Oral Pathology Clinical Pathologic Correlations 7th Edition by Regezi – Test Bank

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INSTANT DOWNLOAD COMPLETE TEST BANK WITH ANSWERS

 

Oral Pathology Clinical Pathologic Correlations 7th Edition by Regezi – Test Bank

 

Sample  Questions

 

 

Chapter 3: White Lesions

Test Bank

 

MULTIPLE CHOICE

 

  1. Three small (2 ´ 2 mm), nodular, nonulcerated, and asymptomatic lesions were found in the floor of the mouth of a 21-year-old man. Microscopically, the lesions were composed of a collection of normal mature lymphocytes with germinal centers. This patient has:
a. Lymphoma
b. Mucous extravasation phenomenon
c. Fordyce granules
d. Dermoid cysts
e. Ectopic lymphoid tissue

 

ANS:   E                     REF:    Chap 3 (Ectopic lymphoid tissue), p 110

 

  1. Ectopic lymphoid tissue is commonly seen in which of the following sites?
a. Posterior lateral tongue
b. Floor of mouth
c. Soft palate
d. Tonsillar pillar
e. All the above

 

ANS:   E                     REF:    Chap 3 (Ectopic lymphoid tissue), p 110

 

  1. Which of the following disorders places the patient at risk for the appearance or development of a malignancy?
a. Primary Sjögren’s syndrome
b. Proliferative verrucous leukoplakia
c. Neurofibromatosis
d. MEN III
e. All the above

 

ANS:   E

REF:    Chap 3 (Preneoplastic and neoplastic lesions), pp 90-95 | Chap 7 (Neurofibroma/Mucosal neuromas of MEN III), pp 178-181 | Chap 8 (Sjögren’s syndrome), pp 196-199

 

  1. Lupus erythematosus is caused by which of the following?
a. Coxsackie virus
b. Herpes simplex virus
c. Immunodeficiency
d. Vitamin A deficiency
e. Autoimmunity

 

ANS:   E

REF:    Chap 3 (Lupus erythematosus/Etiology and pathogenesis), p 104

 

  1. Which of the following microscopic features accounts for the white appearance of leukoedema?
a. Hyperkeratosis
b. Acanthosis
c. Reduced vascular supply
d. Hydropic change of keratinocytes
e. Dyskeratosis

 

ANS:   D                     REF:    Chap 3 (Leukoedema), pp 79-80

 

  1. What is the most likely cause of lichen planus?
a. Coxsackie virus
b. One of the herpes viruses
c. A mycobacterium
d. Candida albicans
e. Immunologic defect

 

ANS:   E                     REF:    Chap 3 (Lichen planus/Etiology and pathogenesis), pp 97-98

 

  1. Which of the following benign conditions exhibits a clinical mucosal pattern that seems to change or migrate over time?
a. Leukoedema
b. Median rhomboid glossitis
c. Fordyce’s granules
d. Geographic tongue
e. None of the above

 

ANS:   D                     REF:    Chap 3 (Geographic tongue/Clinical features), pp 95-96

 

  1. All of the following are a consequence of snuff dipping except:
a. Increased incidence of herpes simplex labialis
b. Mucosal opacification
c. Gingivitis
d. Dependence
e. Tooth abrasion

 

 

ANS:   A

REF:    Chap 3 (White lesions associated with smokeless tobacco), pp 83-85

 

  1. Which of the following represents an opportunistic fungal infection?
a. Shingles
b. Aphthous stomatitis
c. Candidiasis
d. Herpangina
e. Syphilis

 

ANS:   C                     REF:    Chap 3 (Candidiasis), pp 104-108

 

  1. On routine examination of a 52-year-old male pipe smoker, an asymptomatic tissue change was found in his palate. The entire hard palate was white with occasional red dots. He has:
a. Candidiasis
b. Nicotine stomatitis
c. Squamous cell carcinoma
d. Frictional hyperkeratosis
e. Major aphthous ulcer

 

ANS:   B                     REF:    Chap 3 (Nicotine stomatitis), pp 85-86

 

  1. Appropriate management of geographic tongue is:
a. Observation
b. Excisional biopsy
c. Incisional biopsy
d. Nystatin therapy
e. Antidepressant medication

 

ANS:   A                     REF:    Chap 3 (Geographic tongue), pp 95-97

 

  1. Examination of an asymptomatic 27-year-old man reveals numerous circular white lesions surrounding red atrophic patches on the dorsum of the tongue. The lesions cannot be rubbed off with a gauze square. The patient most likely has:
a. Fissured tongue
b. Speckled leukoplakia
c. Benign migratory glossitis
d. Squamous cell carcinoma
e. Lichen planus

 

ANS:   C                     REF:    Chap 3 (Geographic tongue/Etiology), p 95

 

  1. A 14-year-old bone marrow transplant patient developed bilateral white lesions of the lateral border of the tongue that measured 1 ´ 2 cm. Which of the following conditions should receive serious consideration in a clinical differential diagnosis?
a. Hairy leukoplakia
b. White sponge nevus
c. Geographic tongue
d. Pemphigus vulgaris
e. Aphthous stomatitis

