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