Pharm Chapter 25: Oral Conditions and Their Treatment

1. A patient presents with an oral ulcer that begins at an interdental papillae. The condition most likely is:

Herpetic gingivostomatitis

Acute necrotizing ulcerative gingivitis (ANUG)

Aphthous stomatitis

Pericoronitis

Acute necrotizing ulcerative gingivitis (ANUG)

3 multiple choice options

2. Antibiotics should be considered for the treatment of ANUG:

For all patients

For all adult patients but not for children

Only if the patient is running a fever

Only if the patient is immunocompromised or if evidence of systemic involvement exists

Only if the patient is immunocompromised or if evidence of systemic involvement exists

3 multiple choice options

3. Which of the following may be used as a rinse for ANUG?

Phenol

Essential oil

Chlorhexidine gluconate

Hydrogen peroxide

Chlorhexidine gluconate

3 multiple choice options

4. Approximately __________% of the adult population has been exposed to herpes simplex virus (HSV).

10

20 to 30

50 to 60

80 to 90

80 to 90

3 multiple choice options

5. Acyclovir ointment is the treatment of choice for primary and recurrent herpes labialis in immunocompetent patients. It is more effective than acyclovir cream in recurrent herpes.

Both the statement and the reason are correct and related.

The statements and the reason are both correct but not related.

The statement is correct, but the reason is not.

The statement is not correct, but the reason is accurate.

Neither the statement nor the reason is correct.

Neither the statement nor the reason is correct.

Brand Names: Zovirax · Sitavig

3 multiple choice options

6. The following agents are useful in the treatment of oral herpes lesions except one. Which one is the exception?

a. Diphenhydramine liquid

b. Acyclovir

c. Corticosteroids

d. Viscous lidocaine

e. Sodium carboxymethylcellulose

Corticosteroids

7. Cheilosis can result from deficiencies of vitamins:

a. B1 and B2

b. B2 and B6

c. B6 and B12

d. B9 and B12

B2 and B6

3 multiple choice options

8. Alveolar osteitis, or "dry socket," occurs in 2% to 3% of all tooth extractions, most commonly in the __________ region.

a. Mandibular incisor

b. Mandibular molar

c. Maxillary incisor

d. Maxillary molar

Mandibular molar

3 multiple choice options

9. The following statements are true of alveolar osteitis except one. Which one is the exception?

a. Alveolar osteitis occurs in 2% to 3% of all extractions.

b. Cigarette smoking increases its likelihood.

c. Alveolar osteitis is attributed to loss or necrosis of the blood clot at the extraction site.

d. Antibiotic prophylaxis is recommended.

e. Diabetes is a predisposing factor.

Antibiotic prophylaxis is recommended.

3 multiple choice options

10. Recurrent aphthous stomatitis (RAS) is a common oral lesion occurring in approximately __________% of the population

a. 10

b. 20

c. 30

d. 40

20

3 multiple choice options

11. The etiology of aphthous stomatitis involves an immunologic component in which a significant role is played by:

a. B lymphocytes

b. T lymphocytes

c. Plasma cells

d. Monocytes

T lymphocytes

3 multiple choice options

12. Which of the following conditions involves a focal immune dysfunction in which a decreased ratio of T-helper to T-suppressor/cytotoxic cells can be seen?

a. Alveolar osteitis

b. Angular cheilitis

c. ANUG

d. RAS

e. Geographic tongue

RAS (Recurrent aphthous stomatitis)

13. The treatment of RAS may include any of the following except one. Which one is the exception?

a. Corticosteroids

b. Topical lauryl sulfate

c. Diphenhydramine

d. Amlexanox

b. Topical lauryl sulfate

14. Which subtype of lichen planus is characterized by a white, lace-like pattern intersecting to form a reticular pattern?

a. Striated

b. Plaquelike

c. Erosive

d. Hypertrophic

e. Idiopathic

Hypertrophic

15. Glossopyrosis is another term for:

a. Geographic tongue

b. Pericoronitis

c. Vincent infection

d. Bald tongue

e. Burning tongue

e. Burning tongue

16. Pericoronitis most commonly applies to partially erupted:

a. Incisors

b. Premolars

c. First molars

d. Third molars

d. Third molars

17. Long-term exposure of the lip to __________ can cause irreversible tissue changes known as actinic cheilitis.

a. Smoking tobacco

b. The sun

c. Alcohol

d. Cold wind

The sun

18. Actinic lip changes, if keratotic, are best treated with:

a. Sunscreen with a sun protection factor of 15 or greater

b. Acyclovir

c. 5-Fluorouracil (5-FU)

d. Topical steroids

e. Diphenhydramine

5-Fluorouracil (5-FU)

