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ORAL PATHOLOGY

A well-defined radiolucency at the apex of a non-vital tooth is most likely a/an


A. lateral periodontal cyst.
B. ameloblastoma.
C. odontogenic keratocyst.
@D. rarefying osteitis. .
RAREFYING AND CONDENSING OSTEITIS
Frequently, rarefying and condensing osteitis occurs at
the apex of a nonvital tooth or a retained root (Fig. 24-3).
Chronic infection acts as an irritating factor (causing resorption
of bone) and as a stimulating factor (producing
dense bone, perhaps as a defense mechanism to contain
the local problem.

An inflammatory cellular infiltrate found in the connective tissue of healthy gingiva is


A. a routine microscopic finding.
B. an indication of systemic disease.
C. composed chiefly of macrophages.
D. a tissue response to food decomposition.
The most common site of a basal cell carcinoma is the
A. middle third of the face.
B. lower lip.
C. tongue.
D. oral mucosa.
The cell of the dental pulp most capable of transforming into other cells is the
A. fibroblast.
B. undifferentiated mesenchymal cell.
C. odontoblast.
D. histiocyte. .
Cell rests of Malassez are thought to originate from
A. stellate reticulum.
B. dental papilla.
C. Hertwig's root sheath.
D. stratum intermedium. .
When odontoblasts are destroyed or undergo degeneration, they are replaced by
A. ameloblasts.
B. undifferentiated mesenchymal cells.
C. multinucleated giant cells.
D. osteoblasts. .
In an 80-year old patient you would expect
A. a reduced size of the pulp chamber.
B. increased incidence of pulp stones.
C. increased tendency to pulpal fibrosis.
D. All of the above. .

Xerostomia can be associated with


A. hormonal imbalance.
B. hypertension and anxiety.
C. adverse effects of medication.
D. emotional problems.
E. All of the above. .
Aging of the pulp is evidenced by a relative increase in
1. vascularity.
2. nerve tissue.
3. cell numbers.
4. fibrous elements.
5. calcification.
A. (1) (2) (3)
B. (1) and (3)
C. (3) (4) (5)
D. (4) and (5) .
The most common area for the location of periapical osteofibrosis (cementoma) is
A. maxillary anterior region.
B. mandibular anterior region.
C. mandibular premolar region.(cementoblastoma or true cementoma)
D. maxillary posterior region.
E. All of the above. .
In teeth with complete pulp necrosis, the periapical area is involved if
1. there is pain to thermal stimuli.
2. there is pain on percussion.
3. the tooth throbs when the patient is lying down.
4. the radiograph shows an apical radiolucency.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above.
Which of the following cells are characteristic of chronic inflammation of the dental pulp?
1. Neutrophils.
2. Eosinophils.
3. Lymphocytes.
4. Macrophages.
5. Plasma cells.
A. (1) (2) (3)
B. (1) and (2)
C. (1) (4) (5)
D. (1) and (5)
E. (3) (4) (5) .

Cytologic examination may aid in the diagnosis of


1. Herpes simplex.
2. Recurrent aphthae.
3. Pemphigus vulgaris.
4. Erosive lichen planus.
5. Carcinoma in situ.
A. (1) (3) (4)
B. (1) (3) (5)
C. (1) (4) (5)
D. (2) (3) (4) .
Which of the following is necessary to make a diagnosis of an odontogenic keratocyst?
A. Aspiration.
B. Exfoliative cytology.
C. Radiographic examination.
D. Histologic examination.
????A patient has a smooth, red, protruding lesion at the tip of the tongue. Microscopic examination reveals a
stratified squamous epithelium covering loose, fibrous connective tissue with many thin-walled vascular spaces.
The diagnosis is
A. fibroma.
B. papilloma.
C. hemangioma.
D. pleomorphic adenoma.
E. granular cell tumor (myoblastoma).
Enlargement of the thyroid gland can be caused by
A. insufficient fluoride.
B. excess iodine.
C. insufficient iodine.
D. excess calcium.
E. excess sodium. .
Which of the following has the highest rate of recurrence?
A. Odontogenic keratocyst.
B. Nasoalveolar cyst.
C. Median palatal cyst.
D. Incisive canal cyst. .
Which of the following conditions is characterized by abnormally large pulp chambers?
A. Amelogenesis imperfecta.
B. Regional odontodysplasia.
C. Dentinogenesis imperfecta.
D. Dentinal dysplasia Type I.
Regional odontodysplasia
Radiographically, there is a lack of contrast between the enamel dentin, both of which are less radiopaque than
unaffected counterparts. Additionally, enamel and dentin layers are thin, giving the teeth a ghost-like
appearance. The pulp chambers are noticeably enlarged with open apices and enlarged follicles

A primordial cyst
A. develops in place of a tooth.
B. attaches to the apex of a tooth.
C. attaches to the crown of a tooth (dentigerous cyst.)
D. remains after the tooth is extracted.
A primordial cyst is now referred to as odontogenic keratocyst
Osteogenesis imperfecta is manifested by
A. punched-out radiolucencies in the jaws.
B. numerous unerupted supernumerary teeth.
C. osteoporosis and anemia.
D. multiple fractures and blue sclera.
Eosinophilic granuloma
A. is found only at the apices of non-vital teeth.
B. occurs in infants.
C. is a non-lipid reticulo-endotheliosis.
D. is caused by a virus.
An unsual type of ulceration,sometime sreferred to as eosinophili culcer,traumatic granuloma,or
eosinophilic granuloma of soft tissues, appears to be associated particularly with trauma and crush
injury to muscle, although the pathogenesis of the lesion is unclear. It occurs most commonly on
the tongue and presents clinically as a chronic, well-demarcated ulcer which may mimic a
squamous cell carcinoma. Any age can be affected.
Dysplastic lesions of squamous epithelium occur most often on the
A. palate.
B. gingiva.
C. buccal mucosa.
D. dorsum of the tongue.
E. floor of the mouth. .
Which of the following tumors may arise in the parotid salivary gland?
1. Mixed tumor.
2. Adenocarcinoma.
3. Warthin's tumor.
4. Mucoepidermoid tumor.
A. (1) (2) (3)
B. (1) (2) (4)
C. (1) (3) (4)
D. (2) (3) (4)
E. All of the above. .
Which of the following is the most frequent cause of ankylosis of the temporomandibular joint?
A. Intra-articular injection of steroids.
B. Chronic subluxation.
C. Trauma.
D. Anterior disc dislocation.
The most likely origin of a metastic carcinoma of the mandible is a primary lesion of the
1. lung.
2. breast.

3. prostate.
4. nasopharynx.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above. .
Metastatic lesions may occur in the oral soft tissues, in the jawbones or in both osseous and soft tissue. The
common primary sources of tumors metastatic to the oral region are the breast, lung and kidney. The lung is the
most common source of metastases to the oral soft tissues, whereas the breast is the most common source for
metastatic tumors to the jawbones. In the jawbones the mandible is the most common location for metastases,
with the molar area being the most frequently involved site
Diabetes mellitus is the result of
A. hypersecretion of the posterior pituitary.
B. atrophy of the islands of Langerhans.
C. destruction of the adrenal cortex.
D. destruction of the posterior pituitary or associated hypothalamic centres.
Which of the following is/are characterized by an obliteration of pulp chambers and root canals?
1. Ageing. +
2. Chronic trauma. +
3. Dentinal dysplasia. ?
4. Taurodontism. ?@A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above. .
Hyperplastic lingual tonsils may resemble which of the following?
A. Epulis fissuratum.
B. Lingual varicosities.
C. Squamous cell carcinoma.
D. Median rhomboid glossitis.
E. Prominent fungiform papillae
The treatment of an ameloblastoma is
A. chemotherapy.
B. enucleation.
C. resection.
D. radiotherapy.
E. None of the above.
Wide excision taking up to 2cm of adjacent normal bone
In patients with cleft palates there may be
A. an increase in supernumerary teeth.
B. an increase in congenitally missing teeth.
C. a higher incidence of crown defects.
D. All of the above. .
Hypoglycemia is characterized by
1. mental confusion.

2. tachycardia.
3. sweating.
4. nausea.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above. .
A 70-year old female has consumed optimal levels of fluorides all her life. You would expect to find a decreased
incidence of
1. Paget's disease of bone.
2. osteoporosis.
3. hyperparathyroidism.
4. dental caries.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above. .
???Which of the following is most often associated with a non-vital tooth?
A. Periapical cyst.
B. Internal resorption.
C. Periapical cementoma.
D. Hyperplastic pulpitis.
An ameloblastoma can develop from the epithelial lining of which of the following cysts?
A. Periapical.
B. Dentigerous.
C. Residual.
D. Lateral periodontal. .
Which of the following lesions is most commonly found in the anterior region of the mandible?
A. Ameloblastoma.
B. Calcifying epithelial odontogenic tumor (Pindborgs tumour).
C. Central cementifying fibroma. (found in mandibular premolar region)
D. Periapical cemental dysplasia (periapical cementoma(s)).
Prognosis for a patient with oral squamous cell carcinoma depends upon which of the following factors?
1. Size of the tumor.
2. Location of the tumor.
3. Lymph node involvement.
4. Symptoms.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above. .
Prognosis of oral squamous cell carcinomas

The major factors thought to influence prognosis have been incorporated into clinical staging
systems which assess the extent of disease in the patient. The most widely used is the TNM system
(Table 10.2) which is based on three parameters: T, the size of the primary lesion; N, the extent
and distribution of metastases in the regional lymph nodes; M, the presence or not of distant

metastases.
If carcinoma of the tongue is localized (no lymph node involvement), 5-yr survival is > 50%. For localized
carcinoma of the floor of the mouth, 5-yr survival is 65%. Lymph node metastasis decreases survival rate by
about 50%. Metastases reach the regional lymph nodes first and later the lungs.
For lower lip lesions, 5-yr survival is 90%, and metastases are rare. Carcinoma of the upper lip tends to be more
aggressive and metastatic. For carcinoma of the palate and tonsillar area, 5-yr survival is 68% if patients are
treated before lymph node involvement but only 17% after involvement. The prognosis for tonsillar carcinoma
is often better stage for stage than that for oral cancers. Oropharyngeal cancer associated with HPV infection
may have a better prognosis
Desquamative gingivitis is seen in
1. pemphigus vulgaris.
2. mucous membrane pemphigoid.
3. erosive lichen planus.
4. erythema multiforme.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above.
????If extracted teeth are not replaced for several years, the bone will show
A. increased condensation.
B. atrophic change.
C. decreased trabecular size.
D. increased rate of calcification.
A periapical abscess of a mandibular second molar that has perforated the lingual cortical plate below the origin
of the mylohyoid muscle may result in an infection of the
A. buccal space.
B. sublingual space.
C. submandibular space.
D. submental space.
E. superficial masticatory space.
The surgical procedure indicated for odontogenic cysts is
A. enucleation.
B. cauterization.
C. incision and drainage.
Periapical infection from a mandibular second molar may spread by direct extension to the
1. buccal space. (also called sub-maxillary space)
2. buccal vestibule.
3. sublingual space.

4. submandibular space.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above.
Odontogenic infections can spread by
A. direct extension.
B. lymphatics.
C. ingestion.
D. All of the above. .
Histologically, a pulp polyp consists of
1. a mass of collagenous fibres.
2. Russell bodies.
a small spherical intracytoplasmic hyaline body common in plasma cell in chronic inflammation
3. proliferating capillaries.
4. fibroblasts.
5. polymorphonuclear leucocytes.
A. (1) (2) (3) (4)
B. (1) (3) (4)
C. (1) (3) (4) (5)
D. (2) and (5)
E. All of the above. .
Cleidocranial dysostosis can cause
A. premature loss of teeth.
B. concomitant micrognathia.
C. high incidence of clefts.
D. associated high caries index.
E. multiple supernumerary and unerupted teeth.
Xerostomia can be
1. found in the elderly.
2. drug induced.
3. associated with diabetes.
4. predisposing to dental diseases.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above. .
Periapical odontogenic cysts are associated with
A. impacted wisdom teeth.
B. congenitally missing teeth.
C. non-vital teeth.
D. a history of traumatic injury.

Condensing osteitis in the periapical region is indicative of a/an


A. acute inflammation of the pulp.
B. pulpal abscess.
C. chronic inflammation of the pulp.
D. early apical abscess formation.
E. None of the above. .
Dental decks: Also referred to as chronic focal sclerosing osteomyelitis: It is an unusual reaction of bone to
infection which occurs in instances of extremely high tissue reaction of bone to infection incases of hightissue
rxn or low grade infection. Pulp is infected. X-ray well circumscribed radioopaque lesion-sclerotic bone outline
and assoc with apex of root/s. Entire root outline often visible
benign cementoblastoma: root outline not visible
Which of the following conditions is most likely to be associated with a draining fistula?
A. Chronic periapical periodontitis.
B. Reversible pulpitis.
C. Hypercementosis.
D. Traumatic bone cyst.
Which of the following is the LEAST likely primary site for the development of oral squamous cell carcinoma
in the elderly?
A. Dorsum of the tongue.
B. Floor of the mouth.
C. Lateral border of the tongue.
D. Tonsillar fossa. .
Which of the following are vital signs?
1. Blood pressure.
2. Body temperature.
3. Pulse rate and respiration.
4. Pupil size.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above. .
Vital signs are measures of various physiological statistics, often taken by health professionals, in order to
assess the most basic body functions. Vital signs are an essential part of a case presentation. The act of taking
vital signs normally entails recording Body temperature, Pulse rate (or heart rate), Blood pressure, and
Respiratory rate, but may also include other measurements. Vital signs often vary by age
The cardinal signs of inflammation are
1. redness.
2. pain.
3. swelling.
4. loss of function.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above. .

In the management of a patient with an acute odontogenic infection, the treatment should include:
1. elimination of the cause.
2. drainage.
3. supportive therapy.
4. tetanus immunization.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above. .
??Marsupialization (PARTSCH PROCEDURE) is the preferred surgical technique in the management of
1. a cyst.
2. a keratocyst.(enucleation)
3. ranula. (may be recurred if marsupialisation,best treatment:surgical excision with salivary gland removal)
4. osteomyelitis.
A. (1) and (2)
B. (1) and (3)
C. (2) and (4)
D. (1) (2) (3) .
Benign neoplasms
1. grow slowly.
2. are generally painless.
3. can be managed conservatively.
4. can metastasize.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above. .
The most common site in the oral cavity for a squamous cell carcinoma is
A. floor of the mouth.
B. buccal mucosa.
C. palate.
D. gingiva. .
The epithelial attachment
A. in health, is located at the cemento-enamel junction.
B. with periodontitis, moves apically along the root surface as periodontal disease progresses.
C. is composed of stratified squamous non-keratinized epithelium.
D. All of the above.
Hypercementosis at the root apex is often associated with
A. hypothyroidism.
B. Paget's disease.
C. orthodontic tooth movement.
D. normal occlusal function.
E. hyperparathyroidism. .

Dental decks
A loss of sensation in the lower lip may be produced by
1. Bell's palsy.
2. metastatic malignancy to the body of the mandible.
3. trigeminal neuralgia.
4. fracture in the mandibular first molar region.
A. (1) (2) (3)
B. (1) and (3)
??C. (2) and (4)
D. (4) only
E. All of the above. .
Cultures made from a dental abscess indicate the infection is caused by beta hemolytic streptococcus.
Which of the following is the drug of choice?
A. Penicillin.
B. Erythromycin.
C. Tetracycline.
D. Cloxacillin.
Lichen planus occurs most frequently on the
A. buccal mucosa.
B. tongue.
C. floor of the mouth.
D. gingiva. .
A 30-year old HIV positive patient comes to your office for the removal of an abscessed second molar. You
should:
A. Refer him to another dentist because your infection control procedures are inappropriate for this type of
condition.
B. Treat him at the end of the day.
@C. Treat him in the same way you treat all your other patients.
D. Double glove before starting any surgical procedures.
Pain and difficulty on swallowing, trismus and a displaced uvula are signs and symptoms of infection of which
one of the following spaces?
A. Submandibular.
B. Lateral parapharyngeal.
C. Sublingual.
D. Deep temporal.
E. Submasseteric. .
The white appearance of the oral mucosa seen following extended local application of aspirin is the result of
A. hyperparakeratosis.
B. acanthosis.
C. coagulation necrosis.
D. edema.
Hyperkeratosis, acanthosis, dysplasia, increased mitosis, intact basal cell layer and chronic inflammatory cells
are histologic features that may be found in
A. squamous cell carcinoma.
B. carcinoma in situ.

C. papillofibroma.
D. endothelioma. .
Physiologic (racial) pigmentation differs from melanoma because melanoma
A. is macular.
B. contains melanin.
C. affects the gingiva.
D. undergoes clinical changes.
Smoker's melanosis
A. is painful.
B. tends to give rise to melanoma.
C. most commonly affects the anterior gingiva.
D. resolves within a few weeks after quitting smoking.
Aphthous ulcers are characterized by
1. pain.
2. pseudomembranes.
3. inflammation.
4. vesicle formation.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above
Burning mouth syndrome is associated with:
A. Clinically normal-appearing mucosa.
B. Clinically erythematous, atrophic-appearing mucosa.
C. Candidal pseudohyphae on cytologic smears.
D. Keratinocytes with enlarged nuclei on cytologic smears.
In the treatment of necrotizing ulcerative gingivitis (NUG) with associated lymphadenopathy, which of the
following medications is the treatment of choice?
A. An anti-inflammatory.
B. A topical antibiotic.
C. A systemic antibiotic.
D. An analgesic. .
Osteomyelitis of the mandible may follow
1. radiotherapy.
2. dentoalveolar abscess.
3. fracture.
4. Vincents angina. (occurs in the palate)
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above. .
Which of the following is the most effective pharmacologic treatment for angular cheilosis?
A. Penicillin.

B. Erythomycin.
C. Tetracycline.
D. Clindamycin.
E. Nystatin. .
Which articular disease most often accompanies Sjgrens syndrome?
A. Suppurative arthritis.
B. Rheumatoid arthritis.
C. Degenerative arthrosis.
D. Psoriatic arthritis.
E. Lupus arthritis. .
Candidal superinfection of lichen planus is NOT related to:
A. Smoking.
B. Medications.
C. Blood pressure.
D. Diabetes mellitus. .
In primary or secondary hyperparathyroidism, which of the following will NOT be found?
A. Hyperplasia of the gingiva.
B. Alteration of the trabecular bone pattern.
C. Generalized loss of lamina dura.
D. Giant cell tumours of bone.
Repeated facial trauma can cause a/an:
A. Masseter hypertrophy.
B. Osteosarcoma.
C. Suppurative myositis.
D. Ossifying myositis.
E. Ossifying periostitis.
Which of the following is the most frequent major congenital malformation of the head and neck?
A. Cystic hygroma colli.
B. Cleft palate.
C. Encephalotrigeminal angiomatosis.
D. Double lip.
E. Commissural pits. .
The most frequent radiographic appearance of metastatic carcinoma in the oral cavity is a
A. poorly-defined radiolucency, anterior maxilla.
B. poorly-defined radiolucency, posterior mandible.
C. well-defined radiolucency, anterior maxilla.
D. well-defined radiolucency, posterior mandible.
Which of the following is characteristic of periapical cemental dysplasia?
A. Pain.
B. Expansion.
C. Biopsy is NOT usually necessary.
D. Requires endodontics or extraction.
Pain, associated with temporomandibular disorders is most frequently caused by
A. impacted third molars.
B. perforation of the articular disks.

