Oral Path/Radiology

Question 1

Acantholysis, resulting from desmosome
weakening by autoantibodies directed against
the protein desmoglein, is the disease
mechanism attributed to which of the following?
A. Epidermolysis bullosa
B. Mucous membrane pemphigoid
C. Pemphigus vulgaris
D. Herpes simplex infections
E. Herpangina

Answer 1

C. In pemphigus vulgaris, autoantibodies attach to
antigens (desmoglein) found in desmosomes
that keep keratinocytes linked to each other.

Cells eventually separate from each other (acan-
tholysis), resulting in short-lived intraepithelial

vesicles/bullae.

Question 2

Papillomavirus has been found in all of the
following lesions except \_\_\_\_\_.
A. Oral papillomas
B. Verruca vulgaris of the oral mucosa
C. Condyloma acuminatum
D. Condyloma latum
E. Focal epithelial hyperplasia

Answer 2

D. Condyloma latum is one of the lesions that may
be seen in secondary syphilis, which is caused by
Treponema pallidum. All the other lesions listed
may be associated with human papillomavirus.

Question 3

Intranuclear viral inclusions are seen in tissue
specimens of which of the following?
A. Solar cheilitis
B. Minor aphthous ulcers
C. Geographic tongue
D. Hairy leukoplakia
E. White sponge nevus

Answer 3

D. Hairy leukoplakia is viral in origin and shows
intranuclear inclusions in infected epithelial
cells. Hairy leukoplakia is caused by Epstein–Barr

virus, a herpes virus. Intranuclear epithelial inclu-
sions are also seen other herpes virus infections

(e.g., herpes simplex virus infections).

Question 4

The odontogenic neoplasm, which is composed
of loose, primitive-appearing connective tissue
that resembles dental pulp, microscopically is
known as _____.
A. Odontoma
B. Ameloblastoma
C. Ameloblastic fibroma
D. Ameloblastic fibro-odontoma
E. Odontogenic myxoma

Answer 4

E. Odontogenic myxomas are connective tissue
neoplasms that contain little collagen. This gives
them an embryonic look microscopically.

Question 5

A biopsy of the lower lip salivary glands showed
replacement of parenchymal tissue by
lymphocytes. The patient also had xerostomia
and keratoconjunctivitis sicca. These findings
are indicative of which of the following?
A. Lymphoma
B. Crohn’s disease
C. Mumps
D. Sjögren’s syndrome
E. Mucous extravasation phenomenon

Answer 5

D. This triad of signs defines primary Sjögren’s syn-
drome. The patient has secondary Sjögren’s

syndrome if rheumatoid arthritis or other autoim-
mune disease is present.

Question 6

A patient seeks help for recurrent palatal pain.
She presents with multiple punctate ulcers in the
hard palate that were preceded by tiny blisters.
Her lesions typically heal in about 2 weeks and
reappear during stressful times. She has _____.
A. Aphthous ulcers
B. Recurrent primary herpes
C. Recurrent secondary herpes
D. Erythema multiforme
E. Discoid lupus

Answer 6

C. Recurrent intraoral herpes simplex infections
occur only in the hard palate and hard gingiva,

with the exception of AIDS patients. Blister (vesi-
cle) history and recurrence are also supportive of

this diagnosis.

Question 7

Conservative surgical excision would be
appropriate treatment and probably curative for
which of the following?
A. Nodular fasciitis
B. Fibromatosis
C. Fibrosarcoma
D. Rhabdomyosarcoma
E. Adenoid cystic carcinoma

Answer 7

A. Nodular fasciitis is a rapidly developing reactive
lesion that typically does not recur following

excision. Fibromatosis is an aggressive nonen-
capsulated lesion that has significant recurrence

potential. The other lesions listed are malignan-
cies and require more than simple excision to

prevent recurrence.

Question 8

On a routine radiographic exam, a well-defined
radiolucent lesion was seen in the body of the
mandible of a 17-year-old boy. At the time of
operation, it proved to be an empty cavity. This
is a(an) _____.
A. Osteoporotic bone marrow
B. Aneurysmal bone cyst
C. Odontogenic keratocyst
D. Static bone cyst
E. Traumatic bone cyst

Answer 8

E. Traumatic bone cysts characteristically occur in
the body of the mandible of teenagers. They are
pseudocysts in that they have no epithelial lining.
They are empty cavities.

Question 9

9. A 21-year-old woman went to her dentist because
   of facial asymmetry. This had occurred
   gradually over a period of 3 years. The patient
   had no symptoms. A diffusely opaque lesion was
   found in her right maxilla. All lab tests (CBC,
   alkaline phosphatase, calcium) were within

normal limits. Biopsy was interpreted as a fibro-
osseous lesion. She most likely has _____.

A. Cementoblastoma
B. Fibrous dysplasia
C. Cherubism
D. Osteosarcoma
E. Chronic osteomyelitis

Answer 9

C. Cherubism is a fibro-osseous lesion that occurs
in teenagers. Characteristically, it presents with

ill-defined margins and a “ground glass” appear-
ance radiographically. The other features

described also support this diagnosis.

Question 10

A cutaneous maculopapulary rash of the head
and neck preceded by small ulcers in the buccal
mucosa would suggest which of the following?
A. Primary herpes simplex infection
B. Rubeola
C. Varicella
D. Primary syphilis
E. Actinomycosis

Answer 10

B. The maculopapulary rash of rubeola (measles) is
preceded by the herald sign of Koplick’s spots
(punctate ulcers of the buccal mucosa).

Question 11

The idiopathic condition in which destructive
inflammatory lesions featuring necrotizing
vasculitis are seen in the lung, kidney, and
upper respiratory tract is known as _____.
A. Epidermolysis bullosa
B. Stevens–Johnson syndrome
C. Sturge–Weber syndrome
D. Wegener’s granulomatosis
E. Secondary syphilis

Answer 11

D. Destructive inflammation in the three sites noted

is characteristic of Wegener’s granulomatosis.

Question 12

The purpose of a high-voltage transformer in an
x-ray machine is to _____.
A. Decrease the tube current
B. Increase the wavelength of the x-rays
C. Improve timer accuracy
D. Increase the potential between the filament and
the cathode
E. Regulate the rate of release of photons from the
anode
F. Increase resistance in the filament

Answer 12

D. The high-voltage transformer increases the volt-
age from the line voltage to the high voltage

between the anode and cathode necessary to

impart sufficient energy to the electrons to con-
vert some of their energy into photons at the

target.

Question 13

The mean energy of an x-ray beam is influenced
by the \_\_\_\_\_.
A. Kilovoltage
B. Milliamperage
C. Voltage in the filament circuit
D. Quantity of electrons in the tube current
E. Amount of filtration
F. Two of the above
G. None of the above

Answer 13

F. The mean energy (wavelength) of an x-ray
beam is influenced by the kilovoltage setting

on the machine and the amount of built-in filtra-
tion that preferentially absorbs low-energy

photons.

Question 14

The function of the filament is to \_\_\_\_\_.
A. Convert electrons into photons
B. Convert photons into electrons
C. Release photons
D. Release electrons
E. None of the above

Answer 14

D. When heated, the filament releases electrons

thermionic emission

Question 15

The most radiosensitive of the following cells in
terms of cell killing is the \_\_\_\_\_.
A. Salivary gland acinar cell
B. Basal epithelial cell
C. Endothelial cell
D. Neuron.
E. Polymorphonuclear leukocyte.

Answer 15

B. Basal epithelial cells are the most mitotically
active of the cells on the list, and thus are the
most radiosensitive.

Question 16

The long-term histopathologic consequences to
an irradiated organ depend on _____.
A. The presence of oxygen at the time of irradiation
B. The sensitivity of the parenchymal component
C. The damage to the stromal component
D. All of the above
E. None of the above

Answer 16

D. Numbers 1, 2, and 3 are correct.

Question 17

The term ALARA refers to _____.
A. Reducing patient exposure to as low as is
reasonably achievable
B. As little as Roentgen allowed, an algorithm for
limiting patient exposure
C. A legal requirement to optimize occupational
exposure in dental radiology
D. Optimizing image quality
E. Reducing the costs of radiographic examinations

Answer 17

A. ALARA (As Low As Reasonably Achievable) is a
concept for minimizing patient and occupational
exposure.

Question 18

X-ray film is composed of _____.
A. Silver halide crystals suspended in plastic and
coated on a gelatin base
B. Sodium thiosulphate crystals and suspended
within a plastic base
C. A plastic base coated with silver halide crystals
suspended in gelatin
D. Fluorescent particles that react to x-radiation

Answer 18

C. Silver halide is not fluorescent, and thus choices

1 and 2 are incorrect.

Question 19

It is generally desirable that x-ray films be all of
the following except \_\_\_\_\_.
A. High speed
B. Fine grain size
C. Coated with emulsion on both sides
D. Sensitive to visible light

Answer 19

D. Film is sensitive to visible light but this is not a

desired characteristic like the other choices.

Question 20

You are unsure of the location of an opaque
mass seen over a molar root on a periapical
view. A second view of the same region, made
with the x-ray machine oriented more from the
mesial, reveals that the object has moved
mesially with respect to the molar roots on the
first view. The location of the object is _____.
A. Buccal to the roots
B. Lingual to the roots
C. In the same plane as the roots
D. Insufficient information to form an opinion

Answer 20

B. Use the rule of “SLOB”: Same Lingual, Opposite

Buccal.

Question 21

Cone-cutting results from \_\_\_\_\_.
A. Too great a target–film distance
B. Not selecting the proper kVp
C. Not enough time exposure
D. The x-ray machine being improperly aimed

Answer 21

D. Cone-cutting results from misalignment of the x-
ray tube. Use a film-holding device with an exter-
nal guide.

Question 22

If your radiographs start coming out too light,
it may be that \_\_\_\_\_.
A. Your exposure time is too long
B. Your developer needs changing
C. Your developer is too hot
D. The fixer needs changing
E. The films are not sufficiently washed

Answer 22

B. If proper processing procedures are followed, the
developer will become depleted with age and
need changing.

Question 23

If an unwrapped, nonprocessed x-ray film is
exposed to normal light for just a second and
then processed, it _____.
A. May still be used but will be a little dark
B. May still be used but will be a little light
C. May still be used but will be brown
D. Will be completely black
E. Will be completely clear

Answer 23

D. Visible light will expose all the silver bromide

crystals and the film will be black after proces-
sing.

Question 24

To ensure high radiographic image quality, it is
important to daily _____.
A. Check the temperature of the processing
solutions
B. Clean the processing equipment
C. Clean the intensifying screens
D. Calibrate the mA linearity

Answer 24

A. Daily check of the processing solution tempera-
ture, whether using automatic processing or

manual tanks, and comparison with the manu-
facturer’s recommended values will improve

image quality. The other procedures are useful
but can be performed less frequently.

Question 25

Radiographs of the pregnant patient _____. A. Should never be made B. Cause fetal injury C. Should only be made with triple leaded aprons on the mother’s lap D. Should be made when there is a specific need

Answer 25

D. Prudence suggests that radiographic examina- tions of a pregnant patient should be kept to a minimum consistent with the mother’s dental needs.

Question 26

``` Which of the following is a potential sequela of an acute periapical abscess? A. Central giant cell granuloma B. Peripheral giant cell granuloma C. Osteosarcoma D. Periapical granuloma E. Periapical cemento-osseous dysplasia ```

Answer 26

D. An acute exudate (pus) at the apex of a tooth will follow the path of least resistance (e.g., into sur- rounding bone, gingiva, or skin). If the offending tooth is not treated and the abscess becomes chronic, a periapical granuloma may result.

Question 27

Which of the following odontogenic cysts occurs as a result of stimulation and prolifera- tion of the reduced enamel epithelium? ``` A. Dentigerous cyst B. Lateral root cyst C. Radicular cyst D. Odontogenic keratocyst E. Gingival cyst ```

Answer 27

A. Reduced enamel epithelium that overlies the crown of an unerupted tooth may give rise to a cyst occurring in the same position. This is, by definition, a dentigerous cyst. The stimulus for cystic epithelial proliferation is unknown.

Question 28

Two cystic radiolucencies in the mandible of a 16-year-old boy were lined by thin, parake- ratinized epithelium showing palisading of ``` basal cells. All teeth were vital and the patient had no symptoms. This patient most likely has which of the following? A. Odontogenic keratocysts B. Periapical granulomas C. Periapical cysts D. Traumatic bone cysts E. Ossifying fibromas ```

Answer 28

A. The key to this question is the description of the cystic lining of thin, parakeratinized epithelium with basal cell palisading—typical of odonto- genic keratocyst. Tooth vitality, lack of symp- toms, and more than one lesion are also supportive.

Question 29

When a diagnosis of odontogenic keratocyst is made, the patient should be advised as to _____. A. The need for full-mouth extractions B. The association with colonic polyps C. The associated recurrence rate D. The likelihood of malignant transformation E. The need for additional laboratory studies

Answer 29

C. Odontogenic keratocysts are notable because of their recurrence rate, their aggressive clinical behavior, and their occasional multiplicity. When multiple, they may be part of the nevoid basal cell carcinoma syndrome.

Question 30

A painless, well-circumscribed 1 ¥ 3-cm radiolu- cent lesion with radiopaque focus was found ``` in the posterior mandible of an 11-year-old boy. Which of the following should be included in a differential diagnosis? A. Ameloblastic fibro-odontoma B. Paget’s disease C. Dentigerous cyst D. Ameloblastoma E. Langerhans cell disease ```

Answer 30

A. Ameloblastic fibro-odontoma is the only lesion listed that is lucent with opaque foci. The patient’s age is also characteristic for this lesion. Paget’s disease may show a mixed opaque- lucent pattern, but it occurs only over the age of 50 years.

Question 31

``` Herpes simplex virus is the cause of which of the following? A. Minor aphthous ulcers B. Herpetiform aphthae C. Herpes whitlow D. Herpangina E. Herpes zoster ```

Answer 31

C. Herpes whitlow is a term used for secondary herpes simplex infections that occur around the nail bed. The cause of aphthous ulcers is unknown, herpangina is caused by Coxsackie virus, and herpes zoster is caused by varicella- zoster virus.

Question 32

A 12-year-old patient presents with premature loss of primary teeth. On radiographic exam, a sharply marginated lucency is seen in the area of tooth loss. Biopsy shows a round cell infil- trate with numerous eosinophils. This would ``` suggest which of the following? A. Cherubism B. Gardner’s syndrome C. Paget’s disease D. Fibrous dysplasia E. Langerhans cell disease ```

Answer 32

E. Premature tooth loss is seen in several conditions, especially malignancies and Langerhans cell disease because of cellular invasion of the peri- odontal ligament. Sharply marginated bone lesions are characteristic of Langerhans cell disease (and Paget’s disease of the elderly). The eosinophils in a round cell infiltrate suggest Langerhans cell disease (the round cells would be Langerhans cells).

