Oral Pathology for the Dental Hygienist 6th Edition Test Bank

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Chapter 01: Introduction to Preliminary Diagnosis of Oral LesionsTest BankMULTIPLE CHOICE1.Which of the following would be described as a segment that is part of the whole?A.BullaB.VesicleC.LobuleD.PustuleANS:CFeedbackAA bulla is a large, elevated lesion that contains serous fluid and may look like ablister.BA vesicle is a small, elevated lesion that contains serous fluid.CCorrect! A lobule is described as a segment or lobe that is part of a whole.DPustules are circumscribed elevations containing pus.REF:Vocabulary, Clinical Appearance of Soft Tissue Lesions, page 1OBJ:12.A lesion with a sessile base is described as:A.an ulcer.B.stemlike.C.pedunculated.D.flat and broad.ANS:DFeedbackAAn ulcer is a break in the surface epithelium.BA stemlike lesion is referred to aspedunculated.CA pedunculated lesion is stemlike or stalk-based (similar to a mushroom).DCorrect!Sessiledescribes the base of a lesion that is flat and broad.REF:Vocabulary, Clinical Appearance of Soft Tissue Lesions, page 1OBJ:13.Which one of the following isnotdiagnosed through clinical appearance?A.Mandibular toriB.Fordyce granulesC.Black hairy tongueD.Compound odontomaANS:DFeedbackAMandibular tori are identified clinically as areas of exostosis on the lingual

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aspects of mandibular premolars.BFordyce granules are yellow clusters of ectopic sebaceous glands that arediagnosed through clinical appearance.CBlack hairy tongue is diagnosed clinically. The filiform papillae on the dorsaltongue elongate and become brown or black. Causes include tobacco, alcohol,hydrogen peroxide, chemical rinses, antibiotics, and antacids.DCorrect! The compound odontoma isinitially identified radiographically as aradiopaque area in which tooth structure can be identified. There is no clinicalcomponent.REF:Radiographic Diagnosis, page 9OBJ:34.Another name for geographic tongue is:A.median rhomboid glossitis.B.benign migratory glossitis.C.fissured tongue.D.black hairy tongue.ANS:BFeedbackAResearch suggests that median rhomboid glossitis is associated with a chronicfungal infection fromCandida albicans. Sometimes the condition resolves withantifungal therapy.BCorrect! Benign migratory glossitis is another name for geographic tongue.CFissured tongue is seen in 5% of the population. It is a variant of normal.Genetic factors are probably associated with the condition.DBlack hairy tongue is caused by a reaction to chemicals, tobacco, hydrogenperoxide, or antacids. The filiform papillae on the dorsal tongue becomeelongated and are dark brown to black.REF:Geographic Tongue, page 25OBJ:75.This bony hard radiopaque structure in the midline of the hard palate is genetic in origin andinherited in an autosomal dominant manner. The diagnosis is made through clinicalappearance.You suspect a:A.palatal cyst.B.torus palatinus.C.mixed tumor.D.ranula.

