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Question 1

1. Irritation fibroma will be the most favored provisional diagnosis
   for a firm, smooth surfaced, pinkish nodule, occurring on
   (a) Buccal mucosa along the bite line
   (b) Vermilion border of lip
   (c) Soft palate
   (d) Ala of nose

Answer 1

(a) Irritation fibroma being a noninflammatory, fibrous
lesion, manifests as a firm, smooth surfaced, swelling. It
represents a reactive hyperplasia of tissues in response to
local irritation/trauma. The most common cause of irritation
intraorally is occlusal trauma.

Question 2

2. The developmental lesion, histologically similar to giant cell
   fibroma, occurring on lingual gingiva of mandibular canines is
   called
   (a) Procuspid papilla (b) Retromandibular papilla
   (c) Retrocuspid papilla (d) Retrocuspid fibroma

Answer 2

(c) Retrocuspid papilla is a developmental lesion, microscopically
similar to giant cell fibroma. It occurs in children
and young adults and occurs almost exclusively on lingual
aspect of mandibular canines

Question 3

3. Single/multiple folds of hyperplastic tissue in alveolar vestibule,
   occurring in association with flange of an ill fitting denture is
   most likely to be
   (a) Inflammatory papillary hyperplasia
   (b) Inflammatory fibrous hyperplasia
   (c) Giant cell epulis
   (d) Congenital epulis

Answer 3

(b) This lesion is a reactive lesion occurring in response to
irritation caused by the flanges of an ill-fitting complete/
partial denture. It typically manifests as single/multiple
folds of hyperplastic tissue in alveolar vestibule.

Question 4

4. Fibroepithelial polyp is a flattened leaf-like pink lesion occurring
   on
   (a) Soft palate (b) Hard palate
   (c) Gingiva (d) Labial mucosa

Answer 4

(b) Also called leaf-like denture fibroma, it occurs on the
hard palate beneath a maxillary denture. It manifests as a
flattened pink mass that is attached to the palate by a thin
stalk (peduncle).

Question 5

5. All except ____ are common causes of inflammatory papillary
   hyperplasia.
   (a) Ill-fitting dentures
   (b) Poor denture hygiene
   (c) Wearing dentures for 24 hours
   (d) Infection by herpes virus

Answer 5

(d) Also known as denture papillomatosis, this lesion also,
like inflammatory fibrous hyperplasia occurs in response
to factors like poor oral hygiene, ill-fitting dentures, etc. It
occurs most commonly beneath a denture base on the hard
palate.

Question 6

6. Microscopically, one of the most common types of arrangements
   of tumor cells in fibrous histiocytoma is _____ pattern.
   (a) Storiform (b) Herringbone
   (c) Ductal (d) Glandular

Answer 6

(a) Fibrous histiocytoma is a true neoplasm and exhibits both
fibroblastic and histiocytic differentiation. Characterized
microscopically by proliferation of spindle-shaped cells with
vesicular nuclei in short, interlacing fascicles, resembling
the whorled appearance of a straw mat (storiform).

Question 7

7. The most common cause of pyogenic granuloma is
   (a) Infection by pyogenic organisms
   (b) Granulomatous infection
   (c) Exaggerated tissue reaction to local irritation/trauma
   (d) Infection by herpes virus

Answer 7

(c) Initially believed to be a pyogenic infection, it is now thought
to represent an exuberant tissue reaction to local irritation/
trauma

Question 8

8. 75% of pyogenic granulomas occur on the
   (a) Palate (b) Tongue
   (c) Gingiva (d) Lip

Answer 8

(c) Gingival irritation and inflammation being the most
common causes, pyogenic granuloma occurs most
commonly on the gingivae. Other common intraoral sites
are lips, tongue and buccal mucosa

Question 9

9. Which amongst the following lesions does not occur commonly
   on the gingiva?
   (a) Peripheral ossifying fibroma
   (b) Pyogenic granuloma
   (c) Peripheral giant cell granuloma
   (d) Neurofibroma

Answer 9

(d) Pyogenic granuloma, peripheral ossifying fibroma and
peripheral giant cell granuloma are included under the
differential diagnosis of epulides (swelling occurring on
gingivae). Neurofibroma, however, occurs most commonly
on tongue and buccal mucosa

Question 10

10. A gingival lesion which histologically shows trabeculae of osteoid
    or droplets of basophilic cementum like material in a background
    of fibrovascular connective tissue is suggestive of
    (a) Central ossifying fibroma
    (b) Juvenile ossifying fibroma
    (c) Periapical cemental dysplasia
    (d) Peripheral ossifying fibroma

Answer 10

(d) Although all other lesions show somewhat similar features
of presence of osteoid and/or cementum like material, all
of them occur centrally within the bone, while peripheral
ossifying fibroma, as the name suggests, occurs peripherally,
i.e. within soft tissue.

