MFD Part 2 - Oral Medicine Qs & Answers

Dr.
Karim El Mestekawy
karimelmestekawy@yahoo.com
This file is for Oral Medicine for Membership of

the Faculty of Dentistry of the Royal College of
Surgeons in Ireland Part 2 Exam.
Sources for MFD Part 2 Exam depends mainly on
candidates' feedback and there are no pictures
associated with it. So, I tried to make a more
useful feedback by adding pictures that match
the questions.
You can find my questions file in this LINK
The questions & answers file.
MFD Part2 Dublin November 2010
Station 1
Dr.Karim El Mestekawy
a. Differential Diagnosis.
1.Oral Lichen Planus
2.Lichenoid Drug Reaction like Thiazides, Antimalarias or some
dental restorations.
3.Lupus Erythematosis.
4.Pemphigus.
5.Chronic Ulcerative Stomatitis.
b. 4 types occurring in the oral cavity
1.Reticular
2.Papular
3.Atrophic
4.Plaque-Like
c. 3 typical histological features
1.Hyperkeratosis.
2.Elongated rete ridges with a saw tooth appearance.
3.Sub & Intra Epithelial lymphocyte infiltrate.
4. Degeneration of basal keratinocytes.
d. Is it benign/premalignant/malignant?
It is benign except erosive form which has a percentage of less
than 1% of being premalignant.
Station 2
Picture of intraoral swelling for middle age lady (between upper

second incisor & canine)
a. Describe the lesion
A lesion extends between upper lateral incisor and canine
and it has a reddish nodule.
b. Differential Diagnosis
1.Oral Pyogenic Granuloma
2.Giant Cell Granuloma
3. Haemangioma.
c. What type of cells do you see in the histological section?
1. Plasma Cells.
2. Lymphocytes.
3. Neutrophils.
d. Diagnosis
Oral Pyogenic Granuloma
e. What investigations do you need to prove the diagnosis?
Biopsy
MFD Part 2 May 2012 Dublin Centre
Station 3
Picture of Dorsal Surface of the Tongue

a. Which skin lesion does look like or associated with?
Psoriasis
b. Genetic?
Yes
c. Mention 2 etiological factors
1. Candida.
2. Vitamin B Deficiency.
d. Treatment?
Reassurance and removal of the associated disease.
e. Name of the lesion.
Erythema Migrans or Geographic Tongue.
Station 4
Picture 1
Patient is diagnosed with AIDS.

a. Name this lesion.
Recurrent Aphthous Stomatitis.
b. Patient said this lesion is very frequent. Why?
Because the patient is immunodeficient due to AIDS.
c. If this lesion is associated with uveitis and genital ulceration
what is the condition?
Behcet Syndrome.
Picture 2
1.Name of the lesion

Oral Lichen Planus
2. Treatment?
1. Reassurance : In case of being asymptomatic.

2.Pain or Ulceration : Topical Steroids like betamethasone,
prednisolone mouthwash or topical dexamethasone.
3.Severe Cases : Oral Steroids (Azathioprine)
--------------------------------------------------
MFD Part 2 November 2012
Station 5
Picture male patient who is a denture wearer and has controlled

diabetes, he comes complaining of a bilateral symmetrical white
lesion on his cheeks (buccal mucosa)
1.Causes?
May be one of the following:
1. Lichenoid Drug reaction due to Oral Hypoglycemic Drug.
2. A lesion which is genetic in origin (Oral Lichen Planus).
2.Investigations?
1.Blood test for diabetes.
2. ESR (Erythrocyte Sedimentation Rate)
3. Drug History.
3.Treatment?
--------------------------------------------
Bahrain June 2013

Station 6
picture 1
a. what is this lesion?

Recurrent Aphthous Ulcer.
b. why is it recurrent?
1. Genetic in origin.
2. Stress.
c. If associated with uveitis and skin lesions? What is the
syndrome.
Behcet Syndrome.
Picture 2
a. What is the lesion.

Oral Lichen Planus (Reticular Type)
b. Treatment?
MFD Part 2 Jordan December 2014
Station 7
Picture of a lesion in a patient has been diagnosed with chronic

candida infection.
1.D.D?
1.Median Rhomboid Glossitis.
2.Erythema Migrans, Geographic Tongue or Benign Migratory
Glossitis.
2.What other lesion do u expect to see?
Kissing lesions on the surface of the palate due to spread of
infection to it.
NOTE: There may be also Angular Chelitis in case of presence
of median rhomboid glossitis associated with chronic candida
infection in a patient who wears upper complete denture.
3.Most common site?

