Deck 9: Oral Manifestations of Systemic Diseases

Question 1

An enlarged tongue is associated with

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

Answer 1

hypothyroidism.

Question 2

The most common cause of death among patients with diabetes is

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

Answer 2

heart attack.

Question 3

Which statement is characteristic of hyperparathyroidism?

A) It is characterized by low blood levels of calcium.
B) It is characterized by high levels of blood phosphorus.
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.

Answer 3

Kidney failure is the most common cause of secondary hyperparathyroidism.

Question 4

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

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.

Question 5

Excess production by the anterior pituitary gland is termed

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

Question 6

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 7

Thalassemia is

A) caused by an abnormal type of hemoglobin in red blood cells.
B) a disorder of 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 8

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 9

Which statement 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.

Question 10

A "salt and pepper" effect may be noted on intraoral radiographic images of a patient with which type of anemia?

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

Question 11

A "hair-on-end" pattern may be noted on skull radiographic images of a patient with

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

Question 12

The most common cause of hyperpituitarism is

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

Question 13

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 14

Mediterranean or Cooley anemia

A) is caused by a 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 by a dietary deficiency of folic acid.

Question 15

Which statement about type 1 diabetes is true?

A) It is called non-insulin-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 16

Insulin is manufactured by

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

Question 17

A megaloblastic anemia is characterized by red blood cells that are

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

Question 18

Which clinical feature is associated with hyperthyroidism?

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

Question 19

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 adrenal glands.

Question 20

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

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

Question 21

Which medication can decrease the severity of radiation-induced xerostomia in patients with oral cancer?

A) Bisphosphonates
B) Cyclosporine
C) Indomethacin
D) Pilocarpine hydrochloride

Question 22

Which disorder 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 23

Bisphosphonate therapy is used to treat all diseases except one. Which is the exception?

A) Hyperparathyroidism
B) Osteoporosis
C) Multiple myeloma
D) Metastatic breast cancer

Question 24

The Philadelphia chromosome is associated with _____________________ leukemia.

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

Question 25

Which statement concerning polycythemia vera is true?

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

Question 26

Leukopenia most commonly involves

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

Question 27

Which is not a chronic disorder associated with sensitivity to dietary gluten?

A) Celiac disease
B) Gluten-sensitive enteropathy
C) Celiac sprue
D) Sickle cell trait

Question 28

A malignant neoplasm of the hematopoietic stem cells and characterized by an excessive number of abnormal white blood cells is termed

A) leukemia.
B) hemophilia.
C) thrombocytopenic purpura.
D) DiGeorge syndrome.

Question 29

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 30

The recommended treatment for folic acid and vitamin B?? deficiency anemias is

A) surgery.
B) dietary supplements.
C) medications.
D) radiation therapy.

Question 31

Thrombocytopenic purpura results from a

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

Question 32

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 33

Which statement about primary aplastic anemia is true?

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 34

Osteonecrosis of the maxilla and mandible is a complication associated with what type of drug?

A) Phenytoin
B) Nifedipine
C) Bisphosphonate
D) Cyclosporine

Question 35

Which drug 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 anti-inflammatory drugs

Question 36

Type A hemophilia is less common than type B hemophilia. Type A hemophilia is caused by a deficiency of the clotting factor called plasma thromboplastinogen or factor VIII.

A) Both statements are true.
B) Both statements are false.
C) The first statement is true; the second is false.
D) The first statement is false; the second is true.

Question 37

The normal laboratory value for prothrombin time is

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

Question 38

In aplastic anemia, patients experience a dramatic decrease in all the circulating blood cells because of a severe depression of bone marrow activity.

A) Both the statement and reason are correct and related.
B) Both the statement and reason are correct but not related.
C) The statement is correct, but the reason is not.
D) The statement is not correct, but the reason is correct.
E) Neither the statement nor the reason is correct.

Question 39

Which statement 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 40

A reddish-blue or purple discoloration of the skin or mucosa that results from spontaneous extravasation of blood and is caused by an increase in capillary fragility or a deficiency in blood platelets is termed

A) hemophilia.
B) Bruton disease.
C) purpura.
D) pernicious anemia.

