Name: _____________________ DAPA 741 Oral Pathology Examination 4 December 6, 2000 1. Irregularity of the temporomandibular joint surfaces is a radiographic feature of A. Subluxation B. Osteoarthritis C. Trigeminal neuralgia D. Anterior disk displacement 2. Which of the following is an autoimmune disease? A. Bell’s palsy B. Osteoarthritis C. Rheumatoid arthritis D. Trigeminal neuralgia 3. Which joints are commonly affected in osteoarthritis but usually spared in rheumatoid arthritis? A. Hips B. Joints of the hands C. Knees D. Temporomandibular joint 4. Bell’s palsy may be induced by trauma to which nerve? A. Trigeminal nerve B. Glossopharyngeal nerve C. Facial nerve D. Inferior alveolar nerve 5. A patient presents to your office concerned about a painless click when she open her mouth. Your examination of her temporomandibular joint reveals a click at approximately 15 mm of opening. You instruct her to touch the incisal edges of her maxillary and mandibular anterior teeth together and then open from this position. The click disappears when she opens from this position. You diagnosis is A. Subluxation B. Anterior disk displacement C. Crepitus D. Inflammatory arthralgia 6. An ankylosed joint will cause the mandible to deviate to which side on opening? A. The affected side B. The unaffected side C. There would be no deviation on opening 7. Pain from which of the following commonly awakens the patient at night? A. Masticatory myofascial pain B. Tension headaches C. Trigeminal neuralgia D. Osteoarthritis 8. Which of the following disorders may result in blindness and is thus considered an acute ocular emergency? A. Trigeminal neuralgia B. Migrane headache C. Temporal arteritis D. Cluster headaches 9. For which of the following disorders is a muscle relaxant most useful? A. Masticatory myofascial pain B. Masticatory muscle spasms C. Tension headaches D. Inflammatory arthralgia 10. A patient diagnosed with Burning Mouth Syndrome will likely have what clinical intraoral findings? A. No evidence of oral disease B. Diffuse erythema of the oral mucosa C. Beefy red tongue with angular cheilitis D. Ulcerations and erosions surrounded by lacy white striae bilaterally on the buccal mucosa 11. A 27 year old male presents to your office complaining of severe, throbbing pain of two weeks duration on the left side of his head. The pain begins each day in the mid to late afternoon and lasts for about one hour. While in pain he reports tearing from is left eye and mucous discharge from is left nostril. He feels he cannot sit still and paces about while in pain. He is unable to work while in pain. Following an episode of pain he reports that he is asymptomatic until it begins again the next day. Intraoral clinical exam reveals no abnormal findings. A panoramic radiograph reveals no evidence of odontogenic or bony disease or abnormality. Your most likely diagnosis is A. Trigeminal neuralgia B. Classic migraine headache C. Cluster headache D. Temporal arteritis 12. The most appropriate next step in dealing with the patient described in Question 11 is A. Prescribe carbamazapine B. Order a test for ESR (erythrocyte sedimentation rate) and C-reactive protein C. Prescribe high doses of prednisone (corticosteroid) D. Prescribe high doses of prednisone and refer for temporal artery biopsy 13. A 61 year old male presents to your office complaining of a severe short jolting pain of several months duration affecting the left side of his face and upper lip. He describes the pain as an “electric shock”. The pain only lasts for a few moments. The pain often occurred while he was shaving and he has since begun to grow a beard. He recently noticed the pain occurring when he goes outside into the cold wind. Occasionally the pain occurs spontaneously. The pain is not relieved by OTC medications. A physician prescribed a narcotic medication which was likewise ineffective. Clinical examination reveals no cutaneous or mucosal abnormalites. A panoramic radiograph reveals a carious lesion on the distal of the maxillary left second molar. No other odontogenic or bony abnormalites are identified. Your most likely diagnosis is A. Trigeminal neuralgia B. Classic Migraine C. Acute apical periodontitis D. Cluster headache 14. A 20 year old female presents to your office complaining of headaches of several years duration on the right side of her head, often feeling as if they are behind her right eye. Previously she developed these headaches about once a month around the time she was menstruating. In the last several months they have become more frequent, occurring several times each week. During the headaches she feels sick to her stomach and wishes to lay down in a dark, quiet room. She has treated the headaches with Advil and aspirin, neither of which seemed to have much effect. She is currently taking Claritin for allergies and birth control pills. She has been on the Claritin for two years and began taking birth control pills several months ago. She reports her mother and sister have similar headaches. Clinical examination