Deck 7: Neoplasms of the Oral Soft Tissues and Facial Skin

Question 1

Dysplasia means :

A) Orderly cellular proliferation
B) Programmed cell death
C) Loss of normal cell maturation
D) Difficulty swallowing food

Answer 1

Loss of normal cell maturation

Question 2

Which of the following is NOT considered an intrinsic factor for oral cancer?

A) Tobacco smoking
B) Iron deficiency anemia
C) Immunosuppressive diseases such as HIV/AIDS
D) Organ transplantation

Answer 2

Tobacco smoking

Question 3

Which of the following terms describes a white lesion that does not wipe off?

A) Dysplasia
B) Erythroplakia
C) Metaplasia
D) Leukoplakia

Answer 3

Leukoplakia

Question 4

What is the most common site for oral cancer?

A) Posterior lateral border of the tongue
B) Hard palate
C) Vermillion border of lip
D) Soft palate and oropharynx

Question 5

Which of the following terms is used to describe cells that do not appear like their normal counterparts?

A) Invasive
B) Metastatic
C) Anaplastic
D) Benign

Question 6

All of the following are common features of benign tumors EXCEPT:

A) They are usually easy to remove.
B) They do not have time to form a fibrous capsule.
C) They often grow slowly over several years.
D) They do not metastasize to distant sites.

Question 7

Incidence refers to the number of:

A) Treated cases during a specific time period
B) Individuals who die of a certain disease per year
C) Newly diagnosed cases during a specific time period
D) People living with a disease linked to an extrinsic factor

Question 8

Which of the following terms refers to the condition where growth of cells is not coordinated with the growth of adjacent normal tissues?

A) Neoplasia
B) Ulceration
C) Benign
D) Apoptosis

Question 9

The term differentiation describes the degree to which:

A) Cells appear different from their normal counterparts
B) Cells undergo apoptosis
C) Malignant cells are metastasizing
D) Benign cells are invading the surrounding tissue

Question 10

The term adenoma refers to any:

A) Malignant tumor that arises from cartilage
B) Malignant tumor of connective tissue
C) Benign tumor of neural origin
D) Benign tumor that arises from glandular tissue

Question 11

An altered gene capable of causing a neoplasm is called a(n):

A) Recessive gene
B) Oncogene
C) Autosomal gene
D) Aneuploid gene

Question 12

Malignant tumors arising from cells that originated from embryonic ectoderm are termed:

A) Endodonomas
B) Sarcomas
C) Carcinomas
D) Fibromas

Question 13

All of the following statements about precancerous changes in the oral cavity are true EXCEPT:

A) Excessive keratin appears clinically as an ulceration.
B) There may be a lack of keratin production.
C) Abnormal cells can divide at a rapid rate under the influence of a carcinogen.
D) There may be a combination of both excessive keratin and a lack of keratin production.

Question 14

Human papilloma virus strains 16 and 18 are considered a major risk for which of the following cancers?

A) Squamous cell carcinoma of the lateral border of the tongue
B) Squamous cell carcinoma of the buccal vestibule
C) Melanoma
D) Posterior oropharyngeal cancer

Question 15

Exposure of a wide area to a cancer-promoting agent is known as:

A) Differentiation
B) Field cancerization
C) Invasion
D) Infiltration

Question 16

Which of the following is NOT considered a route for tumor metastasis?

A) Bloodstream
B) Lymphatics
C) Along nerves
D) Saliva

Question 17

Which of the following cellular mechanisms eliminates abnormal or damaged cells?

A) Chondrosis
B) Apoptosis
C) Meiosis
D) Differentiation

Question 18

Which of the following is NOT a characteristic feature of an anaplastic cell?

A) Altered nucleus-cytoplasm ratio
B) Decreased mitosis
C) Pleomorphism
D) Hyperchromatism

Question 19

Benign tumors:

A) Spread by metastasis
B) Are most often not life-threatening
C) Do not occur in the brain
D) Are never lethal

Question 20

All of the following statements about risk factors are true EXCEPT:

A) Extrinsic risk factors are related to the patient's environment.
B) They most often are the sole cause of the disease.
C) They predispose a patient to develop a disease.
D) Intrinsic risk factors are not related to the patient's habits or environment.