 

ANS:   A                     REF:    Chap 3 (Hairy leukoplakia), pp 86-87

 

  1. Biopsy of bilateral white buccal mucosa lesions showed hyperkeratotic epithelium with basal cell destruction. The epithelium was supported by connective tissue containing a dense lymphocytic infiltrate. This is descriptive of:
a. Erythema multiforme
b. Lichen planus
c. Pemphigoid
d. Pemphigus
e. White sponge nevus

 

ANS:   B                     REF:    Chap 3 (Lichen planus/Etiology and pathogenesis), pp 97-98

 

  1. Which of the following occurs in the midline dorsum of the tongue?
a. Ectopic lymphoid tissue
b. Basal cell carcinoma
c. Secondary herpes simplex
d. Median rhomboid glossitis (candidiasis)
e. Peripheral giant cell granuloma

 

ANS:   D                     REF:    Chap 3 (Candidiasis/Clinical features), pp 105-107

 

  1. Clinical diagnosis of candidiasis is confirmed by:
a. Characteristic odor
b. Response to injection of vitamin B12
c. Response to administration of prednisone
d. Demonstration of mycelia and spores in scrapings
e. Demonstration of sulfur granules in exudates

 

ANS:   D                     REF:    Chap 3 (Candidiasis/Histopathology), p 107

 

  1. A 9-year-old boy has bilateral, white thickening of his buccal mucosa that extends into the vestibules. The lesions have been present since birth. His brother has similar lesions. Which of the following is suggested?
a. Lichen planus
b. Leukoedema
c. Mucous patches
d. White sponge nevus
e. None of the above

 

ANS:   D                     REF:    Chap 3 (White sponge nevus/Box 3-1), p 80

 

  1. The most common mucosal site for AIDS-related oral hairy leukoplakia is:
a. Conjunctiva
b. Soft palate
c. Lateral tongue
d. Lingual gingiva
e. Buccal mucosa

 

ANS:   C                     REF:    Chap 3 (Hairy leukoplakia/Etiology and pathogenesis), p 86

 

  1. Which of the following is an autosomal-dominant disease?
a. White sponge nevus
b. Geographic tongue
c. Hemangioma
d. Pemphigus vulgaris
e. Median rhomboid glossitis

 

ANS:   A                     REF:    Chap 3 (White sponge nevus), p 80

 

  1. Biopsy of a lesion of the buccal mucosa shows epithelial cells with hyperchromatic and pleomorphic nuclei. Abnormal mitotic figures are found at all levels in the epithelium. The basement membrane is intact. This is consistent with:
a. Lichen planus
b. Leukoplakia
c. Squamous cell carcinoma
d. Carcinoma in situ
e. Focal hyperkeratosis

 

ANS:   D                     REF:    Chap 3 (Idiopathic leukoplakia/Histopathology), pp 93-94

 

  1. Hairy tongue is characterized by hypertrophy of which of the following papillae?
a. Foliate
b. Filiform
c. Fungiform
d. Circumvallate
e. Interdental

 

ANS:   B                     REF:    Chap 3 (Hairy tongue), p 88

 

  1. Chronic exposure to sunlight has been implicated in the pathogenesis of which of the following?
a. Basal carcinoma
b. Squamous cell carcinoma of the skin
c. Actinic cheilitis
d. Carcinoma of the lower lip
e. All the above

 

ANS:   E

REF:    Chap 2 (Squamous cell carcinoma/Carcinoma of the lower lip), p 56 | Chap 3 (Actinic cheilitis/Box 3-8), pp 90-91

 

  1. A middle-aged man developed multiple flat ulcers in his palate, tongue, and buccal mucosa. The lesions measured approximately 1 cm in diameter and were preceded briefly by bullae. The lesions have been persistent for 6 weeks. He has no skin, eye, or genital lesions. Biopsy shows acantholysis with intraepithelial separation. He most likely has:
a. Erythema multiforme
b. Discoid lupus erythematosus
c. Primary herpes simplex infection
d. Mucous membrane pemphigoid
e. None of the above

 

ANS:   E

REF:    Chap 1 (Herpes simplex infection/Mucous membrane pemphigoid), pp 1-6, 15-17 | Chap 2 (Erythema multiforme), pp 43-46 | Chap 3 (Discoid lupus erythematosus), p 102

 

  1. The bullous eruption of attached gingiva mediated by autoantibodies directed against basement membrane antigens is known as:
a. Pemphigus vulgaris
b. Lupus erythematosus
c. Erythema multiforme
d. Behçet’s syndrome
e. None of the above

 

ANS:   E

REF:    Chap 1 (Pemphigus vulgaris), pp 11-15 | Chap 2 (Erythema multiforme/Behçet’s syndrome), pp 42-46 | Chap 3 (Lupus erythematosus), pp 102-104

 

