**Board Review Oral Pathology

In which layer of the stratified epithelium is the generalized leukoedema caused by significant intercellular edema?

a. Corneum

b. Basal

c. Prickle

d. Granular

c. Prickle

What treatment does leukoedema require?

a. Nonsteroidal anti-inflammatory drugs

b. Excision

c. Antifungal drugs

d. No treatment

d. No treatment

A patient has a 2-mm probing depth on the facial aspect of tooth #6, and he has 3 mm of recession. What is the attachment loss in this area?

a. 5 mm

b. 2 mm

c. 3 mm

d. 1 mm

a. 5 mm

The tooth itself is capable of experiencing painful nerve sensation from all the following EXCEPT

a. pressure.

b. heat.

c. cold.

d. olfaction.

d. olfaction.

The type of tissue normally present around the canine area is

a. keratinized, stratified squamous epithelium.

b. nonkeratinized, stratified squamous epithelium.

c. keratinized, simple squamous epithelium.

d. pseudo-stratified columnar epithelium.

a. keratinized, stratified squamous epithelium.

The most appropriate connective tissue donor site would be the

a. buccal mucosa.

b. soft palate.

c. hard palate.

d. sublingual area.

c. hard palate.

A mucocele that is the result of trauma to a minor salivary duct. A mucocele is usually found on the

a. gingiva.

b. lower lip mucosa.

c. hard palate.

d. dorsum of the tongue.

b. lower lip mucosa.

A bony, developmental, benign asymptomatic area found on the midline of the hard palate that appears radiopaque on a radiograph is most likely a(n)

a. odontogenic myxoma.

b. median palatal cyst.

c. compound odontoma.

d. torus palatinus.

d. torus palatinus.

The pleomorphic adenoma is most often found in the

a. palate.

b. mandible.

c. buccal mucosa.

d. lymph nodes.

a. palate.

Which of the following cysts would create difficulty swallowing?

a. Branchial cleft

b. Thyroglossal

c. Nasopalatine

d. Stafne bone

b. Thyroglossal

Which disease may have oral characteristics similar to those found in necrotizing ulcerative gingivitis (NUG)?

a. Primary herpes

b. Mononucleosis

c. Leukemia

d. Nonthrombocytopenic purpura

c. Leukemia

A ranula usually is found on the

a. palate.

b. lower lip mucosa.

c. buccal mucosa.

d. floor of the mouth.

d. floor of the mouth.

A definitive dental diagnosis of soft tissue oral cancer is made by

a. a complete radiographic survey.

b. exfoliative cytology.

c. scalpel biopsy.

d. brush test.

c. scalpel biopsy.

Primordial cysts are most often found radiographically

a. in the anterior maxillary regions.

b. around a supernumerary tooth.

c. posterior to erupted third molars or in place of a tooth that was never present.

d. in the mandibular canine and first premolar areas.

c. posterior to erupted third molars or in place of a tooth that was never present.

The usual location of periapical cemento-osseous dysplasia (cementoma) is

a. mandibular anteriors.

b. maxillary anteriors.

c. the mandibular ramus.

d. maxillary premolars.

a. mandibular anteriors.

Which of the following is a rickettsial infection?

a. Malaria

b. Psittacosis

c. Rocky Mountain spotted fever

d. Tularemia

c. Rocky Mountain spotted fever

A slightly raised, noncoated, red rectangular area in the midline of the tongue has been present as long as the patient can remember. Once thought to be developmental, it is associated with Candida albicans. This condition is most likely

a. geographic tongue.

b. pathologic tongue.

c. median rhomboid glossitis.

d. fissured tongue.

c. median rhomboid glossitis.

A 30-year-old patient calls and complains of sudden swelling in both sides of his neck, which seems to be enlarging. His record indicates that he recently has cancelled two appointments. He needs to have restorative care completed on the mandibular second molars, which have extensive decay. The patient may have

a. actinomycosis

b. mumps

c. syphilis

d. Ludwig angina

d. Ludwig angina

Which of the following two diseases represent different forms of infection resulting from the same virus?

a. Measles and German measles

b. Chickenpox and smallpox

c. Bacterial pneumonia and croup

d. Shingles and chickenpox

d. Shingles and chickenpox

(case) The gingival enlargement was caused by a calcium channel blocker drug. The condition was most likely caused by

a. phenytoin (Dilantin).

b. enalapril (Vasotec).

c. fluoxetine (Prozac).

d. nifedipine (Procardia).

d. nifedipine (Procardia).