C. muscle hyperactivity.
D. subluxation. .
Acute osteomyelitis of the mandible differs from malignant neoplasm because it
A. is asymptomatic.
B. is associated with high fever.
C. has an excellent prognosis.
D. has well defined radiographic margins.
Osteosarcoma differs from fibrous dysplasia because it
A. can invade soft tissue.
B. has ill-defined radiographic margins.
C. can be radiolucent, mixed or radiopaque.
D. is difficult to curette from normal bone.
Focal periapical osteopetrosis (dense bone island) differs from focal sclerosing osteomyelitis in that it is
A. expansile.
B. periapical.
C. radiopaque.
D. caused by pulpitis. .
The epithelial lining of a radicular cyst is derived from
A. the epithelial cell rests of Malassez.
B. oral epithelium proliferating apically from a periodontal pocket.
C. endothelial proliferation of capillaries in the area.
D. metaplasia of histiocytes and/or cementoblasts.
Dentigerous cysts are usually found
A. periapically.
B. pericoronally.
C. interradicularly.
D. mid-root. .
The primordial cyst probably results from
A. cystic degeneration of the stellate reticulum early in the formation of the tooth.
B. epithelial remnants in the periodontal ligament.
C. an extension of pulpal inflammation after death of the pulp.
D. failure of formation of the enamel matrix.
E. the dental lamina. .
A patient with a tumor in the right infratemporal fossa shows a significant shift of the mandible to the right
when opening. Which nerve is involved?
A. Facial nerve VII.
B. Glossopharyngeal nerve IX.
C. Trigeminal nerve V.
D. Hypoglossal nerve XII. .
Which of the following is/are associated with an unerupted tooth?
1. Odontogenic adenomatoid tumor. (73%)(maxillary canine)
2. Periapical cemental dysplasia.3. Calcifying epithelial odontogenic tumor. (52%)
4. Cementoblastoma.

A. (1) (2) (3)


B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above. .
A small, well-circumscribed, periapical radiolucency on a mandibular incisor which is clinically asymptomatic
and responds normally to vitality tests is most likely
A. a periapical granuloma.
B. sclerosing osteitis.
C. a radicular cyst.
D. periapical cemental dysplasia
In a xerostomic patient which salivary gland(s) is/are most likely responsible for the lack of lubrication?
A. Accessory.
B. Labial.
C. Parotid.
D. Sublingual and submandibular.
Which chemical mediator of inflammation is blocked or reversed by a nonsteroidal anti-inflammatory drug
(NSAID)?
A. Bradykinin.
B. Histamine.
C. Substance P.
D. Prostaglandin. .
The parasympathetic post ganglionic fibers leaving the otic ganglion will travel along which cranial nerve?
A. Glossopharyngeal.
B. Branch of the mandibular.
C. Temporal.
D. Facial. .
A patient complains of lip and tongue hypersensitivity (allodynea) following intake of hot, spicy food. The
sensory nerve fibers that are associated with this form of pain are
A. A-alpha.
B. A-beta.
C. A-gamma.
D. A-delta and C. .
Histological sections of a lesion removed from the apex of a carious tooth show immature fibrous tissue and
chronic inflammatory cells. The most likely diagnosis is a/an
A. acute periapical abscess.
B. odontogenic fibroma.
C. radicular cyst.
D. periapical granuloma.
E. central fibroma. .
Chewing automatism is dependent on which mechanism?
A. Reflexes between jaw closing and opening muscles.
B. Swallowing and respiration neuronal activity.
C. Periodontal receptor stimulation.
D. Reticular formation neuronal activity.

The physiopathology of sleep apnea is most likely related to


A. excessive oropharyngeal muscular tonus during sleep.
B. central nervous system respiratory neuron depression.
C. obstruction in lower airways.
D. a severe Class III malocclusion.
A 23 year old female complains of bilateral stiffness and soreness in the preauricular region. Her symptoms
have been present for the past week and are most pronounced in the morning. The most likely cause is
A. fibrous ankylosis of the temporomandibular joints.
B. nocturnal bruxism.
C. early osteoarthritis.
D. mandibular subluxation.
An enameloma is
A. an odontoma.
B. an ameloblastoma.
C. a pearl of enamel at the cemento-enamel junction.
D. an enamel hypocalcification.
Which of the following statements applies to the submandibular lymph nodes?
1. They discharge into the internal jugular nodes.
2. When draining an area of acute infection, they are enlarged, nontender, soft, well defined and movable.
3. They are found medially to the mandible.
4. They drain the anterior palatine pillar, soft palate, posterior third of the tongue.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only.
E. All of the above. .
The epithelium covering the lesions of chronic hyperplastic pulpitis is believed to be derived from the
A. reduced enamel epithelium.
B. epithelium of the oral mucosa.
C. odontoblastic layer.
D. epithelial rests of Malassez.
E. remnants of the dental lamina.
Which of the following conditions is the most dangerous?
A. Acute periapical abscess of a mandibular central incisor.
B. Middle face cellulitis.
C. Chronic periapical abscess of a mandibular third molar.
D. Infected dentigerous cyst.
In an acute periapical abscess, which of the following teeth is most likely to spread infection to the
submandibular space?
A. Mandibular second bicuspid.
B. Maxillary third molar.
C. Mandibular first molar.
D. Mandibular third molar.
E. Mandibular lateral inisor.

Mandibular premolars and first molars primarily in sublingual space and M3 most commonly involves
the submandibular space primarily and directly. M2 may involve the sublingual or submadibular space
depending on the length of its roots.
A 45 year old with insulin dependent diabetes mellitus comes for a morning dental appointment. During the
examination, the patient complains of being lightheaded and weak. Sweating is observed. The patient is most
likely experiencing
A. hyperglycemia.
B. hypoglycemia.
C. syncope.
D. hyperventilation.
E. cerebrovascular accident.
Fordyce's spots or granules have the clinical appearance of small yellow spots on the buccal mucosa. This is due
to the presence of
A. sweat glands.
B. implanted epithelium.
C. cyst formation.
D. sebaceous glands.
E. hyperkeratosis. .
A vertical cross-section of a smooth surface carious lesion in enamel appears as a triangle with the
A. base at the dentino-enamel junction.
B. base facing toward the pulp.
C. apex pointing to the enamel surface
D. apex pointing to the dentino-enamel junction
Which of the following mucosae is normally keratinized?
A. Soft palate.
B. Hard palate.
C. Lateral tongue.
D. Ventral tongue.
Periapical cemental dysplasia is
A. painful.
B. expansile.
C. associated with vital teeth.
D. premalignant. .
Radiographs of Garre's osteomyelitis show
A. radiopaque islands of bone that represent formation of sequestra.
B. a worm-eaten pattern of bone destruction.
@C. thickening of the cortex.
D. A. and B.
E. All of the above. .

Which of the following is NOT characteristic of acute leukemia?


A. Gingival enlargement.
@B. Decreased bleeding time.
C. Elevated leukocyte count.
D. Anemia.
E. Thrombocytopenia. .
Characteristics of acute leukemia include: orpharyngeal esions as initial complaint(10%)
Oral bleeding/ mucosal pallor/gingival swelling/
Which of the following is NOT suggestive of a diagnosis of necrotizing ulcerative gingivitis (NUG)?
A. Bleeding from the gingiva.
B. Punched-out papillae with necrotic slough.
C. Bad breath.
D. Metallic taste.
E. Periodontal pocketing.
???Which of the following is NOT associated with Cushings disease?
A. Buffalo hump.
B. Osteoporosis.
C. Hirsutism.
D. Hypertension.
E. Diabetes insipidus. .
Reference pathology secrets pp 328/387
Cushing disease is hypercortisolism caused by ACTH secreting tumor[ ACTh molecule ahs a melanocyte
stimulating factor and so the condition is associated with hypeerpigmentation of the skin.
CushingSyndrome
Caused by excess corticosteroids production and patients presents with the complex metabolic abnormalities ;
diabetes mellitus, fat redistribution, atrophy of skin and bone neuropsychiatric disturbances and menstrual
irregularities.
KEY:
B- buffalo hump
U- unusual behaviour [ depresssion, personality changes, fatiguability
F- facial features[ moon face, hirsutism in women]
F- fat-obesity
A- ACTH in blood and dexamethasone test abnormalities
L- loss of muscle mass
O- overextended skin ( striae which bruise easiluy due to weak vessels]
H- Hypertension
U- ++urinary cortisol and ++17 hydrocorticosteroids
M- Menstrual irregularities
P-Porosity of bones- osteoporosis
The micro-organisms of dental caries are
1. streptococcus mutans.
2. staphylococcus aureus.
3. lactobacillus acidophilus.
4. B-hemolytic streptococci.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above. .

A bacterial infection causes the most significant increase in


A. basophils.
B. neutrophils.
C. lymphocytes.
D. monocytes.
E. eosinophils.
Following injection of a local anesthetic, a healthy patient suddenly experiences difficulty breathing. You detect
a rash and swelling of the face and neck. The most appropriate drug to administer first is
A. hydroxycine.
B. epinephrine
C. hydrocortisone.
D. diphenhydramine. .
An excisional biopsy of a nodule 5mm in diameter on the lateral border of the tongue was diagnosed as a
fibroma. This patient should have
A. hemisection of the tongue.
B. radiotherapy to site of biopsy.
@C. no additional therapy.
D. re-excision with wider margins.
E. radium implantation around biopsy site.

Hypothyroidism in adults is associated with


A. exophthalmos.
B. weight loss.
C. generalized edema.
D. tachycardia.
E. mental defects. .
Which of the following is most likely to displace the adjacent teeth?
A. Lateral periodontal cyst.
B. Dentigerous cyst.
C. Periapical cemental dysplasia.
D. Periapical abscess.
E. Radicular cyst. .
Radiographically, a dentigerous cyst presents as a well-defined unilocular, radiolucency associated
in some way with the crown of an unerupted tooth (Fig. 6.16). The latter may be displaced for a

considerable distance.
An excisional biopsy of a nodule 5mm in diameter on the lateral border of the tongue was diagnosed as a
fibroma. This patient should have
A. hemisection of the tongue.
B. radiotherapy to site of biopsy.
C. no additional therapy.
D. re-excision with wider margins.
E. radium implantation around biopsy site.
Dental decks: Treatment is conservative surgical excision
The characteristic colour seen in the crowns of teeth with internal resorption is due to
A. deposition of pigment in the cells of the odontoblast layer.
B. the presence of hyperplastic vascular pulp tissue.
C. a peculiar change of consistency of the dentin.
D. an optical phenomenon related to the difference in the refractive indices of the normal and affected areas.
E. the degeneration and necrosis of the pulp tissue.
When the coronal dentine is involved the resorption may present clinically as a
pink spot due to the vascular pulp tissue being visible through the overlying enamel. Radiological

distinction between idiopathic internal and external (burrowing) resorption may be impossible.
A 70 year old insulin-dependent patient has just completed a 7 day course of ampicillin for a respiratory
infection. He presents with signs and symptoms consistent with a diagnosis of oral candidiasis. Which of the
following drugs is/are appropriate to manage this condition?
1. Fluconazole.
2. Nystatin.
3. Ketoconazole.
4. Clindamycin.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above. .
A 23 year old patient presents with severe pain originating from the lower incisor region. The interdental
papillae are cratered and covered with a greyish-white membrane. Abundant calculus is present. The most likely
diagnosis is

A. atrophic candidiasis.
B. necrotizing ulcerative gingivitis.
C. herpetic gingivostomatitis.
D. desquamative gingivitis.
Normal aging changes in the hard tooth tissues include
1. continuous deposition of cementum.
2. continuous deposition of dentin.
3. decreased blood supply to the pulp.
4. increased porosity of enamel.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above. .
A 17 year old patient complains of fever, fatigue and sore throat. The clinical examination shows bilateral
lymphadenopathy. You notice numerous petechiae on the soft palate and oropharyngeal tonsillar enlargement.
What is the most likely diagnosis?
A. Herpangina.
B. Acute lymphonodular pharyngitis.
C. Primary herpetic gingivostomatitis.
D. Non-Hodgkins lymphoma.
E. Infectious mononucleosis.
A 65 year old patient has a tendency for urinary tract stones. The radiographic examination of the maxillae
shows generalized loss of the lamina dura and a ground glass appearance of the bone. What is the most likely
diagnosis?
A. Hyperthyroidism.
B. Addisons disease.
C. Hypothyroidism.
@D. Hyperparathyroidism.
E. Hypoparathyroidism. .
A 52 year old patient presents with a limitation of mouth opening. The patient has loss of attached gingiva and
multiple areas of gingival recession. A panoramic radiograph shows diffuse widening of the periodontal
ligament. The most likely diagnosis is
A. scleroderma.
B. hyperparathyroidism.
C. cicatricial pemphigoid.
D. erythema multiforme.
E. advanced adult periodontitis.
A 34 year old male patient complains of night sweats, weight loss, malaise, anorexia and low-grade fever.
Clinical examination shows a nodular, ulcerated lesion on the palate. The most likely diagnosis is
A. viral hepatitis.
B. infectious mononucleosis.
C. tuberculosis.
D. actinomycosis. .
A 55 year old female patient complains of dry, burning mouth. The clinical and radiological examination shows
xerostomia, periodontitis, multiple caries, periapical abscesses and candidiasis. What is the most likely
diagnosis?

A. AIDS.
B. Diabetes mellitus.
C. Multiple myeloma.
D. Leukemia. .
A 42 year old lethargic patient complains of constipation, weakness and fatigue. The clinical examination
reveals dry skin, facial swelling and diffuse enlargement of the tongue. What is the most likely diagnosis?
A. Infectious mononucleosis.
B. Multiple myeloma.
C. Hypothyroidism.
D. Hyperparathyroidism.
E. Addisons Disease. .
A 4 year old child presents with fever, malaise, cough, conjunctivitis and a runny nose. The clinical
examination shows multiple areas of erythema and many small bluish-white macules on the buccal mucosa.
What is the most likely diagnosis?
A. Herpangina.
B. German measles (rubella).
C. Acute lymphonodular pharyngitis.
D. Measles (rubeola).
E. Hand-foot-and mouth disease.
A 37 year old female patient presents for routine dental treatment. She has tremors, palpitations and excessive
perspiration. Her skin is smooth and warm. She complains of weight loss and diarrhea. What is the most likely
diagnosis?
A. Hyperparathyroidism.
B. Viral hepatitis.
C. Hyperthyroidism.
D. Crohns disease.
E. Iron deficiency anemia.
Most cases of erosive oral lichen planus are effectively treated with
A. cytotoxics.
B. antifungals.
C. antibacterials.
D. antimalarials.
E. corticosteroids. .
A squamous cell carcinoma of the midline anterior floor of the mouth normally spreads to the
A. unilateral neck lymph nodes.
B. mediastinal lymph nodes
@C. bilateral neck lymph nodes.
D. retropharyngeal lymph nodes.
(Oxford Handbook)
Which of the following presents with high serum calcium levels, thinning of cortical bone and giant cell
osteoclasts in the jaw and drifting teeth?
A. Hyperthyroidism.
B. Hyperparathyroidism.
C. Hypothyroidism.
D. Hypoparathyroidism. .
A white diffuse wrinkled appearance of the buccal mucosa which diminishes in prominence or disappears upon
stretching is indicative of

A. leukoedema.
B. lichen planus.
C. candidiasis.
D. linea alba.
E. white sponge nevus. .
A 75-year old female patient is being treated for oral lichen planus with a topical corticosteroid. She also has
low serum PT4 and vitamin D. The most likely cause of a reduced alveolar bone mass in this patient is
A. postmenopausal osteoporosis.
B. senile osteoporosis.
C. drug-induced osteoporosis.
D. osteomalacia. .
Biochemical changes. In Type I or postmenopausal
osteoporosis a decrease in serum PTH with a concomitant
decrease in 1,25-dihydroxyvitamin D results in calcium
malabsorption. Type II or senile osteoporosis is distinctive
in that kidney levels of I-a-hydroxylase are
depressed, as are the numbers of vitamin D receptors in
the intestinal mucosal cells. 29 In both cases, treatment
with vitamin D analogues is effective. 29

A pale 8 year old patient presents with generalized gingival enlargement and spontaneous bleeding. The most
appropriate initial management of this patient is to
A. perform an incisional biopsy.
B. obtain a cytologic smear.
C. order a complete blood count with a differential.
D. obtain bacterial cultures.
E. order fasting blood glucose levels.
The most appropriate treatment of chronic sclerosing osteomyelitis of the mandible includes
1. intravenous antibiotics followed by long term oral antibiotics.
2. hyperbaric oxygen.
3. decortication.
4. radiotherapy.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above. .
I. Disrupt the infectious foci.
2. Debride any foreign bodies, necrotic tissue, or sequestra.
3. Culture and identify specific pathogens for definitive
antibiotic treatment.
4. Drain and irrigate the region.
5. Begin empiric antibiotics based on Gram's stain.
6. Stabilize calcified tissue regionally.
7. Consider adjunctive treatments to enhance microvascular
reperfusion (usually reserved for refractory only
forms):
a. Trephination (may be accomplished during
debridement)
b. Decortication (may be accomplished during
debridement)
c. Vascular flaps (muscle)
d. Hyperbaric oxygen therapy
R. Reconstruct as necessary after resolution of the infection.

Recurrent unilateral submandibular swelling and pain just prior to meals is indicative of
A. an odontogenic infection.
B. sialolithiasis.
C. ranula.
D. sarcoidosis.
E. Sjgrens syndrome. .
Oral lesions may be an early manifestation of
1. leukemia.
2. pernicious anemia.
3. infectious mononucleosis.
4. obstructive jaundice.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above. .
The physical manifestation of jaundice includes a yellow
tinge of the eyes, skin, and oral mucous membranes.
Icterus is frequently the first and sometimes the only clinical
manifestation of liver disease.

A smooth, elevated, red patch devoid of filiform papillae, located in the midline of the dorsum of the tongue
immediately anterior to the circumvallate papillae is indicative of
A. benign migratory glossitis.
B. median rhomboid glossitis.
C. a granular cell tumor.
D. iron deficiency anemia.
E. a fibroma. .
Compared to unstimulated saliva, stimulated saliva is more beneficial for oral health because of a higher
A. calcium level.
B. phosphate level.
C. mucin level
@D. pH level. .
stimulated saliva has enhanced buffering capacity and a greater remineralizing potential than resting saliva
Upon stimulation of salivary flow, which gland is the main source of salivary volume?
A. Submandibular.
B. Submaxillary.
C. Sublingual.
@D. Parotid. .
However, the stimulated flow rate is important to facilitate chewing and swallowing during mastication. The
submandibular gland contributes approximately 65 per cent of the resting whole salivary flow rate. Only
1520 per cent is derived from the parotid, with the sublingual and minor glands both delivering 78 per
cent. In contrast, the parotid provides 4550 per cent of the stimulated whole salivary flow rate
Hypercementosis (cemental hyperplasia)
A. is most often confined to the apical half of the root.
B. most frequently affects molars.

C. affects non vital teeth in the majority of cases.


D. (A) and (C)
E. (B) and (C) .
The risk of transmission of Hepatitis B Virus (HBV) is greater than that of Human Immunodeficiency Virus
(HIV) because HBV is
1. more resistant than HIV.
2. transmissible through saliva.
3. in higher numbers in blood than HIV.
4. autoclave resistant.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above. .
Which of the following are possible causes of Bells Palsy?
1. Incorrect injection technique.
2. Viral infection.
3. Inflammation of the facial nerve.
4. Surgical trauma.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above.
Which of the following is necessary for collagen formation?
A. Vitamin A.
B. Vitamin C.
C. Vitamin D.
D. Vitamin E.
E. Vitamin K. .
In assessing the prognosis of a neoplasm, the most important feature is
A. ulceration.
B. metastasis.
C. size.
D. duration. .
A large, deeply furrowed tongue is commonly found in patients with
A. Pierre Robin Syndrome.
B. geographic tongue.
C. ectodermal dysplasia.
D. Downs Syndrome. .
Appropriate management for the relief of symptoms of primary herpetic gingivostomatitis in an
immunocompromised patient may include
1. Diphenhydramine elixir 12.5mg/5ml.
2. Triamcinolone acetonide in Orabase.