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ANS:BFeedbackAA palatal cyst is radiolucent and not diagnosed through clinical appearance.BCorrect! A torus palatinus is developmental and bony hard and is found on themidline of the palate. Diagnosis is made on the basis of clinical appearance.CA mixed tumor or pleomorphic adenoma is a benign tumor of salivary glandorigin, found unilaterally off the midline of the hard palate. It is composed oftumor tissue that is not bony hard to palpation.DRanulais a term used for a mucocele-like lesion that forms unilaterally on thefloor of the mouth.REF:Torus Palatinus, page 32OBJ:46.The gray-white opalescent film seen on the buccal mucosa of 85% of black adults is a variantof normal that requires no treatment and is called:A.linea alba.B.leukoedema.C.leukoplakia.D.white sponge nevus.ANS:BFeedbackALinea alba is a “white line” that extends anteroposteriorly on the buccal mucosaalong the occlusal plane. It is most prominent in patients who have a clenchingor grinding habit.BCorrect! Leukoedema is a diffuse opalescence most commonly seen on thebuccal mucosa in black individuals.CLeukoplakiais a clinical term for a white lesion, the cause of which is unknown.DWhite sponge nevus is a genetic (autosomal dominant) trait. Clinically, it ischaracterized by a soft white, folded (orcorrugated) oral mucosa. A thick layerof keratin produces the whitening.REF:Leukoedema, page 24OBJ:87.Which one of the following conditions would most likely respond to therapeutic diagnosis?A.Angular cheilitisB.Amelogenesis imperfectaC.Paget diseaseD.Stafne bone cystANS:AFeedbackACorrect! Angular cheilitis most commonly responds to antifungal therapy oncenutritional deficiencies have been ruled out.BAmelogenesis imperfecta is a genetic condition associated with abnormaldevelopment of the enamel.CPaget disease is a chronic metabolic bone disease. A highly elevated serum

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alkaline phosphatase level contributes significantly to the diagnosis.DA Stafne bone cyst is determined through surgical diagnosis in which entrappedsalivary gland tissue is identified.REF:Therapeutic Diagnosis, page 20OBJ:38.The gingival enlargement in this patient was caused by a calcium channel blocker.Which one of the following would likely be the cause?A.DilantinB.NifedipineC.QuinidineD.ClozapineANS:BFeedbackADilantin is an anticonvulsant used to prevent or control seizures.BCorrect! Nifedipine is a calcium channel blocker.CQuinidine is an antiarrhythmic agent used to treat cardiac arrhythmias.DClozapine is an antipsychotic used in the management of psychotic symptoms inschizophrenia.REF:Historical Diagnosis, Figure 1-39, page 18OBJ:39.Radiographic features, including the cotton-wool effect and hypercementosis, are especiallyhelpful in the diagnosis of:A.Paget disease.B.dentinogenesis imperfecta.C.anemia.D.diabetes.ANS:AFeedbackACorrect! Paget disease is a chronic metabolic bone disease. Radiographically, thecotton-wool effect and hypercementosis are characteristic features.BDentinogenesis imperfecta is a genetic condition involving a defect in thedevelopment of dentin.CAnemia, a decrease in red blood cells, requires blood tests to determine theetiologic factors.DDiabetes is a chronic disorder of carbohydrate metabolism characterized by

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abnormally high blood glucose levels.REF:Laboratory Diagnosis, Figure 1-41, pages 17, 19OBJ:310.In internal resorption, the radiolucency seen radiographically is usually:A.well circumscribed.B.diffuse.C.multilocular.D.unilocular.ANS:BFeedbackAWell circumscribeddescribes borders that are specifically defined. Exactmargins of the lesion are identified.BCorrect! Diffuse borders are ill defined, making it impossible to detect the exactparameters of the lesion. Therefore treatment is more difficult.CMultilocularhas also been described as resembling “soap bubbles”; lobes seemto fuse together to make up the lesion. This term has been used to describe theodontogenic keratocyst.DUnilocularmeans having one compartment or unit that is well defined. Thisterm is often used to describe the radicular cyst.REF:Vocabulary, Radiographic Terms Used to Describe Lesions in Bone, page 5OBJ:111.Which one of the following is diagnosed through clinical appearance?A.Fordyce granulesB.Unerupted mesiodensC.Periapical cemento-osseous dysplasiaD.Traumatic bone cystANS:AFeedbackACorrect! Fordyce granules are diagnosed on the basis of their clinicalappearance. They are ectopic sebaceous glands seen on the lips and buccalmucosa. Clinically, they appear as yellow lobules in clusters and are considereda variant of normal.BUnerupted mesiodens requires a radiograph for diagnosis.CPeriapical cemento-osseous dysplasia requires a radiograph, specific patienthistory, and a pulp test to evaluate tooth vitality.DTraumatic bone cyst requires a radiograph and surgical intervention to establisha diagnosis.REF:Clinical Diagnosis, page 7 | Fordyce Granules, page 22OBJ:312.Retrocuspid papillae are located on the:A.palate.B.floor of the mouth.C.gingival margin of the lingual aspect of mandibular cuspids.

