Name: ______Oral Pathology DAPA 741 Examination Four December 11, 2001

1. A complete lack of tooth development is seen a. Frequently b. In several rare syndromes c. Rarely, except in patient with ectodermal dysplasia d. Frequently in patients with Down’s syndrome

2. One of your patients presents with a maxillary incisor tooth that appears as two teeth stuck together. When you count the tooth as one, the patient only has 31 teeth (all other teeth are present). The is an example of a. Fusion b. Gemination c. Concrescence d. Dens Invaginatus

3. A dilated odontome is an extreme example of a. Dens evaginatus b. Cusp of Carabelli c. Dens invaginatus d. Talon cusp

4. The main deleterious effect of an enamel pearl or cervical enamel extension is a. Increased risk of caries b. Compromised periodontal attachment c. Lateral inflammatory lesion in the presence of a vital pulp d. All of the above

5. A 12 year-old patient presents to your office for routine care. Upon examination of his teeth you notice that focal areas of the enamel are thinned, but not unusually soft. This creates the appearance of numerous pits on his teeth. A panoramic radiograph reveals the teeth to be of normal shape. The patient and his mother comment that his primary teeth had a similar appearance. You are confident that the patient has a. Amelogenesis imperfecta b. Dentin dyplasia type I c. Dentiogenesis imperfecta d. Dentin dysplasia type II

6. You arrive early at your new office for your first day of work. Your partners are all gathered around a viewbox looking at a panoramic radiograph. They all look a bit mystified. Noticing you, one of them says, “Let our new associate give it shot.” Expectant eyes turn toward you, yours turn toward the viewbox. The radiograph reveals a permanent dentition with a constriction at the cervical region imparting a bulbous shape to the crowns. In addition the pulp chambers and canals are not visible. Relieved that they did not ask you to perform a root canal on one of these teeth, you state… a. It appears that this patient has amelogenesis imperfecta b. I believe this is an example of dentinogenesis imperfecta c. If I remember correctly from that fine oral path course I had at SIU this is dentin dysplasia type I d. I don’t know… I slept through oral path.

7. Most cases of regional odontodysplasia are the result of a. Medication exposure in utero b. Trauma to the developing dentition c. Deficit of innervation to the area of developing teeth d. Unknown causes

8. Molluscum contagiousm a. Are the result of a viral infection b. May be associated with HIV infection c. Resolve spontaneously over a period of months d. Two of the above e. All of the above

9. Which of the following statements is true? a. Squamous cell carcinoma is the most common form of skin cancer b. Squamous cell carcinoma occurs on the lower lip and tip of the tongue in patients with xeroderma pigmentosum c. Squamous cell carcinoma of the skin has a poorer prognosis than squamous cell carcinoma of the oral cavity d. Two of the above are true e. All of the above are true

10. Basal cell carcinoma a. Is the second most common form of skin cancer b. Rarely metastasizes, but is locally aggressive c. Classically presents as a nodule with a central ulcer and rolled borders d. Two of the above e. All of the above

11. A seventy year-old patient presets to your office for a crown preparation. You notice a 0.5 cm, evenly pigmented, raised, brown, rough-surfaced lesion on the skin of his left face. The lesion appears as if it has been stuck onto the skin. Your most likely diagnosis is a. Basal cell carcinoma b. Seborrheic keratosis c. Actinic keratosis d. Melanoma

12. Which of the following disorders results from a triad of bacteria, androgens and hyperkertinization? a. Acne b. Rosacea c. Psoriasis d. Impetigo

13. Which of the following disorders is commonly treated with antibiotics? a. Acne b. Rosacea c. Impetigo d. Two of the above e. All of the above

14. Which of the following disorders are exacerbated by alcohol and hot beverages? a. Acne b. Rosacea c. Psoriasis d. Impetigo

15. A 37 year-old female presents to your office for routine care. In her medical history she reports facial acne that began in the last few years. She treats this with OTC benzoyl peroxide but feels it is not doing much good. You briefly examine her face and find erythema on the cheeks bilaterally. In this erythematous area are numerous telangectasias and scattered papules and pustules. You tell her a. “You’re right, it looks like adult-onset acne. You may want to talk to a dermatologist who can offer more effective medications. b. “I don’t think you have acne. I think this is rosacea. You should talk to your doctor about proper management.” c. “I don’t think you have acne. I think this may be psoriasis. You should talk to your doctor about proper management.” d. “I don’t think you have acne. I am concerned that this may be a manifestation of lupus erythematosis. You need to see your doctor concerning this soon.”

