Oral Pathology
PATIENT: Male, 29 years old
CHIEF COMPLAINT: "My mouth has been hurting and feeling raw."
BACKGROUND: Asthma, exercise-induced
MEDICATIONS: albuterol inhaler (ProAir HFA), multivitamin
CURRENT FINDINGS: Positive Nikolsky sign
Each of the following should be included in the differential diagnosis EXCEPT one. Which is the EXCEPTION?
A. Erythema multiforme
B.Pemphigus vulgaris
C. Staphylococcal scaled skin syndrome
D. Stevens-Johnson Syndrome
A. Erythema multiforme
Each of the following is a possible symptom of dysgeusia EXCEPT one. Which is the EXCEPTION?
A. Metallic taste
B. Loss of taste
C. Taste present despite not eating anything
D. Change in taste
B. Loss of taste
Which is the most common salivary gland malignancy?
A. Adenoid cystic carcinoma
B. Acinic cell carcinoma
C. Carcinoma ex pleomorphic adenoma
D. Mucoepidermoid carcinoma
D. Mucoepidermoid carcinoma
A drug has a half-life of 4 hours. Which of the following is correct when discontinuing the drug?
A. 75% will be eliminated in 4 hours
B. 80% will be eliminated in 12 hours
C. 90% will be eliminated in 8 hours
D. 94% will be eliminated in 16 hours
D. 94% will be eliminated in 16 hours
Each of the following is a drug interaction between methadone (Methadose®) and buspirone (Buspar®) EXCEPT one. Which is the EXCEPTION?
A. Respiratory depression
B. Palpitations
C. Dizziness
D. Sleepiness
B. Palpitations
Which dental anomaly is most common in the primary dentition?
A. Concrescence
B. Fusion
C. Gemination
D. Twinning
B. Fusion
PATIENT: Female, 43 years old
CHIEF COMPLAINT: “I have a wart on my lower lip.”
CURRENT FINDINGS: Exophytic papule of the lower labial mucosa approximately 1 cm x 1 cm in size
Each of the following viruses is most often implicated in this condition EXCEPT one. Which is the EXCEPTION?
A. HPV 2
B. HPV 4
C. HPV 7
D. HPV 18
D. HPV 18
What is the most common malignancy in the oral cavity?
A. Melanoma
B. Verrucous carcinoma
C. Epithelial dysplasia
D. Squamous cell carcinoma
D. Squamous cell carcinoma
Each of the following is a pharmaceutical drug therapy indicated in the treatment of lupus EXCEPT one. Which is the EXCEPTION?
A. Non-steroidal anti-inflammatory drugs
B. Corticosteroids
C. Antimalarials
D. Antibiotics
D. Antibiotics
Which medication is contraindicated during the third trimester of pregnancy?
A. Ibuprofen
B. Acetaminophen
C. Amoxicillin
D. Lidocaine
A. Ibuprofen
PATIENT: Male, 5 years old, accompanied by mother
CHIEF COMPLAINT: Mother: "My son was diagnosed with an ameloblastic fibroma."
BACKGROUND: New patient exam
CURRENT FINDINGS: Full primary dentition
Where is an ameloblastic fibroma most commonly found?
A. Anterior mandible
B. Anterior maxilla
C. Posterior mandible
D. Posterior maxilla
C. Posterior maxilla
PATIENT: Male, 65 years old
CHIEF COMPLAINT: “The top of my mouth looks white with red dots.”
BACKGROUND: Hypertension, Smoker (cigarettes), 30 pack-year history
MEDICATIONS: atorvastatin (Lipitor®)
CURRENT FINDINGS: Hard palate is diffusely white with elevated papules with red dots in their centers
Which is the most likely cause of the chief complaint?
A. Nicotinic stomatitis
B. Erosive lichen planus
C. Pseudomembranous candidiasis
D. Denture stomatitis
A. Nicotinic stomatitis
Which human herpesvirus strain causes cytomegalovirus infection?
A. 1
B. 2
C. 5
D. 8
C. 5
PATIENT: Male, 65 years old
CHIEF COMPLAINT: “I’m here for a cleaning, but I don’t feel well.”
BACKGROUND: History of methamphetamine use
CURRENT FINDINGS: Signs of methamphetamine overdose
Each of the following is a sign of methamphetamine overdose EXCEPT for one. Which is the EXCEPTION?
A. Dry mouth
B. Hypertension
C. Hyperventilations
D. Miosis
D. Miosis
The dose-response curve shifts in which direction when a non-competitive antagonist is added?
