Oral Pathology

FinalReview

Gastric regurgitation causes which of the following?

A. Erosion• B. Abrasion• C. Attrition• D Hypercementosis

Erosion

A patient states that for almost a year now, she has had a rubbery, firm, painless

nodule within the substance of the parotid gland. The condition is MOST likely a:

A. Mucocele• B. Lymph node• C. Benign Mixed Tumor• D. Squamous Cell Carcinoma• E. Sialolith with encapsulation

Benign Mixed Tumor

• Pleomorphic Adenoma (Benign Mixed Tumor) The palate is the most common intraoral location, but these tumors may be found in any area where salivary gland tissue is present

• Most common salivary gland neoplasm – accounts for about 90% of all benign salivary gland tumors.

Primary herpetic gingivostomatitis is MOST likely to occur in which of the

following age groups?

• A. 1 – 5 years • B. 6 – 10 years• C. 11 – 15 years

Primary Herpetic Gingivostomatitis

• Painful• Erythematous• Edematous • Most common in

children 6mos to 6 yrs.

• Perioral skin, vermillion border of lips & oral mucosa

Which of the following lesions has the greatest malignant potential?

A Leukoedema• B. Lichen Planus• C. Actinic Cheilitis• D. White Sponge Nevus

Actinic (Solar) Cheilitis

A patient has painful lesions on her buccal mucosa. A biopsy reveals acantholysis and a suprabasilar vesicle. Which of the following

represents the MOST likely diagnosis?

A Pemphigus• B. Psoriasis• C. Erythema Multiforme• D. Bullous Lichen Planus• E. Systemic Lupus Erythematosus

PemphigusAcantholysis= epithelial cell separation50% of cases the first signs appear in the oral cavity.Gentile finger pressure with movement on clinically normal mucosa can produce a cleavage in the epithilelum and result in the formation of a bulla. This is called Nikolsky sign.

The MOST common location for a mucous retention swelling or

mucocele is the:

A. Tongue• B. Gingiva• C. Upper lip• D. Lower lip• E. Buccal mucosa

Lower lip• Forms when minor

salivary gland duct is disrupted and mucous salivary gland secretion enters the adjacent connective tissue

• Most common on lower lip

• Size may decrease over time

• Minor salivary glands

A patient presents with a bilateral, grayish-white lesion of the buccal mucosa. This lesion

disappears when the mucosa is stretched. Which of the following is the MOST likely

condition?

A. Leukoedema• B. Leukoplakia• C. Lichen Planus• D. White Sponge Nevus• E. Pachyonychia congenital

Leukoedema

• Accumulation of fluid within the epithelial cells of the buccal mucosa.asymptomatic bilateral, diffuse, grayish-white, milky, opalescet appearance of the mucosa will disappear when applying the clinical "stretch test"

Which of the following lesions is the MOST likely to become malignant?

• • A. Papilloma• B. Leiomyoma• C. Lymphangioma• D. Junctional Nevus• E. Granular Cell Tumor

Junctional Nevus

Ameloblastoma of the mandible is similar radiographically to which of the

following conditions?

A. Osteosarcoma• B. Pindborg Tumor• C. Ameloblastic Fibro-odontoma• D. Central Giant Cell Granuloma

• Remember….sarcoma is a term reserved for a malignant neoplasm of embryonic connective tissue origin.

A 22-year old female patient has a diffuse erythema of the gingiva with scattered, isolated ulcers on the tongue and in the Oropharynx. The marginal gingiva is edematous and inflamed. Her condition is of three days’ duration,

is painful; and she has an elevated temperature and malaise. The MOST likely diagnosis is:

A. Apththous stomatitis• B. Erosive Lichen Planus• C. Benign Mucous Membrane

Pemphigoid• D. Acute Herpetic Gingivostomatitis

Apthous Stomatitis

Apthous Stomatitis

• Young female• Located on soft palate, tonsillar fauces, labial

mucosa, buccal mucosa, and tongue.

Metastatic carcinoma to the jaws is LEAST likely to arise from the:

• Brain• Breast• Kidney• Prostate• Lung

Brain

• Least likely….not usually carcinoma

Radiographs of a patients’ teeth reveal that the crowns are bulbous; the pulps obliterated; and the roots shortened. These findings

are associated with which of the following?