  1. Ingestion of certain drugs is known to occasionally precipitate which of the following?
a. Herpetiform aphthous ulcers
b. Geographic tongue
c. Cicatricial pemphigoid
d. Mucous patches
e. None of the above

 

ANS:   E

REF:    Chap 1 (Mucous membrane pemphigoid), pp 15-17 | Chap 2 (Herpetiform aphthous ulcers), p 39 | Chap 3 (Geographic tongue), pp 95-97 | Chap 4 (Erythroplakia), pp 121-122

 

  1. The keratinocyte desmosome complex is the pathologic target in which of the following diseases?
a. Discoid lupus erythematosus
b. Systemic lupus erythematosus
c. Tuberculosis
d. Pemphigoid
e. None of the above

 

ANS:   E

REF:    Chap 1 (Mucous membrane pemphigoid/Bullous pemphigoid), pp 15-18 | Chap 2 (Tuberculosis), pp 29-32 | Chap 3 (Discoid lupus erythematosus/Systemic lupus erythematosus), p 102

 

  1. Circulating autoantibodies can be demonstrated in which of the following diseases?
a. Minor aphthae
b. Major aphthae
c. Systemic lupus erythematosus
d. Discoid lupus erythematosus
e. Recurrent herpes simplex

 

ANS:   C                     REF:    Chap 3 (Systemic lupus erythematosus), p 102

 

  1. Lesions of immunologic origin are seen in the heart, kidney, and joints in which of the following diseases?
a. Behçet’s syndrome
b. Wegener’s granulomatosis
c. Systemic lupus erythematosus
d. Pemphigus
e. Epidermolysis bullosa

 

ANS:   C                     REF:    Chap 3 (Systemic lupus erythematosus), p 102

 

  1. A positive ANA test would most likely be seen in which of the following?
a. Primary syphilis
b. Primary herpes simplex
c. Systemic lupus erythematosus
d. Erythema multiforme
e. Pemphigoid

 

ANS:   C                     REF:    Chap 3 (Systemic lupus erythematosus), p 102

 

  1. Systemic (acute) lupus erythematosus:
a. Represents an autoimmune disease in which patients develop multiple antibodies against nuclear and cytoplasmic proteins
b. Usually does not develop from preexisting discoid disease
c. May affect kidneys, heart, and joints
d. Has a predilection for middle-aged women
e. All the above

 

ANS:   E                     REF:    Chap 3 (Systemic lupus erythematosus), p 102

 

  1. Degranulation of IgE-coated mast cells is associated with which of the following conditions?
a. Hereditary angioedema
b. Lupus erythematosus
c. Erythema multiforme
d. Contact allergy
e. None of the above

 

ANS:   E

REF:    Chap 2 (Angioedema/Erythema multiforme/Contact allergies), pp 43-49 | Chap 3 (Lupus erythematosus), pp 102-104

 

  1. All of the following conditions affect oral and perioral tissues and are self-limiting (i.e., heal or disappear without therapeutic intervention) except:
a. Varicella
b. Herpangina
c. Erythema multiforme
d. Hand-foot-and-mouth disease
e. Lupus erythematosus

 

ANS:   E                     REF:    Chap 3 (Lupus erythematosus/Treatment), p 104

 

  1. Cutaneous lesions may be seen in all the following except:
a. Erythema multiforme
b. Chronic lupus erythematosus
c. Hairy leukoplakia
d. Secondary herpes simplex infections
e. Primary herpes simplex infections

 

ANS:   C

REF:    Chap 3 (Hairy leukoplakia/Clinical features/Box 3-6), pp 86-87

 

  1. Epstein-Barr virus is responsible for which of the following?
a. Hereditary benign intraepithelial dyskeratosis
b. Hairy leukoplakia
c. Hairy tongue
d. Oral squamous cell carcinoma
e. None of the above

 

ANS:   B                     REF:    Chap 3 (Hairy leukoplakia/Etiology and pathogenesis), p 86

 

  1. Median rhomboid glossitis is a chronic white and/or red lesion occurring in the midline dorsum of the tongue anterior to the circumvallate papillae that is believed to be caused by:
a. Epstein-Barr virus
b. Herpes simplex virus
c. Autoantibodies
d. Smokeless tobacco products
e. None of the above

 

ANS:   E                     REF:    Chap 3 (Candidiasis/Clinical features), pp 105-107

 

  1. The cells that are believed to mediate the destructive basal cell changes seen microscopically in lichen planus are:
a. Plasma cells
b. T lymphocytes
c. B lymphocytes
d. Langerhans cells
e. Keratinocytes

 

ANS:   B                     REF:    Chap 3 (Lichen planus/Etiology and pathogenesis), pp 97-98

 

  1. The white lesion known as idiopathic leukoplakia clinically is most frequently diagnosed microscopically as:
a. Hyperkeratosis
b. Moderate dysplasia
c. In situ carcinoma
d. Invasive carcinoma
e. Leukoedema

 

ANS:   A                     REF:    Chap 3 (Idiopathic leukoplakia), pp 91-95

 