3. Acyclovir capsules 200mg.


4. Dexamethasone elixir 0.5mg/ml.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above. .
Trickish question
Which of the following sites for squamous cell carcinoma has the best prognosis?
A. Lower lip.
B. Retromolar area.
C. Gingiva.
D. Buccal mucosa.
E. Hard palate. .
Carcinoma of the lower lip is a rather different lesion in that it is clearly visible and so is noticed early. It has a
much better prognosis than intraoral carcinoma and early diagnosis often implies successful and relatively
small-scale surgery.
The radiographic image of the incisive foramen is located between the roots of the maxillary
A. incisors above their apices.
B. central and lateral incisors below their apices.
C. central incisors below their apices.
D. central and lateral incisors above their apices.
Aging pulps show a relative increase in
1. fibrous elements.
2. cell numbers.
3. calcification.
4. vascularity.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above. .
In the maxilla, infection from which of the following teeth may drain through the palatal plate of bone and
present as a palatal abscess?
1. Lateral incisors.
2. First premolars.
3. First molars.
4. Third molars.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above. .
Which of the following conditions is the most likely cause of a maxillary midline diastema?
A. Mesiodens.

B. Space shortage.
C. Gemination.
D. Dens invaginatus. .
In hyperparathyroidism, typical features of bone involvement are
1. subperiosteal erosion of the phalanges.
2. osteopetrosis.
3. pathological fractures.
4. renal stones.
A. (1) (3) (4)
B. (1) and (3)
C. (2) and (4)
D. All of the above.
Oral lesions failing to heal may be related to
1. tuberculosis.
2. syphilis.
3. neoplasia.
4. diabetes.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above. .
If left untreated, a pyogenic granuloma will most likely
A. shrink over time.
B. remain unchanged.
C. continue to enlarge.
D. burst and then heal.
E. burst, heal, but then recur.
All of the following are well documented initiating factors of hairy tongue EXCEPT
A. candidiasis.
B. mouth rinses.
C. antibiotics.
D. systemic corticosteroids (Prednisone).
E. radiotherapy to the head and neck.
condition may be provoked by irritation from one or a
combination of local factors: (I) food debris remaining
on the tongue and becoming impacted between the papillae
as a result of inadequate oral hygiene, (2) habitual use
of oxidizing or astringent agents in oral preparations,
(3) local use of some antibiotics, (4) use of tobacco, and
(5) Candida albicans infection. Systemic influences such
as systemic antibiotic therapy, anemia, and general debilitation
play an etiologic role. 52

A large pericoronal radiolucency associated with an impacted third molar tooth is most likely a/an
A. ameloblastoma.
B. odontogenic keratocyst.
C. eruption cyst.
D. dentigenous cyst.

E. calcifying odontogenic cyst.


The best management for a gingival cyst of the newborn is
A. curettage.
B. incisional biopsy.
C. cystologic smear.
D. excisional biopsy.
@E. observation. .
The most appropriate treatment for 0.5cm periapical radiolucency due to a radicular cyst in association with a
non-vital incisor tooth is
A. antibiotics.
B. extraction.
C. root canal therapy.
D. apicoectomy.
E. excisional biopsy. .
Management. Ordinary peliapical shadows with a
working diagnosis of granuloma or cyst should be treated

with nonsurgical endodontics if the treatment plan calls for


maintenance of the tooth. Protocol calls for a 1- to 3-month
recall with clinical and radiographic examination to ensure
that the lesion is not enlarging,

A 29-year old patient presents with a history of painful right neck swelling just prior to meals. Following a
clinical examination, which diagnostic test would most likely be indicated?
A. Panoramic radiograph.
B. Excisional biopsy.
C. C.T. scan.
D. Occlusal radiograph.
E. Fine needle aspiration biopsy.
A patient with pain, fever and unilateral parotid swelling following a general anesthetic most likely has
A. Mumps.
B. sialolithiasis.
C. acute bacterial sialadenitis.
D. Sjgrens syndrome.
E. sarcoidosis. .
If hypothyroidism occurs in the adult, it is associated with
A. exophthalmos.
B. weight loss.
C. generalized edema.
D. tachycardia.
E. mental defects.
Multiple well-defined multilocular radiolucencies of the maxilla and mandible in a 5 year old is most likely
A. ameloblastic fibromas.
B. ameloblastomas.
C. cherubism.
D. hyperthyroidism.
E. hypophosphatasia. .
Multiple osteomas and supernumerary teeth may be associated with

A. Gorlins syndrome.
B. Rubenstein Taybi syndrome.
C. Gardners syndrome.
D. Cleidocranial dysplasia.
E. Ectodermal dysplasia. .
The test(s) diagnostic for primary hyperparathyroidism in a patient with multiple brown tumours is/are
A. parathyroid biopsy.
B. multiple jaw biopsies.
C. radiographic skeletal survey.
D. serum calcium and PTH level.
E. creatine clearance and BUN.
In general, a pigmented macule measuring 4mm in diameter should be treated by
A. incisional biopsy.
B. excisional biopsy.
C. exfoliative cytology.
D. carbon dioxide laser.
E. electrocautery. .
Exfoliative cytology can be useful in detecting viral cytopathologic effects in all of the following EXCEPT
A. shingles.
B. cold sores (herpes labialis).
C. chicken pox.
D. hairy leukoplakia.
E. acute herpetic gingivostomatitis.
The direct immunoflourescence pattern seen in pemphigus vulgaris has been described as
A. target-like.
B. chicken wire.
C. soap-bubble.
D. corrugated.
E. cotton wool.
A decrease of which of the following is indicative of hypoparathyroidism?
A. Serum phosphorus.
B. Serum calcium.
C. Thyroid activity.
D. Serum alkaline phosphatase.
In hypoparathyroidism, Serum phosphate is elevated / alkaline phosphatise and urea are normal
Tissue from a multilocular radiolucent area of the posterior mandible histologically shows follicular areas lined
with columnar cells resembling the enamel organ. The diagnosis is a/an
A. neurofibroma.
B. ameloblastoma.
C. central fibroma.
D. lateral periodontal cyst.
E. dentigerous cyst. .
Which of the following lesions is most commonly found in the anterior region of the mandible?
A. Ameloblastoma.
B. Calcifying epithelial odontogenic tumour.
C. Central cementifying fibroma.

D. Periapical cemental dysplasia.


The best method to diagnose a cystic tumour is to
A. examine the fluid under a microscope.
B. submit the tissue for histological analysis.
C. perform a cytologic smear.
D. culture the fluid.
E. order blood tests.
The microscopic appearance of the central giant cell granuloma of the jaws is similar to that of lesions which
occur in
A. hyperparathyroidism.
B. Paget's disease.
C. cleidocranial dysplasia (dysostosis).
D. hyperpituitarism. .
Osteomalacia is seen in
A. Vitamin C deficiency.
B. adult rickets.
C. protein deficiency.
D. hyperparathyroidism. .
Which conditions are associated with Acquired Immunodeficiency Syndrome (AIDS)?
1. Acute marginal periodontitis.
2. Hairy leukoplakia.
3. Candidiasis.
4. Geographic tongue.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above.
An odour of acetone on the breath may indicate
1. bronchiectasis.
2. rhinitis.
3. salicylate poisoning.
4. diabetes mellitus.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above.
Condensing osteitis in the periapical region is indicative of a/an
A. acute inflammation of the pulp.
B. pulpal abscess.
C. chronic inflammation of the pulp.
D. early apical abscess formation.
E. None of the above. .
"Tic douloureux" is synonymous with
A. psychogenic facial pain.
B. trigeminal neuralgia.

C. facial paralysis.
D. temporomandibular joint dysfunction syndrome.
In an insulin dependent diabetic, hypoglycemia is characterized by
1. mental confusion.
2. tachycardia.
3. sweating.
4. nausea.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above.
Which of the following cells are characteristic of chronic inflammation of the dental pulp?
1. Plasma cells.
2. Macrophages.
3. Lymphocytes.
4. Neutrophils.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above.
Which of the following is a disease characterized by a general lack of bone marrow activity?
A. Thalassemia.
B. Polycythemia.
C. Aplastic anemia.
D. Pernicious anemia.
E. Sickle cell anemia. .
The treatment of an ameloblastoma is
A. chemotherapy.
B. enucleation.
C. resection.
D. radiotherapy. .
Which of the following clinical conditions is the most serious?
A. Acute periapical abscess of a mandibular central incisor.
B. Middle face cellulitis.
C. Chronic periapical abscess of a mandibular third molar.
D. Infected dentigerous cyst.
Root resorption of permanent teeth may be associated with
1. excessive orthodontic forces.
2. periapical granuloma.
3. traumatic injury.
4. cementoma.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above.

Erythroblastosis fetalis may be a cause of


A. supernumerary incisors.
B. pigmented teeth.
C. peg lateral incisors.
D. Fordyce's granules.
E. blue sclerae. .
For a patient with cardiovascular disease, local anesthesia
A. affects blood pressure more than general anesthesia.
B. affects blood pressure less than general anesthesia.
C. is responsible for bacteremia.
D. None of the above. .
Xerostomia can be
1. found in the elderly.
2. drug induced.
3. associated with diabetes.
4. predisposing to dental diseases.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above.
An anemia in which the red blood cells are smaller and less intense in color than normal is called a
A. microcytic hypochromic anemia.
B. microcytic hyperchromic anemia.
C. macrocytic hypochromic anemia.
D. macrocytic hyperchromic anemia.
E. None of the above.
In an 80 year old patient you would expect
1. a reduced size of the pulp chamber.
2. increased incidence of pulp stones.
3. increased tendency to pulpal fibrosis.
4. an increased pulpal vascularity.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above. .
Cleft lip and palate usually result from
A. failure of proper union of the median and lateral nasal processes.
B. failure of the union of the median nasal process with the lateral nasal and maxillary processes.
C. anhidrotic ectodermal dysplasia.
D. failure of development of both the lateral nasal and maxillary processes
Clinical examination of a 42 year old heavy smoker reveals a white patch in the retromolar/tonsillar pillar
region. The patch cannot be wiped off. The most likely diagnosis is
A. lichen planus.
B. leukoplakia.
C. white sponge nevus.
D. frictional hyperkeratosis.
E. pseudomembranous candidiasis.
Enamel pearls form when

A. ameloblasts migrate apically down the root.


B. cells of the epithelial root sheath do not migrate away from the dentin.
C. cells of the dental follicle fail to develop.
D. epithelial rests transform into ameloblast vesicles.
The immediate management of a hematoma following a posterior superior alveolar nerve block is to
A. incise into the buccal sulcus.
B. apply firm direct pressure.
C. aspirate with a needle.
D. place hot towels over the che
A decrease in the neutrophil count is present in
A. granulocytopenia (agranulocytosis).
B. iron deficiency anemia.
C. myeloid leukemia.
D. leukocytosis.
E. thrombocytopenic purpura.
Hypercementosis may be associated with
A. Pagets disease.
B. ameloblastoma.
C. hypophosphatasia.
D. multiple myeloma.
A 17 year old patient complains of fever, fatigue and sore throat. The clinical examination shows bilateral
lymphadenopathy. You notice numerous petechiae on the soft palate and oropharyngeal tonsillar enlargement.
What is the most likely diagnosis?
A. Herpangina.
B. Acute lymphonodular pharyngitis.
C. Primary herpetic gingivostomatitis.
D. Non-Hodgkins lymphoma.
E. Infectious mononucleosis.
Which of the following is most likely to displace the adjacent teeth?
A. Lateral periodontal cyst.
B. Dentigerous cyst.
C. Periapical cemental dysplasia.
D. Periapical abscess.
E. Radicular cyst.
A white, diffuse, wrinkled appearance of the buccal mucosa which diminishes in prominence or disappears upon
stretching is indicative of
A. leukoedema.
B. lichen planus.
C. candidiasis.
D. linea alba.
E. white sponge nevus.
A 55 year old female patient complains of dry, burning mouth. The clinical and radiological examination shows
xerostomia, periodontitis, multiple caries, periapical abscesses and candidiasis. What is the most likely
diagnosis?
A. AIDS.
B. Diabetes mellitus.
C. Multiple myeloma.
D. Leukemia.
When a patient experiences continuous pain in the maxillary premolar and molar areas and there is no evidence
of dental infection, the most likely diagnosis is

A. trigeminal neuralgia.
B. acute maxillary sinusitis.
C. impacted maxillary canine.
D. impacted maxillary third molar.
E. glossopharyngeal neuralgia.
Upper face infections can communicate with the cavernous sinus through
A. the angular vein to the superior ophthalmic vein.
B. the pterygoid plexus to the inferior ophthalmic vein.
C. A. and B.
D. None of the above.
Which disorder is associated with hypercementosis of teeth?
A. Pagets disease.
B. Fibrous dysplasia.
C. Cherubism.
D. Hyperparathyroidism
A small, well-circumscribed, periapical radiolucency on a mandibular incisor which is clinically asymptomatic
and responds normally to vitality tests is most likely
A. a periapical granuloma.
B. sclerosing osteitis.
C. a radicular cyst.
D. periapical cemental dysplasia
A 65 year old patient has a tendency for urinary tract stones. Radiographic examination shows generalized loss
of the lamina dura and a ground glass appearance of the bone. What is the most likely diagnosis?
A. Hyperthyroidism.
B. Addisons disease.
C. Hypothyroidism.
D. Hyperparathyroidism.
E. Hypoparathyroidism.
The most common cause of bilateral swelling of the parotid glands in children is
A. Mikulicz' disease.
B. mumps or acute infectious parotitis.
C. mixed salivary tumor (pleomorphic adenoma).
D. sialolithiasis.
Your patient is currently on warfarin. Before a planned extraction of tooth 3.4, the patients coagulation
mechanism should be evaluated using which test?
A. Bleeding time.
B. Partial thromboplastin time.
C. Prothrombin time or INR.
D. Von Willebrands Factor
Serial extraction (planned extractions) for the correction of an orthodontic problem is CONTRAINDICATED in
patients with
A. a Class II molar relationship.
B. normal overbite.
C. normal overjet.
D. severe arch crowding.
A stone in the salivary glands or ducts is called a
A. sialolith.
B. renolith.
C. calcolith.
D. phlebolith.

E. None of the above.


An abnormal decrease in the flow of saliva is associated with
A. ptyalism.
B. sialomentaplasia.
C. xerostomia.
D. pyroglossia.
E. None of the above.
Unilateral premature eruption of teeth is characteristic of
A. acromegaly.
B. hemihypertrophy.
C. hemiatrophy.
D. cleidocranial dysostosis.
E. adrenogenital syndrome.
Reduced thyroid hormone level in a child is associated with
A. lack of tooth eruption.
B. early tooth eruption.
C. delayed tooth eruption.
D. supernumerary teeth.
High telomerase activity is associated with
A. diabetes mellitus.
B. malignant tumors.
C. hyperthyroidism.
D. cystic fibrosis.
Ludwigs angina initially involves a massive infection of the
A. parapharyngeal and retropharyngeal spaces.
B. submandibular and sublingual regions.
C. buccal superficial fascial and canine spaces.
D. maxillary and ethmoidal sinuses.
The dentino-enamel junction is the most sensitive portion of a tooth because
A. free nerve endings terminate on odontoblasts at this region.
B. odontoblastic processes branch considerably at this region.
C. ameloblasts make synaptic connections with odontoblasts at this junction.
D. odontoblastic tubules help convey hydrostatic forces to the pulp cells.
Which therapeutic agent is absolutely CONTRAINDICATED in the treatment of herpes simplex?
A. Vitamin C.
B. Acetylsalicylic acid.
C. Antibiotics.
D. Corticosteroids.
E. Local anesthetics.
Tissue from a multilocular radiolucent area of the posterior mandible shows microscopically follicular areas
lined with cylindrical cells resembling the enamel organ. The most likely diagnosis is a/an
A. neurofibroma.
B. ameloblastoma.
C. central fibroma.
D. periodontal cyst.
E. dentigerous cyst.
A periapical granuloma
A. erodes rapidly through bone.
B. is asymptomatic.
C. is intensely painful.
D. occurs only in young adults.
E. occurs at the apex of a vital tooth.

Which one of the following oral conditions is NOT caused by a virus?


A. Benign mucous membrane pemphigoid.
B. Herpetic gingivostomatitis.
C. Leukoplakia.
D. Necrotizing ulcerative gingivitis.
A patient has a history of shortness of breath and ankle edema. You would suspect
A. asthma.
B. emphysema.
C. rhinophyma.
D. cardiac insufficiency.
Acquired immunodeficiency syndrome (AIDS) is caused by a/an
A. adenovirus.
B. retrovirus.
C. picovirus.
D. coronavirus.
Contact stomatitis may be caused by
A. dentifrice.
B. lipstick.
C. acrylic.
D. antibiotics.
E. All of the above
Acute or subacute suppurative osteomyelitis occurs most frequently in the
A. anterior maxilla.
B. posterior mandible.
C. posterior maxilla.
D. anterior mandibl
An enameloma is
A. an odontoma.
B. an ameloblastoma.
C. a pearl of enamel.
D. an enamel hypocalcification
Which one of the following is the most common tumor of the salivary glands?
A. Adenocystic carcinoma.
B. Canalicular adenoma.
C. Pleomorphic adenoma.
D. Muco-epidermoid carcinoma
Geographic tongue is characterized by
A. congenital deformity of tissue.
B. atrophic filiform papillae.
C. association with hairy tongue.
D. predominance in elderly patients.
Heavy cigarette smoking significantly increases the incidence of
A. aphthous stomatitis.
B. geographic tongue.
C. lichen planus.
D. atrophic glossitis.
E. mucosal pigmentation.
The risk of transmission of Hepatitis B Virus (HBV) is greater than that of Human Immunodeficiency Virus
(HIV) because HBV is
1. more resistant than HIV.

2. more transmissible through saliva.


3. in higher numbers in blood than HIV.
4. autoclave resistant.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above
In a xerostomic patient, which salivary gland(s) is/are most likely responsible for the lack of lubrication?
A. Accessory.
B. Labial.
C. Parotid.
D. Sublingual and submandibular.
Gigantism is caused by
A. a hyperactive thyroid.
B. atrophy of the posterior pituitary.
C. hyperplasia of the anterior pituitary.
D. hyperplasia of the parathyroids.
E. none of the above.
Which chemical mediator of inflammation is blocked or reversed by a nonsteroidal anti-inflammatory drug
(NSAID)?
A. Bradykinin.
B. Histamine.
C. Substance P.
D. Prostaglandin
Oral signs and/or symptoms of vitamin B2 (riboflavin) deficiency may include
1. glossitis.
2. angular cheilitis.
3. pain.
4. erythematous oral mucosa.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the ab
When a diagnosis of a primordial cyst is made, there is likely to be
A. the normal number of teeth in that jaw.
B. one less than the normal number of teeth in that jaw.
C. one more than the normal number of teeth in that jaw.
D. a squamous cell carcinoma in that jaw.
E. a primordial cyst situated symmetrically on the opposite side.
Acellular cementum on a root is
A. the result of chronic inflammation.
B. a defective cementoid substance.
C. caused by premature degeneration of Hertwig's root sheath.
D. a normal anatomical structure.
Fordyce's granules are
A. ectopic sebaceous glands.
B. ectopic sweat glands.
C. small calcified nodules.
D. aberrant mucous glands

Following radiation therapy to the mandible, extraction of mandibular teeth is most likely to result in
A. fracture.
B. actinomycosis.
C. osteomyelitis.
D. soft tissue necrosis.
E. development of malignancy
Anginal pain is
A. precipitated by exercise or cold weather.
B. not relieved by rest.
C. relieved by digoxin.
D. aggravated by deep inspiration.
The most common type of collagen found in the gingival connective tissue, periodontal ligament, and
cementum is composed primarily of
A. type I.
B. type II.
C. type III.
D. type IV.
The normal white cell differential count for neutrophils is
A. 10-19%.
B. 20-29%.
C. 30-39%.
D. 40-65%.
E. 66%-90%
Which anatomical structures form the inverted Y (Y line) in maxillary periapical radiographs?
A. Nasopalatine/incisive canal and floor of the nasal fossa.
B. Anterior nasal spine and nasopalatine/incisive canal.
C. Floor of the nasal fossa and maxillary sinus border.
D. Zygomatic process of the maxilla and maxillary sinus border.
Adrenal corticosteroids
A. increase heart rate.
B. cause vasodilation.
C. increase protein synthesis.
D. reduce inflammation.
A 25 year old female in her first trimester of pregnancy presents with an acute dental infection. Which of the
following is CONTRAINDICATED for this patient?
A. Prescription of a radiograph.
B. Prescription of penicillin V.
C. Extraction using 2% xylocaine with 1:100,000 epinephrine.
D. Acetylsalicylic acid for pain management.
Which of the following is characteristically found in Paget's disease?
A. Increased acid phosphatase.
B. Increased alkaline phosphatase.
C. Osteoporosis.
D. Incomplete fusion of cranial sutures
"Dens in dente" (dens invaginatus) is most commonly associated with
A. supernumerary teeth.
B. dentinogenesis imperfecta.
C. osteogenesis imperfecta.
D. anterior teeth.
E. amelogenesis imperfecta.

