ORAL MEDICINE/ORAL PATHOLOGY IV -QUIZ 1 S2024

1. The most common clinical manifestation of Behcet disease is:

a. Vasculitis
b. Ulcers in the skin and mucous membranes
c. Pathergy
d. Uveitis

2. Behçet disease is associated with HLA-.

a. B51
b. B59
c. A61
d. A50

3. Which of the following is usually the first symptom of an attack of recurrent aphthous stomatitis?
a. A blister in the mouth
b. A low-grade fever
c. Pain or burning in the mouth
d. The appearance in the mouth of a small ulcer

4. People who take corticosteroids to treat aphthous stomatitis are at risk of developing which of the
following conditions as a side effect of treatment?
a. Allergy to corticosteroids
b. Candida albicans infection
c. Loss of taste sensitivity
d. Thinning hair

5. 40-year-old male presents to our department, and you observe red granular hyperplasia of the gingiva
with short bulbous projections, which are hemorrhagic and friable. What is the name of gingivitis?
a. Grape
b. Grandular
c. Dendritic
d. Strawberry

6. 40-year-old female presents to our clinic complaining of dropping of the mouth. During physical
examination you notice facial paralysis, fissured tongue and swollen upper lip. What is your diagnosis?
a. Miescher cheilitis
b. Melkersson-Rosenthal syndrome
c. Allergy
d. Orofacial granulomatosis

7. 9-year-old child presents with a complain of painful bumps on the tongue. What is your diagnosis?
a. Eruptive lingual papillitis
b. Aphthous ulceration
c. HSV infection
d. Measles

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8. Continuous or particularly severe recurrent aphthous stomatitis may require prolonged use of which of
the following?
a. Chlorhexidine gluconate mouthwashes
b. Corticosteroids
c. Clobetasol ointment
d. Acyclovir

9. Which of the following has NOT been identified as a predisposing factor in recurrent aphthous stomatitis?
a. Allergy
b. Oral trauma
c. Certain foods
d. Stress

10. Which of the following differentiates oral herpes simplex virus infection from recurrent aphthous
stomatitis?
a. Does not involve the gingiva
b. Can be diagnosed by viral culture
c. Is not associated with systemic symptoms
d. Occurs only in the elderly

OLD QUESTIONS

11. This is a new patient for you. Although she hasn't had routine dental care, she hasn't had gingival bleeding
until last week. Now she complains that her gums bleed spontaneously-she found blood on her pillow-and
that they are swollen. On questioning, she tells you that she has been dragging around for the last few days.
(a) What would you do?
Aplastic anemia
complete blood count test

(b) Gingival bleeding is common among healthy patients with periodontal

disease. When should you suspect that gingival bleeding is of systemic
origin and possibly represents the presenting signs of leukemia?
- Gum bleeding in combination with perio diseases
- Sign and symptoms overweight the local factors
or don’t follow the normal clinical course
12. This 54-year-old woman presents to you with a complaint of localized areas of mucosa! burning and a
feeling of roughness on her cheeks. She has been aware of the cheek roughness for about 3 months. She used
to smoke one pack of cigarettes per day but stopped 7 years ago.
(a) How would you describe the lesions on her buccal mucosa?
white lesion network plaque = wickaem striae

(b) What is your diagnosis?

Oral Lichen Planus (OLP)

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13.
(a) How would you describe the lesion on this woman's
mandibular attached gingiva?
Positive nikolsky sign of pemphigus

(b) How would you make a definitive diagnosis?

Diagnosis of pemphigus vulgaris

Direct immunofluorescence show blood contains IgG antibodies

14. A 31-year-old man presented to our clinic with a 5-day history of oral and genital ulcers. He had a 2-year
history of recurrent oral and genital lesions.
(a) Which clinical entity comes first in your mind?
Behcet syndrome

(b) Make the differential diagnosis

sweet disease, IBD

15. Six weeks after you diagnosed a case of primary herpetic gingivostomatitis the mother of this 14-year-old
calls you to say that her son awoke with his mouth looking like this.
(a) What is it?
herpes 90% for erythema multiform

(b) What would you do?

Biopsies with direct immunofluorescence
local corticosteroids

16.
(a) What should you do if a patient presents with a firm, non-
movable, enlarging cervical node?
Biospy when find enlarged nodes and refer

(b) Are non-Hodgkin's lymphomas important to the dentist?