A. Down
B. Left
C. Right
D. Up
A. Down
PATIENT: Male, 45 years old
CHIEF COMPLAINT: “My throat has been sore for a while.”
BACKGROUND: Sore throat for the past three months, Occasional alcohol consumption
CURRENT FINDINGS: Lump in left lateral neck
Each of the following statements about human papillomavirus (HPV)-positive cancer is correct EXCEPT one. Which is the EXCEPTION?
A. It has a better prognosis than HPV-negative oropharyngeal cancers
B. It has increased in incidence over time
C. It is more common in the oropharynx than in the oral cavity
D. It is the most common oral cancer type in the United States
D. It is the most common oral cancer type in the United States
PATIENT: Male, 19 years old
CHIEF COMPLAINT: "I have a weird bump on my tongue."
BACKGROUND: Biopsy results indicate verruca vulgaris
CURRENT FINDINGS: 0.5 mm mucosal-colored, finger-like projections of the anterior tongue
Which agent is most likely responsible for the lesion?
A. Human papillomavirus
B. Human immunodeficiency virus
C. Molluscum contagiosum virus
D. Poxvirus
A. Human papillomavirus
Which is a manifestation of human papillomavirus (HPV) infections?
A. Gumma
B. Maculopapular rash
C. Condyloma acuminatum
D. Chancre
C. Condyloma acuminatum
Each of the following is a mechanism by which glucocorticoids suppress inflammation EXCEPT one. Which is the EXCEPTION?
A. Decreased capillary permeability
B. Decreased leukocyte extravasation
C. Increased IL-1 production
D. Inhibition of vasodilation
C. Increased IL-1 production
Which of the following medications can be used during pregnancy?
A. Promethazine
B. Lisinopril
C. Topiramate
D. Warfarin
A. Promethazine
PATIENT: Male, 57 years old
CHIEF COMPLAINT: “My tooth hurts when I drink iced water.”
BACKGROUND: Hyperlipidemia, Gastroesophageal reflux disease (GERD), Obstructive sleep apnea (OSA)
MEDICATIONS: atorvastatin (Lipitor®), omeprazole (Prilosec®), acetaminophen (Tylenol®)
CURRENT FINDINGS: Macroglossia, Tender to palpation, percussion, tooth 19
Each of the following is a common histological form of true macroglossia EXCEPT one. Which is the EXCEPTION?
A. Fibromatosis
B. Muscular enlargement
C. Tumors
D. Vascular malformations
A. Fibromatosis
PATIENT: Female, 62 years old
CHIEF COMPLAINT: "I want my teeth cleaned."
BACKGROUND: History of basal cell carcinoma removed from nose, two years ago
CURRENT FINDINGS: Mild, generalized plaque and calculus, White, non-wipeable region on the lateral surface of the tongue
Each of the following is included in the differential diagnosis EXCEPT one. Which is the EXCEPTION?
A. Oral epithelial dysplasia
B. Leukoplakia
C. Lichen planus
D. Geographic tongue
B. Leukoplakia
PATIENT: Female, 61 years old
CHIEF COMPLAINT: “My tongue has been burning and feeling raw for three weeks.”
BACKGROUND: Depression
MEDICATIONS: escitalopram (Lexapro®)
CURRENT FINDINGS: No odontogenic or non-odontogenic source identified, Normal salivary flow
Which is the most likely diagnosis?
A. Aphthous stomatitis
B. Burning mouth syndrome
C. Licen planus
D. Trigeminal neuralgia
B. Burning mouth syndrome
PATIENT: Female, 51 years old
CHIEF COMPLAINT: “My gums look puffy.”
BACKGROUND: Pulmonary hypertension
MEDICATIONS: amlodipine (Norvasc®)
CURRENT FINDINGS: Generalized gingival hypertrophy
Which of the following best describes the mechanism of action of the medication?
A. Blocked angiotensin-converting enzyme
B. Blocks the voltage-dependent L-type calcium channels
C. Blocks the release of renin
D. Antagonizes angiotensin II
B. Blocks the voltage-dependent L-type calcium channels
PATIENT: Female, 45 years old
CHIEF COMPLAINT: “I have a bad tooth that has been causing me pain; I would like to have it removed.”
BACKGROUND: Osteoporosis
MEDICATIONS: alendronate (Fosamax®)
CURRENT FINDINGS: Tooth 3 large mesio-occlusal caries
Which of the following is the primary mechanism of action of the patient’s prescribed medication?
A. Inhibits RANKL
B. Inhibits osteoclast function
C. Modulates estrogen receptors
D. Enhances intestinal absorption of calcium
B. Inhibits osteoclast function