– Porphyria– Pierre Robin Syndrome– Amelogenesis Imperfecta– Dentinogenesis Imperfecta– Erythroblastosis fetalis

Dentinogenesis Imperfecta

The routine examination of a healthy 20-year old man discloses a round, brown lesion, 3mm in diameter, on his lower lip. The

lesion is solitary, asymptomatic, and flat. Its duration is unknown. Which of the following is the MOST likely diagnosis?

– Blue nevus– Focal melanosis– Compound nevus– Malignant melanoma– Peutz-Jegher’s Syndrome

Focal melanosis

• Flat circumscribed pigmentation of the lip ofr mouth

• Usually single,• Less than 1cm in

diameter• Common in light-

skinned persons between 25 & 45 years

Papillary hyperplasia is MOST frequently found in which of the following sites?

• Hard palate• Soft palate• Anterior gingival tissue• Posterior gingival tissue

Inflammatory Papillary Hyperplasia of the Palate

• A reactive tissue growth that usually develops beneath a denture

Which of the following reactive lesions of the gingival tissue reveals bone

formation microscopically?

• Peripheral ossifying fibroma• Traumatic neuroma• Pyogenic granuloma• Irritation fibroma• Osteoma

Osteoma

In which of the following locations do premalignant lesions of squamous epithelium MOST often appear (in

the U.S. population)?• Palate• Gingiva tissue• Buccal mucosa• Lateral border and ventral surface of the

tongue• Dorsal surface of the tongue

Lateral border and ventral surface of the

tongue

Which of the following clinical lesions MOST often reveals histologic

evidence of severe dysplasia or carcinoma in situ?

• Leukoedema• Leukoplakia• Lichen Planus• Erythroplakia• White Sponge Nevus

Erythroplakia

A patient, who has been taking penicillin for three weeks, presents with slightly painful white lesions

on the tongue, palate, and cheeks. A dentist wipes the lesions with gauze and notes that they have red surfaces. The most likely diagnosis is:

• Lichen Planus• Candidiasis• Erythema multiforme• Primary herpetic gingivostomatitis

Candidiasis

A patient has two or more of here teeth joined only by cementum. This phenomenon is known as:

• Fusion• Hypercementosis• Gemination• Dilaceration• Concrescence

Concrescence

The virus that causes acute herpetic gingivostomatitis is closely related

to the virus that causes:• Mumps• Measles• Chickenpox• Cat-scratch disease

Chickenpox

Each of the following diseases has been associated with the Epstein-Barr virus EXCEPT one. Which one

is this exception?• Burkitt’s lymphoma• Oral hairy leukoplakia• Infectious mononucleosis• Adenoid cystic carcinoma

Adenoid cystic carcinoma

Epstein-Barr Virus Infection

• Infectious Mononucleosis– Most common in late adolescents and young adults in

upper socioeconomic classes (transmitted my close contact-ex=kissing)

• Hairy Leukoplakia– Most common in HIV infected people

• Nasopharyngeal carcinoma-rare neoplasm• Burkitt lymphoma-rare neoplasm

Squamous cell carcinoma appears in a variety of locations. In which of the

following locations is its prognosis the LEAST favorable?

• Lower lip• Floor of the mouth• Hard palate• Buccal mucosa• oropharynx

oropharynx

Squamous cell carcinoma of the tongue MOST commonly metastasizes

to which of the following? • Lungs• Liver• Bones• Cervical nodes

Cervical nodes

LYMPH NODES

• Submental – mid lower lip, tip of tongue, etc• Submandibular – upper lip, lateral lower lip,

ant lateral tongue, buccal mucosa, etc• Cervical – post. Tongue, palate, etc• Malignant node – enlarged, fixed, indurated

Vesicular lesions precede the formation of ulcers in each of the following EXCEPT one. Which one

is this EXCEPTION?• Herpangina• Herpes zoster• Herpetic stomatitis• Aphthous stomatitis• Hand-foot-and-mouth disease

Aphthous stomatitis

25.Your patient has a deflection upon opening to the right side. Which part of the temporal mandibular joint anatomy is most likely to have a dysfunction?

A. Right lateral pterygoid muscleB. Right ligamentsC. Left lateral pterygoid muscleD. Left ligaments

D. LEFT LIGAMENTS