MICROBIOLOGY-PATHOLOGY (13)

DENTAL ANATOMY AND OCCLUSION (14)

PART l
MONDAY - P.M.
DECEMBER 1998

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COPYRIGHT 1998
JOINT COMMISSION ON NATIONAL DENTAL EXAMINATIONS
AMERICAN DENTAL ASSOCIATION
211 EAST CHICAGO AVENUE, CHICAGO, ILLINOIS 60611

1.

A patient who has anemia, poorly localized

abdominal pain, and wrist and foot drop probably
is manifesting a toxic state induced by which of
the following?
A.
B.
C.
D.
E.

2.

3.

A.
B.
C.
D.
E.

4.

Protooncogenes
Viral oncogenes
Retroviral genes
Analogous chromosomes
Homologous chromosomes

Which of the following bacterial vaccines is given

routinely to children in the U.S.A.?
A.
B.
C.
D.
E.

7.

Measles
Roseola
Chickenpox
Viral meningitis
Infectious mononucleosis

Normal human cells contain gene sequences

homologous to virus genome sequences known to
induce cancer in animals. What term applies to
these gene sequences when found in human
cells?

BCG
Cholera
Polyvalent pneumococcus
Measles, mumps, rubella
Diptheria, pertussis, tetanus

Which of the following commonly produces a

positive heterophile antibody test?
A.
B.
C.
D.
E.

Carbon tetrachloride
Carbon monoxide
Bismuth
Mercury
Lead

A patient with shingies (herpes zoster) is MOST

likely to have had a previous episode of which of
the following?

A.
B.
C.
D.
E.

6.

Which of the following inflammatory responses is

associated with an infection caused by pyogenic
pathogens?
A.
B.
C.
D.

8.

Catarrhal
Granulomatous
Pseudomembranous
Acute suppurative

Which of the following bacterial genera is LEAST

likely to be found among normal anaerobic flora of
the gingival sulcus?
A.
B.
C.
D.
E.

9.

Adenovirus
Cytomegalovirus
Epstein-Barrvirus
Parainfluenza virus
Herpes simplex virus type 1

Mycobactenurn
Fusobactenum
Prevotella
Actinobacillus
Potphyrornonas

If Type A blood is accidentally transfused into a

Type B recipient, the immediate hemolytic
reaction would be the result of which of the
following?
A.
B.
C.
D.
E.

IgM against the A antigen

IgA against the A antigen
IgG against the B antigen
T cytotoxic cell activation
Sensitization to antigens other than A or B

10. Which of the following is the MOST appropriate

5.

Which of the following organisms is commonly

located on the dorsum of the tongue?
A.
B.
C.
D.
E.

Actinomyces israelii
Streptococcus salivanus
Lactobacillus acidophilus
Prevotella rnelaninogenica
Streptococcusmutans

alternative for treating a patient allergic to

penicillin who has an infection caused by bacteria
sensitive to penicillin?
A.
B.
C.
D.
E.

Rifampin
Amoxicillin
Erythromycin
Tetracycline
Cephalosporin

11. In the past 30 years, the mortality rate of which of

16. A patient with rheumatic heart disease is MOST

the following forms of cancer in women has

shown a marked increase?

likely to develop congestive heart failure due to

which of the following?

A.
B.
C.
D.
E.

A.
B.
C.
D.
E.

Uterine cervix
Colorectal
Stomach
Breast
Lung

12. Normal clotting time and normal platelet count

accompanied by prolonged bleeding time
suggest which of the following?
A.
B.
C.
D.
E.

Hemophilia
Steatorrhea
Polycythemia Vera
Thrombocytopenic purpura
Excessive aspirin ingestion

13. Dry heat sterilization of dental instruments

requires
A.
B.
C.
D.
E.

3 minutes at 2 7 0 ' ~ (132'~).

20 minutes at 2 5 0 ' ~ (121'~).
30 minutes at 3 2 0 ' ~ (160'~).
60 minutes at 3 4 0 ' ~ (171'~).
6 hours at 1 0 0 ' ~(38'~).

14. Successful immunization with a hepatitis B

vaccine results in the development of serum
antibodies to which of the following?
A.
B.
C.
D.

