134 'f Section l Anetomic Sciences
ces y 135
a. The peripheral cells are called the tro-
phob/asr, with the b!astocele being the
cavity.
b. This hollow ball of cells develops an
inner ceH mass against one waH.
c. The small mass enlarges to form an
area separating two small cavities.
(I) This layer is called the embryonic
disc.
d. Cells lacing the smaller cavity form the
primordial ectoderma! layer, and cells
lacing the larger one form the primor-
dial endodermal layer.
5. Yolk sac-implantation of the blastocyst
causes breakdown of endometriai tissue.
a. This provides food and materials for
the embryo for a few weeks.
b. The embryo sends out branches of
umbilical arteries and veins.
c. The yolk supplies nutrition to the
embryo through the vitelline arteries.
d. At the same time, the placenta and its
blood supply are forming.
e. When the yolk sac becomes depleted,
the placenta takes over supplying nutri-
ents and removing waste.
f. Five weeks after implantation, the umbil-
ical and placental system is in place.
g. Nutrients and wastes cross, but mater-
nal and fetal blood do not mix.
6. Extraembryonic coelem-at 9 or JO days,
the trophoblast portion of the blastocyst
produces mesob!asts, which begin to fill
the blastocyst cavity.
a. The blastocyst grows faster than these
cells can fill the space, so they end up
lining the cavity around the actual
embryo.
h. These cells will form the amnion,
vitelline sac, and chorion.
E. Primordial layers
I. Ectoderm
a. Forms:
(1) Nervous system.
(2) Sensory epithelium of eye, ear, nose.
(3) Epidermis, hair, nails.
( 4) Mammary and cutaneous glands.
(5) Epithelium of sinuses, oral and
nasal cavities, intraoral glands.
(6) Tooth enamel.
2. Mesoderm-arises between the ectoder-
rnal and endodermal layers of the embry-
onic disc.
a. Forms:
(1) ;\1uscles.
(2) Connective tissue derivatives: bone,
cartilage, blood, dentin, pulp, cemen-
tum, periodontal ligament.
3. Endoderm
a, Forms:
(I) Gastrointestinal (GI) tract epithe-
lium and associated glands.
F. Development ol human tissues
I. Epithelial structures and derivatives
a. Mesoderm
(!) Forms the dermis of the epithelium
and the visceral mesoderm that
covers the yolk sac and subse-
quently becomes the GI tract.
b. Ectoderm
(I) Initially, the embryo is covered by a
single layer of ectodermal cells.
(2) By 11 to 12 weeks, this thickens into
four layers.
(3} Later melanocytes invade and pig-
ment the skin.
2. Nervous system
a. Folds arise in the neural plate in the
third week.
(1) The fold facing the smaller cavity will
show three areas that will form the
forebrain, midhrain, and hindbrain.
b. The forebrain curls down toward the
chest as the cranial nerves develop.
3. Connective tissue
a. Develops from somites as fibroblasts
migrating from either side of the neural
tube.
4. Cartilage and bone-cartilage cells arise
from the sclerotome and migrate to sur-
round the notochord and spinal cord.
a. The skeleton forms in a segmental pat-
tern.
b. Cartilage grows both by apposition and
interstitial growth.
c. Bone replaces cartilage through a
process called endochondral bone
development or by intramembranous
bone lormation.
5. Muscle
By the tenth prenatal week. myoblasts
migrate from the myotome.
6. Cardiovascular system-originates from
angioblasts, which arise from mesoderm
in the walls of the yolk sac.
a. For the first few weeks, nutrition is pro-
vided through the vitelline vascular
system.
b. The heart starts pumping in the fourth
week
Section I Anat;;,mic Scier.
SAMPLE 0UESTIONS
1. The lateral plerygoid muscle attaches to which 9. Aft of the follou;ing are found in the 1>osterior
of the following? triangle of the neck except one. Which one is
A. Lateral surface of the lateral pterygoid plate, the exception?
B. Medial surface of the lateral pterygoid plate. A. External jugular vein.
C. Lateral surface of the media) pterygoid plate, B. Subclavlan vein.
D. Medial surface of the medial pterygoid plate. C. Hypogtossal nerve.
E, Pyramidal process of palatine bone. D. Phrenlc- nerve.
2. Which of the following muscles is responsible E. Brachiat ple).us.
for the formation of the posterior tonsillar 10, Deoxygenated blood from the transverse sinus
pillar? drains into tht
A. Stylopharyngeu•. A. Inierlor ti:agittal sinus
B. Tensor veli palatine. B. Confluence of sinuses
C. Palatog}ossus, C, Sigmoid sinus
D. Pa!atopharyngeus. D. Straight sinus
£, Levator veU palatine. E. Internal jugular vein
3. The superior and inferior ophthalmic veins 11. The oestigial cleft of Rathke's pouch in the
drain into the hypophysis is located between the _ _ _.
A Internal jugular vein A. Anterior and posterior iobes
B. Pterygoid plexus B. Anterior lobe and hypothalll.mus
C. Frontal vein C Posterior lobe and hypoth21lamu,
D. lnfraorbitai vein D. Me<ltan eminence and the optic chiasm
£. Facial vein 12. Involution of the thymus ,.vould occur following
4. The masseter originates from the _ _ _. which yet1r in a healthy individual?
A Condyle of the mandible A. Oyears (al birth).
B. fnfratemporal <::rest of the sphenoid bone B. 12th year.
C. Inferior border of the eygomatic arch C. 2llth year.
D. Pyramidal process of the palatine bone D. 60th year.
E. Mastoid process of remporal bone 13. Blood from the internal carotid arterv reaches
5. Which of the following muscle..:. adtlucts the the posterior cerebral artery by the_·_ _,
vocal cords? A. Anterior cerebral artery
A. 1.,ateraJ cricoarytenoid, B. Anterior communlcatmg artery
B. Posterior cricoarytenoid. C. Posterior communirllting artery
C. Cricothyroid. D. Posterior superior cerehfllar artery
D. Vocalis. £. Basilar artery
E. Tensor veH palatine. 14. The infraorbital nerve is a branch of the
6. Which of the following strata of oral epithelium
is engaged in mitosis? A. Optic nerve
A. Basale. B. Oculornotor nerve
B. Grnnulosum, C. Ophthalmic nerve
C. Corneum, D. Maxillary nerve
D. Spinosum. E, Mandibular nerve
7. The auriculotemporal nerve encircles which of 15. Which of the foflawing cells are capal>le of
the following vessels? mitosis?
A. Maxillary artery. A. Smooth muscle.
R Superficial temporal artery. B. Skeletal muscle,
C. Deep auricular artery, C. Cnrdfac muscle.
D. Middle meningeal artery. D. Type I pneunmcytes.
E. Anterior tympanic artery, E. Neurons.
8. The muscle that is found in the walls of the 16. Which of the following types of epithelium lines
heart is characterized by _ _ _, acimar units of salivary glands?
A. A peripherally placed nucleus A. Simple squamot1s.
R Multiple nuclei B. Stratified squamous,
C Intercalated discs C. Simple cuboidal.
D. Fibers with spindle-shaped cells D, Simple columnar.
£, Pseudostratifierl columnar,
1 3 6 v Section I AnatomJc Sci,wces Section l Anatomic: Scienc'l.:t T t 37

17. To which of the following hones is the tensor 23. You decide to take a radiograph of the 30, There are _ _ pairs of true rib.s. 38. Terminal bronchioles are characterized by
tympani attached? fractured tooth. On the first film you miss the
A. Four cells.
A. lncus. apex of the tooth, so you decide to take another fl, Five A. Goblet
B. Malleus. radiograph. Relaxation or which of the C. Seven B. Ciliated cuboidat
C. Stapes. patient's muscles would help you in taking the D. Eleven C. NonciUated -cuhnidrd
D. Hyoid. second film? E Twelve D. Ciliated squamous
E. Mandible A. Geniohyoid. 31. _ _ vertebrae are characterized by a heart- E. Nonclliated squa1n0us
18. In mature dentin> the ratio of inorganic to B. Stylohyold. shaped body. 39. The most superficial layer of the epidermis is
organic matter is approximately _ _. C. Mvlohvold. A Cervical the stratum _ _ .
A. 94:6 D. L~vat~r vell palatine. B. Thoracic A. Spinosum
B. 50:50 E. Palatopharyngeus. C. Lumbar B. Basale
C. 70:30 24. On further examination, you determine that the D. Sacral C, Grnnulosurn
D. 80:20 articular disc of the patient's temporo- E. Coccygeal D. Lucidum
E. Gll:40 mandibular joint has been displaced. If the 32. The sternal angle between the manubriam and E. Corneum
]9. Which of the following cells forms the myelin patient contracts his lateral pterygoid muscle, the sternum marks the position of the _ _ rib. 40. Langerhans cells are located primarily in
sheath around myelinate<l nerves in the central the disc will move _ _ _. A. First stratum
nervous system? A. Posteriorly and medially B. Second A, Corneum
A. Schwann ceHs, B. Anteriorly and medlaUy C. Third B. Luddum
B, Astrocytes. C. Posteriorly and laterally D. Fourth C Granulosum
C. Microglia. D. Anteriorly and laterally E. Fifth D. Spinosum
D. Oligodenc!rocytes. 25. During the examination, the patient observes 33. Which muscle of the anterolateral abdominal £. Ba,ale
E. Amphlcytes. that he cannot feel it when you touch part of wall is described as being belt• or strap-like? 41. Arterfovenous anastomo.ves in deeper skin are
20. Which of the fol/awing nerves supplies taste his cheek and his upper lip. Which of the A External obHque muscle. important in _ _.
se1tsation to the anterior two.thirds of the following nerves was probably damaged during B. Internal oblique muscle. A. tmmunity
tongue? the accident? C. Transversus abdominis muscle. B. Thermoregulatlon
A. Hypoglossal. A. Lingual. D. Rectus abdominis muscle. C. Controlling the arrector pili muscle
B. Glossopharyngeal. B. Maxillary. E. Quadratus lurnhorum muscle. D. Pigmentation
C. Lingual. C. Long buccaL 34. In addition to the esophagus itself, which of the E. Pain sensation
D. Facial. D, Superior alveolar. following structures also passes through the 42. lVhich of the following bones is formed by
E. Mental. E. lnferlor alveolar. diaphragm through the esophageal opening? intramemhranous ossiflCation?
26~ You decide to restore the missing cusp on the A. The aorta. A. Humerus.
patient~s molar. During the administratiort of R The inferior vena cava. B, Lumbar vertebrae.
the inferior alveolar nerve block, which of the
Test items 21-26 refer to the C. The azygos vein. C. Frontal bone of the skull.
follou,ing ligaments is most likely damaged? D. The posterior and anterior vagal trunks.
following test/et. D. Ribs.
A. Sphenomandibular. E. The splanchnic nerves. E. Clavicle.
A 24-year-olcl man presents to your office for an B. Stvlomandibular. 35. The inferior aspect of the diaphragm is 43. Osteocytes are found in _ _ in mature bone.
emergency visit, after being hit on the left side C. T~mporornandibular. supplied with blood by which of the following A. Trabecutae
of his face with a soccer ball. He complains that D, Interdental. arteries? B. Lacunae
his "tooth got knocked out" and that his jaw A. Median sacra! artery. C. The central canal
27. The lateral thoracic wall of the axilla is B. Lumbar arteries, D. Canallc-uU
feels "out of place." He has no other medical
covered by which of the following muscles?
conditions. C. Inferior phrenic arteries:. E, Spicules
A. Pectoralis major. D. Celiac trunk. 44. marks the end of growth in length of long
21. During intraoral examination, you llnd that the
B. Pectoralls minor. E. Superior mesenteric artery. bones.
patient's lower second premolar is missing.
C. Serratus anterior. 36. Oral epithelium is composed of __ _ A. Diaphyseal closure
H'1tich type of alveolodental fibers was least
D. Subscapularis. epithelium. B. Epiphyseal dosure
inuolocd in resisting the force that pulled this
E. Latissimus dorsi. A. Keratinized simple squamous C, o~sification
patient's tooth out of its socket? 28. The trochlea of the humerus bone articulates
A. Apical. B. Keratinized stratified squamous D. Formation of perio5teurn
with the ___.
B. Oblique. C. Nonkeratinized simple e;quamous E. Cessation of bone rernod·c:llng
A. Ulna of the forearm D, Nonkeratinized ~tratifi~d MJu.,,mous 45. The branchial ardtf'.S disappear when the
C. Alveolar crest.
B. Radius of the forearm E. Nonkeratinized stratified columnar branchia/ arch grows down to contact the _ _.
D. lnterradicular. C. Coronoid process of the ulna of the forearm
22. You also notice that a cusp of his mandibular 37. lVhich of tire following statements is true of the A, second: third branthial arch
D. Olecranon of the ulna of the forearm histology of the trachea? B. second; fifth branchlal arch
second molar has fractured off and that dentin E. Medial epicondyle
is exposed. If this patient were to drink A. The mucosa is covered with oral epithelium. C. third; fifth branchia! arch
29. Which of the following muscles of the back is B. Elastic cartilage rings lie deep to the D. first first bran-chlal groove
something cold. what will he sense? supplied by the CN XI?
A Pain. sub mucosa. E. first; sixth branchial groove
A. Levator scapulae. 46. Facial nerves are derived from the _ brancht'al
B. Pressure. C. The cartilage is ring-shaped; the open end of
B. Latissimus dorsi. the ring faces anterior. arch.
C. Vibration,
C. Trapezius. D. The cartilage is covered by a perichondrhtm. A, First
0. Temperature.
D. Major rhomboid. E. Skeletal muscle extends across the open end of B. Second
E. Minor rhomboid. each cartilage. C. Third
D. Fourth
E. Fifth and sixth
I 3 8 • S.ection I Anatomic Sciences Section I Anatomic Sciences T l 39

47. Cytochrome P450 enzymes may be found in 55. Nucleus ambiguus contains the cell bodies of $3. Which of the following organelles i., 69. You decide to remove lhe. caries and prepare
which of the following cellular organelles? whfch of the following cranial nerves? surrounded by a double membrane? the patient for anesthesia. H1hich nerl'e must
A. Mitochon(lria. A. Ill, IV, and V. A. Ribosome, you anesthetize to ensure adequate anesthesia
B. Golgi apparatus. B VII. IX ,and X. B. Go!gi apparatus. for the patient?
C. Lysosome. C. Vil, IX, and XL C. Lysosome. A. Nasopalatlne nerve.
D. Ribosome. D. IX, X, and XL D. Cytoplasmic inclusion. B. Greater palatine nerve.
E. Endoplasmic reticulum. £. IX, X. and XII. E. Mitochondria. C. Anterior superior alveolar nerve.
48. What type of collagen is found in cementum? 56. The articulating surfaces of the 64. Hassal/'s corpuscles are found in the medulla D. Middle superior alveolar nerve.
A. Type I collagen. temporomandibular- joint are covered with of which of the following glands? E. Posterior superior alveolar nerve,
B. Type ll coll•gen. A. Thymus, 70. After administering the anesthetic, the patient
C. Type lll collagen. A. Fibrocartilage B. Thyroid. complains that her "heart feels like it's racing."
D. Type IV collagen. B, Hyaline cartilage C. Parathyroid. You explain to her that it may be from the
K Type V collagen. C. Articular cartilage D. Pineal. epinephrine in the anesthesia. J.Jlhich of the
49. Calcium bin<ls to which of the following for D, Elastic cartilage E. Suprarenal. following glands could most likely cause the
contraction in smooth muscle? E. Perichondrium 6.5. Which of the following are the most abundant same symptoms in the patient?
A Troponin C. 57. The primary sensory nellrons• nucleus of in the fovea centralis of the eyeball? A, Hypophysis.
8. Calmodulin. te,·mination involved in the jaw jerk reflex is A Rod cells. B Thyroid.
C. Myosin. the B. Cone cells. C. PlneaL
D. Actin. A. Facial nucleus C. Rod and cone cells. D. SuprarenaL
E. Desmosomes. B. Trochlear nucleus D. Amacrine cells,
50. Lymph from the mandibular incisors drain C. Mesencephaiic nucleus E. Ganglion cells. 71. All of the following are rotator cuff muscles
chiefly Into _ _. D. Spinal trigeminal nucleus 66, Which of the following bones is part of the except:
A. Submandibular nodes L Nucleus of solitary tract superior wall (roof) of the orbit? A. Supraspirrntous muscle
B. Suhrnental nodes 58. Red pulp in the spleen consb;ts of _ _. A. Zygomatic. B. infraspinatous muscle
C. Superficial parotid nodes A Fibroblasts B. Lacr!mal. C. Teres minor muscle
D. Deep cervical nodes B. T lymphocytes C. Sphenold. D. Teres major muscle
E. Occipital nodes C. B lymphocytes D. Maxilla. L SuhscapulaTis muscle
51. Which of the following muscle attaches to the D, Macrophages E. Ethmoid. 72. The brachia/ plexus of nerves arises from
anterior end of the articular disc of the E. Chromaffin cells which of the follotuing roots of the anterior
temporomandlbular joint? 59. 1'he vertebral artery meets with the basilar primary rami of spinal nerves?
A, Superficial head of the medial pterygoid artery at the lower border of the _ _. Test items 67-70 refer to the following A. All cervical roots (Cl-C8),
muscle. A. :v1ldbrain test/et. B. All thoracic roots (Tl-T!2).
B. Deep head of the medial pterygoid muscle, B, Pons C. C 8 and Tl.
C. Superior head of the lateral pterygoid muscle. C. Medulla A 30-year-old woman comes to your office for a D. C5 through C8 and TL
D. Inferior head of the lateral pterygoid muscle. D, Temporal lobe dental examination. She has not been to the den- E. C5 through C8 and Tl through T4.
52. All of the following arteries are branches of the- E. Cl tist in 2 years. The patient has type l diabetes, 73. The right subcladan artery arises from the
mandibular dir 1ision of the maxillary artery 60. Where are the cells that produce calcitonin which requires her to take insulin. She is other- and the left subclavian artery arises from
except one. Which one is the exception? located? wise in good health. On intraoral examination, you the
A Incisive artery. A. Red marrow. A. Axillary artery; aortic arch
notice that the dorsum of her tongue has a thick,
B. Submental artery. B. Adrenal gland. B. Brachiocephalic artery: aortic arch
C. Middle meningeal artery,
matted appearance and diagnose her with hairy C. Aortic arch; brachiocephallc artery
C. Parathyroid gland.
D, ~·Jylohyoid artery. tongue. You also find that the patient has deep D. Rrad1iocephnlic artery; axlllary artery
D. Thyroid gland,
E. Deep auricular artery. E. Spleen. caries in her upper second maxillary molar. E, Axillary artery; brachia! artery
53. The maxillary nerve pa.~es through which of 61. Chromosomes line up at a cell's equator during 67, Which type of papillae is affected that causes 74. Tile pulmonary vein of tile lung carries:
the following? which phase of mitosis?
the hair~like appearance of her tongue? A Unoxygenilted bJood from the lungs to the heart
A. Superior orbital fissure, A. Telophase. A Foliate. B. Oxygenated blood from the lungs to the heart
8. Internal acoustic rneatus. B. Metaphase. R Circumvallate, C. Unoxygenated blood to the lungs from the heart
C. Foramen ovale. C. lnt,rphase. C. Fungiform. D. Oxygenated blood to the lungs rrom the heart
D. Foramen rotundum. D. Filiionn, E. Oxygenated blood from the heart to the lungs
D. Anaphas~.
E. Foramen spinosurn. E. Prophase. 68. On the patient's radiograph, you notice that 75. The of the heart is also known as the
54. Injury to which of the following nen•es would 62. Which of the folfowfog types of epithelium lines the pulp chamber in the carious molar appears mitral va/t;e.
affect abduction of tire -eyeball? the oropltarynx? smaller than the surrounding teeth. This is A. Right atrioventricular valve
A. Optic nerve. most likely due to the deposition of which type 8- Left atrioventricular valve
A. Simple s.quamou~.
B. Oculomotor. of dentin? C. Pulmonary valve
B. Stratified squa.mou~.
C. Trochleac A. Secondary. D, Aortic valve
C. Simple cuboidal.
D. Trigcminal. D, Simple columnar. B. Tertiary. E. Tricuspid valve
E. Abducens. E, P5eudo5tratified columnar.
C. Mantle.
D. Sclerotic.
 Sect.ion l Anatomi;: Sciem::ei y l 41

76. 77,e cricopharyngeus muscle of the esophagus 84. Which portion of uriniferous tubules contains 91. Reduction division occurs during the·--· 97. Which of the following ribs cannot be
squamous epithelial cells? A. First stage of mitosis palpated?
A. ls a parasympathetic shmulator of pcristal&is A. Proximal convoluted tubule, B. Second sta2e of mitosis A. First
B. Is a 5yrnpathetic inhibitor o! peri~ta.lsis B. Thick descending limb of Henle's loop, C. First stage of meiosis 8. Second
C. Prevents swallowing air at the pharyngeal end C. Thin segment of Henle'~ loop. D. Second stage of meiosis C. Third
D. Prevents regurgitation of stomach contents at D Thlck ascending segment of Henle's loop. E. Third stage of meiosis D, A and B
the abdominal end E. Distal convoluted tubule. 92. The embryo develops specifically from the 98. An infectfon in a mandibular incisor with an
E. Controls the gag reflex 85. The _ _ is a component of the apex he/ow the mylohyoid muscle drains into
77. The pancreas is enveloped at its head by the juxtaglomerular apparatus which functions in A. The entire blastocyst which of the following spaces?
regulation of blood pressure. B. The entire tmphoblast A. Subllngual space
A First part of the duodenum A Proximal convoluted tubule C, The embryonic disc B Submental :.ii:pace
R Second part of the duodenum B, Distal convoluted tubule D. The extraembryonic coelem C. Submandibular space
C. Third part of the duodenum C. Bowman's capsule E. The morula D. Parapharyngeal space
D. Fourth part of the duodenum D. G!omeru!us 93. Tooth enamel is derived from 99. The spread of an odontogenic iftfecti<>n to
E. First part of the jejunum E. Macu[a densa A. Endoderm which of the following spaces would MOST
78. The gallbladder arises from the _ _. 86, Urinary flltrate is most hypotonic in the _ _. B. Meso<lerm likely be considered life-threatening?
A Common hepatic duct A, Proximal convoluted tubule C. Ectoderm A. Submandibular space
B. Common bile duct B, Descending limb of Henle·s loop D. Endoderm and mesoderm B. Sublingu~l space
C. Left hepatic duct C. Thin segment of Hen!e's loop E. Ectoderm and mesoderm C. Parapharyngeal space
D. Cystic duct D. Thtck a5cending segment of Ht:nle's loop 94. The olecranon fossa is located on the _ _ D. Retropharyngeai space
E. Bile canaliculi E. Distal convo{uted tubule surface of the E. Pterygomandlbu!ar space
79. The apex of a medullary pyramid in the kidney 87. 11te differentiates into ameloblasts. A Superior; radius 100, The median pharyngeal raphe serves as the
is called the A. Stellate reticulum B. Anterior; humerus attachment site for which of the followi11g
A. Cortex B. Inner enamel epithelium in the cap stage C. Posterior; humerus muscles?
B. Medulla C. Inner enamel epithelium in the bell stage D, Anterior; radius A. Lateral pterygoid muscle
C. Renal papilla D. Outer enamel epithelium in the cap stage l}S. The latisslmus dorsi muscle is supplied by the B. Palatopharyng~u5. muscle
D, Major calyx E. Outer enamel epithelium in the bell stage _ _ nerve. C. Levator veli palatine muscle
E. Minor calyx 88. The dental lamina arises from _ _. A. Medial pectoral D. Salpingopharyngeus
80. Ureters travel inferiorly just _ _ the parietal A Somites B. Cranial nerve Xl E. Superior constrictor muscle
peritoneum of the posterior body wall. They B. Neural crest cells C. Dorsal scapular
pass _ _ to the common iliac arteries as they C. The first branchial arch D. Thoracodorsal
enter the pelvis. D. The second bn:mchlai arch 96. The middle trunk of the brachia/ plexus of
A Above; posterior E. The buccopharyngea! membrane nerves arises from:
8. Above; anterior 89. The correct order of tooth formation is _ _. A CS
C. Below; posterior A, Ameloblasts form, odontoblasts form. B. C6
D. Below; anterior ameloblasts start to form enamel, C, C7
E. Above; superior o<lontohlasts start to form dentin D. CS
81. The lumen of the gastrointestinal tract is lined B, Ameloblasts form, odontob-lasts form,
with _ _• odontoblasls start to form dentin,
A. Mucosa arneloblasts start to form enamel
B. Submuc-osa C. Odontobfasts form, odontoblasts start to form
C. Muscularis externa dentin, amelohlasis form. amclnblasts start to
D. Fibrosa form enamel
E. Adventitia D. Ameloblasts form, amelohfa'lts start to form
82. Gnt-assodated lymphoid tissue (GAL1) enamel, odontnblasts form. odontoblasts start
produces secretory _ _. to form dentin
A, !gA E. Odontoblasts form, ameloblasts form,
R lgD odontoblasts start to form dentin,
C lgE am<:loblasts start to form enamel
D, lgG 90. The auricular hillock.fl are derived from the
E. lgM
83. The muscularis externa has a third layer in the A First branchial arch
R Second branchial arch
A. Esophagus C, First and second branchial arch
B Stomach D. Lateral nasal process
C. Liver £. Medial nasal process
D. Small intestine
E. Large intestine
212 ,. Section 2 BiocheMistry and Phy,iology Section 2 Bior:heml1try and Physiology Y 21 3

(3) Increased extracellular K· alsD ( 4) Hypoglycemia.

increases aldosterone secretion by (5) Hypothermia. SAMPLE OUESTI0NS
acting directly on the adrenal ceils. 3. Mechanisms of action-although both
c. Androgens-regulated by the same epinephrine and norepinephrine are I. Nonsteroidal anti-inflammatory agents are pain- 7. The binding of epinephrine or glucagon to the
mechanisms as glucocortlcoids. secreted from the adrenal medulla, epi- relieving and anti,,inflammatory. They are corresponding membrane receptor has which
3. Actions of adrenocortical steroids (Table nephrine is the main cate.::holamine. ~- effective since they act to inhibit prostaglandin of the following effects on glycogen
2-14) adrenergic receptor stimulation tends to synthesis by: metabolism?
A. Inhibiting fatty acid llpo-oxygenMe activity. A. The net synthesis of glycogen ls increased.
C. Adrenal medullary (catecholamines) hor- be the major response to adrenal
8. Inhibiting fatty acid-«peciflc cyclo-oxygenase B. Glycog~n phosphoryla5e is activated while
mones medullary stimulation, even though glyc0gen 5yntha5e ii inactivated.
activity.
L Structure and synthesis epinephrine stimulates both a- and 13· C. Inhibiting fatty acid-specific hydroperoxidase C. Glycogen phosphorylase is inactivated while
a. Synthesized by a series of steps from adrenergic receptors. activity. glycogen synthase is activated.
tyrosine. a. a-receptor-mediated D. Inhibiting phospholipase A,. D. Both giycogen synthase and phosphory!ase are
b. Epinephrine (the methylated form of (I) Increased gluconeogenesis. 2. The synthesis of all steroid hormones involves activated.
norepinephrine) is the major secretory (2) Decreased insulin secretion. which of the following compounds? E. Both glycogen synthase and phosphorylase are
product. (3) Increased vasoconstriction (splan- A. Pregnenolone. inactivatf':d.
c. The adrenal medulla is essentially a chnic, renal, cutaneous, and geni- B. Proge,terone. 8. When an enzyme is competitfr.ely inhibited,
sympathetic ganglion, which has secre- tal). C. Aldosterone. which of the follorving changes occur?
tory cells instead of postganglionic (4) Increased sphincter contraction (GI D. Cortisone. A. The apparent Km is unchanged.
E. Testosterone. B. The apparent Km is decreased.
neurons. The catecholamines are and urinary).
3. Lipid micelles are stabilized by which of the C. Vmax ls decreased.
secreted directly into the bloodstream 1 (5) Dilation of pupils.
following? D. VmM/. is unchanged.
to play an important role in the "fight (6) Increased sweating. A. Hydrophobic interactions. 9. W'hich compound is produced in the hexose
or flight" response. b. 01-receptor-mediated B. Hydrophilic interactions. monophosphate (jx?ntose phosphate) pathway?
2. Regulation of synthesis and secretion (1 J Increased Jipolysis and ketosis. C. Interactions of lipid and water. A. ATP.
a. Catecholamines are stored in granules (2) Increased cardiac contraction and D. Interaction of hydrophobic lipid tails with B. NADH.
in chromaffin cells. rate. hydrophobic domains of proteins. C. NADPH.
b. Stimulation of the sympathetic nerve to (3) Increased glycogenolysis. 4. Which one of the following carbohydrates is a D. Fructose l,G~bisphosphate.
the adrenal gland releases acetyl- c. j3 2-receptor-mediated ketase sugar? E. Phosphoenolpyruvate.
choline at ganglionic type receptors, (1) Increased insulin secretion. A. Galactose. 10. During exercise, which of the following is
which results in the release of cate- (2) Increased glucagon secretion. B. Fructose. decreased?
cholamines. (3) Increased K• uptake by muscle.
C. Glucose. A. Oxidation of fatty acids.
D. Mannose. B. Glucagon release.
c. Examples of stress-related factors that (4) Increased arteriolar dilation in car- E. Glyceraldehydes. C. Glycogenolysls.
result In adrenal medullarv secretion diovascular musde. 5. Mucopolysaccharidoses are hereditary D. Lipogenesis.
(1) Fear, anxiety, and excitement. (5) Increased muscle relaxation in disorders tltat are characterized by the 11. Increased formation of ketone bodies during
(2) Trauma, pain. bronchial wall. Gl wall, and wall of accumulation of glycosaminoglycan.v in various fasting is a result of which of the follouling?
(3) Hypovolemla. the urinary bladder. tissues due to which of the following? A. tncreased rnddatlon of fatty adds as a source oi
A. Overproduction (synthesis) oi proteoglycans. fuel.
B. Deficiency of one of the lysosomal. hydrolytic 8. Decreased formatlon of acetyl CoA in the liver.
enzymes normally involved in the degradation of C Decreased levels of glucagon
one or more of the glycosaminoglycans. D. Increased glycogenesis in muscle.
C. The synthesis of abnormal proteoglycans. 12. Which of the following enzymes found in the
D. The synthesis of highly branched liver is int1ofoed in gluconeogenesis during the
TABLE 2-14. ACTIONS OF ADRENOCORTICAL STEROIDS glycosaminoglycan chains. postabsorptive state?
6. Hydrolysis of which of the following compounds A. Glucose 6-phosphate dehydrogcna.se.
ACTIONS OF GLUCOCORTICOIDS ACTIONS OF MINERALOCORTICOIDS ACTIONS OF ADRENAL Al\lDROGENS
yields urea? B. 6-phosphogluconate dehydrogcna~e.
Increase g:luconeogenesis Increase Na' resorption Femnlei.: pre,ence of pL1blc and a:xHl.iry A. Ornithine. C. Glucose &-phosphatase.
halr; libido B. Arglninosuccinate. D. Glucokinase.
Increase proteoly~I, (catabo!ic) Increase K+ secretion Males: same as testosteronC>
Increase lipolyl5-i& Increase H+ secretion C. Aspartate.
Decrease gluco•e utillzat!on D. Citrulline.
Decrease in•ulin sens.ltivitv E. Arginine,
Anti-inflammatory ·
Jmmunosuppression
Maintain vascular responsiveness
to catecholamines
Inhibit hone formation
lncrease GFR
De<rE'ase REM sleep
M:Ullil L I ~

Frnm Costanzo LS: Physiolo&'Y, ed 3, WB Sa,mders, Phllm:lelphla, 2004.