Dorsum of the tongue ( just anterior to circumvallate papillae)
4.How would you biopsy the lesion and from which side?
Excisional Biopsy from the periphery of the lesion to include
affected and healthy tissue.
NOTE: when you examine the oral tissues for a lesion, you
should first remove the removable appliances from the patient’s
mouth to be able to examine all the patient’s oral tissues to
have a more precise and more accurate evaluation and diagnosis
of the patient’s oral health condition.
Station 8
Picture of large swelling on the lateral side of the palate and the
paper states that he had the 8 beside the swelling extracted.
1.Cause of extratction?
Devitalization as the tumor causes loss of vitality to the tooth.
2.Differential diagnosis?
1. Mucoepidermoid Carcinoma.
2.Adenoid Cystic Carcinoma.
3. Acinic Cell Carcinoma.
3.Type of biopsy?
Fine needle aspiration.
MFD Part 2 Jordan December 2013
Station 9
Picture 1
1.Prevalence?
Most common in population.
2.Is it premalignant?
No
3.What is the treatment?

Reassurance
4.D.D?
1. Dermoid Cyst
2. Epidermoid Cyst.
3. Pseudocyst.
4. Sebaceous Lymphadenoma.
Picture 2
1.D.D? Mention 3
1.Oral Lichen Planus
2.Lichenoid Drug Reaction like Thiazides, Antimalarias or some
dental restorations.
3.Lupus Erythematosis.
2.Investigations?
Biopsy
------------------------------------
Bahrain June 2015
Station 10
picture of swelling in inter dental papilla between upper lateral

and canine.
a) Differential diagnosis?
1.Oral Pyogenic Granuloma
2.Giant Cell Granuloma
3. Haemangioma.
b) Type of cells.
1. Plasma Cells.
2. Lymphocytes.
3. Neutrophils.
c) Investigation?
Biopsy
---------------------------------
Bahrain 2016
Station 11
1.what are the risk factors rather than nicotine or smoking?

1.Alcohol.
2.Immunodeficiency.
3.Human Papilloma Virus.
2.Histological feature?
1. Invasion of deep tissues with cellular pleomorphism.
2.Increase nuclear staining.
3. Abnormality of cell growth and multiplication.
Dublin November 2016
Station 12
1.Diagnose it , other name?

Pseudomembranous candidiasis. Other Name: Thrush
2.Treatment ?
Antifungal (Nystatin)
3. 4 local factors ?
1. Dentures.
2.Orthodontic Appliances.
3.Poor Oral Hygiene.
4.Chronic local irritants.
4. 4 systemic factors ?
1.Xerostomia
2.Immunodeficiency (HIV and AIDS)
3.Diabetes.
4.Cancer.
---------------------------------------------
Ajman April 2017
Station 13
Picture 1
The patient gave a history of recurrence of this ulcer recently

more than before.
1. 4 causes of the ulcer
1.Genetic in origin.
2.Stress.
3.Trauma.
4. Hormonal disturbance.
2. He gave other signs with the ulcer like uvulitis and he asked
about the disease?
Behcet Syndrome
Picture 2
1. Diagnosis.
Oral Lichen Planus
2. Treatment.
prednisolone mouthwash or topical
dexamethasone.
3.Severe Cases : Oral Steroids ( Azathioprine)
-------------------------------------------------
Sudan Jan 2016
Station 14
1. What's the diagnosis?

Oral Pyogenic Granuloma.
2. Management.
1. Reassurance. For Example, In Pregnancy.
2. Surgical Excision.
--------------------------------------------------
UAE April 2016
Station 15
1. What are the predisposing factors?

1. Smoking.
2.Tobacco use.
3. Alcohol.
4. Immunodeficiency (HIV or AIDS)
2. Name one histologial feature?

1. Cellular Pleomorphism.
2. Increased nuclear staining.
3. what are the prognostic factors other than microscopic
evaluation?
1. Persistence of the lesion for more than 3 weeks.
2. Painless Ulcer.
3. Being firm with raised edges, indurated base and fixed to
the surrounding tissues.
4. Referred Otalgia is a common manifestation.
5. Combination with lingual sulcus and ventral surface of the
tongue to create a horseshoe area (coffin area)

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Dr.

This file is for Oral Medicine for Membership of

The questions & answers file.

MFD Part2 Dublin November 2010

b. 4 types occurring in the oral cavity

Picture of intraoral swelling for middle age lady (between upper

MFD Part 2 May 2012 Dublin Centre

Picture of Dorsal Surface of the Tongue

Patient is diagnosed with AIDS.

1.Name of the lesion

1. Reassurance : In case of being asymptomatic.

MFD Part 2 November 2012

Picture male patient who is a denture wearer and has controlled

Bahrain June 2013

a. what is this lesion?

a. What is the lesion.

Picture of a lesion in a patient has been diagnosed with chronic

3.Most common site?

3.What is the treatment?

picture of swelling in inter dental papilla between upper lateral

1.what are the risk factors rather than nicotine or smoking?

Dublin November 2016

1.Diagnose it , other name?

Ajman April 2017

The patient gave a history of recurrence of this ulcer recently

Sudan Jan 2016

1. What's the diagnosis?

1. What are the predisposing factors?

2. Name one histologial feature?

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MFD Part 2 - Oral Medicine Qs & Answers

MFD Part 2 - Oral Medicine Qs & Answers