Sample test questions Krok 2 Stomatology () Терапевтична стоматологiя 2 1. Biopsy material was obtained temperature of 38.9oC, general fatigue, from the focus of a lesion in the impaired speech, inability to eat. This retromolar space. Pathohistological findings: condition has been recurring for the last cellular polymorphism in the stratum 4 years in autumn and spring. There are spinosum, increased mitotic number, giant vesicles and erosions covered in grayish multinucleate cells, acanthosis, some cells fibrinous coating on the hyperemic and in the stratum spinosum exhibit signs of swollen labial and buccal mucosa. Nikolsky’s parakeratosis, keratin pearls are detected. sign is negative. What is the most likely These pathohistological findings indicate the diagnosis? following disease: A. Erythema multiforme exudativum A. Bowen disease B. Pemphigus vulgaris B. Lupus erythematosus C. Acute herpetic stomatitis C. Leukoplakia D. Nonacantholytic pemphigus D. Lichen ruber planus, verrucous form E. - E. Keratoacanthoma 6. A 36-year-old woman complains of dryness 2. During preventive examination a 40-year- and peeling of her lower lip vermillion border. old man presents with the following changes: Both dryness and peeling have been observed marginal gingiva is enlarged, torus-shaped, for a month. Application of indifferent cyanotic, slightly bleeding when touched with ointments was ineffective. Objectively the a dental probe; there is no pain. Staining the vermillion border of the lower lip is bright gums with Lugol’s iodine solution results in red, moderately infiltrated, and densely light-brown coloring of mucosa. Make the covered in white-gray scales, that cannot be diagnosis: removed without pain and bleeding. The lesion focus contains concave areas, while A. Chronic catarrhal gingivitis on the periphery there are patches of dull B. Acute catarrhal gingivitis epithelium that look like irregular white C. Exacerbation of chronic catarrhal gingivitis stripes. What is the most likely diagnosis? D. Chronic hypertrophic gingivitis E. Generalized periodontitis A. Lupus erythematosus B. Candidal cheilitis 3. A patient complains of carious cavity in C. Lichen ruber planus tooth 11. The filling was lost one week ago. D. Leukoplakia The tooth crown is dark, there is residual E. Exfoliative cheilitis filling material at the bottom of the carious cavity. Vertical percussion is painless. X-ray 7. A 35-year-old woman has complaints of shows an oval area of bone tissue resorption cosmetic defects of the front upper teeth with clear margins, 0.4х0.3 cm in size. The root crowns. The defects have been aggravating canal is filled by 2/3 of its length. What is the for the last 10 years. The patient suffers most likely diagnosis? from unpleasant sensations when brushing her teeth, and when chemical stimuli are A. Chronic granulomatous periodontitis applied. Objective examination revealed B. Chronic fibrous periodontitis defects localized in the enamel of the front C. Chronic granulating periodontitis upper teeth vestibular surface. The defects are D. Radicular cyst oval, saucer-shaped, and have clear margins. E. Exacerbation of chronic periodontitis Response to probing and cold stimuli was positive. Make the diagnosis: 4. A 30-year-old woman complains of mild burning sensation in her lower lip and its A. Enamel erosion dryness. She peels skin scales off with her B. Enamel hypoplasia teeth. She has been presenting with this C. Cuneiform defect condition for 10 years. On examination the D. Chemical necrosis of the tooth skin scales are gray and located on the lip from E. Hyperesthesia of tooth hard tissues the Klein’s line to the center of the vermillion border from angle to angle of the mouth. The 8. A 40-year-old man had his root canal of scales are firmly attached in the center and are the 34 tooth filled due to chronic fibrous loose on the periphery. Their forcible removal periodontitis. Soon the treated place became does not result in erosions. What is the most painful. On X-ray the root canal of the 34 likely diagnosis? tooth is filled to the root apex. What tactics should the dentist choose to manage the pain? A. Exfoliative cheilitis B. Lupus erythematosus A. To prescribe physiotherapeutic procedures C. Meteorological cheilitis B. To rinse with antiseptic mouthwash D. Allergic contact cheilitis C. To make insicion along the mucogingival E. Eczematous cheilitis fold D. To provide conduction anesthesia 5. A 32-year-old patient presents with body E. To p r o v i d e i n filtration anesthesia Терапевтична стоматологiя 3 9. A 20-year-old man complains of the area of the 41, 42, 32, and 31 teeth up to spontaneous pain attacks (5-7 minutes) in the 1/3 of the root length. What is the most likely area of 36 that occur for the last 24 hours. diagnosis? Objectively in 36 there is a deep carious cavity on the masticatory surface. Probing is painful A. Localized periodontitis at one point, response to cold