Question 41

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 42

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

A) B6
B) B12
C) C
D) E

Question 43

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

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

Question 44

All are clinical features of gigantism except one. Which is the exception?

A) Headache
B) Chronic fatigue
C) Extreme height
D) Gastrointestinal issues

Question 45

Myxedema is caused by _____________ of the ____________ gland.

A) hypersecretion; thyroid
B) hyposecretion; thyroid
C) hypersecretion; adrenal
D) hyposecretion; adrenal

Question 46

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 47

Which system consists of a group of integrated glands and cells that secrete hormones?

A) Endocrine
B) Viral
C) Neoplastic
D) Immune

Question 48

Which vitamin is needed for deoxyribonucleic acid (DNA) synthesis and, when lacking, affects the development of rapidly dividing cells in bone marrow and epithelium?

A) Thiamin
B) Vitamin B12
C) Riboflavin
D) Vitamin C

Question 49

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

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

Question 50

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

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

Question 51

All terms describe a decrease in circulating red or white blood cells except one. Which is the exception?

A) Thrombocytopenia
B) Anemia
C) Hypochromic
D) Neutropenia

Question 52

Diabetes is characterized by abnormally high blood _________ levels.

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

Question 53

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

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

Question 54

Elevated blood levels of calcium, low levels of blood phosphorus, and abnormal bone metabolism are characteristic of which endocrine disorder?

A) Hyperpituitarism
B) Hyperthyroidism
C) Hypothyroidism
D) Hyperparathyroidism

Question 55

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

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

Question 56

Which type of hyperparathyroidism is the result of an overproduction of parathyroid hormone (PTH) in response to long-term decreased levels of serum calcium often associated with chronic renal disease?

A) Primary hyperparathyroidism
B) Secondary hyperparathyroidism
C) Tertiary hyperparathyroidism
D) Familial hyperparathyroidism

Question 57

All statements are true regarding type 2 diabetes mellitus except one. Which is the exception?

A) It is non-insulin-dependent.
B) The majority of patients are diagnosed with type 2 diabetes.
C) Contributing factors include a decrease in metabolic rate and weight gain.
D) Complications include polydipsia, polyuria, and polyphagia.

Question 58

Which term describes an opposite condition to anemia?

A) Polycythemia
B) Arthralgia
C) Hemolysis
D) Neutropenia

Question 59

Which condition necessitates emergency intervention?

A) Hemostasis
B) Ketoacidosis
C) Insulin shock
D) Myalgia

Question 60

______________ is characterized by insufficient production of adrenal steroids.

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

Question 61

Oral manifestations of a person with Addison disease include which finding?

A) Intraoral melanotic macules
B) Gingival hyperplasia
C) Tooth mobility
D) Macroglossia

Question 62

Persons with acromegaly may experience an enlargement of the maxillary sinuses that may lead to what condition?

A) Deeper voice
B) Nasal septum deformities
C) Perforation of the oral mucosa
D) Maxillary molars requiring endodontic treatment

Question 63

For each vocabulary word below, select the corresponding definition from the list provided.
Polycythemia

A)Severe pain in a joint
B)Reduction of the number of red blood cells
C)Chronic excessive thirst and intake of fluid
D)Small, flat, hemorrhagic patch larger than a petechia on the skin
E)Cell surface protein to which a specific molecule (e.g., a hormone) can bind
F)Stoppage or cessation of bleeding
G)Decrease in number of granulocytes
H)Muscle pain
I)Insoluble protein that is essential for the clotting of blood
J)Platelet
K)Enlargement of the liver
L)Increase in the total red blood cell mass in the blood
M)Abnormal rarefaction of bone
N)Decrease in the number of platelets in circulating blood

Question 64

For each vocabulary word below, select the corresponding definition from the list provided.
Hepatomegaly