HBsAg
HBcAg
HBeAg
HBV-DNA polymerase

17. Which of the following represents the phenotypic

expression of both alleles in a gene pair?
A.
B.
C.
D.
E.

autosomal dominant disorder?

A.
B.
C.
D.
E.

Type 1 diabetes mellitus

Type 2 diabetes mellitus
Gardner syndrome
Cleft palate
Gout

Penetrance
Lyonization
Codominance
Hybridization
Heterozygosity

18. Hereditary angioedema is the result of which of

the following?
A.
B.
C.
D.
E.

Lack of a thymus
Deficiency in C1 esterase inhibitor
Developmental arrest of lymphocytes
Defective VH gene recombination to DJH
Bare lymphocytes (no Class llll antigens)

19. Legionella pneumophilia is commonly transmitted

by
A.
B.
C.
D.
E.

15. Which of the following represents a simple

Heart murmur
Valvular insufficiency
Digitalis toxicity
Cor pulmonale
Aschoff bodies in coronary arteries

sexual contact.
water contaminated with human waste.
aerosolization of organisms in contaminated
soil.
direct contact with respiratory droplets from
a contaminated person.
aerosolization of organisms in air
conditioning cooling towers.

20. Which of the following BEST represents the

pathogenesis of jaundice in patientswith
hepatitis A?
A.
B.
C.
D.
E.

Massive hemolysis
Portal hypertension
Damage to liver cells
Massive fibrosis of the liver
Obstruction of main bile ducts

21. Which of the following pathologic changes is

irreversible?

A.
B.
C.

D.

Fatty change in liver cells

Karyolysis in myocardial cells
Glycogen deposition in hepatocyte nuclei
Hydropic vacuolization of renal tubular
epithelial cells

22. Which of the following is the major VIRAL cause

of birth defects in infants in developed countries?
A.
B.
C.

D.
E.

Measles
Cytomegalovirus
Herpes simplex
Rubella
Varicella-zoster

23. Warts are caused by which of the following?

A.
B.
C.
D.
E.

Papillomaviruses
Herpesviruses
Rhinoviruses
Adenoviruses
Rotaviruses

24. To which of the following molecules does HIV

bind?
A.
B.
C.
D.
E.

CD4
CD8
MHC Class I
MHC Class II
immunoglobulin

27. Uncomplicated healing of a wound by secondary

intention, observed microscopically at three days,
is MOST likely to show evidence of which ofthe
following?

A.
B.
C.
D.
E.

Mature cicatrix
Keloid formation
Granulomatous inflammation
Lack of acute inflammation
Ulceration of the epithelial surface

28. Which of the following represents the MOST

common autopsy finding in instances of sudden
death as a result of myocardial infarction?
A.
B.
C.
D.
E.

Valvular prolapse
Coronary thrombosis
Fibrinous pericarditis
Aneurysm of the heart wall
Rupture of the coronary vessel

29. Which of the following represents the

characteristic cellular infiltrate in delayed type
hypersensitivity?
A.
B.
C.
D.
E.

T cells and macrophages

Eosinophils
Neutrophils
B cells and plasma cells
Mast cells and basophils

30. Which type of oral candidiasis is likely to produce

a firmly adherent white plaque on the oral
mucosa?

25. Which of the following viral diseases has the

LONGEST incubation period?
A.
B.
C.
D.

E.

Herpetic gingivostomatitis
Common cold
Influenza
Measles
Rabies

A.
B.
C.
D.

Acute pseudomembranous
Chronic hyperplastic
Chronic atrophic
Acute atrophic

31. If a foreign antigen enters the body through the

26. Which of the following typically results in sudden
death?
A.
B.
C.
D.
E.

Bronchiectasis
Pneumoconiosis
Pulmonary emphysema
Pulmonary saddle embolus
Idiopathic pulmonary fibrosis

skin, which of the following portions of the

lymphoid system is the antigen MOST likely to
reach FIRST?

A.
B.
C.
D.
E.

Liver
Spleen
Thymus
Lymph nodes
Mucosal-associated lymphoid tissue

32. Each of the following is commonly associated with

congestive heart failure EXCEPT one. Which
one is this EXCEPTION?
A.
B.
C.
D.
E.

Dyspnea
Cyanosis
Anasarca
Ankle edema
Passive congestion of the liver

38. Which of the following genera of bacteria is MOST

commonly found on the skin?
A.
B.
C.
D.
E.