Question 33

A 15-year-old patient has a numb lower lip and pain in her right posterior mandible. A radi- ogram shows uniform thickening of the periodon- tal membrane space of tooth #30. The tooth shows abnormally increased mobility. Which one of the following should be seriously considered? A. Periapical cyst B. Periapical granuloma C. Traumatic bone cyst D. Ameloblastoma E. Malignancy

Answer 33

E. Numb lip is malignancy of the jaw until proven otherwise. About half of the patients with numb lip have associated malignancies. The other half of the patients have acute bone infections or neurologic problems.

Question 34

Which of the following signs or symptoms sug- gest a chronic benign process? ``` A. Paresthesia B. Pain C. Vertical tooth mobility D Uniformly widened periodontal membrane space E. Sclerotic bony margins ```

Answer 34

E. Sclerotic bone margins indicate a long-term, low- grade process, as it takes a considerable amount of time for bone to become radiodense. The signs and symptoms listed in A through D are associated with malignancies.

Question 35

``` Central and peripheral giant cell granulomas share which of the following features? A. Microscopic appearance B. Clinical behavior C. Recurrence rate D. Similar forms of treatment E. Radiographic appearance ```

Answer 35

A. Peripheral and central giant cell granulomas have very different clinical presentations and behaviors, but identical light microscopic features.

Question 36

Diffuse soft swelling of the lips and neck fol- lowing the ingestion of drugs, shellfish, or nuts ``` is known as _____. A. Fixed drug reaction B. Anaphylaxis C. Urticaria D. Acquired angioedema E. Contact allergy ```

Answer 36

D. Acquired angioedema is a rapidly developing allergic reaction that results in characteristic non- erythematous swelling of lips, face, and neck.

Question 37

A 7-year-old patient presents with a quadrant of teeth showing abnormal formation of both enamel and dentin. All of his other teeth appear clinically normal. Radiographically, the affected teeth can be described as “ghost teeth.” He has _____. A. Regional odontodysplasia B. Dens evaginatus C. Dentin dysplasia D. Ectodermal dysplasia E. Cleidocranial dysplasia

Answer 37

A. Regional odontodysplasia is often called “ghost teeth” because of the thin layers of dentin and enamel produced. One quadrant of teeth is affected, and the teeth are nonfunctional.

Question 38

An adult patient presents with a 0.5 ¥ 0.5-cm submucosal mass in the posterior lateral tongue. Biopsy shows a neoplasm composed of glandlike elements and connective tissue ele- ments. It is covered by normal-appearing epithe- lium. This could be which of the following? ``` A. Oral wart B. Pleomorphic adenoma (mixed tumor) C. Granular cell tumor D. Idiopathic leukoplakia E. Peripheral giant cell granuloma ```

Answer 38

B. Salivary gland tumors present as submucosal masses. The combination of epithelial and con- nective tissue elements is indicative of pleomor- phic adenomas, also known as mixed tumors. Oral warts and leukoplakias are surface or epithelial lesions. Peripheral giant cell granulomas are exclusively gingival lesions, and granular cell tumors are composed exclusively of cells with grainy or granular cytoplasm.

Question 39

Oral squamous cell carcinomas present typi- cally in which of the following ways? ``` A. Vesicular eruption B. Pigmented patch C. Inflamed pustule D. Submucosal swelling E. Indurated nonhealing ulcer ```

Answer 39

E. Oral cancers (squamous cell carcinomas) pres- ent typically as indurated nonhealing ulcers. They can also present as white patches, red patches, or irregular masses.

Question 40

A clinical differential diagnosis of an asympto- matic submucosal lump or nodule in the tongue ``` would include all the following except _____. A. Traumatic fibroma B. Neurofibroma C. Granular cell tumor D. Salivary gland tumor E. Dermoid cyst ```

Answer 40

E. The dermoid cyst occurs in the midline floor of mouth when above the mylohyoid and geniohyoid muscles, and in the neck when below the mylohyoid and geniohyoid muscles.

Question 41

``` Ectopic lymphoid tissue would most likely be found in which of the following sites? A. Hard gingiva B. Soft gingiva C. Floor of mouth D. Dorsum of tongue E. Vermilion of the lip ```

Answer 41

C. Ectopic (normal tissue, abnormal site) lymphoid tissue is commonly seen in floor of the mouth as well as in posterior lateral tongue, soft palate, and tonsilar pillar. It appears as one or more small, dome-shaped yellow nodules.

Question 42

``` The Schwann cell is the cell of origin for which of the following tumors? A. Odontogenic myxoma B. Rhabdomyoma C. Neurofibroma D. Mixed tumor E. Leiomyoma ```

Answer 42

C. The Schwann cell is of neural origin and gives rise to one of several neoplasms, including neu- rofibroma and Schwannoma.

Question 43

A 43-year-old-male patient presents with an asymptomatic anterior palatal swelling. A radi- ograph shows a 1 × 1-cm lucency and diver- gence of tooth roots #8 and #9. All teeth in the ``` area are vital. This is most likely a(an) _____. A. Periapical granuloma B. Aneurysmal bone cyst C. Nasopalatine duct cyst D. Globulomaxillary lesion E. Dermoid cyst ```

Answer 43

C. Nasopalatine duct cysts are anterior midmaxillary lesions that occur in the nasopalatine canal. The associated lucency is often heart-shaped because of the superimposition of the nasal spine over the lesion. They do not devitalize teeth.

Question 44

The globulomaxillary lesion of bone _____. A. Is associated with the crown of an unerupted tooth B. Occurs between maxillary lateral and canine teeth C. Typically causes pain D. Typically presents as a mixed lucent-opaque lesion with ill-defined margins E. Is always associated with a nonvital tooth

Answer 44

B. Globulomaxillary lesion is a clinical term used to designate any lucency that occurs between the maxillary lateral incisor and canine.

Question 45

A generalized red, atrophic tongue would sug- gest all of the following except _____. ``` A. Vitamin B deficiency B. Pernicious anemia C. Chronic candidiasis D. Iron deficiency anemia E. Peripheral giant cell granuloma ```

Answer 45

E. Peripheral giant cell granuloma is the exception here. Although it is red, it occurs only in the gin- giva. Answers A through D are the differential diagnoses for red atrophic tongue.

Question 46

``` The nevoid basal cell carcinoma syndrome includes multiple basal cell carcinomas, bone abnormalities, and which of the following? A. Osteomas B. Café-au-lait macules C. Odontogenic keratocysts D. Hypoplastic teeth E. Lymphoma ```

Answer 46

C. Multiple odontogenic keratocysts are part of the | nevoid basal cell carcinoma syndrome.

Question 47

``` All of the following characteristically present under the age of 20 except _____. A. Traumatic bone cyst B. Adenomatoid odontogenic tumor C. Ameloblastic fibroma D. Compound odontoma E. Ameloblastoma ```

Answer 47

E. The mean age for ameloblastoma is 40 years. All other lesions listed occur in children and teenagers.

Question 48

``` Oral and genital lesions are seen in patients with which of the following diseases? A. Behçet’s syndrome B. Peutz–Jegher’s syndrome C. Herpangina D. Wegener’s granulomatosis E. Hairy leukoplakia ```

Answer 48

A. Behçet’s syndrome includes lesions in the mouth, eye, and genitals. The other diseases do not affect the genitalia.

Question 49

A 32-year-old male patient presented with a 1 ¥ 2-cm macular red-blue lesion in his hard palate. The lesion was asymptomatic and had been present for an unknown duration. He had no dental abnormalities and no significant periodontal disease. This could be all the following except _____. A. Vascular malformation B. Nicotine stomatitis C. Ecchymosis D. Kaposi’s sarcoma E. Erythroplasia

Answer 49

B. Nicotine stomatitis appears as opacification of the palate, with red dots representing inflamed salivary ducts.

Question 50

Bremsstrahlung radiation results from _____. A. X-rays interacting with electrons B. Electrons interacting with electrons C. Electrons interacting with nuclei D. L shell electrons falling into the K shell E. Photons interacting with nuclei F. Photons converting into electrons

Answer 50

C. X-ray photons (Bremsstrahlung radiation) results from the interaction of high-speed electrons with tungsten nuclei in the target.

Question 51

X-rays are produced in most conventional den- tal x-ray machines _____. A. Continuously during operation B. When there is a large space charge C. Half the time during operation D. When the anode carries a negative charge E. Only when the beam is collimated F. Only during the first half of each second

Answer 51

C. X-rays are produced in most dental x-ray machines half the time (i.e., in bursts at the rate of 60 per second, each lasting 1/120th second) due to the alternating current supplied to the tube.

Question 52

Deterministic effects are those that _____. A. Show a severity of response proportional to dose B. Are seen only in the oral cavity C. Are found following exposure to low levels of radiation D. Result from particulate radiation such as alpha and beta particles, but not x-rays E. None of the above

Answer 52

A. Deterministic effects are those with dose thresh- olds, thus requiring at least moderate levels of exposure, and where the severity of response is proportional to dose.

Question 53

In the radiolysis of water, _____. A. Free radicals are formed which are nonreactive B. The presence of dissolved O2 reduces the number of free radicals C. The formation of free radicals is the “direct effect” D. The resultant free radicals may alter biological molecules E. Two of the above F. None of the above

Answer 53

E. “Direct effect” refers to production of free radi- cals from the ionization of water (C). These free radicals formed in the radiolysis of water are highly reactive and may alter biological molecules (D). The presence of oxygen increases the number of free radicals.

Question 54

``` The radiosensitivity of cells depends upon _____. A. Mitotic future B. Mitotic activity C. Degree of differentiation D. All of the above E. None of the above ```

Answer 54

D. Options A, B, and C are correct.

Question 55

``` Rectangular collimation is recommended because it _____. A. Deflects scatter radiation B. Decreases patient dose C. Increases film density D. Increases film contrast ```

Answer 55

B. Using a rectangular collimator restricts the area of the patient’s face exposed to the size of the receptor, thus reducing more than half the patient exposure.

Question 56

31. It is acceptable for the operator to hold the film in a patient’s mouth _____. A. If the patient is a child B. If the patient or parent grants permission C. If the patient has a handicap D. If no film holder is available E. Never

Answer 56

E. If someone must hold a film and the patient can- not, then it should be a family member or friend of the patient, not an x-ray operator in the dental office.

Question 57

A comparison of screen film/intensifying screen combinations with direct-exposure films reveals that screen film/intensifying screen combinations _____. A. Render less resolution B. Require more exposure C. Require special processing chemistry D. Are preferred for intraoral radiography

Answer 57

A. The dispersion of visible light from the crystals in the phosphor layer of the intensifying screen reduces image resolution compared to direct- exposure film.

Question 58

``` It is important that the film base be _____. A. Opaque B. Very rigid C. Flexible D. Completely clear E. Sensitive to x-rays ```

Answer 58

C. The base needs to be flexible to go through auto- matic processors and be put into film mounts. Usually, the base is not completely clear and it is the emulsion that is sensitive to x-rays.

Question 59

``` Excessive vertical angulation causes _____. A. Overlapping B. Foreshortening C. Elongation D. Cone-cutting ```

Answer 59

B. The film should be parallel to the long axis of the tooth and the central ray of the beam should be perpendicular to both the film and the tooth. Increasing the vertical angulation foreshortens the image of the tooth.

Question 60

To obtain the most geometrically accurate image, which of the following is false? A. The film should be parallel to the object. B. The central ray should be parallel to the object. C. The central ray should be perpendicular to the film. D. The object-to-film distance should be short. E. The object-to-anode distance should be long.

Answer 60

B. The central ray should be perpendicular to the | object.

Question 61

``` The size of the x-ray tube focal spot influences radiographic _____. A. Density B. Contrast C. Resolution D. Magnification E. Both C and D ```

Answer 61

C. The smaller the focal spot size, the greater the resolution. Density, contrast, and magnification are unchanged, other factors remaining equal.

Question 62

The primary function of developer is to _____. A. Reduce crystals of silver halide to solid silver grains B. Reduce solid silver grains to specks of silver halide C. Remove unexposed silver halide crystals D. Remove exposed silver halide crystals

Answer 62

A. Developer reduces silver bromide to solid silver | grains.

Question 63

``` If an exposed radiograph is too dark after proper development, one should _____. A. Place it back in the fixer B. Place it back in the developer C. Decrease development time D. Increase milliamperage E. Decrease exposure time F. Decrease development temperature ```

Answer 63

E. Reduce exposure time. Do not change develop- | ment parameters if they are correct.

Question 64

The radiolucent portions of the images on a processed dental x-ray film are made up of _____. A. Microscopic grains of silver halide B. Microscopic grains of metallic silver C. A gelatin on a cellulose acetate base D. Unexposed silver bromide

Answer 64

B. Silver halide in the emulsion of an exposed film is converted into grains of metallic silver in the developer.

Question 65

``` The purpose of the “penny test” is to check _____. A. Developer action B. Fixer action C. For proper development temperature D. For proper safelighting conditions ```

Answer 65

D. The “penny test” is a test of darkroom safelighting. A penny is placed on an exposed film (after removing the film from its cover) for 2 minutes and then the film is processed. If the processed film shows a lighter area on the film corresponding to the penny, then the safelighting is too bright and is fogging the film.

Question 66

Proper radiographic infection control includes all of the following except _____. A. Wearing gloves while making radiographs B. Disinfecting x-ray machine surface C. Covering working surfaces with barriers D. Sterilizing nondisposable instruments E. Sterilizing film packets

Answer 66

E. Film packets need not be sterilized because the goal is to prevent crosscontamination, not ensure that everything that goes into a patient’s mouth is sterile.

Question 67

Occlusal radiographs are useful for all of the following except _____. A. For views of the TMJ B. For displaying large segments of the mandibular arch C. When the patient has limited opening D. When there are sialoliths in the floor of the mouth E. When there is buccal-lingual expansion of the mandible

Answer 67

A. The TMJ is much too far from the occlusal plane (the location of occlusal film) to be imaged with this technique. The other choices are all proper indications for using occlusal film.

Question 68

Patient has bilateral white lines @ occlusal plane, what is primary microscopic finding?

Answer 68

Epithelial hyperkeratosis, frictional keratosis, linea alba.

Question 69

Fordyce granules is what?

Answer 69

Ectopic sebaceous gland

Question 70

Fordyce granule is what? • salivary gland • sebaceous gland • sweat gland

Answer 70

• sebaceous gland

Question 71

Varicosities in ventral tongue commonly seen in?

Answer 71

elderly

Question 72

QUESTION: What causes varices on the tongue?

Answer 72

Hypertension

Question 73

Pt with bilateral asymptomatic blue stuff under tongue? a. hemangioma b. varices

Answer 73

varices

Question 74

Pano Radiograph of mandibular gland depression:

Answer 74

``` Stafne defect (also called salivary bone cyst (another name for stafne bone cyst) on PAN) ```

Question 75

Very well-defined round radiolucency posterior mandible below inferior alveolar canal on a panoramic

Answer 75

à static bone cyst (stafne | defect)

Question 76

QUESTION: X-ray of Stafne defect,

Answer 76

salivary inclusion defect

Question 77

Attrition is

Answer 77

wearing away from natural dentition.

