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Home , Branchial cleft cyst, Ranula

Name: ______

DAPA 741 Oral Pathology Examination Two October 24, 2001

1. Which of the following diagnoses can be eliminated from your differential if vesicles are identified? A. Apthous ulcers B. Mucous membrane C. Recurrent herpes D. All of the above

2. Which form of is the result of the attachment of autoantibodies to Type VII collagen? A. Epidermolysis bullosa simplex B. Junctional epidermolysis bullosa C. Dystrophic epidermolysis bullosa D. Epidermolysis bullosa acquisita E. All of the above

3. Bullae in Epidermolysis bullosa typically occur A. Intraorally only B. Over sites of trauma C. On flexor surfaces D. On palmar and plantar surfaces

4. The general characteristics of autoimmune disorders include: A. Acute onset B. Exacerbations and remissions C. D. Cured with corticosteroids

5. Which of the following diagnoses can be eliminated from the differential diagnosis if a Nikolsky sign is noted?

A. vulgaris B. Mucous membrane pemphigoid C. Infectious mononucleosis D. Epidermolysis bullosa

6. Pemphigus vulgaris demonstrates which of the following features on an H&E stain? A. Separation of the epithelial cells from one another above the basal cell layer B. Separation of the from the underlying connective tissue C. Koilocytes D. A band-like infiltrate of lymphocytes within the connective tissue adjacent to the epithelium

7. Which of the following vesiculo-bullous diseases commonly spares the gingiva? A. Pemphigus vulgaris B. C. Mucous membrane pemphigoid D. E. All of the above

8. Your patient is diagnosed with mucous membrane pemphigoid. She says to you “Give me the bottom line, Doc. What are my chances?” You respond: A. “Although not a life threatening condition, mucous membrane pemphigoid may cause blindness secondary to conjunctival involvement.” B. “Mucous membrane pemphigoid is ultimately fatal without treatment.” C. “You will develop repeated, potentially life-threatening, due to the loss of the barrier function of the skin.” D. “Mucous membrane pemphigoid will resolve within 10 –14 days whether treatment is provided or not.”

9. The most common locations for the cutaneous lesions of discoid lupus erythematosis are A. Sun-exposed surfaces B. Flexor surfaces C. Easily traumatized surfaces D. Extensor surfaces E. Palmar-plantar surfaces

10. The oral lesions of lupus erythematosis often appear clinically similar to the oral lesions of: A. Primary B. Lichen planus C. Apthous ulcers D.

11. Apthous ulcers can be distinguished from recurrent herpes because: A. Apthous ulcers heal with periodicity B. Apthous ulcers occur on non-keratinized mucosa C. Apthous ulcers occur as multiple lesions in clusters D. Apthous ul cers begin as a vesicle, then rupture to form the ulcer

12. Erythema multiforme A. Usually resolves in 2 to 6 weeks B. May recur, usually in the spring or autumn C. May demonstrate characteristic “target” or “bull’s-eye” skin lesions D. All of the above

13. You correctly diagnose reticular lichen planus confined to the oral cavity in your patient. You decide to A. Prescribe topical corticosteroids B. Biopsy the lesions because lichen planus is a precancerous condition C. Prescribe systemic antifungal medications D. Provide no treatment

14. Predisposing factors for oral candidosis include: A. Antibiotic use B. Xerostomia C. 24-hour denture wear D. Corticosteroid medications E. All of the above

15. A patient presents to you with a mild burning sensation in her mouth of 2 days duration. She has recently completed a course of Amoxicillin for strep throat. Clinically you notice numerous white plaques located diffusely on her . The plaques rub off with a 2 X 2 gauze to reveal an erythematous base. The most appropriate diagnosis for this condition is A. Toxic mucositis B. Acute pseudomembranous candidosis C. Chronic atrophic candidosis D. Angular

16. The oral manifestations of herpangina consists of lesions most commonly located A. On the vermilion of the B. Bilaterally on the buccal mucosa C. Diffusely on the oral mucosa, but usually sparing the gingiva and hard D. On the soft palate and oropharynx

17. In general, which of the following statements is true of lesions? A. Mucoceles are more common on the lower lip, while neoplasms are more common on the upper lip. B. Mucoceles are more common on the upper lip, while neoplasms are more common on the lower lip C. Both are more common on the buccal mucosa D. Mucoceles and salivary gland neoplasms occur with equal frequency on both

18. A mucocele can often be clinically distinguished from a neoplasm since A. Mucoceles are compressible, and neoplasms are firm B. Mucoceles have a bluish hue and neoplasms are the color of normal mucosa C. Mucoceles fluctuate in size and neoplasms are persistent in size D. Mucoceles cannot be distinguished from neoplasms clinically

19. A patient presents to you complaining that they have pain and swelling in their just anterior to the angle of the when they are eating. Curiously, the pain and swelling subsides soon after finishing a meal. You immediately suspect that the patient has A. Sjogren’s syndrome B. a sialolith C. a pleomorhic adenoma D. Necrotizing sialometaplasia

20. The classic triad of Sjogren’s syndrome includes: A. Dry mouth, dry eyes, dry skin B. Dry mouth, , enlarged parotid gland C. Dry mouth, dry eyes, rheumatoid arthritis D. Dry mouth, dry skin, rheumatoid arthritis

21. Patients with Sjogren’s syndrome have an increased risk of A. B. Lichen planus C. D. None of the above

22. Salivary gland neoplasms are not found A. on the dorsum of the tongue anterior to the circumvallate papillae B. in the C. on the buccal mucosa D. on the soft palate

23. Which of the following salivary gland neoplasms may contain cartilage or bone? A. B. Monomorphic adenoma C. C.

24. Which of the following salivary gland neoplasms is found exclusively in the parotid gland? A. Pleomorphic adenoma B. Polymorphous low-grade C. Papillary cystadenoma lymphomatosum (Warthin’s tumor) D.

