Question 1

An otherwise healthy 24-year-old man presents with a painful ulcer on his tongue. The lesion is oval and measures approximately 3 mm in diameter. The lesion was not preceded by a blister. This problem has been cyclic (once per month), and the lesions have healed in about 1 week. He most likely has:

Accepted Answer

A)  Minor aphthae
B)  Major aphthae
C)  Herpetiform aphthae
D)  Secondary herpes
E)  Erythema multiforme A

Question 2

A 17-year-old patient presents with three large painful tongue ulcers, each of which measures greater than 0.5 cm in diameter. He has scars in his buccal mucosa from previous lesions. The ulcers generally last several weeks before healing. He most likely has:

Accepted Answer

A)  Syphilis
B)  Squamous cell carcinoma
C)  Minor aphthous stomatitis
D)  Major aphthous stomatitis
E)  Tuberculosis D

Question 3

Examination of a patient who is an intense smoker revealed a 1 ´ 2 cm indurated red mass in the floor of his mouth. Submandibular lymph nodes on the same side were asymptomatic and indurated. This patient should be suspected of having:

Accepted Answer

A)  Lichen planus
B)  Erythroplakia
C)  Carcinoma in situ
D)  Squamous cell carcinoma
E)  None of the above D

Question 4

A patient with stage I oral squamous cell carcinoma of the lower lip would be expected to have a _____ prognosis.

Accepted Answer

A)  Good
B)  Fair
C)  Poor

Question 5

A 24-year-old man developed multiple oral ulcers, several penile ulcers, and ocular pain. The lesions were not preceded by blisters. He was taking no medications and had no systemic complaints. This pattern of disease suggests which of the following?

Accepted Answer

A)  Secondary syphilis
B)  Erythema multiforme
C)  Hereditary benign intraepithelial dyskeratosis
D)  Primary herpes simplex infection
E)  Behçet's syndrome

Question 6

Contact allergies are:

Accepted Answer

A)  Seen in tissue directly adjacent to the antigen stimulus
B)  Mediated by Langerhans cells
C)  Rarely associated with denture material
D)  Treated by identification and removal of the offending agent
E)  All the above

Question 7

Granulomatous inflammation is characteristically seen in which of the following?

Accepted Answer

A)  Tuberculosis
B)  Histoplasmosis
C)  Blastomycosis
D)  Coccidioidomycosis
E)  All the above

Question 8

A 52-year-old man presents with an ulcer in the floor of his mouth of 8 weeks' duration. The lesion measures 1 ´ 2 cm, is indurated, and is slightly uncomfortable for the patient. What should the clinician do at this point in time?

Accepted Answer

A)  Observe for 2 more weeks.
B)  Treat patient with prednisone.
C)  Treat patient with nystatin.
D)  Have direct immunofluorescence test done.
E)  Perform a biopsy.

Question 9

A nonpainful, indurated lesion of the floor of the mouth that is present for 6 months best describes which of the following?

Accepted Answer

A)  Lichen planus
B)  Minor aphthous ulcer
C)  Basal cell carcinoma
D)  Squamous cell carcinoma
E)  Iatrogenic ulcer

Question 10

Abundant eosinophils and macrophages are characteristically seen in which of the following?

Accepted Answer

A)  Acute traumatic ulcer
B)  Secondary herpes simplex
C)  Minor aphthous ulcers
D)  Traumatic granuloma
E)  Lichen planus

Question 11

Metastasis from oral squamous cell carcinoma of the posterior lateral border of the tongue is most likely to appear in which of the following sites first?

Accepted Answer

A)  Submental lymph nodes
B)  Submandibular lymph nodes
C)  Mandibular bone
D)  Supraclavicular lymph nodes
E)  Lung

Question 12

The etiology of oral aphthous ulcers has been associated with all the following except:

Accepted Answer

A)  Crohn's disease
B)  Nontropical sprue
C)  Iron deficiency
D)  Ethanol intake
E)  Folic acid deficiency

Question 13

A 28-year-old patient developed a painful 0.5 ´ 0.5 cm oval ulcer in her lower anterior vestibular mucosa. She has had episodes (7 to 10 days' duration) of similar painful ulcers before. This patient most likely has:

Accepted Answer

A)  Herpangina
B)  Recurrent herpes
C)  Recurrent aphthae
D)  Secondary syphilis
E)  None of the above

Question 14

Which of the following inflammatory cells characterizes the infiltrate seen microscopically in tuberculosis, histoplasmosis, and other deep fungal infections?

Accepted Answer

A)  Plasma cells
B)  Macrophages
C)  Neutrophils
D)  Basophils
E)  Eosinophils

Question 15

Direct immunofluorescence is a laboratory test that is effective in confirming which of the following?

Accepted Answer

A)  Major aphthae
B)  Primary herpes simplex
C)  Zoster
D)  Drug allergy
E)  None of the above

Question 16

The combination of malformed permanent incisors and first molars suggests which of the following?

Accepted Answer

A)  Reiter's syndrome
B)  Childhood primary herpes simplex infection
C)  Measles
D)  Congenital syphilis
E)  Behçet's syndrome

Question 17

Prognosis for a patient with oral squamous cell carcinoma largely depends on which of the following factors?

Accepted Answer

A)  Symptomology
B)  Microscopic subtype
C)  Clinical stage
D)  Inflammatory cell infiltrate
E)  All the above

Question 18

The traumatic tongue ulceration seen in infants in association with natal teeth is known as _____ ulceration.

Accepted Answer

A)  Factitial
B)  Iatrogenic
C)  Aphthous
D)  Riga-Fede
E)  Idiopathic

Question 19

An opportunistic mycotic infection that affects the upper air passages in patients with uncontrolled diabetes is known as:

Accepted Answer

A)  Actinomycosis
B)  Mycoplasma
C)  Mucormycosis
D)  Tuberculosis
E)  Primary syphilis

Question 20

Iatrogenic injuries are caused by which of the following?

Accepted Answer

A)  Dental hygienists
B)  Dentists
C)  Physicians
D)  Chiropractors
E)  All the above

Exam 2: Ulcerative Conditions

An otherwise healthy 24-year-old man presents with a painful ulcer on his tongue. The lesion is oval and measures approximately 3 mm in diameter. The lesion was not preceded by a blister. This problem has been cyclic (once per month) , and the lesions have healed in about 1 week. He most likely has: