongated and are dark brown to black.
ff f f ff ff ff ff ff ff
REF: Geographic Tongue, page 24 ff ff ff OBJ: 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.
f f uu 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
ff ff ff ff ff ff ff ff ff ff ff ff ff ff ff
palate. Diagnosis is made on the basis of clinical appearance. A palatal cyst appears
ff f f ff ff ff ff ff ff ff ff ff ff ff ff
radiolucent on a radiographic examination and is not diagnosed through clinical
ff ff f f ff ff ff ff ff ff ff ff
appearance. A mixed tumor orpleomorphic adenoma is a benign tumor of salivary
ff f f ff ff ff ff ff ff ff ff ff
gland origin, found unilaterally off the midline of the hard palate. It is
ff ff ff ff ff ff ff ff ff ff ff ff ff
composed of tumor tissue that is not bony hard to palpation.
ff ff ff ff ff ff ff ff ff ff ff
Ranula is a term used for a mucocele-like lesion that forms unilaterally on the floor of
ff ff ff ff ff ff ff ff ff ff ff ff ff ff ff
themouth.
ff
REF: Torus Palatinus, page 21 ff ff ff OBJ: 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
ff variant of normal that requires no treatment and is termed
uu 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
ff ff ff ff ff ff ff ff ff ff ff ff ff ff ff
or 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 ff
unknown. Whitesponge nevus is a genetic (autosomal dominant) trait. Clinically, it is
ff ff ff ff ff ff ff ff ff ff ff ff
characterized by a soft white, folded (or corrugated) oral mucosa. Athick layer of keratin
ff ff ff ff ff ff ff ff ff ff f ff ff ff
produces the whitening.
ff ff ff
REF: Leukoedema, page 23 ff ff OBJ: 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
f f ff ff ff ff f ff ff ff ff ff
associated with abnormal development of the enamel. Paget disease is a chronic
ff ff ff u ff ff ff ff ff ff ff ff
metabolic bone disease. A highly elevated serum alkaline phosphatase level contributes
ff ff ff ff ff ff ff ff ff ff ff
significantly to the diagnosis. A Stafne bone cyst is determined through surgical
ff ff ff ff ff ff ff ff ff ff ff ff
diagnosis in which entrapped salivary gland tissue is identified.
ff ff ff ff ff ff ff ff u
REF: Therapeutic Diagnosis, page 18 ff ff ff OBJ: 3
8. The gingival enlargement in this patient was caused by a calcium channel
ff ff ff ff ff ff ff ff ff ff ff
blocker. Which medication is the likely cause?
ff ff u 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
ff ff ff ff ff ff ff ff ff ff ff ff
orcontrol 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: Historical Diagnosis, Fig. 1.38, page 17 ff ff ff ff ff OBJ: 3
9. Radiographic features, including cotton-wool radiopacities and hypercementosis,
ff ff ff ff ff ff
ff areespecially 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
ff ff ff ff ff ff ff ff ff
radiopacities and hypercementosis are characteristic features. Dentinogenesis imperfecta is
ff u ff ff ff ff ff ff ff
a genetic condition involving a defect in the development of dentin. Anemia, a
ff ff ff ff ff ff ff ff ff ff ff ff ff
decrease in red blood cells, requires blood tests to determine the etiologic factors.
ff ff ff ff ff ff ff ff ff ff ff ff ff
Diabetes is a chronic disorder of carbohydrate metabolism characterized by
ff ff ff ff ff ff ff f f ff f f
abnormally high blood glucose levels.
ff ff f f ff ff
REF: Laboratory Diagnosis, Fig. 1.40, pages 16, 18 ff ff ff ff ff ff OBJ: 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
Lesions Ibsen: Oral Pathology for the Dental Hygienist, 7th Edition
ff u 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
Alobule is described as a segment or lobe that is part of a whole. Abulla is a large,
f ff ff ff ff ff ff ff ff ff ff ff ff ff f f ff ff ff
elevated lesion that contains serous fluid and may look like a blister. A vesicle is a small,
ff u ff ff ff ff ff ff ff ff ff ff ff ff ff ff ff
elevated lesion that contains serous fluid. Pustules are circumscribed elevations
ff ff ff ff ff ff ff ff ff ff
containing pus.
ff ff
REF: Vocabulary, Clinical of Soft Tissue Lesions, page 1 ff ff ff ff ff ff ff OBJ: 1
2. Alesion with a sessile base is described as
f 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
ff ff ff ff ff ff ff ff ff ff ff ff ff ff ff ff
ffin the surface epithelium. Astemlike lesion is referred to as pedunculated. Apedunculated
ff ff ff f f ff ff ff ff ff ff f f
lesion is stemlikeor stalk-based (similar to a mushroom).
