Deck 9: Oral Manifestations of Systemic Diseases

Question 1

Which of the following statements is true concerning oral complications for adult patients with diabetes mellitus?

A) Patients with diabetes mellitus have a decreased response to plaque.
B) Slow wound healing and decreased susceptibility to infection occur as a result of the immunologic changes and defective collagen production.
C) The gingiva can be hyperplastic and erythematous.
D) Periodontal disease is not considered to be a complication of diabetes.

Answer 1

The gingiva can be hyperplastic and erythematous.

Question 2

Plummer-Vinson syndrome can develop as a result of long-standing _____________ anemia.

A) pernicious
B) iron-deficiency
C) thalassemia
D) aplastic

Answer 2

iron-deficiency

Question 3

Advantages of an insulin pump for therapy of type 1 diabetes include that:

A) blood sugar levels no longer need to be monitored.
B) the pump is internal.
C) the pump can maintain a more predictable control of blood sugar levels than multiple insulin injections.
D) the insulin dosage with the pump is limited to once-a-day dosing.

Answer 3

the pump can maintain a more predictable control of blood sugar levels than multiple insulin injections.

Question 4

The production of adrenal steroids is normally stimulated by release of __________ hormone from the pituitary gland.

A) follicle-stimulating
B) luteinizing
C) adrenocorticotropic
D) growth

Question 5

The most common cause of hyperthyroidism is:

A) hyperplasia of the gland.
B) benign and malignant tumors of the gland.
C) pituitary gland disease.
D) an autoimmune disorder.

Question 6

The most common cause of hyperpituitarism is:

A) hepatomegaly.
B) hypercalcemia.
C) pituitary adenoma.
D) hyperglycemia.

Question 7

Which of the following statements is characteristic of hyperparathyroidism?

A) It is characterized by low blood levels of calcium.
B) It is characterized by high levels of blood phosphorous.
C) Primary hyperparathyroidism occurs when calcium is abnormally excreted by the kidneys and the parathyroid glands increase their production of parathyroid hormone to maintain adequate blood levels of calcium.
D) Kidney failure is the most common cause of secondary hyperparathyroidism.

Question 8

Diabetes is characterized by abnormally high blood ___________ levels.

A) phosphorus
B) calcium
C) glucose
D) neutrophil

Question 9

The most common cause of death among patients with diabetes is:

A) stroke.
B) gangrene.
C) heart attack.
D) kidney failure.

Question 10

Which of the following statements is true of type 1 diabetes?

A) It is called noninsulin-dependent diabetes mellitus.
B) About 30% of all patients with diabetes have type 1 diabetes.
C) The onset of this type of diabetes is gradual and usually occurs in patients who are 35 to 40 years of age or older.
D) It can be complicated by polydipsia, polyuria, and polyphagia.

Question 11

Byetta is:

A) an oral product for treatment of type 1 diabetes.
B) a form of insulin derived from pigs.
C) a medication that has the potential to help restore the response of the body's insulin-producing cells.
D) delivered with a pump that provides the medication on the hour over a 24-hour period.

Question 12

The red blood cells appear _______ and _________ in cases of iron-deficiency anemia.

A) microcytic; hypochromic
B) microcytic; hyperchromic
C) macrocytic; hypochromic
D) macrocytic; hyperchromic

Question 13

Insulin is manufactured by:

A) fatty tissue in long bones.
B) beta cells of the pancreas.
C) the liver.
D) the gallbladder.

Question 14

Iron-deficiency anemia may first result in loss of _______ papillae on the dorsum of the tongue because they have the highest metabolic requirement.

A) filiform
B) fungiform
C) circumvallate
D) foliate

Question 15

Which of the following clinical features is associated with hyperthyroidism?

A) Gigantism
B) Exophthalmus
C) Myxedema
D) Hypercalcemia

Question 16

Excess production by the anterior pituitary gland is called:

A) hyperparathyroidism.
B) hyperthyroidism.
C) hyperpituitarism.
D) hyperglycemia.

Question 17

________________ is characterized by insufficient production of adrenal steroids.

A) Addison disease
B) Addison syndrome
C) Cushing disease
D) Cushing syndrome

Question 18

An enlarged tongue is associated with:

A) hyperpituitarism.
B) hyperthyroidism.
C) hypothyroidism.
D) hyperparathyroidism.

Question 19

Characteristics of acromegaly include:

A) an increase in growth hormone production before the closure of long bones.
B) a rapid and dramatic onset.
C) thinned lips and microglossia.
D) enlargement of the maxilla and mandible, resulting in separation of the teeth and malocclusion.

Question 20

Hyperparathyroidism may result in bone lesions that appear microscopically to be indistinguishable from (a/an):

A) osteogenic sarcoma.
B) osteoma.
C) cemento-osseous dysplasia.
D) central giant cell granuloma.

Question 21

Thrombocytopenic purpura results from:

A) a defect in the capillary walls.
B) a disorder of platelet function.
C) a severe reduction in circulating platelets.
D) a reduction in white blood cells.