  1. Leukoplakia, located in which of the following sites, would be regarded as having the highest risk for malignant transformation?
a. Floor of mouth
b. Upper lip
c. Buccal mucosa
d. Gingiva
e. Palate

 

ANS:   A                     REF:    Chap 3 (Idiopathic leukoplakia/Clinical features), pp 91-93

 

  1. Purple to red pruritic patches on lower legs and forearms are the typical cutaneous manifestation of which of the following?
a. Mucocutaneous candidiasis
b. Lupus erythematosus
c. Hereditary benign intraepithelial dyskeratosis
d. Lichen planus
e. Erythema multiforme

 

ANS:   D                     REF:    Chap 3 (Lichen planus/Clinical features), pp 98-99

 

  1. Hairy tongue:
a. Is a pre-AIDS sign
b. Is an opportunistic Epstein-Barr virus infection
c. Typically occurs bilaterally on the lateral surfaces of the tongue
d. Has malignant potential
e. None of the above

 

ANS:   E                     REF:    Chap 3 (Hairy tongue—entire topic/Box 3-7), pp 88-89

 

  1. Oral mucosal petechiae and/or ecchymoses would be a clinical sign of all the following except:
a. Hemophilia
b. Trauma
c. Idiopathic thrombocytopenia
d. Monocytic leukemias
e. Lupus erythematosus

 

ANS:   E                     REF:    Chap 3 (Lupus erythematosus—entire topic), pp 102-104

 

  1. Oral candidiasis presents in which of the following ways?
a. White plaques that can be removed, leaving a red bleeding surface
b. Red patch
c. Red or white lesion in the midline of the tongue anterior to the circumvallate papillae
d. Cracking and fissuring of the angles of the mouth
e. All the above

 

ANS:   E                     REF:    Chap 3 (Candidiasis/Clinical features), pp 105-107

 

  1. A 42-year-old man presents with a 1 ´ 1 cm white patch on the lateral surface of his tongue. Based solely on this information, clinical differential diagnosis should include:
a. Frictional hyperkeratosis
b. Hairy leukoplakia
c. Idiopathic leukoplakia
d. All the above
e. None of the above

 

ANS:   D

REF:    Chap 3 (Frictional hyperkeratosis/Hairy leukoplakia/ Idiopathic leukoplakia), pp 82-83, 86-87, 91-95

 

  1. A 31-year-old man presents for a routine dental examination. Soft tissue examination shows that both sides of his tongue have several circular red nonulcerated lesions of approximately 1 cm in diameter. The red patches are surrounded by white hyperkeratotic margins. He is asymptomatic and is otherwise in good health. He most likely has:
a. Bilateral squamous cell carcinomas
b. Hairy leukoplakia
c. Median rhomboid glossitis
d. Leukoedema
e. Geographic tongue

 

ANS:   E                     REF:    Chap 3 (Geographic tongue/Box 3-11), pp 95-97

 

  1. A 47-year-old woman presented with painful ulcers and white lesions on her gingiva, tongue, and buccal mucosa of 6 months’ duration. Biopsy of one of the white areas showed hyperkeratosis, basal cell destruction, and an intense lymphocytic infiltrate subjacent to the epithelium. This patient most likely has:
a. Lichen planus
b. Mucous membrane pemphigoid
c. Pemphigus vulgaris
d. White sponge nevus
e. Behçet’s syndrome

 

ANS:   A                     REF:    Chap 3 (Lichen planus—entire topic), pp 97-102

 

  1. Although hairy tongue is often idiopathic, some cases are believed to be associated with which one of the following?
a. Systemic antibiotic therapy
b. Infection by HHV8
c. Trauma
d. Vitamin C deficiency
e. Hot, spicy foods

 

ANS:   A                     REF:    Chap 3 (Hairy tongue/Etiology), p 88

 

  1. Elevated white plaques are seen in the palate of an HIV-positive patient. Under the microscope, scrapings show hyphae and spores among superficial keratinocytes. This confirms which of the following?
a. Idiopathic leukoplakia
b. Lichen planus
c. Hairy leukoplakia
d. Candidiasis
e. None of the above

 

ANS:   D                     REF:    Chap 3 (Candidiasis—entire topic), pp 104-108

 

  1. Which of the following oral lesions most likely results from chronic friction?
a. Vascular malformation
b. Pigmented nevus
c. Focal hyperkeratosis
d. Secondary herpes
e. Leukoedema

 

ANS:   C                     REF:    Chap 3 (Focal [frictional] hyperkeratosis/Etiology), pp 82-83

 

  1. Oral candidiasis is an opportunistic infection that may be associated with one of several predisposing factors. These include all the following except:
a. Prolonged use of oral topical corticosteroids
b. Therapeutic irradiation
c. Antibiotic therapy
d. Smokeless tobacco use
e. AIDS

 

ANS:   D                     REF:    Chap 3 (Candidiasis), pp 104-108

 

  1. Dysplastic changes of oral epithelium can be seen in biopsies of:
a. Idiopathic leukoplakia
b. Leukoedema
c. Melanotic macules
d. Hairy leukoplakia
e. Mucous membrane pemphigoid

