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Exam 2017, questions and answers

Physical Pharmacy (University of Perpetual Help System DALTA)

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ORAL DIAGNOSIS

Which of the following is the most effective aid to detecting incipient proximal caries on the mesial
surface of a maxillary lateral incisor?
A. a dental explorer C. panoramic radiograph
B. direct visualization D. bite-wing radiograph E. periapical radiograph

For five days, a 25-year old man has had painful oral ulcerations. Several reddish macular lesions
are present on his face and hands, most of which have a ring-like or bull’s eye appearance. He
had “cold sores” two weeks earlier. Tentative diagnosis is:
A. lichen planus C. putyriasis rosea
B. aphthous ulcers D. verruca vulgaris E. erythema multiforme

A 65-year old man has an ulcerated, 3cm lesion on the lateral border of the tongue. The
recommended procedure for making a diagnosis is to:
A. excise the entire lesion C. perform an incisional biopsy
B. take a cytologic smear of the ulcerated area D. none of the above.

A well-circumscribed, white patch in the mandibular facial sulcus appears secondary to placing
aspirin in the area. The most probable diagnosis is:
A. hyperkeratosis of the oral mucosa C. hypertrophy of the oral mucosa
B. hyperplasia of the oral mucosa D. necrosis of the oral mucosa

A patient receives a tentative diagnosis of central giant cell granuloma. For definitive diagnosis,
serum calcium level should be determined to distinguish between granuloma and:
A. osteopetrosis D. hyperparathyroidsim
B. fibrous dysplasia E. osteogenesis imperfecta
C. Paget disease of bone

Examination of a 3 –year old boy reveals a fracture of his right leg, blue sclera, deafness and a
peculiarly shaped head. Opalescent dentin is found in many of his primary teeth. The most
probable clinical diagnosis is:
A. Osteopetrosis D. cleidocranial dysostosis
B. Marfan syndrome E. infantile cortical hyperostosis
C. Osteogenesis imperfecta

A patient presents with continuous, spontaneous pain associated with the maxillary right central
incisor. The tooth has a large Class V composite restoration. Cold testing produces lingering pain.
There is no sensitivity to percussion or palpation. The most likely diagnosis is:
A. necrotic pulp, chronic apical periodontitis
B. reversible pulpitis, normal periapex
C. irreversible pulpitis, normal periapex
D. irreversible pulpitis, acute apical periodontitis

A diagnostic test failed to identify five cases of true disease. This type of failure is known as a:
A. false negative C. false positive

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B. positive predictive value D. negative predictive value

A 33-year old female patient states that her mandibular first molar has been hurting since the
recent placement of an amalgam restoration. She describes the pain as mild-to-moderate, which
is not spontaneous, but is provoked by cold, heat and sweets. These symptoms most likely
correspond with:
A. pulp necrosis C. internal resorption
B. reversible pulpitis D. irreversible pulpitis

Ludwig angina is characterized by all of the following, except:

A. subcutaneous emphysema
B. rapid onset of firm, painful swelling
C. origin in a mandibular molar
D. dysplasia, dyspnea and fever
E. involvement of submaxillary, sublingual and submental spaces

Odontomas usually exhibit all of the following features, except:

A. severe pain C. delayed eruption of teeth
B. slow expansive growth D. many small, well-formed teeth

Each of the following may cause xerostomia, except:

A. mumps C. diabetes mellitus
B. a sialolith D. glandular aplasia E. morphine addiction

Globular dentin, very early pulpal obliteration, defective root formation, development of periapical
granulomas and cysts, and premature exfoliation of teeth are characteristic of which of the
following disorders?
A. shell teeth D. dentinal dysplasia
B. hutchinson’s teeth E. regional odontodysplasia
C. dentinogenesis imperfecta

Which of the following is necessary to differentiate among a dentigerous cyst, an odontogenic

keratocyst and an ameloblastoma?
A. Aspiration C. radiographic examination
B. exfoliative cytology D. microscopic examination E. none

Squamous carcinoma of which of the following sites offers the best chance for survival?
A. Lip C. gingiva
B. Palate D. buccal mucosa E. tongue/floor of the mouth

