Deck 2: Inflammation and Repair

Question 1

When formation of exudate is excessive, a drainage tract may develop through the injured tissue. This channel is often termed

A) a fistula.
B) leukocytosis.
C) erythema.
D) emigration.

Answer 1

a fistula.

Question 2

All statements are true concerning the neutrophil except that the neutrophil is

A) the first cell at the site of injury.
B) the primary cell in acute inflammation.
C) the primary cell in chronic inflammation.
D) a phagocyte.

Answer 2

the primary cell in chronic inflammation.

Question 3

Which cell is the first to arrive at the site of injury and is the primary cell type involved in acute inflammation?

A) Macrophage
B) Neutrophil
C) Plasma cell
D) Mast cell

Answer 3

Neutrophil

Question 4

Which symptom is not a classic local sign of inflammation?

A) Redness
B) Swelling
C) Leukocytosis
D) Loss of normal tissue function

Question 5

Which system mediates inflammation by causing increased dilation of the blood vessels at the site of injury and increases the permeability of local blood vessels?

A) Kinin system
B) Clotting system
C) Complement system
D) Lysosomal enzymes

Question 6

The first response of the body to injury is

A) anaphylaxis.
B) erythema.
C) fever.
D) inflammation.

Question 7

The enlargement of lymph nodes is termed

A) atrophy.
B) lymphadenopathy.
C) hyperplasia.
D) leukocytosis.

Question 8

A patient comes to the office for an emergency visit complaining of a toothache in the left posterior mandible. On clinical examination you notice a gray-to-white patch on the left posterior buccal mucosa. On questioning, the patient tells you that this area is also painful. After reviewing the patient's medical history, you question the patient regarding his recent use of

A) hydrogen peroxide.
B) aspirin.
C) antibiotics.
D) mouthwash.

Question 9

A decrease in the size and function of a cell, a tissue, an organ, or the body is referred to as

A) emigration.
B) atrophy.
C) hyperplasia.
D) phagocytosis.

Question 10

The wearing away of tooth structure during mastication is termed

A) attrition.
B) erosion.
C) abrasion.
D) abfraction.

Question 11

Which term describes white blood cells adhering to the walls of a blood vessel during inflammation?

A) Margination
B) Pavementing
C) Leukocytosis
D) Emigration

Question 12

The first microscopic event in the inflammatory response is

A) decreased blood flow.
B) constriction of the microvasculature.
C) phagocytosis.
D) dilation of microvasculature.

Question 13

A white raised line observed on the buccal mucosa along the occlusal plane of the teeth is most likely

A) cheek biting.
B) linea alba.
C) white sponge nevus.
D) frictional keratosis.

Question 14

Serous exudate is composed of which material(s)?

A) Tissue debris and many white blood cells
B) Suppuration
C) Plasma fluids and proteins with a few white blood cells
D) Plasma fluids and red blood cells

Question 15

The loss of tooth structure seen in bulimia is caused by

A) anorexia.
B) erosion.
C) attrition.
D) bruxism.

Question 16

Which symptom is a systemic sign of inflammation?

A) Redness
B) Pain
C) Loss of normal tissue function
D) Fever

Question 17

Healing of an injury with little tissue loss, such as a surgical incision, is referred to as healing by which type of intention?

A) Tertiary
B) Keloid
C) Secondary
D) Primary

Question 18

Which medication is a steroidal anti-inflammatory drug?

A) Aspirin
B) Prednisone
C) Ibuprofen
D) Motrin

Question 19

Neutrophils constitute what percentage of the entire white blood cell population?

A) 5%
B) 20%
C) 65%
D) 90%

Question 20

Which type of inflammation occurs when the injury is minimal and brief and its source is removed from the tissue?

A) Acute
B) Chronic
C) Local
D) Systemic

Question 21

Epulis fissuratum is caused by

A) denture adhesive products.
B) poor suction in the palatal vault.
C) poor denture hygiene.
D) an ill-fitting denture flange.

Question 22

This granular, erythematous papillary surface of the palatal vault was caused by

A) poor oral hygiene.
B) an ill-fitting suction area of a maxillary denture.
C) the denture flange.
D) soaking the denture in caustic rinses.

Question 23

The most common site for the development of a pulp polyp is

A) the occlusal surface of a large open carious tooth.
B) the apex of the tooth.
C) the gingival margin of the tooth.
D) deep in the pulp canal.

Question 24

Which term is defined as an increase in the number of cells in a tissue or organ?

A) Hypertrophy
B) Atrophy
C) Hyperplasia
D) Repair

Question 25

The first sign of attrition is

A) open contacts.
B) disappearance of mamelons on incisors.
C) temporomandibular joint dysfunction.
D) biomechanical forces on the teeth.

Question 26

Which habit is not a cause of abrasion?