 Section 2 8\ochcmi,;try 1;111d Physiofogy Y 2 1 5

13. fn which one of the following tissues is glucose 22. Which of the following amino acids is 29. The participation of calcium in the contraction 36. CO,,_ generated itt the tis.'iues is carried in
transport into the cell unaffected by insulin? positioned at every third residue in the of skeletal mw>cle is facilitatetl or associated n•,;r;us blood primarily in which form?
A. Skeletal muscl<:'. p,-imary structure of the helical portion of the with which of the following? ,\ CO., ln the pla~ma.
B. Uver. collagen-a chains? A. Calcium release from sarcoplasmic reticulum. B H.(O _in the p!asma
C, Adipose Hssue. Glycine, C. HCJ\' i:i the pi.sm;1.
D. Smooth muscle. B. Glutamate.
!, B. Cakium binding to the myosin hertds.
l C Active transport nf calclmn out o! k,ngltudirnd D. CO .. in the red blood cdls
14. Which of the following genetic diseases that C. ProUne. tubules.. E. Ca1~ho~yhemoglohin in the n-:d blood Ct'::!~.
res11lls from a deficiency in the liver enzyme D. Lysine. D. Uptake of calcium by !~tubules. 37. Jllfrich of tlw following is thF moHt significant
that co1werts phenylalanine to tyrosine? E. Hydroxyprnline.
A. Alh!nisrn.
B. Horr..ocystirrnria.
23. Which of the following is [!Of involved in the
process of mineralization?
r SO. Calcium that t?nters tire cell during Sf!loo_th
muscle excitation binds with which 6f the
stimulant of the ,·espir-alory center?
A Decreased blood oxygen tension

C, Porphyrla.
D. Phcny!ketonuria.
A. Matrix vesicles.
R. Amelngenins.
I fotlOwing?
A. Calrno<lu!in.
B Increased hlond hydr(lgt:n ion concentralion.
C. Decreased blnod !:ydroJ:!i."n ion concentratlon.
B. lnactive rnyosin kinase. Ll Increased b!ood carbon dioxide ten~ion
I 5. If the molar percentage of guanine in a human C. Fluoride. C. Troponin, 38. The primary factor determining the percf.•nt of
DNA is 30%, wlutt is the molar percentage of D. Phosphoryns. D. Myosin, hemoglobin saturation is:
at.fenine in that nwlecute? 24. ATP is utilized di•·!rJly for each of the following E, Actin. A. Blood PO.,.
A 101,. proces!les except: 31. Which of the follou.1illg does not affect the ll. 13100,J PC()..
H. 20'.Y,. .A.. Accumul-ati(m of C~1"" by the sarcop!asmic muscle tension produced during contraction? C. Diphospho°glycerrtte concentration .
c. 30'){,. reticulum. A. The extent of rnotor~unit recruitment. D. The tPmp~rature of the blood
D. 40%. B. Tram1port of Na" from [ntraceltular to 8. The µroport_i_qn of each single motor unit that is E. The acidity of the blood.
E. 50'.Y,. extracellular fluir:L stimulated to contract. .19. For which of the following subst<uu-es would
16. Which of the following phrases best describes C. Tnmsport of K•· from extracellular to C. The number of muscle fibers contracting. you expect the renal cieonrnce to be the lowest.
restriction enzymes? intracellular fluid. D, The frequency of stimulation under nonrwf conditions?
A. Site-specific endonudeases. D. Transport of H' from parietal cells into the 32. The pressure in a capillarj-' in skeletal muscle A Urea.
B. Enzymes that regulate RNA lumen of the stomach. is 37 mmHg at the arteriolar end and 16 mmHg H. Crentin!oe.
C. Nonspecific -endonucleases. E. Transport of glucose into muscle cells. at the venular end. The interstitial pressure C. Sodium
D. Topoisomerases. 25. Both active transport and facilitated diffusion is 0 mmHg. The colloid osmotic pressure is D. Water.
17. 11,e coenzyme that serves as an intermediate are characterized by which of the following? 26 mmHg in the capillary and 1 mmHg in the E, Glucose.
carrier of one-carbon units in the synthesis of A Transport in one direction only. interstitial fluid. The net force producing fluid 40. The process of active sodium transport in the
nucleic acids is which of the following? B. Hydrolysis of ATP. movement across the capillary wall is which of ascending limb of the loop of Henle is
A. Ascorbic acid. C. Tr.llnsport against a concentration gradient. the following ? absolutely essential for which of the following
B. Tetrahydrofo!ic acld. D. Competitive inhibition. A. 1 mmHg out of the capillary. processes?
C, Biotin. 26. Which of the fo/lou•ir,g statements regarding B. 3 mmHg out of the capillary, A. Regulation of chloride exnPtion.
D Pyrldoxine. the autonomic nervous system (ANS) is true? C. 12 mmHg out of the capiilary. B. R0gulation of pH in extracellular fllml.
18. Following the production of Okazaki A. The third cranial nerve (the oculomotor nerve) D. 3 mmHg into the capillary. C. Reguialion of aidnsternrie excretion.
fragments, which of the following is required to carries symp11.thetir fibers to the smooth .13, A patient has a heart rate of 70 bpm. Her EDV D. Rt'gulation of water excretion
close the gap between the fragments? muscles of the eye. (end-dia.,tolic ,,otume) is 140 mL. Her ESV (end· 41, f-Jyp<;rtension (long-trrm) will he '-'ompemrntnl
A. DNA ligase. 8. The fadal and the glossopharyngeal cranial systolic iiolume) is 30 mL Calculate the CO by u:hich of the follmdng renal nwc-hanisms?
B. DNA po!ymerase. nerves carry the parasympathetic prega.ngllonic (cardiac output) of this imifoidtwl. A Increased circulating ADH (vasopressin).
C. RNA polymerase. fibers for the autonomic innervation to the A. 9800 mL. R. Increased sympa!h-2tJC activity.
D. Reverse transcriptase. salivary glands. B. 2100 rnL C. DenPi\sed circul;:Jting aldosterone.
19. Which of the following is not involr:ed in the C. The parasympathetic nervous system C. 7700 mL. 0, lncr~a.sed circulating nnglolf"nsi11 I!
process of gene cloning? innervates primarily striated muscle in the D. 15.400 mL 42. Whid, of the following statements regarding
A. DNA polymeraie. body. 34. The velocity of blood flow _ _. tubular sf!cretion in the ltidney is true?
B. DNA liga•e. D. The parasympathetic nervous system is A. Is higher in the capillaries th.an the arterioles A The secrd ion of K' increases when a per~on is
C. RNA polyme,rase. organized for diffusie activation and responses, B. ts higher in the veins than in the venules
D. Reslrlction endonuc!ease. 27. Which of the following resporu;es is due to the C. ls higher in the veins than in the arteries B. The secretion of H' increases when ,1 person is
20. Vitamin K serves as a coenzyme for: stimulatfon of a--adrenergic receptors? D. Falls to zero in the descending aorta during in alkalosis.
A. The enzymatic hydroxylation of proline to A Slowing of heart rate. diastole C. H is a process thf1t transports ~ubstances from
4-hydro:xyproHne. B. Constriction of blood vessels in skin. 35. Which of the following dQi!~ not occur to the fHtrate to the caplllary blood.
B. The carboxylation of inactive prnthromhin to C Increased gastrointestinal motility, compensate for a fall in blood pressure below n !t accounts for most of the K' ln thrc urine
form active prothrombin. D. Increased renal blood flow. normal values? 4,1. Which of the folfmring statements regarding
C The synthesis of nucleic acids 28. Which of the fallowing is a property of C A. Increased cardiac output. salh:arv secretion is true?
D. Protein synthesis. fibers? B. Increased strokt"' volume. A. In ge-.neral, sallva is more hyperionic than
21. Chondroitin sulfate is a major component of A. Have the slowest conduction velodty of any C. Increased heart rate. plasnrn.
which of the following? nerve fiber type. D. De(:re~\sed total peripheral resistance, B. As sct!ivary flow lncreases. bicarhnnats:>
A. Bacteri~1! cell waits. B. Have the largest diameter of any nerve fiber type. cnncentrntlon ckcrc:ases,
B. Mucin. C. Are afferent nerves from muscle ,pindle~. ,, As salivary How i11crc◄1s(~s. ionic conccntrntion
C. D. Are afferent nerves from tendon organs.
D. E. D. regulats.'.d primarily by
E. Hair. hnrn1onal stimul;itinn,
216 v Section 2
Section 2 810,:;he,mistry and Phyw,logy T 2 l 7

44. Which of the following is the predominant $]. Which of tlu;, following proteoglycan:,,· is present 60. Which of tire following cr.:u::nzyme$ are inoolped 68, The co,wer.•..ion of information f'rom DNA into
immunoglobulin in whole safii,a? in extracellular space? in the melahoUsm ofpynwate to acetyl CoA? mRNA. is called rthich of the follmrlflg?
Secretory Hyaluronk acid. Thlamin pyrophosphat0. llpoic acid, FAD, NAD, A. Translation.
B. Secretury B. Kerat(l.n ,md coenzyme A. H. Trnnscrlption.
Secretory C. Chondroit!n suliate. B. NAD, tetr.ahydrofola!t:. lipoit acid, FAD. and C. Transduction
fl Secretory D. Dennatan sulfate r>. Transformation.
45. The pancreas produces enzymes that are Hepar1n. C. nicotinmnlde aden!r:e dlnucleo!;de 69. Which of the following minen:1Ji:::.ed tissues
responsible for the digestion of dietary 52. Porphyrins use which amino fldd in their hrwc the greatest percentage of inorganic
<"ompounds. Which of the following foods synthesis? ~). maU:ria{?
would not be digested by enzymes synthesized A. Aianlne. 61. Relative or absolute lack of insulin in humans A, Enamel.
and secreted by the pancreas? B. Pheny!alM1in<2. would result in which one of the following B Dentin,
A. Carbohydrates. C. reactions in the lhier? Berne.
B, [), A. lncreased D. Calculus.
C 53, Which af the fol/awing is an essential amino B. Increased gtuco11eoger1es:1s 70. Each of the following <le,.,cri/)(.:s collagen e.1.:cept
D. Protein. acid? C. glycngen hr. '<kdown
0
one. l:Vhich is the exception?
46. Which of the following statements reflarding A D. Increased amino ;1dd uptake. A. rv1ost almndant protein in the hody.
the hormone secrelin is true? R 62. Whlch one of the following is elevated in Modincatlon;-;: in prncn!Lagcn occur in th0
A It is res:pon1'tble for activating C plasma during the absorptive period extracellular matrix
Serine. (compat·ed to the postabsorptive state)? C
B. t!Hc: releas.e of pantreatic secrt:tion Alanlne. A Chy!omicrons.
rich in bicarbonate. 54. Aspartame contains aspartic ,acid and which B. Acetoacetate.
C. It st!mulates the release of pancreatic of the following amino acids? C Lactate. oxygen.
D. It stimult>tes the contraction of thf> Pheny!alnnine. D. Glm:agon. 71. llydroxya,,atitc _ _ ,
to release bile. Ii Leuclne. 63. Insuliri produces which of the following A. ls if fluoride is suhstituterl for scmf'
47. Plwsphotipase C is an enzyme that plays an lsoleucine. changes in mammalian cells? of the hydroxy! inns
important role in the production of second D. A. Increase in !iver productlon.
messengers~ which produce intracellular E, B. Increase in concentration, carhonate ion hr(omcs ,nore
responses. Which two second messengers are 55. Which of the following is the end product of Decrease in the transport of glucose into soluh!e
produced through the action of this enzyme? purine degradation in humans? musde. D. ls corn posed nf calcium .and phnsph<tit'.: ln ;:1 l: 1
A. cAMP and tyrosine kinase. A, Urea, D. Increase in the transrmrt of glucose into the ratio
B. AcetylchoHne and histidine. R Urlc acid. bra.in 72. The type of collagen characteristically found in
C. Adenylate cyclase and protein kinase. C Adenosine, 64, Which of the following describes the function cartilage is which of the follocdng?
D. L2-<li;icvM•vcerol and inosltol 1,4, D. Xanthlne. of RNA polymerase? A, L
56. Which of the following participates in both A. Translates DNA into protein, B, IL
48, Hormones secreted by the posterior piluitarJi fatty acid biosynthesis and f>oxidation of fatty B. Terminates transcription. C !IL
gland include which of the follrm:ing? acids? C. Removes introns trans-crlpHmL !\/.
A, Prolactin. A Malonyl CoA, D. Synthesizes RNA 73. process transports amino adds across
B. FolHcle~stirnu!ating hormone. B. FAD, 6S. Analysis of DNA fragments (probing) is possibly tlte luminal surface of the epithelia that lines
C. hormone. C:oA <lue to which of the following properties of the small intestine?
D, Va;;o1Jrc,sin. DNA? A. Simple diffusion.
of which one of the following 57. The rate-limiting enzyme in glycolysis is which B. Primarv active transport
hormones are not mediated through cAMP?
A , "''"""'"""'"n bonds.
of the follo1ving? B, com,:,1m1entary strands. Cotran;port with sodium ion
A Estrogen. A F'rw:tose blsphospl:atase, C. Protein hindlng. D. Cotransport wlth chloride inn.
R Glucagon. B, 1'1l,1sn,hoiln«:tnlzirn1se, D. \Vestern bloHmg:. 74. Cell membranes typically contain th<: f'o-llowing
C. Epinephrin<". 66. 17,e amount of cytosine will be equal to the compounds except:
D. Nor<~pinephrine. D. Glucoklnase. amount of guanine in urhich of the following A. Phospho!ip1ds
50, A scientist has di$covered a new pepiide 58. The coenzyme essential for normal amino acid molecules? B. Proteins
hormone. He thinks it acts through the second metabolism is A. DNA. Cholesterols
mes,~enger system, which utilizes c,4MP. If this A. Biotin R RNA,
;s true, which of lht? following substances B. Tetrnhydrofo!atc C. DNA and RNA.
should decrease the response of this new phosphate D, mRNA
p-eptide hormone in cells? 67. What is the correct general structure of the A. ln;ictlvrites reduced stNoici derivatives
A. A,denylate cyclase. 59. Which of the foflowing metabolic aclivitie~,; is backbone of DNA and RlVA? B. Is not with nerves
B. MonoaminP oxiflase !nhlhit0rs, increased 1 hour after a meal (during the C. lnartivates e;_1tecbninmlncs by oxid:1Uv1~
C. Phosphodiesterase absorptive demnin.:itinn
l} Aspirin. A, u1ycngenc>1ysis, D, Is !ocaled in the synapse where it inr,etivates
B. Oxidation free fatty acids. the neurotr;:insmHtt:r :u:etylchnli1w
C. Glucagon release.
D, Glycol:,:rsis.
2 18 ,r Section 2 Biodiemblry and Physiology
76. Which one of the following does not release
acety{cholinr?
A Symp.:"lthetic prcg;;rnglionic fi:)ers.
B, Symp;i_thetk ;1ost.c1mgllon!c fibers that
innervate the heart.
C. Parasympatlwtic pnstr41rnglinnic fibers to
effoctor organs.
D. Para.symp;thetic pregaogiinn!c fibers.
77. Where are the temperature control centers
located?
A. Cen:;bel!um.
B. Hypothalamus.
C. Mecl111ln.
D. Cerebra! cortex.
78. The energy for skeletal muscle contraction is
derived from which of the following processes?
A. Calcium release from sarcoplasmic membranes
and bindlng t\1 troponln.
B. Cleavage of ATP by the myosln heo.d.
C. Membrane sodium~pntassiu,n A.TPase pump.
D. Sorhum inf1ux rlurlr,g the action pntentiaL
79. lV/uscle spindle stretching when lhe patellar
tendon is tapped produces which of the
following responses?
A. Muscle contraction within muscle where the
:ii:plndles are located.
B. Inc.:reasi:-d symp;1thetlc stimulation of the
spindles.
C. A reduction in the number of afferent lmpu!s>:s
entering the spinal cord.
D. An lnhib\tion of the stretch reflex.
80. The gamma motor neurons control which of the
following?
A. Muscle spindles.
ll lr!s of the eye.
C. Voluntary muscle fibers.
D. Pyloric sphincter.
81. Which of the following would be expecll!d to
raise blood prestmre?
A. A drug that lnhlbits tlw nnglotensin 11-
converting enzyme and thus the production of
angiotensin [l (ACE inhihltors).
B. A drug that inhihits the synthesis ot nitrlc
oxide.
C. A drug that blocks V1"1~opre::.sin receptors.
D. !ncn~r,sed stlmnlnHon of the carotid
barorcc-c-ptor.
82. Which of the folfowing ions has a hlgher
inlracellttlnr concentration compared to the
extrace.llutm· fluid?
A. l\a'.
B. K'.
C. ci·.
ll. IICO,
E. Ca11 ,
83, .4.ll of the following focal chemical factors will
canse vmwdilatation of the arterioles_. except:
A. Decreased K·
R lnc:reased CO:
C Nitric oxide
D. Decreased 0
£. Histamine reI~a!.e
84. Increasing the radius of arterioles will
increase which of the follmti~g?
A. Systolic blood pregsure
B. DiDstnlic blood pressure.
C. Viscosity of the blood
D. CapiHary blood :low.
85. In which of the following might arterial blood
pressure be abnormally high?
A. Ventrlcular fihrillation,
R Acute heart failure,
C. Anaphy\actic shock
D. focreased intrncranial pressure.
86. A major function of surfactant i$ to increase
whid1 of the following? --
A. Pulmonary compliance.
R Alveol.tr surface tension.
C. The work of breathing.
D. The tendency of the lungs to collapse.
87. The minimum volume of air that remains in the
lungs after a maxlmal expiration is termed the
A. Tldal voiume
B. Funf'.tlor;al residual caracity
C. Residual volume
D. Vital capacity
88. The center that prot:ides output lo the
respiratory muscles is located in the _ _.
A. Pons
B. Medulla
C. Cerebral cortex
D. Cerebellum
£. Hypothalamus
89. Aldosterone --··
A. Stimulates Na-· reabsorption in the dlstal and
cnllecting ducts
R ls secret~cl by the juxtaglnmerultir appar:\tus
C. Stimu!ateg K• abeorption in the distal tubule
D. Stimulates bicarhonate reabsorption in the
proximal tubule
90, Whal happens to net fluid filtration in the
glomerul1u; when plm;ma protein concentration
is decreased?
A Net till ration (ullrafiitration) Increases.
B. Net filtrntion (ultraflltralion) decreases.
C. !\;et filtration remains unclumg'P(t
D. Net fi!trn.tiori cea~es,
,91. Which of the following factors would result in
decreased glomerular filtration rate?
A. A foll in plasma protein concentration.
B. An obstruction nf the tubular system which
would increase capsuiar hydrostatic pressurP.
C. Vasodilation of th" <1fferent arterioles.
D. !nulin arlrnin!stratlon.
92. Which of the follordng statements regarding 96, Which of the l'ollmring factors will not
tnbular reabsorptfon is true? influence the rate at which a meal uAll leart'
A. :\1os1 talclum filtered is passively reabsorbed the stomach?
and not regulated under ar:y conditions. A. AcidHk:atinn of the duodenum.
B. Most urea is reahsorhed passlvely and is U. lncre(1sing the tonkity of t!w ·mtc.stiiw,
unaffected by regulatory mechanisms. C. Saline in the duodenum.
C. Glucose is reabsorbecl by secondary active D. Lipid in the intestine.
trnn~port and facilitated dHfusion. 97. H'hich of the followlng forms of thyroid
D. Most filtered phosphate is reabsorbed ln the hormone is most readily found in lhe
collecting ducts and ls unaffected by regulatory circulation?
mechanisms. A Tri~iodothyroninc (T)
93. Which of the following processes is not a trtie B. Thyroxine (T.1).
component of swallowing? C Thyroglobulin.
A Closure of the gfottis. D. TSH.
R Involuntary relnxation of the upper esophageal 98. A hormone acts lo stimulate Us neighboring
sphincteL cell to divide. This hormone would best be
C, Movements of the tongue against the palate. descrlbed as belonging lo which category of
D. Esophageal peristalsis. hormones?
94. Which of the following statements regarding A. Paracrlne.
the regulation of gastrointestinal motility is B, Autocrlne.
true? C. Endocrine.
A Sympathetic stimulation inhibits motility. 99. Blood levels of progesterone are highest
B. Parasympathetic stimulation inhibits motmty. during _ _.
C, Gastro!ntestlnal motilitv is not influenced bv A. The fn!lkuiar phase of the ovarian cycle
the central nervous sy;tem (CNS). ~ B, The luteal phase of the ovarian cyclt'
D. Gastrointestinal motility is not influenced by C. Ovulntlon
hormones. D. Menstruation
95. Which one of the following statements 100. Glucagon trill decrease u:hiclt of the
regarding the regulation of gastrointestinal following?
function is true? A. Glycogenolysis.
A. The main sympathetic nerve supply to the B. G!uconengencsis.
digestive tract is the vagus. C. Glycogenesis.
B. fn general, sympathetic stimulation is D. Blood glucose.
excitatory to ctig-estive activity.
C. Salivary secretion is stlmu!ated by both
branches of the autunomic nervous system,
although not to the same deb'Tee,
D. Paraiymp.athctic stimulation of the salivary
gland:.'! produces a saliva rich in mucus.
272 Y Section 3 Microbiolos:,' and ?ethology Section 3 Mkrobmlogy and P<1tho!ogy Y 273

16. Which of the folfou·ing microbes is the most 24. The most prominent mechanism of spread of
SAMPLE 0UESTIONS common cause of gastroenteritis in children? the hepatitis A virus is bv which of the
A. Reovlruses. following routes? V