In which of the following locations is malignant melanoma of the oral mucosa most likely to
develop?
A. Palate C. buccal mucosa
B. lower lip D. floor of the mouth E. lateral border of the tongue

A patient who has a white blood cell count of more than 100,000/cc most likely is suffering from
A. Leukemia B. polycythemia C. Leucopenia D. pernicious anemia

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A swelling on the anterior floor of the mouth is soft and painless. It has been present for several
months. The overlying mucosa has a bluish tinge. The most likely diagnosis is:
A. A retention cyst D. A mixed salivary gland tumor
B. An infected periodontal abscess E. A carcinoma of the floor of the mouth
C. An obstructed sublingual gland duct

Differential white blood cell counts in the laboratory are useful in the diagnosis of:
A. anemia C. vitamin deficiency
B. eosinophilia D. thrombocytopenic purpura E. spherocytosis

. A 35-year old man has an odontogenic infection. He has frequent infections and has lost weight.
His appetite is good but he has polydipsia. The most probable diagnosis is:
A. malignancy C. disbetes insipidus
B. diabetes mellitus D. Hodgkin’s disease E. acute glomerulonephritis

The most common emergency seen after the use of local anesthesics is:
A. syncope C. a toxic reaction
B. trismus D. an allergic reaction E. an anaphylactoid reaction

The examination technique used for the buccal and labial mucosa is/are:
A. bilateral B. bidigital C. Bimanual D. A,B & C

Lip enlargement with mucopurent exudates is:

A. Cheiloschisis C. Chelitis Glandularis
B. Cretinism D. Peutz Jegher’s E. none of these.

The best examination technique for lymph nodes:

A. inspection only C. inspection & bimanual palpation
B. inspection and bidigital palpation D. inspection & bilateral palpation

A well-circumscribed, white patch in the mandibular facial sulcus appears secondary to placing
aspirin in the area. The most probable diagnosis is:
A. hyperkeratosis of the oral mucosa C. hypertrophy of the oral mucosa
B. hyperplasia of the oral mucosa D. necrosis of the oral mucosa

Examination of a 79-year old man reveals a 3cm flat, mottled, brown-black splotchy lesion on the
left side of his face. The margins of the lesion are not palpable. The patient states that the lesion
has been increasing in size for 10 years. The most likely diagnosis is:
A. “age spot” C. nodular melanoma
B. lentigo maligna D. junctional nevus E. superficial spreading melanoma

The characteristic oral clinical feature of Peutz-Jeghers syndrome is:

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C. macrognathia
D. melanin pigmentation of the lips
E. yellowish spots on the oral mucosa
F. small, papillary lesions on the palate
G. a rhomboidal-shaped red patch on the dorsum of the tongue

The most reliable, histologic criterion for a diagnosis of oral squamous cell carcinoma is:
A. invasion C. pleomorphism
B. degeneration D. encapsulation E. hyperchromatism

A patient has a 3 x 2 cm painless, fluctuant, blue lesion in the floor of the mouth of three days’
duration. The most likely diagnosis is:
A. ranula C. hemangioma
B. lipoma D. dermoid cyst E. lymphoepithelial cyst

Hairy tongue is characterized by hypertrophy of which of the following papillae?

A. Foliate B. filiform C. fungiform D. circumvallate

A 1-year old child has bilateral facial swelling =, a fever, leukocytosis and hyperostosis of his
facial bones. Blood cultures are negatives. He most probable diagnosis is:
A. cherubism C. Caffey’s disease
B. osteomyelitis D. osteogenic sarcoma E. infectious parotitis

Curd like plaques found on the oropharynx due to antibiotics or steroid therapy is:
A. infected tonsils C. Thrush
B. enlarged tonsils D. herpangina E. none of these.

White patch which can be rubbed off and is found on the labial or buccal mucosa is:
A. pachyderma oris C. lichen planus
B. leukoplakia D. ptyalism E. none of these.