Candida
Brucella
Bacillus
Streptococcus
Staphylococcus

39. Which of the following is unique to gram-negative

33.

The appearance of new strains of human

immunodeficiency virus are primarily the result of
A.
B.
C,
D.

natural selection.
genomic recombination.
errors in translation.
errors in transcription.

34. Bleeding esophageal varices are a common

bacteria?
A.
B.
C.
D.
E.

Flagella
Capsules
Ribosomes
Endotoxins
Endospores

40. Inadequate immobilization after a bone fracture is

complication of which of the following conditions?

MOST likely to result in which of the following?

A.
B.
C.
D.
E.

A.
B.
C.
D.
E.

Cirrhosis
Hiatal hernia
Pancreatic carcinoma
Chronic active hepatitis
Hepatocellular carcinoma

Osteornyelitis
Osteoarthritis
Pseudoarthrosis
Heberden's nodes
Rheumatoid arthritis

41. Phage conversion is responsible for which of the

following?

35. Which of the following is the primary site of origin

of neuroblastoma?
A.
B.
C.
D.
E.

Brain
Kidney
Stomach
Mandible
Adrenal gland

36. In the process of cell death, lysosomal enzymes

function mainly to
A.
B.
C.
D.

autolyze necrotic cells.

mediate cell degeneration.
act as a major target for cell injury.
activate the complement sequence.

A.
B.
C.
D.

Transformation of bacteria
Production of beta-galactose
Production of pyrogenic toxin
Ability of Rhizobium species to fix nitrogen

42. Which of the following represents the BESTway

to verify heat sterilization?
A.
B.
C.
D.
E.

Using a chemical monitor

Recording sterilizer pressure
Recording duration of exposure
Recording sterilizer temperature
Testing with biological indicator

43. Which of the following diseases is MOST often

characterized by hyphae growing in and around
vessels?

37. The antigen-binding site of antibody molecules is

localized in the
A.
B.
C.
D.

Fab fragment.
Fc receptor.
J-chain.
constant region.

A.
B.
C.
D.
E.

Candidiasis
Mucormycosis
Blastomycosis
Histoplasmosis
Coccidioidomycosis

44. In either an allergic reaction or a parasitic

49. The process of gene transfer between bacterial

infection, which of the following cells increase in

number in the bloodstream?

cells that involves the uptake of naked DNA

molecules is classified as which of the following?

A.
B.
C.
D.
E.

A.
B.
C.
D.
E.

Basophils
Eosinophils
Plasma cells
Atypical lymphocytes
Nucleated erythrocytes

45. Which of the following viruses is characterized by

Conjugation
Transduction
Translocation
Transformation
Gene conversion

50. Obesity, striae, moon face, buffalo hump, and

latency and by the clinical symptoms that can

follow trauma, fever, or nerve damage?

osteoporosis are manifestations of which of the

following?

A.
B.
C.
D.
E.

A.
B.
C.
D.
E.

Variola
Influenza
Rubella
Herpes simplex
Coxsackievirus A

Myxedema
Acromegaly
Addison's disease
Cushing's syndrome
Diabetes insipidus

51. The capsule of Streptococcus rnutans is an

important virulence factor that

46. Which of the following is the MOST important

function of bacterial pili in causing human
infectious disease?
A.
B.
C.
D.

Making the bacteria motile

Allowing bacteria to adhere to human cells
Transfering DNA from one bacterium to
another
Destroying phagocytic macrophages and
neutrophils

47. Host responses against encapsulated

Streptococcuspneurnoniae are chiefly mediated
by which of the following?

A.
B.
C.
D.
E.

has proteolytic activity.

enhances oral accumulation.
causes circulatory collapse.
prevents phagocytic digestion.
is necessary to cause bacteremia.

52. Which of the following genera form endospores?

A.
B.
C.
D.
E.

Proteus and Escherichia

Clostridiurn and Bacillus
Porphyromonas and Streptococcus
Mycobacteriurn and Actinornyces
Staphylococcus and Corynebactenurn

53. Which of the following chemical agents has the

broadest antimicrobial spectrum of activity?