1. All of the following cells are assocfoted with 9. All of the following conditions are commonly B. Picomaviruses. A Oral-anal.
chronic inflammation except one. Which one is associated llJith a group A, f3•hemolytic C. Toga.viruses. B Respiratory.
the exception? streptococci infection except one. Wltich one is D. Paramyxoviruses. C. Sexual contact.
A. Macrophages. the exception? £. Orthomyxovlrnses. D, Perinatal.
B. Neutrophils, A. Scarlet fever. 17. A cotton wool appearance may be used lo E. Insect vectors.
C. T lymphocytes. B. Toxic shoek syndrome. describe the radiograph of a patient with 25. Accumulation of fluid in the pericardium
D. B lymphocytes. C. Pharyngitis. A. Osteopetrosis occurs mosl often with which of the folfou·ing
E. Plasma cells, D. Endocarditis. B. Osteitis cleformans conditions?
2. Dust cells can be found in th; E. Impetigo. C. Peutz~Jeghers syndrome A. Unstable angina.
A. Brain 10. Karyotyping can be used to diagnose which of D. Seborrheic kerntosis B. Cardiomyopathy.
B. Heart the following diseases? E. Osteogenesis imperfecta C. Myoc-arditis
C Lungs A. Kltnefelter's syndrome. 18. An autoclave ste,·ilizes dental instruments by D. Acute pericarditis.
D. Liver B. Multiple rnyeloma. causing which of the following? E. Tmnponade.
E. Spleen C. Niemann~Pick dlsease. A. Coagulation of proteins. 26. The most common cause of pyeloneph-ritis is
3. Which of the following mediators aid in the D, Pemphigus. B. Denaturing of proteins.
killing of intracellufar bacteria? E, Peutz~Jegher~ syndrome. C. Precipitation of nucleic acids. A. Staphylococcus aureus
A. Histamine. 11. In pem11higm,, autoantibodies are directed D. Disruption of cell membranes. R Vibrio cholerae
B. lnterteukin-2. against which of the following structures? E, Dissolution of lipids. C. Escherichia coli
C. Catalase. A. Acetykholine receptor. 19. Ehlers~D«nlos syndrome is a disease affecting D. Helicobacter pylori
D. IgG. B. S-arcomere. L Bordett7lla pertussis
E. Lysozyme. C. Epidermi5. A. Bone 27. Polycystic kidney disease is most commonly
4. The class of antibodies that plays an important D. Thyroid follicle. B. Connective tissue associated with
role in type I hypersensitfoity reactions is E. Lysosomt:s. C. Muscle A. Renal cell carcinoma
A. lgA 12. Which of the following is a major complication D. Joints 8. Peripheral neuropathy
B. lgD of chronic bronchitis? E. Glycogen synthesis C. Urolithia~i~
C. lgE A. Myxedema. 20. An increase in alkaline phosphatase may be D. Berry aneurysm
D. lgG R Pncumothorax. seen in all of the following conditions except E. i:\fon-Hodgkin ·~ lymphoma
E. lg!>1 C. Emphysema. one. Which one is the exception? 28. Squamous cell carcinoma is the most common
5. DiGeorge's syndrome is characterized by a D. Pernicious anemia. A Hyperparathyroidi5m. oral cancer. It is a tumor of
deficiency of _ _ . E. Malignant transformation. B, 01teoporo5i5, A. Melanocytes
A. B lymphocytes 13. Which of the following cells are defecthie in C Oiteiti~ deforrnans. B. Basal cells
B. T lymphocytes chronic grannlomatous disease? D. Adenoc-arcinoma of the prostate, C. Fibroblasts
C. Both B and T lymphoq1es A. Neutrophi!s. E. Multiple myeloma. D. Keratinoc-ytes
D. Antibodies B. Lymphocytes. 21. The most common cause of death in diabetic E. Macrophages
E. Complement inhibitor C, Plasma cells. patients is _ _. 29. Tinea pedis, which is commonly known as
6. Which of the following is tile most common D. Ki!ler T cells. A. Peripheral ncuropathy athlete's foot) is a fungal infection that is
cause of subacute endocarditis? E. Macrophages. B. Pancreatic cancer caused by the fallowing dermatopl,yte(s):
A. Staphylococcus aureus. 14. Which of the following describes cells that are C. Cardiovascular disease A. Microsporum
B. Staphylococcus epidermidis. abnormal in appearance and may become D. Kidney failure B. Tridwphyton
C, Streptococcus viridans. pre.malignant? E. Opportunistk infections C. Epidt:rmophytnn
D. Streptococcus pyogenes. A. Aplasia. 22. Ncuraminidase is produced by _ _. D. Both A and B
E. Streptococcus pneumoniae. B. Dysplasia. A. Influenza virus E. Both B and C
7. Aschoff bodies are obserued in which of the C. Karyomegaly. B. Hepatitis C viruses 30. Fibrotic and thickened heart valves that result
following conditions? D. Pleornorphism, C. Human immunodeficiency virus in a reduction of blood flow through the valve
A Acute mye!ogenous leukemia. E. Metaplasia. D. Measles virus characterize which of the following?
R. Pheochromocytorna. 15. The HIV vii-us binds directly to the surface £, Rubella \lirus A. Stenosis.
C. Osteopetrosis. receptors of CD4 lymphocytes with _ _. 23. Which of tire follou·ing skin lesions is most B. Reg1:rgitation.
D. Rheumatic fever. A Reverse transcriptase likely premalignant? C. (n5uffidency.
E. Sderoderma . B. In tegrase A. Verruca vulgaris. D, Prolapse.
8. Endotoxin consists of C. Hemaggluttnin B. Keloids. E. lschemla.
A Lipopolys.accharide D. Glycoprotein 120 C. Seborrhek keratosls. 31. Cystic fibrosis is a here<fitary disorder that
b. M protein E. Protease D. Actinic keratosis. results from defective
c. Hyaluronidas.~ E. Compound nevus. A. Collagen
d. Lactic acid B. Lysosomal ent}Tie~
e. Coagula.se C. Chloride channels
0. Fibnllin
E. Myelin
274 Y Section 3 Mkrobidogy and Pathology Section 3 Microbidogy and Patho!ogy .,, 275

32. The most common mutation accounting for the 38. Upon further eraluarion, the doctor requests 43. Cafe au laif spots are seen in conjunction with 49. The clinical pre,"ientation of hemophilia Bis
pathogenesis of trisomy 21 is _ _. an HI\! and hepatitis test. The laboratory potyostotic fibrous dysplasia and endocrine indistinguishable from hemophilia A. Which of
A. Chromosome translocai.ion performed both an ELISA test and Western blot~ abnormalities in which of the following the following best describes the laboratory
B. Meiotic nonclisjunction revealing that the patient is HIV-positive. The disorders? method needed to <lh,tinguish these two
C. Mitotic nondlsjunctlon Western blot is used to identifv which of the A. McCune--Atbright's syndrome. conditions?
D. Single deletion following? ,., 8. Stevens-Johnson 5yndrome. A. Bleeding time.
E, X~link:ed inheritance fl. Antibodies. C. Marfan's syndrome, B. Assay of congulatinn factor levels
33. An endocrine disorder that causes an early B. DNA. D, Goriin-Goltz syndrome, C. Assay of von Willt>brand's factor.
loss of primary teeth and the early eruption of C. RNA. E, Peutz-Jeghers syndrome. D. Blood smear.
secondary teeth is _ _• D. Proteins. 44. The patient's radiographs could be described E. Platelet count.
A. Ylyxedema E. Plaque-forming units. ·1 as having wlrat 1:)-pe of characteristic
B. Hashimoto 's thyroiditis 3.9. Given the patient's history, if the patient was appearance? 50. An infection by which of the following bacteria
C. DlGeorge's syndrome later diagnosed with active hepatitis, which of A.. Cotton wool. may result in the formation of gummas?
D. Plummer's dl&Mse the following would most likely be the B. Ground glass. A. Myc0bactnium tuberrnfosis.
E. Dwarfism causative agent? C. Cobweb. B. Nei:1serfr1 gonnrrhore<)e.
34. Which of the followirrg is not a feature of A. Hepatitis A. D. Soap bubble. C. Trcponema pallidttm.
poststreptococcal glomerutonephriti.s? B. Hepatitis B. E. Starry sky. D. Bordete!!a pertw;sf.-.·.
A.. Hematuria. C Hepatitis C. 45. A bone biopsy was taken from the patient. £, Stn:ptocoCC'us pyngenes.
B. Hypertension. D, Hepatitis D. Which of the following would most likely be 51. Which of tlte following receptors are
C. Edema. E. Hepatitis E. obserued under the microscope? recognized by CDS lymphocytes?
D. Polyuria. 40. Which of the following would the doctor likely A. A dense inflammatory infiltrate. A. Cluss I MHC molecules.
35. The most common cause of osteomyelitis is prescribe for the patient's intraoral infection? B. f'ibrous tissue, B. Class II MHC molecules.
A. Amoxicl!Hn. C. Pleomorphic: cells, C. Surface lgE.
A. srr~ptoCOffU$ pyogenes B. Vancomycin. D, Metastatic calcifications. D. Surface lgM.
B. Staphylococcus aureus C, Ciprofloxacin. E. Giant cells, E. Histamine receptor.
C. lactobacilius casei D. Nystatin. 52. Which of the following cytokines stimulate B
D, Pseudomonos aeruginasa E. Chlorhexidine. lymphocytes to differentiate into plasma cells?
E. Escherichia coif 41. All of the following molecules may be found Test items 46-49 refer to the following A. IL-!.
36. All of the following are histopathologic within the nucleocapsid of an HIV virus except test/et. 8. IL-2.
features of malignant cells except one. Which one. Which one is the exception? C. lL-3.
one is the exception? A, Reverse transcriptase, A 6-year-old boy presents with a history of severe D. IL-4.
A Anaplasia, B. Integrase. epistaxis. For the past 3 years the patient has E. IL-5.
B. Pleomorphism, C, Neuramlnidase. experienced these nose bleeds, often without any 53. All of the following symptoms are mediated bJ•
C Aneuploidy. D, Protease. apparent cause. The patient is otherwise ln good antibodies except one. Which one is the
D. Large nuclei. E. Ribonucleic acid. health, but his mother has noticed that he exception?
E. Low nudear,cytoplasmic ratio, 42. The patient is referred to an infectious disease "brnises easily," Laboratory tests are ordered. A. Arthus reaction.
37. Which of the following be.st describes specialist and placed on "triple therapy." Two B, Tuberculin reaction,
46. The laboratory test results show a normal PT
anapfastic cells that have not invaded the years later. the patient is admitted to the hut a prolonged PTT. A prolonged PTT test C. Asthma.
basement membrane and are confined within emergency room with a dry cough and suggests that the patient has an abnormality D. Erythroblastosis fetalis.
their epithelium of origin? shortness of breath, His temperature is 101 affecting t.l'hich component of the coagulation E. Serum slckness.
A. Dysp!asia. degrees F. The most likely cause of the patient's cascade? 54. Which of the following is re/pased by mast cells
B. Hyperpla:sia, pneumonia is A. Activation oi platelets. after antigen binding?
C. Mcti,_pln.3ia, A. Staphylococcus aureus B. Activation oI thrombopla.stin. A. lgE.
D. Sarcoma. B. ffaemophilus influenzae C. Activation of plasminogen. B. Lysozyme.
E, Carcinoma in situ, C, Pneumoeysti.'i jiroveci (carinii_) D, intrinsic pathway C. IL-4.
D. Kleh.1:fr,lfa pneumoniae E. £.xtrinsic pathway. D. Leukotriene.
E. .S'treptococcus pneumoniae 47. The diagnosis of hemophilia A is made. This E. Interferon.
disease is caused by a defidency of _ _. 55. Symptoms of a myocardial infarction include
Test items 38-42 refer to the following all of the following except one. Which one is the
test/et. A. FactorV
8 FactorV!l. exception?
Test items 43-45 refer to the following A. Angina.
A 43-year-old man presents for an emergency den- C. Factor VIII.
test/et. B. Diaphoresis.
tal appointment complaining of a burning sensa• D. Factor IX.
tion in his mouth. Upon examination, white E. F'actor X. C. Fever.
A mother brings her &.year-old daughter In for an
48. Which of lite following describes the hereditary D, Vomiting.
plaques are observed along the oral mucosa. The examination because she noticed hrown macules E. Oyspnea,
patient otherwise appears healthy. There is no his- on her daughter·s leg. The macnles have jagged transmission of this disease?
A Autosomal dominant.
56. A positive quelling reaction can be observed in
tory of systemic illness. but the patient did state edges but do not appear raised. The mother is bacteria with a _ _.
that he had a blood transfusion more than l O years B. Autosomal recessive.
worried that her daughter may have a malignancy. A. Thick peptidoglyo1n layer
C. X-linked.
ago following a car accident. The doctor referred After further evaluation and tests, the macules are B. Capsule
D. It is not genetically transmitted.
the patient to emergency room for further tests, identified as cafe au lait spots, C. Flagella
D. Cell wall that contains teichoic acid
E. Glycocalyx coating
276 T Section 3 Mv:robtoiosy ,.,,d Pilthology Section 3 Microbiolcsy Md P<1tholo5y • 277

.57. Which of the following groups of micro- 65. Rheumatoid arthritis is characterized by 73. Which of the following structures is the most 81. A p,·oductive cough may be .-,een in all of the
organisms produce dipicoli.nic acid? inflammation of the _ _. common .site for oral cancer? J'ollo,dng conditions except one. Which one is
A. Actinornycetes. A Articular capsule A Soft palate. the exception?
R Histop/asma. B. Articular cartilage B. Lat~ra.l border of the tongue, A. P1wlrn1onk1s
C, Streptococcus. C Cortical bone C. Lower llp. R Lung abscc.ss.
D. Staphyiococcus. D. Perichondrium D. Floor of mouth. C. RronchiectHsls
E. l1o,'<;f1'idillm. E. Synovium E. 13uccal mucosa. D. Asthma.
58. Which of the following consists of glucose 66. The most common form of breast cancer is 74. The presence of Auer rods in a peripheral E. Brnncbogf:nlc carcinoma.
molecules linked together that act as the blood smear suggests which of the Following 82. Antinuclear antibodh:s are seen (n the se,·um
structural component of plaque? A Adenocarcinoma conditions? samples from 1>atients with
A. Fructose. B. Teratoma A Acute lymphocytic leukemia. A Hypngamn1ag_inhnlin~mi11
B. Sucrose. C. Fol!icular lymphoma 8. An11f' lymphob!aslic leukemia. B Chronic.' gram;lomatous: disease
C. Levans. D. Sarcoma C. Anll e myelogenous leukemia. C. Sy'.;tt"mic lupus erytht•nrntosns
D. Dextrans. £. Carcinoma D. Chronic lymphocytic leukemia- D. Multipll" mydnma
E. Fructans. 67. Which of the following antimicrobials is £. Hodgkin's lymphoma E. J~heochrn111nt'.V1on1a
59. 11te most common cause of bacterial meningitis bacteriostatic and inhibits protein synthesis in 7.5. Complications of Barrett'$ eso/Jhagus include 83. Nephrolithiasis ,itt most likely to be associated
in newborns is _ _. bacteria? all of the follorring except one. lt'hich one is the with which of the foffouiing t:onditions?
A. Staphylococcus aureus A. Streptomycin. exception? A. Hyperparathyn,idi5rr1
B, Streptococcu5 pnf!.umonio~ B. Penicillin V. A. Varlces. B Myxedema.
C. Escherichia coli C. Ciprofloxacin. B. Stricture. C. Pydonephritis.
D. Haemophilus influenzae D. Cephalexin. C. Hemorrhage. D. VVllson's diseas~
E. Listeria monocytogenes K Tetracycline. D. Adenocarclnoma E. Tl1r0mh0cytopC'nla_
60. All of the following can be found in the cell 68. Which of t/1e following may be obserued in a E. Ulceration. 84. A.n infant diagnotoed with ost(copetrosis has
wall of a gram-negative bacterium except one. child diagnosed with rickets? 76. The presence of Al-protein antibodies suggests dysfunctfonal _ _.
Which one is the exception? A. Dark pigmentation on the oral mucosa. immunity to infection by which type of A. Chnndrocytes
A. Endotoxin. B. Early eruption of teeth. bacteria? 8, Osieoblasts
B. A thin peptldoglycan layer. C. Hutchinson 'is incisors. A. Stn-ptococcus pyog,:,ri1s C. Ostenclasts
C. l.lpopolysaccharide. D. Abnormal dentin. 13. Streptococcus l1irufans. D. Fibroblasts
D. Teicholc acid. E. ~acroglossia. C. Streptococcus sanguis. E. Lymphocytes
E. 0 antigen. 69. In 2% glutaraldehyde, which of the following D. Staphylococcus aureus. 85. All of the following factors play a role in the
61. What type of vaccine is used for Clostridium times is minimally sufficient for achieving E. Lactobaci!fus easer virulence of the mkrobe that cau!ws w!wo11ing
tetani? sterilization? 77. Hemorrhagic infarction and tissue necrosis cough except one. Which one is the exception?
A. Capsular polysaccharides, A l 5 minutes. suggest which of the following? A. igA protease.
B. Toxoids. B. I-2 hours, A. Aspergillosls. B. Hemagg'httinin.
C Kiiled bacteria. C. 6 hours. B. Blastomycosls. C. Exotoxin.
D. lmmunoglohulins. D. 12 hours. C, Histopl7,1smosis. D. Capsule.
E. No vaccine is available. 70. An 8-J·ear-otd boy presents with macr-oglossia D. Mucormycosls. E Pili
62. The class of antibodies that plays an important and delayed eruption of his primary teeth. E. Toxoplasmosis. 86. T--cell lymplwm<r is most likely to ot:cur in a
role in mucosa[ immunity is _ _. Of the following choices, which one is most 78. Which of the following is usually least patient tL'ilh which of the folloming conditions?
A. lgA likely? malignant? A. Chninic granuiornatous disease.
B. lgD A. Plummer's disease. A. ACl!te lymphoblastlc leukemia. Ft Myastheuia gnwi!'I.
C. lgE B. Osteochondroses. B. Acute lymphocytic leukemia. C. Osteochondroma.
D. lgG C. Cretinism. C. Acute myeloge11ot1!i leukemia. 0. Wilson's disease
E. lgM D, \Vilson's disease, D. Chro11k lym1Jhocytic leukemia. E. Celiac sprue.
63. The presence of which of the follou:ing in a E, Mallory-Weiss syndrome. E.. Chronic myelogcnous leukemia.
patient's serum indicates that the patient is a 71. Which of the following bacteria would be 79. Bronchogenic carcinoma is a complication
highly infectious hepatitis B carrier? expected to fir&t colonize onto plaque? most characteristic of which of the following Test items 87-92 refer to the following
A. HBsAg. A. Streptococci. conditions?
B. HBsAb.
test/et.
B. Bacteroides. A. SiHcosis.
C. HBcAg. C. Fusobacterium. B. Asbestusis. A 60-vear-old homeless man who lives in a com-
D. HBeAg. D. Actinomyces. C. Anthracosis. r:nmtly shelter presents with history of coughing
E HBeAb. E. p,.,,votel/a. D. Sarcoidosis, !or th~ past 6 months. He has a slight lever.
64. All of the following microbes listed are 72. The hereditary transmission of Peutz.Jeghers E, Bronrhiectasis. hemoptysis, and productive cough with a yellow-
associated with infections secondary lo an HIV syndrome is _ _• 80. Which of the following disorder& is least likely ish sputum discharge. After further examination
infection except one. Which one is the A Autosomal dominant to be included in the differential diagnosis of a
-exception? and tests. the patient is diagnosed \Vith actlve
B. Autosoma! recessive patient wilhjaundice?
A, Pneumocystis jiroveci (carinii). C. Sex-linked dominant tuberculosis.
A Hepatitis.
B. Epstein~Barr virus. D, Sex-linked recessive B. Hemolytic fl.nemia.
C. Coxsackievirus. E. Not genetically transmitted C. Cholelithiasis.
D. Mi-·coi)acterlum tuberculosis. D. Glomer·u1onep11ritis.
E, albicans. E. thr- pancreas.
 Section 3 Micr,,biolosy and Pathology T 279

87. When the sputum samples were taken to the Test items 93-97 refer to the following Test items 98-100 refer to the following 99. The palhologJ· report reveals o characteristic
laboratory, what test did the doctor order to be test/et. test/et. patl.ern of tumo1' cells that is dassically
performed lo help make the diagnosis?
A 55-year-okl man presents with malaise and dys- associaJed with Burkitt ':s lymphoma. Which of
A Gram stain, ' A 3•year-old African girl presents in the emergency the foflowing describes this liistopathologic
B. Add~fast Main. pnea. He has a low-grade fever and reports that room with a palpable mass in her lower right pattern?
C, Spor~ stain. his shortness of breath has increased steadily mandible. She is currently in the United States vis- /!,., Honeyco1:1b
D. PPD test (tuberculin test). over the past week and a haif. He has a history of iting relatives with her parents. Her mom claims B Cobweb
E. Voges-Proskauer test rheumatic fever and denies ever using recre- that a few days ago she noticed a growing mass in C. Cotton wool,
88. Alter 2 weeks, tile bacterfol cultures came back ational drugs. He is currently being treated by a her daughter·s jaw. There appears to be slight D. Sun ray.
from the lab confirming the initial diagnosis, dentist for full mouth reconstruction, swelling around the area, although it is painless E. Starry sky.
positively identifying the organism 93. Upon further examination, a heart murmur 100. Tire African form of' Burkitt's lymphoma has
Mycobacterium tuberculosis. M. tuberculosis is and not tender to the touch, After further exami-
was detected. Given the patient's past medical been linked to the £1,stein-Rarr cirus. This
known to infect which oftlte follmving cells? history, u·hich heart valve is most likely nation. a biopsy was taken. and the diagnosis of virus is also responsihlr: for which nf the
A. Fibroblasts. affected? Burkitfs lymphoma was made. following diseases?
B. Basal cells. 98. Burkitrs lymphoma is a malignancy that
A Mitral valve. A Mononucleosis.
C. Type! pneumocytes. B. Tricuspld valve. affects which of the fallowing cells?
R Shingles.
D. i\'Jacrophages. C. Aortic valve. A. Macrophages. C. Chicl.:.~n pox.
E. Erythrocytes. R T lymphocyte-~.
D. Pulmonary valve D. Kaposi's sarcoma
89. Which of' the following is a glycolipid found on C. B lymphocytes
94. Be/'ore the patient's development of rheumatic E. Herpcmgina.
the surface of M. tuberculosis that plays a role fever, he likely suffered from which of the D. Neutrophil5.
in its pathogenesis? following conditions? E. Keratinocytes.
A. Cord factoL A Cystltis.
B. 0 antigen, B. Pharyngitis,
C. Protein A. C. Food poi5oning,
D. Exotoxin A. D. Thrornbocytopcni<l.
E. Leclthinase.
£. Meninigltis.
90, Since the patient was lfoing in a homeless 9.5. After further evaluation and tests, the patient
shelter, the tuberculin test was administered to i,'i diagnosed with snbacute endocardltis. JI' the
all of' the staff and residents living at the in/'ecting microbe was cultured in the
shelter. This test is based on a delayed type laboratory, the results would most likely show
hypersensitivity reaction that is mediated by that this microbe is po.sitive for _ _.
A o:-hemolysis
A. Only IgG 8, [>-h•moly•ls
B. lgG and IgM
C. "themolysi~
C. lgE
D. Coc1gulase
D. T cells and macrophage!: E. LecithinAse
E, Mast cells and bn.sophil~
96. Which of' the following is the most likely
91. Which of the following is the most appropriate complication that may occur from the
drug used in combination therapy for vegetations forming on the patient's defective
tuberculosis to treat the patient? heart valve?
A, Amoxkillin.
A. Myocardial infarction.
B, Clindamycin. 13. Hemorrhage.
C. Cephalosporin.
C. Petechiae.
D. Tetrncycllne. D. Cor pulmonale.
£. RHampin. E. Embolus.
92. After 3 weeks, the patient was feeling ''much 97. After the diagnosis is made, the patient is
better" and was discharged from the hospital, immediately placed on high-dose, IV antibiotics.
although he remained 01i his drug therapy for One of the antibiotics that is administered to
another 6 months. Which of the follon•ing best the patient is streptomycin, an aminoglycoside.
describes the calcified scar that later formed in The antimicrobial effect of streptomycin is to
the affected lung parenchyma and hUar lymph inhibit the .,vntltesis of _ _•
node? A. The bacte~rial cell wall
A. Gumma.
R Folate
R Chancre. C. Proteins
C. Metasti:ttir calcifications.
D Nucleic acids
ll. Tubercle. E. J1·lactamase
E. Ghan complex.
308 " Section 4 Dent,il Anatomy :md Occlusion
Widmalm S, Lillie J, Ash M: Anatomical and elect;omvo-
graphic studies of the lateral pterygoid mu,~le.
J Oral Rehab/I 14:429, 1987.
Woelfel JB. Scheid RC: Dental Anatomy: Its Releeance to
Dentistry. Philadelphia: Lippincott Williams &
Wilkins. 2002.
World Health Organization: Oral Health Survev!: Basic
Methods (3rd edition). Geneva: The World Health
Organizl\tion, 1987.
Zsigmondy A: Ghrundz(ige einer praktischen Methode
zur raschen und genauen, Vonnerkung der zahnart~
zlichen Bf'!obachtungen' und Operationen. Dtsch
V;schr Zahnhk 1:209. !861.
Zsigmondy A: A practical method for n1pidly noting den-
tal ob5ervation5 and operntions. Br 1 Dent Science
17:580, 1874.
SAMPLE 0UESTIONS
J. There are several tooth numbering systems,
some used more than others, and some used by
dental specialties or by svecial organizations,
The so-called universal system consists of:
A. 1\vo--diglt sets of numbers for each tooth ln each
arch quadrant (e.g., 18 to 1 !).
B. Single sequential number for teeth repeated ln
each quadrant (e.g., 8 to l).
C. A .sequential alphab~t letter for each tooth in an
entire dentition (e.g., A to T).
D. Different symbols for each numbered tooth in
each quadrant (e.g., !ii to 11).
2. From the occlusal perspectfoe, which tooth in
the primary dentition oaries the most in form of
which tooth in the permanent dentition varies
the most?
A. Maxillary first primary molar.
B. ~axillary second primary molar.
C. Mandibular first primary molar.
D, Mandibular second primary molar.
3. The primary maxillary first molar has which of
the following characteristics?
A. lt is larger in all dimensions than the primary
maxiUary second molar.
8. All three roots can be seen from mesial
perspective.
C. Bifurcation of roots begins almost immediately
at the site of the cervical line (CFJ).
D. The mesial root is considerably ,horter than the
distal one.
4. From a mesial perspective, the crown of the
primary maxillary first molar has which of the
following characteristics?
A. Pronounced convexi1y on the buccal outline of
the cervical third.
B, The cervical fioe mesially shows some curvature
in an aplcal direction.
C. The dimension at the occlusal third is the same
as at the cervical third.
D. The mesiobuccal cusp Is longer and sharper
than the me.1iolingual cusp.
5. From the lingual perspecti£ie, the crown of the
primary maxillary second molar $lwws wftich of
the following?
A. Small, well-developed mesiolingual cusp.
B. Distolingua! (DL) cusp smaller than the maxlllary
primary fir,t molar DL cusp.
C. There is no supplemental cusp apical to the
mesiolingual cusp,
D. Developmental groove separating the
me:5iolingual and <llstolingual cusps.
SectiQn 4 Dente! AN1tomy tind Ocdusion • 309
6. The primary mandibular first molar has tchich
of the following characteristics?
A, Resembles other primary and permanenl te-eth.
B. From the occlusal perspective. has a heart-
shaped outllne.
C. The mesiobuccal cusp is smaller than the
<llstohuccal cusp.
D. No develop:nental groove ls evident between
the buccal cusps.
7. A comparison occlusally between the primary
mandibular second molar and the permanent
mandibular fir.,;t molar shows which of the
following differences?
A The mestoM, distobucca!, and distal cusps of the
primary molar are almost equal in size; the
distal cusp of the permanent molar is smaller
than the other two cusps.
B. The primary molar crown is wider
buccolinguelly (in comparison with its
mesiodistal measurement) than is the
ptrmanent molar.
C. The primary molar outlfne is somewhat
hexagonal: the permanent molar ls rhomhoidal.
D. The ratio of the crown/root length of both
molars is the same.
8. In comparing permanent and primary teeth.
which of the following differences are noted?
A. Crowns of anterior primary teeth are narrower
mesiodistal!y (in comparison to their crown
length) than the permanent teeth.
R Comparatively, the roots of primary anterior
teeth are narrower and longer.
C. Cervical ridge5 of enamel of the primary
.anterior teeth are les5- prominent.
D. Buccal and lingual ~urfaceE of primary molars
are less Hat above the cervical curvature than
those of permanent molars
9. The overall lengtlt of the primary teeth that are
given hf!re are the average range of dimen.sions
with one exception. Which range for what tooth
is not correct?
A. Ma-xillary central incisor, 16 to 17 mm.
B. Mandibular central incisor, 16 to 17 mm.
C, Maxillary lateral incisor, 16 to 17 mm.
D. Mandihulbr lateral incisor, 15 to 17 mm,
10. For each type of tooth, the primary teeth
consistently show which of the Following
characteristics?
A. Greater mcslodi.stal diameter relative to crown
height than permanent teeth.
R An elongat~d appearance of the primary
crowns and roots.
C. Crowns that are translucent white in color.
D, Root trunk length is one~ha!f of the crown
height.
31 0 T Secti~n 4 De:ital Analamy and Ocdusion Section 4 Dental Anatomy and Ocdusfon • 31 i

11. Which primary tooth is generally accepted as 18. Which of the Following are not type traits of 24. If jaw opening is divided into phases, and it is 3(). The ncclusa/ surface of a primary mandibular
the first to erupt, and at about what mean age? permanent maxillary molars? assumed that the surfaces of the articulating first molar often has a promine11t fadolingtwl
A. Maxillary central incisor, 8 to 12 months. first Second Third bones and disc are associated throughout jaw ridge. This trdnsverse ridge connects U'hich two
B. central lnc-lsor, 7 to 9 months. Molar Molar Molar openin& what is the relationship of the disc
C central incisor, 6 to 10 months. A. Buccal Widest Intermediate Smallest and cnndyle in the follot.t:ing phases? and distolingual.
D. Mandibular central incisor, to lO months. Vlew: molar width molar A. In the earliest phase, the condyle moves B. !\ lesio!ing11a! and <:listohucc.-1!
1