25. Malignant salivary gland neoplasms often share which of the following features with benign salivary gland neoplasms? A. Encapsulated B. Fixed to deep structures C. Slowly growing D. None of the above

26. A 70 year-old man presents to your office with a swelling of his right parotid gland. He says that the swelling has been present for at least 10 years and he has never worried about it. In the last few weeks, however, the swelling has begun to rapidly enlarge. Although you consider several diagnoses as part of you differential, this clinical history is most consistent with which of the following lesions? A. Polymorphous low-grade adenocarcinoma B. Papillary cystadenoma lymphomatosum (Warthin’s tumor) C. Adenoid cystic carcinoma D. Carcinoma ex pleomorphic adenoma

27. A pathologic cavity lined by epithelium, usually containing fluid or a semisolid material surrounded by a wall of collagenous connective tissue is a A. Neoplasm B. C. Abscess D. Granuloma

28. A 9 year-old female presents to you with an asymptomatic swelling in the midline of the neck. The swelling is compressible and freely moveable. You notice the swelling moves vertically when the patient swallows. You suspect the patient has a A. Thyroglossal duct cyst B. Cervical Lymphoepithelial Cyst () C. D.

29. The only benign mesenchymal lesion with a rapid growth rate is the A. Schwannoma B. Irritation C. Peripheral ossifying fibroma D.

30. Psuedocarcinomatous hyperplasia may be a microscopic feature of which two lesions? A. Pyogenic granuloma and granular cell tumor B. Acute and pyogenic granuloma C. Necrotizing sialometaplasia and granular cell tumor D. Pyogenic granuloma and peripheral giant cell granuloma

31. Which of the following characteristics is most associated with malignant mesenchymal lesions? A. Ulceration B. Slow growth C. Moves teeth D. Fluctuates in size E. All are characteristics of malignant mesenchymal lesions

32. Which of benign mesenchymal lesions is commonly painful to palpation? A. Schwannoma B. Neurofibroma C. Neuroma D. Irritation fibroma

33. A 45 year-old man presents to your office for a routine 6 month recall appointment. Since you do a brief oral exam each time you see a patient, you notice a bluish swelling on the hard palate lingual to the maxillary right second molar. Upon questioning he states that he first noticed the swelling several months ago sometime after his last recall visit. You consider which of the following lesions as part of you differential diagnosis? A. Hemangioma B. Mucoepidermoid carcinoma C. Peripheral giant cell granuloma D. Fibrosarcoma

34. An 80-year old male presents to your office with a swelling of the buccal mucosa. The swelling is firm, covered by normal mucosa, is not painful and is freely moveable. Which of the following lesions would be on your differential diagnosis? A. Mucoepidermoid carcinoma B. Granular cell tumor C. Neurofibroma D. Schwannoma

35. A lymphangioma of the neck is also called a A. B. Cervical lymphoepithelial cyst (Branchial cleft cyst) C. D. None of the above

36. Which of the following statements is true concerning chronic hyperplastic candidosis? A. It can be clinically distinguished from other forms of “” because it presents as multiple white patches which rub off to reveal an erythematous base B. It cannot be clinically distinguished from other forms of “leukoplakia” and, therefore, must be biopsied to confirm the diagnosis C. It can be clinically distinguished from other forms of “leukoplakia” because it is painful

37. Which of the following is a sequalae associated with (zoster)? a. Bell’s palsy b. Post-herpetic neuralgia c. Scarring d. Two of the above e. All of the above

38. A 45 year-old visibly distraught male presents to your office complaining that the “roof of his mouth is falling out.” After checking to see if the patient lives on Arsenal Street, you look in his mouth to discover a large crater-like ulcer on his hard palate. The patient states that he developed a swelling in that location several weeks ago. A few days ago most of the swelling “fell out” and he was left with this hole in the roof of his mouth. Which of the following would be on your differential diagnosis? a. Squamous cell carcinoma b. Necrotizing sialometaplasia c. Pleomorphic adenoma d. Two of the above e. All of the above

39. A friend of your who graduated from the University of Illinois at Chicago School of Dentistry calls to ask your advice about a patient. He states that a 35 year-old female presented to his office after seeing his ad on a billboard for $99 same day dentures. He noticed that the patient had a large ulcerated soft tissue lesion on her gingiva between teeth 3 and 4. The patient had several grossly carious teeth and extensive deposits of plaques and calculus. The patient was unaware of the lesion. Since he didn’t buy the oral path textbook in school, he was wondering what you thought it might be. Which of the following lesions may this represent? a. Pyogenic granuloma b. Peripheral ossifying fibroma c. Peripheral giant cell granuloma d. Two of the above e. All of the above

40. A pathologist receives a lesion from an oral surgeon. The surgeon neglects to fill out the clinical description section on the submission form. The microscopic appearance of the lesion is a cystic space lined by squamous epithelium. The epithelial lining is surrounded by a dense infiltrate of lymphocytes often forming germinal centers. This lesion could represent either a. A reactive lymph node or a lymphoepithelial cyst b. A lymphoepithelial cyst or a dermoid cyst c. A lymphoepithelial cyst or a branchial cleft cyst d. A reactive lymph node or a dermoid cyst e. A branchial cleft cyst or a dermoid cyst