Question 21

Surgical debulking of tumors is utilized:

A) Prior to placing an obturator
B) When a large tumor is not totally resectable
C) When the tumor has not metastasized
D) When the tumor has not invaded the adjacent tissues

Question 22

Predisposing factors for squamous cell carcinoma of the skin include all of the following EXCEPT:

A) Dark-colored skin
B) Immunosuppression
C) Therapeutic radiation
D) Actinic keratoses

Question 23

Which of the following would NOT be used to reduce the symptoms of diminished salivary flow after radiotherapy?

A) Sialagogues
B) Buffered lozenges with sugar
C) Saliva substitutes
D) Daily fluoride application

Question 24

Typical side effects of chemotherapy include all of the following EXCEPT:

A) Osteoradionecrosis
B) Alopecia
C) Anemia and leukopenia
D) Mucositis

Question 25

All of the following are problems that arise when salivary gland function is compromised EXCEPT:

A) Rampant caries
B) Increased antimicrobial peptides
C) Oral infections including candidiasis
D) Decreased lubrication and loss of taste

Question 26

All of the following statements about actinic keratosis are true EXCEPT:

A) It is a premalignant condition.
B) Women are affected more than men.
C) There are rough, raised areas of excessive keratin.
D) The term actinic refers to sun exposure.

Question 27

Oral cancers of the lateral border of the tongue and floor of mouth occur with greatest frequency in what risk group?

A) IV drug abusers
B) Tobacco smokers
C) HIV/AIDS patients
D) Xerostomia patients

Question 28

Oral submucous fibrosis is a precancerous condition seen in individuals who:

A) Suffer from immune suppression after solid organ transplant
B) Are IV drug abusers
C) Are chain smokers
D) Chew betel quid and its derivatives

Question 29

Which of the following lesions is described as having a "stuck-on raisin-like" appearance in the early stages?

A) Basal cell carcinoma
B) Squamous cell carcinoma
C) Seborrheic keratosis
D) Acquired melanocytic nevus

Question 30

Melanomas are neoplasms that:

A) Rarely metastasize
B) Arise from melanocytes
C) Do not occur in the oral cavity
D) Are considered benign but aggressive

Question 31

Verrucous means :

A) Variegated in color
B) Tumor-like
C) Wart-like
D) Vascular-like

Question 32

Acquired melanocytic nevi:

A) Are lesions that are greater than 14 mm in diameter
B) Have a rough irregular surface and progress to cancer
C) Are premalignant melanomas
D) Occur on the skin and produce melanin pigment

Question 33

Basal cell carcinomas are:

A) Related to chronic overexposure to ultraviolet (UV) radiation
B) Highly malignant and metastasize early
C) Are benign neoplasms and not invasive
D) Are premalignant

Question 34

The TNM Classification of Malignant Tumors is a cancer staging system that includes all the following EXCEPT:

A) Color
B) Tumor size
C) Node involvement
D) Metastasis

Question 35

Squamous cell carcinoma of the soft palate and oropharyngeal carcinoma often test positive for which of the following viruses?

A) Coxsackie virus
B) Herpes zoster virus
C) Herpes simplex virus
D) Human papilloma virus

Question 36

Unlike other leukoplakias, proliferative verrucous leukoplakia:

A) Has a low rate of malignant transformation
B) Is not treated surgically
C) Occurs more commonly in men younger than 40 years of age
D) Has a high rate of malignant transformation

Question 37

All of the following are characteristics of basal cell carcinomas EXCEPT:

A) Mutation of genes in the basal cells occurs.
B) Early lesions may resemble pimples that fail to resolve.
C) They invade superficially and metastasize early.
D) They can occur in Gorlin syndrome, where the mutation is inherited.

Question 38

The most common site for intraoral development of squamous cell carcinoma is the:

A) Posterior lateral border of the tongue
B) Hard palate
C) Vermillion border of lip
D) Soft palate and oropharynx

Question 39

Verrucous carcinoma occurs with greatest frequency in what risk group?

