Question 1

A "white" hairy tongue indicates an increase in the amount of

Accepted Answer

The increased amount of keratin on the filiform papillae gives the tongue a white appearance. Medications may affect the surface of the tongue but generally do not produce a white color. Fluoride use does not cause a "white" hairy tongue. The presence of the HPV does not cause a "white" hairy tongue.

Question 2

A medical history of a patient prescribed a calcium channel blocker may reveal which condition?

Accepted Answer

A patient taking a calcium channel blocker may exhibit gingival enlargement. A cementoma is not a result of a patient taking a calcium channel blocker. An elevated serum alkaline phosphatase level is significant for Paget disease but not for use of a calcium channel blocker. Ulcerative colitis may contribute to oral lesions but not gingival enlargement.

Question 3

Each condition is considered benign and of unknown cause except one. Which one is the exception?

Accepted Answer

Amelogenesis imperfecta represents a group of inherited conditions affecting the enamel of teeth. Hairy tongue is a benign condition of unknown cause. Migratory glossitis is a benign condition of unknown cause. Fissured tongue is a benign condition of unknown cause.

Question 4

While obtaining diagnostic information from a patient, the dental hygienist learns that the appearance of this patient's teeth is familial. The correct diagnosis is

Accepted Answer

Dentinogenesis imperfecta is a pathologic condition in which the family history plays a significant role in the diagnosis. Tetracycline staining is not a familial condition. Pulpal dysplasia is not a pathologic familial condition. Extrinsic staining is not a familial condition.

Question 5

Leukoedema is a generalized opalescence appearing on the buccal mucosa; linea alba is a dark pigmented line appearing on the buccal mucosa.

Accepted Answer

The first statement is true, and the second statement is false. Leukoedema is a generalized opalescence appearing on the buccal mucosa, as stated, but linea alba is not a dark pigmented line. The statement that leukoedema is a generalized opalescence appearing on the buccal mucosa is true; the statement that linea alba is a dark pigmented line is false. (Linea alba is a white line.) Leukoedema is a generalized opalescence appearing on the buccal mucosa, but linea alba is not a dark pigmented line.

Question 6

All conditions are associated with lingual varicosities except one. Which is the exception?

Accepted Answer

Lingual varicosities do not swell during the eating process. Red to purple enlarged vessels are seen with lingual varicosities. Lingual varicosities may be associated with varicosities in the legs. Lingual varicosities are considered an age-related condition, often seen in individuals over the age of 60.

Question 7

The term erythroplakia is best used in which context?

Accepted Answer

Erythroplakia is a descriptive clinical term for a red lesion. Microscopic diagnosis requires a biopsy. Laboratory diagnosis involves the use of clinical laboratory tests, including blood chemistries and urinalysis. Surgical diagnosis requires surgical intervention.

Question 8

The pathologic lesion seen on the dorsal surface of the tongue is characteristic of

Accepted Answer

Median rhomboid glossitis appears as a flat or slightly raised oval or rectangular erythematous area in the midline of the dorsal surface of the tongue. Fissured tongue is characterized by deep fissures or grooves. Hairy tongue has the appearance of white, elongated filiform papillae. Migratory glossitis is another name for geographic tongue and appears as patches on the lateral and dorsal surfaces of the tongue.

Question 9

The lingual thyroid is most often found in which intraoral location?

Accepted Answer

The lingual thyroid is seen as a mass in the midline of the dorsal surface of the tongue, posterior to the circumvallate papillae. The lingual thyroid is not seen on the buccal mucosa. The lingual thyroid is not found at the junction of the hard and soft palate. The lingual thyroid is not found at the labial commissures.

Question 10

Where is the common intraoral location for leukoedema?

Accepted Answer

A generalized opalescence is imparted to the buccal mucosa in leukoedema. Leukoedema is not evident on the lateral borders of the tongue. The soft palate and uvula is not a location to find leukoedema. The floor of the mouth is not a location to see leukoedema.

Question 11

What is the radiographic appearance of periapical cemento-osseous dysplasia in its earliest stage?