Which of the following produce(s) no radiographic image?

a. Dental caries

b. Supernumerary teeth

c. Odontoma

d. Fibroma

d. Fibroma

Which of the following diagnostic methods is most reliable and ensures the highest degree of accuracy when evaluating squamous cell carcinoma?

a. Surgical

b. Microscopic

c. Therapeutic

d. Clinical

b. Microscopic

Which of the following does not define the term pathogenesis?

a. How the lesion begins

b. Behavior of the lesion

c. Clinical picture of the lesion

d. Development of the lesion

c. Clinical picture of the lesion

A pyogenic granuloma is known to scar down to a(n)

a. pregnancy tumor.

b. fibrogranuloma.

c. lipoma.

d. osteoma.

b. fibrogranuloma.

The patient is a 28-year-old woman who is pregnant. A gingival lesion involving the interproximal papillae between teeth #7 and #8 on the labial surface is bright red, soft, and spongy; it bleeds easily. The histology report shows proliferation of inflammatory cells and thin epithelium. The lesion described is most likely

a. fibroma.

b. pyogenic granuloma.

c. redundant tissue.

d. papilloma.

b. pyogenic granuloma.

Which one of the following cysts has the potential for developing into an ameloblastoma?

a. Lateral periodontal cyst

b. Primordial cyst

c. Stafne bone cyst

d. Residual cyst

b. Primordial cyst

The clinical oral examination of the patient reveals a possible leukoplakia. The first course of action should be to

a. perform a scalpel biopsy.

b. perform a cytologic smear.

c. give the patient vitamin A therapy.

d. have the patient return in 2 months to evaluate the growth.

a. perform a scalpel biopsy.

Which one of the following tests is not used for pemphigus?

a. Pels-Macht

b. Tzanck

c. Enzyme-linked immunosorbent assay (ELISA)

d. Nikolsky sign

c. Enzyme-linked immunosorbent assay (ELISA)

A palatal condition of an elderly patient that is primarily caused by chronic irritation from the suction chamber of a denture is clinically observed as

a. fibroma.

b. papilloma.

c. papillary hyperplasia.

d. median palatal cyst.

c. papillary hyperplasia

A lesion found on the buccal mucosa of a 30-year-old white woman is pink, well defined, and soft to palpation. It has been slow growing and histologically consists of collagenous fibers, fibroblasts, and fibrocytes, but with no fat cells or bone. It has a pedunculated base. The lesion is most likely a

a. sarcoma.

b. fibroma.

c. fibrolipoma.

d. fibro-osteoma.

b. fibroma.

A radiolucent lesion in the posterior part of the mandible anterior to the angle has the radiographic features of a cyst. After surgical intervention, the histology report shows submaxillary salivary gland tissue; also, the lesion is not lined with epithelium. One may conclude that the lesion is most likely a(n)

a. residual cyst.

b. traumatic bone cyst.

c. lingual mandibular bone concavity.

d. ameloblastoma.

c. lingual mandibular bone concavity.

A cyst commonly found unilaterally in the floor of the mouth changes size between meals. Clinically, it has a bluish hue. It may be caused by

a. decayed tooth.

b. blockage or trauma to a major salivary duct.

c. failure of developmental fusion of the branchial arches.

d. medications.

b. blockage or trauma to a major salivary duct.

The onset of this chronic, recurring autoimmune disease is at 30 years, with no gender predilection. A triad of symptomatic locations (oral, eye, and genital) is involved, and two of the three areas must be present to make the diagnosis of

a. erythema multiforme.

b. Stevens-Johnson syndrome.

c. Behçet syndrome.

d. minor aphthous ulcers.

c. Behçet syndrome.

For which one of the following is the etiology definitely known to be an irritant?

a. Papilloma

b. Torus

c. Granuloma

d. Lipoma

c. Granuloma

A tooth involved in a cyst is discovered to be nonvital on pulp testing. The cyst is probably a

a. residual cyst.

b. lateral periodontal cyst.

c. radicular cyst.

d. dentigerous cyst.

c. radicular cyst.

Which one of the following can be a characteristic of pemphigus vulgaris?

a. Nikolsky sign

b. Occurs predominantly in African American females

c. Is caused by a drug reaction

d. Occurs predominantly in white males

a. Nikolsky sign

The clinical assessment reveals an inflamed, palpable benign tumor in the anterior of the palate, lingual to the maxillary incisors. The tumor arises from deeper tissue and appears to originate from the periodontal ligament. The radiograph shows the lesion infiltrating bone but no metastasis. The patient is a 35-year-old woman. A possible diagnosis is a

a. peripheral giant cell granuloma.

b. lipoma.

c. torus palatinus.

d. pleomorphic adeoma.

a. peripheral giant cell granuloma.