 

ANS:   A

REF:    Chap 3 (Idiopathic leukoplakia/Histopathology/Box 3-9), pp 92-95

 

  1. Biopsy of a white lesion from the lower lip of an 82-year-old man showed hyperkeratosis, basophilic change of collagen, numerous telangiectasias, and epithelial atrophy. This is indicative of which of the following:
a. Lip biting
b. Squamous cell carcinoma
c. Idiopathic leukoplakia
d. Lichen planus
e. Actinic cheilitis

 

ANS:   E                     REF:    Chap 3 (Actinic cheilitis/Histopathology), p 90

 

  1. Benign migratory glossitis:
a. Is not associated with any risk of malignant transformation
b. Represents a self-limited viral infection
c. Responds to systemic acyclovir
d. Typically affects the ventral surface of the tongue
e. Is commonly seen in children

 

ANS:   A

REF:    Chap 3 (Geographic tongue/Treatment and prognosis), pp 96-97

 

  1. A 27-year-old man presents for a routine oral examination. Both sides of his buccal mucosa exhibit a filmy white opacity that disappears when the cheek is stretched. There is no pain, and the tissue feels normal to palpation. This would most likely be:
a. Squamous cell carcinoma
b. Hairy leukoplakia
c. Nicotine stomatitis
d. Leukoedema
e. Benign migratory glossitis

 

ANS:   D                     REF:    Chap 3 (Leukoedema/Clinical features), p 79

 

  1. Ectopic sebaceous glands:
a. Are known as Fordyce’s granules
b. Appear as yellow-white nodules intraorally
c. Do not need to be biopsied
d. Have no malignant potential
e. All the above

 

ANS:   E                     REF:    Chap 3 (Fordyce’s granules), p 110

 

  1. Which of the following clinical abnormalities in a white lesion associated with the use of smokeless tobacco would indicate the need for biopsy?
a. Mass
b. Induration
c. Ulceration
d. Red patch
e. All the above

 

ANS:   E

REF:    Chap 3 (White lesions associated with smokeless tobacco/Etiology), p 84

 

  1. Opaque white lesions cover right and left buccal mucosae, vestibules, and floor of the mouth of a 15-year-old girl. The lesions do not rub off and are asymptomatic. Biopsy showed intracellular edema and perinuclear condensation of keratin in keratinocytes. There is no inflammatory cell infiltrate of submucosa. This description suggests which of the following?
a. Leukoedema
b. Cheek chewing
c. Idiopathic leukoplakia
d. Lichen planus
e. White sponge nevus

 

ANS:   E                     REF:    Chap 3 (White sponge nevus/Box 3-1), p 80

 

  1. Candidiasis is also known by which of the following synonyms?
a. Thrush
b. Candidosis
c. Perleche
d. Yeast infection
e. All the above

 

ANS:   E                     REF:    Chap 3 (Candidiasis/Box 3-13), pp 104-108

 

  1. Atrophy of the tongue papillae may be seen in all the following except:
a. Pernicious anemia
b. Hairy tongue
c. Geographic tongue
d. Iron deficiency anemia
e. Vitamin B deficiency

 

ANS:   B                     REF:    Chap 3 (Hairy tongue—entire topic), p 88

 

  1. The use of smokeless tobacco is:
a. Related to the development of opportunistic oral infections
b. More prevalent among young women than young men
c. Associated with the development of oral ulcers
d. A good substitute for smoking cigarettes
e. None of the above

 

ANS:   E

REF:    Chap 3 (White lesions associated with smokeless tobacco—entire topic/Box 3-3), pp 83-85

 

  1. Which of the following oral lesions has malignant potential?
a. “Snuff dipper’s pouch”
b. Leukoplakia associated with smoking
c. Epithelial dysplasia
d. Actinic cheilitis
e. All the above

 

ANS:   E

REF:    Chap 3 (White lesions associated with smokeless tobacco/Leukoplakia/Actinic cheilitis), pp 83-85, 90-95

 

  1. All the following oral diseases have a relatively short (days to weeks) self-limited course except:
a. Secondary herpes
b. Erythema multiforme
c. Lichen planus
d. Aphthous ulcers
e. Herpes zoster

 

ANS:   C                     REF:    Chap 3 (Lichen planus/Clinical features), pp 98-99

 

  1. A 57-year-old patient presents with bright red mucosa under her 10-year-old maxillary denture. The tissue is painful and has been present for several weeks. The remainder of her examination is negative. This is most likely which of the following?
a. Allergy to her denture material
b. Chronic candidiasis
c. Erythroplasia
d. Hemangioma
e. None of the above

 

ANS:   B                     REF:    Chap 3 (Candidiasis/Clinical features), pp 105-107

 

  1. The white appearance associated with acute pseudomembranous candidiasis is due to which of the following?
a. Focal decrease in vascularity
b. Edema of keratinocytes
c. Hyperkeratosis
d. Fungal colonies growing in and on the superficial keratin
e. Acanthosis

 