Question 78

All of the following cause xerostomia except? a. caries b. candidiasis c. dental attrition

Answer 78

c. dental attrition

Question 79

Most attrition of enamel is against what? a) Enamel b) Amalgam c) Hybrid resin d) Microfill resin

Answer 79

porcelain first choice | d) Microfill resin?

Question 80

All of the following reasons to restore erosion lesion except one, which one? a. prevents future erosion b. reduced sensitivity c. esthetic

Answer 80

b. reduced sensitivity

Question 81

What causes erosion?

Answer 81

Chemical, gastric reflux, & Bulimia

Question 82

Which one is a chemical cause of tooth destruction?

Answer 82

Erosion | - Type of wear from gastric acids: erosion

Question 83

Abfraction (flexure of tooth) à I

Answer 83

f it’s not too deep, don’t touch it. If deeper, fill with glass ionomer cement? Compomers

Question 84

Mobile mass initially but is now sessile (fixed):

Answer 84

indicative of malignancy

Question 85

Metastasis is most common to

Answer 85

posterior mandible.

Question 86

Discrete, non-tender, soft tissue swelling, what is it – malignancy, benign tumor, bone cancer

Answer 86

benign tumor,

Question 87

What is usually seen with affected hypertrophic filiform papillae?

Answer 87

Hairy tongue

Question 88

Causes of Hairy tongue?

Answer 88

antibiotic, corticosteroid, hydrogen peroxide - Mostly in heavy smokers, poor oral hygiene, general debilitation, hyposalivation, radiotherapy, fungal/bacterial overgrowth, certain meds.

Question 89

Which of the following is seen with hyperplastic (or was it associated with) foliate papilla: hairy tongue, Lingual tonsil hyperplasia, median rhomboid glossitis, lymphadenopathy

Answer 89

Lingual tonsil hyperplasia,

Question 90

Hyperplastic lingual tonsils may resemble which of the following? a. Epulis fissuratum. b. Lingual varicosities. c. Squamous cell carcinoma d. Median rhomboid glossitis. e. Prominent fungiform papillae.

Answer 90

c. Squamous cell carcinoma except not indurated and soft to palpation biopsy if smoker

Question 91

Loss of filliform papilla-

Answer 91

vitamin B deficiency

Question 92

Bilateral swelling of parotid cannot be caused by:

Answer 92

Anorexia | - Bilateral usually caused by infections. Unilateral - sialoliths or obstruction.

Question 93

why brush tongue?

Answer 93

to reduce odor. It removes biofilm, which can be associated with overgrowth of bacteria due to meds.

Question 94

Transillumination of soft tissues is useful in detecting which of the following problems in a child? Sialolithiasis, Koplik’s spots, aortic stenosis, sickle cell disease

Answer 94

Sialolithiasis

Question 95

``` Baby with nodules on the palatal, what is it? • bone nodulus • Epstein pearls • congenital epulus • bohn nodule ```

Answer 95

• Epstein pearls Epstein pearls are whitish-yellow cysts that form on the gums and roof of the mouth in a newborn baby.

Question 96

Neonate with numerous nodules on alveolar ridge. What is it? • Eruption cyst • Bohn’s nodule • Congenital cyst of newborn

Answer 96

Bohn’s nodule (keratin-filled cysts of salivary gland origin, on junction of hard/soft palate + buccal/lingual of dental ridges, away from midline)

Question 97

(Hutchinson triad):

Answer 97

congenital syphilis | interstitial keratitis, Hutchinson incisors, and 8th nerve deafness.

Question 98

Indents on incisal edge with narrowing at mesial and distal?

Answer 98

``` Congenital syphilis (Hutchinson’s incisors and mullberry molars) ```

Question 99

Stages of syphilis that is most infectious: primary and secondary, primary, secondary, tertiary, primary secondary and tertiary - In secondary syphilis, the bacteria have spread in the bloodstream and have reached their highest numbers.

Answer 99

primary and secondary secondary In secondary syphilis, the bacteria have spread in the bloodstream and have reached their highest numbers.

Question 100

oral lesions if lupus

Answer 100

palate, buccal mucosa, gingiva

Question 101

Which syndrome has rash on cheeks, ulcers, kidney, etc?

Answer 101

Lupus

Question 102

Which skin condition has endocarditis and glom-?

Answer 102

lupus

Question 103

Cavernous sinus problem -

Answer 103

due to infection of upper lip/canine space, infxn from max ant teeth

Question 104

Most likely to cause cavernous sinus thrombosis: valve infected by endocarditis, soft tissue abscess in upper lip

Answer 104

soft tissue abscess in upper lip (veins of face don’t | have valves)

Question 105

Which of the following causes cavernous sinus thrombosis: A) Subcutaneous abscess of upper lip B) Subcutaneous abscess of lower anterior region

Answer 105

Subcutaneous abscess of upper lip Infections in upper anterior teeth are within the "dangerous triangle" area, which is visualized by imagining a triangle with the top point about at the bridge of the nose and the two lower points on either corner of the mouth.

Question 106

Cavernous sinus infection would most likely come from, maxillary sinus, paranasal sinus, frontal sinus, anterior maxillary teeth

Answer 106

anterior maxillary teeth

Question 107

Site of infection most likely to enter cavernous sinus? Anterior triangle of face, naso-labial cyst

Answer 107

Anterior triangle of face

Question 108

Why are you afraid of having infection in anterior triangle (i.e. upper lip)?

Answer 108

Because there are valve-less veins that can send infection back to the brain.

Question 109

Danger zone of Cavernous Sinus thrombosis: What is the first signs/symptoms? a. pre-orbital swelling (bulging eye) b. loss vision c. headache

Answer 109

headache most common initial symptom of CST is a headache, which develops as a sharp pain located behind or around the eyes that steadily gets worse over time. - Symptoms often start w/ in 5- 10 days of developing an infection in the face or skull, such as sinusitis or a boil.

Question 110

``` Which space is not involved/associated with Ludwig's angina? Sublingual Submandibular Retropharyngeal Submental ```

Answer 110

Retropharyngeal

Question 111

Cellulitis most of the time is ____. Ludwig's angina is _____& a complication is edema of ______.

Answer 111

Cellulitis most of the time is unilateral. Ludwig's angina is bilateral & a complication is edema of GLOTTIS.

Question 112

Patient has bilateral submandibular infection; tongue is elevated due infection -

Answer 112

Ludwig's Angina | - Ludwig angina = bilateral cellulitis of submandibular & sublingual spaces.

Question 113

What do you need to worry about the most with Ludwig’s Angina?

Answer 113

edema of glottis

Question 114

What is the main danger in Ludwig’s angina?

Answer 114

closing of the airway

Question 115

Mandibular 2nd molar infection spreads to what space?

Answer 115

Submandibular space

Question 116

QUESTION: Infection on the mandibular buccal side of premolars is most likely to go where?

Answer 116

Submandibular space

Question 117

Infxn of mnd 2nd pm goes into

Answer 117

submandibular space

Question 118

You are extracting a mandibular 3rd molar and the distal root disappears into which space?

Answer 118

Submandibular space

Question 119

Which muscle separates 2 potential infection spaces from a maxillary 2nd molar? Buccinator or Masseter

Answer 119

Buccinator

Question 120

If you have an infection in the lateral pharyngeal space, what muscle is involved?

Answer 120

Medial pterygoid

Question 121

Inferior Alveolar Nerve tract infection involves what space?

Answer 121

Pterygomandibular space

Question 122

Strawberry tongue is seen in

Answer 122

``` scarlet fever (Also, Kawasaki disease & toxic shock syndrome) ```

Question 123

where do aphthous ulcers happen

Answer 123

``` non-keratinized usually not over bone does not form vesicles no fever, no gingivitis usually painful ```

Question 124

Patient has ulcer at mucolabial fold, it goes away and comes back, what could it be?

Answer 124

Aphthous

Question 125

Pt has occasional sores on mucolabial fold on mandibular arch that healed without scarring after a week or so?

Answer 125

Minor Aphthous | ulcer. Ulcer healing with scar tissue: major

Question 126

Ulcer on tongue that repeats every 4 months?

Answer 126

Apthous ulcer

Question 127

A chancre due to Syphilis mostly resembles: 1) Cancer 2) Herpes 3) Herpangina 4) Apthous Ulcer

Answer 127

4) Apthous Ulcer

Question 128

History of lesions that go away after 1 week –

Answer 128

recurrent aphthous ulcers

Question 129

What don’t you treat aphthous ulcers with?

Answer 129

Acyclovir | - Acyclovir: Anti-viral used to tx herpes

Question 130

Bechets syndrome produces what type of mouth lesion? Apthous Ulcers Apthous stomatitis Recurrent, herpes

Answer 130

Apthous Ulcers - Behçet disease/syndrome is a rare immune-mediated small-vessel systemic vasculitis that often presents with mucous membrane ulceration & ocular problems. Triple-symptom complex of recurrent oral aphthous ulcers, genital ulcers, and uveitis.

Question 131

desquamative gingivitis

Answer 131

lichen planus, mucous membrane pemphigoid (95%), and pemphigus

Question 132

lichen planus, mucous membrane pemphigoid (95%), and pemphigus in relationship to epithelium

Answer 132

Lichen Planus and pemphigoid = sub epithelial, and pemphigus is suprabasilar vesicle.

Question 133

acantholysis: pemphigus or pemphigoid

Answer 133

pemphigus

Question 134

Tzanck cells

Answer 134

pemphigus

Question 135

type of hypersensitivity in pemphigus

Answer 135

II

Question 136

pemphigus ABs against

Answer 136

desmoglein

Question 137

where are vesicles in pemphigus

Answer 137

suprabasilar, with acantholysis

Question 138

vesicles in pemphigoid

Answer 138

subepithelial

Question 139

acantholysis in pemphigoid?

Answer 139

no

Question 140

ABs in pemphigoid against

Answer 140

hemidesmosomes

Question 141

``` A patient has painful lesions on her buccal mucosa. A biopsy reveals acantholysis and a suprabasilar vesicle. Which of the following represents the MOST likely diagnosis? A. Pemphigus B. Psoriasis C. Erythema multiforme D. Bullous lichen planus E. Systemic lupus erythematosus ```

Answer 141

Pemphigus

Question 142

Pemphigus: which was a vesicular disease & which layer it affects?

Answer 142

Lichen Planus and pemphigoid = sub epithelial, and pemphigus | is suprabasilar vesicular disease.

Question 143

Immunofluorescence of antibodies: Pemphigus -

Answer 143

intraepithelial, desmosomes.

Question 144

Pemphigoid and pemphigus: which one comes apart | from connective tissue?

Answer 144

Pemphigoid

Question 145

Vesicular dz: If antibody is linear...

Answer 145

pemphigoid

Question 146

Vesicular dz: If antibody is fishnet...

Answer 146

pemphigus

Question 147

Immunofluorescence used for dx of: pemphigus or LP

Answer 147

pemphigus

Question 148

White film w/ positive Nikolsky –

Answer 148

pemphigus, tx w/ incisional biopsy

Question 149

Another name for chronic desquamative gingivitis?

Answer 149

Cicatricial pemphigoid

Question 150

what's targeted and destroyed in lichen planus

Answer 150

basal keratinocytes by T-cells

Question 151

inflammation cells in pemphigus

Answer 151

mixed

Question 152

inflammation cells in pemphigoid

Answer 152

eosinophils

Question 153

histo pattern in lichen planus

Answer 153

saw tooth | loss of rete pegs

Question 154

Histologically, the loss of the rete peg often is a sign of? a. pemphigus b. lichen planus c. pemphigoid d. syphilis

Answer 154

b. lichen planus - Rete pegs are the epithelial extensions that project into the underlying connective tissue in both skin and mucous membranes. Development of a "saw-tooth" appearance of the rete pegs, which is much more common in non-oral forms of lichen planus.

Question 155

Lichen planus most commonly found on

Answer 155

buccal mucosa

Question 156

Lichen planus more common in .

Answer 156

women

Question 157

Lichen planus, what do you treat with?

Answer 157

Topical corticosteroids or anti-histamines

Question 158

Young child/infant exhibits ulcerations of mouth -

Answer 158

epidermolysis bullosa pemphigus etc usually older

Question 159

A child is most likely to have which of these: pemphigus, pemphigoid, erythema multiform, epidermolysis bullosa

Answer 159

epidermolysis bullosa

Question 160

Child formed blisters/ulcerations with minor lip irritation?