12. ,4 most favorable sequence of eruption far the B. DL cusp; S.amesize Same size Smallest forward the disc. C. lV:esiobuccnl and
permanent dentition is which of the following as as M 1 size B. ln the early phase, the disc and condyle move D. Dlstobur-cal and d1stnllngual
(right side)? (Eruption sequence given by C Occlusal More anteriorly in concert. 31. ·which premolar would be the most likely tt>
numbers in parentheses.) view: rhomboid rttomboidal or C. In an intermediate phase, the condy!e moves have a single valp horn?
A 3. 30; (2) 8, 25; (3) 7, 26; (4) 5; (5) 28, shaped forward at a slower rate. first
6; (7) 31, 2, D. MB root In Hne-with ln line with Roots D. In the flna! phase. the disc moves forward at first.
3, 30; (2) 8, (3) 7; ( 4) 27, 6; (5) 28, 5; apex: cusp tip crown dis- faster rate.
29, 4; (7) 31, center placed 25. Occlusal interferences can be defined by all of MaxilJary second.
30, 3; (2) 25, 8; (3) 26, 7: (4) 27, (5) 4; the following except· 32. ft'hlch one of the following is not a normal
29, 6; (7) 31, 2, 19. Which of the following is not an arch trait of
the maxillary canine? A. Oc:dusal contact relations that Interfere with anatomical feature of mandibular incisors?
30, 3; (2) 25, 8; (3) 25, 7: (4) 27, 6; 28, 5; function. A. Bifurcated roots.
A In the same dentition, the crown is larger than
29, 4: (7) 2, 3L B. Interference to jaw closure into the intercuspal B
the mandibular canine.
13. primary tooth generally erupts last? C Four rle'v~l,omnc,,tal
B. The indsa! margin of the crown
A. Mandibular second molar. C. 1nt,er1<2renc,,s to laterotrusive movements. D. Inds.al edges placed .:-lightly lingnally.
least one third to one half of (TO½-'fl
B. Maxillary second molar. D. lnterferences to jaw opening. 33. The heights of contour of the distal surfaces of
C. canine. Labial aspect: mesial and distal ridges
toward cervix, 26. If posterior teeth on the left side contact permanent mandibular central incisors are
D. M,mo10111m canlne. occlusally during a right lateral excursion of located in which coronal third?
D. symmetry of mesial/distal halves when
14. Comparing the overall length of primary the mandible., the left side occlusal contact Middle.
viewed from inclsal.
central incisors (Ei f) with permanent would be referred to as: B. CervicaL
maxillary central incisors (Bl 9), which is the 20. Which one of the following morphological A. Laterotrusive contact. C. OcdusaL
correct ratio expressed as a percentage? characteristic is representatfoe of all posterior B. Protrusive contact. D. lncisaL
A. About 50'.Y., maxillary teeth? C. Mediotrusive contact. 34. On avera~, approximately what is the
B. About 60%, A. Marked mesial concavity on crowns and roots. D. Centric relation. dimension of the permam:nt maxillary canine at
C. About 70%. R Tips of cusps are well within the confines of the 27. Which one of the following is considered a the ttJldest mesiodistal diameter of the crown?
D. About Sm,,. root trunks. primary ligament of the TA-fJ? A mm.
15. At what time is the crown completed for the C. From me-sial/distal aspect, crowns are A Stylomandlbular, B. 6.5mm.
tooth indicated? rhomboidal in shape. B. Sphenornandibular. C. 7.5 mm,
A Primary maxillary centra! incisor, 3 weeks. D. From mesial/distal aspect, all maxillary C. Stylohyokl. D_ 8.5 mm.
B. Permanent maxillary central incisor, 2 to posterior crowns are trapezoidal with shortest D. Temporomandibular. 35. Which one of the follmdng is found on the
3 years. uneven sl<le to\.vard ocdusal surface. 28. }J,fand1'bular movement resulting from occlusal crown of permanf'nt mandifmlar first mol<irs
C. Primary maxillary lateral incisor, 2 to 3 months, 21. In terms of vertical dimension, where is the contacts of the teeth from retruded contact but is not found on the crowns of mandibular
D, Permanent maxillary lateral incisor, 2 to 3 mental foramen found most frequently? positiort (CRC) to intercuspal position (slide in second molars?
years. A. At the of the premolars. centric) ma)' show all except one of the MB cusp.
16. When are the crowns of the primary maxillary B. to the apices. following directional components when viewed B. Distobucca) groove.
second molars completed? Below the only in the horizontal plane. Which is the C. groove.
A 11 months. 0. No location predominates. exception? D. cusp.
B. 10 months. 22. A major anatomi<:al variant of the two-rooted A. Vertical component. 36. The Y..shaped central derelopmental groove is
9 months. B. Horizontal component. most likely found on which of the following
mandibular molar is a tooth with an
D. 8 months, L-:1teral component. premolars?
additional distolingual and third root. What
17. Whic/1 of the fol/ou,ing is not a type trait of the is the prevalence of these three•rooted 0, Protrusive component. A.
peYmanent maxillary second premolar? mandibular first molars? 29. Where is the height of contour located relative B. 'lfanr!;hnl:ir first.
A Buccal view: narrow shoulders of A. May exceed 10'.){, in Caucasians. to the following teeth (viewed from the mesia/)? C
crown; mesio-- and w,,cruucow,u, B. Less than 1% in Eurasian and Asian A. Facial surfaces of aH molars, middle third.
8. Ocdusal table outline: ovoid. B. Lingual surfaces of all premolars and molars, 37. In a cusp-embrtu.mre relationship, the
cervical third. maxillary first premolar is most likely to
C. Lingual s:urfac:es of molars and premolars, articulate with which of the follmDing
profile is not visible. cervical or mlddle third. mandibular teeth?
D. Anterior teeth, cervical or mldd!e third. First premolar only.
23. Which jaw activity does not involve one of the
B. Fir.st molar only.
following muscles?
C. Canine and first premolar.
A, Clenching, superior heads of lateral pterygoid
D. First :1nd second premolars.
muscles (LPM).
B. inferior heads of LPM.
C. ja\v movements, inferior heads of LPM.
D. jaw opening, deep masseter muscle.
312 • 54::<.tion 4 Dental Anatomy and Ocduslon
38. Equal contracture of the lateral pterygoid
muscle bilaterally produces which of the
fvllo111ing mandibular mrn,ements?
A. Retrus\ve.
B. Elevation.
C. Protrusive
D. LaternL
Test items 39-51 relate to the following
case presentation.
A 35-year-old woman presents with a painful lim-
itation of jaw opening (28 mm), a painful tooth
on the right side, and swelling at the angle ol the
jaw. She has a history of temporomandibular dis-
ease (TMD) and conservative treatment. :Vledica!
history reveals that the patient is being treated
for tuberculosis with combination antituberculo-
sis drugs including rifampin (Rifadin). She is also
being treated with an anticoagulant. warfarin
(Coumadin), a low level of aspirin, and paroxe-
tine (Paxil) for depression. The intraoral exami-
nation shows extensive teeth wear from
bruxism, diagnosed by a sleep specialist as sleep
bruxism. Tooth 32 has a deep carious lesion and,
on radiographic examination, a periapical radi-
olucency.
39. The incidence of tuberculosis is increasing as a
result of an association with AIDS. Oral
infections of tuberculosis (TBC) do occur but
are uncommon. Diagnosis of oral lesions may
present several challenges, as set forth in all of
the following statements except one. Which one
of thl? follmring statements is false?
A. Lesions secondary to HIV may be present.
B. Isolation of M. tulH:rculosis by culture requires 4
to 6 weeks or longer.
C. Mycobacteria can be demonstrated by special
stains in only 27'J:, to GO'Xt of cases.
D. Molecular tests ( e.g., polymerase chain
reactlon) show slow turnaround times.
40. All the following side effects hm;e been
reported to be related to the use of rifampin
except one. Which is the exception?
A Green bocmy fluids-sweat, tears, urine,
B. liepatotoxicity.
C. Thrombocytopenla.
D. Rashes.
41, Which of the following modes of action does
not relate to rifampin?
A. lnhlbits Ri'\A synthesis.
B. Binds tightly to eukaryotlc RNA polymerase.
C. Tuhcrculoeida.l to intracellular and extrace!iu!ar
orgnnisms.
D. Reduces activity of hepati<: mixed-function
oxidases.
42. Exacerbation of bruxism has been reported to
occur 1i:ith all the following agents except one?
Which Js the exception?
A Pn:rm:etinc (Paxil\
B. Selective serotdnin reuptake inhibitors.
C Naproxen_ ( Napro3yn ),
D, Amphet.11lline clt'iivativ~ ("Ecs~asy").
43. Migraine is a form of headache that is
currenrly thought to be best understood on the
basis of all the following with one exception.
The ~xception is which of the following?
A As a dysfunction of braJnstem pathways or
diem::ephallc nuclel.
13. As a primary disorder of the brain.
C. As similar in mechanism to tension headaches,
D. As. a neurovascu!ar hec1rlache.
44. Three key factors in the pathogenesis of pain in
migraine are usually considered. Which of the
following is not considered to be a key factor?
A. Cranial blood vessels.
B. P,-.~111yloid-containing plaques in the brain.
C, Trlgeminal innervation of the vessels.
D. Reflex connection of trige-rninal system with
crnnia l parasympathetic outflow.
45. The treatment of the patient with low levels of
aspirin is done for which of the following
reasons?
A. To reduce the likelihootl of platelet aggregi,,tion.
B. To stimulate cyclo-oxygentlse in the platelet5.
C. To increase the formation of thromboxane.
D. To cause p!ateJets to regenerate cyclo-
oxygenase.
46. When there is a pulpal-periodontal infection of
a mandibular third molar, which of the
following listed facial and c,:,rvkal spaces is
most likely to have become infected when there
is swelling at the angle of the jaw?
A Retromolar space.
B. Submaxi!!ary space.
C. Submasseteric space.
D. Parotici space.
47. Lymphatic drainage from tooth 32 will first
in1Jolve which of the following node groups?
A. Lateral upper deep cervical node.
13. Medial upper deep cervict,11 node.
C. Lateral lower deep cervical node.
D. Submaxil!ary node.
48. All but one the following are considerations
relevant to the diagnosis and treatment of
tuberculosis. Which of the following statements
is not true?
A. Increase in the prevalence nf TB.
B. Orn! TB lesions occur most frequently on the
glngivaL
C. F.merg('"nce oi rnultidrug-resistant strains.
0. Hi~h risk of M. tubernrlo,'>i! infection in patients
infected with human immunorleficlencv virus
(HIV). , C, Devl!':lopment ( centrn!) groove ls well defined.
49. Extraction of tooth 32 r<'vealed ,,nached soft
tissue. Which of the following is most important
for a presumptive diagnosis of tuberculosis?
A. Cll6t'-ous n<:>crntic areas.
B. Acld~fast bacilli.
C Epithelioid his.tiocytes.
D. L,ngcrhans giant ce!ls.
50. Which one of the following disorder.,; is the
least likely to be a differential diagnostic factor
in the patient's limited jaw opening?
A. Exacerbation of TMJ and TMD.
B. Tris mus secondary to TMJ pain.
C. Myalgia secondary to TJVlD.
D. Myositis secondary to bruxing.
51. The patient is on an anticoagulant drug
(e.g., warfarin /Coumadin}) as u;ell as
rifampin. What is the effect of rifampin on the
anticoagulation effect ofwarfarin (Coumadill)?
A. Increases the anticoagutant -effect of warfarln,
B. Increases the cyclic conversion of vitamin K
e.poxirle reductase.
C Antkoagulation effect Is inhihited.
D. Decn:asP,S its metabollc clearance by inducing
activity of hepatic oxidases.
52. A transverse ridge is:
A The CDmbination name for jolning oblique and
trlangular ridges
B. A combination name for jointng buccal and
lingual cusp triangular riclge.i
C. Chnracteristically found on all primary and
permanent molars
D. Found occasionally on maxlllary primary first
molar
53. From the occlusal aspect, the primary
maxillary first molar has which of the following
characteristics?
A Crown outline di'V~rge:s llngunlly and di5t<llly.
B. Small traverse ridge freqllently pn•sent <:allecl
an obllqtt<:' rldge.
C. Four tusps are present.
D. Mesia! marglnal ridge ls thin and poorly
f!eveloped.
54. From the lingual perspective the primary
maxiJlary first molar has which of tlte following
characteristics?
A. Distolint,n,rn! cut.pis the most prominent cusp.
B. iV1e:siolingual cusp poorly dt>fined
C Distoburcal cusp cannot be !!een fr-om lingual
aspect.
D. Crown converges -conslderably in a Hngua!
direction.
55. The primary maxillary second molar has what
characteristics?
A Does not have a well-defmed rnesial trlan~ular
fossa. ~
B. Oblique ridge ab:c;e-nt or not well developed.
D, A tubercle of Carflb~•m (Supplemt>ntary cusp) is
well dcvl?lnped.
Section 4 D1:ntal AMtomy and Ocdufion -,, 313
56, From the occluHa/ asp<.:ct the primary maxillary
second tno1ar has which of the fo-1/orring
characteristics?
A. Somnvhz1t rhombolrla! in form.
B. Three well d{;'vdoped cusps.
C. Two 51;pp!em,,ntal cusps. including tubercle ol
Carabelli.
D. Poody defined mesia! triangular fossa.
57. From the occlusal aspect, the primary
mandibular second molar has which of the
following characteristics?
A Somewhat rectangular in form.
B. The outline of the crov,Ti converges meslally,
C. Three buccal cusps are dissirnil.:rr in siz~:.
D. Cusps do not have well defined triangular
ridges.
58. A comparison of the pulp chambers and
root canals of maxillary primary and
permanent s<>cond molars show; which of
the following?
A. Enamel cap of primary tnoth is relatively thick
but less consistent in d~1)th.
B. ComparnUvely le1.s thirkness of dentin at the-
occlusal fossa of primary molars,
C. Pulp chambers are proportionally larger in
primary molars.
D. Pulp lioms are lower in primary molars.
especially distal horns.
59. In a comparison of maxillary, primarv and
permaneat second molars, which of tire
following <liffercnc-es are noted?
A. Enamel rods at the cervix slope gingiv;-1Hy in the
primary molar.
B. En~niel rods at th~ cervix slope occlusallv in
the permanent molar. "
C. Buccal cervical ridges are less pronounced in
the primary molar.
D. Roots of prlmary teeth ate longer and more
slender ln comparison wlth crown size than
those of permanent teeth.
60. Based on average MD diamettirs of the crowns
of primary teeth. the range for ave,-age overall
length of the primary maxillary arch is about
what dimensfon?
A. 60-68 mm.
B. 68-76 111m.
C. 76-84 mm.
D. 84-H2 mm.
61. What is the average height of curvature of the
cervical line (CE.I) on the mesial and distal of
the permanent maxillary and mandibular
incisors?
A ;\bout 35 mm nn the mesial of the muxi!!arv
central incisor.
B. About l.5 mm on the cHstnl oi the rnaxillary
central incisor.
C. Ahou: 2.0 mm on the nwsird nf tlw m<HHiihul;lr
central lncis:or,
D About I.() mm on the di~tnl of tht'. rn,,mdllmlar
central incisor.
 Section 4 Dental An.itomy and Ocd:.ision • 315

62. Considering the period of 2i1 months to about 6 69. W'h{ch of the following a,-e NOT arch trails of 75. Recent focus on causatii,e factors in bruxism 82. Rest position (RP) is defined:
years of age which of the following is true? tile canines? include ALL of the following Except? A. As any position of tile nrnncllh!e that lacks
A. Not all the primary teeth have attaif!ed their :\-!axillary Mandibular A Occlusal interferences. contact of the teeth.
occlusal ;evel. Canine (6) Canine (27) B, Part of a sieep arousal response. 8, As the centric relation position of the fOVi.dyles
B. Parts of hoth Jaws contain\ng primary teeth A. Crown size ,Large,- (same Smaller (same C. Palhophysiological factors. with the teeth apart.
change noticeably in size. dentition) dentition) D N<>urotransmitters in the centrai nervous C. As a man<libulnr position with mastlcatory
C A significant increase in intercanine width B. Lingual Common None system. muscles at complete rest
occurs shortly before and during the time the pits/grooves 76. AU of the follou:ing are supporting cusps D. A.s a dinical mandlbu!nr position in relation to
primary teeth are lost an<l the permanent teeth C. L.1biolingual Near cervlx Near cervix EXCEPT? the lnterocclusal space.
emerge. diameter same as 27 same as 6 A. Buccal cusp of Tooth #29. 83. Name the point angle which represents the
D. Denta! arch form is more or less constant and D. lnclsal view, Symmetrical Marked B. Lingual cusp of tooth# 4. junction of the cutting edge of an indsor with
prnctically no dimensional changes take place M;D halves asymmetry C. ML cusp of tooth #3. the surface that is toward the tongue and the
in depth or width after 9 month~ of age. 70. Which of the following are NOT type traits of D. ML cusp of tooth# 19. surface that is away from the midline.
63. Which sequence of eruption of permanent teeth the permanent maxillary central and lateral 77. Measurement of horizontal overlap (over jet) of A. Distoproximoincl~aL
occurs most onen? (S.7-6,.54-3•2·1 ,tl3•M:rM,·P2 • incisors? the teeth is easily done by which of the B. Distolabioincisal.
P1..C•Ll·CIJ. First #, # 's in each series is following methods? C. DistolinguolncisaL
Central Lateral
considered to be the first to erupt. A Measure from the fadal surface of a mandibular D. Labioincisol\nguo.
Incisor Incisor
A 6-1-2-4-3-5-7-8 (Maxilla} incisor to the facial surface of a maxlllary 84. Root bifurcation would be a more likely finding
A. Labial view: lncisat 3rd Jnct. inclsal/
B. 6-1-2-3-4-5-7-8 (Maxilla). incisor with the subject in lntercuspal position. in which of the following permanent teeth?
Meslal Contact mid 3rd
C. (&-1)-2-4-3-5-7-8 (Mandible). B. With the 5ubject intercuspal position, mark the A. Maxillary canine.
B. Labial view: Jnct. incisal/ Middle third
D. l-6-2...j-5-3-7-8 [Mandible). position of the maxillary incisal edie on the B. P.fondibular canine.
Distal Contact mid 3rd
64. Tile firSt evidence of calcification (weeks in facial surface of the mandibular inch,or with a C Mnxillary central incisor_
C. Mesia! view: Within inclsal Jnct. incisal/
utero) in the primary dentition occurs in which pencil. D. Mandibular laterai incisor.
contacts third mid 3rd
of the following teeth at about what age? Then have the subject open the mouth and 85. What is the correct schematic outline of the
D. Lahial: Slightly Sharp rt.angle
A Maxillary central incisor-14 (13-16) weeks. measure from the mark that you made to the following teeth?
mesioinclsal angle rounded
B. Mandibular central incisor-12 (10-13) weeks. indsal edge of the mandibuhu incisor. A. Mandibular premo!<1rs, vlewed from occlusal.
71. Which posUion of the mental foramen relatitie
C. Maxillary lateral incisor-14 (13-16) weeks, C. Measure from the miclline between the rhomboidal.
to the mandibular premota,·s and ffrst molar
D. Mandibular lateral incisor-14 (13-15) weeks, maxillary central lncisors to the mid!ine of the B. l\.faxill:iry central incisors, viewed from f.:iciaL
occurs most frequently?
65. A most characteristic feature of the primary mandibular central incisors. triangles.
A. Between the first and second premolars.
maxillary central incisor is which of the D. Measure from the incisal edgt of a maxillary C. Moxilla.ry lateral in<:isors, viewed from mesial.
B. In line with the second premolar.
following? incisor to the incisal edge of a mandibular tnipezoidai.
C Distal to the second premolar.
A. Faclolinguat breadth of the crown, incisor with the mandible in the maximum open D, All mandibular posterior teeth. dlstal aspect,
D, In line with the mesial root of the first molar,
B. Mesiodistal width of the crown. position. rhomboidal.
72. The maxillary sinus overlies the alveolar
C. Mesial and distal margin outlines in line with 78. In a cusp•fossa occlusal relationship, the 86. A distinct central developmental grooue,
processes in particular what tee/Jt?
profiles of root. maxillary second premolar is most likely to prominent buccal triangular ddge, two cusps
A. First and second maxillary molars.
D. Root/crown ratio. articulate with tvhich of the fallowing and distinct mesial and distal occlusa( pits
B. All maxillary molars.
66. When is the crown of the permanent mandibular teeth? would be mo!~t characteristic of:
C, First and second premolars.
mantlibular second molar completed? A. First premolar only. A. Mandibular Hrst premolars.
D. First and second premolars and first and
A. About 7-8 years, B. Second premolar only, B. Primary mandibular first molars.
second molars.
ll. About 8-9 years. C. Canine and first premolar. C. Primary m;J;ndibu!ar second molars.
73, The masseter muscle, which has a complex of
C. About 9--10 years. D. First and second premolars. D. Mandibular .second premolars.
internal components, includes all the following
D. About 10-11 years. 79. Which of the following contributes primary 87. From the incisal view. a greater mesiodistal
£XCEP77
67. Which of the following is NOT a type trait of sensory innervation to the temporomandibular measurement than faciolingual measurement
A. Pennation.
the permanent maxillary first premolar? joint? can be seen in idiich of the following
B. Structural composition permitting regional
A Ocdusal table outline, trapezoldaI. A. Auricu!otemporal nerve. permanent anterior crowns?
activation.
B. Generally two roots - mesiai and distal. R Infra.orbital nerve. A. Maxi!Iary central incisor
C. Mnltlp!e internal aponeuroses.
C. Central groove is long. D. Internal aponeuroses that do not move or C. Branch of the lingual nerve. B. Mllxillary canine,
D. Supplementary grooves are rare. D. Facial nerve. C. M;ilmtibular canine.
deform.
68. Which of the following are NOT type traits of 80. The smallest cusp on the crown of a 5 lobed D. \fandlbulnr centrnt in<:'isor,
74. Sleep bruxism can be characterized by which
permanent mandibular first and second mandibular second premolar is tile: 88. ,ffaximum rotation and translation of both
of the following?
premolars? A. Buccai cusp. cond;yles takes place at:
A. Episode~ of massive, bilateral clenching.
first Sf:cond B. Tooth grinding that may last for uµ to 20 B. Di~tohuccat cusp. A. :Vfoximum opening.
Premolar Premolar minutes. C. Distal cusp. B. Maximum prntrusive.
A. Buccal vlew: Crown bilate-rally Bilaterally D. Di5toling:ual cusp, C Right nm! left lutf'rnl t:xcurs:ive movf'nlf'l!ts.
C. Often coincides with passage from lighter to
A5ymmetrical symmetrical deeper sleep.
81. A typical primary mandibular first molar has D. Hinge movemf:'nL
B. Lingual aspect· Entire bucca! Buccal profile D. Occurs ;t_pproxlm21tely every 20 minutes in the how many pulp horns?
profile vis:lble not seen sleep cycle. A. l.
C. Lingual aspect: Most of ocdusai Little, if any 8. 2.
surface visible seen C.
D. Lingual aspect: Contour height: Cervical third D. 4.
Middle third
316 v Section ff o~t,1 Anatomy and Ocd,.rnion
Questions 89-1 00 relate to the foffowing
history and examination
A mother brings her 12-year-o!d boy to the dentist
to ask about her son grinding his teeth and about
some white "spots" located on the smooth-sur-
faced enamel of several of his anterior teeth and
premolars. Among other questions about the
cause of the defects, the mother then asks when a
systemic disturbance occurred that may have
caused the "spots." The patient has excessive
tooth wear from bruxing and clenching. The den-
tist measures the cervical-incisal length of the per-
manent maxillary central incisor (10.5 mm). Also
measured ls the distance from the CEJ to the mid-
point of the defect (5.5 mm). Given that the crown
is completed over a period of 4 to 5 years it is pos-
sible to estimate the age at which the hypoplasia
occurred using 6 months or yearly periods in the
following formula:
ADF • ACF - (yrs. of formation/crown height x
distance of defect from CEJ)
89. Using an average age of crown formation (ACf)
of both 4 and 5 years, the age of defect
formation (ADF) is estimated to be about what
time?
A. 7-9 months in utero.
B. 0-1 years of age.
C. 1-2 yearo.
D. 2-3 years,
90. The increase of lluorosis of permanent teeth in
both nonfluoridated and optimally fluoridated
populations points to the need for dentists to
caution parents with children about potential
causes of f1uorosis in children. Which of the
following cautions about fluoride is correct,
but the age or implied age is NOT Correct?
A Excess (> 1 ppm) fluoride in the drinking water
during enamel formation,
B. Exceasive (> pea-fiized amount) use of fluoride
toothpaste under 6 ye~rs of age.
C. Use of fluoride toothpa!le !or children under 4
years o[ age.
D. Use oi a 1.1 % sodium fluoride toothpaste or gel
by pediatric patients only when 6 years of age
and older.
91. Systemic etiologic factors that are said to be
a.uociated with enamel defects such as
hypoplasia occur generally in what period of
time?
A. Before birth.
B. Generally after birth and before the age of 6
years.
C. During the first year postpartum for
Hutchin~mn'e; incisors.
D. During birth.
Section 4 Dental Anatomy and Ocdusion T 31 7
91?. The differential diagnosis of while ''spots'' of 97. Aggravation of bruxism has been suggested to 99. During muscle contraction what physical
the enamel of primary and permanent teeth occur secondarily to all of the following change DOES NOT occur relative to muscle
should include disorders that have a occlusal relationships except one. f+'hicfl one fiber contraction?
substantiated cause. 'Which of the following DO is the EXCEPTION? A. Sarcomeres-shorten,
NOT have an evidence•based causal A Occlusal lnterferences in centric relation. R Thick and thin filaments-shorten,
relationship u:irlt enamcil hypoplasia? B. Occlusal Interferences in the intercuspa! C. 1 Band-shortens.
A. Rickets. po~ition, D. H zone-shortens.
8. Congenital syphilis. C. Iatrogenic occlusal relations that imerfere with 100. Regarding the superior and inferior heads of
C. Measles. bruxism. the lateral pterygoid muscle (SHLP and IHlP),
D. Fiuorosis. D, Angle Class Ill malocclusion (prognathism). which of the following statements is NOT
93. Clenching and grinding of teeth involves 98. The differential diagnosis of enamel TRUE?
contraction of skeletal type muscles. Several hypoplasia should lake into account A. Hypothetically, SHLP and IHLP can be
types of myofilaments are present in the suggested differences between non.fluoride considered to be parts of one musde.
contractile efement,'i of skeletal muscles. Which and fluoride opacities. Which of the following B. Distributions of SHLP and IHLP activities are
statement abo.ut muscle filaments IS NOT true? statements does not suggest a basis for a shaded according to biochemical demands of
A Mvosin forms the thick filament of muscle. ,liagnosis of non-nu.oride (NF) enamel tasks.
B. A~tin is a major protein of thln filaments. hypoplasia? C, SHLP stabilizes the condyle and disk against
C. Tltin ls a protein of elastic filament. A. Levels of Fin drinking water that range from the artlcular eminence in a wide range of jaw
D. Connectin is a protein of intermediate filament. 0.2 to 0.34 ppm have been reported to be movements and forces,
94. 711e clinical examination of the patient reveals associated with prevalences of NF enamel D. tHLP plays a m1.jor role in the generation and
extensive wear of the right canines, and opacities ranging from 22% to 35 %. fine control of horizontal forces.
somewhat less wear of the lateral incisors. B. At a level of l to l.5 ppm of f in drinking
Also there is tenderness of the jaw closing water, only few F opacities occur.
muscles, particularly on the right side. The C. Most NF enamel opacities appear as white,
muscle(s) that would be invoked primarily in opaque !.pots in smooth surface enamel; areas
providing most of the force for anterior tooth of mild dental nuorosis are lusterless, opaque
clenching include which of the following white patches.
masticatory muscles? D. Fluorosis and NF opacities are clinkally
A Inferior lateral pterygoid muscle, significantly different.
B. Superior lateral pterygoid muscle.
C. Anterior ternporali~ musde.
D. Masseter musc!e.
95. Sleep bruxism (SB) is defined by many bat not
all of the following characteristics. Which is
the EXCEPTION?
A. Stereotypical movement disorder.
B. Grinding and clenching of the teeth during
sleep.
C. More frequent in the younger gener2'-tion.
D. lndivlduals who brux during the daytime
inevitably brux at nlght.
96. Recent physiologic evidence suggests that
central and/or autonomic nervous systems
rather than peripheral sensory factors play a
dominant role in the genesis of sleep bruxism
(SB). Which statement about the central genesis
of SB is NOT true?
A. During sleep the mouth is usually open due to
motor repression.
R Tooth contact most Hkely occurs in association
wlth sleep arousal.
C. Some peripheral sensory factors may exert an
lnfluence on SB through their interaction with
sleep a,;,vake mechanisms.
4
D, Sequential change from autonomic
( cardiac)/brain cortical activities follows
SB~related jaw motor activity.
1. AU of the following are supporting cusps
EXCEP17
A. Buccal cusp of Tooth #29.
B. Lingual cu,p oi tooth !14.
C. ML cusp of tooth #3.
D. ML cusp of tooth #19.
2. The lateral pterygoid muscle attaches to which
of the following?
A Lateral surface of the lateral pterygoid plate.
8. Medial surface of the lateral pteryg_oid plate.
C, Lateral surface of the medial pterygoid plate.
D. Medial surface of the medial pterygo!<I plate.
E. Pyrarnldal process of palatine bonc:.
3. A transverse ridge is:
A. The cornbinatlon name for joining oblique and
triangular ridges
B. A combination name for joining huccal and
lingual cusp triangular ridges
C. Charact eri,tically found on an primary and
permanent mo!ars
D. Found occasionally on maxillary primary first
molar
4. Bronchogenic carcinoma is a complication most
characteristic of which of the following
conditions?
A. Silicosis.
B. Asbestosis.
C. Anthracosis.
D, Sarcoldosis.
E. Bronchiectasis.
5. Which of the follou•ing statements regarding
tubular ,-eabsorption is true?
A. l'vlost calcium filtered is pa$sively rca bsorbed
and not regula.tecl under any c-orn1itiong,
B. Most urea i, reabsorhed passively and is
unaffected by regulatory mechanisms.
C. Glucose is reabsorbed by secondary <lcUve
tran5port and facilitated diffusion.
D. Most filtered phosphate is reabsorbed in the
collecting ducts and l~ unaffected by regulatory
mechanisms.
6. The class of antihodie,,; that plays an important
role in type I hypcrsensitit>lty reaction ..; is _ _.
A. lgA
B. lgD
C. lgE
D. IgG
£. lgM
7. The amount of cytosine tdll be eqtu1l to the
amount of guanine in which of the following
molecules?
A. DNA.
B. Rf\A.
C. D:-IA and RNA.
D. mRNA.
8. The hrartchial arche:~ disappf.'ar when the
branchial arch grou:s down to contact the
A se-eon<l; third hranchial arch
B. second; flfth brnnchiai arch
C. thlr<l; fifth brand1iaf arch
D. first; first bnmchial groove
E. first: sixth hranchial groove
319
 Sample Exam .,.- 32 J
3 2 O -. Samp-le exam