Brown to black pigmentation caused by adrenal insufficiency is commonly associated with:

A. angular cheilitis C. candidiasis
B. perleche D. addison’s disease E. syphilitic lesion

Severe form of cellulites involving all spaces of the floor of the mandible is:
A. Ranula B. dermoid cysts C. Ludwig’s angina D. sialolithiasis

Decotisyl is a:
A. antiarrhythmic C. analgesic
B. anticoagulant D. adrenocorticosteroid E. antifungal

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Coumarin is a:
A. antiarrhythmic C. analgesic
B. anticoagulant D. adrenocorticosteroid E. antifungal

Propanolol is a:
A. antiarrhythmic C. analgesic
B. anticoagulant D. adrenocorticosteroid E. antifungal

Normal bleeding time is:

A. 1-2 mins. B. 2-3 mins. C. 5-7 mins. D. 4-8 mins E. 10 mins’

The following are subjective symptoms, except:

A. pain C. change of temperature
B. sensitivity D. abnormal taste

Also known as Vincent’s Infection:

A. ANUG C. gingivo fibromatosis
B. Hyperplastic gingivitis D. dilantin hyperplasia E. pubertal gingivitis

Eruption of several vesicles with erythematous borders caused by Coxsakie virus is:
A. infected tonsils C. thrush
B. enlarged tonsils D. herpangina E. none.

. Brown to black pigmentation caused by adrenal insufficiency is commonly associated with:

A. angular chelitis C. candidiasis
B. perleche D. Addison’s disease E. Syphylytic lesion.

The normal color and condition of the hard palate is:

A. smooth pink with fissuring
B. bright pink, few dilated veins and nodules prominences
C. keratinized pale pink with bluis gray hue
D. dark pink with yellowish hue.

White patch which can be rubbed off and is found on the labial or buccal mucosa is:
A. pachyderma oris C. lichen planus
B. leukoplakia D. ptyalism E. none.

Bony exostosis found on the hard palate:

A. Smoker’s patch
B. stomatitis nicotina
C. torus palatinus
D. palatal papillomatosis
E. none.

. Translucent bluish lesion found at eh ducts of the submandibular and sublingual glands and is
often caused by trauma is:

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A. ranula
B. dermoid cysts
C. Ludwig’s angina
D. sialolithiasis
E. none.

Mass or dough-like produced by the sebaceous glands found on the floor of the mouth is:
A. ranula
B. dermoid cysts
C. Ludwig’s angina
D. sialothiasis.

Grayish yellow pseudomembrane with punched out interdental papilla.

A. ANUG
B. hyperplastic gingivitis
C. gingivofibromatosis
D. dilantin hyperplasia
E. pubertal gingivitis.

Epileptic patient having tough gingiva.

A. ANUG
B. hyperplastic gingivitis
C. gingivofibromatosis
D. dilantin hyperplasia
E. pubertal gingivitis.

. Bluish red gingival which tends to bleed easily and is due to hormonal imbalance:
A. ANUG
B. hyperplastic gingivitis
C. gingivofibromatosis
D. dilantin hyperplasia
E. pubertal gingivitis.

The normal bleeding time is ___mins.:

A. 1-2 B. 2-3 C. 5-7 D. 4-8 E. 10.

Case Analysis:
A 46 year old woman presents a request to have her dentition cared for. She has not
experience recent dental pain but intermittent bouts were felt from tooth number 11 in the
recent past. Medical history reveals that the patient is currently taking nitroglycerin to
relieve the chest pains she once suffered 3 years ago. She has familial history of
cardiovascular defect from which her deceased mother died of. Dental history indicates
that tooth number 11 is discolored. It was traumatized due to a vehicular accident she had
2 years ago.
Dental examination reveals that all teeth are present and the following teeth were
found to have amalgam fillings: 16, 27, 36, 46. Tooth #11 has incisal fracture and were
observed to be discolored. Radiograhpically, tooth #11 has thickened periodontal space.

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Further clinical tests indicates that the tooth is unresponsive to both hot and cold
stimulation but positive to percussion.

Before treating the patient a/an:

A. complete bacterial count should be performed.
B. accurate medical history must be taken.
C. complete blood cell count should be obtained
D. Urinalysis should be performed.

Knowledge of the patient’s medical and dental history can affect the:
A. treatment plan
B. drugs prescribed
C. frequency of appointments
D. both A & B
E. A,B & C.