A.
B.
C.
D.
E.

IgE
IgD
Opsonins
Cytotoxic T lymphocytes
Delayed hypersensitivity

A.
B.
C.
D.
E.

Phenol
Ethanol
lsopropanol
Glutaraldehyde
Quaternary amine

54. Which of the following viruses does NOT establish

48. MOST rickettsia1 diseases can produce severe

a latent infection?

illness in humans because rickettsiae

A.
B.
C.
D.

produce potent exotoxins.

cause extensive CNS damage.
are destructive for epithelial cells.
are destructive for endothelial cells.

A.
B.
C.
D.
E.

Poliovirus
Epstein-Barr
Herpes simplex
Varicellazoster
Cytomegalovirus

55. Cor pulmonale is usually the direct result of

A.
B.
C.
D.
E.

viral pneumonia.
myocardial ischemia.
systemic hypertension.
resistance to blood flow through the lungs.
streptococcal hypersensitization.

60. A patient states that he immediately begins

wheezing and has difficulty breathing when
exposed to penicillin. Which ofthe following
classes of antibodies is responsible for the
difficulty in breathing?
A.
B.
C.
D.
E.

IgA
IgE
IgG
IgM
IgD

56. Which of the following represents one function of

macrophages in immunity?
A.
B.
C.
D.

Produce IL-2
Produce antibody
Present antigen to antigen-specific T cells
Mediators of antibody dependent cellular
cytotoxicity

61. Multiple drug resistance is related MOST closely

to bacterial
A.
B.
C.
D.
E.

plasmids.
chromosomes.
transduction.
transformation.
viruses in the bacterial wall.

57. What is the role of lactobacilli in coronal caries?

A.
B.
C.
D.
E.

Primary pathogen in most cases

Highly pathogenic in animal models
Causes progression of existing lesions
Highly adherent colonizer of smooth
surfaces
Consumes lactic acid produced by
streptococci

62. An enterotoxin formed by Staphylococcus aureus

causes
A.
B.
C.
D.

food poisoning.
a rash on the skin.
neuromuscular paralysis.
spasms of voluntary muscles.

63. The basic chemical structure of endotoxins

includes which of the following?

58. Which of the following represents the formation of

an intravascular blood clot?
A.
B.
C.
D.
E.

Thrombosis
Hemorrhage
Infarction
Embolization
Transudation

A.
B.
C.
D.
E.

Capsular polysaccharide
Acid stable peptidoglycan
H and L chain glycoproteins
Lipoteichoic acid, polysaccharide, protein
Somatic 0 polysaccharide, core
polysaccharide, lipid A

64. Which of the following causes whooping cough?

59. Which of the following statements is CORRECT

A.
B.
C.
D.
E.

Haemophilus intluenzae
Streptococcuspneumoniae
Bordetella pertussis
Brucella melitensis
Klebsiella pneumoniae

regarding glioblastoma multiforme?

A.
B.
C.
D.
E.

The tumor is most common before puberty.

It is classified as a type of meningioma.
It is the most common tvpe of astrocvtoma.
Its prognosis is generaliy more favorable
than Grade I astrocytoma.
It is derived from the epithelial lining of the
ventricles.

65. Which of the following disorders is LEAST likely to

be included in the differential diagnosis of a
patient with acute appendicitis?
A.
B.
C.
D.
E.

Crohn's disease
Duodenal peptic ulcer
Meckel's diverticulitis
Pelvic inflammatory disease
Gastroenteritis with mesenteric adenitis

66. Dimorphism in microorganisms is characterized

A.
B.
C.
D.

71. Penicillin is usually non-toxic to human cells

because human cells LACK which of the
following?

by the capability to produce

both sexual and asexual spores.
both a yeast phase and a mycelial phase.
two distinct types of clinical infections.
both by budding and by production of
spores.

A.
B.
C.
D.

Mitochondria
Peptidoglycans
Topoisomerases
Nuclear membranes

72. Anaerobic bacteria obtain their energy

67. During a Type I hypersensitivity reaction,
leukotrienes and prostaglandin
from which of the following?
A.
B.
C.
D.
E.

are generated

Thymus
Histamine
Arachidonic acid
Bradykinin and other kinins
Granules of mast cells and basophils

requirements from which of the following

reactions?
A.
B.
C.
D.
E.