Question 11

11. Intraoral lipomas occur most commonly on
    (a) Gingiva (b) Buccal mucosa
    (c) Tongue (d) Palate

Answer 11

(b) Lipomas occur most commonly in areas where there are
plenty of adipocytes, which will be more in buccal mucosa
compared to palate, gingiva or tongue

Question 12

12. The most common histological variant of lipoma is
    (a) Fibrolipoma (b) Angiolipoma
    (c) Myxoid lipoma (d) Spindle cell lipoma

Answer 12

(a) This variant shows excessive fibrosis between the adipocytes

Question 13

13. Damage to a nerve bundle is the most common cause of
    (a) Solitary circumscribed neuroma
    (b) Neurilemmoma
    (c) Traumatic neuroma
    (d) Neurofibroma

Answer 13

(c) It is not a true neoplasm but an exuberant attempt at repair
of a damaged nerve trunk.

Question 14

14. Which amongst the following is the more common nerve tissue
    tumor of head and neck region?
    (a) Traumatic neuroma
    (b) Schwannoma
    (c) Neurofibroma
    (d) Solitary circumscribed neuroma

Answer 14

(d) It represents a reactive lesion, with the etiology usually being
trauma. It shows a striking predilection for the face, especially
nose and cheeks.

Question 15

15. Microscopic pattern of Antoni A type of tissue proliferation is
    found in
    (a) Neurilemmoma (b) Neurofibroma
    (c) Hodgkin’s disease (d) Verrucous carcinoma

Answer 15

(a) Antoni type A tissue is made up of elongated/spindle shaped
cells with spindle-shaped/wavy nuclei which are aligned in
a characteristic palisading pattern, while the intercellular
fibers are arranged in parallel fashion between the rows of
nuclei.

Question 16

16. _____________ is the most common location for occurrence of
    neurilemmoma.
    (a) Lip (b) Tongue
    (c) Palate (d) Vestibule

Answer 16

(b) Although neurilemmoma shows a predilection for head and
neck region, tongue is the most common intraoral site, with
other locations being palate, floor of mouth, buccal mucosa
and gingiva

Question 17

17. The most common peripheral nerve neoplasm is
    (a) Neurofibroma
    (b) Granular cell tumor
    (c) Schwannoma
    (d) Solitary circumscribed neuroma

Answer 17

(a) This common peripheral nerve neoplasm arises from a
mixture of cell types including Schwann cells and perineural
fibroblasts

Question 18

18. The central, acellular, eosinophilic mass found in center of Antoni
    A tissue of neurilemmoma is called
    (a) Verrucous body (b) Verruciform body
    (c) Verocay body (d) Basaloid body

Answer 18

(c) Verocay bodies are composed of reduplicated basement
membrane and cytoplasmic processes of the Schwann cells.

Question 19

19. Ancient neurilemmoma are those tumors that show _______
    changes.
    (a) Degenerative (b) Myxoid
    (c) Squamous metaplasia (d) Basaloid

Answer 19

(a) Degenerative changes within ancient neurilemmoma
consist of hemorrhage, hemosiderin deposit, fibrosis,
inflammation and nuclear atypia.

Question 20

20. Neurofibroma arises from
    (a) Perineural fibroblasts (b) Schwann cells
    (c) Mixture of (a) and (b) (d) Fibroblasts

Answer 20

(c) Earlier believed to arise from Schwann cells, it is now
understood that it can arise from a mixture of cell types
including perineural fibroblasts

Question 21

21. Neurofibroma can also be a component of
    (a) von Willebrand’s disease
    (b) von Recklinghausen’s disease
    (c) van der Waals disease
    (d) von Ebner’s disease

Answer 21

(b) Multiple lesions of neurofibromas occurring in a person
is referred to as neurofibromatosis/von Recklinghausen’s
disease. Unlike neurofibroma though, it is a hereditary
disease, inherited as an autosomal dominant trait