ff ff ff ff ff ff ff ff
REF: Vocabulary, Clinical Appearance of Soft Tissue Lesions,
ff ff ff ff ff ff ff
page 1OBJ: 1
ff ff f f
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
ff ff ff ff ff ff ff ff ff ff ff
which tooth structure can be identified. No clinical component exists. Mandibular tori are
ff uu 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
ff ff ff f f ff ff ff ff ff ff
ffthrough clinical appearance. Black hairy tongue is diagnosed clinically. The filiform
ff ff ff ff ff ff ff ff ff ff
papillae on the dorsal tongue elongate and become brown or black. Causes include
ff ff ff ff ff ff ff ff ff ff ff ff ff
tobacco, alcohol, hydrogen peroxide, chemical rinses, antibiotics, and antacids.
ff ff ff ff ff ff ff ff ff
REF: Radiographic Diagnosis, page 9 ff ff ff OBJ: 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
ff ff ff ff ff ff ff ff ff ff ff
seen in 5% of the population. It is a variant of normal. Genetic factors are typically
ff ff uu ff ff ff ff ff ff ff ff ff ff ff ff ff
associated with the condition. Black hairy tongue is caused by a reaction to chemicals,
ff ff ff ff ff ff ff ff ff ff ff ff ff ff
tobacco, hydrogen peroxide, or antacids. The filiform papillae on the dorsal tongue
ff ff ff ff ff ff ff ff ff ff ff ff
become elongated and are dark brown to black.
ff f f ff ff ff ff ff ff
REF: Geographic Tongue, page 24 ff ff ff OBJ: 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.
f f uu 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
ff ff ff ff ff ff ff ff ff ff ff ff ff ff ff
palate. Diagnosis is made on the basis of clinical appearance. A palatal cyst appears
ff f f ff ff ff ff ff ff ff ff ff ff ff ff
radiolucent on a radiographic examination and is not diagnosed through clinical
ff ff f f ff ff ff ff ff ff ff ff
appearance. A mixed tumor orpleomorphic adenoma is a benign tumor of salivary
ff f f ff ff ff ff ff ff ff ff ff
gland origin, found unilaterally off the midline of the hard palate. It is
ff ff ff ff ff ff ff ff ff ff ff ff ff
composed of tumor tissue that is not bony hard to palpation.
ff ff ff ff ff ff ff ff ff ff ff
Ranula is a term used for a mucocele-like lesion that forms unilaterally on the floor of
ff ff ff ff ff ff ff ff ff ff ff ff ff ff ff
themouth.
ff
REF: Torus Palatinus, page 21 ff ff ff OBJ: 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
ff variant of normal that requires no treatment and is termed
uu 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
ff ff ff ff ff ff ff ff ff ff ff ff ff ff ff
or 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 ff
unknown. Whitesponge nevus is a genetic (autosomal dominant) trait. Clinically, it is
ff ff ff ff ff ff ff ff ff ff ff ff
characterized by a soft white, folded (or corrugated) oral mucosa. Athick layer of keratin
ff ff ff ff ff ff ff ff ff ff f ff ff ff
produces the whitening.
ff ff ff
REF: Leukoedema, page 23 ff ff OBJ: 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
f f ff ff ff ff f ff ff ff ff ff
associated with abnormal development of the enamel. Paget disease is a chronic
ff ff ff u ff ff ff ff ff ff ff ff
metabolic bone disease. A highly elevated serum alkaline phosphatase level contributes
ff ff ff ff ff ff ff ff ff ff ff
significantly to the diagnosis. A Stafne bone cyst is determined through surgical
ff ff ff ff ff ff ff ff ff ff ff ff
diagnosis in which entrapped salivary gland tissue is identified.
ff ff ff ff ff ff ff ff u
REF: Therapeutic Diagnosis, page 18 ff ff ff OBJ: 3
8. The gingival enlargement in this patient was caused by a calcium channel
ff ff ff ff ff ff ff ff ff ff ff
blocker. Which medication is the likely cause?
ff ff u 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
ff ff ff ff ff ff ff ff ff ff ff ff
orcontrol 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: Historical Diagnosis, Fig. 1.38, page 17 ff ff ff ff ff OBJ: 3
9. Radiographic features, including cotton-wool radiopacities and hypercementosis,
ff ff ff ff ff ff
ff areespecially 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
ff ff ff ff ff ff ff ff ff
radiopacities and hypercementosis are characteristic features. Dentinogenesis imperfecta is
ff u ff ff ff ff ff ff ff
a genetic condition involving a defect in the development of dentin. Anemia, a
ff ff ff ff ff ff ff ff ff ff ff ff ff
decrease in red blood cells, requires blood tests to determine the etiologic factors.
ff ff ff ff ff ff ff ff ff ff ff ff ff
Diabetes is a chronic disorder of carbohydrate metabolism characterized by
ff ff ff ff ff ff ff f f ff f f
abnormally high blood glucose levels.
ff ff f f ff ff
REF: Laboratory Diagnosis, Fig. 1.40, pages 16, 18 ff ff ff ff ff ff OBJ: 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.