During treatment, the systolic reading was not detected, in this case, it would be wise to do the
following: 1. Have the patient remove any bulky clothing. 2. Remove the air from the manometer.
3. Reposition the stethoscope on the brachial artery. 4. Place the patient in a different position.
5. Ask another dentist to take the BP for second opinion. :
A. 1,3 B. 2,4 C. 1,2,3 D. 1,2,3,4,5

. Under which of the following conditions might a patient not be referred for further evaluation of
the blood pressure to determine any abnormalities?
A. The patient indicates he or she is on blood pressure medication.
B. After retaking the BP, it is normal.
C. After retaking the BP, it is not normal.

Medically, the patient is suffering from:

A. myocardial infarction
B. angina pectoris
C. congenital heart disease
D. rheumatic heart disease.

. The drug used by the patient is taken:

A. orally
B. intramuscularly
C. intravenously
D. sublingually.

It is necessary to consult with the patient’s physician before any treatment can be performed.
A. True
B. False.

The attacks are usually:

A. a feeling of strangulation, crashing or compressing
B. prolonged, oppressive pain or unusual discomfort in the center of the chest
C. sudden, intense shortness of breath

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D. brief lasting only a matter of minutes and stops when the person rests .

During an attack, the patient:

A. is kept in semi recycling position, then call the physician or get to an
hospital soon
B. never reach the hospital alive
C. may vomit or go into shock or convulsions
D. A. B & C.

Vitality test includes the following, except:

A. hot and cold test
B. use of pulp tester
C. tooth mobility
D. A,B,C,D.

The tentative pulpal diagnosis on tooth #11 is:

A. reversible pulpitis
B. irreversible pulpitis
C. necrosis
D. normal tooth.

The tentative periradicular diagnosis on tooth #11 is:

A. acute apical abscess
B. acute apical periodontitis
C. chronic apical pathosis
D. normal tooth.

The systemic visual purpose of oral diagnosis is:

A, suggest and provide a basis for the most suitable plan of treatment
B. excise a malignant neoplasm of the oral tissue
C. identify the abnormality
D. recognize the disease by its physical appearance
E. none of these.

A comparison of the different diseases and contrasted by the use of the clinical, pathologic and
laboratory examination is ___diagnosis:
A. differential B. final C. tentative D. prognosis E. referral.

Prospect as to the recovery from a disease as indicated by the nature and symptoms is ___
diagnosis.
A. differential B. final C. tentative D. prognosis E. referral.

The only potential complication associated with hepatitis is:

A. impaired healing C. presence of erythematous candidiosis
B. abnormal bleeding D. burning mouth E. none.

A subjective symptoms maybe defined as:

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A. an individualized reaction experienced by the patient and elicited from the patient
through inquiry
B. a clinical manifestation that is detected by the examiner during examination of the
patient
C. a clinical reaction detected by the examiner by inspection, palpitation and auscultation
D. an observable clinical manifestation of a systemic disease.

Auscultation is a valuable clinical examination technique and can have application in detecting:
A. TMJ dysfunction
B. speech impediments due to poor dentition
C. inflammation of the periapical tissues
D. abnormal breathing sound
E. Both A & D.

Administration of aspirin should be avoided in patient taking anticoagulants because:

A. it decreases anticoagulant effect C. it increases the anticoagulant effect
B. it oversedates the patient D. it causes gastritis E. none.

Mass or dough-like produced by the sebaceous glands found on the floor of the mouth is:
A. ranula B. dermoid cysts C. Ludwig’s angina D. sialothiasis.

Grayish yellow pseudomembrane with punched out interdental papilla.

A. ANUG C. gingivofibromatosis
B. hyperplastic gingivitis D. dilantin hyperplasia E. pubertal gingivitis.

Eruption of several vesicles with erythematous borders caused by Coxsakie virus is:
A. infected tonsils B. enlarged tonsils C. thrush D. herpangina E. none.

Brown to black pigmentation caused by adrenal insufficiency is commonly associated with:

A. angular chelitis C. candidiasis
B. perleche D. Addison’s disease E. Syphylytic lesion.

The normal color and condition of the hard palate is:

A. smooth pink with fissuring
B. bright pink, few dilated veins and nodules prominences
C. keratinized pale pink with bluish gray hue
D. dark pink with yellowish hue.

White patch which can be rubbed off and is found on the labial or buccal mucosa is:
A. pachyderma oris B. leukoplakia C. lichen planus D. ptyalism E. none.

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