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D.canine eminence.ANS:CFeedbackARetrocuspid papillae are not located on the palate.BRetrocuspid papillae are not located on the floor of the mouth.CCorrect! Retrocuspid papillae are located on the gingival margin of the lingualaspect of mandibular cuspids.DRetrocuspid papillae are not located on the canine eminence.REF:Retrocuspid Papilla, page 23OBJ:313.Which one of the following isnotconsidered a variant of normal?A.Fordyce granulesB.LeukoedemaC.Linea albaD.Pyogenic granulomaANS:DFeedbackAFordyce granules are seen in more than 80% of adults over 20 years of age andare considered a variant of normal.BLeukoedema is observed in about 85% of black individuals and is considered avariant of normal.CLinea alba is located on the buccal mucosa along the occlusal plane of the teeth.It is most prominent in patients who have a clenching or bruxism habit. It is socommon that it is considered a variant of normal.DCorrect! Pyogenic granuloma is a reactive inflammatory response to injury. It isnot a variant of normal.REF:Box 1-1, Case Study, page 21 | Variants of Normal, pages 22-24OBJ:614.When antifungal therapy is used to treat angular cheilitis, which diagnostic process is beingapplied?A.MicroscopicB.LaboratoryC.SurgicalD.TherapeuticANS:DFeedbackAMicroscopic diagnosis requires a biopsy.BLaboratory diagnosis involves the use of clinical laboratory tests, includingblood chemistries and urinalysis.CSurgical diagnosis requires surgical intervention.DCorrect! Therapeutic diagnosis is used here in the treatment and management ofangular cheilitis, which is most commonly a fungal condition. A careful patient

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history should be obtained to rule out a contributory nutritional deficiency.REF:Therapeutic Diagnosis, page 20OBJ:315.A lesion with a stemlike base is described as:A.sessile.B.macular.C.pedunculated.D.lobulated.ANS:CFeedbackAA sessile base is broad and flat.BA macular lesion is flat, does not protrude, and is distinguished by its color. Afreckle is an example of a macule.CCorrect!Pedunculatedmeans the lesion has a stemlike or stalklike base similarto that of a mushroom.DLobulatedmeans the lesion consists of lobules making up the whole.REF:Vocabulary, Clinical Appearance of Soft Tissue Lesions, page 1OBJ:816.A small, circumscribed lesion, usually less than 1 cm in diameter, that is elevated or protrudesabove the surface of normal surrounding tissue is a:A.papule.B.macule.C.vesicle.D.bulla.ANS:AFeedbackACorrect! A papule is defined as a small circumscribed lesion, usually less than 1cm in diameter, that is elevated or protrudes above the surface of normalsurrounding tissue.BA macule is flat and does not protrude above the surface of normal tissue.CA vesicle is elevated and contains serous fluid.DA bulla is elevated, contains serous fluid, and looks like a blister.REF:Vocabulary, Clinical Appearance of Soft Tissue Lesions, page 1OBJ:117.Which one of the following is considered a genetic/inherited disorder?A.Linea albaB.Amelogenesis imperfectaC.Necrotizing ulcerative gingivitisD.Internal resorptionANS:B

