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Final Exam, Oral Pathology (DENS 2702)

May 8, 2006
1. Which of the following statements is TRUE for erythema migrans (geographic tongue?

a. It often is associated with fissured tongue

b. It shows Monro abscesses histologically

c. It is often associated with psoriasis of the skin

d. It primarily affects females

e. More than one of the above is true


2. Which of the following is NOT a typical part of Reiter’s disease

a. Balanitis circinata

b. Nongonococcal urethritis

c. Psoriasis

d. Bullae of oral mucosa

e. Arthritis


3. Which of the following statements is TRUE for lichen planus?

a. It occurs primarily in males

b. It is only found in the mouth

c. Wickham’s striae occur in the mouth

d. It does not produce oral ulcers

e. It is a congenital disorder


4. Which of the following is NOT a typical part of systemic lupus erythematosus?

a. Positive Nikolsky sign

b. Arthritis

c. Hypercoagulation states

d. Kidney damage

e. Vasculitis


5. Which of the following statements is TRUE for lupus erythematosus?

a. It primarily affects males

b. Oral lesions look like lichen planus

c. The butterfly rash occurs primarily over the buttocks

d. The LE cell is a keratinocyte

e. The basement membrane of the skin is attacked primarily by IgA antibodies


6. Which of the following diseases is NOT a form of pemphigus?

a. Pemphigus vulgaris

b. Pemphigus foliaceous

c. Pemphigus circinata

d. Pemphigus erythematosus

e. Pemphigus vegetans

7. Which of the following statements is TRUE for pemphigus vulgaris?


a. Tzanck cells are not part of this disease

b. It primarily affects teenagers and young adults

c. Without treatment more than half of patients will die of the disease

d. It is associated with white keratotic lines in the mouth

e. The mouth is seldom affected in patients
8.-14. Match EACH of the terms in List B with the most appropriate disease from List A. Answers from List A may be used more than once and not all List A answers need to be used.


List A:

a. Cicatricial pemphigoid

b. Peutz Jeghers syndrome

c. Lichen planus

d. Erythema multiforme

e. Ehlers Danlos syndrome





List B:

8. Civatte body a b c d e

9. Target lesions on skin a b c d e

10. Gorlin sign a b c d e

11. Stevens Johnson syndrome a b c d e

12. Intussusception a b c d e

13. Symblepharon a b c d e

14. Oral melanotic macules a b c d e


15. Which of the following statements is TRUE for cicatricial pemphigoid?

a. It produces oral blisters within the epithelium (between keratinocytes)

b. It occurs primarily in young adults

c. IgG is reactive at the basement membrane with direct immunofluorescence

d. It is associated with major kidney damage (nephrotic syndrome)

e. It is much more common in males than in females


16. Which of the following blistering diseases produce the blister ABOVE the basement

membrane, i.e. between the cells of the spindle cell layer?

a. Pemphigus vulgaris

b. Cicatricial pemphigoid

c. Bullous lichen planus

d. Linear IgA disease

e. Epidermolysis bullosa
17. Which of the following statements is TRUE for white sponge nevus?

a. It is usually located on the dorsum of the tongue

b. It usually arises during childhood

c. It must be biopsied to assure that no dysplastic cells are present

d. Its skin component is an erythematous, pruritic rash

e. It is inherited as an autosomal recessive disorder



18. A patient with which of the following white keratotic lesions is MOST LIKELY to

have ocular involvement?

a. White sponge nevus

b. Chronic cheek bite (frictional keratosis)

c. Witkop disease (hereditary benign intradermal dyskeratosis)

d. Leukoedema

e. Smokeless tobacco keratosis
19. Erythema multiforme is often triggered by an attack of herpes labialis. This statement

is:


a. True

b. False
20. Which of the following statements is TRUE for epidermolysis bullosa?