Answer 160

Epidermolysis bullosa

Question 161

``` Which pemphigoid like-lesion most often in infants? Pemphigus vulgarius Pemphigoid Erythema multiform Epidermolysis bullosa ```

Answer 161

Epidermolysis bullosa - small blisters that develop from mild provocation over areas of stress—ie elbows and knees

Question 162

HIV patient with oropharyngeal candidiasis, what would you prescribe?

Answer 162

fluconazole

Question 163

Which oral medication would you give to tx vaginal candidiasis? Nystatin, griseofulvin, Monistat, Diflucan

Answer 163

Diflucan (fluconazole)

Question 164

If pt undergoes radiotherapy for cancer, the most common oral infection that necessitates drug tx in this stage is?

Answer 164

Candida albicans

Question 165

Candidiasis in cancer patients due to- chemotherapy, radionecrosis

Answer 165

chemotherapy

Question 166

Pt has multiple white patches that can be scraped off

Answer 166

candidiasis

Question 167

Oral cytology smears are MOST appropriately used for the diagnosis of

Answer 167

Pseudomembranous candidiasis

Question 168

What oral manifestation is often seen in children with HIV?

Answer 168

Candidiasis

Question 169

Systemic medication for Candida:

Answer 169

amphotericin B

Question 170

Which is associated w/ burning mouth?

Answer 170

Candida

Question 171

Lesion in the middle of tongue also pt had it on palate before and pt is healthy? Kaposi, candidiasis, Syphilis

Answer 171

candidiasis

Question 172

Symptoms of actinic cheilitis?

Answer 172

Loss of vermillion border

Question 173

How do you treat actinic cheilitis?

Answer 173

- According to wiki, its 5-fluorouracil or imquimide – block DNA synthesis, but I’m not sure if those were even answer choices.

Question 174

Actinic Chelitis:

Answer 174

lower lip shows epithelial atrophy and focal keratosis --> same as Actinic Keratosis

Question 175

``` Which of the following lesions has the greatest malignant potential? A. Leukoedema B. Lichen planus C. Actinic cheilitis D. White sponge nevus ```

Answer 175

- Actinic chelitis can lead to SCC

Question 176

``` What problem causes bilateral angular cheliits? high vertical dimension low interocclusal space high occlusal distance Low VDO ```

Answer 176

Low VDO

Question 177

Angular chelitis for dentures, you need to

Answer 177

increase interocclusal space. It’s associated with overclosure.

Question 178

Angular chelitis is caused by all of the following except: a. Fungal infection b. Decreased VDO c. Increased VDO d. Other options

Answer 178

c. Increased VDO (causes clicking of teeth) decreased VDO causes it, b/c increase interocclusal distance; also cheek biting!!)

Question 179

What problem causes bilateral angular cheliits? high vertical dimension, low interocclusal space, high occlusal distance, Low VDO

Answer 179

Low VDO

Question 180

Median rhomboid glossitis —

Answer 180

smooth red area of tongue that lacks the lingual papillae

Question 181

Healthy 36-year-old, red patch on palate, redness in middle of tongue: - Kaposi sarcoma - Syphilis - Median rhomboid glossitis - Gonorrhea

Answer 181

- Median rhomboid glossitis --> Candidiasis

Question 182

tx for primary herpes

Answer 182

palliative

Question 183

acyclovir for which herpes

Answer 183

1, 2, VZV, EBV

Question 184

ganciclovir which herpes

Answer 184

IV, for CMV

Question 185

alph herperviridae

Answer 185

HSV 1, 2, VZV

Question 186

beta herpesviridae

Answer 186

CMV, 6, 7

Question 187

gamma herpesviridae

Answer 187

EBV

Question 188

how many ppl have herpes

Answer 188

- 65-90% worldwide; 80-85% USA

Question 189

Kid with primary herpes infection. What is the age of infection? 2 y/o, 4 y/o, 8 y/o, 10 y/o

Answer 189

2 y/o

Question 190

Young person w/ fever & oral vesicles:

Answer 190

Fever = PRIMARY herpes stomatitis

Question 191

Ways to treat kid w/ herpetic gingivostomatitis EXCEPT: a. antibiotics b. gives numbing anesthetic before eating c. has pt rest and drink lots of water

Answer 191

a. antibiotics

Question 192

Herpes zoster (VZV) – _____ treats herpes labialis

Answer 192

Valacyclovir

Question 193

``` Patient gets recurrent herpetic lesions very often with gingivostomatitis. What should be done? (herpetic gingivostomatitis) Acyclovir Palliative tx Systemic antibiotics Steroids ```

Answer 193

Palliative tx - Treatment includes fluid intake, good oral hygiene and gentle debridement of the mouth. In healthy individuals, the lesions heal spontaneously in 7–14 days without scarring.

Question 194

Herpes can be diagnosed by

Answer 194

exfoliative cytology b/c a characteristic multinucleated cell appears in the smear of herpes infections.

Question 195

Recurrent intraoral herpes occurs almost exclusively on

Answer 195

mucosa overlying bone. The hard palate is the most common site.

Question 196

best med for herpes, CMV =

Answer 196

acyclovir

Question 197

Valcyclovir (Valtrex):

Answer 197

Tx for herpes simplex/herpes zoster

Question 198

where Secondary herpes?

Answer 198

lip, gingival, and palate

Question 199

Herpetic whitlow -

Answer 199

Herpes on finger - Herpetic whitlow is an intensely painful infection of the hand involving 1 or more fingers that typically affects the terminal phalanx

Question 200

Which most closely mimics dental pain: herpes zoster, CMV, herpangina

Answer 200

herpes zoster,

Question 201

Patient comes with recurrent herpetic stomatitis on the lips and history shows no signs of primary herpetic gingivostomatitis. Why?

Answer 201

Most primary infections are subclinical.

Question 202

Tx of herpetic gingivostomatitis

Answer 202

– within 3 days of onset: treat with Acyclovir 15mg/kg 5 times per day for 7 days - More than 3 days, just do palliative care (plaque removal, systemic NSAIDS, and topical anesthetics). 3 days = borderline. - Contagious when vesicles are present

Question 203

recurrent herpes infection

Answer 203

Reactivation of the primary

Question 204

QUESTION: Which disease is caused by the virus that causes acute herpetic gingivostomatitis?

Answer 204

Herpes simplex 1

Question 205

Herpes lesion intraorally, how do you treat?

Answer 205

Palliative, acyclovir? Tx is supportive—topical before eating, analgesics, maintain fluid/electrolyte balance, anti-viral agents. DO NOT GIVE CORTICOSTEROIDS.

Question 206

How is Acyclovir selective toxicity mechanism of action?

Answer 206

only phosphorylated in infected cells and inhibits viral mRNA - Acyclovir is selective and low in cytotoxicity as the cellular thymidine kinase of normal, uninfected cells does not use acyclovir effectively as a substrate.

Question 207

Post-herpetic neuralgia cause by: VZV, HSV 1, HSV 2, CMV

Answer 207

VZV | - Complication of long term shingles infection

Question 208

What does histoplasmosis oral lesion look like?

Answer 208

Recurrent herpes | - Painful, ulcer with irregular borders, similar to cancer

Question 209

Patient has upper denture, when he removes it, there is unilateral lesion on the palate. What could it be?

Answer 209

– Herpes

Question 210

Pic with half the tongue (left side) that looks like herpes lesion and other nothing on it-

Answer 210

herpes zoster

Question 211

Kaposi sarcoma by

Answer 211

herpes 8 & most likely on hard palate

Question 212

A patient has a RPD and a firm, swelling under the buccal flange midway between incisors and molars. What is it?

Answer 212

Traumatic | neuroma

Question 213

Mandibular Denture. Lump hurts & is anterior to posterior areas. What caused it?

Answer 213

Traumatic neuroma

Question 214

pyogenic granuloma, peripheral giant cell granuloma, and peripheral ossifying fibroma -- where in mouth?

Answer 214

pyogenic granuloma -- anywhere peripheral giant cell granuloma, and peripheral ossifying fibroma only gingiva and alv mucosa

Question 215

Picture said: “erythematous, bleeding swelling” mandibular swelling right next to premolars on right side?

Answer 215

pyogenic granuloma

Question 216

Pink growth on palatal between canine and 1st PM? Papilloma, pyogenic granuloma, peripheral ossifying, irritation fibroma

Answer 216

pyogenic granuloma

Question 217

Which lesion shows the most rapid change in size? * fibroma * pyogenic granuloma

Answer 217

pyogenic granuloma

Question 218

Fastest growing tumor? a. oncocytoma b. pyogenic granuloma c. pleomorphic adenoma

Answer 218

b. pyogenic granuloma

Question 219

Fast growing Lesion on gingiva that blanches and bleeds easily when pressed?

Answer 219

pyogenic granuloma

Question 220

who is giant cell granuloma common in

Answer 220

younger, female

Question 221

where is giant cell granuloma

Answer 221

anterior mx and man

Question 222

characteristics of giant cell granuloma

Answer 222

anterior max, man, | large lesion that expand the cortical plate & can resorb root + move teeth.

Question 223

Where do you find giant cells? Hyperthyroidism, Hypothyroidism, Hyperparathyroidism, Hypoparathyroid

Answer 223

Hyperparathyroidism

Question 224

Giant cell lesion found in bone, what test would you run to help with diagnosis? Bence Jones, calcium levels, Complete blood count

Answer 224

Bence Jones (from multiple myeloma)

Question 225

Giant cell lesion is most like histology of congenital epulis of the newborn. Y/N

Answer 225

NO! —Granular cell Myeloma

Question 226

most common benign neoplasm of EPITHELIAL TISSUE ORIGIN.

Answer 226

Squamous cell papilloma

Question 227

where Squamous cell papilloma

Answer 227

tongie (posterior), soft palate, gingiva, lips

Question 228

Lesion on the palate that verrucous and pedunculated -

Answer 228

Papilloma

Question 229

The causes of Verrucous xanthoma?

Answer 229

Human papilloma virus | - Xanthoma = fatty deposits under skin

Question 230

Lesion in lip with cauliflower shape:

Answer 230

Papilloma

Question 231

``` The most common between five choices? 1- Papilloma 2- Rhabdomyoma 3- Leiomyoma 4- Lymphangioma 5- Neurofibromatosis ```

Answer 231

Papilloma

Question 232

Condyloma acuminatum (genital/venereal wart) is caused by which virus?

Answer 232

HPV

Question 233

Which of the following does not have cauliflower-like, pebbly appearance? Verrucous carcinoma, fibroma, condyloma acuminatum, papilloma.

Answer 233

fibroma

Question 234

most common HPVs for genital warts

Answer 234

6 & 11 for condyloma acumintam

Question 235

Which one resembles Epilus Fissuratum –

Answer 235

Fibroma (both share trauma as etiology)

Question 236

Epulis fissuratum is most similar cellularly to: fibroma, granuloma cell tumor, etc

Answer 236

- Fibroma (and a question about how to treat a patient with old denture and epulis – usually make new denture or modify; don’t just wear same denture)

Question 237

another name for fibroma

Answer 237

Focal Fibrous Hyperplasia

Question 238

QUESTION: Fibromas are a result of what dysfunction? Neoplasia, dysplasia, hyperplasia

Answer 238

hyperplasia

Question 239

QUESTION: In most of the cases, localized fibromas are often: Dysplasia, metaplasia, anaplasia, hyperplasia

Answer 239

hyperplasia

Question 240

QUESTION: Congenital epulis histological similar to: hemangioma, lymphangioma, granular cell myoblastoma

Answer 240

granular cell myoblastoma

Question 241

Patient has congenital epulis. What is the histology most similar to?

Answer 241

Granular cell tumor

Question 242

If you have leukoplakia for biopsy, do you incise or excise for biopsy?

Answer 242

Incision | - incise multiple areas w incisional biopsy

Question 243

In smoker’s soft palate, there are red points. What could it be? Erythroplakia, initial stages of SCC, nicotinic stomatitis

Answer 243

Erythroplakia not nicotinic stomatitis because that's on hard palate

Question 244

What presents with severe dysplasia? Erythroplakia, white sponge nevus

Answer 244

Erythroplakia

Question 245

Lesion commonly with dysplasia and carcinoma in situ --

Answer 245

Erythroplakia

Question 246

SCC racially

Answer 246

least in white, worst in black men

Question 247

`Lesion that resembles SCC. 16 weeks and then disappears. a. papilloma b. keratoacanthoma c. papillary hyperplasia

Answer 247

keratoacanthoma | - skin tumor that can occur on sun-exposed areas

Question 248

Which of the following has the best survival rate? a. squamous cell carcinoma b. adenocarcinoma c. osteosarcoma

Answer 248

b. adenocarcinoma

Question 249

SCC on tongue, what you do?

Answer 249

Incisional

Question 250

What is the #1 risk factor for oral cancer?

Answer 250

Tobacco

Question 251

Most likely site for SCC? Least likely?

Answer 251

Ventrolateral tongue. palate is least

Question 252

Chewing Betel nut can lead to--> SCC, xerostomia, gingival recession

Answer 252

SCC

Question 253

Pt has been a smoker (60 pack yr. history) & has ulcer in lower lip. Ulcer is non-indurated; what’s the most probable diagnosis?

Answer 253

SCC

Question 254

Most common malignancy in the oral cavity? a. metastatic ca b. basal cell ca c. epidermoid ca d. mucoepidermoid ca e. adenoid cystic ca

Answer 254

epidermoid ca a. metastatic ca (most common malignancy found in bone) b. basal cell ca (most common type of skin cancer) c. epidermoid ca (aka SCC...I’m pretty sure this is the right answer...Xtina) d. mucoepidermoid ca (most common salivary gland carcinoma) e. adenoid cystic ca (second most common salivary gland carcinoma)

Question 255

Most malignant cancer in oral cavity?

Answer 255

Epidermoid carcinoma (SCC)

Question 256

Which is the most likely to become malignant?

Answer 256

low grade mucoepidermoid carcinoma

Question 257

What race most likely to get oropharyngeal cancer?

Answer 257

black

Question 258

What percentage gets oral cancer?

Answer 258

3% of new cancers among males & 1.6% of new cancer among females

Question 259

How many people in the US get oral cancer:

Answer 259

30,000 SSC new cases annually

Question 260

What population has the worst survival rate for SCC?

Answer 260

Black

Question 261

Lowest 5-year oral cancer survival rate?

Answer 261

black people

Question 262

``` Which one has the best prognosis? Verrucous carcinoma in vestibule verrucous carcinoma floor of mouth SCC floor of mouth SCC in other areas ```

Answer 262

Verrucous carcinoma in vestibule

Question 263

Smokeless tobacco:

Answer 263

verrucous carcinoma

Question 264

Verrucous leukoplakia -

Answer 264

HPV 16 and 18

Question 265

Most common most pathogenic location for verrucous carcinoma:

Answer 265

buccal vestibule

Question 266

``` Verrucous carcinoma presents with: • warty lesion • white ulcerated patch (that’s what it looks like on google images) • smooth pedunculated lesion • large warty mass ```

Answer 266

large warty mass- variant of SCC

Question 267

Leukoedema –

Answer 267

blue/grey/white mucosa that blanches. It disappears when stretching. Mostly bilateral. No treatment.

Question 268

A patient presents with a bilateral, grayish-white lesion of the buccal mucosa. This lesion disappears when the mucosa is stretched. Which of the following is the MOST likely condition? A. Leukoedema B. Leukoplakia C. Lichen planus D. White sponge nevus

Answer 268

Leukoedema

Question 269

philadephia chromosome 22

Answer 269

translocation, chronic myelogenous leukemia

Question 270

main pathologic finding in chronic lymphocytic leukemia

Answer 270

lymph node enlargements may be complicated by autoimmune hemolytic anemia

Question 271

20yo, bleeding gums, nruising easily | suspect what?

Answer 271

leukemia

Question 272

Patient shows up with kid that has bleeding gums, problems healing & has discomfort –

Answer 272

leukemia

Question 273

young person that is fatigued and has a jacked-up mouth, looks like multi pyrogenic granuloma, very inflamed and red gums.

Answer 273

leukemia

Question 274

Pt had erythematous and gingival enlargement over past 5 weeks. And increased report of bruising on body –

Answer 274

cause is acute | leukemia: Specifically, AML

Question 275

