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DAPA 741 Oral Pathology Examination Two October 18, 2000

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DAPA 741 Oral Pathology Examination Two October 18, 2000 Name: __________________________ DAPA 741 Oral Pathology Examination Two October 18, 2000 1. Which of the following diagnoses can be eliminated from your differential if vesicles are identified? A. Apthous ulcers B. Mucous membrane pemphigoid C. Recurrent herpes D. All of the above 2. Which form of Epidermolysis bullosa 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. Lymphadenopathy D. Cured with corticosteroids 5. Which of the following diagnoses can be eliminated from the differential diagnosis if a Nikolsky sign is noted? A. Pemphigus 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 epithelium 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. Lichen planus C. Mucous membrane pemphigoid D. Erythema multiforme 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, infections 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 is 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 herpes simplex B. Lichen planus C. Apthous ulcers D. Herpangina 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 oral mucosa. The plaques rub off with a 2X2 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 cheilitis 16. The oral manifestations of herpangina consists of lesions most commonly located A. On the vermilion of the lip B. Bilaterally on the buccal mucosa C. Diffusely on the oral mucosa, but usually sparing the gingiva and hard palate D. On the soft palate and oropharynx 17. In general, which of the following statements is true of salivary gland 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 lips 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 neck just anterior to the angle of the mandible 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, periodontal disease, 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. Squamous cell carcinoma B. Lichen planus C. Lymphoma D. None of the above 22. Salivary gland neoplasms are not found A. on the dorsum of the tongue anterior to the cicumvallate papillae B. in the sublingual gland C. on the buccal mucosa D. on the soft palate 23. Which of the following salivary gland neoplasms may contain cartilage or bone? A. Pleomorphic adenoma B. Monomorphic adenoma C. Oncocytoma C. Mucoepidermoid carcinoma 24. Which of the following salivary gland neoplasms is found exclusively in the parotid gland? A. Pleomorphic adenoma B. Polymorphous low-grade adenocarcinoma C. Papillary cystadenoma lymphomatosum (Warthin’s tumor) D. Adenoid cystic carcinoma 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. Cyst 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 (Branchial Cleft Cyst) C. Nasolabial Cyst D. Dermoid Cyst 29. The only benign mesencymal lesion with a rapid growth rate is the A. Schwannoma B. Irritation fibroma C. Periperal ossifying fibroma D. Pyogenic granuloma 30. Psuedocarcinomatous hyperplasia may be a microscopic feature of which two lesions? A. Pyogenic granuloma and granular cell tumor B. Acute sialadenitis 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. Lipoma D. Schwannoma 35. A lymphangioma of the neck is also called a A. Ranula B. Cervical lymphoepithelial cyst (Branchial cleft cyst) C. Cystic hygroma D. None of the above 36. Lymphomas are monoclonal. This means that A. the cells of the lesion have a similar morphologic appearance under the light microscope B. the cells of the lesion arise from a common precursor cell C. the lesion is confined to a single lymph node D. all of the above 37. The malignant cell of Hodgkin’s disease A. is the Reed-Sternberg cell B. makes up only 1 to 3 percent of the lesion C. classically appears binucleated D. all of the above 38. Burkitt’s lymphoma is associated with which of the following viruses? A.
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