Question 22

22. ______ cells are found in large numbers in neurofibroma, which
    may be used as a diagnostic feature.
    (a) Macrophages (b) Neutrophils
    (c) Lymphocytes (d) Mast cell

Answer 22

(d) Neurofibroma is composed of interlacing bundles of
spindle-shaped cells with thin, wavy nuclei. These cells
are associated with delicate collagen bundles and myxoid matrix. Mast cells are numerous in the lesion and can be a
useful diagnostic featur

Question 23

23. Lisch nodules and Crowe’s sign are components of
    (a) Neurilemmoma (b) Neurofibroma
    (c) Neurofibrosarcoma (d) Neurofibromatosis

Answer 23

(d) Axillary freckling (Crowe’s sign) and translucent brownish
pigmented spots on the iris (Lisch nodules) belong to a set
of 7 features. The diagnostic criteria of neurofibromatosis
are met if a patient has 2 or more of these 7 feature

Question 24

24. The most common and serious complication of neurofibromatosis
    is
    (a) Pheochromocytoma
    (b) Wilms tumor
    (c) Malignant peripheral nerve sheath tumor
    (d) Leukemia

Answer 24

(c) Neurofibrosarcoma/malignant peripheral nerve sheath
neoplasm occurs in about 5 percent of cases of neurofibromatosis.
They occur most commonly on trunk and
extremities

Question 25

25. Development of ________ occurs in 90% of cases of multiple
    endocrine neoplasia Type 2B.
    (a) Pheochromocytoma
    (b) Medullary carcinoma of thyroid
    (c) Wilms tumor
    (d) Rhabdomyosarc

Answer 25

(b) This carcinoma arises from the parafollicular (C) cells
of thyroid gland which are responsible for secretion of
calcitonin. They are most often diagnosed in patients
between the ages of 18–25 and have a marked propensity
for metastasis.

Question 26

26. A pigmented tumor occurring in the 1st year of life, arising from
    neural crest and associated with high urinary levels of vanillyl
    mandelic acid is highly suggestive of
    (a) MEN type 2B
    (b) Melanotic neuroectodermal tumor of infancy
    (c) Gingival cyst of infancy
    (d) von Recklinghausen’s disease

Answer 26

(b) This tumor always occurs in the first year of life and is
accepted to arise from neural crest cells. Most commonly
seen in anterior maxilla as a rapidly expanding blue/black
mass. High urinary levels of VMA are seen in most neural
crest tumors like pheochromocytoma, neuroblastoma,
etc.

Question 27

27. Paraganglioma or carotid body tumors are derived from
    (a) Ectoderm (b) Neural plate
    (c) Neural crest (d) Mesoderm

Answer 27

(c) Paraganglia are specialized tissue of neural crest origin
that are associated with autonomic nerves and ganglia
throughout the body.

Question 28

28. The epithelioid cells in paraganglioma are arranged in nests
    called as
    (a) Zellballen (b) Abtrofung
    (c) Alveoli (d) Islands

Answer 28

(a) These nests consist primarily of chief cells, which show
central, vesicular nuclei and a granular, eosinophilic
cytoplasm.

Question 29

29. The most common site of occurrence of granular cell tumor is
    (a) Tongue (b) Gingiva
    (c) Palate (d) Vestibule

Answer 29

(a) Uncommon benign, soft tissue tumor that shows a
predilection for oral cavity especially tongue. Earlier
believed to arise from skeletal muscles, now it is believed
to arise from Schwann cells.

Question 30

30. In contrast to granular cell tumor, the overlying epithelium in
    congenital epulis never shows
    (a) Ulceration
    (b) Pseudoepitheliomatous hyperplasia
    (c) Atrophy
    (d) Acanthosis

Answer 30

(b) This tumor appears as pink red, polypoid mass on alveolar
ridge of a newborn infant and is characterized histologically
by sheets of large, closely packed, polyhedral cells showing
fine, granular eosinophilic cytoplasm.

Question 31

31. The principal difference between hemangioma and vascular
    malformation is
    (a) Pigmentation
    (b) Rate of blood flow through lesion
    (c) Endothelial cell proliferation
    (d) Site of occurrence

Answer 31

(c) Apart from endothelial proliferation, hemangiomas also
show gradual involution after a rapid growth phase in early
infancy

Question 32

32. _______ is the most common tumor of infancy.
    (a) Melanotic neuroectodermal tumor of infancy
    (b) Congenital epulis of newborn
    (c) Gingival cyst of newborn
    (d) Hemangioma

Answer 32

(d) Hemangiomas are not present at birth, but develop within
first month of life. They are the commonest tumors of
infancy affecting primarily the head and neck region.