Which of the following medications is CONTRAINDICATED in the management of a patient who is taking
Coumadin?
A. Acetaminophen.
B. Penicillin.
C. Acetylsalicylic acid.
D. Codeine.
E. Clindamycin.
A 70 year old insulin-dependent patient has just completed a 7 day course of ampicillin for a respiratory
infection. He presents with signs and symptoms consistent with a diagnosis of oral candidiasis. Which of the
following drugs is/are appropriate to manage this condition?
1. Fluconazole.
2. Nystatin.
3. Ketoconazole.
4. Clindamycin.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above.
A 34 year old male patient complains of night sweats, weight loss, malaise, anorexia and low-grade fever.
Clinical examination shows a nodular, ulcerated lesion on the palate. The most likely diagnosis is
A. viral hepatitis.
B. infectious mononucleosis.
C. tuberculosis.
D. actinomycosis.
A large encapsulated tumor is removed from the hard palate. It is filled with fluid. The best method of
determining the nature of this lesion is to
A. examine the fluid under a microscope.
B. culture the fluid and examine for bacterial growth.
@C. submit the tissue for histological examination
D. submit the tissue for exfoliative cytological study.
E. aspirate the fluid for electrophoresis study.
Exfoliative cytology is unsuitable for the
following lesions: homogeneous leukoplakias. smoothsurfaced
exophytic lesions, submucosal lesions, unulcerated
pigmented lesions, verruca vulgaris, papilloma.
condyloma acuminata, etc. On the other hand, exfoliative
cytology can give useful information for erythroplakia.
the "erythro" patch of erythroleukoplakia. ulcers. erosions,
and fungal and viral infections such as oral herpes
simplex.

Aging pulps show a relative increase in


1. fibrous elements.
2. cell numbers.
3. calcification.
4. vascularity.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above

Clinical management of gingival enlargement caused by Phenytoin (Dilantin) therapy includes


A. the use of analgesics to control pain.
B. withdrawal of the medication.
C. extraction of the teeth.
D. gingivectomy and maintenance of good oral hygiene.
E. a mouth guard to control mouth breathing.
A biopsy of a clinically suspicious malignant lesion fails to support the clinical diagnosis. You should
A. assure the patient that there is no malignancy.
B. take a second biopsy.
C. observe the patient yearly.
D. recall the patient in one month.
E. make a cytological smear.
The most appropriate laboratory test to identify an acute bacterial infection is
A. hemoglobin level.
B. complete blood count.
C. white cell count.
D. red cell count.
??A loss of sensation in the lower lip may be produced by
A. Bells palsy.
B. trigeminal neuralgia.
C. metastatic malignancy to the body of the mandible.
D. fracture in the mandibular canine region.
Lack of ramus height is caused by faulty development of
A. membranous bone.
B. endochondral bone.
C. Meckels cartilage.
D. temporomandibular joint.
Odontoblast gap junctions
A. adhere the cells to one another.
B. attach the cells to the basement membrane.
C. seal off the dentin from the pulp.
D. permit lateral cell-cell communication.
The benign neoplasm that originates from squamous epithelium is called a/an
A. adenoma.
B. choriocarcinoma.
C. chondroma.
D. lipoma.
E. papilloma.
Which of the following lesions of the oral or maxillofacial region is premalignant?
A. Ectodermal dysplasia.
B. Focal fibrous hyperplasia.
C. Smokers melanosis.
D. Fibrous dysplasia.
E. Epithelial dysplasia.
For a 62 year old female with complete dentures who has never smoked, which of the following clinical lesions
has the highest probability of progressing to squamous cell carcinoma?
A. Smooth red patch of the mid posterior dorsal tongue.
B. Bilateral buccal mucosal leukoedema.

C. White plaque of the mandibular alveolar ridge mucosa.


D. White plaque of the ventral tongue
A 50 year old woman has a history of rheumatoid arthritis, bilateral enlargement of one or more salivary glands
and lacrimal glands, as well as dryness of the eyes, nose, mouth and throat. The diagnosis is
A. erythema multiforme.
B. Reiter's syndrome.
C. Gardner's syndrome.
D. Sjgren's syndrome.
E. Plummer-Vinson syndrome
Fibrous dysplasia of the jaws
A. is of known etiology.
B. is premalignant.
C. has monostotic and polyostotic forms.
D. begins in the fifth decade.
E. is bilaterally symmetrical.
Which of the following is most often associated with a nonvital tooth?
A. Chronic periradicular periodontitis.
B. Internal resorption.
C. Periapical cemento-osseous dysplasia.
D. Hyperplastic pulpitis.
Myxedema is associated with
A. insufficient parathyroid hormone.
B. excessive parathyroid hormone.
C. insufficient thyroid hormone.
D. excessive thyroid hormone.
Condensing osteitis in the periapical region is indicative of a/an
A. acute inflammation of the pulp.
B. pulpal abscess.
C. chronic inflammation of the pulp.
D. early apical abscess formation.
Root resorption of permanent teeth may be associated with
1. excessive orthodontic forces.
2. chronic periradicular periodontitis.
3. traumatic injury.
4. periapical cemento-osseous dysplasia.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above.
Which of the following results from a necrotic pulp?
A. Dentigerous cyst.
B. Lateral periodontal cyst.
C. Chronic periradicular periodontitis.
D. Pulp polyp.
Which of the following is/are associated with an unerupted tooth?

1. Odontogenic adenomatoid tumor.


2. Periapical cemento-osseous dysplasia.
3. Calcifying epithelial odontogenic tumor.
4. Cementoblastoma.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above.
An ankylosed tooth is usually
A. nonvital.
B. associated with a root fracture.
C. infraerupted.
D. found in the permanent dentition.
The microscopic appearance of the central giant cell granuloma of the jaws is similar to that of lesions which
occur in
A. hyperparathyroidism.
B. Paget's disease.
C. cleidocranial dysplasia.
D. hyperpituitarism.
An ameloblastoma can develop from the epithelial lining of which of the following cysts?
A. Periradicular.
B. Dentigerous.
C. Residual.
D. Lateral periodontal.
Radiographically, the opening of the incisive canal may be misdiagnosed as a
1. branchial cyst.
2. nasopalatine cyst.
3. nasolabial cyst.
4. periradicular cyst.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above.
A well circumscribed 3mm radiolucent lesion is present in the apical region of the mandibular second premolar.
The tooth responds normally to vitality tests. The radiolucency is most likely
A. a periradicular periodontitis.
B. a dentigerous cyst.
@C. a rarefying osteitis.
D. the mental foramen.
RAREFYING AND CONDENSING OSTEITIS
Frequently, rarefying and condensing osteitis occurs at
the apex of a nonvital tooth or a retained root (Fig. 24-3).
Chronic infection acts as an irritating factor (causing resorption
of bone) and as a stimulating factor (producing
dense bone, perhaps as a defense mechanism to contain
the local problem.

A patient complains of acute pain 24 hours after the insertion of a restoration in a tooth with no preexisting
periapical pathology. The tooth is vital and tender to percussion. The radiograph will show
A. an apical radiolucency.

B. acute osteitis.
C. root resorption.
D. condensing osteitis.
E. normal lamina dura.
Radiographically, a primordial cyst will show
A. mixed radiolucency and radiopacity.
B. a radiolucency around the crown of an impacted tooth.
C. a radiolucency containing multiple rudimentary teeth.
D. a radiolucency.
E. None of the above
A radiopaque area within the alveolar process containing several rudimentary teeth suggests a/an
A. periapical cemento-osseous dysplasia.
B. ameloblastoma.
C. compound odontoma.
D. complex odontoma.
E. Pindborg tumor.
The primary consideration in the management of a patient with multiple deep abfraction lesions is
A. provision of an occlusal splint.
B. tooth brushing modification.
C. diet counselling.
D. occlusal adjustment.
Gigantism is caused by
A. a hyperactive thyroid.
B. atrophy of the posterior pituitary.
C. hyperplasia of the anterior pituitary.
D. hyperplasia of the parathyroids.
A 17 year old male patient exhibits delayed eruption of permanent teeth. Radiographs indicate multiple,
impacted permanent teeth. The head size appears large with prominent frontal eminences and slightly
constricted facial features. The most likely diagnosis is
A. osteopetrosis.
B. osteitis deformans.
C. Gardner's syndrome.
D. acromegaly.
E. cleidocranial dysostosis.
One week following extraction of teeth 1.8 and 4.8, an 18 year old male returns to the dental office complaining
of persistent bleeding from the extraction sites. The medical history was unremarkable, except for episodes of
bruising and joint swelling as a child. Subsequent blood tests showed normal bleeding time and a factor VIII
level of 14%. The most likely cause would be
A. dry socket.
B. ibuprofen intake.
C. Hemophilia A.
D. cirrhosis.
E. Vitamin K deficiency.
Hypercementosis of tooth roots, replacement of skeletal bone with poorly mineralized bone, and an increased
serum alkaline phosphatase are characteristic features of
A. acromegaly.
B. osteopetrosis.
C. osteitis deformans (Paget's disease).
D. osteomyelitis.
E. myelomatosis.

One week following extraction of teeth 1.8 and 4.8, an 18 year old male returns to the dental office complaining
of persistent bleeding from the extraction sites. The medical history was unremarkable, except for episodes of
bruising and joint swelling as a child. Subsequent blood tests showed normal bleeding time and a factor VIII
level of 14%. The most likely cause would be
A. dry socket.
B. ibuprofen intake.
C. Hemophilia A.
D. cirrhosis.
E. Vitamin K deficiency
Hypercementosis of tooth roots, replacement of skeletal bone with poorly mineralized bone, and an increased
serum alkaline phosphatase are characteristic features of
A. acromegaly.
B. osteopetrosis.
C. osteitis deformans (Paget's disease).
D. osteomyelitis.
E. myelomatosis.
Compared to unstimulated saliva, stimulated saliva is more beneficial for oral health because of a higher
A. calcium level.
B. phosphate level.
C. mucin level.
D. pH level.
A common side effect for a patient with Parkinsons disease taking a drug that has a significant anti-cholinergic
effect is
A. hypertrophy of the salivary gland.
B. saliva that has a low pH.
C. sialorrhea.
D. xerostomia.
Which of the following statements about the nutritional management of diabetes is correct?
A. A diet planned according to Canadas Food Guide to Healthy Eating must be modified for a person with
diabetes.
B. The Glycemic Index of foods should be used when planning the diet.
C. The fat content of the diet should be 30-35% of energy intake.
D. Sucrose up to 10% of total daily energy intake (e.g. 50% of 2000 kcal/day) is acceptable.
Which of the following bone lesions of the mandible is/are malignant?
1. Osteosarcoma.
2. Osteochondroma.
3. Ewing's tumor.
4. Fibrous dysplasia.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above.
The most common form of latex allergy is a/an
A. immediate localized (Type 1) contact urticaria and erythema.
B. immediate generalized (Type 1) conjunctivitis and rhinitis.
C. immediate generalized (Type 1) bronchospasm and anaphylaxis.
D. delayed (Type IV) contact dermatitis
A differential diagnosis for gingival enlargement should include which of the following conditions?

A. Multiple myeloma.
B. Monocytic leukemia.
C. Erythema multiforme.
D. Pemphigus vulgaris.
In infectious mononucleosis you are most likely to find
1. a positive Paul Bunnel test.
2. lymphadenopathy.
3. palatine petechiae.
4. leukopenia.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above.
A Vitamin B2 (riboflavin) deficiency usually arises in patients
1. who are elderly.
2. with acute infection.
3. consuming a high protein or fat diet.
4. taking systemic antibiotics.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above.
The risk of latex allergy increases with a/an
1. increased exposure to latex.
2. history of spina bifida.
3. history of allergy to bananas, chestnuts or avocado.
4. history of eczema.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above
Which of the following materials is most likely to initiate a hypersensitivity reaction?
A. Titanium.
B. Gold.
C. Nickel chromium.
D. Chrome cobalt.
E. Silver amalgam
What is the most significant radiographic finding in hyperparathyroidism?
A. Demineralization of teeth.
B. Multiple odontogenic keratocysts.
C. Hypercementosis.
D. Rampant caries.
E. Generalized loss of lamina dura.
Cawson PP 154

A hemorrhagic bone cyst (traumatic cyst) is a radiolucency most frequently seen


A. in the mandibular ramus.
B. posteriorly to the maxillary molars.
C. from the symphysis to the ramus of the mandible.
D. in the maxillary premolar area.
@E. None of the above
The mandible is involved more frequently than
the maxilla. The premolar and molar regions are the most
common locations, but the symphysis is also frequently involved
(Fig. 16-19).

A 22 year old patient has been experiencing general malaise, fever, sore throat and coughing for one week.
There are multiple ulcerations of the oral mucosa, crusting of the lips and red circular lesions on the palms of
the hands. The most likely diagnosis is
A. gonorrhea.
B. infectious mononucleosis.
C. acute herpetic gingivostomatitis.
D. AIDS.
E. erythema multiforme.
Soames Pp 157
Erythema multiforme occurs mainly in young adults and is more common in males than in females.
There may be a prodromal phase with upper respiratory infection, headache, malaise, nausea, and
sometimes arthralgia.
The skin lesions have a variety of forms, including erythematous maculopapular rashes and
vesiculobullous eruptions in addition to the characteristic and virtually diagnostic target or iris
lesions (Fig. 12.17). These consist of concentric rings of varying erythema and oedema, in the
centre of which may be an intact or ruptured and crusted bulla. The hands and feet are most
commonly involved.
Oral lesions may involve any part of the mucosa, although the lips and anterior parts of the mouth
are most commonly affected (Figs 12.18, 12.19). The appearance of the lesions varies with time.
Erythematous patches are quickly followed by vesiculobullous eruptions which rapidly break down
into erosions as the bullae disintegrate. The erosions on the lips are accompanied by bleeding and
crusting. Circumoral crusting haemorrhagic lesions are an important sign in arriving at a clinical
diagnosis. The diagnosis of erythema multiforme is based primarily on the clinical findings.
An increased heart rate may be associated with
A. hypothyroidism.
B. prolonged corticosteroid therapy.
C. hyperthyroidism.
D. Down's syndrome.
During root canal therapy, which of the following organisms will cause endocarditis in a patient with valvular
heart disease?
A. Hemolytic streptococcus.
B. Non hemolytic streptococcus.
C. Coagulase positive staphylococcus.
D. Candida monilia.
E. Bacteroides melaninogenicus.
The microorganisms responsible for formation of a dental or periapical granuloma are found mainly in the
A. granuloma.
B. root canal.
C. periapical periodontal ligament.
D. periapical alveolar bone and bone marrow.
E. periapical cementum.

The radiographic change most suggestive of multiple myeloma is


A. no bone alteration.
B. punched out radiolucent lesions.
C. multiple radiopaque lesions.
D. diffuse ground glass appearance.
E. generalized hypercementosis.
Which structure is responsible for root development?
A. Dental papilla.
B. Hertwig's epithelial sheath.
C. Enamel organ.
D. Cellular cementum.
E. Undifferentiated mesenchymal cells.
The discontinuity of the lamina dura on a radiograph may be a consequence of
1. pulpitis.
2. metastatic carcinoma.
3. parathyroid hyperplasia.
4. eburnated bone.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above.
Which of the following is/are associated with the presence of microorganisms in the bloodstream?
A. Anachoresis. =bacteriemia originating from pulpal infection
B. Cavernous sinus thrombosis.
C. Bacteremia.
D. All of the above
The cell of the dental pulp most capable of transforming into other cells is the
A. fibroblast.
B. undifferentiated mesenchymal cell.
C. odontoblast.
D. histiocyte.
Cell rests of Malassez are thought to originate from
A. stellate reticulum.
B. dental papilla.
C. Hertwig's root sheath.
D. stratum intermedium.
Decreased size or obliteration of pulp chambers and canals is diagnostic of
A. Hand-Schuller-Christian disease.
B. cleidocranial dysostosis.
C. amelogenesis imperfecta.
D. osteogenesis imperfecta. [ occuring with dentinogenesis imperfecta]
When odontoblasts are destroyed or undergo degeneration, they are replaced by
A. ameloblasts.
B. undifferentiated mesenchymal cells.
C. multinucleated giant cells.
D. osteoblasts.

In an 80-year old patient you would expect


A. a reduced size of the pulp chamber.
B. increased incidence of pulp stones.
C. increased tendency to pulpal fibrosis.
D. All of the above.
Aging of the pulp is evidenced by a relative increase in
1. vascularity.
2. nerve tissue
3. cell numbers.
4. fibrous elements.
5. calcification.
A. (1) (2) (3)
B. (1) and (3)
C. (3) (4) (5)
D. (4) and (5)
The most common area for the location of periapical osteofibrosis (cementoma) is
A. maxillary anterior region.
B. mandibular anterior region.
C. mandibular premolar region.
D. maxillary posterior region.
E. All of the above.
Ref: Soames 199
Cementum is a modified form of bone and, with the exception of the cementoblastoma, disorders of
the jaws containing cementum- like tissue are now classified as lesions of bone. The
cementoblastoma is still classified as an odontogenic tumour because of its unique association with
the root of a tooth. It is this which distinguishes it, otherwise it is indistinguishable from
osteoblastoma of bone.
The cementoblastoma is a rare benign neoplasm most frequently seen in patients under 25 years of
age. It usually arises in the molar or premolar area of the mandible and is attached to the root of a
tooth. Most cases involve the mandibular first permanent molar. It presents as a slowly enlarging
swelling which sometimes gives rise to pain, but the involved tooth is vital. Radiographs show a
well-demarcated, mottled, or dense radiopaque mass with a radiolucent margin attached to the root
of a tooth which usually shows resorption
Which of the following cells are characteristic of chronic inflammation of the dental pulp?
1. Neutrophils.
2. Eosinophils.
3. Lymphocytes.
4. Macrophages.
5. Plasma cells.
A. (1) (2) (3)
B. (1) and (2)
C. (1) (4) (5)
D. (1) and (5)
E. (3) (4) (5)
A periapical abscess of a mandibular second molar that has perforated the lingual cortical plate below the origin
of the mylohyoid muscle may result in an infection of the
A. buccal space.