15, Measurement of horizontal ot:erlap (over jet) of 20. Which of the follou:ing structures is the most 28. Both active transport an<l faci(itated diffusion
9. Glucagon will decrease which of the
the teeth is easily done by uthich of the common site for oral cancer? are characterized by which of the following?
following? A. Soft palate.
following methods? .. A. Transport in one direction only,
A. Glycogenolysis B. Lateral border of the tongue.
A Measure from the facial surface of a mandmuiar H. Hydrolysis ol ATP.
B. Gluconeogenesis. \,,, Lower Hp.
C, Glycogenesis. Incisor to the facial surface of a maxillary C. Transport against a co;1centration gradient.
inclsor with the subject in !ntercuspal position, D. Floor of mouth. D. Competitive lnhihH\on.
D. Blood glucose. E. Buccal mucosa.
JO. When an enzyme ts competitively inhibited, B. With the sub\ect intercuspal position. mark the 29. Which of the following bacteria would be
position of the maxillary indsaI edge on the 21. :Wandibular movement resulting from occlusa{ expected to first colonize onto plaque?
which of the following changes occur?
facial surface of the mandibular incisor with a contacts of the teeth from retruded contact A, Streptococci.
A. The apparent Km is unchanged.
pencil. Then have the subject open the mouth position (CR(] to intercuspal position (slide in B. Bacteroides.
B. The apparent Km is decreased.
and measure from the mark that you made to centric) may show all except one of the following C. Fusobacterium.
C. Vmax is decreased.
the indsal edge of the mandibular incisor. directional components when viewed only in the D. Attinomyce.~.
D. Vmax is unchanged.
C. Measure. from the midline between the horizontal plane. Which t's the exception? E. PrePotd!o.
J 1. A typical primary mandibular first molar has
maxillary central incisors to the mldline of the A. Vertical cornponenL 30. Cell membrane typic-ally contain the following
how many pulp horns?
mandibular central incisors. B. Horizontal component. compounds except:
A 1. C Lateral component
D. Measure from the indsal edge of a maxillary A. Phosphotipids
B. 2. D. Protrusive component.
incisor to the ine:isal edge of a mandibular B. Proteins
c. 3,
incisor with the mandible in the maximum open 22. Which of the following muscles is responsible for C. Cholesterols
D. 4. the formation of the posterior tonsillar pillar?
position. D. Tria<:ylglycerols
16. Increasing the radius of arterioles will A. Stylopharyngeus. E. Sphingollpids
increase which of the following? R Tensor veli palatine. 31. Which of the following muscles adducts the
Test items 12-14 refer to the following A. Sv,tolic blood pres~rnre. C. P.alatoglossus. vocal cords?
test/et. B. Diastolic blood preMure. D. Palatopharyngeus. A. Lateral cricoarytenoid.
C. Viscosity of the blood. E. Levator veli palatine. B. Posterior cricoarytenoid.
A 3-year-old African girl presents in the emergency 23. Which of the following does not occur to C Cricothyroid.
D. Capillary blood flow.
room with a palpable mass in her lower right 17. Which of the following nerves supplies taste compensate for a fall in blood pressure below D. Vocalis.
mandible. She is currently in the United States vis- sensation to the anterior two-thirds of the normal values? E. Tensor veli palatine.
iting relatives with her parents. Her ~om daiI~s tongue? A. lncreaserl cardiac output. 32. Which of the following best describes
that a few days ago she noticed a growmg mass m A. Hypoglossal. B. Increased stroke volume. anaplastic cells that have not invaded tile
her daughter's jaw. There appears to be slight B. Glossopharyngeal. c_ Increased heart rate, basement membrane and are confined within
swelling around the area, although it is painless C. Lingual. D. Decreased total peripheral resistance. their epithelium of origin?
and not tender to the touch. After further exami- D. facial. 24. Relative or absolute lack of insulin in humans A. Dysplasia,
nation, a biopsy was taken, and the diagnosis of E. Mental. would result in which one of the fallowing B. Hyperplasia.
18. Which of the following are NOT arch traits of reactions in the lit;er? C. MetapJasia.
Burkitt's lymphoma was made. A Increased glycogen synthesis.
J2. Burkitt's lymphoma is a malignancy that the canines? D. Sarcoma.
Mandibular B. Increased gluconeogene:si,;. E. Carcinoma in situ.
affects which of the following cells? Maxillary
C. DetreAsed glycogen breakdown. .13. Which muscle of the anrerolateral abdominal
A Macrophages. Canine (6) Canine (2.7)
D. Increased amino acid uptake. wall is described as being belt• or strap,like?
B. T lymphocytes. A. Crown size Larger (same Smaller (same
25. In 2% glutaraldeh_yde, which of the following A. External oblique muscle.
C. B lymphocytes, denhtion) dentition)
times is min,lmally sufficient for achieving R internal oblique muscle.
D. Neutrophils. R Lingual Common None
sterilization? C. Transversus ahdomlnis muscle.
E. Keratinocytes. pitsigrooves A. 15 minutes. I} Rectus abd0mi11is muscle.
13. The pathology report reveals a characten'stic C. Labiolingual Near cervix Near cervix B. 1-2 hours. E. Quarlratus lumborum muscle.
pattern of tumor cells that is classically diameter same as 27 same as 6 C. 6 hours. 34. In a comparison of maxillary, primary and
associated with Burkitt's lymphoma. Which of D, h1clsal view, Symmetrical Marked D. 12 hours. permanent second molars, which of the
the following describes this histopathologic M/D halves asymmetry 26. Which of the following bones is part of the following differences are noted?
pattern? 19. ff'hich of the follawing statements regarding superior wall (roof) of the orbit? A. Enamel rods at the cervix slope gingivally in the
A. Honeycomb. the regulation of gastrointestinal motility is A. Zygomatk, primary molar.
B. Cobweb. true? B. LacrlmaL B. £name! rods at the cervlx slope occlusally in
C. Cotton wool. A. Sympathetic stimulation inhi~its _motlHty. C. Spbenoid, the permanent molar.
D. Sun ray. B. Parasympathetic stimulation mhtbits motility,
D, Maxilla. C. Buccal cervical ridges <1re less pronounced In
E. Starry sky. C. Gastrointestinal motillty is not influenced by E. Ethmold. the primary molar.
J4. The African form of Burkitt's lymphoma has the centnil nervoos system (CNS). 27. On average, approximately what is the D. Roots of primary teeth nre longer r:md more
been linked to the Epstein-Barr vfrus. This virus D. Gastrointestinal motility is not influenced by
dimension of the permanent maxillary canine slender in comparison with cro\-vo size than
is also responsible for which of the following hormones. at the widest mesiodistal diameter of the those of permanent teeth.
diseases? crown?
A. Mononucleosis.
A. 5.5 mm.
B. Shingles. B. 6.5 mm.
C. Chicken pox. C 7.5mm.
D. Kaposi's sarcoma. D. 8,5mm.
E. Herpangina,

322 • Sample Exam
Test items 35-37 refer to the following
test/et.
A mother brings her 6-year-old daughter in for an
examinatlon because she noticed brown macules
on her daughter's leg, The macules have jagged
edges but do not appear raised. The mother is
worried that her daughter may have a malignancy.
After further evaluation and tests, the macules are
identified as cafe au lait spots.
35. Cafe au lait spots are seen in conjunction with
polyostotlc fibrous dysplasia and endocrine
abnormalities in which of the following
disorders?
A. McCune-Albright's syndrome.
B. Stevens~Johnson syndrome.
C. Marfan·s syndrome.
D, Gorlin~Goltz syndrome.
E. Peutz-Jeghers syndrome,
36. The patient's radiographs could be described
as having what type of characteristic
appearance?
A Cotton wooL
B. Ground glass,
C. Cobweb.
D. Soap bubble.
E. Starry sky.
37♦ A bone biopsy was taken from the patient.
Which of the following would most likely be
observed under the microscope?
A. A dense inflammatory infHtrate,
R Fibrous tissue,
C, Pleomorphic cells.
D. Metastatic calcifications.
E. Giant cells,
38. The overall length of the primary teeth that are
given here are the average range of dimensions
with one e.'l:ception. Which one is the
exception?
A Maxillary central incisor, 16 to 17 mm.
B. Mandibular central incisor, 16 to l7 mm.
C. Maxillary lateral incisor. 16 to 17 mm,
D. Mandibular lateral lncisor, 15 to l 7 mm.
39. Fibrotic and thickened heart valves that result
in a reduction of blood now through the valve
characterize which of the following?
A Stenosis.
B. Regurgltaiion,
C. lnsufficiency,
D. Prolapse,
E. Ischemia.
40. From the occlusal aspect the primary maxillary
second molar has which of the following
characteristics?
A... Somewhat rhomboidal in form.
B. Three wen devt>loped <;usps.
C Two supplemental cusps, including tubercle of
Carabe.l!L
D. Poorly defined rnesial triangular fossa.
Sample exam • 323
41. All of the following local chemical factors will 49. There are seu:,-al tooth numbering systems, 54. During the examination, the patient observes
cause vasodilatation of the arterioles, except: some used more than others, and some used by that he cannot feel it when you touch part of
dental specialties or by special organizations. his cheek and his upper lip. Which of the
A. Decreased K
R increased CO,, The so.called unicersal system consists of: following nerve.,; was prohahly damaged during
C. Nitric oxlde - A. Two-digit sets of numbers for each tooth in the accident?
D. Decreased 0,, each arch quadrant (e.g., IS to 11). A Lingual.
E. Histamine release B. Slngle sequential number for teeth repeated in B. Maxillary.
42. The inferior aspect of the diaphragm is supplied each quadrant (e.g.. 8 to 1). C. Long buccaL
with blood by which of the following arteries? C. A sequential ~lphabet letter for each tooth in an D. Superlor alveolar.
entire dentitlon (e.g., A to T). E. Inferior alveolar.
A. Median sacral artery.
B. Lumbar arteries. D. Dlfierent symbols for each numbered tooth in 55. You decide to restore the missing cusp on the
each quadrant (e.g,, Q '. to 1.i ), patient's molar. During the administration of
C. lnferior phrenic arteries.
the inferior alveolar nerve block, which of the
D. Celiac trunk.
following ligaments is most likely damaged?
E, Superior rnesenterk artery.
43. The coenzyme essential for normal amino acid A. Sph~nornandibnlar.
metabolism is _ _. Test items 50-55 refer to the B. Stylom,c,ndibult1r.
following testlet. C. Tc•mporomandibular.
A. Biotin
D. lnterck~ntal
B. Tetrahydrofolate
A 24-year-old man presents to your office for an
C. Pyrldoxal phosphate
emergency visit, after being hit on the left side of 56. Polycystic kidney disease is most commonly
D. Nlacin
his face with a soccer ball. He complains that his associated with
44. Equal contracture of the lateral pterygoid
muscle bilaterally produces which of the "tooth got knocked out" and that his jaw feels "out A. Renal cell cardnoma
following mandibular movements? of place." He has no other medical conditions. R Peripheral nenropathy
50. During introora/ examination, you find that C. llrolithtasis
A Retrusive.
the patient;s lower second premolar is missing. D. Berry aneurysm
B. Elevation.
C. Protrusive, Which type of alceolodental fibers was least E. Non-Hodgtin's lympboina
intio/ved in resisting the force that pulled this 57. Which of the following types of epithelium lines
D, Lateral.
45. Which of the following cells forms the myelin patient's tooth out of its socket? the oropharynx?
sheath around myelinated nerves in the central A. Apical. A. Simple squamous.
B. Oblique, B. Strnt!Hed 5quamom;,
nen-ous system?
C. Alveolar crest. C. Simple cuboidul.
A. Schwann cells.
D, lnterradkular. D. Simple columnar.
B, Astrocytes.
51. You also notice that a cusp of his mandibular E. Pseudostratified columnar,
C, Microglia.
second molar has fractured off and that dentin 58. A scientist has discovered a new pevtide
D. Oligodendrocytes.
is exposed. Jf this patient were to drink hormone. He thinks it acts through the second
E. Amphicytes.
46. Which of the following mineralized tissues have something cold, what will he sense? messenger system, which utilizes cA1lfP. Jf this
the greatest percentage of inorganic material? A. Pain. is true, which of the follor.l)ing .i,ubstances
13. Pressure. should deer-ease the res1wnse of this new
A. Enamel.
C. Vibration. peptide hormone in cells?
B. Dentin.
D. Temperature_ A. Aden:y!ate cyclase.
C. Bone.
D, Calculus. 52. You decide to take a radfograph of the frac- B. Monoaminc oxidase inhibitors.
47. Which of the following is not a feature of tut'ed tooth. On the first film you miss the apex C, Phosphodiestcrnse.
of the tooth, so you decide to take another 0, Aspirin.
poststreptococeal glomerulonephritis?
radiograph. Relaxation of which of the 59. From the ocrlusal perspective1 which tooth in
A. Hematuria.
patient's muscles would help yon in taking the the vrimary dentition varies the most in form
B. Hypertension.
C. Edema, second film? from that of any tooth in the permanent
A, Cieniohyoid. denlition?
D. Polyurla.
48. In a cusp-embrasure relationship, the B. Stylohyoid. A. !VlaxiHary first primary rnoli1r.
maxillary first premolar is most likely to C. Mylohyoid B. Maxil!nry second primary molar.
articulate with which of the following D. Levator veli palatine, C. Mandlbular first primary rnoiar.
E. Palatopharyngeus, D. Mandibular priniary second molar.
mandibular teeth?
53. On further examination, you determine that the 60. The most common cause of ost<>omyelitis is
A First premolar only.
B. First molar only. articular disc of the patient's
C. Canine and first premolar. temporomandibu/ar joint has been displaced. A Streptococtus pyogerws
D. First and second premolars. If the fJatient contracts his lateral ptery,goid B. Staphy/ococcu!'; aureu.,
muscle, the disc will move C. Lartobacilfus casei
A Posteriorly and medially D Pseudorrw:ws aeruginnsn
R Anteriorly and medially £, Escherichia colt
C. Post~riorly and lateralJy
D..Anteriorly and laterally
324 ., Sample Exam Sample Exam .,. 325

61. 1'/Je muscle that is found in the walls of the 70. The superior and inferior ophthalmic veins 76. The median pharyngeal raphe serves as the 83. Hassall's corpuscles are found in tht' medulla
heart is characU:rized by _ _ . dl'ain into the _ _ . attachment site for which of the following of which of the following glands?
A. A peripherally placed nucleus A. Internal jugular vein muscles? A Thymu~,
B. Multiple nuclei B. P:erygoid plexus A. Lateral pterygoid muscle B. Thyroid.
C. Intercalated discs C. Frontal vein B. Palatopharyngeus muscle C. P.:m.tthyn)1d.
D. Fibers with spindle-shaped cells D. lnfraorbital vein C. Levalor veli palatine muscle D. PineaL
62. The smallest cusp on the crown of a 5 lobed E. Facial vein D. Salpingopharyngeus E. Suprarenal.
mandibular second premolar is lite: E. Superior constrictor muscle 84. The masseter originates from the--··
A. Buccal cusp. 77. A most favorable sequence of eruption for the A. Co,idyle of the m.:1ndibk 0
•

B. [)Jstnbuccai cusp. Test items 71-74 refer to the following permanent dentition is which of the following H. infratempornJ crest of the sphenoid bone.
C. Distal cusp. test/et. (right side)? (Eruption sequence given by C. Inferior bonier of the 2ygom.1tic Hrch.
D. DistolingL1al cusp numbers in parentheses.) D, Pyramidal process of the palatine hone.
A 6--year-old boy presents with a history of severe A. (I) 3, 30; (2) 8, 25; (;l) 7, 26; (4) 27, 5; (5) 28, 4;
63, Which of th~ following is n<>t irwolt:ed in the E:. Mastuid proct:ss uf ternrora! bone
epistaxis. For the past 3 years the patient has (fi) 29, 6; (7) 31. 2. 85. Considering the period of 24-monlhs to about
proce.~s of mineralization?
A, Matrix vesicles.
experienced these nose bleeds, often without any B. (1) 3, 30; (2) 8, 25: (3) 26. 7; (4) 27. 6; (5) 28, 5: 6 years of age which of the folfowing is true?
lt Arnelogen!n:-. apparent cause. The patient ls otherwise in good (6) 29, 4; (7) 31, 2. A. Not all the primary teeth hove att.-ilned their
C. Fluoride. health. but his mother has noticed that he C. (l) 30, 3; (2) 25, 8: (3) 26, 7; ( 4) 27, 5: (5) 28, 4: ocdusal leveL
D- Phosphoryns. "bruises easilv." Laboratory tests are ordered. (6) 29, 6; (TJ :n, 2. B. Parts of both jaw!. containing prlmary teeth
64. T-cell lymphoma is most likely to occur in a 71. The labar:iton• test results show a normal PT D. (l) 30, 3: (2) 25, 8; (3) 26, 7; (4) 27, 6; (5) 28, 5; cha1~ge notie:eah!y in r;i2e,
patient with which of the follou:ing conditions? but a prolong;d PIT. A prolonged PIT test (6) 29, 4; (7J 2, 31. C. A !lignificant lm:reas.c ln lnten'an\n('. width
A. Chronic granulomatous disease. suggests t/Jot the patient has an abnormality 78. Which of the following metabolic activities is occurs shortly before and during the time the
B. Myasthenia gr<'lvis. affecting which component of the coagulation increased 1 hour after a meal (during the primary teeth are lost and tile permanent teeth
C. Osteochondromn. cascade? absorptive state)? emerge.
D Wilson's disease. A Activation of platelets. A. Glycogeno!ysls. D. Dental arch form i! more or less constant and
E. Celiac sprue. B. Activation of thrombopiastln. B. Oxidation of free fatty acids. pr<ictically no dimensional changes take place
65. For which of the following substances would C. Activation of plas1ninogen. C. Glucagon release. in depth or width after 9 montl!s of age.
you expect the renal clearance to be the lowest, D. Intrinsic pathway. D. Glyc-nlysis. 86. The primm-y factor determining the percent of
under normal conditions? E. Extrinsic pathway. 79. The most prominent mechanism of spread of hemoglobin saturation is:
A. Urea, 72. The diagnosis of hemophilia A is made. This the hepatitis A t>irus is by which of the A. Blood PO.,.
B, Creatinlne. disease is caused by a deficiency of _ _• following route,f? B Blood PC().,.
C. Sodium. A. Factor V. A Ora\..anal. C. Diphnsphn'gJycerote concentrntion.
D. Water. B. Factor VIL B. Respiratory. D. The temp.,.rature of th<::! blond.
E. Clucose. C. Factor VIII. C. Sexual contact. E. The acidity of the blood.
66. Di George's syndrome is characterized by a D. Factor IX. D. Perinatal. 87. What is tlte tlfterage height of cur,.iatnre of the
deficiency of _ _. E. Factor X. E, fnsect vectors. cervical line (CE.I) on the mesial and distal of
,.._. B lymphocytes 73, Which of the following describes the he,·editary 80. If the molar percentage of guanine in a human the permanent maxillary and mantlihulat·
B. T lymphocytes transmission of this disease? DNA is 30%~ what is the molar percentage of incisors? ·
C. Both B and T lymphocytes A. Auto-smnal dominanL adenine in that molecu{e? A. About 3.5 mm on the rnesla! of th<" 1:iaxillary
D. Antibodif>s B Autosomal recessive. A. !OW.. centred inds.or.
E. Complement inhlhltor C. X-linked. B. 20'.V.. B. About 1.5 mm on the distal of the max!Hary
67. Which of the folloudng phrases best describes D. lt is not genetically transmitted. C. 30¼,. central incisor.
restriction enzymes? 74. The clinical presentation of hemophilia 8 is D. 40~,. C. About 2.0 mm on the mesial of the m<1ndlhnlat
n. Site"specHlc endonudeases. indistinguishable from hemophilia A. ff'1llc/1 of E. 50%. central incis0r.
B Enzymes. that regulate 1-{;"iA. the following best describes the fq/mralory 81. The muscularis externa has a third layer in the D. About 1.0 mm on th(~ distal of thr- mandibular
C. Nonspecific e-ndonudea.ses method needed to distinguish these two central incisor.
D. Topoisomernses. conditio,u;? A Esoph;,gus 88. Which of the folloudng de,sr:ribes cells that are
68. The gallbladder arises from the _ _• A Bleeding time. B. Stomach abnormal in appearance and may become
A. Common hepatic duct 8. Assay of coagulation factor levels, C. Liver premalignant?
B. Common bile duct C. A5say of von Willebrand's factor. D. Small intestine A. Aplasi;L
C. Left hepatic duct D. Blood smear. E. Large intestine B. Dysp!asia.
D. Cystic duct E. Platelet count. 82. .4n infection by which of the following bacteria C. Karyomcgaly,
K Bile canalicu!i may result in the formation of gummas? D. Pleomorphi~m
69. Uthich one of the following disorders is the 7.5. Hydrolysis of which of the folloti:ing A. /1.{ycobacterinm tuberculosis E. MC'taplnsia
least likely to be a differential diagnostic factor compounds yields urea? B. Neisseria grinorr/weac. 89. Which jaw activity does not involve one of the
in the patient's limited jaw opening? A. Ornithine, C. Treponr:ma pol/idum. following musdes?
A. Exacerbation of TMJ and TMD. B. Arglninosuccinate. D. Bordeteita pertussis, A. C!end1ing, superior heads of lateral pterygnid
B. Trismus secomtary to TMJ pain. C. Aspartate. E. Streptococcus pyogenes. rnu:::;cles (LPM).
C. ~tyalgia secondary to TMD. D. Citrulline. B. Clenehing. inferlor he,1ds of LPVL
D. Mymliti5 secondary to bruxing. C. lp'.':iilaternl jaw movements, inferior heacls uf LPM.
D. Simpie jaw opening. cleE.•p massc-ter muscle.
326 "" Sample exam Sample Lxam "' 3 2 7