``` 6 years old patient has acute lymphatic leukemia (ALL). Her deciduous molar has a large carious lesion and furcation lucency. How will you treat this person? a. pulpotomy b. pulpectomy c. extraction d. nothing ```

Answer 275

extraction

Question 276

where do most malignant salivary tumors start

Answer 276

parotid

Question 277

Most common salivary gland benign major or minor:

Answer 277

Pleomorphic adenoma (benign mixed tumor)

Question 278

Most common malignant major:

Answer 278

Mucoepidermoid carcinoma

Question 279

Most common malignant minor:

Answer 279

Adenoid cystic carcinoma

Question 280

Adenoid cystic carcinoma: most common site spreads how micro pattern

Answer 280

palate spreads through perineural spaces swiss chesse micro

Question 281

swiss cheese pattern on micro

Answer 281

adenoid cystic carcinoma

Question 282

Picture of an ulcerated tumor on palate? SCC, salivary gland tumor, tori

Answer 282

salivary gland tumor don't exclude salivary sialometaplasia

Question 283

Most common salivary gland tumor:

Answer 283

Pleomorphic adenoma

Question 284

best prognosis of salivary malignancy

Answer 284

Adenoid cystic carcinoma

Question 285

Most common gland in Pleomorphic adenoma:

Answer 285

MOST COMMON SITE = MINOR GLANDS OF PALATE | *MOST COMMON TUMOR OF PAROTID GLAND*

Question 286

Which of the salivary tumor glands has the best prognosis: Mixed Tumor, Adenoid cystic carcinoma, Mucoepidormoid Carcinoma,

Answer 286

Mixed Tumor (plemomorphic adenoma), - Malig Mixed tumor & adenomatoid = worst

Question 287

which salivary tumor spreads perineurally

Answer 287

adenoid cystic carcinoma

Question 288

QUESTION: Peri-neural invasion is seen in: adenoid cystic carcinoma, Pleomorphic adenoma, low grade mucoepidermoid carcinoma, OKC

Answer 288

- ACC (adenoid) tumor has a marked tendency to invade nerves. Perineural invasion is seen in about 80% of all specimens.

Question 289

Which has swish cheese appearance?

Answer 289

Adenoid cystic carcinoma

Question 290

which salivary tumor has lymphocytes with germinal centers

Answer 290

Warthin tumor (adenolymphoma) = benign cystic tumor of the salivary glands containing abundant lymphocytes and germinal centers

Question 291

Warthin tumor is most common in what gland?

Answer 291

Parotid (don’t get mixed up with Wharton’s duct)

Question 292

most common epithelial odontogenic tumor

Answer 292

ameloblastoma

Question 293

ameloblastoma frequency stats

Answer 293

most common, most aggressive epithelial odontogenic tumor

Question 294

ameloblastoma mostly where

Answer 294

mandibular

Question 295

ameloblastoma tx

Answer 295

excision

Question 296

Ameloblastoma histology:

Answer 296

stellate reticulum | group of cells located in the center of the enamel organ of a developing tooth.

Question 297

Which one can lead to ameloblastoma?

Answer 297

Dentigerous Cyst

Question 298

What cyst is ameloblastoma most likely to stem from?

Answer 298

Dentigerous cyst

Question 299

spread of ameloblastoma

Answer 299

local invasion

Question 300

What is the most definite way to distinguish ameloblastoma from OKC? a. smear cytology b. reactive light microscopy c. reflective microscopy

Answer 300

b. reactive light microscopy

Question 301

Multiluncency in bone and ramus:

Answer 301

ameloblastoma

Question 302

X-ray: A painless, well-circumscribed radiolucency and radioopacity in the posterior mandible of 11 yrs old boy. What is the differential diagnosis?

Answer 302

Ameloblastic fibro – Odontoma

Question 303

Which lesion can become ameloblastomic? dentigerous cyst, lymphedema, epidermoid

Answer 303

dentigerous cyst

Question 304

QUESTION: Radiographic picture: upside down molar with lucency around crown, what is it?

Answer 304

Dentigerous cyst STARTS AT CEJ

Question 305

which tumor starts at CEJ

Answer 305

dentigerous cyst

Question 306

Which cyst is most likely to become neoplastic? a. dentigerous b. residual c. radicular

Answer 306

dentigerous

Question 307

Complex Odontoma –

Answer 307

irregular calcified lesions w/ no distinct tooth components

Question 308

Compound Odontoma –

Answer 308

identifiable tooth components

Question 309

Syndrome associated with multiple odontoma-

Answer 309

Gardner’s syndrome

Question 310

Picture of multiple small teeth within a radiolucency around the canine: compound odontoma, pindborg tumor, calcifying odontogenic

Answer 310

compound odontoma, - Tumor of mixed (epithelial and mesenchymal) origin is the odontoma. These calcified lesions take 1-2 general configurations. They may appear as multiple miniature or rudimentary teeth (compound odontoma).

Question 311

adenomatoid odontogenic tumor stats

Answer 311

2/3 tumor: adenomatoid odontogenic tumor: 2/3 in maxilla, 2/3 in female, 2/3 in anterior jaw assoc w unerupted teeth

Question 312

Radiolucent lesion Between maxillary canine-lateral with radiopacity inside:

Answer 312

``` adenomatoid tumor (AOT) - REMEMBER lesion goes to apex ```

Question 313

Mixed density lesion in a young child:

Answer 313

AOT

Question 314

16 y/o boy: x-ray showed maxillary anterior tooth with a radiolucency with “SPECKS” in it (yes that’s the word that was used) -

Answer 314

Adenomatoid Odontogenic Tumor

Question 315

Amelogenesis imperfecta inheritance

Answer 315

autosomal dominant.

Question 316

Pictures of teeth, premolars just erupted. Thick dentin, thin enamel, pulps not obliterated, and no teeth contact

Answer 316

– Amelogenesis imperfecta | - Amelogenesis imperfecta in X-ray shows open contacts

Question 317

Radiographic picture with large decay and radiolucency. In addition to periapical radiolucency, what another thing do you see?

Answer 317

Amelogenesis imperfecta (tooth lacks enamel)

Question 318

enamel in amelogenesis imperfecta

Answer 318

Hypoplastic pitting enamel

Question 319

“Ghost cells” -

Answer 319

keratinized calcifying odontogenic cyst

Question 320

When does enamel hypoplasia occur?

Answer 320

Altered matrix formation (BELL STAGE)

Question 321

All of the following are congenital except... a. dentinal dysplasia b. amelogenesis imperfecta c. regional odontodysplasia d. ectodermal dysplasia

Answer 321

c. regional odontodysplasia aka odontogenesis imperfecta

Question 322

Regional odontodysplasia:

Answer 322

ghost teeth. (enamel, dentin and pulp are all affected. Non hereditary, eruption is delayed or doesn’t occur)

Question 323

dentinogenesis imperfecta types

Answer 323

DI Type 1 is with osteogenic imperfecta. DI Type 2 is not with OI. DI Type 3 is the bradywine type, which occurs in absence of OI, exhibits multiple periapical radiolucency, shell-like appearance, & large pulp chambers/exposures.

Question 324

X-ray with obliterated pulp chambers

Answer 324

dentinogenesis imperfecta

Question 325

dentinal dysplasia types

Answer 325

DD Type 1 – radicular: shorter roots, obliterated pulp chamber. - DD Type 2 – coronal: pulp enlarged, “thistle” tube appearance, primary dentition appears similar to DI type II.

Question 326

What is seen with Osteogenesis Imperfecta?

Answer 326

Dentinogenesis Imperfecta

Question 327

Osteogenesis imperfecta is usually associated with/seen with? a. Dentinogenesis Imperfecta b. Amelogenesis imperfecta c. hypercementosis d. cleidocranial dysplasia

Answer 327

a. Dentinogenesis Imperfecta (DI)

Question 328

``` All of the following are differential diagnosis for Dentinogensis imperfecta except? ectodermal dysplasia amelogenesis imperfecta enamel dysplasia dentinal dysplasia enamel hypoplasia (AI) ```

Answer 328

ectodermal dysplasia

Question 329

Which is not associated with dentogenesis imperfecta?

Answer 329

Ectodermal dysplasia because the enamel is the ectoderm, dentin is mesoderm I think

Question 330

Dentinogenesis Imperfecta =

Answer 330

poorly mineralized dentin, enamel frequently fractures from the teeth leading to rapid wear and attrition of the teeth.

Question 331

Which one is associated with dentinogenesis imperfecta? • Blue sclera • hypodontia

Answer 331

• Blue sclera (this is from osteogenesis imperfecta) Other characteristics of this condition: opalescent teeth, affects both primary and permanent, teeth are bluish-brown and translucent, enamel is lost early.

Question 332

Blue sclera seen in?

Answer 332

Osteogenesis imperfecta

Question 333

Radiographs of a patient's teeth reveal that the crowns are bulbous; the pulps, obliterated; and the roots, shortened. These findings are associated with which of the following? Porphyria Pierre Robin syndrome Amelogenesis imperfecta Osteogenesis imperfecta Erythroblastosis fetalis

Answer 333

Osteogenesis imperfecta

Question 334

What is the most common? Dentinal dysplasia, amelogenesis imperfecta, dentinogenesis imperfecta, cleft lip

Answer 334

cleft lip (Cleft Lip/palate)

Question 335

Dentin dysplasia looks like dentinogenesis imperfect WITH ONE DIFFERENCE?

Answer 335

Dysplasia has radiolucency.

Question 336

12 y/o boy’s X-ray shows roots are short & open apex. Sister also has same condition. What condition is this? Dentinogenesis imperfecta Amelogenesis Imperfecta Dentin dysplasia

Answer 336

Dentin dysplasia – autosomal dominant DI - autosomal dominant AI - autosomal recessive

Question 337

A picture of dentin dysplasia –

Answer 337

Short rooted teeth with periapical lucencies

Question 338

Some teeth appear to be clinically normal, but exhibit (1) globular dentin, (2) very early pulpal obliteration, (3) defective root formation, (4) periapical granulomas and cysts, and (5) premature exfoliation. The condition is known as which of the following? ``` A. Shell teeth B. Dentin dysplasia C. Regional odontodysplasia D. Amelogenesis imperfect E. Dentinogenesis imperfecta ```

Answer 338

B. Dentin dysplasia

Question 339

conical anterior teeth

Answer 339

ectodermal dysplasia

Question 340

Ectodermal dysplasia expressed as?

Answer 340

anodontia or hypodontia, with or without a cleft lip and palate.

Question 341

Congenitally missing teeth often seen in?

Answer 341

Ectodermal dysplasia

Question 342

Ectodermal dysplasia inheritance:

Answer 342

It is X-linked, not autosomal dominant

Question 343

Characteristic of Ectodermal Dysplasia is?

Answer 343

Oligodontia (some missing teeth, > 6 teeth, not all teeth) and hypohidrotic (reduced sweating) or anhidrosis (lack of sweating)

Question 344

Ectodermal dysplasia:

Answer 344

partial or complete anodontia

Question 345

Hypohidrotic child

Answer 345

à ectodermal dysplasia | - Sweating dysfunction, abnormal reduced of sweating due to heat

Question 346

Ectodermal dysplasia and hair –

Answer 346

sparse hair

Question 347

Having hypodontia will prevent/undermine formation of what?

Answer 347

Alveolus (others were maxillary and mandibular arch but not | together)

Question 348

Hypodontia- FEWER number of teeth 1. max deficiency 2. man deficiency 3. mid-face deficiency 4. cortical bone deficiency 5. alveolar bone deficiency

Answer 348

5. alveolar bone deficiency | - Less teeth à reduced alveolar ridge development so the vertical dimension of the lower face is reduced

Question 349

Bilateral jaw expansion

Answer 349

Cherubism:

Question 350

A kid presents for bilateral enlargement, painless, etc. , what is the Tx?

Answer 350

No Tx required | they imply cherubism

Question 351

**Mccune-Albright Syndrome

Answer 351

— polyostotic fibrous dysplasia—areas radiolucent/radiopaque---potential for malignant transformation Café au lait spots (coast of Maine)—bone and skin disorder—brown spots!