16. The brown tumor of hyperparathyroidism has a microscopic appearance identical to that of a. Fibrous dysplasia b. Central giant cell granuloma c. Ossifying fibroma d. Granular cell tumor

17. Which of the following lesion is associated with inflammatory bowel disease (IBD)? a. Addison’s disease b. Psoriasis c. Pyostomatitis vegitans d. Dentin dysplasia

18. Which of the following disorders involves a premature loss of the teeth? a. Dentin dysplasia type I b. Crohn’s disease c. Hypophosphatasia d. Two of the above e. All of the above

19. A 20 year-old male presents to your office complaining of constant sores in his mouth. Examination reveals deep linear ulcers in his mandibular vestibule. In addition, he has numerous epulis fissuratum-like lesions despite having a normal dentition. You suspect that he most likely has a. Major apthous ulcers and you prescribe a topical corticosteroid b. Lichen planus and you prescribe of combination of topical and systemic corticosteroids c. Crohn’s disease and you refer the patient to his physician d. Diabetes mellitus and you refer the patient to his physician

20. Lymphomas can be classified using the Working formulation or the REAL classification. The difference between the two is a. The Working formulation is based on the light microscopic appearance while the REAL classification is based on surface antibody expression. b. The Working formulation and the REAL classification are both based on the light microscopic appearance but use different criteria. c. The Working formulation and the REAL classification are both based on surface antigen expression but use different criteria. d. The Working formulation and the REAL classification are synonymous.

Match the following characteristics to the possible associated problem. a. Acute infections b. Chronic infections c. Lymphoma d. Both acute infections and chronic infections e. Both chronic infections and lymphoma

21. Soft

22. Tender

23. Non-tender

24. Freely moveable

25. Fixed

26. Which of the following tumors most commonly involves the posterior jaw? a. Hodgkin’s disease b. Burkitt’s lymphoma, American form c. Burkitt’s lymphoma, African form d. Acute myeloid leukemia

27. Which of the following statements is true? a. The most common location of Hodgkin’s disease in the head and neck is ther cervical lymph nodes b. The malignant cell of Hodgkin’s disease comprises only 1-3% of the tumor c. Patients may have systemic signs including fever, night sweats, weight loss, fatigue and pruritis. d. Two of the above e. All of the above

28. Which of the following subtypes of Hodgkin’s disease has the best prognosis? a. Lymphocyte predominance b. Mixed cellularity c. Nodular sclerosing d. Lymphocyte depletion

29. Which of the following is the major manifestation of iron deficiency anemia in the oral cavity? a. Spontaneous gingival hemorrhage b. Petecheiae and purpura c. An ulcer without an erythematous zone around it d. Angular cheilits and atrophic glossitis e. Generalized gingival enlargment

30. In which of the following syndromes is iron deficiency anemia associated with and increased incidence of oral squamous cell carcinoma? a. Nevoid basal cell carcinoma syndrome b. Plummer-Vinson syndrome c. Xeroderma pigmentosum d. Osteogenesis imperfecta

31. What are the two main causes of death in HIV patients? a. Kaposi’s sarcoma and lymphoma b. Opportunistic infection and progressive wasting syndrome c. Kaposi’s sarcoma and progressive wasting syndrome d. Opportunistic infections and squamous cell carcinoma

32. Which of the following AIDS associated conditions is the result of an Epstein- Barr virus infection? a. Candidosis b. Oral hairy leukoplakia c. Mononucleosis d. Kaposi’s sarcoma

33. Which of the following viruses is thought to cause at least some of the AIDS associated parotid gland enlargement? a. Human papilloma virus b. Epstein-Barr virus c. Cytomegalovirus d. Molluscum contagiosum virus

34. Which is the most common oral malignancy in heterosexual AIDS patients? a. Squamous cell carcinoma b. Kaposi’s sarcoma c. Lymphoma d. Mucoepidermoid carcinoma

35. Squamous cell carcinoma is thought to be an AIDS associated disease because a. It occurs at a much younger age in the AIDS population b. It occurs in unusual oral locations in the AIDS population c. It is more aggressive in AIDS patients d. All of the above