90. Hemorrhagic infarction and tissue necrosis 97. The effects of which one of thl:' foltou.Jing 102. The patient is referred to an infectious 109. In comparing permanent and primary teeth,
s1,_ggۥt which of the following? hormones are not mediated through cAAfP? disease speciaUst and placed on ' 1triple which of the follorl'ing differences are noted?
A. Asperglllosis. A. E:!>trogen. therapy. '1 Two years later, the patient is A. Crowns of anterior primary teeth are narrower
B. Blastomycosis. B. Gh..:cagon. admitte,l to the emergency room with a dry mcsiorlistally (;n comparison to their crown
C. 1-llstoplc,smnsls. C. Epinephrlne. cough and ,,;hortness of breath. His length) than the permanent teeth.
D, Mucormycnsis. D. Norepinephrinc· temperature is 101° F. The most likely cause of B. Comparntively, the roots of primary anterlm
£, Toxoplas1nosis. the patient's pneumonia is _ _ . teeth are narrower and longer.
91, lVhich of the following ribs cannot be A . ..,)'taphylococcus aureus C. Cervical ridges of enamel of the primary ante-
palpated? 8, Hciemophilvs influen::ae rior teeth are less prominent.
Test items 98-102 refer to the following C. Prreumocys:i.1 jiroveci (carinif) D. Buccal and lingual surfaces of primary molars
A. First
8. Second test/et. D. K{Pbsiefla pneumoniac .are iess flat above the cervical curvature than
C. Third E. Streptococcus pneumoniae those of permanent molars
A 43-year-old man presents for an emergency den-
D. A and B 110. Cystic f'ibrosis is a hereditary disorder that
tal appointment complaining of a burning sensa- 103, The primary maxillary first molar has which
92. Which of the following is relea!;ed by mast cells results from defective
tion in his mouth. Upon examination, white of the following characteristics? A. Collagen
after antigen binding?
plaques are observed along the oral mucosa. The A It is larger in all dimensions than the primary B. Lyios.ornal enzymes
A. lgE.
B. Ly.ozyme. patient otherwise appears healthy. There is no his- maxillary second molar. C Chloride channels
C. llA. tory of systemic illness, but the patient did state B. AU three roots can be seen from mesial per• D. Flbri!!in
D. Le-ukotriene. that he had a blood transfusion more than IO years spective. E. Myehn
E. Interferon. ago following a car accident. The doctor referred C. Bifurcation of roots begins almost immediately 111, Which of the following strata of oral
93. lJthere are the temperature control centers the patient to emergency room for further tests. at the slte of the cervical line (CE.I), epithelium is engaged in mitosis?
located? •98. U1,on further evaluation, the doctor requests D. The mesial mot is com1iderab!y shorter than A. Basale .
A. Cerebellum. cw HIV and hepatitis test~ The laboratory the distal one. B, Granulosum.
B. Hypothalamus. performed both an El/SA test and Western 104. J.flhich of the following is the end product of C. Comeum.
C. Medulla. blot1 re()ealing that the patient is HIV-positive. purine degradation in humans? D, Spioosnm,
D. Cerebral cortex, The Western blot is used to identify which of A. Urea. 112. The class of antilmdies that plays an
94. Which of the following is a major complication the following? B. Uric acid. important role in mru:osal immunity is _ _ .
of chronic bronchitis? A Antibodies. C. Adenosine, A. lgA
A. Myxedema. B. DNA. D. Xanthlne, B. lgD
B. Pneumothornx. C. RNA. 105. Which of the following is an essential amino C. lgE
C. Emphysema. D. Proteins, acid? D. lgG
0, Pernicious anemia. £, Plaque-formlng units. A. Tyrosine. E. lgM
E. Malignant transformation. 99. Given the patienrs history, if the patient was B. Tryptophan. 113. lVhich of the following cells are defective in
95. A comparison occlusatly between the primary later diagnosed with actiue hepatiti.vJ which of C. Proline. chn1nic grarwlomatous disease?
mandibular second molar and the permanent the following would most llkeiy be the 0. Serine, A, Neutrophils,
mandibular first molar shows which of the causative agent? E, Alanine. B. Lymph<,cytes.
following differences? A. Hepatitis A. 106. Which of the following are the most abundant C. Plasma ce!is..
A. The meslo-, tlistobuC"Cai, and distal cusps of the B. Hepatitis B. in the fovea cenlralis of the eyeball? D. Killer T cells.
primary molar are almost equal in size: the C. Hepatitis C. A. Rod ceils, E. Macrorhagcs.
distal cusp of the permanent molar ls smaller D. Hepatitis D. B. Cone cells, 114. The coenzyme that serves as an interme<liate
lhan the other two cusps. E. Hepatitis E. C. Rod and cone cells, carrier of one-carbon units in the synthesis of
B. The primary moiar crown ls wider 100. Which of the Following would the doctor likely D, Amacrine cells. nucleic acids is which of the following?
buccolingually (in comparison with Its prescribe for the patient's inlraoral irrfectfon? 107. The middle trunk of the brachia! plexus of A. Ascorbic add,
mesiodistal measurement) than is the A. Amoxicillin. nerves arises from: B. Tetrahyctrofolic acid.
permanent molar. B. Vancomycin. A. C5 C. BioOn.
C. The primary molar outline is somewhat C. CiproOoxacln. B. C6 D. Pyridoxine.
hexagonal; lhe permanent nwlar is D. Nys.tatin C. C7 115. Which of the following genetic diseases that
rhomboidal. E. Chlorhexi<lin'"-. D. CS results from a deficiency in the liver enzyme
D. The ratio of the crown/root length of both 101. All of the following molecules may be found 108. Tineu pedis. which b~ commonlv known as that cmwerts phenylalanine ta tyrm;;ne?
molars ls the same, within the nucleocapsid of an HIV virus athlete's foot, is a fungal infeciion that is A. Albinism.
.96. Calcium binds to which of the following for except one. Which one is the exception? caused by the following dermatophyte(s): B. Homocys.tinurl<L
contraction in smooth muscle? A. Reverse transcriptase A Microsporum C. Porphyria.
A. Troponin C. B. lntegrase. B. Tm:hnphyton D. Phenylketonuriu.
8. Calmodulin. C, Neuramlnidnse. C Epidermophyton
C. Myosin. D. Protease. D. Both A and B
D. Actin. E. Ribonucleic add. E. Both B and C
E. Desmos(}mes.
328 v Sample Exam Sample Exam • 329

Test items 116-127 relate to the following 120. Migraine is a form of headache that is 126. Extraction of tooth 32 reveafed attached soft 133, Which of the following factors would result in
case presentation. currently thought to be best understood on the tissue. Which of the following is most decreased glomerular filtration rate?
basis of all the foflowing with one exception. important for a presumptive diagnosis of A. A fall \n plnsmn protein concentration.
A 35-year-old woman presents with a painful lim- The excl!ption is which of the fallowing? tuberculosis? B. An obstruction of the tt;bular system whlch
itation of jaw opening (28 mm), a painful tooth A. As a dysfunction of brainstem pathways or A. Caseous necrotic areas. wnulrl increase capsular hydrostatic pressure.
on the right side, and swelling at the angle ol the dier:.cephaHc nucleL B. Acid~fast bacillL C Vasodilatmn of the afferent arterioles.
jaw. She has a history of temporomandibular dis- R As a primary di!order of the brain. C. Epithellold histlocytes, D lnulln admini:',tration.
ease (TMD) and conservative treatment. Medical C As ~imii.ar in mechanism to tension D. Langerhans giant cells. 134. The most common form of breast cancer is
history reveals that the patient is being treated headaches. 127. The patient Is on an anticoagulant drug (e.g.,
D. As a neurovascnlar headaC'he. u:arfarin [Coumadinj) as well as rifampin. A. Adenocar<'inoma
for tuberculosis with combination antituberculo-
121. Three key factors in the pathogenesis of pain lv'hat is the effect of rifampin on the B. Teratoma
sis drugs including rifampin (Rifadin). She is also
in migraine are usually com•idered. Which of anticoagulation effect of warfarin (Coumadirt)? C. follk:ulnr lymphoma
being treated with an anticoagulant, warfarin the follou.Jing is not considered to be a key A. Increases tte anticoagulant effect of warfarin. D. Sarcoma
(Coumadin), a low level of aspirin, and paroxe- factor? B. Increases the cyclic converl'\ion of vitamin K E. Carcinoma
tine (Paxil) for depression. The intraoral exami- A. Cranial blood vessels. epoxlde reductase. 135. Which of the following are NOT type traits of
nation shows extensive teeth wear from B. ~-amyloid-containing plaques in the brain. C. Anticoagulation effect is inhibited. the permanent maxillary central and lateral
bruxism, diagnosed by a sleep specialist as sleep C. Trigeminal lnnervation of the vessels. D. Decreases its metabolic clearance by inducing ittdson'i?
bruxism. Tooth 32 has a deep carious lesion and, D, Reflex connection of trigeminal system with activity of hepatic oxidases. Central Lateral
on radiographic examination, a periapical radi- cranlal parasympathetic outflow. Incisor Incisor
olucency. 122. The treatment of the patient with low levels of 128. Gut-associated lymphoid tissue (GAL1J A. Labial view: lncisal 3rd Jnct. incisali
116. The incidence of tuberculosis is increasing a,,; aspirin is done for which of the following produces secretory _ _. Mesia! C'oniact mid 3rd
a result of an association with AIDS. Oral reasons? A. lgA B. Labial view: JncL inclsal/ :V1iddle third
infections of tuberculm;is (TBC) do occur- but A. To reduce the llkelihood of platelet aggrega- B. lgD Distal Contact mid 3rd
are uncommon. Diagnosis of oral lesions may tion, C. lgE C. Mesla! view: Within incisa! JncL incisal/
present several challenges, as set forth in all B. To stlmulate cydo-oxygenase in the platelets. D. lgG contacts thir<l mid 3rd
of the following statements except one, Which C. To increase the formation of thromhoxane. E. lgM D. Labial: Slightly Sharp rt. angle
one of the following statements is false? D. To cause platelets to regenerate cydom.-ygc- 129. Antinuclear antibodies are seen in the serum mesloincisal rounded
A Lesions secondary to HIV may be present. nase. samples from patients with _ _. angle
B. Isolation of M tu~rculosis by culture requlres 123. When there is a pulpal"periodontal infection A. Hypogammaglobulinemia 136. 17te apex of a medullary pyramid in tlle
4 to 6 weeks or longer. of a mandibular third molar, which of the B. Chronic granulomatous dlsease kidney is called the _ _.
C. Mycobacteria can be demonstrated by special following listed facial and cervical spaces is C, Sy,temic lupus erythematosus A Cortex
5t.ain.s ln only 27% to 60% of cases. most likelv to have become infected when D. Multiple myeloma B. Medulla
D. Molecular tests ( e.g,, polymerase chain reac- there is sl~;elling at the angle of the jaw? E. Pheochromocytoma C. Renal papH!a
tion) show slow turnaround times, A. Retromolar space. 130. What is the correct general structure of the D. Major calyx
117. All the following side effects have been B, Submaxillary space. backbone of DNA and RNA? E. Minor calyx
reported to be related to the use ofrifampin C. Submasseterlc space. A Sugar-hasf':-6ugar. 137. All of the following conditions are commonly
except one. Which is the exception? D. Parotid space. B. Bases Jinked through phosphodiester linkages. associated with a group A, /3,hemolytfr
A Green bodily fluids-sweat, tears, urine, 124. Lymphatic drainage from tooth 32 will C. Bases linked through hydrogen bonds. streptococci infcctfon except one. Whic/1 one is
R Hepatitis. first involoe which of the following node D, Sugars linked through phosphodiester link- the exception?
C. Leucopenia, group,f? ages. A. Scarlet fever.
D. Nephrotoxlcity. A. Lateral upper deep cervical node. 131. All of the following are found in the posterior B. Toxic shuck syndrome.
118. Which of the following modes of action does B. Medial upper deep cervical node. triangle of the neck except one. Which one is C. Pharyngitis.
not relate to rifampin? C. Lateral lower dieep cervical node, the exception? D. Endocard!Hs.
A. Inhibits RNA synthesis. D. Submaxillary node. A. External jugular vein. £. lmpE:-tigo.
B. Binds tightly to eukaryotic RNA polymerase. 125. Alt but one the following are consideratiom, B. Subclavian vein. 138. The auriculotemporal nerve encircles which
C. Tuberculocidll.l to intracellular and extracellu~ relevant to the diagnosis and treatment of C. Hypoglossnt nerve, of the following vessels?
lar organlsms. tuberculosis. Which of the following D. Phrenic nerve. A. Maxi!k1ry artery,
D. Reduces activity of hepatic mlxed-functlon oxiM statements is not true? E. Brachia{ plexus. B. Superficial temporal artery.
dases. A. Increase in the prev;:1lence of TB. 132. H"hich of the following amino acids is C. Deep auricular artery.
119. Exacerbation of bruxism has been reported to B. Oral TB lesions occur most frequc-ntly on the positioned at every third residue in the D. Mirldle mening<.:al artery,
occur with all the following agents except gingival. primary structure of the helical portion of the E. Anterior tympanic artery.
one? Which is the exception? C, Emergence of multldrug-resi3tant strains, collagen-a-chains?
A. Paroxetine (Paxll). D. High risk of A{ turxm:ufo.<Jis infection in patient~ A. Glycine.
B, Selective serotonin reuptake inhibitors. infected with human immunodeficiency B, Glutamate,
C, Naproxen (Naprosyn). virus (HIV). C. Proline.
I} Amphetamine derivativie ("Ecstasy"), D. Ly5ine.
K Hydroxyproline.
330 T Sample Exam
Sample Exam • 331

Test items 139-143 refer to the following
test/et.
A 55-year-old man presents with malaise and dys-
pnea. He has a low-grade fever and reports that
his shortness of breath has increased steadily
over the past week and a half. He has a history of
rheumatic fever and denles ever using recre-
ational drugs. He is currently being treated by a
dentist for lull mouth reconstruction.
139. Upon further examination1 a heart murmur
was detected. Given the patient's past medical
history, which heart valve is most likely
affected?
A. Mitra! valve.
B. Tricuspid valve.
C. Aortic valve.
D. Pulmonary valve,
140. Before the patienrs development of rheumatic
fever, he likely suffered from which of the
following conditions?
A Cystitis.
B. Pharyngitis.
C. Food poisoning.
D. Thrombocytopenia.
E. Menlnigitis.
141. After further evaluation and tests, the patient
is diagnosed with subacute endocarditis. If
the infecting microbe was cultured in the
laboratory, the re,,ults would most likely shmv
that this microbe is positive for _ _.
A. a-hemolysis
B. !3-hemolysis
C. )'-hemolysis
D. Coagulase
E. Lecithinase
142. Which of the following is the most likely
complication that may occur from the
vegetations forming on the patient's defectire
heart valve?
A.Myocardial infarction,
B.Hemorrhage.
C.Petechiae.
D.Cor pulmonale.
E. Embolus.
143. After the diagnosis is made, the patient is
immediately placed on high-dose, IV
antibiotics~ One of the antibiotics that is
admint..~tered to the patient is streptomycin,
an aminoglycoside. The antimicrobial effect of
streptomycin is to inhibit the synthesis of
A. The bacterial cell wall
B. Folale
C. Protelns
D. Nucleic acids
E. jl-Iactamase
144. The conwrsion of information from DNA into 152. The pancreas is enveloped at its head by the 159, 17re cricopharyngeus muscle of the <'sophagus
mRNA is called which of the following?
A Translation. A. first part of the duodenum A, Is a para.sympathetic stimulator of pe-ristalsi!:
R Transcription. B. Second part of the duodenum B. Is a ~ymp.:1thetic inhibitor or peristaltib
C, Transduction, C. TI1ird !)art of the duodenum C. Prevents S-\•.:allowing i,ir at th-e pharyngeal
D, Transformation. D. Fourth part of the duodenum end
145. Maximum rotation and translation of both E. first part of the jejunum D. Prevents regurgitation oJ stomach contents at
condyles takes place at: 153. Afucopolysaccharidoses are hereditary• the ahrlomina! end
A. Maximum opening. disorders that are characterized by the E. Controls th~ gag reflex
B. Maximum protrusive. accumulation of glycosaminoglycans in 160. The most common cause of bacterial
C. Right and left lateral excursive movements. various tissues due to which of the following? meningitis in neu:borns is _ _.
D. Hinge movement A. Overproduction (.e:ynth~is) of proteoglycans, A. Stt1phylococc11s aureus
146. The right subclavian artery arises from the B. Deficiency of one of the lysosomal, hydroiytic B, Streptncoccus prre11mnnioe
_ _ and the left subclavian artery a.rises enzymes normally involved in the C Escherichia coli
from the _ _. degradation of one or more of the
D. Haemophilus influenzae
A Axillary artery; aortic arch glycosaminoglycan.s, £. Listeria monorytogenes
B. Brachiocephalic artery; aortic arch C. The synthesis of abnormal proteoglyctins. 161. ln which one of the following tissues is
C. Aortic arch: brachtocephaHc artery D, The synthesis of highly branched glucose transport into the cell urwffocted by
D. Brnchiocephallc artery: axillary artery glycos.1minoglycan chains. insulin?
E. Axillary artery; brachial artery E. Arginin~. A. Skeletal muscle.
147. Rest position (RP) Is defined: 154. A hormone acts to stimulate its neighboring B. Liver
A ..4.s any position of the mandible that lacks cell to divide. This hormone would best be C. Adipose tlssue.
contact of the teeth. described as belonging to which category of D, Smooth musde.
B. As the centric relation position of the hormones? 162. Deoxygenated blood from the tram,·ot~rse sinus
condy!es with the teeth apart. A Paracrine. drains into the
C. As a mandibular position with masticatory B. Autocrine. A. Inferior sagittal sinus
muscles at complete rest. C. Endocrine. B. Confluence of sinuses
D. As a clinical mandibular positJon in relation to 155. The most common cause of pyelonephritis is C. Sigmoid sinus
the interocd~sal space. D. Straight sinus
148. Which of the following ions has a higher A. Staphylococcus aureus K Internal jugular vein
intracellular c.oncentratiott compared to the B. Vibn~ cholerae 163. The primary maxillary second molar has
extracellular fluid? C. Escherichia coli what characteristics?
A. Na·. D. Helicobacter pylon.' A. Does not have a well~deflned mes!al tri.1ngular
B. K•. E, Bordetetla pertussis fossa.
C. CI·. 156. Which of the following types of epithelium B. Oblique ridge absent or not well developed.
D. Hco,- acimar units of tines salivary glands? C. Development (central) groove is well defined.
E. Ca2•. A. Simple squamous. D. A tuhercle of C'arnbelli {Supplementory cusp)
149. All of the following cells are associated with B. Stratified squamou!I. is well develope(!.
chronic inflammation except one. Which one C. Simple cuboidal. 164. Facial nerves are derived from the
is the exception? D. Simple columnar. branchial arch.
A. Macrophages. E. Pseudostratified columnar. A. First
B. Neutrophils. 1§7. The _ _ is a component of the B. Second
C. T lymphoc,1es. juxtaglomerular apparatus which functions C. Third
D. B lymphocytes. in regulation of blood pressure. D. Fourth
E. Plasma cells. A. Proximal convoluted tubule E. Fifth and sixth
150. When is the crown of the permanent B. Distal convoluted tubule 165. Analysis of DNA fragments (probing) is
mandibular second molar completed? C. Bowman's capsule possibly due to which of the following
A. About 7-8 years. D. Glomeruius properties of DNA?
B. About &-9 years. E. Macula densa A. Pbosphodiester bonds.
C. About !,-!O years. 158. Tire masseter muscle, which has a complex of B. Compllmentary strands.
D. About 10-11 years. internal components, includes all the C. Protein binding,
151. Which of the following proteoglycans is following EXCEPT? D. Western blotting,
present in extracellular space? A. Permation. 166. From the occlusal aspect, the primary
A. Hyaluronic add. B. Structural composition permitting regional mandibular second molar has which of the
B. Keratan sulfate. activation. following characteristics?
C Chondroitin sulfate. C. Multiple internaf aponeuroses. A Somewhat rectangular in form.
D. Dermatan sulfate. D. Internal aponeuroses that do not move or B. The outline of the crown crnn'erge, meslally
E. Heparin. deform. C. Three buccal cusps are dissimilar in size.
D. Cusps do not have well define(] Lriangular
ridges.
332 ,,, Sample Exam Sample Exam Y 333