Question 33

33. The most common complication of hemangioma is _______
    (a) Amblyopia (b) Ulceration
    (c) Airway obstruction (d) Hemorrhage

Answer 33

(b) Ulceration may occur with or without secondary infection.
Although hemorrhage may be seen, there is usually no
significant blood loss

Question 34

34. Port wine stain is a common component of __________________
    syndrome.
    (a) Osler Weber-Rendu (b) Kelly Paterson
    (c) Sturge-Weber (d) Klinefelter

Answer 34

(c) It is a nonhereditary developmental condition manifested
by facial port-wine stain, leptomeningeal angiomas,
tramline-like calcification on skull radiographs and ocular
involvement like glaucoma and vascular malformations on
conjunctiva, choroid and retina.

Question 35

35. Which special stain can be employed to diagnose hemangiopericytoma?
    (a) PAS (b) Alcian blue
    (c) Masson trichrome (d) Reticulin

Answer 35

(d) The reticulin stain is used to demonstrate the reticulin
network surrounding the blood vessels and individual
tumor cells.

Question 36

36. The most probable diagnosis for multiple translucent vesicle like
    lesions on the anterior 2/3rd of tongue, that appears enlarged
    (macroglossia) could be
    (a) Neurilemmoma (b) Neurofibroma
    (c) Lymphangioma (d) Pemphigus vulgaris

Answer 36

(c) Lymphangiomas are benign, hamartomatous tumors
of lymph vessels. They are classified according to size
of lymph vessels as lymphangioma simplex, cavernous
lymphangioma and cystic lymphangioma

Question 37

37. Lymphangiomas occur most frequently in _______ region.
    (a) Head and neck (b) Skin
    (c) Lower extremities (d) Abdomen

Answer 37

(a) About 50 percent to 75 percent of all cases occur in head
and neck region. About half of all lesions are noted at birth
and around 90 percent develop by 2 years of age.

Question 38

39. Active endothelial cell proliferation is not seen in which of the
    following lesions?
    (a) Cavernous hemangioma
    (b) Capillary hemangioma
    (c) Port-wine stain
    (d) Kaposi’s sarcoma

Answer 38

(c) Portwine stains/nevus flammeus represent vascular
malformations where there is no endothelial cell proliferation.

Question 38

38. Which amongst the following tumors occurs almost exclusively
    in males?
    (a) Sjögren’s syndrome
    (b) Hemangioma
    (c) Nasopharyngeal angiofibroma
    (d) Pyogenic granuloma

Answer 38

(c) It is a rare fibrovascular lesion that occurs only in the
nasopharynx and almost exclusively in males. It is believed
to be a vascular malformation rather than a true neoplasm.

Question 39

40. Sturge-Weber syndrome/angiomatosis demonstrates port-wine
    stain usually distributed unilaterally along the course of one or
    more branches of ________ cranial nerve.
    (a) VII (b) V
    (c) III (d) VIII

Answer 39

(b) Sturge-Weber angiomatosis is a nonhereditary developmental
condition characterized by hamartomatous vascular
proliferation of brain and facial tissues. It is believed to
be caused by persistence of a vascular plexus around the
cephalic portion of the neural tube.

Question 40

41. All except ____________ are histological types of leiomyoma.
    (a) Alveolar (b) Solid
    (c) Vascular (d) Epithelioid

Answer 40

(a) Leiomyomas are benign tumors of smooth muscle origin,
probably vascular smooth muscle. Solid, vascular and
epithelioid are its three types.

Question 41

42. Oral leiomyomas are either solid or _______ in type.
    (a) Epithelioid (b) Vascular
    (c) Alveolar (d) Myxoid

Answer 41

(b) Oral leiomyoma manifests as slow growing firm mucosal
nodule. Most common sites are lips, tongue, palate, and
cheek.

Question 42

43. Which stain is employed to stain the smooth muscles in
    leiomyoma?
    (a) Mallory (b) Masson trichrome
    (c) Van Gieson (d) PAS

Answer 42

(b) Being a spindle cell lesion, special stains like Masson’s
trichrome may be required to demonstrate muscle fibers.
Smooth muscle fibers are stained bright red with Masson’s
trichrome stain.