A)Severe pain in a joint
B)Reduction of the number of red blood cells
C)Chronic excessive thirst and intake of fluid
D)Small, flat, hemorrhagic patch larger than a petechia on the skin
E)Cell surface protein to which a specific molecule (e.g., a hormone) can bind
F)Stoppage or cessation of bleeding
G)Decrease in number of granulocytes
H)Muscle pain
I)Insoluble protein that is essential for the clotting of blood
J)Platelet
K)Enlargement of the liver
L)Increase in the total red blood cell mass in the blood
M)Abnormal rarefaction of bone
N)Decrease in the number of platelets in circulating blood

Question 65

Physical characteristics of a person with type 1 diabetes include all except one. Which is the exception?

A) Peak age of 50 years
B) Thin body build
C) Polydipsia, polyuria, polyphagia
D) Abrupt onset

Question 66

For each vocabulary word below, select the corresponding definition from the list provided.
Ecchymosis

A)Severe pain in a joint
B)Reduction of the number of red blood cells
C)Chronic excessive thirst and intake of fluid
D)Small, flat, hemorrhagic patch larger than a petechia on the skin
E)Cell surface protein to which a specific molecule (e.g., a hormone) can bind
F)Stoppage or cessation of bleeding
G)Decrease in number of granulocytes
H)Muscle pain
I)Insoluble protein that is essential for the clotting of blood
J)Platelet
K)Enlargement of the liver
L)Increase in the total red blood cell mass in the blood
M)Abnormal rarefaction of bone
N)Decrease in the number of platelets in circulating blood

Question 67

For each vocabulary word below, select the corresponding definition from the list provided.
Fibrin

A)Severe pain in a joint
B)Reduction of the number of red blood cells
C)Chronic excessive thirst and intake of fluid
D)Small, flat, hemorrhagic patch larger than a petechia on the skin
E)Cell surface protein to which a specific molecule (e.g., a hormone) can bind
F)Stoppage or cessation of bleeding
G)Decrease in number of granulocytes
H)Muscle pain
I)Insoluble protein that is essential for the clotting of blood
J)Platelet
K)Enlargement of the liver
L)Increase in the total red blood cell mass in the blood
M)Abnormal rarefaction of bone
N)Decrease in the number of platelets in circulating blood

Question 68

Secondary hyperparathyroidism occurs when calcium is abnormally excreted by the liver. The most common cause of secondary hyperparathyroidism is liver failure.

A) Both statements are true.
B) Both statements are false.
C) The first statement is true; the second statement is false.
D) The first statement is false; the second statement is true.

Question 69

In infants, facial and oral changes in hypothyroidism include these characteristics except one. Which is the exception?

A) Thickened lips
B) Delayed eruption of teeth
C) Macroglossia
D) Exophthalmos

Question 70

For each vocabulary word below, select the corresponding definition from the list provided.
Anemia

A)Severe pain in a joint
B)Reduction of the number of red blood cells
C)Chronic excessive thirst and intake of fluid
D)Small, flat, hemorrhagic patch larger than a petechia on the skin
E)Cell surface protein to which a specific molecule (e.g., a hormone) can bind
F)Stoppage or cessation of bleeding
G)Decrease in number of granulocytes
H)Muscle pain
I)Insoluble protein that is essential for the clotting of blood
J)Platelet
K)Enlargement of the liver
L)Increase in the total red blood cell mass in the blood
M)Abnormal rarefaction of bone
N)Decrease in the number of platelets in circulating blood

Question 71

For each vocabulary word below, select the corresponding definition from the list provided.
Thrombocyte or mucous membrane

A)Severe pain in a joint
B)Reduction of the number of red blood cells
C)Chronic excessive thirst and intake of fluid
D)Small, flat, hemorrhagic patch larger than a petechia on the skin
E)Cell surface protein to which a specific molecule (e.g., a hormone) can bind
F)Stoppage or cessation of bleeding
G)Decrease in number of granulocytes
H)Muscle pain
I)Insoluble protein that is essential for the clotting of blood
J)Platelet
K)Enlargement of the liver
L)Increase in the total red blood cell mass in the blood
M)Abnormal rarefaction of bone
N)Decrease in the number of platelets in circulating blood