Explain
yes bc dentist is the first to identify the lesion , and can b
mistaken as absceess or toothache

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17. 34-year-old woman with chronic rhinosinusitis and nasal polyposis presented to the facial plastic surgery
clinic with rhinorrhea, bloody nasal crusting, and nasal deformity that had progressed over a period of 7
years. She had no history of intranasal cocaine use. Blood tests showed that antineutrophil cytoplasmic
antibodies (ANCA) were present at increased titers.
(A) The destruction of the nasal septum has resulted in ____ deformity
saddle nose deformity

(B) A diagnosis of ______ was made

GPA or wegener gralunomatosis
(C) What are the common oral findings of the disease?
strawberry gingivitis

18. A 20-year-old woman has had recurrent painful mouth ulcers for the past 5 years. She is otherwise healthy
and reports no genital or anal ulcers, skin lesions, gastrointestinal or joint problems, or fevers. Physical
examination reveals several ulcers 3mm in diameter, in the vestibule and internal surface of the tongue. She
has no lesions on the skin or other mucosal surfaces. How should she be evaluated and treated?
Herpeciform recurrent aphtous ulcer

Evaluation:
- reccurence of ulcer that is confine to mouth in abcennce of
systemic disease
- clinical, laboratory testing only considered in persistent, severe, or
recurrent

tx : OH ( soft brush sodium lauryl sulfate, alcohol free supplment vit

B2 , omega 3, avoid injury and food trigger flare-up

19.

aphtous ulcer herpeciform => multiple

20.
Amyloidosis

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21. what is it - picture
-geographic tongue

22. what is it - picture

-pernicious anemia

23. for hemostasis after surgery:

a. microfibrillar collagen hemostat
b. oxidized cellulose
c. tranexarnic acid mouthwash
d. all of the above

24. what is it - picture

-Chron’s disease

25. Shogrens syndrome includes:

a. oral lesions
b. caries
c. all of the above

26. which is not a type of pemphigus?

a. atrophic
b. hypertrophic
c. verrucous

27. most common pemphigus?

vulgaris

28. what is it – picture

a. aphthous
b. fistula
c. abscess

29. cyclic neutropenia includes:

RAS, recurrent gingivitis, and periodontitis

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30. What is erythema multiforme (EM)?
Acute condition w target loke lesion, erosion and bullae in genital, oral, occular mucosa

31. What are the signs and symptoms of erythema multiforme (EM) minor?
EM without mucosal disease and sytemic

32. What are the signs and symptoms of erythema multiforme (EM) major?
EM with severe mucosal involvment + systemic symptoms

33. What should be the focus of the history for suspected erythema multiforme (EM)?
bc 90% herpes , 10% medication NSAIDS, antibio
DDX : EM is selflimited => recurence et disappear for a while
34. erythema multiforme caused by:
herpes simplex virus

35. oral lymphomas:

non-hodgkins lymphoma

36. radiation caries:

-3 months from the initiation of RT and is progressive over the years

37. tzank cells:

38. acantholysis:
intraepithelial separation of bullaes

SAQ
39. what is this in the picture, diagnosis, how is the sign called and differential diagnosis

Positive nikolsky sign of pemphigus

DDx: Mucous mb pepmphigoid

40. picture this – what is your diagnosis:

Median rhomboid glossitis

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41. describe picture b and what is the tx
-desquamative gingivitis

42. what is it, what is the cause (from the description that was given was the medication) and what is the
treatment
-black hairy tongue

43. clinical picture different from lectures (like a macule) and this – what is the diagnosis and treatment?
-amalgam tattoo

44. what is it and what is the treatment?

-oral candidiasis

45. what is the cause of it, what is the diagnosis, what is

-necrotizing ulcerative gingivitis

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46. picture and histo – what is it and what is the autoantibody
-pemphigus

desmoglein 1 et 3

47. moderate pain, after initiation, not interfering with oral intake – what is the diagnosis, what is the grade,
what is the treatment
-mucositis

48. picture – what is it and what is the treatment

-primary herpetic gingivostomatitis

49. Examination & Treatment of Recurrent aphthous stomatitis?

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50. Continuous or particularly severe recurrent aphthous stomatitis may require prolonged use of which of the
following? (similar to 8)
a. Chlorhexidine gluconate mouthwashes
b. Azathioprine
c. Dexamethasone rinse
d. Clobetasol

51. What is the main treatment for orofacial granulomatosis?

a. Antibiotics
b. Corticosteroids
c. Immunosuppressants
d. Surgery

52. What is the most common symptom granulomatosis?

a. Swelling
b. Pain
c. Itching
d. Burning

53. What type of lesions are associated with orofacial granulomatosis?

a. Papules
b. Nodules
c. Plaques
d. All of the above

54. What is the most common cause of orofacial granulomatosis?

a. Allergies
b. Infections
c. Abnormal immune responses in people with genetic predisposition
d. Genetic disorders