reveals no cutaneous or mucosal abnormalities. A panoramic radiograph reveals numerous carious teeth. No bony abnormalities are identified. Your most likely diagnosis is A. Masticatory myofascial pain B. Cluster headaches C. Trigeminal neuralgia D. Migraine headaches 15. Which of the following causes of head and neck pain is an autoimmune disease? A. Trigeminal neuralgia B. Migraine headaches C. Cluster headaches D. Temporal arteritis 16. Which of the following are causes of iron deficiency anemia? A. Excessive blood loss B. Increased demand for red blood cells C. Decreased absorption of iron D. All of the above 17. The oral manifestations of iron deficiency anemia are similar to which of the following disorders? A. Pemphigoid B. Lichen planus C. Candidosis D. Primary herpes gingivostomatitis 18. Acromegaly is the result of A. Excess production of growth hormone after closure of the epiphyseal plates B. Excess production of thyroid hormone after closure of the epiphyseal plates C. Excess production of growth hormone before closure of the epiphyseal plates D. Excess production of thyroid hormone before closure of the epiphyseal plates 19. Decreased production of thyroid hormone in an adult resulting in the deposition of ground substance in tissues such as the tongue and lips in known as A. Cretinism B. Myxedema C. Giantism D. Graves disease 20. Which of the following disorders results in muscular tetany, and may be indicated by a twitching of the upper lip when the face below the zygomatic arch is tapped (Chvostek’s sign). A. Hypoadrenalcorticism (Addison’s disease) B. Hyperparathyroidism C. Hypoparathyroidism D. Hypercortisolism (Cushing’s disease) 21. Which of the following disorders may cause a hyperpigmentation of the oral mucosa which may be mistaken for normal racial pigmentation. A. Hypoadrenalcorticism (Addison’s disease) B. Hyperparathyroidism C. Hypoparathyroidism D. Hypercortisolism (Cushing’s disease) 22. The general clinical manifestions of which of the following conditions is often summed up by the phrase “stones, bones and groans?” A. Hypophosphatasia B. Hyperparathyroidism C. Diabetes mellitus D. Hypothyroidism 23. NIDDM (non-insulin dependent diabetes mellitus) often becomes clinically detectible during pregnancy or in obesity because these two condition cause A. an increased peripheral resistance to insulin B. a decrease in the production of insulin by ß-cells C. an autoimmune destruction of ß-cells D. increased metabolism of insulin by the liver 24. The brown tumor of hyperparathyroidism appears microscopically identical to which of the following? A. Ameloblastoma B. Absecess C. Osteosarcoma D. Central giant cell granuloma 25. Which of the following are oral manifestations of diabetes mellitus? A. Candidosis B. Lichenoid reaction C. Macroglossia (enlarged tongue) D. All of the above 26. Which of the following disorders manifests in the oral cavity as a diffuse, nodular swelling with deep ulcer and epulis-like fibrous hyperplasias? A. AIDS B. Diabetes mellitus C. Pernicious anemia D. Crohn’s disease 27. A supernumerary tooth located between the central incisors is known as a A. Mesiodens B. Distodens C. Natal tooth D. Transposed tooth 28. The teeth which most commonly present as microdonts are A. Mandibular second premolars and third molars B. Maxillary central and lateral incisors C. Maxillary lateral incisors and third molars D. Maxillary lateral incisors and mandibular second premolars 29. A single enlarged tooth or joined double tooth is considered the result of what process when the tooth count is normal when the anomolous tooth is counted as one? A. Gemination B. Fusion C. Concresence D. Hyperdontia 30. Which of the following is thought to result from an inflammatory process? A. Gemination B. Fusion C. Concresence D. Microdontia 31. Which of the following anomalies results in increased periodontal attachment loss? A. Dens invaginatus and taurodontism B. Cusp of Carabelli and talon cusp C. Enamel pearl and cervical enamel extension D. Dens evaginatus and fusion 32. Which of the following teeth most commonly demonstrates dens invaginatus? A. Lateral incisor B. Premolar C. Third molar D. Canine 33. Amelogenesis imperfecta is a group of disorders which all demonstrate a defect in enamel formation. It is inhereted in a _______________ pattern. A. Autosomal dominant B. Autosomal recessive C. X-linked D. All of the above 34. Which of the major types of amelogenesis imperfecta (AI) is the result of a complete lack of enamel mineralization manifesting radiographically as enamel which may be less radiopaque than the underlying dentin? A. Hypoplastic B. Hypocalcified C. Hypomineralized D. The enamel in all types of AI is more radiopaque than dentin. 35. A young man presents to your office with a chief complaint of multiple missing teeth. Clinical exam reveals several of the remaining teeth to be loose and a draining sinus track associated with the mandibular left second molar. The remaining teeth appear otherwise normal, with no apparent enamel loss or pitting.