Chapter 01: Introduction to Preliminary Diagnosis of Oral Lesions
Ibsen: Oral Pathology for the Dental Hygienist, 8th Edition
MULTIPLE CHOICE
1. Which vocabulary word is used to describe a segment that is part of the whole?
a. Bulla
b. Pedunculated
c. Lobule
d. Macule
ANS: C
A lobule is described as a segment or lobe that is part of a whole. Bulla is a circumscribed,
elevated lesion, more than 5 mm in diameter, containing serous fluid and looks like a blister.
Pedunculated describes a lesion that is attached by a stemlike or stalklike base, similar to that
of a mushroom. Macule is a flat area usually distinguished by a color different from that of
surrounding tissue. A freckle is an example of a macule.
REF: Vocabulary, Clinical of Soft Tissue Lesions, page 1 OBJ: 1
2. A lesion with a sessile base is described as
a. an ulcer.
b. stemlike.
c. pedunculated.
d. flat and broad.
ANS: D
Sessile describes the base of a lesion that is flat and broad. An ulcer is a break in the surface
epithelium. A stemlike lesion is referred to as pedunculated. A pedunculated lesion is stemlike
or stalk-based (similar to a mushroom).
REF: Vocabulary, Clinical Appearance of Soft Tissue Lesions, page 1
OBJ: 1
3. Which condition is not diagnosed through clinical appearance?
a. Mandibular tori
b. Fordyce granules
c. Black hairy tongue
d. Compound odontoma
ANS: D
The compound odontoma is initially identified radiographically as a radiopaque area in which
tooth structure can be identified. No clinical component exists. Mandibular tori are identified
clinically as areas of exostosis on the lingual aspects of mandibular premolars. Fordyce
granules are yellow clusters of ectopic sebaceous glands diagnosed through clinical
appearance. Black hairy tongue is diagnosed clinically. The filiform papillae on the dorsal
tongue elongate and become brown or black. Causes include tobacco, alcohol, hydrogen
peroxide, chemical rinses, antibiotics, and antacids.
REF: Radiographic Diagnosis, page 9 OBJ: 3
,4. Another name for erythema migrans is
a. median rhomboid glossitis.
b. geographic tongue.
c. cobblestone tongue.
d. scrotal tongue.
ANS: B
Geographic tongue is another name for erythema migrans. Median rhomboid glossitis, once
thought to be developmental but currently research indicates it is associated with a chronic
fungal infection from Candida albicans. Cobblestone tongue is observed in a patient with
Sjogrens syndrome, an autoimmune condition. Scrotal tongue is another name for fissured
tongue.
REF: Geographic Tongue, page 24 OBJ: 4
5. This bony hard, radiopaque structure in the midline of the hard palate is diagnosed through
clinical diagnosis. It is genetic in origin and inherited in an autosomal dominant manner. You
suspect:
a. median palatal cyst.
b. torus palatinus.
c. pleomorphic adenoma.
d. incisal canal cyst.
ANS: B
Torus palatinus is radiopaque, developmental, bony hard, and found on the midline of the hard
palate. Medial palatal cyst is a rare fissural cyst that appears as a radiolucency in the midline
of the hard palate. Pleomorphic adenoma is a benign salivary gland tumor, unilaterally found
on the posterior palate and associated with the parotid gland. Incisal canal cyst is usually a
heart shaped radiolucency found at the apices of the maxillary centrals.
REF: Torus Palatinus, page 21 OBJ: 3
6. The gray-white opalescent film seen on the buccal mucosa of 85% of black adults is a variant
of normal that requires no treatment and is termed
a. linea alba.
b. leukoedema.
c. leukoplakia.
, d. white sponge nevus.
ANS: B
Leukoedema is a diffuse opalescence most commonly seen on the buccal mucosa in black
individuals. Linea alba is a “white line” that extends anteroposteriorly on the buccal mucosa
along the occlusal plane. It is most prominent in patients who have a clenching or grinding
habit. Leukoplakia is a clinical term for a white lesion, the cause of which is unknown. White
sponge nevus is a genetic (autosomal dominant) trait. Clinically, it is characterized by a soft
white, folded (or corrugated) oral mucosa. A thick layer of keratin produces the whitening.
REF: Leukoedema, page 23 OBJ: 3
7. Which condition responds to therapeutic diagnosis?
a. Angular cheilitis
b. Amelogenesis imperfecta
c. Leukoplakia
d. Linea alba
ANS: A
Angular cheilitis is associated with Candida albicans and responds to treatment with
antifungals. Amelogenesis imperfecta is genetic and diagnosed through clinical, historical and
radiographic features. Leukoplakia is purely a clinical term to describe a white lesion with
unknown cause. Biopsy and microscopic examination are necessary to establish a diagnosis.
Linea alba is considered a variant of normal and diagnosis is made through clinical diagnosis.
REF: Therapeutic Diagnosis, page 19 OBJ: 2
8. The gingival enlargement in this patient is caused by a calcium channel blocker. Which one of
the following medications is the cause?
a. Dilantin
b. Nifedipine
c. Tetracycline
d. Cyclosporine
ANS: B
, Nifedipine is a calcium channel blocker that causes gingival enlargement. Dilantin is an
anticonvulsant medication used to control seizures and other neurologic conditions that does
cause gingival enlargement. Tetracycline is an antibiotic responsible for discoloring teeth.
Cyclosporine is an immunosuppressant drug that also causes gingival enlargement, and is
used to prevent rejection of organ transplants.
REF: Historical Diagnosis, Fig. 1.38B, page 17 OBJ: 2
9. Radiographic features, including cotton-wool radiopacities and hypercementosis, are
especially helpful in the diagnosis of
a. Paget disease.
b. dentinogenesis imperfecta.
c. anemia.
d. diabetes.
ANS: A
Paget disease is a chronic metabolic bone disease. Radiographically, cotton-wool radiopacities
and hypercementosis are characteristic features. Dentinogenesis imperfecta is a genetic
condition involving a defect in the development of dentin. Anemia, a decrease in red blood
cells, requires blood tests to determine the etiologic factors. Diabetes is a chronic disorder of
carbohydrate metabolism characterized by abnormally high blood glucose levels.
REF: Laboratory Diagnosis, Fig. 1.41, pages 16, 18 OBJ: 3
10. Which one of the following is recommended when diagnosing lingual thyroid?
a. Biopsy
b. Thyroid scan
c. Clinical location
d. FMS
ANS: B
Thyroid scan is the safest way to determine the presence of thyroid tissue on the posterior
tongue. Biopsy is not recommended because of bleeding complications. Clinical location is
helpful but does not definitively determine the presence of thyroid tissue. An FMS will not
contribute anything in determining the presence of thyroid tissue.
REF: Vocabulary, Radiographic Terms Used to Describe Lesions in Bone, page 24
OBJ: 4
11. Which condition is diagnosed through clinical appearance?
a. Fordyce granules
b. Unerupted mesiodens
c. Periapical cemento-osseous dysplasia
d. Traumatic bone cyst
ANS: A