Which one of the following cysts is the result of extracting a tooth without the cystic sac?

a. Radicular cyst

b. Residual cyst

c. Lateral periodontal cyst

d. Primordial cyst

b. Residual cyst

Which one of the following diagnostic processes should be applied to establish the diagnosis of nicotine stomatitis?

a. Surgical and microscopic

b. Radiographic

c. Laboratory

d. Clinical and historical

d. Clinical and historical

Clinically, this benign white, cauliflower-like lesion usually on the palate is similar to a wart. The histology report indicates long, finger-like projections of stratified squamous epithelium. The etiology is human papillomavirus (HPV) types 6 and 11. What is the most likely condition?

a. Verruca vulgaris

b. Papilloma

c. Aspirin burn

d. Linea alba

b. Papilloma

In which of the following locations is a lateral periodontal cyst usually found?

a. Between the roots of mandibular canines and premolars

b. Between the roots of maxillary central incisors

c. On the maxillary canine

d. In the mandibular third molar area

a. Between the roots of mandibular canines and premolars

A platelet count of 150,000 to 400,000/mm3 of blood and a normal bleeding time are not indicative of

a. thrombocytopenia

b. anemia

c. leukemia

d. nonthrombocytopenic purpura

a. thrombocytopenia

All the following are characteristic of necrotizing ulcerative gingivitis EXCEPT

a. punched-out papillae and craters.

b. hyperkeratinization.

c. odor.

d. pain and bleeding.

b. hyperkeratinization.

What is the causative agent of herpangina?

a. Chickenpox virus

b. Coxsackievirus

c. Epstein-Barr virus

d. Varicella-zoster virus

b. Coxsackievirus

In treating fibrous dysplasia, which one of the following would not be advised because it can trigger a malignancy?

a. Radiation

b. Surgery

c. Chemotherapy

d. Bone marrow depressants

a. Radiation

Precocious puberty is most characteristic of

a. Jaffe syndrome.

b. monostotic fibrous dysplasia.

c. cherubism.

d. McCune-Albright syndrome.

d. McCune-Albright syndrome.

Achlorhydria, inability to absorb vitamin B12, and burning, painful tongue are characteristics of

a. thrombocytopenia.

b. hypervitaminosis.

c. pernicious anemia.

d. hyperkeratosis.

c. pernicious anemia.

Bone marrow anoxia occurs in

a. secondary polycythemia.

b. pernicious anemia.

c. thalassemia.

d. aplastic anemia.

a. secondary polycythemia.

In which of the following cysts are nonvital teeth involved?

a. Nasoalveolar cyst

b. Lateral periodontal cyst

c. Radicular cyst

d. Cyst of the incisive papilla

c. Radicular cyst

Which of the following cysts could develop into an ameloblastoma?

a. Residual cyst

b. Primordial cyst

c. Median mandibular cyst

d. Lateral periodontal cyst

b. Primordial cyst

A radicular cyst is most often caused by

a. deep restorations.

b. trauma.

c. primary occlusal traumatism.

d. dental caries.

d. dental caries.

Epulis fissuratum is caused by

a. denture flange.

b. suction chamber of a denture.

c. allergic reaction to acrylic material.

d. denture cleaners.

a. denture flange.

Sickle cell anemia is of hereditary origin and occurs primarily in

a. whites.

b. Native Americans.

c. Eskimo population.

d. African Americans.

d. African Americans.

Which one of the following is found in a person with achlorhydria?

a. Low blood glucose level

b. Lack of hydrochloric acid

c. Too much hydrochloric acid

d. Xerostomia

b. Lack of hydrochloric acid

Which one of the following is found in a person with leukopenia?

a. Decrease in the number of white blood cells

b. Increase in the number of white blood cells

c. Decrease in the number of red blood cells

d. Decrease in the number of platelets

a. Decrease in the number of white blood cells

Which clinical feature is most associated with bulimia?

a. Abrasion

b. Abfraction

c. Erosion

d. Attrition

c. Erosion

Aspirin burn is caused by the misuse of aspirin. It will appear on the buccal mucosa as

a. a white lesion with sudden onset.

b. an erythematous lesion with chronic history.

c. a lesion requiring microscopic analysis.

d. an allergic reaction.

a. a white lesion with sudden onset.

On which location do you normally see thermal burns?

a. Hard palate

b. Soft palate

c. Buccal mucosa

d. Floor of the mouth

a. Hard palate

Necrotizing sialometaplasia is observed clinically on the

a. palate.

b. buccal mucosa.

c. lower lip.

d. floor of the mouth.

a. palate.

Which one of the following does not cause gingival enlargement?

a. Dilantin

b. Cyclosporine

c. Acyclovir

d. Norvasc

c. Acyclovir

Pulp polyps are seen clinically

a. within the open crown of a carious tooth.

b. at the apex of a tooth.

c. between the roots of teeth.

d. on the buccal aspect of alveolar bone.

a. within the open crown of a carious tooth.

