Question 1

Most oral cancers appear to be linked to which of the following?

Accepted Answer

Most oral cancers are associated with tobacco use, including smoking and smokeless tobacco (chewing tobacco and snuff). Other risk factors may include heavy alcohol use, exposure to sunlight (for lip cancer), and a history of human papillomavirus (HPV) infection. Herpes simplex virus, cytomegalovirus, trauma, and X-radiation do not appear to be significant risk factors for oral cancer.

Question 2

A clinical differential diagnosis of a chronic, relatively nonpainful ulcer of the hard palate would include all the following except:

Accepted Answer

Aphthous ulcers typically do not occur on the hard palate, especially when considering chronic, relatively nonpainful ulcers. They are more common on movable mucosa, not on the hard, fixed tissues. Squamous cell carcinoma, necrotizing sialometaplasia, tuberculosis, and traumatic ulcers can all present as chronic ulcers in the hard palate area.

Question 3

A 45-year-old man presented with a draining chronic abscess, the origin of which was within the mandible. A cutaneous sinus, located at the lower posterior border of the mandible, exuded pus with yellow granules. This is a typical clinical presentation of which of the following diseases?

Accepted Answer

The presenting features of a draining chronic abscess with pus and yellow granules from a cutaneous sinus located at the lower posterior border of the mandible are typical of actinomycosis. Tertiary syphilis usually presents with gummatous lesions, whereas oral tuberculosis typically presents with ulceration in the oral cavity. Mucormycosis may present with blackish necrotic tissue in the involved area.

Question 4

The dentist or hygienist, through careless physical contact, could contract all the following from a diseased patient (with oral lesions) except:

Accepted Answer

Squamous cell carcinoma is not a contagious disease that can be transmitted through physical contact. It is a type of skin cancer that develops due to prolonged exposure to sunlight or other sources of UV radiation. The other choices listed are all infectious diseases that could potentially be transmitted through physical contact with a diseased patient.

Question 5

A 52-year-old man presents with an ulcer in the floor of his mouth of 8 weeks' duration. The lesion measures 1 ´ 2 cm, is indurated, and is slightly uncomfortable for the patient. What should the clinician do at this point in time?

Accepted Answer

An ulcer in the floor of the mouth that has been present for 8 weeks and is indurated and uncomfortable should be biopsied to rule out malignancy. This is especially important in older patients who are at higher risk for oral cancer. Observation or treatment with medications such as prednisone or nystatin would not be appropriate at this point without a definitive diagnosis. Direct immunofluorescence testing may be useful in certain cases but is not the first-line approach in evaluating a potential malignancy.

Question 6

A spirochetemia is associated with which of the following?

Accepted Answer

The answer of A spirochetemia is associated with which of...

Question 7

Degranulation of IgE-coated mast cells is associated with which of the following conditions?

Accepted Answer

The answer of Degranulation of IgE-coated mast cells is associated...

Question 8

The overall 5-year survival rate for oral squamous cell carcinoma, which has only significantly improved in the past decade, is approximately:

Accepted Answer

The overall 5-year survival rate for oral squamous cell carcinoma is approximately 60%. This statistic reflects improvements in detection, treatment, and management strategies for this type of cancer over recent years.

Question 9

Which of the following, relative to syphilis, is incorrect?

Accepted Answer

The incidence of syphilis has not been dropping dramatically; in fact, many regions have reported increases in syphilis rates in recent years. Choices A, B, D, and E are correct statements regarding syphilis.

Question 10

The traumatic tongue ulceration seen in infants in association with natal teeth is known as _____ ulceration.

Accepted Answer

The traumatic tongue ulceration seen in infants in association with natal teeth is known as Riga-Fede ulceration.

Question 11

After the effects of local anesthesia began to diminish, a dental patient became aware of a painful gingival ulcer that was associated with excessive dental instrumentation. This would be an example of a(n) _____ ulcer.

Accepted Answer

An iatrogenic ulcer is caused by medical or dental treatment, such as excessive dental instrumentation.

Question 12

The combination of malformed permanent incisors and first molars suggests which of the following?

Accepted Answer

Malformed permanent incisors and first molars are commonly seen in congenital syphilis, a sexually transmitted disease caused by the bacterium Treponema pallidum. This can lead to a condition known as Hutchinson's teeth, which are smaller and more widely spaced than normal teeth, and have notched biting edges. Other complications of congenital syphilis can include deafness, blindness, and neurologic abnormalities.

Question 13

Chronic cough, productive cough, chest pain, and chronic oral ulcers would be suggestive of all the following except:

Accepted Answer

The answer of Chronic cough, productive cough, chest pain, and...

Question 14

Granulomas and granulomatous inflammation are defined microscopically by the presence in tissue of abundant numbers of which of the following?

Accepted Answer

The answer of Granulomas and granulomatous inflammation are defined microscopically...

Question 15

A patient breaks out in numerous painful oral ulcers. The patient has just recovered from lesions caused by reactivated herpes simplex virus. Which of the following diagnoses should be entertained for the new oral lesions?

Accepted Answer

The answer of A patient breaks out in numerous painful...

Question 16

The so-called traumatic granuloma that mimics oral squamous cell carcinoma clinically is most commonly seen in which of the following sites?

Accepted Answer

The traumatic granuloma, also known as a traumatic ulcerative granuloma with stromal eosinophilia (TUGSE), most commonly occurs on the tongue. It can mimic oral squamous cell carcinoma both clinically and histologically, leading to diagnostic challenges.

Question 17

The presenting clinical sign(s) of primary syphilis when it occurs in the oral/perioral region through oral-genital contact is (are):

Accepted Answer

Chronic ulceration is the typical presenting sign of primary syphilis in the oral/perioral region, characterized by a painless ulcer (chancre) at the site of infection.

Question 18

A patient with stage I oral squamous cell carcinoma of the lower lip would be expected to have a _____ prognosis.

Accepted Answer

Stage I oral squamous cell carcinoma of the lower lip is an early-stage cancer that has not spread to other parts of the body. Therefore, the prognosis is generally good with a high chance of cure. However, the treatment may still involve surgery, radiation, or chemotherapy.

Question 19

Penicillin is the drug of choice for treatment of which of the following?

Accepted Answer

Penicillin is the drug of choice for Actinomycosis, a bacterial infection that commonly affects the soft tissues of the face and neck. It is not effective for the treatment of major aphthae, tuberculosis, or histoplasmosis.

Question 20

Ziehl-Neelsen is a microscopic special stain that is used to demonstrate microorganisms (in tissue) that cause which of the following?

Accepted Answer

Ziehl-Neelsen stain is commonly used to demonstrate the acid-fast bacteria that cause tuberculosis.

Quiz 2: Ulcerative Conditions