stimulus is B. Generalized periodontitis, initial stage painful, with an aftereffect that lasts for 5 C. Generalized periodontitis, stage I minutes. Percussion is painless. X-ray shows D. Catarrhal gingivitis root canals to be slightly curved, canal lumen E. Parodontosis, stage I is clearly visible. The tooth is planned to be used as an abutment for a dental bridge. What 13. A 45-year-old man complains of persisting is the optimal treatment method in this case? dull pain in 46 that occurs in response to thermal and chemical stimuli. Examination A. Vital extirpation of 46 detected in the precervical area of its B. Biological approach vestibular surace a deep carious cavity filled C. Vital amputation with soft pigmented dentin. Probing is sharply D. Devital amputation painful at one point. Cold water stimulus E. Filling of the carious cavity induces a dull pain that gradually intensifies. Make the diagnosis: 10. A 34-year-old man complains of acute spasmodic pain in the region of his upper jaw A. Chronic fibrous pulpitis on the left that is aggravating when affected B. Acute deep caries by cold stimuli. Toothache irradiates to the C. Chronic deep caries ear and temple. He had acute toothache in D. Chronic gangrenous pulpitis the 27 tooth one year ago, but he did not E. Chronic fibrous periodontitis consult a dentist. Pain recurred three days ago. Objectively: the 27 tooth has a carious cavity 14. A 38-year-old man came to the dentist. communicating with the dental cavity.Probing After history-taking and examination he of the opened carious cavity is extremely was found to have exacerbated generalized painful. X-ray picture shows widening of periodontitis of the II degree with periodontal periodontal fissure at the root apex of the 27 pockets 3-5 mm deep. After the local tooth. What is the most likely diagnosis? factors were removed and anti-inflammatory treatment was provided to the patient, it is A. Exacerbation of chronic fibrous pulpitis necessary to remove the periodontal pockets. B. Exacerbation of chronic granulating What method should be applied in this case? periodontitis Curettage C. Exacerbation of chronic fibrous A. periodontitis B. Gingivectomy D. Acute diffuse pulpitis C. Gingivotomy Flap surgery E. Exacerbation of chronic gangrenous pulpitis D. E. Vestibuloplasty 11. A 38-year-old woman complains of burning pain in her lips and angles of her 15. A 38-year-old man, an arc welder, is a mouth, their dryness. She has an 8-year- chain smoker. He came to the dentist to have long history of diabetes mellitus. Objectively: a denture made for him. Howerver, in the the vermillion border is dry, congestively middle of his lower lip against the background hyperemic, covered in scales of variable of unchanged vermillion border there is a size. In the angles of the mouth there are gray-white polygonal lesion 6x4 mm with clear fissures covered in white coating, the skin margins. The lesion is covered with tightly is macerated. What ointment should be attached small scales and is level with the prescribed for topical treatment in the given vermillion border (neither protruding nor case? retracted). Palpation of the lesion focus is painless, the lesion has no thickened base; A. Clotrimazol lateral palpation detects thickened surface B. Interferon of the lesion. Regional lymph nodes are C. Prednisolone unchanged. Make the provisional diagnosis: D. Lanolin E. Erythromycin A. Localized precancerous hyperkeratosis B. Verrucous precancer 12. A 23-year-old man complains of gum C. Lupus erythematosus bleeding when he brushes his teeth or eats D. Cancer of the lower lip solid food. Objectively: the gums of the E. Lichen ruber planus, hyperkeratotic form front lower jaw are hyperemic, swollen and bleeding when palpated. Oral and gingival 16. A 53-year-old patient complains of an mucosa in other areas are not affected. The ulcer on the lateral surface of the tongue. The occlusion is deep. The teeth are firm, except ulcer appeared 6 months ago in the result for the 41 and 31 (degree 1 mobility). X-ray of a trauma caused by sharp tip of the 37 shows resorption of the alveolar septum in tooth metal crown. A dentist replaced the Терапевтична стоматологiя 4 crown with the one of better quality and 20. A 28-year-old patient complains of pain prescribed keratoplastic drugs. Despite these and bleeding of gums in the frontal part of the measures the ulcer continues to grow. Lately upper jaw on the left. Two years ago, the 22 there has been pain during talking, chewing, tooth was covered with a porcelain-fused-to- swallowing; sometimes the pain irradiates metal crown. Objectively: interdental papilla to the pharynx. Objectively: on the lateral between the 21 and 22 tooth is hypertrophied, surface of the tongue there is a painful ulcer markedly hyperemic, overlaps the crown of with uneven raised dense margins and lumpy the 22 by 1/3 of its height, bleeds when floor covered with grayish necrotic coating.