Which one of the recurrent aphthous ulcers occurs most often?

a. Minor aphthous ulcers

b. Major aphthous ulcers

c. Sutton Disease

d. Herpetiform

a. Minor aphthous ulcers

Wickham striae and desquamative gingivitis are characteristic features of

a. erythema multiforme.

b. Cannon disease.

c. pemphigus.

d. lichen planus.

a. erythema multiforme.

Which one of the following is not part of the triad of symptoms associated with reactive arthritis?

a. arthritis.

b. urethritis.

c. conjunctivitis.

d. appendicitis.

d. appendicitis.

The varicella-zoster virus causes

a. measles.

b. mononucleosis.

c. verruca vulgaris.

d. shingles.

d. shingles.

Which of the following provides the most conclusive diagnostic evidence in distinguishing pemphigus from pemphigoid?

a. Clinical picture

b. History of the disease

c. Biopsy and histology report

d. Nikolsky's sign

c. Biopsy and histology report

An isolated radiopaque area in the periodontal ligament space is observed on a patient's radiographs. This radiopaque structure may be a(an)

a. epithelial rest.

b. cementum spur.

c. exostosis of alveolar bone.

d. cementicle.

d. cementicle.

A lesion is noted on the lips of a 40-year-old female patient. The lesion appears as several discrete vesicles; some have ulcerated. When questioned, the patient says she "always gets a sore like that" before she develops a cold. The patient most likely has

a. a chancre.

b. perlèche.

c. an aphthous ulcer.

d. herpes labialis.

d. herpes labialis.

Which of the following statements most accurately describes the most common effect of pregnancy on the health of the mother's oral tissues?

a. Pregnancy-associated gingivitis is caused by hormonal changes, and nothing can be done about it.

b. Pregnant women can often experience the growth of tumors in the mouth that relate to hormonal changes.

c. Hormonal changes during pregnancy result in increased bacteria and increased gingival response to plaque biofilm.

d. Pregnancy results in hormonal changes, but these changes do not affect the mother's oral tissues.

c. Hormonal changes during pregnancy result in increased bacteria and increased gingival response to plaque biofilm.

An intraoral examination of the gingiva reveals a clinical picture of punched-out papillae. The patient complains of pain and a bad taste. The history indicates that the patient's diet is poor, that he has been under stress, and that he has had little rest. What is the best course of action for the condition you suspect?

a. Perform culture and laboratory studies

b. Apply a therapeutic course, debride the mouth, and recommend hydrogen peroxide oral rinse and possibly systemic antibiotics

c. Immediately refer the patient to a periodontist

d. Perform periodontal therapy, including extensive root planing and stain removal

b. Apply a therapeutic course, debride the mouth, and recommend hydrogen peroxide oral rinse and possibly systemic antibiotics

Which one of the following is most important to the pathologist when a chondroma is suspected?

a. A complete personal history of the patient

b. Remove a very small part of the tumor in question

c. Submission of a "large enough" sample of tissue for histologic study because a chondroma resembles a malignant chondrosarcoma

d. Radiographs of all large bones

c. Submission of a "large enough" sample of tissue for histologic study because a chondroma resembles a malignant chondrosarcoma

The clinical assessment of a patient's lesion is best described as a well-defined, yellowish, blister-like eruption. Straw fluid may be aspirated. It is a rare, benign neoplasm. The histology report shows a predominance of fat cells. The lesion is a(n)

a. papilloma.

b. osteoma.

c. lipoma.

d. fibroma.

c. lipoma.

Clinical assessment of a lesion reveals a severe hypersensitivity reaction, with the lips and tongue especially affected. Additionally, "bull's eye" or "target" skin lesions are present, and the onset of all lesions was abrupt or "explosive." The condition is most likely

a. lichen planus.

b. herpes.

c. erythema multiforme.

d. mononucleosis.

c. erythema multiforme.

The dental hygienist observes an adult patient with the following clinical feature and medical history: gingival enlargement resulting from a history of Zimmerman-Laband syndrome and phenytoin (Dilantin) therapy. Which one of the following statements is correct?

a. The patient should stop taking the drug.

b. An overgrowth of the connective tissue is present.

c. The epithelium remains the same.

d. A gingivectomy would "cure" the condition.

b. An overgrowth of the connective tissue is present.

Which of the following makes Behçet's syndrome different from recurrent ulcerative stomatitis?

a. Bull's-eye skin lesions

b. Triad of locations of lesions (oral, eye, and genital)

c. Exudate from lesions

d. Mesenchymal proliferations

b. Triad of locations of lesions (oral, eye, and genital)

Which one of the following is referred to as "Cooley anemia"?

a. Acute anemia

b. Thalassemia

c. Primary aplastic anemia

d. Thrombocytopenia

b. Thalassemia