Oral Pathology

Muhamad Taha Sulaiman

4th grade
 MCQ
Q1: floor of mouth carcinomas spread is?
A: Laterally – Superficial B: Laterally- Deep
C: Centrally – Superficial D: Centrally-Deep

Q2: Carcinoma Of The Floor Of The Mouth arise?

A: From Body of Hyoid B: From muscle of tongue
C: Lingual surface of Mandible D: None
(its some how tricky in book says its from anterior so anterior is C )

Q3: Which site accounts for approximately 10% of all

oral carcinomas?
A: Floor of mouth B: Alveolar ridge and gingiva
C: Retromolar region D: Buccal mucosa
Q4: Betel quid chewer is likely to get Carcinoma at
Which Site ?
A: Tongue B: Floor of mouth
C: Buccal mucosa D: All of them

Q5: Why Carcinoma Of Retromolar region is

difficult To treat? Because of :
A: spread into underlying bone B: surgery is difficult
C: metastases D :All of them

Q6: surgical removal of posterior tongue risks

aspiration of food and saliva and may necessitate ?
A: cricothyrotomy B: tracheostomy
C: laryngectomy D: tracheotomy

Q7: In Carcinoma the final staging is confirmed

according to ?
A: FIGO B:Dukes Staging
C:TNM D: Ann Arbor
Q8:Most patients with oral carcinoma present
at stage ?
A: I-II B: II-III
C: III-IV D: II-III-IV

Q9: MRI imaging is useful to detect ?

A: perineural spread B: minor bone involvement
C: extension around skull base D: A+C

Q9: Which Imaging method used to detect metastases

to the mouth or jaws ?
A:CT B:MRI
C:PET D: EEG

Q10: Radiotherapy and chemotherapy treatment

usually takes ?
A: 10 months B:10 weeks
C: 6 months D: 6 weeks
Q11: Which method of treatment is preferred for small
carcinomas of the tongue ?
A: Radiotherapy B: Surgery
C: NSAID+ Antibiotic D: multimodality

Q12: In this image the most probable diagnosis is?

A: Early stage oral Carcinoma B: Chemical burn

C: gangrenous stomatitis D: NONE
Q13 : In previous image Best treatment strategy is?
A: Radiotherapy B: Surgery
C: multimodality D:Hyaluronic Acid (Filler)

Q14: Which of the Following is not Unwanted effects

of radiotherapy to the oral region ?
A: Severe xerostomia B: Ulceration
C:Acute candidosis D: Skin Eczema

Q15: which of the following is Immediate adverse

effects of cancer surgery to the oral region ?
A:Trismus B:Flap failure
C: Dysphagia D: Pain

Q16:Chemotherapy blocks activation of ?

A:downstream signaling B:Nerve growth factor
C:Tumor necrosis factor D:Epidermal growth
factor
Q17:Which of the following drug used for
Epidermal growth factor block?
A:Cefipime B:Cefpyrome
C: cetuximab D: Cefdinir

From this image answer these question (18-19-20)

Q18: Identify Technique used here?

A:lymphangiography B:lymphosocintigraphy
C:Lymphoseek D:paired – agent imagining
Q19: Which structure used for biopsy?
A: SA node B:AV node
C: sentinel node D: segmental nodules

Q20: Which tracer used for imaging ?

A: Radionuclide B:stable nuclide
C: Radioisotope D: Sable isotope

Q21: Which of the following doesn’t affect survival

from oral cancer ?
A: Advanced age B:Female gender
C: Posterior location D: Poor general health

Q22: cause of The poorer survival of older people is?