B. sublingual space.
C. submandibular space.
D. submental space.
E. superficial masticatory space
Thinned cortical bone, decreased cancellous trabeculation, enlargement of the medullary cavity and decreased
bone density are radiographic features of
A. osteomalacia.
B. osteopetrosis.
C. primary occlusal traumatism.
D. osteoradionecrosis.
E. osteoporosis.
Histologically, a pulp polyp consists of
1. a mass of collagenous fibres.
2. Russell bodies.
3. proliferating capillaries.
4. fibroblasts.
5. polymorphonuclear leucocytes
A. (1) (2) (3) (4)
B. (1) (3) (4)
C. (1) (3) (4) (5)
D. (2) and (5)
E. All of the above.
Periapical odontogenic cysts are associated with
A. impacted wisdom teeth.
B. congenitally missing teeth.
C. non-vital teeth.
D. a history of traumatic injury.
Condensing osteitis in the periapical region is indicative of a/an
A. acute inflammation of the pulp.
B. pulpal abscess.
C. chronic inflammation of the pulp.
D. early apical abscess formation.
E. None of the above.
Which of the following conditions is most likely to be associated with a draining fistula?
A. Chronic periapical periodontitis.
B. Reversible pulpitis.
C. Hypercementosis.
D. Traumatic bone cyst
Trephination is indicated when
A. a soft tissue swelling is fluctuant and pointing.
B. an acute pulpitis is present.
C. pus is trapped within bone.
D. a chronic periapical lesion is present
Function(s) of the dental pulp include(s)
1. defensive.
2. sensory.
3. circulatory.
4. dentin repair.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only

E. All of the above


Which condition produces a radiopaque image?
A. Osteomalacia.
B. Multiple myeloma.
C. Osteopetrosis.
D. Letterer-Siwe disease.
E. Central giant cell reparative granuloma
A loss of sensation in the lower lip may be produced by
1. Bell's palsy.
2. metastatic malignancy to the body of the mandible.
3. trigeminal neuralgia.
4. fracture in the mandibular first molar region.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above
After ossification of the epiphyseal cartilages, an overproduction of the growth hormone of the anterior pituitary
gland produces the clinical condition known as
A. gigantism.
B. acromegaly.
C. myxoedema.
D. Paget's disease.

The white appearance of the oral mucosa seen following extended local application of aspirin is the result of
A. hyperparakeratosis.
B. acanthosis.
C. coagulation necrosis.
D. edema.
Enlargement of the gingiva, described as idiopathic fibromatosis, is best described as
A. degeneration.
B. inflammation.
C. hyperplasia.
D. neoplasia.
Hyperkeratosis, acanthosis, dysplasia, increased mitosis, intact basal cell layer and chronic inflammatory cells
are histologic features that may be found in
A. squamous cell carcinoma.
B. carcinoma in situ.
C. papillofibroma.
D. endothelioma
Routine radiographs of a middle-aged black female reveal a radiolucency at the apices of the mandibular central
incisors. The teeth are vital. The most likely clinical diagnosis is a/an
A. apical periodontal cyst.
B. periapical granuloma.
C. periapical cemental dysplasia.
D. ameloblastoma.
Osteomyelitis of the mandible may follow
1. radiotherapy.
2. dentoalveolar abscess.
3. fracture.
4. Vincents angina.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above.
Pain, associated with temporomandibular disorders is most frequently caused by
A. impacted third molars.
B. perforation of the articular disks.
C. muscle hyperactivity.
D. subluxation.
The epithelial lining of a radicular cyst is derived from
A. the epithelial cell rests of Malassez.
B. oral epithelium proliferating apically from a periodontal pocket.
C. endothelial proliferation of capillaries in the area.
D. metaplasia of histiocytes and/or cementoblasts.

The primordial cyst probably results from


A. cystic degeneration of the stellate reticulum early in the formation of the tooth.
B. epithelial remnants in the periodontal ligament.
C. an extension of pulpal inflammation after death of the pulp.
D. failure of formation of the enamel matrix.
E. the dental lamina.
Which of the following is/are associated with an unerupted tooth?
1. Odontogenic adenomatoid tumor.
2. Periapical cemental dysplasia.
3. Calcifying epithelial odontogenic tumor.
4. Cementoblastoma.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above.
A small, well-circumscribed, periapical radiolucency on a mandibular incisor which is clinically asymptomatic
and responds normally to vitality tests is most likely
A. a periapical granuloma.
B. sclerosing osteitis.
C. a radicular cyst.
D. periapical cemental dysplasia.
Histological sections of a lesion removed from the apex of a carious tooth show immature fibrous tissue and
chronic inflammatory cells. The most likely diagnosis is a/an
A. acute periapical abscess.
B. odontogenic fibroma.
C. radicular cyst.
D. periapical granuloma.
E. central fibroma
An enameloma is
A. an odontoma.
B. an ameloblastoma.
C. a pearl of enamel at the cemento-enamel junction.
D. an enamel hypocalcification.
The epithelium covering the lesions of chronic hyperplastic pulpitis is believed to be derived from the
A. reduced enamel epithelium.
B. epithelium of the oral mucosa.
C. odontoblastic layer.
D. epithelial rests of Malassez
E. remnants of the dental lamina.
Which of the following conditions is the most dangerous?
A. Acute periapical abscess of a mandibular central incisor.
B. Middle face cellulitis.
C. Chronic periapical abscess of a mandibular third molar.
D. Infected dentigerous cyst
Osteomyelitis of the mandible may follow
1. radiotherapy.

2. dentoalveolar abscess.
3. fracture.
4. Vincents angina.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above
The epithelial lining of a radicular cyst is derived from
A. the epithelial cell rests of Malassez.
B. oral epithelium proliferating apically from a periodontal pocket.
C. endothelial proliferation of capillaries in the area.
D. metaplasia of histiocytes and/or cementoblasts

A 15-year old presents with hypoplastic enamel on tooth 1.5. All other teeth are normal. This was most probably
caused by a/an
A. vitamin D deficiency.
B. generalized calcium deficiency.
C. high fever encountered by the patient when he had measles at age 3.
D. infection of tooth 5.5 during the development of tooth 1.5.
E. hereditary factor
Radiolucent lesions of the jaws can be seen in
1. hyperparathyroidism.
2. multiple myeloma.
3. fibrous dysplasia.
4. hyperthyroidism.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above.
Radiographs of Garre's osteomyelitis show
A. radiopaque islands of bone that represent formation of sequestra.
B. a worm-eaten pattern of bone destruction.
C. thickening of the cortex.
D. A. and B.
E. All of the above.
An excisional biopsy of a nodule 5mm in diameter on the lateral border of the tongue was diagnosed as a
fibroma. This patient should have
A. hemisection of the tongue.
B. radiotherapy to site of biopsy.
C. no additional therapy.
D. re-excision with wider margins.
E. radium implantation around biopsy site.
Lancinating paroxysmal pain in the posterior part of the tongue, tonsil, nasopharynx and pharynx is most likely
diagnostic of
A. Mnire's disease.
B. trigeminal neuralgia.
C. sphenopalatine neuralgia.
D. glossopharyngeal neuralgia.
E. psychotic glosso pyrosis.
The characteristic colour seen in the crowns of teeth with internal resorption is due to
A. deposition of pigment in the cells of the odontoblast layer.
B. the presence of hyperplastic vascular pulp tissue.
C. a peculiar change of consistency of the dentin.
D. an optical phenomenon related to the difference in the refractive indices of the normal and affected areas.
E. the degeneration and necrosis of the pulp tissue
Oral lesions may be an early manifestation of
1. leukemia.
2. pernicious anemia.
3. infectious mononucleosis.
4. obstructive jaundice.

A. (1) (2) (3)


B. (1) and (3)
C. (2) and (4)
D. (4) only
Hypercementosis (cemental hyperplasia)
A. is most often confined to the apical half of the root.
B. most frequently affects molars.
C. affects non vital teeth in the majority of cases.
D. (A) and (C)
E. (B) and (C)
In assessing the prognosis of a neoplasm, the most important feature is
A. ulceration.
B. metastasis.
C. size.
D. duration

Which of the following sites for squamous cell carcinoma has the best prognosis?
A. Lower lip.
B. Retromolar area.
C. Gingiva.
D. Buccal mucosa.
E. Hard palate.
The radiographic image of the incisive foramen is located between the roots of the maxillary
A. incisors above their apices.
B. central and lateral incisors below their apices.
C. central incisors below their apices.
D. central and lateral incisors above their apices.
In hyperparathyroidism, typical features of bone involvement are
1. subperiosteal erosion of the phalanges.
2. osteopetrosis.
3. pathological fractures.
4. renal stones.
A. (1) (3) (4)
B. (1) and (3)
C. (2) and (4)
D. All of the above.
Oral lesions failing to heal may be related to
1. tuberculosis.
2. syphilis.
3. neoplasia.
4. diabetes.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above.
A decrease of which of the following is indicative of hypoparathyroidism?
A. Serum phosphorus.
B. Serum calcium.
C. Thyroid activity.
D. Serum alkaline phosphatase.
The microscopic appearance of the central giant cell granuloma of the jaws is similar to that of lesions which
occur in
A. hyperparathyroidism.
B. Paget's disease.
C. cleidocranial dysplasia (dysostosis).
D. hyperpituitarism.
Surgery of irradiated bone is complicated by the fact that the
A. original neoplasm may invade the area of surgery.
B. bone becomes brittle.
C. blood vessels become sclerosed compromising normal healing.
D. All of the above.

E. None of the above

Untreated diabetes mellitus characteristically demonstrates


A. hypoglycemia.
B. hyperglycemia.
C. hypophagia.
D. hyperlipidemia.
E. dysuria.
An odour of acetone on the breath may indicate
1. bronchiectasis.
2. rhinitis.
3. salicylate poisoning.
4. diabetes mellitus.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above.
"Tic douloureux" is synonymous with
A. psychogenic facial pain.
B. trigeminal neuralgia.
C. facial paralysis.
D. temporomandibular joint dysfunction syndrome.
Postoperative bleeding in thrombocytopenic purpura is due to a deficiency of
A. vitamin C.
B. vitamin K.
C. prothrombin.
D. platelets.
Erythroblastosis fetalis may be a cause of
A. supernumerary incisors.
B. pigmented teeth.
C. peg lateral incisors.
D. Fordyce's granules.
E. blue sclerae.
An anemia in which the red blood cells are smaller and less intense in color than normal is called a
A. microcytic hypochromic anemia.
B. microcytic hyperchromic anemia.
C. macrocytic hypochromic anemia.
D. macrocytic hyperchromic anemia.
E. None of the above.
Which of the following conditions is most likely to lead to thrombosis?
A. Stasis of blood.
B. Presence of bacteria in blood.
C. Deficiency of circulating platelets.
D. Increased concentration of plasma
E. Lowered oxygenation of hemoglobin.
A decrease in the neutrophil count is present in
A. granulocytopenia (agranulocytosis).

B. iron deficiency anemia.


C. myeloid leukemia.
D. leukocytosis.
E. thrombocytopenic purpura.
The term applied to a low white blood cell count is
A. leucocytosis
B. leukopenia
C. thrombocythemia
D. thrombocytopenia
A patient who uses nitroglycerine has
A. rheumatic heart disease.
B. asthma.
C. coronary artery disease.
D. high blood pressure.
E. cardiac arrhythmia.
The principal action of nitroglycerin is vasodilation
Of the following, the most common site of a basal cell carcinoma is the
A. middle third of the face.
B. lower lip.
C. tongue.
D. oral mucosa.
Soames Chap. 10
This is a common neoplasm of the skin of the face, particularly in elderly patients with a history of
long exposure to ultraviolet radiation. Occasionally, basal cell carcinomas present on
the lips, particularly the upper lip, but many are probably skin tumours that have spread to involve
the vermilion. Multiple naevoid basal cell carcinomas arising at a younger age and on non-sunexposed
sites are a characteristic feature of the naevoid basal cell carcinoma syndrome
The most common malignancy found in the oral cavity is
A. basal cell carcinoma.
B. transitional cell carcinoma.
C. melanoma.
D. squamous cell carcinoma.
E. pleomorphic adenoma
MD 197
Squamous cell CA accounts for about 95% of all oral cancers. Arises from epithelial lining of the oral cavity
Aetiological factors: Smoking, betel quid, tobacco use, alcohol, UV-light, diet, viruses-HPV [ found in 70% of
oropharyngeal CA but less associated with oral cancers.
Smoking is the most important aetiological factor.
Lip is the most common site of oral cancer often to one side of the midline.
When a patient experiences continuous pain in the maxillary premolar and molar areas and there is no evidence
of dental infection, the most likely diagnosis is
A. trigeminal neuralgia.
B. acute maxillary sinusitis.
C. impacted maxillary canine.
D. impacted maxillary third molar.
E. glossopharyngeal neuralgia
Upper face infections can communicate with the cavernous sinus through

A. the angular vein to the superior ophthalmic vein.


B. the pterygoid plexus to the inferior ophthalmic vein.
C. A. and B.
D. None of the above.
The most common cause of bilateral swelling of the parotid glands in children is
A. Mikulicz' disease.
B. mumps or acute infectious parotitis.
C. mixed salivary tumor (pleomorphic adenoma).
D. sialolithiasis.
A stone in the salivary glands or ducts is called a
A. sialolith.
B. renolith.
C. calcolith.
D. phlebolith.
E. None of the above.
An abnormal decrease in the flow of saliva is associated with
A. ptyalism.
B. sialomentaplasia.
C. xerostomia.
D. pyroglossia.
E. None of the above
Unilateral premature eruption of teeth is characteristic of
A. acromegaly.
B. hemihypertrophy.
C. hemiatrophy.
D. cleidocranial dysostosis.
E. adrenogenital syndrome
Which one of the following oral conditions is NOT caused by a virus?
A. Benign mucous membrane pemphigoid.
B. Herpetic gingivostomatitis.
C. Leukoplakia.
D. Necrotizing ulcerative gingivitis
BMMP: associated with
Herpetic gingivostomatitis associated with
Hairy leuokoplakia associated with EBV
Contact stomatitis may be caused by
A. dentifrice.
B. lipstick.
C. acrylic.
D. antibiotics.
E. All of the above.
Asymptomatic, bilateral, reticular, radiating, grayish-white linear lesions of the buccal mucosa most likely
represent
A. lichen planus. Wickham's striae
B. white sponge naevus.
C. pemphigus.
D. discoid lupus erythematosus.

E. erythema multiforme.
Acute or subacute suppurative osteomyelitis occurs most frequently in the
A. anterior maxilla.
B. posterior mandible.
C. posterior maxilla.
D. anterior mandible.
Occasionally, mucous glands are seen in the epithelial lining of a dental cyst. Which of the following terms best
designates this state?
A. Anaplasia.
B. Metaplasia.
C. Dysplasia.
D. Neoplasia.
E. Hyperplasia
Acute herpetic gingivostomatitis is a disease characterized by
A. mouth ulcers, conjunctivitis, hyperpyrexia and submaxillary lymphadenitis.
B. recurrent ulcers and enlargement of gums and symptoms of malaise and fever.
C. inflamed gums, lymphadenitis, fever and mouth ulcers.
D. fever, mouth ulcers, parotid swellings and hypertrophic gingivitis.
When a diagnosis of a primordial cyst is made, there is likely to be
A. the normal number of teeth in that jaw.
B. one less than the normal number of teeth in that jaw.
C. one more than the normal number of teeth in that jaw.
D. a squamous cell carcinoma in that jaw.
E. a primordial cyst situated symmetrically on the opposite side.
A primordial cyst is a devleopmental odontogenic cyst. It is found in an area where a tooth should have formed
but is missing. Primordial cysts most commonly arise in the area of mandibular third molars. Under
microscopes, the cyst looks like an odontogenic keratocyst
Oral peripheral giant cell lesions of the periodontium are usually considered to be
@A. non-neoplastic granulomatous lesions.
B. precursors of sarcoma.
C. malignant neoplasms.
D. benign neoplasms.
E. tuberculomas.
Treatment of all of these forms of epulis is by local excision. The origin of the lesion is often interdental and, in
more advanced cases, the periodontal membrane may be quite deeply involved. If excision is not complete,
there may be recurrence of the lesion and removal should include all affected tissue. With repeated recurrence, it
is sometimes necessary to remove the adjacent teeth in order to secure the elimination of the tissue of origin. In
their tendency to recur, epulides may appear to be neoplasms, but the recurrence is due only to persistence of
the conditions that caused the initial abnormal response
Acellular cementum on a root is
A. the result of chronic inflammation.
B. a defective cementoid substance.
C. caused by premature degeneration of Hertwig's root sheath.
D. a normal anatomical structure.

Fordyce's granules are


A. ectopic sebaceous glands.
B. ectopic sweat glands.
C. small calcified nodules.
D. aberrant mucous glands.
The normal white cell differential count for neutrophils is
A. 10-19%.
B. 20-29%.
C. 30-39%.
D. 40-65%.
E. 66-90%.
Which of the following is characteristically found in Paget's disease?
A. Increased acid phosphatase.
B. Increased alkaline phosphatase.
C. Osteoporosis.
D. Incomplete fusion of cranial sutures.
A patient has an asymptomatic, white patch on the oral mucosa. Which of the following methods of examination
is most likely to lead to a diagnosis?
A. Biopsy.
B. Culture.
C. Exfoliative cytology.
D. Application of methylene blue.
Master Dentistry 151
Lesion is likely to be non-erosive lichen planus which is usually asymptomatic, painless and the most common
type
A large encapsulated tumor is removed from the hard palate. It is filled with fluid. The best method of
determining the nature of this lesion is to
A. examine the fluid under a microscope
B. culture the fluid and examine for bacterial growth.
C. submit the tissue for histological examination
D. submit the tissue for exfoliative cytological study.
E. aspirate the fluid for electrophoresis study
The benign neoplasm that originates from squamous epithelium is called a/an
A. adenoma.
B. choriocarcinoma
C. chondroma
D. lipoma.
E. papilloma.
adenoma. from glandular tissue
choriocarcinoma = uterine tissue
chondroma -cartilage
lipoma.= fat cells
A 50 year old woman has a history of rheumatoid arthritis, bilateral enlargement of one or more salivary glands
and lacrimal glands, as well as dryness of the eyes, nose, mouth and throat. The diagnosis is
A. erythema multiforme.
B. Reiter's syndrome.

C. Gardner's syndrome.
D. Sjgren's syndrome.
E. Plummer-Vinson syndrome.
Radiographically, a primordial cyst will show
A. mixed radiolucency and radiopacity.
B. a radiolucency around the crown of an impacted tooth.
C. a radiolucency containing multiple rudimentary teeth.
D. a radiolucency.
E. None of the above.
PRIMORDIAL CYST
A primordial cyst is less common than the OKC and is
thought to develop as early cystic degeneration in the
tooth germ before mineralization has been initiated. The
involved tooth bud may be of the regular permanent dentition
or a supernumerary tooth. The radiographic picture
is nonspecific, showing only a cystlike radiolucency
where a tooth has not developed.