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FeedbackALinea alba is a variant of normal characterized by the white line that extendsanteroposteriorly on the buccal mucosa, along the occlusal plane.BCorrect! Amelogenesis imperfecta represents a group of inherited conditionsaffecting the enamel of teeth.CNecrotizing ulcerative gingivitis is an ulcerating gingival condition caused byanaerobic bacteria.DInternal resorption is usually associated with an inflammatory response in thepulp.REF:Historical Diagnosis, page 16OBJ:318.Ectopic geographic tongue can be found:A.on the lateral border of the tongue.B.within bone.C.on mucosal surfaces other than the tongue.D.on the dorsal tongue.ANS:CFeedbackAGeographic tongue may be seen on any surface of the tongue, including thelateral borders.BEctopic geographic tongue is a mucosal condition and is unrelated to the bone.CCorrect! Ectopic geographic tongue is also calledstomatitis areata migransandis found on mucosal surfaces other than the tongue.DGeographic tongue may be seen on any mucosal surface and is commonly seenon the dorsal surface of the tongue.REF:Geographic Tongue, page 25OBJ:719.A Stafne bone cyst contains:A.salivary gland tissue.B.an empty void.C.inflammatory cells.D.an epithelium-lined cyst containing serous fluid.ANS:AFeedbackACorrect! Stafne bone cyst is a developmental invagination in the lingual aspectof the mandible that is filled with salivary gland tissue.BAn empty void describes the contents of a traumatic bone cyst.CA Stafne bone cyst has no inflammatory response. It is developmental andrequires no treatment.DA Stafne bone cyst is not a true cyst and does not have an epithelial lining. Itcontains normal salivary gland tissue.REF:Surgical Diagnosis, page 20OBJ:3

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20.Which papillae are elongated in the condition called black hairy tongue?A.CircumvallateB.FoliateC.FiliformD.FungiformANS:CFeedbackACircumvallate papillae on the posterior dorsal tongue do not elongate.BFoliate papillae are located on the posterior lateral borders of the tongue. Theyare vertical, slightly exophytic folds of tissue located in the same area as thelingual lymphoid tissue (lingual tonsils) and do not elongate.CCorrect! The filiform papillae are composed primarily of keratin and are thepapillae that elongate in black hairy tongue.DFungiform papillae on the dorsal areas do not elongate.REF:Hairy Tongue, page 26OBJ:321.Diagnosis of anemia is best accomplished through:A.laboratory tests.B.evaluation of the color of the gingiva.C.bleeding on probing.D.the patient’s medical history.ANS:AFeedbackACorrect! Laboratory blood tests provide the best information with which todiagnose anemia.BAlthough the color of the gingiva may be a clinical sign, a diagnosis of anemia,or more specifically the type of anemia, must be made through laboratorytesting.CBleeding on probing is not useful in the diagnosis of anemia.DThe patient’s medical history may be helpful in the diagnosis of anemia, but it isonly contributory. The final diagnosis comes from appropriate laboratory tests.REF:Laboratory Diagnosis, page 17OBJ:322.A radiolucency that “scallops around the roots of teeth” is often used to describe a:A.traumatic bone cyst.B.Stafne bone cyst.C.lingual mandibular bone concavity.D.median palatine cyst.ANS:AFeedbackACorrect!Scalloping around the rootsis a term often used to describe theradiographic appearance of a traumatic bone cyst.BA Stafne bone cyst usually presents as an oval radiolucency anterior to the angle

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of the ramus and inferior to the mandibular canal.CA lingual mandibular bone concavity is the same as a Stafne bone cyst.DA median palatine cyst is a developmental cyst that presents as a unilocularradiolucency found in the midline of the hard palate.REF:Vocabulary, Radiographic Terms Used to Describe Lesions in Bone, page 5OBJ:323.When geographic tongue occurs on the dorsal tongue, the erythematous areas may beappropriately described as:A.inflamed.B.depapillated.C.allergic.D.fungal.ANS:BFeedbackATheerythematous areas seen on the dorsal tongue in geographic tongue are notcaused primarily by inflammation.BCorrect! In geographic tongue, the erythematous areas on the dorsal tongue aredevoid of filiform papillae and therefore are appropriately described asdepapillated.CGeographic tongue is not an allergic reaction.DGeographic tongue is not a fungal infection.REF:Geographic Tongue, page 25OBJ:724.It has been suggested thatCandida albicansis associated with which one of the following?A.Median rhomboid glossitisB.Linea albaC.LeukoedemaD.Retrocuspid papillaeANS:AFeedbackACorrect! Research has suggested that median rhomboid glossitis may beassociated withCandida albicans.BLinea alba is a variant of normal.CLeukoedema is a variant of normal.DRetrocuspid papillae are developmental and found on the gingiva of the lingualaspect of mandibular canine teeth.REF:Median Rhomboid Glossitis, page 24OBJ:725.Which term is used to describe a lesion with borders that are specifically defined and in whichone can see the exact margins and extent of the lesion?A.UnilocularB.Well circumscribed