167. Whiclt of the follnwing are not type traits of' 174. Which one of the following is considered a 179. Which of the following is the most 185. From the incisal deu:, a greater mesiodistal
permanent maxillary molars? primaty ligament of the 17'rfJ? appropriate drug used in combinotion measurement than fadolinguaf measureuwnl
A. Sty!omandibular. therapy for tuberculosis to treat the patient? can be seen in which of the foffowinM
First Second 17Jfrd
8 Sphenomandihular. A. Amoxidllin. permanent anterior crowns?
Molar Molar Molar
C. Stylohyoid B. Clinclamycin. A. \-1,;xlllary central ir.dsor.
A. Fluccal Widest Inter~ Smallest
D_ T~rnpornmandH:rnlilr. C Ceph&losporin. B. l\foxillary canine,
vlev:: molar mediate molar
D. Tetracycline. C :\fondlhular canine.
\Vidth
E. Rifampin. D Mandibular central lndsoc
B. DL cusp: Same ,ize Same size Sma!lP-s1
Test items I 75-180 refer to the following 180. After 3 weeks, the patient was feeling ''much 186. The ,,estigial cleft of Rathke's pouch in the
as MJ as M, size
More Triangle
test/et. better" and was discharged from the hospital, hypopf1ysis is located between the
C. Occlusal Squar~/
although he remained on his drug therapy for A. Anterior an<! po:aerior lobes
view: rhom- rhom- or heart- A 60-year-old homeless man who lives in a com- another 6 months. Which of tlu~ following best R Anterior lobe ctnd hypothal:1mu:-
Doiel boidal shaped munity shelter presents with history of coughing describes the calcified scar that later formed C. Poste!'lor lobe and hypotlrnlamus
D. MB root ln line ln line wiih Roots for the past 6 months. He has a slight fever. in the affected lung parenchyma and hilar D. !'v1edian eminence 11.nd the optk s.'hiaslll
apex: wlth crown dis- hemoptvsis. and productive cough with a yellow- lymph node? 187, A comparison of the pulp chambers and ro<Jt
cusp tlp center placed
ish sputum discharge. After further examination A. Gumma. canals of maxillary primary and permanent
168. A cotton wool appearance may be used to
and lests, the patient is diagnosed with active B. Chancre. ,,r;econd molars shows which of the follmdng?
describe the radiograph of a patient with - ~ ·
tuberculosis. C. Metastatic caklfkaUons. A. Enamel cap of primary tooth is relatively th!ck
A Ostcopetrosis D. Tuhercle.
175. When the sputum samples were taken to the but less cnns!stent in depth.
B. O~teitis dcformans
laboratoryt what test did the doctor order to E. Ghon complex B. ComparaHvely less thkkness of dentin at th<?
C. Peutz-Jeghers syndrome
be performed to help make the diagnosis? occlusal foss;ci of primary molars.
D, Seborrheic keratosi.s
A. Gram staln. 181. An infection in a mandibular incisor with an C. Pu!:, chambf'rs are proportionally larger in pri ➔
E. Osteogenesis imperfecta
B. AcicHast stain, apex below the mylohyoid muscle drains into rnarv molars
169. The energy for skelet<il muscle contraction is
C. Spore stain. which of the following spaces? D. Puli; horn" are lower in primary molar5, espe-
,lerfoed from which of the following processes?
D PPD test (tuberculin test) A. Sublingual space ciaHy distr1I horns.
A. Calcium release from sarcoplasm!c mem-
E. Voges-Proskauer tes:L B. Submental :space 188. The center that provides outpnt to the
branes antl binding to troponin.
176. Alter 2 weeks. the bacterial cultures came C, Suhmandlbular space respiratory muscles is located in the _ _ .
B. Cleavage of ATP by the rnyosin head.
back from th~ lab confirming the initial D. Parapharyngeal space A. Pons
C Membrane &odiurn-potas~lum ATPase pump,
diagnosis, positive[)-' identifying the organis,:n 182. Phaspholipase C is an enzyme that play:; an R fVfedullo
D. Sodium influx during the action potential.
Mycobacterfum tuberculosis. 1U. tuberculm;rs important role in the production of second C. Cerebral cortex
170. Which of the following is a prope,·ty of C mf?sse.ngers, which produce intracellular
is known to infect which of the following D. Cerebellum
fibers?
cells? responses. Which two second messengers are E. Hypothalamus
A. Have the slowest conduction velocity of any
A. Fibroblasts. produced through the action of this enzyme? 189. 11ie brachia( plexus of nerves arises from
nerve fiber type.
B. Basal cells. A. cAMP and tyrosine kinase. ttrhich of the following roots of the anterior
B Have the largest diameter of any nerve fiber
C, Type l pneumocytes. 8- Acetylcholine and histidine. primary rami of spinal nen;es?
type. C. Adenylatc cycla~e and protein kinase.
D. Macrophages. A. All cervical roots \ C l-C8),
C. Are afferent nerves from muscle spindles.
E. Eryl hrocytes. D. l,2-diacylglycerol and inositol 1,4,5-triphos- B. All thoraclc roots (Tl-T12).
D. Are afferent nerves from Golgi tendon organs. phate.
J 77. Which of the folfowlng is a glycolipid found C. C 8 and Tl
E. Are preganglionk autonomic fibere:.
on the surface of M. tuberculosis that plays a 183. Which of the following cytokines ,,;timulate B I.l C5 through CS and TL
171. To which of the following bones is the tensor
role in its pathogenesis? lymphocytes to differentiate into plasma cells? £. C5 throuf{h C8 a:1d Tl through T4,
tympani attached? A. IL-1.
A. Cord factor. 190. Aschoff bodies are observed in which of the
A Incus. B. IL-2.
B. 0 antigen. following conditiom;?
B. Malleus. c. n~3.
C. Proteln A. A. Acute mye!ngenous leukemia.
C. Stapes. D. IL-4.
D. Exotoxin A. B. Phcochromocytoma.
D. Hyoid.
E. Lecithinase. £. IL-5. C. Osteopetrnsis.
E. Mandible. 184. Which of tire following ,"itatemenls regarding D, Rheumatic !ever.
172. An increase in alkaline phosf)hatase may be 178. Since the patient was living in a homeless
shelte,~ the tuberculin test was administered the parasympathetic nervous system is true? E Sclerndcrma
seen in all of the following conditions except
to all of the tilaff anti residents liuing at the A. The third cranial nerve (the oculomotor 191. Nonsterofrlal anti-inflammatory agents are
one. Which one is the exception? nerve) carries ~ymp.nthetic fibers to the
shelter. 11ris test is base<J on a delayed type poinrellering and anti-innommntory. Tirey are
A. Hyperp~rathyroidi!'lm,
frypersen.o;itieity reaction that is mediated by ~month muscles of the eye. effective since they act to inhibit
B, Osteoporosi!';.
B. The facial and the glossopharyngeal crau!al prostaglandin s;vnthn;is by:
C. Osteitis deformans. nerves carry the parnJympath~tk pregan-
A OnlylgG A. inhlbitlng fatty acid llpo-0::.ygen.:1.sc activity,
D. Adenocarcinoma of the prostate. gliontc fibers for the antonom!c innervation to
B. lgG and lgM B. lnhlhiting fatly acid-specific cyclo-oxygP1:as<e~
E. Multiple myeloma. the salivary glan<ls.
C. lg£ actlvity.
173. The hereditary transmission of Peutz.Jeghers C. The parasympathetic nervous system Inner-
D, T cells and macrophnge~ C. Inhibiting fatty aC!d~spe,lfic hydrr,pcroxld;1se
syndrome is _ _.
E. Mast cells and basophil~ vates prirnarHy striated muscle ln the body. activity.
A. Autosomal domimmt
D. The parasympathetic nervous system is D. lnhthiting pho~pho!ip,:ise A2.
B. Autosomal recessive organized for diffuse activation and responses.
C Sex~linke<l (lorninanr
D. Sex-Hnkecl recessive
E_ Not genetically transmitted
334 Y Sample Exam
192. Terminal bronchioles are characterized by
cells.
A. Goblet
R Cll!ated cuboidal
C. Nonci!lated cuboidai
D. Ciliated squamous
E. Noncitiated squamous
193. A major anatomical variant of the two-rooted
mandibular molar is a tooth with an
additional distolingual and third root. What is
the preullence of these three-rooted
mandibular first molars?
A. May e.xceed l O'¾, in Caucasians,
B, Less than lW; in Eurnsian and Asian populations.
C. Greater than S'K, ( even up to 40':¾i) in popula-
tions with Mongoli~ln traits.
D. Greater than 8'.t in African populations.
194. Which one of the following statemeats
regarding the regulation of gastrointestinal
function is true?
A. The main sympathetic nerve supply to the
dlgestiv-e tract i~ the vagus,
B. In general, sympathetic stimulation is excita-
tory to dlgestive activity.
C. Salivary secretion is stimulated by both
branches of the autonomic nervous system,
although not to the same degree.
D. Parasympathetic stimulation of the salivary
glands produces a saliva rlch in mucus.
195. The occlusal surface of a primary mandibular
first molar often has a prominent faciolingual
ridge. This transverse ridge connects which
two cusps?
A. Buccal and distolingual.
B. Mesiolingual and di5tobuccaL
C. Mesiobuccal and mesiollngual.
D. Distobuccal and dlsto!ingnaL
196. Which of the following disorders i.t; least likely
to be included in the differential diagn<>sis of
a patient with jaundice?
A, Hepatitls,
B. Hemolytic anemia.
C. Cholelithiasi.-;.
D. Glomerulonephritis
E. Carcinoma of the pancreas.
197. Arteriovenous anastomoses in deeper skin are
important in _ _.
A. lmmunity
B. Thennoregulation
C. Controlling the arrect.or pili muscle
D. Pigmentation
E. Pain sensation
198. Complications of Barrett's esopltagus include
alt of the following except one. Which one is
tlte exception?
A. Varices.
B. Stricture.
C. Hemorrhage.
D. Adenocarcinorna.
E. Ulceration.
Test items 199-202 refer to the following
test/et.
A 30-year-old woman comes to your office for a
dental examination. She has not been to the den-
tist in 2 years. The patient has type l diabetes.
which requires her to take insulin. She is other-
wise in good health. On intraoral examination, you
notice that the dorsum of her tongue has a thick,
matted appearance and diagnose her with hairy
tongue. You also find that the patient has deep
caries in her upper second maxillary molar.
199. Which type of papillae is affected that causes
the hair-like ap11earance of her tongue?
A. FoHate.
B. Circumval\nte.
C. Fungiform.
D. Flliform.
200. On the patient's radiograph, you notice that
the pulp chamber in the carious molar
appears smaller than the surroun,ling teeth.
This is most likely due to the deposition of
which type of dentin?
A. Secondary.
B. Tertlary.
C. Mantle.
D. Sclerotic.
201. You decide to remoue the caries and prepare
the patient for anesthesia. Which nerve must
you anesthetize to ensure adequate
anesthesia for the patient?
A. Nasopalatlne nerve.
B. Greater palatine nerve.
C. Anterlor superior alveolar nerve.
D, Middle superior alveolar nerve.
E. Posterior superior alveolar nerve.
202. After administering the anesthetic, the patient
complains that her "heart feels like it's
racing." You explain to her that it may be
from the epinephrine in the anesthesia. Which
of the following glands could most likely
cause the same symptoms in the patient?
A. Hypophyoi,.
B. Thyroid.
C. Pineal.
D. Suprarcnal.
203. Which of the followiag microbes is the most
common cause of gastroenteritis in children?
A Reovlruses.
B. Picornaviruses.
C. Togaviruses.
D. Pararnyxoviruses.
204. Name the point angle which represents the
junction of the- cutting edge of an incisor with
the surface that is toward the tongue and the
surface that is aa,ay from the midline.
A. Distopro:.cimoindsal.
B. Dlstolabwlnci:rnl.
C. Distolinguolndsal.
D Labioincisnlinguo.
Sample Exam Y 335
205. llreters travel inferiorly just _ _ the parietal Questions 212-223 relate to the following
peritoneum of the posterior body wall. They history and examination
pass _ _ to the common iliac arteries as
they enter the pelvis. A mother brings her l2,year-old boy to the dentist
A. Above; posterior to ask about her son grinding his teeth and about
B. Above; anterior some white ··spots·· located on the smooth-sur-
C. Below; posterior faced enamel of several of his anterior teeth and
D. Below; anterior premolars. Among other questions about the
E. Above; superior cause of the defects, the mother then asks when a
206. Aspartame contains aspartic acid and which systemic disturbance occurred that may have
of the following amino acids?
caused the "spots". The patient has excessive
A Phenylalanine.
B. Leucine. tooth wear from bruxing and clenching. The den-
C. lsoleucine. tist measures the cervical-incisal length of the per•
D. Lysine. manent maxillary central incisor (10.5 mm). Also
E. Praline. measured is the distance from the CEJ to the mid-
2()7. Injury to which of the fol/owil!g nerves would point of the defect (5.5 mm). Given that the crown
affect abduction of the eyeball?
is completed over a period of 4 to 5 years it is
A. Optic nerve. possible to estimate the age at which the hypopla-
B. Oculornotor.
sia occurred using 6 months or yearly periods in
C. Trochlear. the following formula:
D. TrigeminaL
E. Abducens. ADF ACF - (yrs. of lormationicrm,m height x
208. Which of the following statements regarding distance of defect from CEJ).
tubular secretion in the kidney is true?
A. The secretion of K· increases when a person is 212. llsing an average age of crown formation
in acidosis. (ACF) of both 4 and 5 years. the age of defect
B. The secretion of H+ increases when a person is fonnation (ADF) is estimated to be about what
in alkalosis. time?
C. It ls a process that transports substances from
A. 7-9 months in utero.
the filtrate to the capillary blood. B. 0-1 yean of age.
D. lt accounts for most of the K+ in the urine.
C. 1-2 ye.ars.
2()9. _ _ marks the end of growth in length of
D. 2-3 years.
long bones. 213. The increase offluorosis of permanent teeth
A. Diaphyseal closure in both nonfluoridated and optimally
B. Epiphyseal closure fluoridated populations points to the need for
C, Ossification dentists to caution parents with children
D. Formation of periosteum about potential causes of fluorosis in
E. Cessation of bone remodeling
children. Which of the following cautions
210. The presence of M-proteln antibodies suggests about fl.uoride is correct, but the age or
immunity to infection by which type of Implied age is NOT Correct?
bacteria?
A. Excess(, 1 ppm) fluoride in the drinking
A. Streptococcus pyogenes. water during enamel formation,
B. Streptococcus viridans. B. Excessive(> pea-sized amount) use of fluoride
C. Streptococcus sanguis. toothpaste under 6 years of age.
D. Staphylococcus aureus,
C Use ot fluoride toothpa~te only for cbHdren
E, lactobadflus casei. under 4 years of age.
211. The synthesis of all steroid hormones involves D. Use of a LI% sodium fluoride toothpaste or
which of the following compounds? gel by pediatric patients only when 6 years oi
A. Pregnenolone.
age and older.
B. Progesterone.
214. Systemic etiologic factors that are said to be
C. Aldosterone. associated with enamel defects such as
D. Cortisone. hypoplasia occur generally in what period of
£. Testosterone.
time?
A. Before birth,
B. GenetaHy after hlrth and before the age of 6
years.
C, During the first year postpartum for
Hutchinson's incisors.
D. During birth.
336 -rr Sample Exam
215. The differential diagnosis of white "spots" of
the enamel of primary and permanent teeth
should include disorders that haf.Je a
sulu;tantiated cause. Hlhich of the following
DO NOT have an euidence-based causal
relationship with enamel hypoplasia?
A. Rickets.
B. Congenttal syphilis.
C. Measles,
D. F!uorosis.
216. Clenching and grinding of teeth involves
contraction of skeletal type muscles. Several
types of myofilaments are present in the
contractile elements of skeletal muscles.
Which statement about muscle filaments IS
NOT true?
A. Myosin forms the thick filament of muscle.
B, Actin is a major protein of thin filaments.
C. Titin is a protein of elastic fllament
D. Connectin is a protein of intermediate
filament.
217. The clinical examination of the patient
reveals extensive wear of the right canines,
and somewhat less wear of lhe lateral
incisors. Also there is tenderness of the jaw
closing muscles, particularly on the right side.
The muscle(s) that would be involved
primarily in providing most of the force for
anterior tooth clenching include which of lhe
following masticatory muscles?
A. Inferior lateral pterygoid muscle.
B. Superior lateral pterygoid muscle.
C. Anterior temporalis muscle,
D. Masseter musde.
218. Sleep bruxism (SB) is defined by many but not
all of the following characteristics. Which is
the EXCEPTTON?
A. Stereotypical movement disorder.
B. Grinding and c!ench!ng of the teeth during:
sleep.
C More frequent in the younger generation.
D. lndtviduals who brux during the daytime
inevitably brux at night.
219. Recent physiologic evidence suggests that
central and/or autonomic nervous systems
rather than peripheral sensory factors play a
dominant role in the genesis of sleep bruxism
(SB). Which statement about the central
genesis of SB is NOT true?
A. During sleep the mouth is usually open due to
motor repression.
R Tooth contacl most likely occurs in associa-
tion with sleep arousat
C Some peripheral sensory factors may exert an
Influence on SB through their intera~tion with
sleep-awake m~chani~ms,
D. change from autonomic
cortical activities foHows SB~
reiated jaw motor activity,
220. Aggravation of bruxism has been suggested to 225. Hypertension (long~term) UJill be compensated
occur secondarily to all of the following by which of the following renal mechanisms?
occlusal relationships except one. Which one A. Increased circulating ADH (vasopressin),
is the EXCEPTION? R Increased 5ympathetic activity,
A. Occlusal interferences in centric relation. C. Decreased clrculating: aldosterone.
B. Ocdusal interferences in the intercuspal posl- D. Increased circulating anglotensin H
tion. 226. The most superficial layer of the epidermis is
C, latrogenlc occlusa! relations that interfere with the stratum
bruxism. A Spinosum
D. Angle Class HI malocclusion (prognathism), 8. BaMle
221. The differential diagrwsi.-, of enamel C, Granulosum
hypopla:,ia should take into account D. Lucidum
suggested differences between non•fluoride E. Corneum
and fluoride opacities. Which of the following 227. Where are the cells that produce calcltonin
statements does not suggest a basis for a located?
diagnosis of non..fluoride (lVFJ enamel A. Red marrow.
hypoplasia? B. Adrenal gland.
A. Levels of Fin drinking water that range from C. Parathyroid gland.
0.2 to 0.34 ppm have been reported to be D, Thyroid gland.
associated with prevalences of NF enamet E. Spleen,
opacities ranging from 22'¾, to 35%, 228. In mature dentin, the ratio of inorganic to
B. At a level of l to 1.5 ppm of F in drinking organic matter is approximately _ _.
water, only few f opacities occur. A 94:6
C. Most NF enamel opacities appear as white, B. 50:50
opaque spot5 in smooth surface enamel; areas C. 70:30
of mild dentnl fluorosis are lusterless, opaque D. 80:20
white pa.tche~. E. 60:40
D. f]uorosi! and NF opacities are dinically slgnH- 229, All of the following symptoms are mediated by
icantly different. antibodies except one. Which one is the
222. During muscle contraction what physical exception?
change DOES NOT occur relative to muscle A Arthus reaction..
fiber contraction? B. Tuberculin reaction.
A. Sarcomeres-shorten. C. Asthma.
B. Thick and thin filaments-shorten. D. Erythroblastosis fetalis.
C. I Band-shortens, E. Serum sickness.
D. H zone-shortens. 230. The pancreas produces enzymes that are
223. Regarding the superior and inferior heads of responsible for the digestion of dietary
the lateral plerygoid muscle (SHLP and lf!LP), compounds. Which of the following foods
which of the following statements is NOT would not be digested by enzymes synthesized
TRUE? and secreted b.,v the pancreas?
A. Hypothetically, SHLP and IHLP can be consid- A. Carbohydrates.
ered to be parts of one muscle B. Lipid,.
B. Dlstrlbutioos of SHLP and IHLP activities are C. Vitamins.
shaded according to biochemical demands of D. Protein.
tasks, 231. The primary sensory neurons' nucleus of
C, SHLP stabilizes the condyle and disk against termination invo-lve.d in the jaw jerk reflex is
the articular eminence in a wide range of jaw the
movements and iorces, A. Facial nucleus
D, IHLP plays a major role in the generation and B. Trochlear nucleus
fine control of horizontal forces. C Mesencephalic nucleus
ll Spinal trigeminal m1c!eus
224. The process of active sodium transport in the E. Nucleus of solitary tract
ascending limb of the loop of Henle is 232. Altlosterone
absolutely essential for which of the following A. Stimulates N reabsorptlon in the distal and
processes? collecting duct!
A. Regulation of chloride excretion. R Is 5ecreted by the juxtaglnmerular apparatus
B. Regulation of pH ln extracellular fluld, C. Stlmulates K absorption in the distal tubule
C. Regulation of aldosterone excretion, D. Stimulates bicarbonate reabsorption in the
D. Regulation of water excretion. proximal tubule
Sample Exam T 337
233. The first eriidence of calcification (weeks in
utero) in the primary dentition occurs in
which of tl,e foltou·t'ng teeth at about what
age?
A. Maxillarv central incisor-14 (13-16) weeks,
B. Mandib1;l1"1r central lncisor-12 (10-13) weeks;,
C Maxillary lateral lndsor-14 (13-lG) weeks.
o_ Mandihuiar lateral incisor-•14 (13-1:3)
weeks,
234. From the lingual perspective, the crown of the
p,•imary maxilfory second molar shows which
of the following?
A. Small, we!l-developN! m"'~iolingual cusp.
B. Distollngual (DL) cusp smaller thnn the maxi!~
lary primary first molar DL cusp.
C. There is no supplemental CUS[) apical to the
mesiolingual cusp.
D. o~velopmental groove separating the mesl-
olingual and distolingual cusps.
235. An B•year-old boy presents with macroglossia
and delayed eruption of his primary teeth. Of
the following choices, which one is most
likely?
A. Plurnmer·s disease.
B. Osteochonctroses.
C. Cretinism,
D. Wilson's disease.
E. MaHory~\Veiss syndrome.
236. A major function of surfactant is to inc1-·ease
which of the following?
A. Pulmonary compllance.
B. Alveolar surface tension.
C. The work of breathing.
D. The tendl"ncy of the lungs to collapse,
237. Red pulp in th~ spleen consists of _ _.
A. Fibroblasts
B. T lymphocytes
C. B lymphocytes
D, Macrophages
E. Chromaffin cells
238. The t'elocity of blood flow _ _.
A. Is higher in the capillaries than the arterioles
B. 11 higher in the vPins than in the venules
C. Is higher in the veins than in the arterles
0. Falls to zero in the descending aorta during
diastole
239. Neuraminldase is prodnced by
A. Tnf!uenra virus
B. Hepatitis C viruses
C. Human immunodeficiency virus
D. Measles virus
E. Rubella virus
240. IVhich sequence of eruption of permanent
teeth occurs most often? (8-7-6-54-3-2•1 = M3-llf2~
llfJ.P2•Pl-C-U-Cl). First#, #'sin eaclr se.-ies is
considered to be the first to erupt.
A. 6-l-2+3-5--7-8 (Maxilla).
B. 6-l-2-3--4-5-7-8
C.
D. H>·Z·4·CrCH-iO
 338 Y Sample Exam
Sample Exam T 339

241. All of the following are histopalhologic 249. The auricular hillocks are derived from the 256, Nephrolithiasis is most likely to be associated 264. The presence of Auer rods in a peripheral
features of malignant cells except one. J,Vhicl1
with which of the following conditions? blood smear suggests which of' the following
one is the exception? A. Fir'st branchlal arch A. Hyperparl'l.thyroidism. conditions?
A. Anaplasia. B Second branchial arch R. Myxed'°ma. A. Acute lymphocytk lt:\1kernl;1.
B. Pleomorphis:m. C. First and second branchial arch
C, An•uploidy.
C. Pyeloneph:ritis. B. Acute \yrnphnhl,,stk lz•ukt'!nla
D. Lateral nasal process D, Wilson's diseaie. C. Acute rnyrloge-ncn1s leukPmi.:1.
D. Large nuclei. E. Medial nasal process E. Thrombocytopeni..:L D. Chronic !ymptweytic !eukrmla.
E, Low nudear-cytoplasmic ratio. 250. Comparing the overall length of primary 257. The rate-limiting enzyme in glycolysis is which E. Hu,:lgkin's lymphnrna.
242. The vertebral artery meets with the basilar central incisors (E!F) with permanent of the following? 26S. Hormones secreted by the posterior pituitary
artery at the lower border of the _ _. maxillary central incisors (8! 9), which is the A. Fructose bisphosphatase. gland incltlfle which of the following?
A. Mldbrain correct ratio expressed as a percentage?
B. Pons
B. Phosphofructokinase, A. Prolactin.
A. About 50%. C. Phosphoglucose isomerase. B. Follide*stimulating honnone
C. Medulla B. About 60%. D. Glucokinase. C. Luteinizing hormone.
D. Temporal lobe C. About 70%.
E. Cl 258. The type of collagen characteristically found D. V,~sopre1sln.
D. About 80%. in cartilage is which of the following? 266. Which of tht! following is the predominant
243. Which of the following is not invofred in the 251. Ehle,-s•Danlos syndrome is a disease affecting A. Typ• I. immnnoglobulin in whole s,lliva?
process of gene cloning?
B. Type II. A. Secretory lgA
A. DNA polymerase. A Bone
B, RNA ligase.
C. Type ill. B. Secretory lgG.
B, Connective tissue D, Type IV. C. Se\:retory lg\1.
C. RNA polymerase. C, Muscle 259. A most characterb;tic feature of the primary D. Secretory lgB.
D, Re111triction endonudease. D. Joints maxillary central incisor is which of the 267. Which of the following is not an arch trait of
244. Which of the following is the most significant E. Glycogen synthesis follouiing? the maxillary canine?
stimulant of the respiratory center? 252. Which of the following participate In both A. Faciolingual breadth of the crown. A. tn the sJme dentition, lhe crown is larger than
A Decreased blood oxygen tension. fatty acid biosynthesls and b-oxidatlon of fatty B, Mesiodistal width of the crown. the mandibular canine.
B. Increased blood hydrogen ion concentratlon. acids? C. '.\1esial and distal margin ontHnes in iine with B. The incisal margin of the crown occupies at
C, Decreased blood hydrogen ion concentration. A. Malooyl CoA. profile5 of root. least one thlrcl to one hali of crown height
D. Increased blood carbon dioxide tension, B. fl\D. D. Root/crown ratio. C. Labia! aspect: mesiai and distal mMginal
245. The infraorbital nerve l$ a branch of the C. Acetyl CoA. 260. The spread of an odontogenic infection to ridge! converge toward cervix.
D. NAD. which of the following spaces would MOST D. Marked symmetry of mesial/dlstal halves
A. Optic nerve 253. Insulin produces which of the following likely be crmsidered life-threatening? when viewed from indsal.
B. Ocuiomotor nerve changes in mammalian cells? A. Submandibular space 268. During exercise, which oF the fo{lott1-ing is
C. Ophthalmic nerve
A. Increase in liver glycogen production. B. Sublingual space decreased?
D. Maxillary nerve B. Jnc.rease in blood glucose concentration.
E. Mandibular nerve C. Par.pharyngeal space A. Oxidation of fatty acids.
C. Decrease in the transport of glucose into D. Retropharyngeal space B. Glucagon release.
246. Root bifurcation would be a more likely finding muscle, E. Pterygonumdibular S(Jace C. Glycogenolysls,
in which of the following permanent teeth? D. Increase in the transport of glucose into the 261. The most common mutation accounting for fl Lipogenesls.
A. MaxiHary canine. brain. the pathogenesis oftrisomy 21 is _ _ . 269, Involution of the thymus would occur
B. Mandibular canine. 254. Osteoeytes are found in _ _ in mature hone~ A. Chromosome translotation following which ·year in a healthy
C, Maxillary central incisor. A. Trabeculae B, Meiotic nondlsjunction indittidual?
D, Mandibular lateral incisor. B. Lacunae C. Mitotic nondisjunction /\, 0 years (at birth),
247. Which one of the following carbohydrates is a C. The central canal D. Single deletion B. 12th year.
ketose sugar? D. Canaliculi E. X-linked inheritance C. 20th year.
A. Galactose. E. Spicules 262. What type of collagen is found in cementum? IJ 60th ye.er.
B. Fructose. 255. Which one of the following morphological A. Type I collagen. 270. Monoamine oxidase (J1AO) _ _.
C. Glucose, characteristic is representative of all B. Type II collagen, A, lna<:tlvates reduced steroid deriv.:1tives
D, Mannose. posterior maxillary teeth? C. Type Ill collagen. [L Is activnted by MAO inhibitors
E. Glyceraldehydes. A Marked mesiaI concavity on crowns and D. Type IV collagen. C, Inactivates catf'cholamincs l>y oxklMive
248. Which of the following antimicrobials is roots, E. Type V collagen. deamln;tt!{)n
bacteriostatic and inhibits protein synthesis B, Tips of cusps are weH within the confines of D, ls located ln the syrwps1: where lt lnacllvatt'.S
263. What happens to net filtration in the
in bacteria? the root trunks. glomerulus when plasma protein the neurotransmitter acetylcho!ine
A. Streptomycin. C. From mesial/dfstal aspect, crowns are rhom- concentration is decremwd? 271. Sleep bruxism can be characterized by which
B. Penicillin V boidal In shape. A. Net filtration (ultraiiltration) incr~ases. of the Following?
C. Ciprofloxacln, D. From mesial/distal aspect, all maxillary poste- B. Net ftltraHon (ultrafiltration) decreases. A Episodes of ma~sive. hil.::1!('.ra! clenching.
D. Cephalexin.
rior crowns are trapezoidal with shortest C. Net filtrntion remains unchanged. 8. Tooth grtnding thJI may la:-t for up to 20 min-
£. Tetracydine. uneven side toward occlusa! surface. D, Net filtration ceases. utes.
C Often co!nddes ,villi passag-e from lighter to
deeper sleep_
D, Occurs upprnxlmately every 20 mlr:utes in the
sleep cycle,
340 "' Sample Exam Sample Exam ,,. 341

272. An endocrine disorder that causes an early 280. In addition to the esophagus itself, which of the 288. Which one of the following is not a normal 296, Porphyn'ns use which amino acid in their
loss of primary teeth and the early eruption of follmtting structures also passes through the anatomical feature of mandibular synthesis?
secondary teeth is _ _. diaphragm through the esophageal opening? incisors? A Alanine,
A. Myxedemn A. The aorta. A Bifurcated roots. B. Phenyla!aninr-
ll Hashimoto·s thyrolctit!s B The Inferior vena cava B. lnconsplcuous cingula. C. Cysteine.
C. DiGeorge's syndrome C. The azygo.s vein. C. Four develo[)mental lobes, D. Glycine.
D. Plummer's disease D, The posterior and anterior vag:al trunks, D. lncisal edges placed slightly !ingua!ly. 297. The dental lamina arises from _ _ .
E. Dwarfism E, The splanchnlc nerves. 289. The differentiates into ameloblasts. A. Somites
273. Which of the following factors will not 281. Which one of the following does not release A. Stellate reticulurr. B, Neural crest cells
influence the rate at which a meal will leave acetylcholine? 8. Inner enamel epithelium in the cap stage C. The first branchia! arch
the stomach? A, Sympathetic pregangHonic fibers. C. Inner enamel epltheHum in th€ bell stage D, The second branchia! arch
A. Acidification of the duodenum. B Sympathetic pos.tgangllonic fibers that inner~ D, Outer enamel epithelium in the cap stage E. The buccopharyn~eal membrane
B. Increasing thE.' tonicity of the inte~tine. vate the heart. E. Outer enamel epltheHum in the bell stage 298. Karyotyping can b~ used to diagnose which of
C. Saline in the duodenum, C. Parasympathetic postgangtionic fibers to 290. Which of the following statements is true of the following diseases?
D. Lipid in the intestine. effector Ort.Jans. the hi..;tology of the trachea? A. Klinefelter's syndrome.
274. Occlusal interferences can be defined by all of D. Parasympathetic preganglionic fibers, A. The mucosa is covered with oral epithellum, B. MultiplE' rnyeloma.
the following except: 282. An infant diagnosed with osteopetrosis has B. Elastic cartilage rings lie deep to the submuco5e.. C. Niemann-Pick disease.
A. Occlusal contact relations that interfere with dysfunctional _ _. C, The cartHage is ring-shaped; the open end of D, Pemphlgus,
function. A Chondrocytes the ring faces ,mterior. £. Peutz-Jeghers syndrome.
B. Interference to jaw closure Into the intercus~ B. Osteoblasts D. The cartilage is covered by a perichondrium. 299..'lfuscle spindle stretching when the patellar
pal position. C Osteoclasts E. Skeletal muscle extends across the open end tendon is tapped produces which of the
C Interferences to laterotnisive movements. D. Fibroblasts of each cartilage. following responses?
D. interferences to jaw opening. E. Lymphoc,1es 291. In pemphigus, autoantibodies are directed A. M11scle contraction within muscle where the
275. The olec:ranon fossa is located on the 283. Langerhans' cells are located primarily in against which of the following structures? splndles are located.
surface of the _ _. stratum _ _. A. Acetykholine receptor. B. lncreased sympathetic stimulation of the spin-
A Superior; radius A. Corneum B. Sarcomere. dles.
8. Anterior; humerus B. Lucidum C. Epidermis. C A reduction ln the m1mber of aff0rN1t impulse-s
C Posterior; humerus C. Granu!osum D. Thyroid follicle, entering the spinal cord,
D. Anterior: radius D. Spino.sum E. Lysosomi"..s. D. An inhibition of the stretch reflex.
276. Ur1,ich of the following is usually least E. BMale 292. Which one of the following is elevated in 300. In terms of vertical dimension, where is the
malignant? 284, Which of the follouring woul,J be expected to plasma during the absorptive period mental foramen found most frequently?
A. Acute lymphoblastic leukemia. raise blood pressure? (compared to the postabsorptii:e state)? A At the apices of the premolars.
B. Acute lymphocytic leukemia. A A drug that inhibits the angiotensin A. Chylomicrons. B. Coronal to the af}ices.
C. Acute myetogenous leukemia. lkonverting enzyme and thus the productlon B. Acetoacetate. C. Below the apices,
D. Chronic lymphocytic leukemia. of anglotensln ll (ACE lnhlbitors). C. Lactate. D. No particttl.t1r location predominates,
£. Chronic myelogenous leukemia. R A drug that inhihiti the synthesis of nitric D. Glucagon. 301~ Urinary filtrate is most hypotnnic in the _ _.
277. Each of the following describes collagen oxide. 293. Recent focus on causative factors in bruxism A. Pnn.:imal convoluted tubule
except one. Which is the exception? C. A drug that btocks va!!:opressin receptors, include AU, of the following Except? B. Descending limb of Henle'::> loop
A. Most abundant protein ln the body. D, increased stimulatlon of the carotid baro- A. Ocdusal interferences. C. Thin segment of Henle's loop
8. Modifications to procollagen occur in the receptor. B. Part of a .sleep arousal response. D. Thick ascending segment o[ Henle·s loop
extracellular matrix. 285. lHwn are the crowns of the primary maxillary C. Piithophy.~iologlc.al factors, E. Dista! convoluted tubule
C. Incorporates hydroxyproline ?nto the molecule second molars completed? D, Neurotransmitters in the central nervous sys~ 302. There are _ _ pairs of true ribs.
byTrna. A, 11 months. tern. A Four
D. Hydroxylation of proline requires "itamin C B. JO months. 294. A distinet central developmental groove, B. Five
and molecular oxygen. C. 9 months. prominent buccal triangular ridge, two cusps C. Seven
278. Wllich position of th~ mental for-amen relative D. 8 months. and distinct mesial and distal occlusal pits D, Eleven
to the mandibular premolars and first molar 286. Which of the following processes is not a true would be most characteristic of: E. Twelve
occurs most frequently? component of swallowing? A. Mandibular first premolars. 303. Based on a11erage MD diameters of the croums
A, Between the first and second premolars. A. Closure of the glotti:a. B. Primary mandibular first molars. of primary teeth, the range for average oceralt
B. ln tine with the Sf'cond premolar. B. Involuntary rt>laxation of the upper C, Primary mandibular second molars. length of the primary maxillary arch is about
C. Distal to the second premolar. e~ophageal sphincter. D. Mandibular second premolars. what dimens;on?
D. In line with the mesi<\I root of the first molar. C, Involuntary movements of the tongue against 295. An autoclave sterilizes dental instruments by A. 60-68 mm.
279. From the lingual perspective the primary the palate. causing which of the following? B. 68-76 mm.
maxillary first molar ltas which of the D. Esoplv1g0al peristalsis. A. Coagulation of proteins. C. 76-84 mm.
following characteristics? 287. Which of the following receptors are B. Denaturing of proteins. D. 8·1-92 mm.
A. Distollngual cusp is the most prominent cusp, recognized by CDS lymphocytes? C. Precipitation of nucleic adds.
B. l\fosiolingual cusp poorly defined. A. Class I MHC molecules. D. Disruption of cell membranes,
C. Dlstobuccal cusp cannot be seen from lingual B. Class 1l MHC motecu!es. E. Dissolution of lipids.
aspect. C. Surface
D. Crown converges consirlerab:y in a lingual D, Surface
direction. Histamine receptor.
342 v Sample Exam Sample Exam "' 343