A 17 year old male patient exhibits delayed eruption of permanent teeth. Radiographs indicate multiple,
impacted permanent teeth. The head size appears large with prominent frontal eminences and slightly
constricted facial features. The most likely diagnosis is
A. osteopetrosis.
B. osteitis deformans. -[pagets disease]
C. Gardner's syndrome.
D. acromegaly.
E. cleidocranial dysostosis.
Hypercementosis of tooth roots, replacement of skeletal bone with poorly mineralized bone, and an increased
serum alkaline phosphatase are characteristic features of
A. acromegaly.
B. osteopetrosis.
C. osteitis deformans (Paget's disease).
D. osteomyelitis.
E. myelomatosis.
Which of the following conditions is an example of a mucous retention phenomenon?
A. Nicotine stomatitis.
B. Kopliks spots.
C. Ranula.
D. Residual cyst.
E. Nasopalatine cyst.
Hemangiomas of the jaws
A. never occur in bone.
B. are malignant.
C. can appear cystic radiographically.
D. are metastatic lesions.
In infectious mononucleosis you are most likely to find
1. a positive Paul Bunnel test.
2. lymphadenopathy.
3. palatine petechiae.
4. leukopenia.
A. (1) (2) (3)

B. (1) and (3)


C. (2) and (4)
D. (4) only
@E. All of the above
A hemorrhagic bone cyst (traumatic cyst) is a radiolucency most frequently seen
A. in the mandibular ramus.
B. posteriorly to the maxillary molars.
C. from the symphysis to the ramus of the mandible.
D. in the maxillary premolar area.
E. None of the above.
An increased heart rate may be associated with
A. hypothyroidism.
B. prolonged corticosteroid therapy.
C. hyperthyroidism.
D. Down's syndrome.
Acute maxillary sinusitis is associated with
1. pain in the posterior maxillary teeth.
2. nasal discharge.
3. tenderness of posterior maxillary teeth to percussion.
4. increase of pain when bending over
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above.
An osteoma is
@A. radiopaque.
B. radiolucent.
C. either radiopaque or radiolucent.
D. radiolucent surrounded by a radiopaque line
On radiographic examination, tOli, exostoses, and periosteal
osteomas may appear as single or multiple, smoothly contoured, somewhat rounded, dense radiopaque masses
Tori, exostoses, and osteomas, like multiple mature
PCODs or FCODs, are radiopaque, but they do not have
radiolucent perimeters. Also, their identity can be substantiated
on clinical examination by the presence of
bony hard exophytic nodules.

The radiographic change most suggestive of multiple myeloma is


A. no bone alteration.
B. punched out radiolucent lesions.
C. multiple radiopaque lesions.
D. diffuse ground glass appearance.
E. generalized hypercementosis.
Ocular lesions are associated with
A. lichen planus.
B. herpangina.
C. necrotizing ulcerative gingivitis.
D. leukoplakia.
E. cicatricial pemphigoid.

The discontinuity of the lamina dura on a radiograph may be a consequence of


1. pulpitis.
2. metastatic carcinoma.
3. parathyroid hyperplasia.
4. eburnated bone.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above
Which of the following is caused by a specific microorganism?
A. Geographic tongue.
B. Candidiasis.
C. Median rhomboid glossitis.
D. Granuloma pyogenicum.
Decreased size or obliteration of pulp chambers and canals is diagnostic of
A. Hand-Schuller-Christian disease.
B. cleidocranial dysostosis.
C. amelogenesis imperfecta.
D. osteogenesis imperfecta.
Which condition produces a radiopaque image?
A. Osteomalacia.
B. Multiple myeloma.
C. Osteopetrosis.
D. Letterer-Siwe disease.
E. Central giant cell reparative granuloma
Routine radiographs of a middle-aged black female reveal a radiolucency at the apices of the mandibular central
incisors. The teeth are vital. The most likely clinical diagnosis is a/an
A. apical periodontal cyst.
B. periapical granuloma.
C. periapical cemental dysplasia.
D. ameloblastoma.
Difficulty in mouth opening, dysphagia, tongue stiffness and generalized induration of the skin are
characteristic of
A. lupus erythematosus.
B. scleroderma.
C. erythema multiforme.
D. lichen planus.
E. malignant disease.
Unilateral numbness of the chin is associated with
A. malignancy.
B. Bell's palsy.
C. periapical abscess.
D. trigeminal neuralgia.
E. development of malignancy
A radiopaque area within the alveolar process containing several rudimentary teeth suggests a/an
A. periapical cemental dysplasia.
B. ameloblastoma.
C. compound odontoma.
D. complex odontoma.

E. Pindborg tumor.
The radiographs of dentinal dysplasia Type I show
A. obliteration of pulp chambers and root canals.
B. small underdeveloped roots.
C. involvement of primary as well as permanent teeth.
D. (A) and (B)
E. All of the above.
Difficulty in mouth opening, dysphagia, tongue stiffness and generalized induration of the skin are
characteristic of
A. lupus erythematosus.
B. scleroderma.
C. erythema multiforme.
D. lichen planus.
E. malignant disease.
Unilateral numbness of the chin is associated with
A. malignancy.
B. Bell's palsy.
C. periapical abscess.
D. trigeminal neuralgia.
Following radiation therapy to the mandible, extraction of teeth is most likely to result in
A. fracture.
B. actinomycosis.
C. osteomyelitis.
D. soft tissue necrosis.
A radiopaque area within the alveolar process containing several rudimentary teeth suggests a/an
A. periapical cemental dysplasia.
B. ameloblastoma.
C. compound odontoma.
D. complex odontoma.
E. Pindborg tumor.
The radiographs of dentinal dysplasia Type I show
A. obliteration of pulp chambers and root canals.
B. small underdeveloped roots.
C. involvement of primary as well as permanent teeth.
D. (A) and (B)
E. All of the above.
Which of the following conditions produces a radiolucent image?
A. Sialolithiasis.
B. Osteosclerosis.
C. Odontoma.
D. Internal resorption.
E. None of the above.
Radiographically, a benign bone neoplasm can be differentiated from a malignant one because in the benign
lesion
1. the margins are irregular and fade into the surrounding bone.
2. the cortex remains intact.
3. the margins are defined and demarcated.
4. there can be perforation of the periosteum.
A. (1) and (2)

B. (1) (2) (4)


C. (2) and (3)
D. (2) (3) (4)
Following radiation therapy to the mandible, extraction of teeth is most likely to result in
A. fracture.
B. actinomycosis.
C. osteomyelitis.
D. soft tissue necrosis.
E. development of malignancy
Radiographically, the opening of the incisive canal may be misdiagnosed as a
1. branchial cyst.
2. nasopalatine cyst.
3. nasolabial cyst.
4. radicular cyst.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above.
branchial cyst of the second arch may occur at any level in the
neck and frequently lie under the sternocleidomastoid
muscle (see Fig. 31-14, B).

A circumscribed radiolucent area at the apex of a vital mandibular incisor is indicative of


A. periapical abscess.
B. periapical cemental dysplasia.
C. granuloma.
D. radicular cyst.
E. follicular cyst.
On a bitewing radiograph of posterior teeth, which of the following is most likely to be misdiagnosed as
proximal caries?
A. Cemento-enamel junction.
B. Marginal ridge.
C. Carabelli cusp.
D. Calculus.
E. Cemental tear.
Basal cell carcinoma
A. metastasizes to the submental lymph nodes.
B. metastasizes to the submaxillary lymph nodes.
C. metastasizes to the cervical lymph nodes.
D. metastasizes to the pre-auricular lymph nodes.
E. does not normally metastasize.
The lamina dura is
A. cortical bone.
B. spongy bone.
C. immature bone.
D. a cribiform plate perforated by nutrient canals.
E. None of the above
It is possible to misdiagnose the midline palatal suture as a
A. fracture.
B. palatal cyst.

C. granuloma.
D. abscess.
A periapical radiolucency can represent a
1. periapical granuloma.
2. radicular cyst.
3. metastatic carcinoma.
4. mental foramen.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above.
A radiopaque area within the alveolar process containing several rudimentary teeth suggests a/an
A. periapical cemental dysplasia.
B. ameloblastoma.
C. compound odontoma.
D. complex odontoma.
E. Pindborg tumor.
Ankylosis is commonly
A. associated with a non-vital pulp.
B. the result of a root fracture.
C. associated with a root penetrating cavity.
D. resulting in a submerged tooth, out of occlusion.
E. found in permanent teeth.
Ameloblastomas originate from the
A. odontogenic epithelium.
B. mucous cysts.
C. epithelial rests of Malassez.
D. neural crest cells.
In the early stage, a periradicular abscess can be differentiated from a lateral periodontal abscess by
A. pain.
B. type of exudate.
C. tenderness to percussion.
D. response of pulp to electrical stimulation.
E. radiographic examination.
Median anterior maxillary cysts occur in the
A. nasal bone.
B. incisive canal and in the palatine process.
C. zygomatic process.
D. hamular process.
E. None of the above.
Vitality tests are used to differentiate between
A. cementoma and a periapical granuloma.
B. cementoma and an incisive canal cyst.
C. periapical granuloma and an apical cyst.
D. periapical granuloma and the mental foramen.

A patient with myxedema is characterized by


A. exophthalmos.
B. satin skin and fine hair.
C. enlargement of the thyroid gland.
D. being dull, slow moving, expressionless.
E. gross coarse features and an alert look.
In the presence of an acute bacterial infection, laboratory tests will show an increase in
A. polymorphonuclear leukocytes.
B. plasma cells.
C. lymphocytes.
D. monocytes.
E. eosinophils
Gingival enlargement observed in acute leukemia is due to
A. reactive fibrosis.
B. edema.
C. tissue infiltration by cells.
D. capillary fragility.
E. hematoma.
When tumour cells revert to a more primitive, embryonic, or undifferentiated form with an increased capacity
for reproduction and a decreased function, this is called
A. anaplasia.
B. metaplasia.
C. hypoplasia.
D. hyperplasia.
A constant finding in the radicular cyst is
A. cholesterol clefts.
B. foam cells.
C. lining epithelium.
D. polymorphonuclear leukocytes.
E. multinucleated giant cells.
A patient presents with apparent paralysis of one side of the face which appeared the day before. What is the
most likely diagnosis?
A. Glossodynia.
B. Bell's palsy.
C. Myasthenia gravis.
D. Trigeminal neuralgia.
Multiple neurofibromatosis and "caf au lait" spots on the skin are typical of
A. Gardner's syndrome.
B. Plummer-Vinson syndrome.
C. Von Recklinghausen's disease.
D. Down's syndrome.
Coxsackie A virus is the etiologic agent in
A. thrush.
B. herpangina.
C. lichen planus.
D. aphthous stomatitis.
E. None of the above.

Herpangina is a viral illness in which ulcers and sores (lesions) form inside the mouth,
and there is a sore throat and fever.See also: Hand, foot, and mouth disease
Causes, incidence, and risk factors: Herpangina is typically caused by Coxsackie group A
viruses. The number of cases of herpangina is unknown, but it is a common childhood
infection. It is most often seen in children ages 3 - 10, but it can occur in any age group.
????Which of the following is NOT associated with Cushings disease?
A. Buffalo hump.
B. Osteoporosis.
C. Hirsutism.
D. Hypertension.
E. Diabetes insipidus.
Cushing's syndrome Cushing's syndrome is a complex of
symptoms, including buffalo IOrso (adiposity about the
upper portion of the trunk and a bump at the base of the
neck), moon face (puffiness of the face). altered hair distribution
(masculinizing effects in women. girls. and boy).
hypertension. elevated blood glucose levels. increased excretion
of 17-ketosteroids in the Uline. and osteoporosi .
These symptoms are evoked by an increased output of glucocorticoids,
especially cortisol.

Sickle cell anemia is


A. a genetic disease.
B. caused by exposure to radiation.
C. a viral infection.
D. a drug reaction.
E. an auto-immune disease
An ameloblastoma is most frequently found in
A. the anterior region of the maxilla.
@B. the mandible, near the junction of the body and the ramus.
C. the posterior region of the maxilla.
D. in the anterior region of the mandible near the midline.
Which of the following tumors has the best prognosis in terms of patient survival?
A. Osteosarcoma.
B. Melanoma.
C. Ameloblastoma.
D. Adenocarcinoma.
Pleomorphic salivary adenomas are most likely to exhibit
A. rapid growth with early death of patient.
B. early metastasis to distant organs.
C. slow growth but tendency to local recurrence.
D. early ulceration and hemorrhage
Squamous cell carcinomas of the lip occur most frequently on the
A. commissures.
B. lower lip near the midline.
C. inner surface of upper lip.
D. inner surface of lower lip.
E. upper lip near the midline.
Which of the following bone lesions of the mandible is/are malignant?

1. Osteosarcoma.
2. Osteochondroma.
3. Ewing's tumor.
4. Fibrous dysplasia.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above.
The radiographs of dentinal dysplasia Type I show
A. obliteration of pulp chambers and root canals.
B. small underdeveloped roots.
C. involvement of primary as well as permanent teeth.
D. (A) and (B)
E. All of the above.
The clinical appearance and texture of an early carcinoma of the floor of the mouth could be
A. red and soft.
B. white and rough.
C. ulcerated and indurated.
D. All of the above.
E. None of the above.
Signs and symptoms of diabetic patients include
1. polyuria.
2. polydipsia.
3. glycosuria.
4. dysphagia.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above.
polydipsia and polyuria and polyphagia are with diabetes.

Increased tooth mobility and the absence of lamina dura are signs of
A. hyperthyroidism.
B. hyperpituitarism.
C. hyperparathyroidism.
D. scleroderma.
Multiple giant cell lesions of the bone are associated with
A. hyperthyroidism.
B. hypothyroidism.
C. hyperparathyroidism.
D. hypoparathyroidism.
A common clinical sign of occlusal traumatism is
A. tooth mobility.
B. pocket formation.

C. gingival recession.
D. temporomandibular joint pain - dysfunction syndrome.
E. pulp calcifications
Which gingival manifestation(s) would be expected in a patient with a blood dyscrasia?
1. Enlargement.
2. Bleeding.
3. Ulceration.
4. Atrophy.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above.
Which one of the following is the most common tumour of the salivary glands?
A. Adenocystic carcinoma.
B. Adenoma.
C. Pleomorphic adenoma.
D. Muco-epidermoid carcinoma.
Which of the following cysts contains the crown of a tooth?
A. Radicular.
B. Multilocular.
C. Dentigerous.
D. Inclusion.
A positive Nikolsky's sign is a diagnostic feature of
A. lichen planus.
B. erythema multiforme.
C. pemphigus.
D. chronic marginal gingivitis.
E. lupus erythematosus.
A 14-year old boy presents with bilateral pearly-white thickening of the buccal mucosa which has been present
since birth. His brother has similar lesions. Your diagnosis is
A. leukoplakia.
B. lichen planus.
C. mucous patches.
D. white-sponge naevus.
This hereditary disorder is transmitted as an autosomal dominant but with incomplete penetrance
and variable expressivity. Any part of the oral mucosa may be involved (Fig. 9.1), and clinically the
edges of the lesion are not well defined but gradually merge with the normal mucosa. The
superficial layers of the epithelium are soft and of uneven thickness, producing a shaggy or folded
surface. Other mucosal surfaces, for example the nose, oesophagus, and anogenital region, may
also be involved. The oral mucosal lesions may be apparent in infancy or early childhood, or may
not become evident until adolescence. Histologically, the epithelium is acanthotic and the surface
shows marked hyperparakeratosis (Fig. 9.2). A characteristic feature is marked intracellular oedema
of the prickle and parakeratinized cell layers. Only the cell walls and the pyknotic nuclei in the
centres of the cells are visible, thus giving a so-called basketweave appearance. There are no
inflammatory changes in the lamina propria and there is no cellular atypia. The oral epithelial
naevus is not a premalignant lesion. Tx: reassure

Mucoceles are most commonly found in the


A. upper lip.
B. lower lip.
C. tongue.
D. buccal mucosa.
E. soft palate.
A proliferative lesion found at a denture periphery is probably a
A. fibroid epulis.
B. epulis fissuratum.
C. epulis granulomatosum.
D. giant cell granuloma.
E. squamous cell carcinoma.
"Dens in dente" (dens invaginatus) is associated with
A. supernumerary teeth.
B. dentinogenesis imperfecta.
C. osteogenesis imperfecta.
D. anterior teeth.
E. amelogenesis imperfecta.
On a periapical radiograph, the coronoid process may be superimposed over the apices of the
A. maxillary third molar.
B. maxillary second premolar.
C. mandibular third molar.
D. mandibular first molar.
E. maxillary central incisors.
Geographic tongue is characterized by
A. congenital deformity of tissue.
B. atrophic filiform papillae.
C. association with scrotal tongue.
D. predominance in elderly patients.
Which of the following conditions produces a radiolucent image?
A. Sialolithiasis.
B. Osteosclerosis.
C. Odontoma.
D. Internal resorption.
E. None of the above.
In fibrous dysplasia
A. foci of cartilage are a common histological finding.
B. an inflammatory infiltrate is characteristically present.
C. there are characteristic changes in the blood chemistry.
D. a ground-glass appearance is present on radiographs.
The most frequent location of a dentigerous cyst is the
A. third molar area.
B. symphysis of the mandible.
C. midline of the hard palate.
D. apical area of a devitalized tooth.

E. premolar area.
A dentigerous cyst is one which encloses part or all of the crown of an unerupted tooth. It is
attached to the amelocemental junction and arises in the follicular tissues covering the fully formed
crown of the unerupted tooth. An eruption cyst is a true dentigerous cyst which arises in an extra-alveolar
location.
Clinical and radiographic features
Dentigerous cysts occur over a wide age range and although many are detected in adolescents and
young adults there is an increasing prevalence up to the fifth decade. They are about twice as
common in males than in females and twice as common in the mandible than in the maxilla. The
cysts most frequently involve teeth which are commonly impacted or erupt late. The majority are
associated with the mandibular third molar and then, in order of decreasing frequency, the
maxillary permanent canines, maxillary third molars, and mandibular premolars. Uncommonly, they
are associated with supernumerary teeth or with complex and compound odontomes. Pain is not a
feature unless there is secondary inflammation.
Radiographically, a dentigerous cyst presents as a well-defined unilocular, radiolucency associated
in some way with the crown of an unerupted tooth. Soames Pathology Pp 62
Multiple supernumerary teeth are most commonly found in
A. cherubism.
B. cretinism.
C. hypothyroidism.
D. cleidocranial dysplasia.
E. Down's syndrome.
Which of the following results from a necrotic pulp?
A. Dentigerous cyst.
B. Lateral periodontal cyst.
@C. Dental granuloma.
D. Pulp polyp.
E. Periapical osteofibrosis.
If a well-defined radiolucency
is at the apex of an untreated asymptomatic tooth with a
nonvital or diseased pulp and if anatomic structures can
be ruled out, the radiolucency is a dental granuloma or a
radicular cyst in approximately 90% of cases. Although
these two entities cannot be distinguished by radiographic
features alone, if the radiolucency is 1.6 cm or
more in diameter, or 200 mm2, it is more likely to be a
cyst. 23,31 In practice, it is unnecessary to differentiate between
small periapical granulomas and cysts, since both
respond well to conservative root canal therapy.

Cervical radiolucency at the cemento-enamel junction is most likely due to


A. caries at the site.
B. bone loss at the alveolar crest.
@C. less density of tissue at the cemento-enamel junction.
D. gingival recession
Among the following, which may be associated with root resorption?
1. Excessive orthodontic forces.
2. Periapical granuloma.
3. Cementoma.
4. Hypercementosis.
5. Traumatic injury.