A: Nutritional deficiency B:less able to withstand
treatment C:Poor Hygiene D:Genetics
Q23: Neck recurrences may be treated by
A: Neck Dissection B: Radiotherapy
C: Antibiotic D: A+B

Q24 : Palliative treatment is given to patients

A: advanced tumours B: treatment failures
C: as first line therapy D: A+B

Q25: A small, but possibly growing, proportion of patients

survive treatment of the primary carcinoma but die later
from
A:large Tumor B:not effective treatment
C: Metastases D:none

Q26: Small carcinomas are

A: More difficult to detect B: likely get metastases
C: Good Prognosis D: not critical
Q27: one of Role of the dental practitioner in cancer
after treatment is
A: provide additional support to patients B: Be vigilant and
suspicious
C: Refer all high-risk lesions on discovery D:ALL of them

Q28: Tolonium chloride used for white lesion will

result in
A: true – positive B: False – negative
C:false –positive D: True - negative

Q29:VERRUCOUS CARCINOMA is
A: High grade CA B: MODERATE CA

C: low grade CA D: Advanced

Q30:VERRUCOUS CARCINOMA is associated with

A: alcohol B: Betel quid chewer

C: snuff dipping D: smoking

Q30:VERRUCOUS CARCINOMA affect
A: Buccal mucosa B: Tongue
C:Floor of mouth D :all

Q31: This image shows

A: Leukoplakia B:Lichen planus

C: VERRUCOUS CARCINOMA D: Leukoedem
Q31: This FIGUER shows

A: Leukoplakia B:Lichen planus

C: VERRUCOUS CARCINOMA D: Leukoedem

Q32:from previous figure is associated with

A: spiky parakeratotic surface B: epithelium
folds
C: epithelium thickened D: all

Q33: pushing invasion seen in

A: Leukoplakia B:Lichen planus
C: VERRUCOUS CARCINOMA D: Leukoedem
Q34:T1 in TNM system is

A: 2–4 cm in greatest dimension B: Tumour 2 cm or less greatest dimension

C: Tumour more than 4 cm in D: Tumour invades through the cortical bone

Q35:T2 in TNM system is

A: 2–4 cm in greatest dimension B: Tumour 2 cm or less greatest dimension

C: Tumour more than 4 cm in D: Tumour invades through the cortical bone

Q36:T3 in TNM system is

A: 2–4 cm in greatest dimension B: Tumour 2 cm or less greatest dimension

C: Tumour more than 4 cm in D: Tumour invades through the cortical bone

Q37:T4 in TNM system is

A: 2–4 cm in greatest dimension B: Tumour 2 cm or less greatest dimension

C: Tumour more than 4 cm in D: Tumour invades through the cortical bone

Q38: Metastasis in multiple ipsilateral lymph nodes, none more than

6 cm maximum diameter, without extranodal extension is

A : N2C B:N2B

C:N3A D:N3B

Q39: Metastasis in a lymph node more than 3 cm maximum diameter with extranodal extension