Question 22

A "hair-on-end" pattern may be noted on skull radiographs of a patient with:

A) polycythemia.
B) aplastic anemia.
C) sickle cell anemia.
D) thalassemia.

Question 23

Mediterranean or Cooley anemia:

A) is caused by the deficiency of vitamin B₁₂.
B) has a sex-linked inheritance pattern and occurs predominantly in males.
C) is called thalassemia major in the homozygous form.
D) is caused byva dietary deficiency of folic acid.

Question 24

Which of the following statements is true of primary aplastic anemia?

A) It is caused by a virus.
B) The bone marrow failure is the result of a drug or chemical agent.
C) It is associated with chemotherapy, radioactive isotopes, radium, or radiant energy.
D) The cause is unknown.

Question 25

Because of an abnormal type of hemoglobin in the red blood cells of a patient with sickle cell anemia, the cells develop a sickle shape in the presence of:

A) low blood sugar.
B) decreased oxygen.
C) wheat gluten.
D) increased carbon dioxide.

Question 26

A megaloblastic anemia is characterized by red blood cells that are:

A) hypochromic and microcytic.
B) hyperchromic and macrocytic.
C) microcytic and have nuclei.
D) macrocytic and have nuclei.

Question 27

Which of the following statements is true concerning acute lymphoblastic leukemia versus acute myeloblastic leukemia?

A) Acute lymphoblastic leukemia primarily affects children and young adults and has a poor prognosis.
B) Acute myeloblastic leukemia primarily affects children and young adults and has a poor prognosis.
C) Acute lymphoblastic leukemia primarily affects children and young adults and has a good prognosis.
D) Acute myeloblastic leukemia primarily affects children and young adults and has a good prognosis.

Question 28

The Philadelphia chromosome is associated with:

A) acute lymphoblastic leukemia.
B) acute nonlymphoblastic leukemia.
C) chronic lymphoblastic leukemia.
D) chronic granulocytic leukemia.

Question 29

A platelet count of less than __________/mm³ is considered thrombocytopenia.

A) 20,000
B) 100,000
C) 150,000
D) 400,000

Question 30

A "salt and pepper" effect may be noted on intraoral radiographs of a patient with which of the following types of anemia?

A) Sickle cell anemia
B) Aplastic anemia
C) Thalassemia
D) Pernicious anemia

Question 31

Leukopenia most commonly involves:

A) neutrophils.
B) basophils.
C) eosinophils.
D) monocytes.

Question 32

Thalassemia is a disorder:

A) caused by an abnormal type of hemoglobin in red blood cells.
B) hemoglobin synthesis.
C) caused by a severe depression of bone marrow activity.
D) caused by an increase in the number of circulating red blood cells.

Question 33

The Schilling test detects an inability to absorb an oral dose of vitamin __.

A) B₆
B) B₁₂
C) C
D) E

Question 34

The normal laboratory value for prothrombin time is:

A) 1-3 seconds.
B) 11-16 seconds.
C) 25-40 seconds.
D) 1-6 minutes.

Question 35

Which of the following statements is true concerning polycythemia vera?

A) It may be caused by living at high altitudes or an elevation in carbon monoxide.
B) Causes include use of diuretics, vomiting, diarrhea, or excessive sweating.
C) It occurs primarily in children.
D) The cause is unknown.

Question 36

Pernicious anemia is caused by a deficiency of intrinsic factor, which is secreted by:

A) beta cells of the pancreas.
B) parietal cells of the stomach.
C) the gallbladder.
D) the suprarenal glands.

Question 37

Which of the following disorders of red blood cells and hemoglobin is associated with sensitivity to dietary gluten found in wheat and wheat products?

A) Aplastic anemia
B) Polycythemia vera
C) Secondary polycythemia
D) Celiac sprue

Question 38

The International Normalized Ratio (INR) is an expression of the ratio of prothrombin time to:

A) fibrinogen.
B) thromboplastin activity.
C) proaccelerin.
D) proconvertin.

Question 39

Polycythemia vera is caused by:

A) a neoplastic proliferation of bone marrow stem cells.
B) a physiologic response to decreased oxygen.
C) decreased plasma volume.
D) smoking.

Question 40

_______________ is an autosomal-dominant inherited disorder of platelet function.

A) Bruton disease
B) von Willebrand disease
C) DiGeorge syndrome
D) Hemophilia

Question 41

Type A hemophilia is caused by a deficiency of factor _____.

A) VII.
B) VIII.
C) IX.
D) X.

Question 42

Which of the following drugs may be taken during the course of radiation treatment to reduce the severity of radiation-induced xerostomia?

A) Prednisone
B) Pilocarpine hydrochloride
C) Aspirin
D) Nonsteroidal antiinflammatory drugs

Question 43

Which of the following statements is true concerning X-linked congenital agammaglobulinemia?

A) T cells do not mature.
B) Plasma cells are normal.
C) B cells do not mature.
D) B cells are normal.