19. Treatment of xerostomia consists of all of the following actions except one. Which one is the exception?

a. Change the medication or reduce the dose.

b. Prescribe an anticholinergic agent to stimulate an increase in saliva.

c. Prescribe artificial saliva.

d. Use fluoride trays and gels to counteract the formation of caries.

e. Use water or sugarless gum instead of gums, hard candies, and beverages containing sugar.

Prescribe an anticholinergic agent to stimulate an increase in saliva.

Pilocarpine is a(n) cholinergic agent that produces an increase in saliva.

20. Pilocarpine is a(n) __________ agent that produces an increase in saliva.

a. Adrenergic

b. Antiadrenergic

c. Cholinergic

d. Anticholinergic

Cholinergic

21. Gingival enlargement is a side effect of some drugs. Corticosteroids are used for the treatment of this condition.

a. Both statements are true.

b. Both statements are false.

c. The first statement is true, the second statement is false.

d. The first statement is false, the second statement is true.

c. The first statement is true, the second statement is false.

FALSE -> Cyclosporine

22. Which of the following agents is associated with gingival enlargement?

a. Chlorhexidine

b. Cyclosporine

c. Angiotensin-receptor blocker

d. Clindamycin

e. Cyclobenzaprine

Cyclosporine

23. Chlorhexidine causes intrinsic discoloration of the teeth, whereas stannous fluoride causes extrinsic discoloration.

a. Both parts of the statement are true.

b. Both parts of the statement are false.

c. The first part of the statement is true, the second part is false.

d. The first part of the statement is false, the second part is true.

d. The first part of the statement is false, the second part is true.

24. T/F: The ulcerated area of ANUG begins at the marginal gingiva.

True

False

False

interdental papillae

25. T/F: Acyclovir should not be used prophylactically to prevent minor outbreaks of herpes because excessive use may lead to resistant strains of herpes.

True

False

True

26. A decrease in vertical dimension is thought to contribute to angular cheilitis.

True

False

False

27. The most common drug implicated in lichenoid-like eruptions is hydrochlorothiazide.

True

False

True

28 Most cases of osteonecrosis of the jaw (ONJ) are associated with:

a. infection.

b. cancer therapy.

c. bisphosphonate therapy.

d. use of steroids.

bisphosphonate therapy.

29. According to the Centers for Disease Control, patients with active herpetic lesions can be treated provided that they are either emergency dental care or the treatment is for the lesions only. All other care should be delayed, until the lesions have healed.

a. Both statements are true.

b. Both statements are false.

c. The first statement is true, the second statement is false.

d. The first statement is false, the second statement is true.

a. Both statements are true.

30. HSV-1 is involved in most _____ lesions and transmission is usually ________.

Oral; not sexual

31. Which antiviral agent is available without a prescription?

Docosanol

32. Candida albicans is a part of the normal oral flora. A decrease in occlusal vertical dimension (OVD) will often lead to angular cheilitis.

a. Both statements are false.

b. The first statement is false, the second is true.

c. The first statement is true, the second is false.

d. Both statements are true.

c. The first statement is true, the second is false.

33. Which is the most potent topical corticosteroid?

Clobetasol (Temovate)

34. The majority of cases of osteonecrosis of the jaw (ONJ) are associated with patients taking corticosteroids.

True

False

False

The majority of cases of osteonecrosis of the jaw (ONJ) are associated with patients taking very potent intravenous bisphosphonates124. These drugs are given frequently and in relatively high doses. ONJ may also occur spontaneously or after dental extraction or trauma, high-dose IV bisphosphonate therapy, or high-dose denosumab 120 mg subcutaneously once/month (eg, for cancer treatment). ONJ may be a refractory osteomyelitis rather than true osteonecrosis, particularly when developing after bisphosphonate use.

35. Which is the most common drug associated with lichenoid-like eruptions?

hydrochlorothiazide