A) IV drug abusers
B) Tobacco smokers
C) HIV/AIDS patients
D) Smokeless tobacco users

Question 40

All of the following statements about radiation-induced xerostomia are true EXCEPT:

A) It is defined as severe dry mouth after radiation.
B) Only cancers of the head and neck have this complication.
C) The salivary glands are radioresistant and not easily destroyed.
D) Typically the watery serous saliva of the parotid gland is lost first.

Question 41

A malignant tumor of adipose tissue is called a(n):

A) Lipoma
B) Adenoma
C) Carcinoma ex-pleomorphic adenoma
D) Liposarcoma

Question 42

The most common location for granular cell tumors is the:

A) Dorsal tongue
B) Junction of the hard and soft palate
C) Floor of the mouth
D) Gingiva and alveolar ridge

Question 43

Minor salivary glands occur in the oral cavity, with the exception of:

A) Gingiva and anterior hard palate
B) Labial and buccal mucosa
C) Soft palate and pharynx
D) Tongue and floor of the mouth

Question 44

All of the following statements about myofibromas are true EXCEPT:

A) They arise from a common connective tissue cell, myofibroblasts.
B) Most present as submucosal nodules or exophytic masses.
C) They grow rapidly and frequently recur.
D) They are most common in the tongue, lips, and buccal mucosa.

Question 45

Malignant peripheral nerve sheath tumors are known as:

A) Neurofibromas
B) Neurofibrosarcomas
C) Schwannomas
D) Rhabdomyosarcomas

Question 46

Warthin tumor is almost exclusively found in the parotid gland in which of the following risk groups?

A) Immunosuppressed cancer patients
B) IV drug abusers
C) Smokers
D) Alcoholics

Question 47

Hemangiomas are:

A) Malignant tumors of blood vessels
B) Rarely seen in the head and neck region
C) Composed of a proliferation of fibroblasts
D) Composed of a proliferation of endothelial cells

Question 48

Which of the following does not arise from tissue surrounding and supporting peripheral nerve?

A) Schwannoma
B) Neurofibroma
C) Granular cell tumor
D) Liposarcoma

Question 49

Which nerve might be at risk for damage during removal of a pleomorphic adenoma within the parotid gland?

A) Facial nerve
B) Lingual nerve
C) Superficial temporal
D) Greater occipital

Question 50

Neurotropic means the tumor:

A) Preferentially metastasizes to the brain
B) Invades peripheral nerves
C) Expands and destroys bone
D) Metastasizes via the lymphatics

Question 51

Canalicular adenoma is almost exclusively found in which of the following salivary glands?

A) Submandibular
B) Minor
C) Parotid
D) Sublingual

Question 52

Which of the following salivary tumors has pain as an early sign and is neurotropic?

A) Adenoid cystic carcinoma
B) Mucoepidermoid carcinoma
C) Warthin tumor
D) Polymorphous low-grade adenocarcinoma

Question 53

Lipoma is a benign tumor of what type of tissue?

A) Fat
B) Nerve
C) Muscle
D) Tendon

Question 54

The most common intraoral location for a lipoma is the:

A) Tongue
B) Buccal mucosa
C) Floor of the mouth
D) Soft palate

Question 55

Polymorphous low-grade adenocarcinoma is most frequently seen in which of the following?

A) Parotid gland
B) Submandibular gland
C) Minor salivary glands in the palate
D) Parathyroid glands

Question 56

Lymphangiomas that occur in the cervical (neck) area are called:

A) Angiosarcomas
B) Hemangiomas
C) Cystic hygromas
D) Synovial sarcomas

Question 57

Which of the following neoplasms has the appearance of bubble-wrap?

A) Schwannoma
B) Hemangioma
C) Lymphangioma
D) Neuroma

Question 58

Guidelines to distinguish melanoma from other pigmented lesions include all of the following EXCEPT:

A) Irregular border
B) Variegated color
C) Asymmetrical shape
D) Diameter greater than 14 mm

Question 59

Mucoepidermoid carcinoma within the body and ramus of the mandible can mimic a(n):

A) Osteoma
B) Salivary gland tumor
C) Melanoma
D) Odontogenic tumor

Question 60

Which of the following is the most common malignant salivary gland neoplasm?

A) Pleomorphic adenoma
B) Mucoepidermoid carcinoma
C) Warthin tumor
D) Canalicular adenoma

Question 61

What type of cells are malignant in chronic lymphocytic leukemia?