A) Pipe placement by smokers
B) Playing wind instruments
C) Holding needles or pins with the teeth
D) Frequent sucking of lemons

Question 27

Excessive scarring in skin is termed

A) a keloid.
B) healing by primary intention.
C) a hematoma.
D) healing by tertiary intention.

Question 28

Which lesion occurs on the gingiva or alveolar process and contains many multinucleated giant cells, red blood cells, and chronic inflammatory cells?

A) Ranula
B) Central giant cell granuloma
C) Fibroma
D) Peripheral giant cell granuloma

Question 29

This lesion on the palate is typically associated with heavy pipe and cigar smoking and is termed

A) tobacco pouch keratosis.
B) necrotizing sialometaplasia.
C) nicotine stomatitis.
D) frictional keratosis.

Question 30

Which does not cause gingival enlargement?

A) Hormonal changes
B) Calcium channel blockers
C) Hereditary factors
D) Nitroglycerin

Question 31

This type of erosion is classically associated with

A) anorexia nervosa.
B) bulimia.
C) sucking lemons.
D) abrasive toothpaste.

Question 32

Which choice is most likely to result in frictional keratosis?

A) High-fiber diet
B) Chewing on an edentulous ridge
C) Malignancy
D) Daily use of mouthwash

Question 33

Necrotizing sialometaplasia is thought to result from

A) lack of blood supply to the affected salivary gland.
B) a sialolith.
C) trauma to the floor of the mouth.
D) pleomorphic adenoma.

Question 34

Aspirin burn on the oral mucosa

A) is caused by ingestion of too many aspirin tablets.
B) is caused by placing the aspirin on the tooth with the toothache, causing the surrounding mucosa to become necrotic.
C) is painless.
D) requires a biopsy for diagnosis.

Question 35

The major cause of a mucocele is

A) a sialolith.
B) salivary duct obstruction.
C) trauma to a minor duct.
D) allergic reaction.

Question 36

Which inflammatory periapical lesion is most painful?

A) Periapical abscess
B) Periapical granuloma
C) Radicular cyst
D) Residual cyst

Question 37

The diagnosis of a traumatic ulcer is usually based on

A) history of the lesion.
B) scalpel biopsy.
C) therapeutic procedures.
D) laboratory tests.

Question 38

Resorption of tooth structure from outside the tooth is termed

A) internal resorption.
B) external resorption.
C) idiopathic tooth resorption.
D) condensing osteitis.

Question 39

Electric burns in the oral area are usually seen in which patient group?

A) Electricians
B) Infants and young children
C) Elderly
D) Individuals involved in an electrical fire

Question 40

Traumatic neuroma is a lesion caused by injury to which structure?

A) The epithelium
B) A peripheral nerve
C) A salivary gland
D) Striated muscle

Question 41

Each habit is most likely to result in frictional keratosis except one. Which is the exception?

A) Chronic cheek biting
B) Chewing on an edentulous ridge
C) Cigarette smoking
D) Tongue chewing

Question 42

Repair of bone injury is similar to the process that takes place in fibrous connective tissue except that it involves the creation of bone tissue. The removal of osteoblast-producing tissues and excessive movement of the bone promote bone healing.

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 43

A process during inflammation in which white blood cells move to the blood vessel wall is termed

A) chemotaxis.
B) margination.
C) leukocytosis.
D) transudate.

Question 44

In cases of healing, if an infected injury is left open and the edges are not surgically joined until the infection is controlled; this process is referred to as healing by _________ intention.

A) primary
B) secondary
C) tertiary

Question 45

These elongated folds of tissue are a result of irritation from an ill-fitting denture. The accurate diagnosis for this lesion is

A) palatal papillomatosis.
B) gingival hyperplasia.
C) chronic hyperplastic pulpitis.
D) epulis fissuratum.

Question 46

If the source of injury has been completely removed, the inflammation and immune responses in the tissues are completed in which time frame?

A) One day after removal of injury
B) Two days after removal of injury
C) Seven days after removal of injury
D) Two weeks after removal of injury

Question 47

Each statement regarding the atrophy of tissue cells is true except one. Which is the exception?

A) Atrophied cells are capable of returning to their normal size after stress is removed.
B) Atrophy can occur with changes in cellular growth, malnutrition, ischemia, or hormonal changes.
C) Atrophy can be present in the muscular wasting that occurs in some chronic diseases that do not allow for mobility.
D) Atrophy occurs in the smooth muscles of the uterus and the mammary glands in response to pregnancy.

Question 48

During the acute inflammatory process, the second type of white blood cell to emigrate from the blood vessel into the injured tissue is termed

A) macrophage.
B) neutrophil.
C) plasma cell.
D) lymphocyte.

Question 49

Hyperemia is responsible for which two clinical signs of inflammation?

A) Emigration and pain
B) Heat and erythema
C) Transudation and redness
D) Swelling and chemotaxis

Question 50

The inflammatory response is a dynamic process, continually changing in response to injury and repair. Repair of tissue occurs only if the persistent source of injury is removed.