Accepted Answer

In stage I of periapical cemento-osseous dysplasia, the appearance is radiolucent. Radiopacities are not seen in the early stage of perioapical cemento-osseous dysplasia. In stage II, the appearance is radiolucent and radiopaque. Cotton-wool radiopacities are seen in patients with Paget disease.

Question 12

Studies have linked the presence of a lingual thyroid in association with the following life events except one. Which is the exception?

Accepted Answer

Infancy is not associated with the presence of a lingual thyroid. The emergence of a lingual thyroid is linked to hormonal changes, such as pregnancy. The emergence of a lingual thyroid is linked to hormonal changes, such as menopause. The emergence of a lingual thyroid is linked to hormonal changes, such as puberty.

Question 13

Which term describes a lesion in which parts of a whole are joined together, or fused, to make one?

Accepted Answer

Coalescence describes the process by which parts of a whole join together, or fuse, to make one. Fissured describes a cleft or groove, normal or otherwise, showing prominent depth. Diffuse describes a lesion with borders that are not well defined. Multilocular lesions are described radiographically as "soap bubbles" (i.e., a lesion with many lobes beyond the confines of one distinct area).

Question 14

Each condition is considered a variant of normal except one. Which is the exception?

Accepted Answer

Geographic tongue is characterized by diffuse areas devoid of filiform papillae. It is not a variant of normal. Melanin pigmentation is commonly seen in dark-skinned individuals and is considered a variant of normal. Linea alba is located on the buccal mucosa along the occlusal plane. It is most prominent in patients who have a clenching or bruxism habit. It is so common that it is considered a variant of normal. Retrocuspid papilla is a sessile nodule on the gingival margin of the lingual aspect of the mandibular cuspids and is considered a variant of normal.

Question 15

The eight categories that provide information leading to a definitive diagnosis are as follows: microscopic, clinical, laboratory, surgical, differential findings, radiographic, therapeutic, and

Accepted Answer

Historical information reveals past experiences that may be relevant to the diagnosis. Etiology is not a component of the definitive or final diagnosis. The chief complaint may be helpful in understanding the patient's perspective but is not considered a diagnostic tool. Treatment is decided after the definitive or final diagnosis is made, and it is not part of the information leading to the diagnosis.

Question 16

Various sizes of circumscribed elevations that contain pus are termed

Accepted Answer

Pustules are variously sized circumscribed elevations containing pus. Vesicles are elevated lesions that contain serous fluid. Papules are elevated lesions that protrude above the surface of normal surrounding tissue. Lobules are segments or lobes that are part of the whole.

Question 17

The human papillomavirus (HPV) is associated with what condition?

Accepted Answer

Verruca vulgaris (the common wart) is caused by a low-risk type of the human papillomavirus. Thrush, or pseudomembranous candidiasis, is a superficial fungal infection seen in the oral cavity. Tuberculosis is a bacterial infection caused by inhalation of airborne droplets from someone with active disease. Herpangina is caused by a coxsackie virus and is characterized by fever, sore throat and oral lesions.

Question 18

Because of its size and location, patients with a lingual thyroid may complain of

Accepted Answer

Clinical symptoms of lingual thyroid can include dysphagia, or difficulty swallowing, because of the mass located at the posterior dorsal surface of the tongue. Gingival inflammation is not associated with patients with a lingual thyroid. Intraoral ulcers are not associated with patients with a lingual thyroid. Tooth erosion is not associated with patients with a lingual thyroid.

Question 19

Urticaria is an example of a(n)

Accepted Answer

Urticaria is an immediate response to an allergen. Urticaria is not the result of a genetic disorder. Urticaria is not the result of a developmental disturbance. Urticaria is not a result of immunodeficiency.

Question 20

Your patient is diagnosed with a lingual thyroid. What is the next step on the treatment plan?

Accepted Answer

A thyroid scan should be performed to determine if the thyroid gland is functioning normally. A biopsy is not needed for a lingual thyroid because it is composed of normal thyroid tissue. Surgical removal is not recommended since this may represent the patient's functioning thyroid. Radiographic evaluation is not helpful in the confirmation of a lingual thyroid.

Quiz 1: Introduction to Preliminary Diagnosis of Oral Lesions