Question 352

Fibrous Dysplasia on radiographs –

Answer 352

ground glass appearance, diffuse expansion of the | mandible (“orange peel”)

Question 353

Panoramic with big radiopacity? diffuse with vital tooth --- lucent with vital tooth --

Answer 353

- fibrous dysplasia: it is diffuse radiopacity-vital tooth | - osseous fibroma: radiolucent vital tooth

Question 354

35 yo female, picture of a couple of radiolucency lateral to lateral incisors, asymptomatic:

Answer 354

fibrous dysplasia | - Monostotic fibrous dysplasia may be completely asymptomatic and is often an incidental finding on x-ray

Question 355

``` Which of the following is frequently accompanied by melanin pigmentation (cafe-au- lait spots)? A. Osteomalacia B. Hyperparathyroidism C. Osteogenesis imperfecta D. Polyostotic fibrous dysplasia ```

Answer 355

D. Polyostotic fibrous dysplasia (Mccune-Albright Syndrome)

Question 356

X-ray, what is the cause of radioopacity on the apex of the infected tooth -

Answer 356

condensing osteitis

Question 357

what's one non-lucent lesion

Answer 357

Condensing osteitis (radiopaque)

Question 358

Picture said: “scalloped border, tooth is vital, patient is asymptomatic”

Answer 358

traumatic bone cyst

Question 359

Traumatic bone cyst

Answer 359

(aka simple bone cyst) = nothing inside, not a true cyst b/c not epithelial lined so pseudocyst that heals by itself. It scallops around the roots of the tooth.

Question 360

Young patient with traumatic bone cyst, what tx? None, spontaneous healing Surgical exploration curettage of the osseous socket and bony walls intralesional steroid injections

Answer 360

None, spontaneous healing

Question 361

cotton wool x ray

Answer 361

paget's | also hypercementosis and loss of lamina dur

Question 362

dentures and hats stop fitting

Answer 362

Paget's

Question 363

cancer risk with Paget's

Answer 363

osterosarcomas

Question 364

labs in Paget's

Answer 364

increased alkaline phosphatase, normal P and Ca

Question 365

Paget x ray

Answer 365

cotton wool

Question 366

Which one most likely has potential (high incidence) for malignant transformation? osteomas, Paget’s disease

Answer 366

Paget’s disease

Question 367

``` Which of the following has the potential for undergoing spontaneous malignant transformation? A. Osteomalacia B. Albright's syndrome C. Paget's disease of bone D. Osteogenesis imperfecta E. von Recklinghausen disease of bone ```

Answer 367

C. Paget's disease of bone

Question 368

Paget’s disease can lead to (malignancy)

Answer 368

osteosarcoma

Question 369

``` Radiographic picture: Floating tooth not in bone, opacities in lesion, what is it? • Whole jaw cyst • Ameloblastoma • Keratocyst • Dentigerous cyst • Langerhans X ```

Answer 369

• Langerhans X

Question 370

Hand-Schuller-Christian triad:

Answer 370

Diabetes insipidus, exophthalmos, & lytic bone lesions (Langerhans dis).

Question 371

nasolabial cyst origin

Answer 371

Not a bone cyst, occurs outside of bone & is a soft-tissue cyst

Question 372

A patient has a swelling under the upper lip that is by her lateral incisor and raises the ala of the nose from the outside. What is it?

Answer 372

Nasolabial cyst

Question 373

Radiolucency radiating from root of central incisor toward midline, could be all of the below except: lateral periodontal cyst, nasopalatine cyst, some sort of fibrous dysplasia, nasolabial cyst

Answer 373

nasolabial cyst

Question 374

nasolabial cyst on xray?

Answer 374

can't see,not in bone

Question 375

QUESTION: Lining of nasolabial cyst -

Answer 375

pseudostratified squamous (so like respiratory)

Question 376

What is the rarest cyst?

Answer 376

Lateral Periodontal Cyst

Question 377

The most common non-odontogenic cyst: a. dermoid b. thyroglossal c. lymphoepithelial d. nasopalatine duct cyst

Answer 377

d. nasopalatine duct cyst

Question 378

heart shaped cyst near central incisors

Answer 378

nasopalatine

Question 379

Nasopalatine cyst treatment?

Answer 379

Enucleation

Question 380

Intraoral picture of nasopalatine cyst by incisive papilla on backside of #7 & 8. The foramen and nasopalatine canal is where the incisive papilla is and if there’s a cyst there then what does it look like clinically?

Answer 380

Soft tissue is swelling and discolored.

Question 381

LYMPHOEPITHELIAL CYST:

Answer 381

- Usually an enlargement of the parotid or lacrimal gland

Question 382

Round yellow-white bump underneath tongue?

Answer 382

Oral lymphoepithelial cyst

Question 383

Patient (young child) w/ nodules on right side of tongue that are fluid filled the rest of the mouth is WNL, no other systemic signs a. Neurofibromatosis b. Lymphangioma c. Granular cell tumor

Answer 383

Lymphangioma

Question 384

odontogenic keratocyst characteristics

Answer 384

benign but locally aggressive usually spreads along md like a sausage other name keratocystic odontogenuc tumor high reoccurence rate

Question 385

KOT associated with syndromes

Answer 385

Gorlin's (aka basal cell nevus) , multiple OKCs

Question 386

Which highest incidence of recurrence? • Odontogenic keratocyst • Dentigerous cyst

Answer 386

• Odontogenic keratocyst | - High recurrence, Intrabony, posterior mandible but anywhere; BCNS association

Question 387

Initial treatment for OKC is enucleate or resect?

Answer 387

enucleate | - Conservative treatment generally includes simple enucleation, with or without curettage

Question 388

Nevoid basal cell carcinoma

Answer 388

(Gorlin syndrome) = commonly see multiple OKCs and palmar pitting, plantar keratosis (odontogenic keratin cyst, KCOT)

Question 389

QUESTION: Pt has calcified falx cerebri, multiple OKCs, bifid ribs. What syndrome does the patient have?

Answer 389

Gorlin Goltz syndrome aka Basal cell | bifid rib syndrome.

Question 390

What is most often seen with nevoid basal cell carcinoma?

Answer 390

Odontogenic keratocyst

Question 391

What does multiple OKC tell you?

Answer 391

Gorlin-gotz syndrome (also called basal cell nevus syndrome)

Question 392

Nevoid BCC and palmar melatonin indicative of:

Answer 392

OKC

Question 393

Which syndrome includes multiple osteomas?

Answer 393

Gardner’s (Multiple facial | osteomas & skin nodules)

Question 394

Gardner’s syndrome has

Answer 394

multiple osteoma, odontoma and intestinal polyps

Question 395

What do Gardners and Peutz-Jeghers syndrome have in common?

Answer 395

GI polyps | - GI polps in Gardner’s, Peutz-Jegher, Crohn’s

Question 396

In Gardner’s Syndrome, there may be cancerous transform of what?

Answer 396

polyps in intestine

Question 397

Peutz Jeger syndrome on lips.

Answer 397

freckles (melanosis)

Question 398

Peutz-Jeghers syndrome –

Answer 398

multiple melanotic macules and gastrointestinal polyposis

Question 399

multiple melanotic macules and gastrointestinal polyposis

Answer 399

Peutz-Jeghers syndrome –

Question 400

peak of bell's palsy

Answer 400

2 days

Question 401

unilateral eye and lip drooping, unable to close

Answer 401

bell's palsy

Question 402

most common cause

Answer 402

herpes simplex

Question 403

which cranial nerve is bell's palsy

Answer 403

7th (facial)

Question 404

cause of erythema multiforme

Answer 404

unknown

Question 405

which AB in erythema multiforme and where

Answer 405

IgM deposition in microvasculature of skin and oral mucous membranes usually after infx or drug exposure

Question 406

Target lesions?

Answer 406

``` Erythema Multiforme (also has positive nikolsky sign) - Nikolsky sign - top layers of the skin slip away from the lower layers when slightly rubbed. ```

Question 407

Blow cold air on mucosa causing a positive Nikosky sign a) erythema multiform b) herpes c) pemphigoid d) epidermolysis bullosa

Answer 407

a) erythema multiform also pemphigus

Question 408

nikolsky sign pemphigus and pemphigoid

Answer 408

pemphigus +, pemphigoid -!

Question 409

Widening of PDL and loss of mandibular ramus:

Answer 409

Scleroderma

Question 410

= limited SCLERODERMA

Answer 410

CREST Syndrome | usually only in lower arms & legs, sometimes face & throat

Question 411

Description of geographic tongue:

Answer 411

burning sensation on the tongue, moves around

Question 412

Migratory glossitis picture: red-white borders –

Answer 412

Erythema migrans

Question 413

Guy with lesions on his tongue that seem to move locations?

Answer 413

Erythema migrans

Question 414

Cause of geographic tongue:

Answer 414

unknown

Question 415

Lesion hurts after eating spicy food, has white lesions with red borders that move:

Answer 415

Geographic tongue

Question 416

round bluish lesion on side of lip

Answer 416

Oral path picture of Basal Cell carcinoma:

Question 417

Painless ulcer, upper lip, it grew bigger after 2 weeks -

Answer 417

Basal cell carcinoma

Question 418

Mucocele

Answer 418

= caused by ruptured salivary duct, commonly seen on the lower lip, & usually due to trauma. - NEVER ON THE GINGIVA

Question 419

Most common location for mucocele?

Answer 419

Lower lip

Question 420

Patient had SSC removed and now has a mucocele looking lesion on the lower lip, what is it? mucocele, fibroma, SSC

Answer 420

mucocele

Question 421

You get mucocele due to?

Answer 421

Rupture of salivary ducts (trauma related)

Question 422

Texture/consistency of dermoid cyst vs ranula:

Answer 422

dermoid is doughy/rubbery consistency while ranula is more fluctuant, bluish

Question 423

blue mass under tongue, blue nodule on the floor of mouth, fluctuant

Answer 423

ranula

Question 424

Lady presents w/ blue swelling under tongue?

Answer 424

ranula

Question 425

``` QUESTION: Ranula are due to? sialolith mucus plug trauma fibrous plug ```

Answer 425

trauma

Question 426

Trauma to floor of mouth • Mucocele • Submandibular hemangioma • Ranula

Answer 426

Ranula

Question 427

How do you treat a ranula? excisional, incisional, aspiration

Answer 427

excise (all of it)/excisional

Question 428

'sausage link appearance' on sialography

Answer 428

sialodochitis

Question 429

Sialolithiasis (calcified salivary stone) is found where?

Answer 429

Submandibular Duct (Wharton’s)

Question 430

Sialoliths are most common in what gland?

Answer 430

Submandibular gland & duct

Question 431

what causes enlarged acini

Answer 431

sialolith in duct --> sialadenitis

Question 432

``` How do you treat painful sialolith in Wharton’s duct initially? Moist heat Dilation of duct Surgically remove sublingual gland Surgically remove submand gland ```

Answer 432

Surgically remove submand gland (cannulate the duct and remove stone) (massage or lemon drops not an option) for smaller stone, moist heat is first option