Question 72

For each vocabulary word below, select the corresponding definition from the list provided.
Receptor

A)Severe pain in a joint
B)Reduction of the number of red blood cells
C)Chronic excessive thirst and intake of fluid
D)Small, flat, hemorrhagic patch larger than a petechia on the skin
E)Cell surface protein to which a specific molecule (e.g., a hormone) can bind
F)Stoppage or cessation of bleeding
G)Decrease in number of granulocytes
H)Muscle pain
I)Insoluble protein that is essential for the clotting of blood
J)Platelet
K)Enlargement of the liver
L)Increase in the total red blood cell mass in the blood
M)Abnormal rarefaction of bone
N)Decrease in the number of platelets in circulating blood

Question 73

For each vocabulary word below, select the corresponding definition from the list provided.
Polydipsia

A)Severe pain in a joint
B)Reduction of the number of red blood cells
C)Chronic excessive thirst and intake of fluid
D)Small, flat, hemorrhagic patch larger than a petechia on the skin
E)Cell surface protein to which a specific molecule (e.g., a hormone) can bind
F)Stoppage or cessation of bleeding
G)Decrease in number of granulocytes
H)Muscle pain
I)Insoluble protein that is essential for the clotting of blood
J)Platelet
K)Enlargement of the liver
L)Increase in the total red blood cell mass in the blood
M)Abnormal rarefaction of bone
N)Decrease in the number of platelets in circulating blood

Question 74

When a patient is taking long-term antibiotic therapy, what is a common oral manifestation that may be seen?

A) Risk of candidiasis
B) Xerostomia
C) Tooth discoloration
D) Gingival enlargement

Question 75

For each vocabulary word below, select the corresponding definition from the list provided.
Myalgia

A)Severe pain in a joint
B)Reduction of the number of red blood cells
C)Chronic excessive thirst and intake of fluid
D)Small, flat, hemorrhagic patch larger than a petechia on the skin
E)Cell surface protein to which a specific molecule (e.g., a hormone) can bind
F)Stoppage or cessation of bleeding
G)Decrease in number of granulocytes
H)Muscle pain
I)Insoluble protein that is essential for the clotting of blood
J)Platelet
K)Enlargement of the liver
L)Increase in the total red blood cell mass in the blood
M)Abnormal rarefaction of bone
N)Decrease in the number of platelets in circulating blood

Question 76

Identify a common nutritional deficiency associated with anemia:

A) Calcium
B) Phosphorus
C) Iron
D) Vitamin D

Question 77

Which condition may cause children to demonstrate premature exfoliation of the primary dentition as well as premature eruption of the permanent teeth?

A) Diabetes
B) Hyperthyroidism
C) Hypothyroidism
D) Hyperparathyroidism

Question 78

Children affected with hyperthyroidism may demonstrate which characteristic?

A) Lack of energy
B) Fatigue
C) Hyperactivity
D) Dry skin

Question 79

For each vocabulary word below, select the corresponding definition from the list provided.
Osteoporosis

A)Severe pain in a joint
B)Reduction of the number of red blood cells
C)Chronic excessive thirst and intake of fluid
D)Small, flat, hemorrhagic patch larger than a petechia on the skin
E)Cell surface protein to which a specific molecule (e.g., a hormone) can bind
F)Stoppage or cessation of bleeding
G)Decrease in number of granulocytes
H)Muscle pain
I)Insoluble protein that is essential for the clotting of blood
J)Platelet
K)Enlargement of the liver
L)Increase in the total red blood cell mass in the blood
M)Abnormal rarefaction of bone
N)Decrease in the number of platelets in circulating blood

Question 80

Skin and mucosal pallor, angular cheilitis, and loss of filiform and fungiform papilla on the tongue are characteristics of what condition?

A) Type 1 diabetes
B) Cretinism
C) Graves' disease
D) Anemia