A : N2C B:N2B

C:N3A D:N3B

Q40:M2 IN Tnm is
A: No distant metastasis B: Distant metastasis present

C: Metastasis in a single ipsilateral lymph node, 3 cm maximum

D:None

Q41: Stage 1 IN TNM is

A : T2 N0 M0 B:T1 N1 M1

C: T1 N0 M0 D: T3 N0 M0

Q42: Stage 2 IN TNM is

A : T2 N0 M0 B:T2 N2 M2

C: T1 N0 M0 D: T3 N0 M0

Q43: Stage 3 IN TNM is

A : T2 N0 M0 B:T3 N3 M3

C: T1 N0 M0 D: T1-3 N1 M0

Q44: Stage 4a IN TNM is

A : T2 N0 M0 B:T4 N4 M4

C: T1-4a N2 M0 D: T1-3 N1 M0

Q45: Stage 4b IN TNM is

A : T2 N0 M0 B: T4BAny N M0

C: T1-4a N2 M0 D: T1-3 N1 M0

Q46: Stage 4c IN TNM is

A : Any T Any N M1

B: T4BAny N M0

C: T1-4a N2 M0 D: T1-3 N1 M0

Q47: Tumour invades skull base is

A:T3 B: T4A

C:T4B D: stage 4A
 T/F
1. The lateral border of the anterior two-thirds of
the tongue and the adjacent ventral tongue are
common sites For carcinoma. T
2. carcinoma arising centrally on the dorsum is
common. F
3. adjacent ventral tongue are common sites For
carcinoma. F
4. Carcinoma in the tongue is renowned for its
predictable spread. F
5. The tongue becomes progressively stiffer and
more painful. Eating, swallowing and talking
become difficult. T
6. Carcinoma of the tongue is also known for its
unpredictable metastasis. T
7. Tongue carcinoma develops metastases at an
early stage.
8. if they extend up onto the ventral tongue, they
may then extend into underlying BONE. F
9. Alveolar ridge and gingiva carcinomas tend to
be well differentiated and more slowly growing
than tongue . T
10. Even after diagnosis of carcinoma, the speed
of treatment is not critical .F
11. Palpation is always effective in delineating
the outline of a tumour. F
12. Well-differentiated carcinomas containing
no keratin are usually firm and readily
identified . F
13. Particular attention is paid to extension to
the base of skull, prevertebral fascia for
management of Carcinoma.T
14. Actual and potential dental infection in the
mouth must be dealt with afterstarting
treatmentfor carcinoma . F

15. teeth for which rapid successful treatment

cannot be guaranteed are usually extracted .T
16. carcinoma is given a score for size (N) . F
17. lymph node metas tasis (M) . F
18. distant blood-borne metastasis (T) . F
19. Carcinoma stage Between 0-5 . F
20. If radiotherapy fields include the larynx, the
voice may be affected. T
21. Oral carcinomas are normally treated
according to standardised protocols like
carcinomas at other body sites . F
22. Small differences in site and extent of
carcinoma make large differences to the
optimum treatment . T
23. In practice, most intraoral carcinomas are
treated by surgery combined with radiotherapy .
 T
24. Irradiation provides a more acceptable
functional result than major surgery .T
25. When surgery is used, it is usually
performed first, unless there has been a poor
response . T
26.
27. excise the carcinoma ideally 1 cm or more.
T
28. Tis :Carcinoma in situ, not invasive,
dysplasia only .T
29. N0 :No regional lymph node metastasis .T
30. M0 :No distant metastasis
31. LONG TERM Unwanted effects of
radiotherapy IS Skin erythema . F
32. GRAFTING FOR ESTHETIC margin of
more than a few millimetres is rarely achieved .
T
33. Reconstructive surgery is normally
performed to provide a better cosmetic and
functional result AFTER CA TREATMENT.T
34. radiotherapy with chemo 25% improvement
in survival at best .F
35. all patients are able to tolerate concomitant
chemotherapy. F
36. Lymph node metastases have been detected,
neck dissection will be performed. T
37. the sternomastoid muscle, internal jugular
 vein and accessory nerve may also be sacrificed
in neck dissection . T
38. Neck dissection may also be required to
allow recon- structive flap surgery. T
39. The highest mortality from oral cancer is in
the first year. F
40. About 30% of patients develop a second
primary carcinoma . F
41. In general the more ANTERIOR the tumour
is, the poorer the survival. F
42. Treatment of a second primary may be made
more EASILY by previous surgery or
radiotherapy for the first carcinoma.
43. Recurrence in lymph nodes usually appears
within 2 years . T
44. Recurrent carcinoma is often less well
differentiated and more aggressive. T
45. Palliative care only aid to pain control. F
46. Extranodal spread from affected lymph
nodes may ulcerate through the skin.T
47. immunotherapy isn’t useful for patient with
CA . F
48. dentists, frequently fail to make the
diagnosis OF CA. T
49. antibiotics can prove fatal FOR CA. T
50. ALWAY perform an excisional biopsy of a
possible small carcinoma. F
51. a patient with unexplained red and white
patches of the oral mucosa that are not painful is
classified as urgent . F
52. Be vigilant and suspicious is for prevention .
F
53. Screening is intended to provide an accurate
diagnosis . F
54. Brush biopsy uses a round stiff-bristle brush
to collect cells from the surface . T
55. The lower border of the lesion is ill defined
FOR Verrucous carcinoma . F
56. Verrucous carcinoma excised relatively
easily unless it is extensive. T
57. verrucous carcinoma may progress to
invasive squamous carcinoma .T