ANS:   D                     REF:    Chap 3 (Candidiasis/Histopathology), p 107

 

  1. Oral epithelial dysplasia may:
a. Appear white clinically
b. Appear red clinically
c. Be seen on any mucosal surface
d. Progress to invasive squamous cell carcinoma
e. All the above

 

ANS:   E                     REF:    Chap 3 (Idiopathic leukoplakia—entire topic), pp 91-95

 

  1. The hard palate and gingiva are the characteristic sites for the appearance of all the following except:
a. Oral pigmented nevus
b. Lichen planus
c. Oral melanoma
d. Kaposi’s sarcoma
e. Secondary herpes simplex

 

ANS:   B                     REF:    Chap 3 (Lichen planus/Etiology and pathogenesis), pp 97-98

 

  1. Bilateral buccal mucosa white lesions would least likely be seen in which of the following?
a. Lichen planus
b. Cheek chewing
c. Hereditary benign intraepithelial dyskeratosis
d. White sponge nevus
e. Idiopathic leukoplakia

 

ANS:   E                     REF:    Chap 3 (Idiopathic leukoplakia/Clinical features), pp 91-93

 

  1. A 21-year-old African American man presents for a routine examination. Both sides of his buccal mucosa exhibit a filmy white opacity. There is no pain, and the tissue feels normal to palpation. This could be which of the following?
a. Squamous cell carcinoma
b. Hairy leukoplakia
c. Nicotine stomatitis
d. Leukoedema
e. Geographic stomatitis

 

ANS:   D                     REF:    Chap 3 (Leukoedema/Clinical features), p 79

 

  1. The microscopic feature that accounts for the white clinical appearance of lichen planus is:
a. Fibrin membrane over a chronic ulcer
b. Intracellular edema of keratinocytes
c. Acanthosis
d. Hyperkeratosis
e. Vasculitis

 

ANS:   D                     REF:    Chap 3 (Lichen planus), pp 97-102

 

  1. The clinical differential diagnosis for chronic red gingival patches would include:
a. Atrophic lichen planus
b. Contact hypersensitivity
c. Lupus erythematosus
d. Chronic candidiasis
e. All the above

 

ANS:   E

REF:    Chap 3 (Lupus erythematosus/Differential diagnosis/Lichen planus/Differential diagnosis), pp 101, 104

 

  1. The etiology of hairy tongue is associated with:
a. Systemic antibiotic therapy
b. Oral hydrogen peroxide abuse
c. Therapeutic irradiation to the head and neck
d. All the above
e. None of the above

 

ANS:   D                     REF:    Chap 3 (Hairy tongue/Etiology), p 88

 

  1. Actinic cheilitis:
a. Is quite harmless if Vaseline is used to protect the lip
b. Is due to infrared radiation
c. Has no malignant potential
d. Is seen predominantly in the lower lip
e. None of the above

 

ANS:   D                     REF:    Chap 3 (Actinic cheilitis), pp 90-91

 

  1. All the following are effective in the treatment of acute oral candidiasis except:
a. Mycelex troches
b. Lotrimin tablets
c. Acyclovir tablets
d. Nystatin pastilles
e. Mycostatin oral suspension

 

ANS:   C                     REF:    Chap 3 (Candidiasis/Treatment and prognosis), p 108

 

  1. Which of the following provides a patient with increased risk for the development of oral squamous cell carcinoma?
a. Idiopathic leukoplakia
b. Erythroplakia
c. Submucous fibrosis
d. Lichen planus
e. All the above

 

ANS:   E

REF:    Chap 3 (Idiopathic leukoplakia/Submucous fibrosis/Lichen planus), pp 91-95, 97-102, 109-110 | Chap 4 (Erythroplakia), pp 121-122

 

  1. Fluconazole is a systemically taken drug that is particularly effective in the treatment of which of the following?
a. Candidiasis
b. Syphilis
c. Actinomycosis
d. Tuberculosis
e. Zoster

 

ANS:   A

REF:    Chap 3 (Candidiasis/Treatment and prognosis/Box 3-16), p 108

 

  1. Idiopathic leukoplakia:
a. May recur after excision
b. Is caused by papillomavirus
c. Is clinically diagnostic and therefore requires no biopsy
d. Is most commonly seen in children and young adults
e. None of the above

 

ANS:   A                     REF:    Chap 3 (Idiopathic leukoplakia/Treatment and prognosis), p 95

 

  1. Hairy leukoplakia:
a. May be seen in non-HIV immunosuppressed patients
b. May appear as a flat or papillated lesion
c. Occurs most commonly on the tongue
d. May be bilateral
e. All the above

 

ANS:   E                     REF:    Chap 3 (Hairy leukoplakia), pp 86-87

 

  1. A 32-year-old man presented with a 1 ´ 2 cm macular red-blue lesion in his hard palate. The lesion was asymptomatic and had been present for an unknown duration. He had no dental abnormalities and no significant periodontal disease. This could be all the following except:
a. Vascular malformation
b. Nicotine stomatitis
c. Ecchymosis
d. Kaposi’s sarcoma
e. Erythroplasia