a. It is always inherited as an autosomal dominant disorder

b. It is caused by defective attachment of the epithelium with the basement

membrane

c. It is usually first diagnosed in late middle age

d. It only affects the mouth, not the skin

e. It is best treated with corticosteroids


21. Iron replacement therapy is MOST LIKELY to be needed for which of the following disorders?

a. Peutz-Jeghers syndrome

b. Lupus erythematosus

c. Hereditary hemorrhagic telangiectasia

d. Pemphigus erythematosus

e. Pernicious anemia


22. A generalized thickening of the periodontal ligaments is NOT a sign of systemic sclerosis. This statement is:

a. True


b. False

23. Which of the following statements is TRUE for amyloidosis?

a. Mucopolysaccharides are deposited throughout the body

b. In the mouth it tends to produce macroglossia

c. It is a disease of young children

d. It does not tend to be fatal

e. It is best diagnosed by biopsy of the lip mucosa
24. A tonsillolith is a calcified “stone” of the pharyngeal tonsil. This statement is:

a. True


b. False

25. Which of the following disorders is NOT typically associated with a white keratotic

plaque or macule of the buccal or vestibular mucosa?

a. Chronic cheek bite

b. White sponge nevus

c. Leukoedema

d. Smokeless tobacco keratosis

e. Hereditary hemorrhagic telangiectasia


26. Which of the following statements is TRUE for Hodgkin’s disease?

a. Neck nodes are usually involved

b. It usually affects children

c. Blocked lymph nodes can produce Ludwig’s angina

d. It is a T-cell malignancy

e. It has a very good prognosis if nodes on both sides of the diaphragm are involved


27. Which of the following diseases is MOST LIKELY to present as eczema in its early stages?

a. Hodgkin lymphoma

b. Cervical lymphadenitis

c. Primary lymphoma of bone

d. Mycosis fungoides

e. African Burkitt’s lymphoma


28. Which of the following statements is TRUE for multiple myeloma?

a. It primarily affects persons 35-50 years of age

b. Skull radiolucencies have a prominent radiopaque ring around them

c. 5-year survival is more than 60%

d. It has a predilection for whites

e. It is associated with amyloid deposition


29. Which of the following is NOT a manifestation of neutropenia?

a. Premature periodontitis

b. Oral ulcer without inflammatory halo

c. White coated tongue

d. Recurrent pneumonitis

e. Recurrent pharyngitis


30. Which of the following is NOT a manifestation of hemophilia?

a. Spontaneous gingival hemorrhage

b. Decreased coagulation time

c. Hemarthrosis

d. Abnormal PTT

e. Ecchymosis


31. Very painful bone infarction, which can mimic toothache pain if the jaws are involved, is MOST LIKELY to occur in which of the following diseases?

a. Thalassemia major

b. Pernicious anemia

c. Burkitt’s lymphoma

d. Agranulocytosis

e. Sickle cell disease
32. Spontaneous gingival hemorrhage is MOST LIKE to be associated with which of the following diseases?

a. Hodgkin disease

b. Hemophilia A

c. Burkitt lymphoma

d. Thalassemia major

e. Sickle cell anemia


33.-37. Match each term in List B with the most appropriate disease from List A.

Answers from List A may be used more than once and not all List A answers

need to be used.
List A:

a. Infectious mononucleosis

b. Thalassemia

c. Iron deficiency anemia

d. Burkitt’s lymphoma (African type)

e. Benign lymphoid hyperplasia



List B:

33. Jawbone destruction with tooth exfoliation a b c d e

34. Smooth lingual dorsum a b c d e

35. Hair-on-end skull appearance on radiography a b c d e

36. Necrotizing ulcerative gingivitis a b c d e

37. Cervical lymphadenopathy a b c d e


38. A “dirty ulcer” in the mouth is associated with aplastic anemia. This statement is:

a. True


b. False
39. Spontaneous gingival hemorrhage is MOST LIKE to be associated with which of the

following diseases?