Question 43

44. The most common site of occurrence for rhabdomyosarcoma is
    (a) Abdomen (b) Lower extremity
    (c) Head and neck (d) Trunk

Answer 43

(c) Rhabdomyoma are benign tumors of skeletal muscle tissue
and show a striking predilection for head and neck region

Question 44

45. The most common choristomas of oral cavity consist of
    (a) Fibrous tissue (b) Myxoid tissue
    (c) Bone and/or cartilage (d) Adipose

Answer 44

(c) Choristoma is a tumor-like growth of microscopically
normal tissue in an abnormal location.

Question 45

46. The most common location for occurrence of choristomas
    intraorally is
    (a) Ventral surface of tongue
    (b) Posterior tongue near foramen cecum
    (c) Anterior 2/3rd of tongue
    (d) Floor of mouth

Answer 45

(b) Choristomas show a striking predilection for the tongue,
which accounts for 85 percent of cases. The most common
location is the posterior tongue near the foramen cecum.

Question 46

47. “Herringbone” pattern of proliferation of spindle-shaped cells is
    typically seen in
    (a) Fibrous histiocytoma
    (b) Malignant fibrous histiocytoma
    (c) Neurofibrosarcoma
    (d) Fibrosarcoma

Answer 46

(d) Well-differentiated fibrosarcomas consist of fascicles of
spindle-shaped cells that classically form a “herringbone”
pattern.

Question 47

48. The most common soft tissue sarcoma of adults is
    (a) Malignant fibrous histiocytoma
    (b) Neurofibrosarcoma
    (c) Osteosarcoma
    (d) Fibrosarcoma

Answer 47

(a) It is a malignant neoplasm displaying both fibroblastic as
well as histiocytic features

Question 48

49. The most common of histopathological varieties of liposarcoma
    is
    (a) Round cell (b) Well-differentiated
    (c) Myxoid (d) Pleomorphic

Answer 48

(c) This variety accounts for nearly 50 percent of all cases. They
demonstrate proliferating lipoblasts within a myxoid stroma
that contains a rich capillary network.

Question 49

50. Malignant triton tumor is a variety of neurofibrosarcoma wherein
    there is __ tissue differentiation.
    (a) Smooth muscle (b) Cartilage
    (c) Glandular (d) Skeletal muscle

Answer 49

(d) Apart from malignant atypical spindle cells, some tumors
can demonstrate heterologous elements which include
skeletal muscle differentiation, cartilage, bone or glandular
structures.

Question 50

51. Vascular tumor with histological features intermediate between
    hemangioma and angiosarcoma is called
    (a) Hemangioendothelioma
    (b) Hemangiopericytoma
    (c) Kaposi’s sarcoma
    (d) Ewing’s sarcoma

Answer 50

(a) Hemangioendothelioma demonstrates microscopic features
which are intermediate between those of hemangiomas
and angiosarcoma. Such tumors are considered to be of
intermediate malignancy

Question 51

52. Kaposi’s sarcoma is now believed to be caused by
    (a) Human papilloma virus 2
    (b) Cytomegalovirus
    (c) Human herpes virus 8
    (d) Herpes simplex virus 2

Answer 51

(c) Kaposi’s sarcoma occurs most commonly in association
with AIDS. It is now believed to be caused by the human
herpesvirus 8, also called Kaposi’s sarcoma associated
herpesvirus.

Question 52

53. All except _____ are a variety of Kaposi sarcoma.
    (a) Pleomorphic (b) Endemic African
    (c) Classic (d) AIDS related

Answer 52

(a) Four clinical presentations of Kaposi sarcoma are recognized:
classic, endemic African, iatrogenic immunosuppression
associated and AIDS related.

Question 53

54. Which amongst the following endemic African type of Kaposi’s
    sarcoma is seen primarily in children and young adults?
    (a) Florid (b) Lymphadenopathic
    (c) Aggressive (d) Benign nodular

Answer 53

(b) Occurs primarily in young black children and exhibits
generalized, rapidly growing tumors of the lymph
nodes, occasional visceral organ lesions, and sparse skin
involvement.

Question 54

55. The most common soft tissue sarcoma of children is
    (a) Leiomyosarcoma (b) Fibrosarcoma
    (c) Rhabdomyosarcoma (d) Ewing’s sarcoma

Answer 54

(c) Rhabdomyosarcoma, a malignant neoplasm of skeletal
muscle origin is the most common soft tissue sarcoma of
children. The most frequent site is the head and neck, which
accounts for 40 percent of all cases.