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C.DiffuseD.MultilocularANS:BFeedbackAUnilocularmeans having one compartment or unit that is well defined (as in aradicular cyst).BCorrect!Well circumscribeddefines a lesion with borders that are specificallydefined and in which one can see the exact margins and extent of the lesion.CDiffusedescribes a lesion with borders that are not well defined.DMultilocular lesions are described radiographically as resembling “soap bubbles”(i.e., a lesion with many lobes beyond the confines of one distinct area).REF:Vocabulary, Radiographic Terms Used to Describe Lesions in Bone, page 5OBJ:126.Fordyce granules:A.are ectopic sebaceous glands.B.are seen on the dorsal tongue.C.require antibiotic treatment.D.are lesions that require biopsy for diagnosis.ANS:AFeedbackACorrect! Fordyce granules are ectopic sebaceous glands.BFordyce granules are seen on the buccal and labial mucosa, not the dorsaltongue.CFordyce granules require no treatment.DFordyce granules are diagnosed through clinical appearance. Biopsy is notnecessary.REF:Fordyce Granules, page 22OBJ:427.The base of this lesion would be described as:A.pedunculated.B.lobule.C.bulla.D.sessile.ANS:DFeedback

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AA pedunculated lesion has a stemlike base similar to that of a mushroom stem.BA lobule is a segment or lobe that is part of the whole.CA bulla usually contains serous fluid and looks like a blister.DCorrect! The base of this lesion is sessile, or broad and flat.REF:Vocabulary, Clinical Appearance of Soft Tissue Lesions, Figure 1-5A,pages 1, 3OBJ:128.This torus palatinus would be described as:A.bullous.B.papular.C.lobulated.D.nodular.ANS:CFeedbackABullous lesions contain serous fluid and look like blisters.BA papule is a soft tissue lesion that is elevated above the surface of normalsurrounding tissue.CCorrect! This torus palatinus is lobulated (i.e., lobes that are fused together).DA nodule is a palpable solid lesion found in soft tissue.REF:Vocabulary, Clinical Appearance of Soft Tissue Lesions, Figure 1-1, page 2OBJ:129.Another name for an amalgam tattoo is a:A.melanoma.B.focal argyrosis.C.nevus.D.multiple myeloma.ANS:BFeedbackAA melanoma is a malignant tumor.BCorrect! Focal argyrosis is a synonym for amalgam tattoo.CA nevus is a benign overgrowth of melanocytes.DMultiple myeloma is a malignant proliferation of plasma cells.REF:Clinical Diagnosis, page 9OBJ:230.Which one of the following isnotapparent in leukoedema?