Respiration
Fermentation
Atmospheric oxygen
Oxidative phosphorylation
Catalase and superoxide dismutase

73. In order for a virus to infect a host cell, it must first

a graft versus host reaction occur?

adsorb onto the cell surface. This process

necessitates

A.
B.

A.
B.

68. Under which of the following circumstances does

C.

D.
E.

When nonvital tissues are grafted

When viable lymphoid cells are present in
the graft
When the recipient and the donor are
syngeneic
When the graft is contaminated with gramnegative microorganisms
When the donor and the recipient are of
different races

69. Which of the following is associated with an

C.
D.

phagocytic activity by the cell.

an inhibition of the cellular secretion of
interferon.
an insertion of virally specified glycoproteins
into the host-cell membrane.
a specific binding of the virus to a
cell-membrane receptor.

74. Neisseria gonorrheae has affinity for which of the

increased risk of breast cancer?

following structures?

A.

A.
B.
C.
D.
E.

B.
C.
D.
E.

History of bearing multiple children

Estrogen deficiency
Silicone implants
Fibroadenoma
Obesity

Skin
Nerve cells
Plasma cells
Muscle fibers
Mucous membrane

75. Which of the following is MOST likely caused by

70. Which of the following are directly associated with
destruction of glomerular basement membranes
in a patient with glomerulonephritis?
A.

B.
C.
D.

Eosinophils
Lymphokines
IgE antibodies
Polymorphonuclear leukocytes

chronic blood loss due to a long-standing peptic

ulcer?
A.
B.
C.

D.
E.

Aplastic anemia
Hemolytic anemia
Pernicious anemia
Myelophthisic anemia
Iron deficiency anemia

76. An afebrile patient with conjugated

hyperbilirubinemia and an absence of
urobilinogen MOST likely has which of the
following conditions?
A.
B.
C.
D.
E.

Cholelithiasis
Aplastic anemia
Hemolytic anemia
Acute hepatitis
Alcoholic cirrhosis

81. Individuals with severe, uncomplicated pulmonary

emphysema might be expected to show which of
the following?
A.
B.
C.
D.

Cough
Chest pain
Normal or increased total lung capacity
Difficulty when breathing in (inspiration)

82. Which of the following is an oncogenic RNA

virus?

77. Which of the following genera of fungi is MOST

frequently recovered from healthy mucous
membranes?
A.
B.
C.
D.
E.

Candida
Aspergillus
Histoplasma
Blastomyces
Coccidioides

A.
B.
C.
D.
E.

Rotavirus
Retrovirus
Herpesvirus
Paramyxovirus
Papillomavirus

83. Candidiasis in the adult oral cavity may signify a

change in the balance of oral microbiota. This
particular change is often seen in persons who
are taking which of the following drugs?

Which of the following disinfectants is effective

against herpes simplex viruses but NOT
rhinoviruses?
A.
B.
C.
D.
E.

Phenolics
lodophores
Glutaraldehydes
Sodium hypochlorite
70% isopropyl alcohol

A.
B.
C.

Antiviral
Antifungal
Antibacterial

84. In addition to Kaposi's sarcoma, which other

malignant neoplasm is often observed in AIDS?
A.
B.
C.
D.
E.

Mycosis fungoides
Testicular carcinoma
Neuroblastoma
Non-Hodgkin's lymphoma
Rhabdomyosarcoma

79. The chemotactic accumulation of inflammatory

cells that occurs at the sites where immune
complexes are deposited is MOST probably due
to the presence of
A.
B.
C.
D.
E.

C5a.
Factor B.
IL-2.
IgA.
IgE.

80. In which of the following organs or tissues are

ascending infections common?
A.
B.
C.
D.
E.

Bone
Heart
Kidney
Peritoneum
Subcutaneous connective tissue

85. Which of the following represents a malignant

tumor arising from mesenchymal tissue?
A.
B.
C.
D.
E.

Sarcoma
Adenoma
Carcinoma
Hamartoma
Choristoma

86. Certain enzymes are responsible for suppuration.

These enzymes derive chiefly from
A.
B.
C.
D.
E.

serum.
tissue.
neutrophils.
lymphocytes.
plasma cells.

87. Which of the following represents the classic

92. Which of the following represents the epithelial

microscopic lesion of rheumatoid arthritis?

change MOST predictive of cancer?

