Practice Questions Flashcards
47 yo man sees his dentist for a routine checkup. His gums bleed easily while brushing his teeth and he has marked gingival recession with erythema, along with extensive plaque and calculus formation over tooth surfaces. Which of the following organisms is msot likely to be associated with the development of his oral lesions? A. Actinobacillus B. Candida C. Epstein-Barr virus D. Herpes simplex virus E. Human papillomavirus F. Mucor circinolloides
A. Actinobacillus
oral flora changes in periodontitis
A 17 yo girl notices small, sensitive, grey/white area forming around the lateral border of her tongue 2 days before the end of her final examinations. ON examination by the PA, the girl is febrile. There is a shallow, ulcerated, 0.3 cm lesion with an erythematous rim. No specific therapy is given and the lesion disappears within 2 weeks. The history shows the girl does not use tobacco or alcohol. Which of the following is the most probably diagnosis. A. Aphthous ulcer B. Herpes simplex stomatitis C. Leukoplakia D. Oral thrush E. Sialadenitis
A. Aphthous ulcer
Canker sore. Tend to occur during periods of stress. Not infectious; probably autoimmune in origin.
A 55 yo woman notes a nodule while rubbing her tongue on the side of her mouth. On physical examination by her dentist, there is a firm, nontender 0.6 cm nodule covered by pink buccal mucosa at the bite line next to the first molar on the lower right. The lesion is excised and does not recur. What is the most likely diagnosis? A. Candidiasis B. Fibroma C. Leukoplakia D. Pyogenic granuloma E. Sialadenitis
B. Chronic irritation is the most likely cause for an irritation fibroma of the buccal mucosa, which is d/t connective tissue hyperplasia
A 23 yo primigravida has noticed a rapidly enlarging nodule next to a tooth for the past 16 days. On physical examination there is a 1cm, soft, reddish, pedunculated mass above the left upper bicuspid. She is adviced that the lesion will likely regress. Which of the following pathologic findings is most likely found in this lesion? A. Granulation tissue B. Lymphoid proliferation C. Neutrophilic exudate D. Rhabdomyosarcoma E. Squamous hyperplasia
A. A pyogenic granuloma may begin to enlarge abruptly and increase in size rapidly, which can be alarming but the process is benign and often regressive, or resolves into fibrous CT.
A 25 yo man notices several 0.3 cm, clear vesicles on his upper lip after a bout of influenza. The vesicles rupture, leaving shallow, painful ulcers that heal over the course of 10 days. Three months later, after a skiing trip, similar vesicles develop, with the same pattern of healing. Which of the following microscopic findings is most likely to be associate with these lesions? A. budding cells with pseudohyphae B. Mononuclear inflammatory infiltrates C. Neutrophils within abcesses D. Squamous epihtelial hyeprkeratosis E. Intranuclear inclusions
E.
A 35 yo HIV+ male complains of a bad taste in his mouth and discoloration of his tongue for the past 6 weeks. On physical examination, there are areas of adherent, yellow-to-grey, circumscribed plaque on the lateral aspects of the tongue. This plaque can be scraped off to show as a pseudomembrane to show an underlying granular, erythematous base. What is the most likely diagnosis? A. Aphthous ulcer B. Cheliosis C. Hairy Leukoplakia D. Herpetic stomatitis E. Leukoplakia F. Oral thrush
F. Oral thrush
A 42 yo man has had a constant bad taste in his mouth for the past month. On PE there are white fluffy patches on the sides of the tongue. These cannot be scraped off. A biopsy is taken and on microscopic examination shows squamous epithelial hyperkeratosis, parakeratosis, and koilocytosis. Immunohistochemical staining for EBV is positive. Which of the following is the most likely risk factor for his oral lesions?
C. HIV Infection