Question 55

56. Only one amongst the following is a round cell tumor. Identify it
    (a) Fibrosarcoma (b) Kaposi’s sarcoma
    (c) Rhabdomyosarcoma (d) Ewing’s sarcoma

Answer 55

(d) Ewing’s sarcoma is composed of small round cells with welldefined
nuclear outlines and ill-defined cellular borders.

Question 55

57. Which amongst the following is not a round cell tumor?
    (a) Ewing’s sarcoma
    (b) Kaposi’s sarcoma
    (c) Olfactory neuroblastoma
    (d) Round cell liposarcoma

Answer 55

(b) Kaposi’s sarcoma is basically a vascular lesion which in
initial stages shows proliferation of miniature vessels, with
development of spindle cell population in later stages

Question 56

58. Which one of the lesions given below is a congenital lesion?
    (a) Embryonal rhabdomyosarcoma
    (b) Port-wine stain
    (c) Fetal rhabdomyosarcoma
    (d) Angiosarcoma

Answer 56

(b) Port-wine stain is a form of vascular malformation which is
present at birth and persists throughout life

Question 57

59. A hemangioma can be best classified as
    (a) Hamartoma (b) Choristoma
    (c) Neoplasm (d) Cyst

Answer 57

(a) Hamartoma is a tumor developmental malformation.

Question 58

60. All are true neoplasms except
    (a) Hemangioma
    (b) Granular cell tumor
    (c) Lymphangioma
    (d) Sturge-Weber angiomatosis

Answer 58

(b) It is an uncommon soft tissue neoplasm that is currently
believed to originate from either Schwann cells or
neuroendocrine cells

Question 59

61. Which virus is most commonly associated with squamous
    papilloma?
    (a) Human papilloma virus
    (b) Human herpes virus
    (c) Epstein-Barr virus
    (d) Human immunodeficiency virus

Answer 59

(a) HPV 6 and HPV 11 viruses have consistently been
demonstrated in the lesions of oral squamous cell papilloma

Question 60

62. The squamous papilloma is clinically and microscopically
    indistinguishable from which other lesion occurring in skin?
    (a) Verrucous carcinoma
    (b) Verruca vulgaris
    (c) Molluscum contagiosum
    (d) Dyskeratosis congenita

Answer 60

(b) Squamous papilloma is the mucosal variant of the common
wart occurring on skin, called verruca vulgaris. They cannot
be clinically and histologically differentiated.

Question 61

63. Multiple papilloma like lesions occurs in which one of the
    following syndromes?
    (a) Cowden
    (b) Treacher Collins syndrome
    (c) Rubinstein-Taybi syndrome
    (d) Grinspan syndrome

Answer 61

(a) Cowden syndrome is an autosomal dominant disease
characterized by multiple papilloma like lesions, multiple
hamartomas and neoplasia of thyroid, GIT and CNS, etc.

Question 62

64. Which one of the following benign lesions resembles squamous
    cell carcinoma clinically and microscopically?
    (a) Verruca vulgaris (b) Keratoacanthoma
    (c) Squamous acanthoma (d) Leukoedema

Answer 62

(b) Keratoacanthoma is a low-grade malignancy originating
from the sebaceous glands and is considered to be variant
of invasive squamous cell carcinoma

Question 63

66. Which amongst the following types of nevi shows the greatest
    risk of developing into malignant melanoma?
    (a) Intradermal nevus (b) Compound
    (c) Blue nevus (d) Junctional nevus

Answer 63

(d) Microscopically, the junctional activity or proliferation and
lateral spread of nevus cells along the basal layer has been
known to be associated with a high risk of development of
malignant melanoma.