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A.Intracellular edema in the spinous cellsB.Acanthosis of the epitheliumC.Generalized opalescence of the buccal mucosaD.A white diffuse material on the buccal mucosa that can be wiped offANS:DFeedbackAIntracellular edema in the spinous cells is found in leukoedema.BAcanthosis of the epithelium is found in leukoedema.CGeneralized opalescence of the buccal mucosa is seen in leukoedema.DCorrect! A white diffuse material that can be wiped off is significant indiagnosing pseudomembranous candidiasis.REF:Leukoedema, page 24OBJ:831.Which of the following best describes an elevated, 5-mm soft tissue lesion containing serousfluid?A.MaculeB.VesicleC.LobuleD.PustuleANS:BFeedbackAA macule is a flat area usually distinguished by a color different from thesurrounding tissue.BCorrect! A vesicle is a small (less than 1 cm in diameter), elevated lesion thatcontains serous fluid.CA lobule is described as a segment or lobe that is part of a whole.DA pustule is a circumscribed elevation containing pus.REF:Vocabulary, Clinical Appearance of Soft Tissue Lesions, page 1OBJ:132.A lesion with a pedunculated base is best described as:A.an ulcer.B.stemlike.C.pallor.D.broad and flat.ANS:BFeedbackAAn ulcer is a break in the surface epithelium.BCorrect! A stemlike lesion is referred to aspedunculated.CPallor is a paleness of the skin or mucosal tissues.DBroad and flatdescribes the base of a sessile lesion.REF:Vocabulary, Clinical Appearance of Soft Tissue Lesions, page 1

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OBJ:133.All of the following lesions are identified radiographically except one. Which one is theexception?A.Root resorptionB.Fordyce granulesC.Interproximal dental cariesD.Compound odontomaANS:BFeedbackARoot resorption is identified radiographically when the apex of the tooth appearsshortened or blunted.BCorrect! Fordyce granules are yellow clusters of ectopic sebaceous glands thatare diagnosed through clinical appearance.CInterproximal dental caries are seen as radiographic radiolucencies.DA compound odontoma is initially identified radiographically as a radiopaquearea in which tooth structure can be identified.REF:Clinical Diagnosis, page 7 | Fordyce Granules, page 22OBJ:334.These reddish-purple clusters observed on the ventral surface of the tongue and diagnosedthrough clinical observation are referred to as which of the following variants of normalconditions?A.Palatal cystB.Mandibular toriC.Lingual varicositiesD.RanulaANS:CFeedbackAA palatal cyst is radiolucent and not diagnosed through clinical appearance.BMandibular tori are outgrowths of hard dense bone and found on the lingualaspect of the mandible.CCorrect! Lingual varicosities are prominent lingual veins usually observed on theventral and lateral surfaces of the tongue.DRanulais a term used to describe a mucocele-like lesion that forms unilaterallyon the floor of the mouth.REF:Lingual Varicosities, page 23OBJ:4

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35.An elevated serum alkaline phosphate level, significant in the diagnosis of Paget disease, isdetermined from which of the following diagnostic categories?A.LaboratoryB.TherapeuticC.ClinicalD.SurgicalANS:AFeedbackACorrect! Laboratory tests, including blood chemistries, can provide informationthat contributes to a diagnosis.BTherapeutic testing applies the principle of diagnosis based on clinical andhistorical information with confirmation by the response of the condition totherapy.CClinical diagnosis suggests that the strength of the diagnosis comes from theclinical appearance of the lesion.DSurgical diagnosis is based on information about a lesion gained during surgicalintervention.REF:Laboratory Diagnosis, page 17OBJ:236.All of the following conditions would most likely respond to therapeutic diagnosis except one.Which one is theexception?A.Angular cheilitisB.Necrotizing ulcerative gingivitisC.Nutritional deficienciesD.Stafne bone cystANS:DFeedbackAAngular cheilitis commonly responds to antifungal therapy once nutritionaldeficiencies have been ruled out.BNecrotizing ulcerative gingivitis responds to hydrogen peroxide rinses.CNutritional deficiencies are common conditions diagnosed by therapeutic means.DCorrect! Stafne bone cyst, in which entrapped salivary gland tissue is identified,is diagnosed through surgical examination.REF:Surgical Diagnosis, page 20OBJ:337.The variant of normal coloration seen on the mandibular gingival surface of this patient isreferred to as:

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