Question 433

``` Patients with sialadenitis (actini enlarge) caused by sialith in the duct. It is a large, painful sialoth near the orifice of Wharton’s duct. What procedure do you do for removal? a. transoral to unblock duct b. extraoral to remove gland c. cannulation & dilation ```

Answer 433

c. cannulation & dilation (Cannulate the duct (sialotomy) to remove stone)

Question 434

mucocele vs antral pseudocyst

Answer 434

mucocele is destructive and requires surgery while the Antral Pseudocyst (mucous retention pseudocyst) does not require intervention and will dissipate. antral pseudocyst in max sinus?

Question 435

Antral Y (they also called it an “inverted Y”)

Answer 435

- A radiographic anatomical landmark: The Y line of Ennis (Inverted Y). It is created by the superimposition of the floor of the nasal cavity (straight radiopaque line) and the border of the maxillary sinus (curved radiopaque line).

Question 436

What is the inverted Y made up of?

Answer 436

Maxillary sinus & floor of nasal cavity

Question 437

What is the isthmus of Y (where nasal floor (straight radiopaque line) and maxillary sinus (curved radiopaque line) start and meet). What are the two anatomical factors that border this?

Answer 437

Floor of nasal cavity & maxillary sinus

Question 438

Photo of maxillary sinus with radiopacity in one of the sinus and you have to identify the condition:

Answer 438

mucous retention cyst --> antral cyst

Question 439

Ankylglossitis-

Answer 439

congenital oral anomaly that may decrease mobility of the tongue tip & is caused by an unusually short, thick lingual frenulum from tongue to FOM.

Question 440

Parulis

Answer 440

localized collection of pus in gingival soft tissue. Pus is produced as a result of necrosis of non-vital pulp tissue or occlusion of a deep periodontal pocket.

Question 441

Reason for parulis -

Answer 441

incomplete root canal

Question 442

Oral signs of tuberculosis

Answer 442

cervical lymph nodes, larynx, and middle ear. TB oral lesions are uncommon - usually chronic painless ulcers. Primary lesions usually enlarged lymph nodes. - Secondary lesions on tongue, palate and lip. Rare is leukoplakic areas.

Question 443

What does tuberculosis lesion in the oral cavity look like?

Answer 443

Large ulcer - Painful nonhealing indurated often multiple ulcers - Most frequently affected sites were the tongue base & gingiva. The oral lesions look like irregular ulceration or a discrete granular mass.

Question 444

positive test for blanching

Answer 444

hemangiomas

Question 445

Hemangioma excised from tongue. Which is it? Choristoma, hamartoma, teratoma

Answer 445

hamartoma

Question 446

4 yr. old kid has hemangioma on his tongue from birth. It grew at the same rate he did. What is it? chroistoma, hamartoma, teratoma

Answer 446

hamartoma HAMARTOMA- Normal tissue overgrowth. It grows at the same rate as surrounding tissues. CHORISTOMA- TISSUE overgrowth in wrong location

Question 447

ecchymosis

Answer 447

Ecchymosis - a discoloration of the skin resulting from bleeding underneath, typically caused by bruising. goes away by itself

Question 448

Allergic stomatitis of the mouth is commonly seen because of what flavors in a toothpaste?

Answer 448

Cinnamon

Question 449

Causes of allergic gingivitis include: a. flavoring in toothpaste b. food coloring in foods c. Fluoride in toothpaste

Answer 449

flavoring in toothpaste

Question 450

Patient has red gums and is told she has “plasma cell gingivitis”. Common cause is?

Answer 450

cinnamon flavoring in the dentrifice

Question 451

Child with granulomatous gingival hypertrophy and bleeding rectal-anus has what?

Answer 451

Crohn’s | - Crohn’s = chronic inflammatory bowel disease that affects the lining of the GI tract.

Question 452

Oral granulomas, apthous ulcer, rectal bleeding is seen in: a. Wegener’s granulomatosis b. ulcerative colitis c. Crohn’s disease

Answer 452

c. Crohn’s disease

Question 453

Which would be located in the floor of the mouth and be “doughy”? A Ranula B. Dermoid cyst C Lymphoepithelial cyst

Answer 453

- dermoid cyst is a firm, dough-like, sac-like growth on or in the skin that is present at birth & range in size.

Question 454

inheritance pattern of white sponge nevus

Answer 454

autosomal dominant

Question 455

White lesion on movable mucosa that you can’t wipe/stretch off?

Answer 455

leukoplakia or white sponge nevus leukoplakia presents later in life, sponge nevus usually before puberty

Question 456

Patient has bilateral white lines @ occlusal plane, what is primary microscopic finding?

Answer 456

White Sponge Nevus

Question 457

Buccal cheek of 60 yrs man, not wipeable? Leukoplakia, candida, white spongy nevus

Answer 457

white spongy nevus Leukoplakia (more on floor 50%, tongue 25%)

Question 458

trigeminal neuralgia: age

Answer 458

Average age of pain onset in trigeminal neuralgia typically is 6th decade of life, but it may occur at any age. Symptomatic or secondary trigeminal neuralgia tends to occur in younger patients > 35 years

Question 459

pain in neuralgia

Answer 459

Pain is stabbing or electric shock like sensation and is typically quite severe. Pain is brief (few seconds to 1-2 minutes) and paroxysmal, but it may occur in volleys of multiple attacks. Pain may occur several times a day; patients typically experience no pain between episodes.

Question 460

distribution of pain in trigeminal neuralgia

Answer 460

Pain is one-sided (unilateral, rarely bilateral). One or more branches of the trigeminal nerve (usually lower or midface) are involved.

Question 461

Patient feels pain on biting and feeling of fullness in maxillary posterior teeth. No decay noted, why? sinusitis, atypical trigeminal neuralgia

Answer 461

atypical trigeminal | neuralgia

Question 462

carbamazepine for pain?

Answer 462

Trigeminal Neuralgia, | do not use to treat constant, facial pain

Question 463

tx for trigeminal neuralgia

Answer 463

carbamazepine

Question 464

Maxillary sinusitis bacteria:

Answer 464

Strep pneumonia

Question 465

Drug for max sinusitis:

Answer 465

Amox with clavulanic acid (for b-lactamase strep)

Question 466

Which of the following is most likely to be interpreted as toothache by the patient?

Answer 466

Maxillary sinusitis | - can cause pain or pressure in the maxillary (cheek) area (e.g., toothache, headache)

Question 467

md anterior, vital teeth, | black 30-50yo female

Answer 467

cemento-osseous dysplasia

Question 468

X-Ray: Black women, middle aged, anterior radiolucency (can be radio opaque), vital teeth:

Answer 468

cemento osseous dysplasia, periapical | cemental dysplasia

Question 469

Most common place for periapical cemental | dysplasia:

Answer 469

Lower anteriors

Question 470

#25 has radiopaque lesion at apex. It has normal PDL, vital, tissues normal, no caries or existing restoration?

Answer 470

periapical cemento- | osseous dysplasia

Question 471

Focal Cemento-Osseous Dysplasia

Answer 471

30-50 white female | • Posterior mand / asymptomatic solitary lesion

Question 472

Peripheral Ossifying Fibroma

Answer 472

= gingival nodule composed of cellular fibroblastic connective tissue stroma, which is associated with the formation of randomly dispersed mineralized products (bone, cementum-like tissue, or dystrophic calcification).

Question 473

Which of the following reactive lesions of the gingival tissue reveals bone formation microscopically?

Answer 473

Peripheral ossifying fibroma

Question 474

Clinical picture with nodules & café au lait spots:

Answer 474

neurofibromatosis

Question 475

An adult patient presents with multiple, soft nodules and with macular pigmentation of the skin. Which of the following BEST represents this condition? a. lipomatosis b. neurofibromatosis c. metastatic malignant melanoma d. polyostotic fibrous dysplasia e. bifid rib-basal cell carcinoma syndrome

Answer 475

b. neurofibromatosis

Question 476

Which of these conditions have supernumerary teeth & lisch nodule on iris?

Answer 476

neurofibromatosis

Question 477

Neurofibromatosis clinical presentations:

Answer 477

Café au lait, lisch nodules of the iris

Question 478

Auriculotemporal syndrome

Answer 478

(Frey syndrome) - symptom where you sweat near cheek area when eating. Often after parotid surgery.

Question 479

sweating near cheek when eating

Answer 479

frey's syndrome (auriculotemporal)

Question 480

Auriculotemporal nerve is severed, what are the symptoms?

Answer 480

gustatory sweating | - Ligation of auriotemporal nerve – disrupt gustory sweating

Question 481

actoninomyces re: air

Answer 481

anaerobes

Question 482

Actinomycosis of jaw presents how?

Answer 482

Lumpy Jaw

Question 483

Actinomycosis has

Answer 483

abscess, draining fistula, & contains yellow sulfur granules. Tx is incision & drainage + antibiotics

Question 484

Which disease is most likely to cause suppuration?

Answer 484

Actinomycosis

Question 485

A patient presents with malocclusion and a unilateral, slowly progressing elongation of her face. This elongation has caused her chin to deviate away from the affected side. The MOST probable diagnosis is which of the following? A. Ankylosis B. Osteoarthritis C. Myofascial pain D. Condylar hyperplasia

Answer 485

D. Condylar hyperplasia

Question 486

Dens in dente are most commonly seen in

Answer 486

maxillary lateral incisor.

Question 487

Talon cusp is for?

Answer 487

dens evagenatus, NOT invagenalis

Question 488

Lesion looks like SCC?

Answer 488

Keratoacanthoma

Question 489

Keratosis happen where in the mouth? a. palate b. buccal mucosa c. floor of mouth d. upper lip

Answer 489

d. upper lip

Question 490

keratoacanthoma looks like

Answer 490

crater with crust inside | basal cell is more reddish and can be flat

Question 491

Sjogren’s

Answer 491

– autoimmune destroy glands

Question 492

Complications of Sjogren’s syndrome –

Answer 492

keratoconjunctivitis,

Question 493

Sjogren’s Synd associated with all EXCEPT Herpes Keratoconjunctivitis SLE

Answer 493

Herpes

Question 494

What is most common with Sjogren’s syndrome? Lymphoma, pleomorphic adenoma, increased sweating and osteoarthritis.

Answer 494

Lymphoma

Question 495

Which articular disease most often accompanies Sjogren’s syndrome? ``` A. Suppurative arthritis. B. Rheumatoid arthritis. C. Degenerative arthrosis. D. Psoriatic arthritis. E. Lupus arthritis. ```

Answer 495

B. Rheumatoid arthritis.

Question 496

Xerostomia is present in all of the following except? | Sjogren’s syndrome, Vit C. Deficiency, parotid problems

Answer 496

Vit C. Deficiency | - Xerostomia is rarely due to a vitamin deficiency

Question 497

Sjogren syndrome laboratory test:

Answer 497

SS-A / SS-B (also ANA or Rheumatoid factor)

Question 498

Secondary Sjogren Syndrome:

Answer 498

dry eye, dry mouth, rheumatoid arthritis

Question 499

Which of these are used in lab test for sjogren?

Answer 499

ANA | - Typical Sjogren’s syndrome ANA patterns are SSA/Ro and SSB/La

Question 500

Sarcoidosis:

Answer 500

abnormal collections of inflammatory cells (granulomas) that can form as nodules

Question 501

Treatment of sarcoidosis? Corticosteroids, antibiotics

Answer 501

Corticosteroids

Question 502

TB is similar to?

Answer 502

Sarcoidosis

Question 503

Sarcoidosis commonly involved organ:

Answer 503

lungs

Question 504

Sarcoidosis is mainly related to which organ?

Answer 504

predominately a pulmonary disease

Question 505

character of sarcoidosis

Answer 505

granulomatous

Question 506

osteosarcoma on x-ray

Answer 506

sunray appearance, symmetric widening of PDL

Question 507

An 18-year-old male complains of tingling in his lower lip. An examination discloses a painless, hard swelling of his mandibular premolar region. The patient first noticed this swelling 3 weeks ago. Radiograph indicate a loss of cortex and a diffuse radiating pattern of trabeculae in the mass. Which of the following is the MOST likely diagnosis? a. leukemia b. dentigerous cyst c. ossifying fibroma d. osteosarcoma e. hyperparathyroidism

Answer 507

osteosarcoma

Question 508

Most common primary malignant tumor of young people?

Answer 508

Osteosarcoma

Question 509

Osteosarcoma in x ray:

Answer 509

sun burst and symmetrical widening of PDL.

Question 510

Enlarge PDL and radiolucency at mandibular angle?

Answer 510

Osteosarcoma sunburst

Question 511

Widening of PDL is early sign of what?

Answer 511

Osteosarcoma

Question 512

Uniform widening of PDL and there is resorption in the bone: osteosarcoma, fibrous dysplasia

Answer 512

osteosarcoma

Question 513

Young patient has paresthesia and growth in mandible: is

Answer 513

going to be osteosarcoma (young patient)

Question 514

Bence-Jones proteins in urine

Answer 514

multiple myeloma (light chains)

Question 515

high protein in multiple myeloma

Answer 515

M protein

Question 516

which cells in multiple myeloma

Answer 516

monoclonal B (plasma)

Question 517

Multiple Myeloma radiographic appearance?

Answer 517

Punched out lesions

Question 518

QUESTION: 1st sign of multiple myeloma:

Answer 518

bone pain (in limbs & thoracic region)

Question 519

Usually in post. mandible, no symptoms, moves teeth, cortical expansion and root displacement, always radiolucent and honeycombed pattern

Answer 519

odontogenic myxoma

Question 520

Soap bubble lesion in x-ray, what is it? Giant cell, Odontogenic Myxoma

Answer 520

- Soap bubble lesion= odontogenic myxoma often seen with impacted tooth

Question 521

ostomyelitis appearance

Answer 521

onion skin

Question 522

Girl with caries into the pulp on tooth #3 – radiograph shows alternating RL/path at inferior border of mandible (a.k.a “onion skin”, bacterial)

Answer 522

à Garre’s Osteomyelitis aka chronic osteomyelitis

Question 523

onio skin appearance

Answer 523

Garre's (proliferative periostitis) and Ewing sarcoma

Question 524

When there is no barrier, how far does the dentist need to be for protection?

Answer 524

6 feet, 90-135 degrees

Question 525

Most of the x-ray is converted to?

Answer 525

Heat

Question 526

What is the oil in the x ray tube for? prevent rust, reduce radiation, dissipate heat to the target, lubricate

Answer 526

dissipate heat to the target

Question 527

Why is there oil in x-ray tube?

Answer 527

cools off the anode

Question 528

Thermionic emission where?

Answer 528

Cathode - Thermionic emission = electron emission from a heated metal (cathode). The cathode has its filament circuit that supplies it with necessary filament current to heat it up.

Question 529

what is the best x-ray:

Answer 529

short wavelength, high energy

Question 530

``` What is primary source of radiation to the operator when taking x-rays? radiation left in the air scatter from the patient scatter from the walls leakage from the x-ray head ```

Answer 530

scatter from the patient

Question 531

In performing normal dental diagnostic procedures, the operator receives the greatest hazard from which type of radiation? A. Direct primary-beam B. Secondary and scatter C. Gamma

Answer 531

B. Secondary and scatter

Question 532

What characterizes secondary radiation?

Answer 532

coming off the matter

Question 533

What is the max radiation dosage for a dental professional per year?

Answer 533

50msv/year or 5 rem/year | - per month = 4 msv, per week = 1 msv

Question 534

what produces heat in x ray

Answer 534

filament

Question 535

Digital image: which is digital detector?

Answer 535

Charge coupled device

Question 536

MRI uses what electromagnetic wave?

Answer 536

RADIOWAVES

Question 537

What does collimation do?

Answer 537

reduces x-ray beam size/diameter & volume of irradiated tissue, reduces area of exposure - usually with circle diameter of 2.75 in

Question 538

does collimator increase penetrability

Answer 538

no

Question 539

Collimation in x-rays -

Answer 539

reduces low energy radiation

Question 540

Collimation =

Answer 540

block (lead)

Question 541

What the collimator does:

Answer 541

reduce the 1) volume of tissue being irradiated and 2) reduce the amount of scatter radiation by 60%

Question 542

Collimation does everything except: reduce pt exposure, increase penetrability, reduce operator exposure, film fog, reduce average energy of x-rays

Answer 542

increase penetrability, reduce average energy of x-rays (energy is unchanged) - Scatter radiation decreases with change to rectangular collimator, film fog (scattered radiation that reaches the film, unwanted darkness - -> decreased by collimation decreases and image quality increases.

Question 543

Collimation controls

Answer 543

size & shape of x-ray beam

Question 544

The greatest decrease in radiation to the patient/gonads can be achieved by: a. change from D to F speed b. thyroid collar c. filtration d. collimation e. high doses low frequency

Answer 544

collimation

Question 545

Which of the following safety techniques provides the GREATEST DECREASE in overall radiation-risk to patients? A. Changing from Group D to Group E film B. Switching from round to rectangular collimation C. Using an automatic rather than manual processing switch D. Adding a cervical collar to a leaded apron

Answer 545

B. Switching from round to rectangular collimation

Question 546

By what % do you decrease radiation when you use a square collimator vs. rectangular?

Answer 546

80%

Question 547

the use of intensifying screens

Answer 547

à reduce the radiation

Question 548

X-rays filters are used for?

Answer 548

Reduced intensity of electron beam, selectively absorbs low energy photons

Question 549

Which material is used as a filter in X-ray machines? Lead, aluminum, tungsten

Answer 549

aluminum

Question 550

filter absorbs:

Answer 550

Long wavelength

Question 551

X-ray tube target metal is made out of:

Answer 551

tungsten (target = tungsten/filter = aluminum)

Question 552

Central X ray perpendicular to object but not film:

Answer 552

elongation

Question 553

Central X-ray perpendicular to film but not object:

Answer 553

foreshortening

Question 554

head too low on pan

Answer 554

maxillary anterior teeth will appear elongated & the mandibular anterior teeth will appear foreshortened.

Question 555

chin too high

Answer 555

(a lack of negative vertical angulation, the occlusal plane of the teeth will then appear horizontal or, with a positive occlusal plane, as a "frown line.") = reverse smile line

Question 556

What happens when you don’t have proper vertical angulation when taking x-rays –

Answer 556

elongation of the object

Question 557

Change in vertical angulation when taking a PA will cause what? A. Distortion B. Magnification C. Elongation or foreshortening

Answer 557

C. Elongation or foreshortening

Question 558

If you take a PA and the tooth is foreshortened, why did it happen?

Answer 558

Vertical angulation was too large

Question 559

QUESTION: Foreshortening of roots caused by

Answer 559

excess vertical angulation

Question 560

X-ray beam is perpendicular to the film, not to the tooth, =

Answer 560

foreshortening

Question 561

Overlap on bitewings due to

Answer 561

horizontal angulation

Question 562

X-ray with cone cut. What’s wrong?

Answer 562

MISALIGNED XRAY TUBE HEAD, incorrect | beam centering

Question 563

Pano – max centrals look abnormally wide –

Answer 563

position of pt head is too far back - If pt is positioned too far backward, the anterior teeth image will be so wide that the outline of the crowns cannot be discerned.

Question 564

QUESTION: Reversed occlusal plane on pano –

Answer 564

chin raised too high, patient head/chin tilted too far upward • Chin up = frown • Chin down = steeper smile

Question 565

Pano, with short upper roots?

Answer 565

Patient’s didn’t put tongue on the top of their mouth.

Question 566

Penumbra =

Answer 566

blurring at edge of structure on radiograph The area on the film that represents the image of a tooth is the umbra, or complete shadow. - The area around the umbra is called the penumbra or partial shadow. It’s the zone of unsharpness along the edge of the image; the larger it is, the less sharp the image will be.