Question 64

65. The nevus cells in junctional nevi are located in _____ layer of
    epithelium.
    (a) Stratum granulosum (b) Stratum spinosum
    (c) Stratum intermedium (d) Stratum basale

Answer 64

(d) In junctional nevus, the nevus cells located within the basal
layer of epithelium proliferate, spread laterally along the
basal layer and then begin to cross the junction and spread
into the underlying connective tissue in groups and nests

Question 65

68. The only lesion out of the following that can be diagnosed
    histologically is
    (a) Proliferative verrucous leukoplakia
    (b) Leukoplakia
    (c) Erythroplakia
    (d) Verrucous hyperplasia

Answer 65

(d) Although verrucous hyperplasia (VH) and proliferative
verrucous leukoplakia (PVL) are clinically related, the term
PVL is clinical while the diagnosis of VH is always confirmed
histologically. VH is considered a forerunner to verrucous
carcinoma and once the diagnosis of VH is confirmed it is
treated as verrucous carcinoma

Question 65

67. Spot the only premalignant lesion from the below given
    conditions
    (a) Oral submucous fibrosis
    (b) Sideropenic dysphagia
    (c) Leukoplakia
    (d) Lichen planus

Answer 65

(c) A premalignant lesion is defined as a morphologically
altered tissue in which cancer is more likely to develop
than its normal counterpart. Leukoplakia, erythroplakia
and palatal changes associated with reverse smoking are
the examples of premalignant lesions.

Question 66

69. Indicate the incorrect statement regarding microscopic
    appearance of epithelial dysplasia
    (a) Enlarged nucleoli
    (b) Basilar hyperplasia
    (c) Flattened rete ridges
    (d) Individual cell keratinization

Answer 66

(c) Flattened rete ridges is a feature of atrophy of epithelium
which may or may not show dysplastic histological features,
while drop-shaped rete ridges is a feature of hyperplasia
occurring in basal layer which is a dysplastic feature.

Question 67

70. Only one amongst the following is a developmental condition,
    while others are premalignant lesions/conditions
    (a) Leukoedema
    (b) Leukoplakia
    (c) Oral submucous fibrosis
    (d) Erythroplakia

Answer 67

(a) Leukoedema is a benign lesion which occurs usually
bilaterally on the buccal mucosa. Since it resembles
leukoplakia closely, it must be differentiated from it. That
is easily done by stretching and everting the mucosa due to
which the lesion of leukoedema becomes indistinct while
leukoplakia does not. Also microscopically, leukoedema
presents with a markedly hyperplastic spongiotic layer
showing prominent intracellular edema.

Question 68

71. Spot the only lesion from below given ones which presents as
    bright red velvety patch
    (a) Median rhomboid glossitis
    (b) Oral submucous fibrosis
    (c) Nicotina palati
    (d) Keratoacanthoma

Answer 68

(a) Also called central papillary atrophy of tongue, this lesion
is now believed to be a candidal infection, manifesting as
a well-defined, oval, pink area on the center of tongue due
to absence of papillae

Question 69

72. Rodent ulcer is another name of
    (a) Verrucous carcinoma
    (b) Basal cell carcinoma
    (c) Squamous cell carcinoma
    (d) Osteosarcoma

Answer 69

(b) Basal cell carcinoma is the most common malignancy
in humans caused by prolonged exposure to ultraviolet
radiation. It manifests clinically as a small ulcer with rolled
margins, it infiltrates to adjacent as well as deeper tissues
like bone, muscles, etc. thus its synonym.

Question 70

73. The commonest malignant neoplasm of oral cavity is
    (a) Basal cell carcinoma
    (b) Verruca vulgaris
    (c) Epidermoid carcinoma
    (d) Malignant melanoma

Answer 70

(c) Epidermoid or squamous cell carcinoma is a malignant
neoplasm arising from the epithelium and its cause is
attributed to the use of tobacco in various forms, including
smokeless variety.

Question 71

74. Which amongst the following is a common clinical presentation
    of squamous cell carcinoma?
    (a) Soft, fluctuant swelling
    (b) Hard swelling with egg shell crackling
    (c) Chronic, non-healing ulcer with indurated margins
    (d) Multiple, vesicles and bullae

Answer 71

(c) The classical presentation of squamous cell carcinoma is
that of a chronic nonhealing ulcer with indurated margins,
although verrucous carcinoma as well as carcinoma of
buccal and alveolar mucosae may manifest as exophytic
growths

Question 71

75. Lentigo maligna, acral lentiginous and mucosal lentiginous are
    forms of which of the following neoplasm?
    (a) Oral melanocytic nevus
    (b) Adenosquamous carcinoma
    (c) Nasopharyngeal carcinoma
    (d) Malignant melanoma

Answer 71

(d) It is tumor of epidermal melanocytes and is associated with
factors like sun exposure, artificial ultraviolet radiation
exposure, fair, freckled skin, number of melanocytic nevi and
genetic factors like familial and xeroderma pigmentosum