A.
B.
C.
D.

A.
B.
C.
D.
E.

E.

Tophus
Pannus
Aschoff body
Heberden node
Wire-loop lesion

88. A 43-year-old woman exhibits radiographic

evidence of an osteolytic lesion of the humerus.
Her serum calcium level is elevated.
Microscopically, the bone lesion shows numerous
giant cells. Which of the following represents the
MOST probable diagnosis?
A.
B.
C.
D.

Renal rickets
Fibrous dysplasia
Osteitis deformans
Hyperparathyroidism

Dysplasia
Metaplasia
Acanthosis
Parakeratosis
Hyperkeratosis

93. Acute leukemias are MOSToften seen in which of

the following age groups?
A.
B.
C.
D.
E.

Under 20 years
20-40 years
40-60 years
60-80 years
Over 80 years

94. Which of the following is a major component of

nephrotic syndrome?

89. Adult respiratory distress syndrome might be

caused by each of the following EXCEPT one.
Which one is this EXCEPTION?
A.
B.
C.
D.
E.

Shock
Heroin overdose
Viral pneumonia
Cigarette smoking
Breathing 100 percent 0 2

A.
B.
C.
D.
E.

95. Which of the following is the MOST common skin

cancer in humans?
A.
B.

90. Which of the following is thought to be of MOST

significance in the
an uncontrolled diabetic?
A.

Genetics

endothelium

Anemia
Hematuria
Hypertension
Proteinuria
Red cell casts in the urine

C.
D.

E.

Malignant melanoma
Basal cell carcinoma
Squamous cell carcinoma
Sebaceous adenocarcinoma
Transitional cell carcinoma

96. Which of the following represents the MOST

probable cause for prolonged bleeding time in a
patient with leukemia?

A.
B.
C.
D.

E.

Decreased factor Vlll

lncreased factor IX
lncreased megakaryocytes
Decreased level of serum calcium
Decreased number of blood platelets

91. Rheumatic fever can be a sequelae to which of

the following streptococcal infections?
A.
B.
C.
D.

E.

Pyoderma
Diphtheria
Scarlet fever
Dental caries
Streptococcal gangrene

97. An abscess in the oral cavity with central necrosis

extruding pus containing sulfur granules would be
which of the following?
A.
B.
C.
D.

Furuncle
Tuberculosis
Actinomycosis
Vincent's infection

98. Patients with which of the following malignancies

have the poorest prognosis?
A.
6.
C.
D.
E.

Lung cancer
Malignant melanoma
Pancreatic carcinoma
Carcinoma of the colon
Squamous carcinoma of the tongue

99. Asymptomatic carriers are a major hazard of

which of the following?
A.
6.
C.
D.
E.

Plague
Shigellosis
Salmonellosis
Typhoid fever
Legionnaire's disease

100. Acid phosphatase is elevated in which ofthe

following malignancies?
A.
6.
C.
D.
E.

Multiple myeloma
Carcinoma of the breast
Squamous cell carcinoma
Carcinoma of the thyroid
Metastatic carcinoma of the prostate

NATIONAL BOARD DENTAL EXAMINATIONS

PART 1
TEST:
FORM:
DATE:

MICROBIOLOGY-PATHOLOGY
13 (A13)
D98

Item

Key

Item

Key

Item

Key

Item

Key

1
2
3
4
5

E
C
A
E
B

26
27
28
29
30

D
E
B
A
B

51
52
53
54
55

B
B
D
A
D

76
77
78
79
80

A
A
E
A
C

6
7
8
9
10

C
D
A
A
C

31
32
33
34
35

D
C
D
A
E

56
57
58
59
60

C
C
A
C
B

81
82
83
84
85

C
B
C
D
A

11
12
13
14
15

E
E
D
A
C

36
37
38
39
40

A
A
E
D
C

61
62
63
64
65

A
A
E
C
B

86
87
88
89
90

C
B
D
D

16
17
18
19
20

B
C

B
E
C

41
42
43
44
45

C
E
B
B
D

66
67
68
69
70

B
C
B
E
D

91
92
93
94
95

C
A
A
D
B

21
22
23
24
25

B
B
A
A
E

46
47
48
49
50

B
C
D
D
D

71
72
73
74
75

B
B
D
E
E

96
97
98
99
100

E
C
C
D
E