Question 567

Fuzziness on outside of radiograph due to: • Umbra • Penumbra

Answer 567

Penumbra

Question 568

``` Penumbra is affected by all except: • Moving x-ray tube • Moving film • X-ray dimensions/field/scatter • Film-object distance (decrease) • Reduction of film target distance ```

Answer 568

Reduction of film target distance

Question 569

How does penumbra affect the contrast of an x-ray?

Answer 569

Decrease in contrast

Question 570

Penumbra – how to prevent this in x-rays:

Answer 570

decrease size of focal spot, increase source-object distance, and reducing object-film distance (should be parallel), central ray must be perpendicular to tooth, object and film, no movement.

Question 571

How to reduce penumbra? moving object, decrease object/source distance, decrease object/film distance

Answer 571

decrease object/film distance

Question 572

How do you prevent penumbra? o Should be produced from a point source to blurring of the edges of the image o Strong beam to penetrate o X-ray should be parallel

Answer 572

o X-ray should be parallel (reduce object-film distance)

Question 573

PA distortion

Answer 573

14%

Question 574

Pano distortion is:

Answer 574

25% but could range 10-30%

Question 575

What does it look like on a pano when your patient moves during the pano?

Answer 575

vertical blur line

Question 576

radioagraph position to evaluate orbital rim areas

Answer 576

Water's view kissing projection

Question 577

If you have lesion of maxillary sinus, what kind of radiograph do you take?

Answer 577

Waters

Question 578

Which is most important x-ray for diagnosis of maxillary sinus? occlusal, panoramic, MRI, Waters

Answer 578

Waters

Question 579

``` Best to see siaolilith in Wharton's? Occlusal Water's PAN PA ```

Answer 579

Occlusal

Question 580

Best imaging for sinusitis or sinus infection: CT, occlusal radiograph, PA radiograph, Panoramic.

Answer 580

CT - Know that sinuses are best viewed with Waters technique, but this was not in answer choice neither was none of the above as a choice. Answer will either be Waters or CT!

Question 581

Best diagnostic image for pathology in max sinus: waters, CT, MRI, periapical, pan

Answer 581

waters

Question 582

Which radiograph would you use to view a fracture of the mandibular symphisis?

Answer 582

Posterio-Anterior | also Mand occlusal works too. Lateral oblique for fractures in angle, body and ramus

Question 583

Best view for zygomatic arches:

Answer 583

Panoramic

Question 584

You have pano, what can’t you do without intraoral photos?

Answer 584

space analysis

Question 585

Pano: arrow pointing b/w posterior wall of maxilla and posterior wall of zygomatic process of maxilla:

Answer 585

pterygomaxillary fissure | - Tear drop shaped in max sinus - pterygomaxillary fissure ààà

Question 586

external oblique ridge on radiograph

Answer 586

running down roots on | mandibular molars

Question 587

genial tubercle on radiograph

Answer 587

radiopaque line under mandibular anteriors

Question 588

QUESTION: Pano, what is the round opacity under #24 and #25: Genial tubercles, nutrient canal, zygomatic process of maxilla, normal anatomy

Answer 588

Genial tubercles

Question 589

Nutrient canals seen radiographically are most common where?

Answer 589

Mandibular incisors

Question 590

Vertical BWX are better than horizontal BWX because?

Answer 590

More alveolar bone

Question 591

What cannot be seen with a PA? pterygoid hamulus, coronoid notch, mental foramen, mand. Canal

Answer 591

coronoid notch

Question 592

What structure can you not see on a PA radiograph? - Hamular process - Mental Foramen - Coronoid process - Mandibular foramen

Answer 592

Mandibular foramen (too posterior & inferior)

Question 593

Source/object distance for lateral ceph: 5 feet, 6 feet, 15 cm, 60 cm

Answer 593

5 feet,

Question 594

X-ray taken from mesial of max 1st premolar, buccal root will be where? mesial, distal, occlusal

Answer 594

distal

Question 595

``` What can you see on a radiograph? Lingual ridge height Root dehiscence Trabeculation pattern PDL ```

Answer 595

Trabeculation pattern

Question 596

Kvp:

Answer 596

ability for the beam to penetrate tissues, energy

Question 597

mA:

Answer 597

of x-ray in a beam à radiation quantity (not quality!), density & patient dose

Question 598

for most penetration : kvp and mA?

Answer 598

YOU WANT TO HAVE HIGH KVP AND LOW mA for MOST penetration

Question 599

Dark films

Answer 599

(overexposed/image too dense): due to incorrect mA (too high), exposure (too long), incorrect kVp (too high).

Question 600

Light films

Answer 600

(underexposed/image not dense enough): due to incorrect mA (too low) or exposure (too short), incorrect focal-film distance, or cone too far from the patient's face, or film is placed backwards.

Question 601

intensity and distance proportion

Answer 601

intensity = 1/ (distance squared) | inversely proportional

Question 602

Deterministic effects:

Answer 602

has threshold, severity of effect is dose-related

Question 603

Stochastic effects:

Answer 603

no threshold & no dose-related, probability of effect /likelihood that something will happen - Stochastic effects are associated with long-term, low-level (chronic) exposure to radiation. Increased levels of exposure make these health effects more likely to occur, but do not influence the type or severity of the effect.

Question 604

Radiosensitive:

Answer 604

Bone marrow, reproductive cells, lymphoid cells, immature cells, intestine.

Question 605

RadioRESISTANT:

Answer 605

muscle, nerves

Question 606

Digital X-rays have _____ less exposure from d-films to digital films:

Answer 606

digital has 50% less radiation exposure

Question 607

Going from a D speed film to digital film, What’s the speed difference?

Answer 607

Speed increases

Question 608

By reducing film speed from D to E & still keeping film density the same. What would you need to change?

Answer 608

Decrease Exposure time

Question 609

Latent period is

Answer 609

time between when you exposed patient & clinical reaction to x-ray.

Question 610

In radiobiology, the "latent period" represents the period of time between A. cell rest and cell mitosis. B. the first and last dose in radiation therapy. C. film exposure and image development. D. radiation exposure and onset of symptoms

Answer 610

D. radiation exposure and onset of symptoms

Question 611

Which electron shell has highest power?

Answer 611

(f/d... outermost shell)

Question 612

Which electron level has the highest binding energy? N K L or M

Answer 612

- K is located closest to the nucleus --> highest energy

Question 613

Radiographic Picture looks washed out/too light, no contrast, what was adjusted? * Decrease kvp * Increase kvp * Increase time * Less developing solution

Answer 613

• Increase kvp

Question 614

What was the problem with x-ray that appears too white? incorrect distance from target to film distance, low mA, low density.

Answer 614

low mA,

Question 615

If x-ray is too dark,

Answer 615

it was too long in developer solution. - Dark films (overexposed/image too dense): due to incorrect milliamperage (too high), exposure (too long), incorrect kVp (too high)

Question 616

You take an x-ray at a certain mA, KvP and exposure time is 8 seconds when the beam is 10 inches away. What if everything were the same except the beam was 20 inches away?

Answer 616

quadruple the exposure time

Question 617

You increase the distance of the tube by 2x the length, how much does the x-ray exposure decrease? intensity is

Answer 617

decreased by 4

Question 618

If change from 8 mm cone to 16 mm, how much exposure time do you need to increase by? 2, 4, 6, 8 mA and exposure are increased.

Answer 618

4 - Remember that going from an 8 mm to 16 mm cone means the cone/target is LONGER. This is the PID (target to film distance). If the PID is increased there is LESS magnification. If the PID is shorter there is MORE magnification. Also density (darker x-ray) increases when kA,

Question 619

Increase PID distance from 8 to 16, exposure time change from 0.5sec to? 0.25, 1, 2, 3...... with paralleling technique.

Answer 619

2

Question 620

The x-ray of an interproximal ________ the size of the actual crater

Answer 620

underestimates

Question 621

QUESTION: How do you increase the average energy of the beam? Kvp versus mA

Answer 621

Kvp

Question 622

Deterministic radiology effects:

Answer 622

increases effect with dosage-direct effect

Question 623

The severity of response increases with the amount of X-ray exposure. This effect is called: Deterministic, Stochastic, Genetic

Answer 623

Deterministic

Question 624

Radiation that is stochastic, with non-threshold effects would a clinician notice first – leukemia, skin burn, hair loss, bone marrow effect

Answer 624

leukemia

Question 625

Irradiation cause saliva to have lower -

Answer 625

sodium content

Question 626

Know how x-rays interact with matter:

Answer 626

photoelectric effect - photoelectric effect: electrons are emitted from matter (metals and non-metallic solids, liquids or gases) as a consequence of their absorption of energy from electromagnetic radiation of very short wavelength and high frequency, such as UV radiation. Electrons emitted in this manner may be referred to as photoelectrons.

Question 627

QUESTION: Radiation injury from – free radical formation from indirect, free radical from direct

Answer 627

free radical formation from indirect

Question 628

How do you minimize exposure radiation?

Answer 628

minimizing the amount of tissue being radiated

Question 629

Which type of radiation is constantly in effect: Inhaled radon radiation, not terrestrial or cosmic

Answer 629

Inhaled radon radiation,

Question 630

Most radiation from nature – inhaling radon, internal, terrestrial, cosmic

Answer 630

inhaling radon

Question 631

Dentist is more exposed to what type of radiation besides machine? Scatter tube Scatter patient Scatter wall

Answer 631

Scatter tube

Question 632

How does x-rays primarily damage cells?

Answer 632

Hydrolysis of water molecules

Question 633

Radiation induced mutation is the result of?

Answer 633

Hydrolysis of water molecules.

Question 634

Radiation affects the body by:

Answer 634

LYSIS of H20

Question 635

Which structure is most radio sensitive:

Answer 635

hemopoitic bone marrow

Question 636

What is most radio-resistant cell:

Answer 636

Muscle

Question 637

Which one of the following tissues is least sensitive to ionizing radiation: muscle, lymphocytes, squamous epithelium

Answer 637

muscle

Question 638

What will cause xerostomia: chemo or radiation?

Answer 638

radiation

Question 639

Radiation of 4(Gy) to the skin will cause?

Answer 639

Erythem

Question 640

``` A higher kilovoltage produces x-rays with: Greater energy levels More penetrating ability Shorter wavelengths Increase in density ```

Answer 640

Increase in density

Question 641

KVp inc -->

Answer 641

more penetrating, high energy

Question 642

Increasing mA results in an increase in:

Answer 642

Temperature of the filament & Number of x-rays produced

Question 643

Increasing ImA alone results in a film with:

Answer 643

High contrast

Question 644

If you increase distance, then you need to increase

Answer 644

mA

Question 645

How do you change from a low contrast (longer scale of contrast) to a high contrast (shorter scale) without changing density: increase mA and kvp, decrease mA and kvp, increase kvp decrease mA, decrease kvp increase mA

Answer 645

decrease kvp increase mA

Question 646

If something is a structure in mouth is thick –

Answer 646

it absorbs more radiation, appears more radio-opaque on x-ray

Question 647

To get osteoradionecrosis, radiation dose must be:

Answer 647

Above 50 gys (above 60)

Question 648

Which is greater risk for ORN? IV bis for a year, radiation 65 grays

Answer 648

radiation 65 grays

Question 649

Bisphosphonates used for all except: multiple myeloma, osteomyelitis, metastasis to bones from breast cancer, metastasis to bones from prostate cancer

Answer 649

osteomyelitis

Question 650

Indication for bisphosphonates:

Answer 650

osteoporosis

Question 651

Does bisphosphonate add calcium to bone

Answer 651

à No, it inhibits osteoclast via apoptosis

Question 652

What is the mechanism of action of bisphosphonates?

Answer 652

Inhibit osteoclasts

Question 653

oral bisphosphonates

Answer 653

alendronate (Fosamax) Risendronate (Actonel) Ibandronate (Boniva)

Question 654

IV bisphosphonates

Answer 654

Ibandronate (Boniva) Zolendronic acid (Reclast) Pamidronate (Aredia)

Question 655

ortho in pts on bisphosphonates

Answer 655

no

Question 656

What is not true about a patient who takes Fosamax and will need an invasive procedure?

Answer 656

Discontinue Fosamax 1 week before | procedure (that stuff stays in the system longer than that)

Question 657

Pt taking bisphosphonates for 1 yr. IV, highest risk during dental tx?

Answer 657

Osteonecrosis

Question 658

QUESTION: Pt doesn’t like her bridge & didn’t like her smile. Can you do bone graph in a bisphosphonate pt and would it last?

Answer 658

NO BONE | GRAFTING

Question 659

A scenario about a patient who is taking bisphosphonates and gets osteonecrosis of the jaw. Diagnosis is? a. Osteonecrosis without radiation b. Osteonecrosis with radiation

Answer 659

a. Osteonecrosis without radiation

Question 660

QUESTION: Osteonecrosis of jaw -

Answer 660

more common in mandibular & has nothing to do with radiation

Question 661

Osteoradionecrosis most associated w/ what?

Answer 661

Mandible

Question 662

Osteoradionecrosis scenarios -

Answer 662

preextract questionable teeth, hyperbaric oxygen pre and post if doing invasive procedures

Question 663

Pt has stage 1 osteonecrosis from bisphosphonate. What do you do?

Answer 663

debride area or rinse with chlorhexidine - If STAGE 1 - rinse Chlorhexidine - If STAGE 2 - Refer to OS or do under Hyperbaric O2

Question 664

Pt has a history of osteonecrosis & IV bisphosphonates but extractions are needed, what do you do?

Answer 664

Do it under hyperbaric O2

Question 665

Best tx for bisphosphate pt:

Answer 665

Section crown off & still do RCT avoid extractions

Question 666

pernicious anemia deficiency

Answer 666

B12; intrinsic factor in stomach

Question 667

microcytic hypochromic anemia

Answer 667

Fe deficiency | most common

Question 668

most common anemia

Answer 668

microcytic hypochromic (Fe deficiency)

Question 669

Which hemoglobin is affected in sickle cell anemia?

Answer 669

S

Question 670

Pt has sickle cell anemia & has a thrombolytic crisis, what could precipitate this? a. Nitrous oxide / oxygen use b. Cold c. Trauma d. Infection

Answer 670

Cold Sickle cell anemia is seen exclusively in black patients. Periods of unusual stress or of O2 deficiency (hypoxia) can precipitate a sickle cell crisis.

Question 671

What disease is more predominate in males? Mandibular dysostosis (Treacher Collins syndrome) Hypothyroidism Diabetes Sickle cell anemia Hemophilia

Answer 671

Hemophilia

Question 672

Which one of the following effects males almost exclusively? * hemophilia * downs * diabetes

Answer 672

hemophilia

Question 673

Macrocytic anemia which vitamin deficient? A, B, C, D, E

Answer 673

B