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 51

Which statement is characteristic of erosion?

A) It is a pathologic wearing away of tooth structure that results from a repetitive mechanical habit.
B) It is caused by local factors such as occlusal interferences in combination with stress and tension.
C) If tooth structure is lost around a restoration, the restoration will appear raised from the surrounding demineralized tooth structure.
D) Its first clinical sign is the disappearance of mamelons on the anterior teeth and the flattening of occlusal cusps on the molar teeth.

Question 52

A tooth must be extracted if internal root resorption is present and a perforation occurs.

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 53

During inflammation, pain may be caused by which microscopic event?

A) Phagocytosis
B) Leukocytosis
C) Exudate formation
D) Anaphylaxis

Question 54

An example of an irreversible cellular response that occurs during tissue injury is termed

A) atrophy.
B) hypertrophy.
C) hyperplasia.
D) necrosis.

Question 55

Aspirin burn to the oral mucosa appears as

A) white.
B) pigmented.
C) bulbous.
D) papillary.

Question 56

This sessile-based lesion is on the gingiva of a 13-year-old female. It is soft to palpation and bleeds easily. The accurate diagnosis for this lesion is

A) peripheral giant cell granuloma.
B) pyogenic granuloma.
C) traumatic neuroma.
D) irritation fibroma.

Question 57

A wedge-shaped defect at the cervical area of a tooth, the cause of which is related to microfracture of the tooth structure in areas of concentration of stress, is termed

A) attrition.
B) erosion.
C) abrasion.
D) abfraction.

Question 58

Each factor may impair healing except one. Which is the exception?

A) Tobacco use
B) Staphylococcus
C) Nutritional supplements
D) Renal failure

Question 59

The decrease in size and function of a cell, tissue, organ or body describes

A) atrophy.
B) hypertrophy.
C) hyperemia.
D) regeneration.

Question 60

The most likely cause of a ranula is

A) inflammation of gland tissue.
B) blockage of blood supply.
C) trauma to a minor duct.
D) salivary duct obstruction.

Question 61

Hyperemia is responsible for which two clinical signs of inflammation?

A) Erythema and swelling
B) Erythema and heat
C) Swelling and pain
D) Pain and loss of normal tissue function

Question 62

Frequent vomiting seen in patients with bulimia can result in generalized erosion of which tooth surface?

A) Buccal
B) Lingual
C) Mesial
D) Distal

Question 63

The fluid with a high protein content that leaves the microcirculation during the inflammatory process is termed

A) transudate.
B) margination.
C) exudate.
D) pavementing.

Question 64

Local factors that impair healing include the following except one. Which is the exception?

A) Hemorrhage into the tissues
B) Excessive moving of the injured tissue
C) Increased scar tissue
D) Poor blood supply

Question 65

An increase in blood viscosity reveals

A) blood moving quickly through the vessels.
B) decreased amounts of red blood cells.
C) increase in plasma fluid.
D) thicker blood unable to flow as normal.

Question 66

Chronic hyperplastic pulpitis presents with all symptoms except one. Which is the exception?

A) Pain
B) Can occur in primary and permanent teeth
C) Seen as a pink nodule protruding from the tooth
D) Occurs in teeth with large carious lesions

Question 67

Matured fibrous tissue seen 2 weeks after an injury appears whiter or paler at the surface of the repaired injury for what two reasons?
1) Increased granulation tissue
2) Increased numbers of collagen fibers
3) Enlarged lymphocyte population
4) Decreased vascularity

A) 1 and 2
B) 1 and 3
C) 2 and 3
D) 2 and 4

Question 68

The fluid component of blood in which the blood cells are suspended and is composed mainly of water and proteins is termed

A) plasma.
B) serous fluid.
C) transudate.
D) exudate.

Question 69

What is the treatment for a patient with linea alba?

A) Brush the affected area; recommend good oral hygiene
B) Antibiotic therapy
C) Gentle irrigation
D) No treatment required

Question 70

All of the statements refer to chronic inflammation except one. Which is the exception?

A) Duration may last weeks, months or years
B) Tissue returns to its original state
C) Heals less readily
D) Associated with functional deficiencies

Question 71

Your patient presents with tooth structure that has been lost around occlusal restorations. The amalgam restorations appear raised from the surrounding demineralized tooth structure. Identify the traumatic injury to the teeth that has occurred:

A) Attrition
B) Abrasion
C) Abfraction
D) Erosion

Question 72

Innate or natural defenses used to protect the body include the following except one. Which is the exception?

A) Intact skin
B) Components of saliva
C) Drainage of an abscess
D) Stomach acid

Question 73

Which permanent tooth would most likely demonstrate abfraction?

A) #7
B) #13
C) #18
D) #27

Question 74

Bruxism is a form of

A) abrasion.
B) attrition.
C) erosion.
D) abfraction.