A) B lymphocytes
B) Polymorphonuclear neutrophils
C) Thrombocytes
D) Monocytes

Question 62

Which of the following is implicated as the cause of endemic Burkitt lymphoma?

A) Human herpes virus 8
B) Human papilloma virus
C) Epstein-Barr virus
D) Coxsackie virus

Question 63

Non-Hodgkin lymphoma in the area of a nonhealing extraction site can mimic a(n):

A) Dentigerous cyst
B) Epulis granulomatosum
C) Primordial cyst
D) Irritation fibroma

Question 64

Malignant leukocytes in leukemia:

A) Form solid tumors within the bone marrow and spleen
B) Are associated with decreased production of white blood cells in the bone marrow
C) Proliferate within the vascular channels
D) Are overproduced by the bone marrow

Question 65

All of the following statements about multiple myeloma are true EXCEPT:

A) It is a malignancy of T cells.
B) The condition is rarely diagnosed before the age of 40.
C) Bone pain and pathological fractures are often the presenting signs.
D) Multiple radiolucencies occur in bone.

Question 66

Leiomyomas are most common in the uterus where they are commonly known as:

A) Lipomatous adenomas
B) Angio-rhabdomyomas
C) Vascular rhabdomyomas
D) Fibroids

Question 67

Eosinophilic granuloma is:

A) A form of Langerhans cell histiocytosis that is confined to one bone
B) Caused by foreign antigens that create immunoglobulins
C) Due to plasma cell proliferation within lymph nodes
D) A form of Langerhans cell histiocytosis that is widespread and in multiple locations

Question 68

Port wine stain is a form of vascular malformation that:

A) Develops along the path of the trigeminal nerve
B) Is malignant and gradually enlarges into a tumor mass
C) Is considered premalignant and a form of epithelial dysplasia
D) Develops into a cystic hygroma

Question 69

Which of the following is a vascular malformation that develops along and affects the first (ocular) division of the trigeminal nerve?

A) Gorlin syndrome
B) Sturge-Weber syndrome
C) Down syndrome
D) Stevens-Johnson syndrome

Question 70

A higher risk of non-Hodgkin lymphoma is present in all of the following EXCEPT:

A) Sjögren syndrome
B) Immune deficiency disorders
C) Fungal infections such as tuberculosis and syphilis
D) Viral infections such as human herpes virus 8

Question 71

Acute and chronic myelogenous leukemia are similar in that:

A) Both occur more frequently in children.
B) The 5-year survival rate is less than 10%.
C) Both are more common in adults.
D) Signs and symptoms are absent.

Question 72

Which leukemia is most common in childhood with a peak incidence of 2 to 5 years?

A) Acute lymphoblastic
B) Chronic lymphocytic
C) Chronic myelogenous
D) Acute myelogenous

Question 73

Which of the following is a benign tumor of mature striated skeletal muscle?

A) Rhabdomyoma
B) Leiomyoma
C) Adenoma
D) Angioleiomyoma

Question 74

Over 50% of metastases from distant sites to the oral soft tissues occur at what favored site?

A) Lateral border of the tongue
B) Gingiva
C) Floor of the mouth
D) Junction of the hard and soft palate

Question 75

Lymphomas are:

A) Not always malignant
B) Do not occur within the oral cavity proper
C) Named according to their location in the body
D) Solid tumors that develop in lymph nodes or lymphoid tissues

Question 76

Rhabdomyosarcomas are:

A) Malignant tumors of smooth muscle
B) Benign tumors of striated skeletal muscle
C) Malignant tumors of striated skeletal muscle
D) Benign tumors of smooth muscle

Question 77

What percentage of oral metastases are the first sign of cancer spread from a distant site?

A) 10%
B) 30%
C) 50%
D) 70%

Question 78

Abnormal immunoglobulins detected in the urine of patients with multiple myeloma are called:

A) Creatinine
B) Bence-Jones proteins
C) IgE immunoglobulins
D) Uremic crystals

Question 79

Oral manifestations of leukemia include all of the following EXCEPT:

A) Mucosal ulceration
B) Gingival atrophy and frictional hyperkeratosis
C) Spontaneous bleeding
D) Gingivitis and periodontitis