a. Hodgkin disease

b. Hemophilia A

c. Burkitt lymphoma

d. Thalassemia major

e. Sickle cell anemia
40. Angiocentric T-cell lymphoma usually affects the maxillofacial region. This statement is:

a. True


b. False
41. Agranulocytosis is usually a drug reaction or “allergy”. This statement is:

a. True


b. False
42. Which of the following statements is TRUE for hemophilia?

a. Hemophilia A is found primarily in males

b. Hemophilia B is the most common form of the disease

c. Daily aspirin is the most effective treatment

d. Patients have normal PTT

e. None of the above is true

43. Which of the following anemias is MOST LIKELY to be seen in Plummer-Vinson syndrome?

a. Pernicious anemia

b. Folic acid deficiency

c. Vitamin B12 deficiency

d. Iron deficiency

e. Cooley’s anemia


44. Which of the following signs is NOT a typical part of infectious mononucleosis?

a. Chronic fatigue

b. Facial erythema

c. Spontaneous gingival hemorrhage

d. Sore throat

e. Enlarged tonsils


45. Which of the following odontogenic cysts is MOST LIKELY to develop a squamous cell carcinoma in its epithelial lining?

a. Dentigerous cyst

b. Odontogenic keratocyst

c. Lateral periodontal cyst

d. Gorlin cyst

e. Periapical cyst


46. Which of the following is TRUE for calcifying odontogenic (Gorlin) cyst?

a. It has no radiopacities

b. It occurs primarily in the anterior part of jaws

c. There is no peripheral (gingival) counterpart

d. It is best treated by hemimandibulectomy

e. It is often associated with bifid ribs


47. Which of the following is TRUE for cementoblastoma?

a. It destroys the root from which it arises

b. Recurrences are common

c. It causes necrosis of the affected pulp

d. It usually produces a well demarcated radiolucency

e. It is more much frequent in males


48. The botryoid odontogenic cyst is a special variant of which of the following cysts?

a. Eruption cyst

b. Odontogenic keratocyst

c. Gingival cyst of adult

d. Dentigerous cyst

e. Lateral periodontal cyst


49. Which of the following statements is TRUE for the odontogenic keratocyst?

a. It seldom presents radiographically as a dentigerous cyst

b. It produces a huge amount of keratin

c. It has a very high recurrence rate compared to other cysts

d. It is usually diagnosed in persons older than 60 years

e. It often transforms into squamous cell carcinoma


50. Which of the following statements is TRUE for odontogenic myxoma?

a. It occurs primarily in the anterior maxilla

b. It often presents as a multilocular radiolucency

c. The myxofibroma variant is more likely to be seen in persons older than 50 years

d. It tends to perforate through the cortex rather than expanding it

e. It is a malignancy of primitive pulp tissue (the dental papilla)


51. Which of the following statements is TRUE for Hodgkin’s disease?

a. Neck nodes are seldom involved

b. It usually affects children

c. Blocked lymph nodes can produce lymphedema

d. It is a T-cell malignancy

e. It has a very good prognosis if nodes on both sides of the diaphragm are involved


52. Tingible bodies are MOST LIKELY to be seen in which of the following diseases

a. Non-Hodgkin’s lymphoma

b. Burkitt’s lymphoma

c. Multiple myeloma

d. Lymphoid hyperplasia

e. Cyclic neutropenia

53.-58. Match EACH of the terms in List B with the most appropriate disease from List A. Answers from List A may be used more than once and not all List A answers need to be used.



List A:

a. Dentigerous cyst

b. Gingival cyst of newborn

c. Gorlin cyst (calcifying odontogenic cyst)

d. Thalassemia

e. Thrombocytopenia





List B:

53. Epstein pearls a b c d e

54. Ghost cells a b c d e

55. Defective gene for beta or alpha hemoglobin a b c d e

56. Eruption cyst a b c d e

57. Hydrops fetalis a b c d e



58. Decreased number of platelets a b c d e



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