 

ANS:   B                     REF:    Chap 3 (Nicotine stomatitis—entire topic), pp 85-86

 

  1. Oral white patches that are of unknown cause, cannot be rubbed off, and cannot be clinically diagnosed as any other condition should be:
a. Ignored
b. Treated symptomatically if painful
c. Observed
d. Biopsied
e. None of the above

 

ANS:   D                     REF:    Chap 3 (White lesions—entire chapter), pp 79-111

 

  1. A 55-year-old man presents with a 1 ´ 1 cm white lesion of his edentulous alveolar ridge. The clinical differential diagnosis should include:
a. Lichen planus
b. Hairy leukoplakia
c. Ectopic lymphoid tissue
d. Frictional hyperkeratosis
e. All the above

 

ANS:   D                     REF:    Chap 3 (Focal [frictional] hyperkeratosis), pp 82-83

 

  1. Which of the following typically presents clinically as a yellow submucosal nodule?
a. White sponge nevus
b. Squamous cell carcinoma
c. Ectopic lymphoid tissue
d. Amalgam tattoo
e. None of the above

 

ANS:   C                     REF:    Chap 3 (Ectopic lymphoid tissue), p 110

 

  1. Which of the following microscopic features is responsible for the clinical appearance of Wickham’s striae?
a. Fibrin deposition
b. Reduced vascularity
c. Acantholysis
d. Hyperkeratosis
e. Intracellular keratinocyte edema

 

ANS:   D                     REF:    Chap 3 (Lichen planus/Clinical features), pp 98-99

 

  1. Circulating antibodies directed against nuclear and cytoplasmic proteins are seen in which of the following conditions?
a. Discoid lupus erythematosus
b. Systemic lupus erythematosus
c. Primary syphilis
d. Mucous membrane pemphigoid
e. Hereditary epidermolysis bullosa

 

ANS:   B                     REF:    Chap 3 (Systemic lupus erythematosus), pp 102-103

 

 

Chapter 5: Pigmented Lesions

Test Bank

 

MULTIPLE CHOICE

 

  1. In addition to multiple neurofibromas, what other lesions are seen as part of the syndrome neurofibromatosis?
a. Traumatic neuromas
b. Mucosal vascular malformations
c. Intestinal polyps
d. Cutaneous pigmented patches
e. Odontogenic keratocysts

 

ANS:   D                     REF:    Chap 5 (Café-au-lait macules), p 138

 

  1. Mucosal neuromas, pheochromocytoma, and medullary carcinoma of the thyroid constitute which of the following syndromes?
a. Albright’s syndrome
b. Sjögren’s syndrome
c. von Recklinghausen’s disease of skin
d. Peutz-Jeghers syndrome
e. None of the above

 

ANS:   E

REF:    Chap 5 (Café-au-lait macules), p 138 | Chap 8 (Sjögren’s syndrome), pp 196-199 | also Clinical Overview

 

  1. Amalgam tattoo is a common oral lesion that must be differentiated through clinical history or biopsy from which of the following?
a. Chronic infection
b. Squamous cell carcinoma
c. Early melanoma
d. Hereditary hemorrhagic telangiectasia
e. Gardner’s syndrome

 

ANS:   C

REF:    Chap 5 (Amalgam tattoo [focal argyrosis]/Differential diagnosis), p 145

 

  1. Lateral or radial spread at the epithelial–connective tissue interface is a characteristic growth feature of which of the following pigmented lesions?
a. Blue nevus
b. Ephelis
c. In situ melanoma
d. Invasive melanoma
e. Amalgam tattoo

 

ANS:   C                     REF:    Chap 5 (Oral melanoma), p 142

 

  1. Acquired oral melanin pigmented lesions may be associated with which of the following?
a. Aspirin abuse
b. Penicillin ingestion
c. Chronic infection by C. albicans
d. Xerostomia
e. None of the above

 

ANS:   E

REF:    Chap 5 (Melanocytic lesions—entire topic/Box 5-3), pp 134-144

 

  1. A 40-year-old woman presents with multiple melanotic macules of her lips and buccal mucosa. If the patient is found to have adrenal insufficiency, which of the following conditions should be considered?
a. von Recklinghausen’s disease of skin
b. McCune-Albright syndrome
c. Addison’s disease
d. Peutz-Jeghers syndrome
e. None of the above

 

ANS:   C                     REF:    Chap 5 (Oral melanotic macule/Clinical features), pp 136-137

 

  1. Both in situ and invasive oral melanomas exhibit the same distinctive site predilection. This is the:
a. Buccal mucosa
b. Palate
c. Lateral tongue
d. Lower lip
e. Tonsillar pillar

 

ANS:   B                     REF:    Chap 5 (Oral melanoma), p 142

 

  1. Oral mucosal lesions may exhibit a red to blue to black color for one of several reasons. These would include all the following except:
a. Increased number of submucosal vessels
b. Submucosal extravasation of blood
c. Deposition of foreign material
d. Increased thickness of epithelium
e. Hyperemia (vascular congestion)