A. (1) (2) (4)


B. (1) (2) (4) (5)
C. (1) (2) (5)
D. (1) (2) (3) (5)
E. All of the above.
The appropriate management for an avascular white lesion, 5 x 3mm in size, that has been present on the buccal
mucosa for 6 months and has recently become ulcerated is
A. observation.
B. excisional biopsy.
C. incisional biopsy.
D. aspiration biopsy.
E. cytologic examination.
A radicular cyst
A. enlarges rapidly.
B. infiltrates bone.
C. contains fluid.
D. cannot cause cortical bone expansion.
E. is associated with a vital tooth.
Which of the following is/are associated with xerostomia?
1. Atropine administration.
2. Acute anxiety state.
3. Mikulicz's disease.
4. Sjgren's syndrome.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above.
The prolonged use of antibacterial lozenges or mouthwashes contributes to the development of
A. oral candidiasis.
B. geographic tongue.
C. cancrum oris.
D. Koplik's spots.
E. aphthous ulcers.
Which of the following is NOT a sign or symptom of the myofascial pain dysfunction syndrome?
A. Pain.
B. Muscle tenderness.
C. Limitation of jaw motion.
D. "Clicking" or "popping" noise in the joints.
E. Radiographic changes of the joint.
Ludwig's angina may cause
A. respiratory obstruction.
B. cavernous sinus thrombosis.
C. suppurative encephalitis.
D. subdural empyema.
Tissue from a multilocular radiolucent area of the posterior mandible shows microscopically follicular areas
lined with cylindrical cells resembling the enamel organ. The most likely diagnosis is a/an

A. neurofibroma.
B. ameloblastoma.
C. central fibroma.
D. periodontal cyst.
E. dentigerous cyst
A 12 year old boy has a history of severe sore throat followed by migratory arthralgia and swollen joints of the
extremities. This history is suggestive of
A. gout.
B. osteoarthritis.
C. Still's disease.
D. rheumatic fever.
E. rheumatoid arthritis.
Radiographically, a benign bone neoplasm can be differentiated from a malignant one because in the benign
lesion
1. the margins are irregular and fade into the surrounding bone.
2. the cortex remains intact.
3. the margins are defined and demarcated.
4. there can be perforation of the periosteum.
A. (1) and (2)
B. (1) (2) (4)
C. (2) and (3)
D. (2) (3) (4)
The most logical explanation for causing swelling beneath the eye caused by an abscessed maxillary canine is
that the
A. lymphatics drain superiorly in this region.
B. bone is less porous superior to the root apex.
C. infection has passed into the angular vein which has no valves.
D. the root apex lies superior to the attachment of the caninus and levator labii superioris muscles.
Exophthalmia [exopthalmos] may be a sign of
A. hypoadrenalism.
B. hyperadrenalism.
C. hypothyroidism.
D. hyperthyroidism.
E. hypoparathyroidism.
Myxoedema is associated with
A. insufficient parathyroid hormone.
B. excessive parathyroid hormone.
C. insufficient thyroid hormone.
D. excessive thyroid hormone.
Which of the following conditions has the highest white blood cell count?
A. Acute myeloblastic leukemia.
B. Polycythemia vera.
C. Aplastic anemia.
D. Infectious mononucleosis
Excessive formation of scar tissue beyond the wound margin is called

A. a fibroma.
B. a keloid.
C. a fibro-epithelial polyp.
D. epithelial hyperplasia
Cleft lip and palate usually result from
A. failure of proper union of the median and lateral nasal processes.
B. failure of the union of the median nasal process with the lateral nasal and maxillary processes.
C. anhidrotic ectodermal dysplasia.
D. failure of development of both the lateral nasal and maxillary processes.
E. None of the above.
Median palatine cysts are classified as
A. developmental.
B. residual.
C. idiopathic.
D. odontogenic.
E. none of the above.
A clinical finding common to alcoholism, poorly-controlled diabetes mellitus, uremia and liver disease is
A. smooth tongue.
B. increased blood pressure.
C. coated tongue.
D. labial fissures.
E. halitosis.
Radiographically, the opening of the incisive canal may be misdiagnosed as a
1. branchial cyst.
2. nasopalatine cyst.
3. nasolabial cyst.
4. radicular cyst.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above
A periapical granuloma
A. erodes rapidly through bone.
B. is asymptomatic.
C. is intensely painful.
D. occurs only in young adults.
E. occurs at the apex of a vital tooth.
Intraoral soft tissue examination will NOT assist in the diagnosis of
A. lichen planus.
B. sinusitis.
C. erythema multiforme.
D. anemia.
E. vitamin deficiencies.
The most common complications caused by supernumerary teeth are
1. malposition of permanent teeth.
2. non-eruption of permanent teeth.

3. a dentigerous cyst.
4. an apical periodontal cyst (radicular cyst).
A. (1) (2) (4)
B. (2) (3) (4)
C. (1) (2) (3)
D. All of the above.
SoamesPP-6
A well circumscribed 3mm radiolucent lesion is present in the apical region of the mandibular second premolar.
The lesion may be
1. a periapical granuloma.
2. a periapical cyst.
3. a chronic periapical abscess.
4. the mental foramen.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above
Which of the following conditions are associated with AIDS?
1. Acute marginal periodontitis.
2. Hairy leukoplakia.
3. Candidiasis.
4. Geographic tongue.
A. (1) and (2)
B. (1) (2) (3)
C. (1) and (4)
D. All of the above.
Which of the following lesions has a tendency to bleed easily?
A. Pyogenic granuloma.
B. Osteoma.
C. Fibroma.
D. Papilloma.
E. Lipoma.
A circumscribed radiolucent area at the apex of a vital mandibular incisor is indicative of
A. periapical abscess.
B. periapical cemental dysplasia.
C. granuloma.
D. radicular cyst.
E. follicular cyst
White lesions of the oral mucosa may be produced by
1. thickening of the epithelium.
2. increase of the keratinized layers.
3. coagulation by heat or chemicals.
4. mycotic infection.
A. (1) (2) (3)

B. (1) and (3)


C. (2) and (4)
D. (4) only
E. All of the above.
Aphthous stomatitis
1. is considered to be an autoimmune condition.
2. is more frequent in men than in women.
3. may be related to the menstrual cycle.
4. is rarely seen clinically with vesicle formation.
5. is of three to four days duration.
A. (1) (2) (3)
B. (1) (3) (4)
C. (1) (3) (5)
D. (2) (3) (4)
E. (2) (3) (5)
White lesions of the oral mucosa may be produced by
1. thickening of the epithelium.
2. increase of the keratinized layers.
3. coagulation by heat or chemicals.
4. mycotic infection.
@A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above.
CawsonPP 225
Aphthous stomatitis
1. is considered to be an autoimmune condition.
2. is more frequent in men than in women.
3. may be related to the menstrual cycle.
4. is rarely seen clinically with vesicle formation.
5. is of three to four days duration.
A. (1) (2) (3)
B. (1) (3) (4)
C. (1) (3) (5)
D. (2) (3) (4)
E. (2) (3) (5)
CawsonPP 183-185
Granulation tissue is composed of
A. plasma cells and giant cells.
B. fibroblasts, capillaries and chronic inflammatory cells.
C. fibroblasts and eosinophils.
D. epithelioid cells and tissue phagocytes.
The most common site of intra-oral squamous cell carcinoma is the
A. palate.
B. floor of the mouth.

C. gingiva.
D. buccal mucosa.
Reference: DIFFERENTIAL DIAGNOSIS of OMF LESIONS- NK Wood/ PW Goaz: Pp 52
Squamous cell carcinoma (M: F= 3: I to 2: I) Overall picture
Buccal (10:1)
Floor (93%)
Tongue
Lip (98%)- out of the mouth
The hard palate is the commonset site for oral melanoma: Dental Secrets-65
Intra oral sites predilection
Tongue
25-40% of oral carcinomas
FOM
15-20%
Buccal Mucosa 10%
Gingiva
10%
Soft palate
10-20%
Hard palate (rare) presenting as asymptomatic red or white plaques or ulcerated and ketotic
The cell concerned with antibody production is called
A. polymorphonuclear leukocyte.
B. m ast cell.
C. plasma cell.
D. macrophage.
E. megakaryocyte.
Which of the following is most radiopaque?
A. Calcifying odontogenic cyst.
B. Fibrous dysplasia of bone.
C. Ameloblastoma.
D. Complex composite odontoma.
Intermittent painful swelling in the submandibular region that increases at mealtime is indicative of
A. a ranula.
B. a blockage of Wharton's duct.
C. Ludwig's angina.
D. a blockage of Stensen's duct.-parotid gland duct
E. an epidemic parotitis.
Heavy cigarette smoking significantly increases the incidence of
A. aphthous stomatitis.
B. geographic tongue.
C. lichen planus.
D. atrophic glossitis.
E. mucosal pigmentation
The skin lesion associated with actinomycosis may be
A. indurated.
B. fistulated.
C. purplish-red in colour.
D. All of the above.
Cawson PP93
Healing of a herpes simplex lesion is

A. prolonged over several months.


B. spontaneous within 7-14 days without scar formation.
C. spontaneous within 7-14 days with scar formation.
D. spontaneous within 2-4 days.
E. None of the above.
An 80 year old man develops multiple painful skin vesicles along the distribution of the right infraorbital nerve.
This is suggestive of
A. psoriasis.
B. herpes zoster.
C. pemphigus vulgaris.
D. candidiasis (candidosis).
Which of the following anatomic spaces is most likely to be involved as a result of an apical infection of a
mandibular third molar?
A. Sublingual.
B. Submandibular.
C. Submental.
D. Submasseteric.
Spontaneous hemorrhage from the gingiva may be indicative of
A. parotitis.
B. Hodgkins disease.
C. diabetes.
D. leukemia
A patient with a white blood cell count of 34,000/mm3 has a differential of lymphocytes 62%, lymphoblasts 4%
and polymorphonuclear leukocytes 34%. The most likely form of leukemia is
A. aleukemic.
B. granulocytic.
C. monocytic.
D. lymphocytic.
E. plasma cell.
The most common malignant tumor of the tongue is a/an
A. papilloma.
B. adenocarcinoma.
C. fibroma.
D. squamous cell carcinoma.
E. granular cell myoblastoma.
A patient presents with a non-healing lesion on the side of the nose. It has a rolled border and has been
increasing in size. The most likely diagnosis is
A. a sebaceous cyst.
B. a basal cell carcinoma.
C. lupus erythematosus.
D. verruca vulgaris.
E. an epulis
On a bitewing radiograph of posterior teeth, which of the following is most likely to be misdiagnosed as
proximal caries?
A. Cemento-enamel junction.
B. Marginal ridge.
C. Carabelli cusp.

D. Calculus.
E. Cemental tear.
A benign cementoblastoma is a solitary
A. circumscribed radiopacity involving a mandibular molar.
B. circumscribed radiolucency involving the apices of the mandibular incisors.
C. radiolucency involving the apices of the maxillary incisors.
D. unilocular radiolucency in an edentulous area.
Soames PP 199
A patient having a white blood count of 30,000 per cubic millimeter would be said to have
A. leukocytosis.
B. leukopenia.
C. neutrophilia.
D. erythropenia.
E. erythrocytosis.
A disease of childhood characterized by mental retardation, delayed growth and delayed tooth eruption may be
caused by deficient
A. thyroid hormone.
B. testicular hormone.
C. posterior pituitary hormone.
D. anterior pituitary growth hormone
Laboratory examination of the blood of a patient with an acute bacterial infection would show
A. lymphocytosis.
B. leukocytosis.
C. monocytosis.
D. leukopenia.
E. eosinophilia.
Oral lichen planus has lesions which
A. bleed readily.
B. occur in the debilitated.
C. exhibit a positive Nikolsky's sign.
D. histopathologically show lymphocytic infiltration.
Which of the following is NOT a true cyst?
1. Dentigerous cyst.
2. Odontogenic keratocyst.
3. Traumatic bone cyst.
4. Radicular cyst.
5. Lateral periodontal cyst.
A. (1) and (3)
B. (1) and (4)
C. (1) and (5)
D. (2) and (5)
E. (3) and (5) .
Swelling related to increased tissue fluid is called
A. thrombosis.
B. edema.
C. hematoma.

D. embolism.
E. surgical emphysema.
Basal cell carcinoma
A. metastasizes to the submental lymph nodes.
B. metastasizes to the submaxillary lymph nodes.
C. metastasizes to the cervical lymph nodes.
D. metastasizes to the pre-auricular lymph nodes.
E. does not normally metastasize.
If untreated, which of the following lesions has the WORST prognosis?
A. Basal cell carcinoma of the nose.
B. Ameloblastoma.
C. Melanoma of the soft palate.
D. Verrucous carcinoma.
Oral leukoplakia has the most favourable prognosis when it is
A. present in a non-smoker.
B. accompanied by pain.
C. infected with Candida albicans.
D. speckled in appearance.
E. on the hard palate.
Radiographically, the anterior palatine foramen may be mistaken for
1. an incisive canal cyst.
2. a median alveolar cyst.
3. a radicular cyst.
4. a naso-alveolar cyst.
5. a globular maxillary cyst.
A. (1) and (3)
B. (2) and (4)
C. (2) and (5)
D. (2) and (3)
E. (1) and (5)
The appearance of a circumscribed radiolucent area sharply outlined, bounded by an even radiopaque border,
located at the apex of a non-vital tooth, is consistent with
A. periapical cemental dysplasia.
@B. a radicular cyst.
C. rarefying osteitis.
D. an eosinophilic granuloma.
RAREFYING AND CONDENSING OSTEITIS
Frequently, rarefying and condensing osteitis occurs at
the apex of a nonvital tooth or a retained root (Fig. 24-3).
Chronic infection acts as an irritating factor (causing resorption
of bone) and as a stimulating factor (producing
dense bone, perhaps as a defense mechanism to contain
the local problem.

Multinucleated giant cells are associated with


1. plasmocytoma. (-)
2. odontogenic myxoma.
3. hyperparathyroidism.(+)
4. tuberculosis. (+)
5. osteoclastoma.

A. (1) (3) (4)


B. (2) and (3)
C. (2) and (4)
D. (3) (4) (5)
E. (2) (4) (5)
Which of the following is NEVER associated with an impacted tooth?
A. Adeno-ameloblastoma.
B. Odontogenic myxoma.
C. Pindborg's tumor.
D. Primordial cyst.
E. Ameloblastoma
Median anterior maxillary cysts are found in
A. the zygomatic process of the maxilla.
B. the incisive canal.
C. the uvula.
D. the hamular process.
E. None of the above.
Soft, white, elevated plaques of the oral mucosa are characteristic of
A. angioma.
B. candidosis (candidiasis).
C. actinomycosis.
D. herpes simplex.
E. submucous fibrosis.
The tissue which cannot be seen on dental radiographs is
A. dentin.
B. enamel.
C. cementum.
D. pulp.
E. periodontal ligament.
Which of the following is/are NOT usually affected by hereditary ectodermal dysplasia?
A. Salivary glands.
B. Teeth.
C. Sweat glands.
D. Hair.
E. Fingernails.
Which of the following is NOT associated with infectious mononucleosis?
A. Pharyngitis.
B. Lymphadenopathy.
C. Petechiae of the palate.
D. Gingival enlargement.
E. Fatigue.
The term "carcinoma in situ" implies that the lesion shows
A. metaplasia.
B. early invasion of malignant cells through the basement membrane.
C. dysplasia of cells confined within the epithelium.
D. distant metastasis of a malignant tumour.

A sarcoma is a
A. benign neoplasm of connective tissue.
B. malignant neoplasm of connective tissue.
C. benign neoplasm of epithelial tissue.
D. malignant neoplasm of epithelial tissue.
Osteomalacia is seen in
A. vitamin C deficiency.
B. adult rickets.
C. protein deficiency.
D. hyperparathyroidism.
E. normal pregnancy.
A periapical granuloma can be differentiated from a radicular cyst by
A. radiography.
B. history.
C. percussion.
D. biopsy.
The redness of an inflammatory lesion of oral mucosa is due to
A. increased number of capillaries.
B. increased size of capillaries.
C. decreased thickness of epithelium.
D. decreased connective tissue elements.
E. All of the abov
The term used to describe epithelial changes including nuclear hyperchromatism, loss of increased nuclear to
cytoplasmic ratio and abnormal mitoses is
A. acanthosis.
B. hyperkeratosis.
C. dysplasia.
D. parakeratosis.
E. hyperparakeratosis.
Osteoporosis may result from
A. hypothyroidism.
B. acromegaly.
C. diabetes.
D. prolonged steroid therapy.
The microscopic finding of intra-epithelial vesicles is an important diagnostic feature of
A. lichen planus.
B. erythema multiforme.
C. lupus erythematosus.
D. pemphigus.
E. agranulocytosis.
Which of the following histopathological features would be the most reliable indicator of the malignancy of a
neoplasm?
A. Hyperchromatism.
B. Pleomorphism.
C. Encapsulation.
D. Invasion.

E. Degeneration.
Multilocular radiolucencies associated with vital mandibular teeth show multinucleated benign giant cells in a
biopsy specimen. The next step is to
A. extract the teeth.
B. obtain a serum calcium.
C. commence antibiotic therapy.
D. commence root canal treatment.
E. perform a mandibular resection
The definitive diagnosis of central malignancy of the jawbone is made on
A. clinical examination.
B. radiographic translucency and loss of trabeculation.
C. exfoliative cytology.
D. biopsy.
E. All of the above.
A "butterfly-rash" of the face can sometimes be found in
A. erythema multiforme.
B. lupus erythematosus.
C. pemphigus vulgaris.
D. acne rosacea.
Exfoliative cytology is of value in the diagnosis of
A. lichen planus.
B. aphthous ulceration.
C. herpes simplex.
D. benign mucous membrane pemphigoid.
E. erythema multiforme.
Which of the following epithelial changes is most likely to be precancerous?
A. Acanthosis.
B. Hyperkeratosis.
C. Parakeratosis.
D. Dysplasia.
Palpation gives information as to
1. induration.
2. tenderness.
3. size.
4. fixation.
5. mobility.
A. (1) (3) (4)
B. (2) and (5)
C. (2) (4) (5)
D. (1) (2) (4) (5)
E. All of the above.
Which one of the following would be of greatest value in determining the etiology of an oral ulceration?
A. History of the oral lesion.
B. Cytological smear.
C. Systemic evaluation.
D. Laboratory tests.

A pleomorphic adenoma (mixed tumor) is most frequently found in the


A. parotid salivary gland.
B. submandibular salivary gland.
C. sublingual salivary gland.
D. tongue
Smooth, irregular, red patches surrounded by a white border on the dorsal surface of the tongue is indicative of
A. fissured tongue.
B. geographic tongue.
C. black hairy tongue.
D. red raspberry tongue.
A healthy 38 year old has a 4mm in diameter, well defined radiolucency at the apex of tooth 4.1. The tooth has a
normal response to vitality tests. The most appropriate management is
A. incision and drainage.
B. extraction.
C. observation.
D. apicoectomy.
E. open the tooth for drainage.
Nicotinic stomatitis
A. is associated with squamous cell carcinoma of the palate.
B. is caused by smokeless tobacco.
C. appears clinically as small red dots surrounded by an elevated pale mucosa.
D. is characterized by dysplastic changes.
E. is irreversible.
Typical history of a mucocele is
A. a slowly growing tumor mass.
B. a pain immediately before eating.
C. a trauma, swelling, rupture, disappearance, recurrence.
D. an ulcerated area on buccal mucosa.
E. frequent bleeding.
A distinctive clinical entity originating as a proliferative response of the soft tissue of the oral mucosa to a nonspecific irritant is called
A. cellulitis.
B. abscess.
C. pyogenic granuloma.
D. "canker sore".
E. None of the above.
A radicular cyst
A. enlarges rapidly.
B. infiltrates bone.
C. contains fluid.
D. does not cause cortical bone expansion.
E. is associated with a vital tooth.
It is possible to misdiagnose the midline palatal suture as a
A. fracture.
B. palatal cyst.
C. granuloma.
D. abscess.
Which of the following can be characterized by a narrowing of pulp chambers and root canals?

1. Aging.
2. Chronic trauma.
3. Dentinal dysplasia.
4. Taurodontism.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above.
Hypothyroidism affects dental development by
A. causing microdontia.
B. delaying the eruption timetable.
C. causing sclerotic bone to form over the occlusal surface of erupting teeth.
D. accelerating the eruption timetable.
An end result of ionizing radiation used to treat oral malignancies of the jaws is
A. deformity.
B. reduced vascularity.
C. increased vascularity.
D. increased brittleness.
Mottled enamel is a
A. form of enamel hypoplasia.
B. manifestation of fluorosis.
C. sign of amelogenesis imperfecta.
D. side effect of tetracycline therapy
A 12 year old boy has a history of severe sore throat followed by migratory arthralgia and swollen joints of the
extremities. This history is suggestive of
A. acute herpetic gingivostomatitis.
B. osteoarthritis.
C. chronic polyarthritis.
D. rheumatic fever.
E. rheumatoid arthritis.
Median palatine cysts are classified as
A. developmental.
B. residual.
C. idiopathic.
D. odontogenic
A patient with xerostomia complains that he has to sip water when chewing food. Which salivary gland(s) is
most likely responsible for the lack of lubrication?
A. Submandibular.
B. Labial.
C. Parotid.
D. Sublingual.
A periapical radiolucency can represent a
6. periapical granuloma.
7. radicular cyst.
8. metastatic carcinoma.
9. mental foramen.
A. (1) (2) (3)

B. (1) and (3)


C. (2) and (4)
D. (4) only
E. All of the above.
Early signs and symptoms of localized alveolar osteitis (dry socket) include
1. bleeding.
2. bad odour.
3. pus formation.
4. pain.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above
Ankylosis is commonly
A. associated with a non-vital pulp.
B. the result of a root fracture.
C. associated with a root penetrating cavity.
D. resulting in a submerged tooth, out of occlusion.
E. found in permanent teeth.
A periapical infection of a mandibular third molar may spread by direct extension to the
1. parapharyngeal space.
2. submandibular space.
3. pterygomandibular space.
4. submental space.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above
Ameloblastomas originate from the
A. odontogenic epithelium.
B. mucous cysts.
C. epithelial rests of Malassez.
D. neural crest cells.
A patient is not able to close her left eye, wrinkle her forehead or smile on the left side. The most likely
diagnosis is
A. contralateral subarachnoid hemorrhage.
B. fracture of the base of the skull.
C. Horner's syndrome.
D. acute mastoiditis.
E. facial nerve paralysis (Bell's palsy).
Ludwig's angina may cause death by
A. heart failure.
B. asphyxia.
C. convulsions.
D. paralysis of muscles of respiration.
E. pyemia.
Median anterior maxillary cysts occur in the
A. nasal bone.
B. incisive canal and in the palatine process.

C. zygomatic process.
D. hamular process.
E. None of the above.
A periapical granuloma is
1. radiolucent.
2. painless.
3. neoplastic.
4. inflammatory.
A. (1) and (3)
B. (1) (2) (4)
C. (3) and (4)
D. All of the above
A 68-year old male develops a unilateral parotitis six days following an abdominal operation for intestinal
obstruction. The probable cause is
A. an ascending infection of the parotid duct from the mouth.
B. a suppurative parotitis secondary to bacteremia from the intestinal surgery.
C. epidemic parotitis.
D. calculus in parotid duct.
E. Mikulicz's disease.
If an odontogenic infection involves the pterygomandibular space, the most obvious clinical sign will be
A. trismus.
B. facial swelling.
C. swelling in the submandibular area.
D. rise in body temperature above 39C (102F)
A periapical radiolucency associated with a vital maxillary central incisor can represent a
1. nasopalatine cyst.
2. dentigerous cyst.
3. foramen of the incisive canal.
4. periapical granuloma.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above.
Which of the following cysts is most likely to undergo transformation into an ameloblastoma?
A. Radicular.
B. Dentigerous.
C. Fissural.
D. Traumatic.
Which one of the following is seen in primary herpetic stomatitis, herpes simplex, herpes zoster and varicella?
A. Macules.
B. Papules.
C. Vesicles.
D. Pustules.
Acquired Immune Deficiency Syndrome (AIDS) may be characterized by
1. candidiasis.
2. rapid weight loss and night sweats.
3. extreme malaise, fever or chills.

4. a smooth and red tongue.


A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above.
A constant finding in the radicular cyst is
A. cholesterol clefts.
B. foam cells.
C. lining epithelium.
D. polymorphonuclear leukocytes.
E. multinucleated giant cells.
A patient presents with apparent paralysis of one side of the face which appeared the day before. What is the
most likely diagnosis?
A. Glossodynia.
B. Bell's palsy.
C. Myasthenia gravis.
D. Trigeminal neuralgia.
Tetracycline will cause crown discolouration when prescribed at the age of
1. 6 months in utero.
2. 2 years.
3. 7 years.
4. 14 years.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above.
Coxsackie A virus is the etiologic agent in
A. thrush.
B. herpangina.
C. lichen planus.
D. aphthous stomatitis.
E. None of the above.
Which of the following has malignant potential?
A. Junctional naevus.
B. Lentigo.
C. Periapical granuloma.
D. White folded gingivo-stomatosis.
Which is NOT a sign of thyrotoxicosis?
A. Tremor.
B. Exophthalmos.
C. Slow pulse rate.
D. Temperature elevation
An ameloblastoma is most frequently found in
A. the anterior region of the maxilla.
B. the mandible, near the junction of the body and the ramus.
C. the posterior region of the maxilla.
D. in the anterior region of the mandible near the midline.
An acute periapical abscess originating from a mandibular third molar generally points and drains in the
A. submandibular space.

B. pterygomandibular space.
C. buccal vestibule.
D. buccal space.
Which of the following tumors has the best prognosis in terms of patient survival?
A. Osteosarcoma.
B. Melanoma.
C. Ameloblastoma.
D. Adenocarcinoma.
Pleomorphic salivary adenomas are most likely to exhibit
A. rapid growth with early death of patient.
B. early metastasis to distant organs.
C. slow growth but tendency to local recurrence.
D. early ulceration and hemorrhage
Squamous cell carcinomas of the lip occur most frequently on the
A. commissures.
B. lower lip near the midline.
C. inner surface of upper lip.
D. inner surface of lower lip.
E. upper lip near the midline.
The clinical appearance and texture of an early carcinoma of the floor of the mouth could be
A. red and soft.
B. white and rough.
C. ulcerated and indurated.
D. All of the above.
E. None of the above
Which one of the following is the most common tumour of the salivary glands?
A. Adenocystic carcinoma.
B. Adenoma.
C. Pleomorphic adenoma.
D. Muco-epidermoid carcinoma
Which of the following cysts contains the crown of a tooth?
A. Radicular.
B. Multilocular.
C. Dentigerous.
D. Inclusion
D. (2) (4) (5)
E. (3) (4) (5)
Enamel maturation is completed
A. at eruption.
B. following eruption.
C. when the enamel organ is complete.
D. prior to eruption but after root formation has begun
The cause of a cleft lip is failure of the union of the
A. maxillary processes.
B. maxillary and lateral nasal processes.
C. palatine processes.
D. All of the above.
E. None of the above.
A positive Nikolsky's sign is a diagnostic feature of
A. lichen planus.

B. erythema multiforme.
C. pemphigus.
D. chronic marginal gingivitis.
E. lupus erythematosus.
Embryologically, fusion of the palatal shelves should be completed by the
A. fifth week.
B. tenth week.
C. sixteenth week.
D. twentieth week
Mucoceles are most commonly found in the
A. upper lip.
B. lower lip.
C. tongue.
D. buccal mucosa.
E. soft palate.
The radiologic change most suggestive of multiple myeloma is
A. multiple radiolucent lesions.
B. multiple radiopaque lesions.
C. diffuse ground glass appearance.
D. generalized hypercement
A proliferative lesion found at a denture periphery is probably a
A. fibroid epulis.
B. epulis fissuratum.
C. epulis granulomatosum.
D. giant cell granuloma.
E. squamous cell carcinoma
After tooth eruption, which of the following materials gradually decreases in concentration from the enamel
surface ?
A. Carbonate.
B. Protein.
C. Fluoride.
D. Calcium.
E. Chloride.
Geographic tongue is characterized by
A. congenital deformity of tissue.
B. atrophic filiform papillae.
C. association with scrotal tongue.
D. predominance in elderly patients
In fibrous dysplasia
A. foci of cartilage are a common histological finding.
B. an inflammatory infiltrate is characteristically present.
C. there are characteristic changes in the blood chemistry.
D. a ground-glass appearance is present on radiographs
Which of the following results from a necrotic pulp?
A. Dentigerous cyst.
B. Lateral periodontal cyst.
C. Dental granuloma.
D. Pulp polyp.
E. Periapical osteofibrosis.
In fibrous dysplasia
A. foci of cartilage are a common histological finding.

B. an inflammatory infiltrate is characteristically present.


C. there are characteristic changes in the blood chemistry.
D. a ground-glass appearance is present on radiographs
The most frequent location of a dentigerous cyst is the
A. third molar area.
B. symphysis of the mandible.
C. midline of the hard palate.
D. apical area of a devitalized tooth.
E. premolar area.
Multiple supernumerary teeth are most commonly found in
A. cherubism.
B. cretinism.
C. hypothyroidism.
D. cleidocranial dysplasia.
E. Down's syndrome.
Abnormalities in blood clotting may be associated with a deficiency of vitamin
A. B12.
B. C.
C. E.
D. K.
Mottled enamel is a/an
A. form of enamel hypoplasia.
B. manifestation of fluorosis.
C. enameloma.
D. side effect of tetracycline therapy
The appropriate management for an avascular white lesion, 5 x 3mm in size, that has been present on the buccal
mucosa for 6 months and has recently become ulcerated is
A. observation.
B. excisional biopsy.
C. incisional biopsy.
D. aspiration biopsy.
E. cytologic examination.
A radicular cyst
A. enlarges rapidly.
B. infiltrates bone.
C. contains fluid.
D. cannot cause cortical bone expansion.
E. is associated with a vital tooth.
The radicular or root-end cyst occurs as a result of
A. trauma.
B. pulpal necrosis.
C. hyperparathyroidism.
D. poorly calcified bone.
Ludwig's angina may cause
A. respiratory obstruction.
B. cavernous sinus thrombosis.
C. suppurative encephalitis.
D. subdural empyema.
Recurrence after surgery is a feature of the pleomorphic adenoma. The reason for this is the
A. tendency of the tumor to show hematogenous metastases.
B. marked and early lymph node involvement.

C. anaplastic histologic characteristics of the tumor.


D. tendency to infiltrate the capsule of the gland.
Tissue from a multilocular radiolucent area of the posterior mandible shows microscopically follicular areas
lined with cylindrical cells resembling the enamel organ. The most likely diagnosis is a/an
A. neurofibroma.
B. ameloblastoma.
C. central fibroma.
D. periodontal cyst.
E. dentigerous cyst
Exophthalmia may be a sign of
A. hypoadrenalism.
B. hyperadrenalism.
C. hypothyroidism.
D. hyperthyroidism.
E. hypoparathyroidism.
Myxoedema is associated with
A. insufficient parathyroid hormone.
B. excessive parathyroid hormone.
C. insufficient thyroid hormone.
D. excessive thyroid hormone
Excessive formation of scar tissue beyond the wound margin is called
A. a fibroma.
B. a keloid.
C. a fibro-epithelial polyp.
D. epithelial hyperplasia.
Cleft lip and palate usually result from
A. failure of proper union of the median and lateral nasal processes.
B. failure of the union of the median nasal process with the lateral nasal and maxillary processes.
C. anhidrotic ectodermal dysplasia.
D. failure of development of both the lateral nasal and maxillary processes.
E. None of the above
Median palatine cysts are classified as
A. developmental.
B. residual.
C. idiopathic.
D. odontogenic.
E. none of the above
The median palatal cyst is a fissural cyst and arises from proliferation of entrapped epithelium when the right
and and left palatal sheves fuse in the midline.
The nasopalatine duct cyst arises from remanants of duct epithelium in area of nasopalatine foramen.
Soft tissue counterpart also occurs in the midline of the palate and is the palatal cyst of newborn or Epstein's
pearl)
A periapical granuloma
A. erodes rapidly through bone.
B. is asymptomatic.
C. is intensely painful.
D. occurs only in young adults.
E. occurs at the apex of a vital tooth

The periapical granuloma is a tumor like proliferation of granulation tissue found around the apex of a nonvital tooth.
It is associated with chronic inflammation which may stimulate proliferation of the epithelial rests of Malassez
to form a cyst.
(apical/radicular/periapical)
Which lesion(s) may appear radiographically as multilocular radiolucencies?
1. Ameloblastoma.
2. Odontogenic myxoma.
3. Primordial cyst.
4. Keratocyst.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above
Enlargement of the thyroid gland can be caused by
A. insufficient fluoride.
B. excess iodine.
C. insufficient iodine.
D. excess calcium.
E. excess sodium.
Which of the following conditions is characterized by abnormally large pulp chambers?
A. Amelogenesis imperfecta.
B. Regional odontodysplasia.
C. Dentinogenesis imperfecta.
D. Dentinal dysplasia Type I.
Which of the following has the highest rate of recurrence?
A. Odontogenic keratocyst.
B. Nasoalveolar cyst.
C. Median palatal cyst.
D. Incisive canal cyst.
A primordial cyst
A. develops in place of a tooth.
B. attaches to the apex of a tooth.
C. attaches to the crown of a tooth.
D. remains after the tooth is extracted.
Eosinophilic granuloma
A. is found only at the apices of non-vital teeth.
B. occurs in infants.
C. is a non-lipid reticulo-endotheliosis.
D. is caused by a virus.
Dysplastic lesions of squamous epithelium occur most often on the
A. palate.
B. gingiva.
C. buccal mucosa.
D. dorsum of the tongue.
E. floor of the mouth.

Which of the following tumors may arise in the parotid salivary gland?
1. Mixed tumor. (+)
2. Adenocarcinoma.(?)
3. Warthin's tumor(+).
4. Mucoepidermoid tumor.(+)
A. (1) (2) (3)
B. (1) (2) (4)
C. (1) (3) (4)
D. (2) (3) (4)
E. All of the above.
Which of the following is the most frequent cause of ankylosis of the temporomandibular joint?
A. Intra-articular injection of steroids.
B. Chronic subluxation.
C. Trauma.
D. Anterior disc dislocation.
The most likely origin of a metastic carcinoma of the mandible is a primary lesion of the
1. lung.
2. breast.
3. prostate.
4. nasopharynx.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above
Hyperplastic lingual tonsils may resemble which of the following?
A. Epulis fissuratum.
B. Lingual varicosities.
C. Squamous cell carcinoma.
D. Median rhomboid glossitis.
E. Prominent fungiform papillae.
Which of the following lesions has a tendency to bleed easily?
A. Pyogenic granuloma.
B. Osteoma.
C. Fibroma.
D. Papilloma.
E. Lipoma.
Which of the following is NOT associated with osteogenesis imperfecta?
A. Brown teeth.
B. Brittle bones.
C. Thin enamel.
D. Blue sclerae.
E. Enamel loss.
A biopsy specimen should
1. not be distorted by instruments.
2. be fixed within 30 minutes after removal.
3. be representative of the lesion.
4. be obtained using electrosurgery.
A. (1) only

B. (1) and (4)


C. (1) (2) (3)
D. All of the above.
Desquamative gingivitis is seen in
1. pemphigus vulgaris.
2. mucous membrane pemphigoid.
3. erosive lichen planus.
4. erythema multiforme.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above
In which of the following conditions is there a risk of malignant change after repeated surgical interventions?
A. Fibrous dysplasia.
B. Mucocele.
C. Lymphangioma.
D. Torus palatinus.
Which of the following anatomic spaces is most likely to be involved as a result of an apical infection of a
mandibular third molar?
A. Sublingual.
B. Submandibular.
C. Submental.
D. Submasseteric
Which of the following is the LEAST likely primary site for the development of oral squamous cell carcinoma
in the elderly?
A. Dorsum of the tongue.
B. Floor of the mouth.
C. Lateral border of the tongue.
D. Tonsillar fossa
In the management of a patient with an acute odontogenic infection, the treatment should include:
1. elimination of the cause.
2. drainage.
3. supportive therapy.
4. tetanus immunization.
A. (1) (2) (3)
B. (1) and (3)
C. (2) and (4)
D. (4) only
E. All of the above.
The mandible grows primarily at the
A. symphysis and condyles.
B. posterior border of the ramus and the alveolar crest.
C. condyles and lateral border of the body.
D. condyles and posterior border of the ramus.
E. symphysis and posterior border of the ramus.
The maxilla is formed from
A. bundle bone.
B. endochondral bone.
C. membranous bone.
D. lamellar bone.

Which of the following are mechanisms of growth of the naso-maxillary complex?


A. Sutural.
B. Cartilaginous.
C. Appositional.
D. All of the above.
A patient presents with a non-healing lesion on the side of the nose. It has a rolled border and has been
increasing in size. The most likely diagnosis is
A. a sebaceous cyst.
B. a basal cell carcinoma.
C. lupus erythematosus.
D. verruca vulgaris.
E. an epulis
A characteristic of malignant tumors is the ability to
A. invade and metastasize.
B. grow to large size and remain within their capsule.
C. remain localized.
D. grow slowly.
Hypercementosis at the root apex is often associated with
A. hypothyroidism.
B. Paget's disease.
C. orthodontic tooth movement.
D. normal occlusal function.
E. hyperparathyroidism.
Histoplasmosis is a
A. non-specific bacterial infection.
B. protean disease.
C. viral disease.
D. fungal disease.
Histoplasmosis (also known as "Cave disease,"[1] "Darling's disease,"[1] "Ohio valley disease,"[1] and
"Reticuloendotheliosis"[1]) is a disease caused by the fungus Histoplasma capsulatum. Symptoms of this
infection vary greatly, but the disease primarily affects the lungs.[2] Occasionally, other organs are affected; this
is called disseminated histoplasmosis, and it can be fatal if untreated. Histoplasmosis is common among AIDS
patients because of their lowered immune system
Symptoms: start within 3 to 17 days after exposure; the average is 1214 days. Most affected individuals have
clinically silent manifestations and show no apparent ill effects.[4] The acute phase of histoplasmosis is
characterized by non-specific respiratory symptoms, often cough or flu-like. Chest X-ray findings are normal in
4070% of cases.[4] Chronic histoplasmosis cases can resemble tuberculosis;[5][6] disseminated histoplasmosis
affects multiple organ systems and is fatal unless treated.[7]
While histoplasmosis is the most common cause of mediastinitis, this remains a relatively rare disease. Severe
infections can cause hepatosplenomegaly, lymphadenopathy, and adrenal enlargement.[2] Lesions have a
tendency to calcify as they heal. Ocular histoplasmosis damages the retina of the eyes. Scar tissue is left on the
retina which can experience leakage, resulting in a loss of vision not unlike macular degeneration
Swelling related to increased tissue fluid is called
A. thrombosis.
B. edema.
C. hematoma.
D. embolism.
E. surgical emphysema

Acanthosis is a thickening of the following layer


A. granular layer.
B. stratum corneum.
C. basal cell layer.
D. prickle cell layer.
Koilonychia is
A. bifid uvula.
B. auricular tags.
C. ankyloglossia.
D. mulberry molars.
E. Spoon shaped (concave) nails
What type of tissue covers the articular surfaces of the human temporomandibular joint?
A. Hyaline cartilage.
B. Fibrocartilage. (is a synovial joint :no hyaline cartilage, and has a dense fibrocartilage)
C. Epithelium.
D. Dense, avascular, fibrous connective tissue.
E. Loose, vascular, fibrous connective tissue.
Oral leukoplakia has the most favourable prognosis when it is
A. present in a non-smoker.
B. accompanied by pain.
C. infected with Candida albicans.
D. speckled in appearance.
E. on the hard palate.
Five clinical criteria demonstrate a particularly high risk of malignant change.
The verrucous type is considered high risk.
Erosion or ulceration within the lesion is highly suggestive of malignancy.
The presence of a nodule indicates malignant potential.
A lesion that is hard in its periphery is predictive of malignant change.
OL of the anterior floor of the mouth and undersurface of the tongue is strongly associated
with malignant potential.
In all cases, the relative risk of malignant potential is determined by the presence of epithelial
dysplasia upon histological examination.
A 30-year old HIV positive patient comes to your office for the removal of an abscessed second molar. You
should:
A. Refer him to another dentist because your infection control procedures are inappropriate for this type of
condition.
B. Treat him at the end of the day.
C. Treat him in the same way you treat all your other patients.
D. Double glove before starting any surgical procedures