 

ANS:   D                     REF:    Chap 5 (Melanocytic lesions—entire topic), pp 134-144

 

  1. Which of the following can have clinical features that are similar to early superficial or in situ melanoma?
a. Early Kaposi’s sarcoma
b. Amalgam tattoo
c. Drug-induced pigmentation
d. Melanotic macule
e. All of the above

 

ANS:   E                     REF:    Chap 5 (Melanoma/Differential diagnosis), p 144

 

  1. Pigmented nevi are commonly seen in skin but are relatively rare in the oral mucosa. Intraorally, they are most likely to be found in which of the following locations?
a. Tongue
b. Buccal mucosa
c. Floor of mouth
d. Lower lip
e. Palate

 

ANS:   E                     REF:    Chap 5 (Nevomelanocytic nevus/Clinical features), p 140

 

  1. A 30-year-old woman presents with recently acquired generalized tanning of the skin and multiple intraoral pigmented macules. Oral biopsy showed excessive melanin pigment in basal keratinocytes. This patient should be suspected of having:
a. Addison’s disease
b. Sunburn
c. Kaposi’s sarcoma
d. Leukemia
e. Melanoma

 

ANS:   A                     REF:    Chap 5 (Oral melanotic macule/Histopathology), p 137

 

  1. Café-au-lait macules (more than five) and multiple neurofibromas are typically seen in which of the following conditions?
a. Lichen planus
b. Crohn’s disease
c. Addison’s disease
d. Peutz-Jeghers syndrome
e. None of the above

 

ANS:   E                     REF:    Chap 5 (Café-au-lait macules), p 138

 

  1. All of the following are known to have the capacity to cause oral mucosal pigmentation except:
a. Amalgam
b. Bismuth
c. Mercury vapors
d. Penicillin
e. Minocycline

 

ANS:   D                     REF:    Chap 5 (Nonmelanocytic lesions—entire topic), pp 145-147

 

  1. Which of the following pigmented lesions of oral mucosa is most commonly encountered in dental patients?
a. Freckles (ephelides)
b. Intramucosal nevus
c. Melanoma
d. Amalgam tattoo
e. Bismuth line

 

ANS:   D                     REF:    Chap 5 (Amalgam tattoo/Clinical features), p 145

 

  1. A 37-year-old man presents with a blue-black macule (1 ´ 1 cm) in his palate. The area is covered with intact epithelium and there was no apparent inflammatory response. Biopsy shows deposits of black foreign material. This suggests which of the following?
a. Kaposi’s sarcoma
b. Melanoma
c. Amalgam tattoo
d. Erythroplakia
e. Melanotic macule

 

ANS:   C                     REF:    Chap 5 (Amalgam tattoo), p 145

 

  1. The characteristic oral manifestation of Peutz-Jeghers syndrome is:
a. Bilateral reticular white lesions in the buccal mucosa
b. Red patch in the palate
c. Nodular yellow-white lesions in the buccal mucosa
d. Perioral pigmented macules
e. Red patch on midline dorsum of the tongue

 

ANS:   D                     REF:    Chap 5 (Oral melanotic macule/Clinical features), pp 136-137

 

  1. All the following suggest the possibility of intraoral melanoma except:
a. Rapid increase in size
b. Satellite lesions
c. Ulceration
d. Bilateral symmetric lesions
e. Darkening color

 

ANS:   D                     REF:    Chap 5 (Oral melanoma—entire topic), pp 142-143

 

  1. A 34-year-old man presents with an asymptomatic 1 ´ 1 cm pigmented lesion in the right side of his palate. It is flat, and it is asymptomatic. Biopsy shows melanin pigment within a collection of benign-appearing spindle-shaped cells in the submucosa. This is consistent with:
a. Melanoma
b. Amalgam tattoo
c. Blue nevus
d. Melanotic macule
e. Physiologic pigmentation

 

ANS:   C                     REF:    Chap 5 (Nevomelanocytic nevus—entire topic), pp 139-141

 

  1. Oral melanomas are classified into microscopic subtypes based primarily on which of the following feature?
a. Evidence of invasion of lymphatic vascular spaces
b. Microscopic growth pattern
c. Number of mitotic figures
d. Nuclear pleomorphism
e. Evidence of lymph node metastasis

 

ANS:   B                     REF:    Chap 5 (Oral melanoma), pp 142-143

 

  1. All the following drugs are known to have the ability to cause pigmentation of the oral mucosa except:
a. Dilantin
b. Minocycline
c. Cytoxan
d. AZT (zidovudine)

 

ANS:   A                     REF:    Chap 5 (Drug-induced pigmentations), pp 145-146

 

  1. Generally, which of the following has the worst prognosis?
a. Oral verrucous carcinoma
b. Cutaneous basal cell carcinoma
c. Cutaneous melanoma
d. Oral melanoma
e. Oral erythroplasia

 

ANS:   D                     REF:    Chap 5 (Oral melanoma), p 142