304. Symptoms of a myocardial infarclion include 1

312. ll hich primary tooth generally erupts last? 320. A positive quelling reaction can be observed 327. ATP is utilfaed direct(y for t::.ac!t of the
all of the following except one, Which one is A. Mandibular second molar, in bacteria with a follou•ing processes except:
the exception? B. Maxillary second molar. A. Thick peptidog!ycan layer A. Acnmrnla~Jnn of Ca~· by the ltarcopl:t~rnk
A lrngina, C. Maxillary canine. B. Capsule reticulum.
R Diaphorcsis. D, Mandibular canine. C. FlaKella B. Transport of Na· from intracellular to extni.cel•
C. Fever. 313. The latissimus dorsi muscle is supplied by tlte D. C~ll wall that contains teichoic acid Jular fluid.
D. Vomiting. _ _ nerve. E, Giycoca!yx coating C. Tran~port of K· from cxtrncellul~ir to intrncel•
E. Dyspnea. A. Medial pectoral 321. In which of the following might arterial blood lular fluld.
305. Ur'hich process transports amino acids across B, Cranial nerve Xl pressure be abnormally high? D. Transport of H· from parietal ce!ls into the
the luminal surface of the epithelia that lines C. Dorsal scapular A. Ventricular fibrmation, lumen of the !>tomach
the small intestine? D. Thoracodorsal B. Heart failure. E. Transport of glucose into musde cells.
A. Simple diffusion. 314. Which of the following responses is due to the C Anaphylactic shock 328. All of th<' follmriag microb<>s listed are
B. Primary active transport. stimulation of a-adrenergic receptors? D. Increased intrac.ranial pressure. assodated with infections secondary to an
C. Cotransport wlth sodium ion. A. Slowing of heart rate. 322. All of the following can be found in the cell HIV infection except one. lVhich one is the
D. Cotransport with chloride !on. B. Constriction of blood vessels in skin. wall of a gram"ftegative bacterium except one. ex~eption?
306. Which of the following cells are capable of C. Increased gastrointestinal motility. Which one is the exception? A. Pneumocysiis Jitoved (carinii)
mitosis? D. increased renal blood Dow. l\.. Endotoxin. B. Epstein,Barr virus.
A. Smooth muscle. 315. Which of the following contributes primary B. A thin peptidoglycan layer. C. Cox~acklevirus.
B. Skelelal muscle, sensory innervation to the C. Lipopolys.accharide. D. Myco/xrcteriwn tubern:losis.
C. Cardiac muscle. temporomandibu/ar}oint? D. Teichoic acid. E. Condida albicans.
D. Type I pneumocytes. A, Aurlculotempornl nerve. E, 0 antigen. 329. Which of the following is not a type trait of
E. Neuron~. B. Infra.orbital nerve. 323. The articulating surfaces of the the permanent maxillary second premolar?
307. Vitamin K serves as a coenzyme for: C. Branch of the lingual nerve. temporomandibular joint are covered with A. Buccal view: narrow shoulders (margins of
A. The enzymatic hydroxylation of proline to 4~ D. Facial nerve. crown; mesio- and disto-occlusal angles).
hydroryproline, 316. All of the following arteries are branches of A. Fibrocartilage B. Occlusal table outline: ovoid.
B. The c.arboxylation of lnactive prothrombln to the mandibular division of the maxillary B, Hyaline cartilage C. Mesiom;irginal groove interrupts mesial mar-
form active prothrombin, artery except one. Which one is the exception? C. Artlcular cartilage ginal ndge,
C. The synthesis of nucleic acids. A. Incisive artery. D. Elastic cartilage D. Lingual view: buccal profile is not visible.
D. Protein synthesis. B. Suhmental artery. E. Perichondrlum 330. What is the correcl schematic outline of the
308. Squamous cell carcinoma is the most common C. Middle meningeal artery. 324. The binding of epinephrine or glucagon to the follmcing teeth?
oral cancer. It is a tumor of D. Mylohyoid artery. corresponding membrane receptor ha,s u:ltich A Mandibular premolnrs, viewed from occlusal,
A. Melanocytes E. Deep auricular artery. of the following effects on glycogen rhomboidal.
B. Basal cello 317. Rheumatoid arthritis is characterized by metabolism? B. Maxlllary central lndsors, viewed from fodal.
C. Fibroblasts innammatian of the _ _. A. The net synthesis of glycogen is increased. triangles.
D. Kerntinocytes A. Articular capsule B. Glycogen phosphoryla~e iJ activated while C. Maxillary lateral incisors, viewed from mesial,
E. Macrorhages B. Articular cartilage glycogen synthas.e is inactivated. trapezoidal.
309. Which of the following is NOT a type trait of C. Cortical bone C. Glycogen pho$phorylase is inactivated \•vhHe D, Al! mandibular posterior teeth, distal aspect,
the permanent maxillary first premolar? D. Perichondrium glycogen synthase is activated. rhomboidal.
A. Occlusal table outline, trapezoidaL E. Synoviurn D, Both glycogen. synthase and phosphorylase 331. Which of the follou1ing consists of glucose
B. Generally two roots-mesial and distal. 318. Which of the following are NOT type traits of are l'lCtiva.ted. molecules linked together that act as the
C. Central groove is long. permanent mandibular first and second E. Both glycogen synthase and phosphorylase structural component of plaque?
D, Supplementary groo~es are rare, premolars? are lnac.tivate<l, A Fructose.
310. Which of the following skin lesions is most First Second 325. If posterior teeth on the left side contact B. Sucro-s:e.
likely premalignant? Premolar Premolar occlusally during a right lateral excursion of C Levans.
A Verruca vulgaris, A. Buccal Crown bilaterally Bilaterally the mandible, the left side occlusal contact D. Dextrans.
B. Keloids. view: Asymmetrical symmetrical WQufd be referred to as: E. Fructans
C Seborrheic keratosis. B. Lingual Entire buccal Buccal profile A. Laterotrusive contact_ 332. Hydroxyapatite _ _.
D. Actinic keratosis. aspect: profile visible not seen B. Protrusive contact. A. ls weakened if fluoride is substltuted for some
E. Compound nevus. C. Lingual Mo~t of occlusal Little, if any C. Mediotrusive contact of the hydm::-.yl ions
311. Which of the following statements regarding aspect: surface visible seen D. Centri<" relation. R Is a noncrystalline structure
the hormone secretin is true? D, Lingual Contour height: Cervical third 326. Bfood from the internal carotid artery C. If containing carlmnat!? ion becomes more sol¥
A It is responsible for activating ch)"-motrypsinogen, aspect: Middle third reaches the posterior cerebral artery by the uble
B. lt stimulates the release of pancreatic secreM 319. Which of the folfowing muscles of the back is D. Is composed of cakinm ;rnd phosphatr: in .a
tlon rich in bicarbonate. supplied by the CN XI? A, Anterior cerebral artery 1:1 ratio
C. It stimulates the release of pancreatic A. Levator scapulae. B, Anterior comrnunicnting artery 333. Tooth enamel is <lerfred from _ _.
enzyme!. B. Latisslrnus dorsL C. Posterior communicating artery A End0df'rm
D. It .'!ltimulates the contraction of the galibl;1cider C. Trapezius. D. Po.sierior superior cerebellar artery B, Mesoderm
to release blle, D. Major rhomboid E. Basilar artery C. Ectoderm
E. Minor rhomboid. D. Fndo<lerm and mesuderm
E Ectoderm and mt:soderm
344 .,. Samptc Exam Sample Exam T 345

334. Which portion of uriniferous tubules contains 341. The minimum volume of air that remains in /149. The Y.shaped central developmental groove is 356. lVhich of the fnllou:lng coenzymes are
squamous epithelial cells? the lungs after a maximal expiration is most likely found on whtC'h of the following incolr:ed in the metabolism of pyruvate to
A.Proximal convoluted tubde. termed the _ _. premolars? acetyl CoA?
FtThick descending limb of Henle's loop. A Tidal volume A Maxiitary first. A. Th1arnio pyrophospharn, Upoic Jcid. FAD.
C.Thin segment ot Henie ·s loop. B. Functional residua! capacity B. Mandibular first. NAD, and coenzymt A
D.Thick a~cending segment of Henle's loop. C. Residual volume C. Maxillary second. R NAD, tetrnhydrnfol:ne, lipok acid, FAD, and
E.Distal convoluted tubule. D, Vital capacity D. Manctihul~r second. vitamin 13 12 .
335. Which of the following enzymes found in the 342. Fram a mesial perspective, the primary 350. The sternal angle between the manubrium C. Mg.,, !:AD. nicntinamide. adenine rHrmc!eotide.
liver is involved in gluconeogenesis during the maxillary ffrst molar has wltich of the and the sternum marks the position of the and btotin.
postabsorptive state? following characteristics? rib. D. Coenzyme A. niacin. FAD, and ascorbic acid,
A. Glucose 6~phosphate dehydrogenase. A. Pronounced convexity on the buccal outline of A. First 357. The primary mandibular first molar has
B. 6~phosphogluconate dehydrogenase. the eervical third. B. Second which of th<> following characteristics?
C, Glucose &--pho!lphata~~- B. The cervical line mesially shows some curva~ C. Third A. Resembles other primary and permanent
D. Glucokinase, ture in an apical direction. D. Fourth teeth.
336. The heights of contour of the distal surfaces C. The dimension at the occlusal third is the E. Fifth B. From the occlusa! perspective. has n
of permanent mandibular central incisors are same as at the cervical third. 351. Which compound is produced in the hexose heartshaped outline
located in wltich coronal third? D. The mesiohuccal CU!!p is longer and sharper monophosphate (pentose phosphate) C The rnesiobucral cusp is smal!er than the dis-
A. ~1idclle. than the mesiolingual cusp. pathway? tobuccn! cusp.
B. CervicaL 343. The embryo develops fr'om the _ _• A. ATP. D. No developmental groove is evident ])etween
C Occ!usaL A, The entire blastocyst B. NADH. the bucc.:~I cusps.
D. Incisal. B The entire trophoblast C. NADPH. 358. Which of the following muscle attaches to the
337. Accumulation of fluid in the pericardium C. The embryonic dlsc D. Fructose 1,6-bisphosphate. anteriur end of the articular disc of the
occurs most often with which of the following D. The extraembryonlc coe!em E. f'llosphoeno!pyruvate. temporomatulibular joint?
conditions? E. The moruJa 352. Which of the following is the most common A. Superficii:1l head of the medial pterygold mus-
A, Unstable angina. 344. Which primary tooth is generally accepted as cause of subacutc endocarditis? cle.
R C~trdiomyopathy. the first to erupt, and at about what mean A Staphylococcu!I aureus. B. Deep head of the mcdlal pterygoid muscle.
C. Myocarditis, age? B. 5itaphylococcus epidermidis.. C. Superior head of the lateral pterygoid
D. Acute perlcarditis. A Maxmary central incisor, 8 to l 2 months. C. Streptococcus viridans. musde,
E. Tamponade, B. ~axlllary central incisor, 7 to 9 months. D. Streptococcus pyogene.s. D. Inferior head of the lateral pterygold muscle.
338. The correct order of tooth formation is C. Mandibular central inclsor, 6 to 10 months. E. Streptococcus pneumoniae. 359. In a ctrsp-.fossa occlusal relationship, the
A. Amelobiasts form. odontoh!asts form, D. Mandibular central incisor, 8 to 10 months, 353. From the occlusal aspect, the primary maxitlary second premolar is most likely to
ameloblasts start to form enamel, odonto- 345. Blood levels of progesterone are highest maxillary first molar has which of the articulate with which of the following
blasts start to form dentin during _ _. follou:;ing characteristics? mandibular teeth?
B. Ameloblasts form, odontobiasts form, odonto- A. The follicular phase of the ovarian cycle A. Crown outline diverges lingually and diAtally. A. First premolar only.
blasts start to form dentin, amelohlasts start R The IuteaJ phase of the ovarian cycle B. Sman traverse ridge frequently present called B. Second premolar only.
to form enamel C. Ovulation an oblique ridge. C Canine and first !Jrernolar.
C. Orlontoblasts form, odontoblasts start to form D. Menstruation C, Four cusps are pre!lent. D. First .and second premol;)rs.
dentin, ame!oblasts form, ame!oblasts start to .146. The of the heart ,'s also known as the D. Mesla1 marginal ridge is thin and poorly develM B60. The presence of which of the following itt a
form enamel mitral valve. oped. patient's serum indicates that the patient is a
D. Ametoblasts form, ameloblasts start to form A. Right atrloventricular valve 354. Lymph from the mandibular incisors drain highly infectious hepatitis B carrier?
enamel. odontob!asts form. odontoblasts start R Left atrioventricular valve chiefly into _ _. A. HBsAg.
to form dentin C. Pulmonary valve A. Submandibular nodes B. HBsAb.
£. Odontoblasts form, ameloblasts form, odonto- D. Aortic valve B. Suhmental nodes C:. flBcAg
b!asts start to form dentin, amelobi;,sts start E. Tricuspid valve C. Superficial parnti<l nodes D. HBeAg.
to form enameI 347. The most common cause of death in diabetic D. Deep cervical nodes E. f!lleAb.
339. Reduction division occurs during the _ _ . patients is _ _. E. Occipital nodes 361. Which of the following statement$ regarding
A. First stage of mitosis A. Peripheral neuropathy 355. Ur'hich of the following may be observed in a salivary secrrtion is true?
B, Second stage of mitosis B. Pancreatic cancer child diagnosPd w{th rickets? A. ln general, saliva is rnore hypertonie than
C. First stage of meiosis C. Car<liovascular disease A Dark pigmentation on the oral mucosa. plasma,
D. Second stage of meiosis D. Kidney fa!tme B. Early eruption of teeth. B. As .~mlivary flow increases, biccwbnn.ate conM
E, Third stage of meiosis L Opportunistic infections C. Hutchinson's incisors. centration decreases.
340. All of rite following factors play a role in the 348. At what time is the crown completed for the D, Abnormal dentin. C. As salivary flow incrc<1Ses. lonk concentration
virulence of the microbe that causes whooping tooth indicated? E. Macroglossia, increases.
cough except one. Which one is the exception? A. Primary maxll!ary central incisor, ~1 weeks. D. Salivary secretion i:s regulated primarily by
A lgA protease. 8, Permanent maxillary central incisor, 2 to 3 hormonal ;;tinrnlatinn.
B. Hemagglutinln. years.
C Exoto:xin. C. Primary maxillary lateral incisor, 2 to 3
D. Capsule. months.
£. Pili. D. Permanent maxillary lateral Incisor, 2 to 3
years.
346 T Sample Exam Sample Exam Y 34 7

362. The pulmonary vein of the lung carries: 369. The trochlea of the humerus bone articulates 377. Calcium that enters the cell during smooth 385. For each type of tooth, the primary teeth
A. Unoxygenated blood from the lungs to the with the muscle excitation binds with which of the conttistently show which of the follo1l'ing
heart A. Ulna of the forearm following? characteristks?
B, Oxygenatf'd blood from the lungs to the heart B. Radius of the forearm A. Cttlmodulin. A. Greater rnesiodista! diameter relative to crown
C. Cnoxygenated blood to the lu.ngs from the C. Coronoid process of the ulna of the forearm B. Inactive myosin kinase. heigb t than permanent teeth.
heart D. Olecranon of the ulna of the forearm C, Troponin. B. An elongated appearance ot th~ primary
D. Oxygenated blood to the lungs from the heart E. Mediai epicon<lyle D, Myosln. crowns and roots.
E. O:;icygenated blond from the heart to the lungs 370. Increased formation of ketone bodies E, Actin. C. Crowns that are translucent white in color.
363. _ _ vertebrae are characterized by a during fa.sting is a result of which of the 378. The lumen of the gastrointestinal tract is D. Root trunk one~half that of crown helght.
heartshaped body. following? lined with 386. All of the following are rotator cuff muscles
A Cervical A, increased oxidation of fatty acids as a source A. ri.focosa except:
B. Thoracic of fuel. B. Submucosa A. Supraspinatous muscle
C. Lumbar B. Decreased formation of acety! CoA ln the liver. C. Muscularis externa B. lnfra.spinatous muscle
D. Sacral C. Decreased levels of glucagon. D. Fibrosa C. Teres minor musde
£. Coccygeal D, Increased glycogenesis in muscle. E. Adventitia D. Teres major muscle
364. Lipid micelles are stabilized by which of the 371. Nucleus ambiguus contain.v the cell bodies of 379. Which one of the following is found on the E. Suhscapularis muscle
following? which of lite following cranial nerves? crown of permanent mandlbular firSt molars 387. Which of the folfou:ing does not affect the
A. Hydrophobic internctions. A. Ill. IV, and V. but is not found on the crowns of mandibular mus.de tension produced daring
B. Hydrophilic interactions. B. VII. IX ,and X. second molars? contraction?
C, Interactions of lipid and water. C. VIL IX, and XL A. MB cusp. A The extent of motor~unit recruitment.
n lnteractlon of hydrophobic llpid tails with D. IX. X, and XI. B. Distobuccal groove. B. The proportion of each 5ing!e motor unit that
hydrophobic domains of proteins, E. !X. X, and XII. C. Lingual groove. is stimulated to contract.
365. The HIV virus binds directly to the surface 372. The participation of calcium in the D. DB cusp.

l
C. The number of muscle fibers contracting:.
receptors ofCD4 lymphocytes with _ _. contraction of skeletal muscle is facilitated or 380. Which of the following mediators aid in the D, The frequency of stimulation
A, Reverse transcriptase associated with which of the following? kilting of intracellular bacteria? 388. Cytochrome P450 enzymes may be found in
B. lntegrase A. Calcium release from sarcoplasmic A. Histamine. which of the following cellular organelles?
C. Hemaggiutinin reticulum. B. lnter!eukin-2. A. Mitochondria.
D. Giycoprotein 120 B. Calcium binding to the myosin heads, C. Catalase. B" Golgl apparatus.
E. Protease C, Active transport of cakium out of longitudinal D. lgG. C. Lysosome.
366. The maxillary sinus ot)erlies the alveola.7' tubules. £. Lysozyme. D, RJbosome.
processes in particular what teeth? D. Uptake of calcium by T-tubules. 381. Chromosomes line up at a cell's equator E. Endoplasmlc retlnrlum.
A. First and second maxillary molars. ,173. Jl'hat type oF vaccine i• used for Clostridium during which phase of mitosis? 389. A patient /,as a heart rate of 70 bpm.
B, All maxillary molars. tetani? A. Telophase. Her EDV (end-diastolic volume) is 140 mL.
C. First anrl second premolars. A. Capsular polysaccharides. B. Metaphase. Her ESV (endsystolic volume) is 30 mL
D. First and second premolars and first and sec~ R Toxolds. C. lnterphase. Calculate the CO (cardiac output) of this
ond molars. C. Killed bacteria. D, Anaphase. individual.
367. If jaw opening is divided into phases. and it is D. lmmunoglobulins. E. Prophase. A. 9800 mL.
assumed that the surfaces of the articulating E. No vaccine is available. 382, Following the production of Okazaki B. 2100 ml.
bones and disc are associated throughout jaw 374. Where is tire height of contour located relative fragments, which of the following is required C. 7700 enL.
openirlgj what is the relationship of the disc to the following teeth (iiiewed from the mesiaO? to close the gap between the fragments? D. 15.400 rnL
and condyie in the following phases? A. Facial surfaces of all molars, middle third. A. D'.'!A lii..e, 390. Which premolar would be the most likely to
A. In the very ea.rtiest phase, the condyle moves B. Llngual surfaces of all premolars and molars. B. DNA polymerase. have a single pulp horn?
forward before the disc. cervical thlrd. C. RNA polymera,e. A. Maxillary first,
B. Jn the early phase, the disc and condyle move: C. Lingual surfaces of molars and premolars, cer~ D. Reverse transcriptase. I3, Mandibuli,r first.
anteriorly in concert. vical or middle thlrd. 383. The maxillary nenx: passes through which of C. Mandihular second.
C In an intermediate phase, the condy!e moves D. Anterior teeth, cervical or middie third. the following? D. M21xillary .second.
forward nt a slower rate. 375. The gamma motor neurons control which of A Superior orbital fissure. 391. lVhich of thr following groups of
0. In the final phase, the dlsc moves forward at a tire following? R fnternal acoustic meatus, microorganisms produce dipkolinic acid?
faster rate. A, Muscle S!Jindle~. C. Foramen ovale. A. ActinomJ·cetes.
368. Endotoxin consists of _ _. B. Iris of the eye. D. foramen rotundum. R HL<.;topiasmo
A. Lipopolysae:charide C. Voluntary muscle fibers. E. Foramen spinosum, C, Streptococcus.
B. M protein D. Pyloric sphlncter. 384. A productive cough may be seen in all of the D. .5itaphylococcus.
C. Hyaluronh1ar.e 376. Which of the following organelles is following conditions except one. Which one is E, C/o.<;tridfum,
D, Lactic acid surrounded by a double membrane? the exception? .192. Which of the following describes the function
E. Coagulase A. Ribosome. A. Pneumonia. of RNA polymerase?
8. Golgi apparatus. B. Lung abscess. A. Trnnslntes DNA into protein.
C. Lyso5ome. C. Bronchledasls. B. Tennln.ates tran,cription.
D. Cytoplasmic inclusion. D. Asthma. C Removes lntrons during transcription.
£. ~itochondria, E. Bronchogenic carcinoma, D. Synthesizes RNA 5' ➔ 3'.
F. Ganglion cells.
348 • Sample Exam
393. Which of the following bones is formed by
intramembranous ossification?
A Humerus,
B. Lumbar vertebrae.
C. Frontal bone of the sku!L
D. Ribs.
E. Clavlde.
3,94. The pressure in a capillary in skeletal muscle
is 37 mmHg at the arteriolar end and 16
mmHg at the venular end, The interstitial
pressure is O mmHg. The colloid osmotic
pressure is 26 mmHg in the capillary and 1
mmHg in the interstitial fluid, The net force
producing fluid mot,ement across the
capillary w<,ll is which of the following?
A. l mmHg out of the capillary.
B. 3 mmHg out of the caplUary.
C J 2 mm Hg out of the capillary.
D. 3 mrnHg into the capillary.
395. Which of the fo//ou:ing forms of thyroid hormone
is most readily found in the circulation?
A. Tri-iodothyronin• (T3).
B. Thyroxine (T4).
C. Thyroglobulin.
D. TSH.
396. Dust cells can be found in the
A. Brain
B. Heart
C, Lungs
D. Liver
E. Spleen
397. The lateral thoracic u:all of the ax/Ila is
cooered by which of the follou.Jing muscles?
A Pectoralis major.
B. Pectoraiis minor.
C. Serrntus anlerioL
D. Subscapularis.
E. Latlssimus dorsL
398. CO~ generated in the tissues ls carried in
ve,;ous blood prima,·ily in which form?
A, CO., in the plasma.
B. H,CO, in the plasma,
C, HC0 3 in the plasma.
D. CO, in the red blood cells.
E. Carhoxyhemoglobin in the red blood ceHs.
399. Oral epithelium ia composed of _ _
epithelium.
A. Keratiniz:ed 5impl~ squamous
B. Keratinized .itr.titified squamous
C. Nonkeratinized simple squamous
D. Nonkeratinized .!';tratified ~quamous
E. Nonkeratinized stratified columnar
400. Chondroitin sulfate is a major component of I. A. The inferior head of the lateral pterygoid muscle
which of the following? attaches to the lateral surface of the lateral
A Bacterial cell waHs. pterygoJCI plate of sphenoitl bone. lts superior
B. Muci11. head att.'tches to the infratemporal crest of the
C. lgA. greater wing of sphenoid bone, The deep fibers
D. Cartilage. of the medial pterygol<l muscle attaches to the
E. Hair. medial surface of the lateral pterygoid plate,
2. D. The palatopharyngeus forms the posterior
tonsillar pillar. It also functions to dose off
the na1opharynx and larynx during swallow-
ing. The anterior tonsmar pillar is formed by the
palatoglos5us.
3. E. The superior and inferior ophthalmic veins
drain 1nto the facial vein and cavernous sinus.
4, C. The masseter originates from the inferior border
of the zygomatic arch; spedflcally, its superficial
head and deep head originate from the anterior
two thirds or posterior one third of the inferior
border, re,pectively, Its superficial head inserts
into the lateral surface of the angle of the
mandible; Its deep head inserts into the ramus
and body o{ the mandible.
5. A. Lateral crkoarytenoid. The ohlique and tran~-
verse arytenoids and thyroartenold also adduct
the vocal folds. The posterior cric0arytenoids
abducts the vocal cords, The cricolhyroid mus-
cle raises the crlcold cartilage and tenses the
vocal cords.
6. A. The site of cen division (mitosis) occurs in the
stratum basale (basal layer, stratum germina-
tivurn) of oral epitheHurn
D. After branching from the mandibular nerve
(CN V:J, the auriculntemporal nerve Irave!s pos~
teriorly and encircles the middle meningeal
artery, remainlng posterior and medial to the
condyle. It then continues up tuwards the TMJ,
external ear, and temporal region, passing
through the parntid gland and traveling with the
superficial temporal artery and veln
8. C. lnt-ercalatecl discs are only found in cardiac mus-
cle. Multiple, peripherally po"-itlnned nuclei are
found in the fibers of skeleh:11 niusde. Smooth
muscle cells are ipin<lle-shape(I.
9. C The hypogiossal (CN XII) nerve i5 not found in
the posterior triangle; it is, however, present in
the suhmandihular triangle. Contemts of the pos-
terior triangle lnclmie the external jugular and
sohclavian vein and their tributarles, the sub~
c-lavian artery and its branches, branches of the
cervical plexus, CN Xl, nerves to the upper limb
and muscles of the triangle floor, the phrenk
nerve, and the brachia! plexus.
10, C. Deoxygenated blood from the transverse slnus
drains to the slgmnld sinus, which empties into
the internal ju~ular velns. The transverse
sinuses receive blood from the confluence of
sinuses, which is irn:ated in the poslerior cra-
nium.
11. A. The vestigta! deft of Ra.thke's p0uch is !oc,Hed
betwt-:en the anterior and posterior lobes-
spccifkally, betvveen the pars intermedia and
anterior lobe. It con.sis.ts oi cyst-llke spaces
(Rathke's cysts) and represf'nts the ve.stigiat
lumen of Rathke's pouch,
12. B~ The thymns is active llt birth and increases ln
size until puberty (around age 1~). after which it
graduaHy atrophies am! ls replaced by fatty tis-
sue.
13. C. The Internal carotid artery is joined to the pos-
terior cerehrt'l:I £1rtery via the posterior co1nmu•
nicating artery, which is part nf the circle of
Willis.
14. D. It is ii branch of the rnaxiilary (CN V.)) nerve. The
maxillary nerve branches from th~e trigeminnl
ganglion and exits the skull through the forami:~n
roiundum. Wh0n it reaches th<~ ptnygopal.ttine
ganglion, it terminates as the infranrbital and
zygomatic nerves.
349
348 T Sample Exam
393. Which of the following bones is formed by
intra.membranous ossification?
A. Humerus,
B. Lumbar vertebrae.
C. frontal bone of the skull.
D. Ribs.
E. Clavicle.
394~ The pressure in a capillary in skeletal muscle
is 37 mmHg at the arteriolar end and 16
m.mHg at lite venular end. The interstitial
pressure is O mmHg. The colloid osmotic
pressure is 26 mmHg in the capillary and 1
mmHg in the interstitial f1uid. The net force
producing fluid movement ac,-oss the
capillary wall is whic/1 of the following ?
A. 1 mmHg out of the capillary.
B. 3 mmHg out of the capillary.
C. 12 mmHg out of the capillary.
D. 3 rnmHg into the capillary,
395. Which of the following forms of thyroid hormone
is most readily found in the circulation?
A. Trl-iodothyronine (T3).
B. Thyroxine (T4).
C. Thyroglobulin.
D. TSH.
396. Dust cells can be found in the _ _.
A. Brain
B. Heart
C. Lungs
D. Liver
E. Spleen
397. The lateral thoracic wall of the axil/a is
covered by which of the following muscles?
A. Pecto1alis major.
B. Pectoralls minor.
C, Serratus anterior.
D. Subscapularis.
E. Latissimus dorsi.
398. CO~ generated in the tissues is carried in
ven~ous blood primarily in which form?
A CO2 in the plasma,
B. H.1C03 In the plasma.
C. HCO,· in the plasma.
D. C0 in the red blood cells.
0
E. Carhoxyhemoglobln In the red blood cells.
399. Oral epithelium is composed of _ _
epithelium.
A Keratinized simple squamous
B. Keratinized stratified squamous
C. Nonkeratinized simple s-quamous
D. Nonkeratinized stratified squamous
E. Nonkeratinized stratHled columnar
400. Chondroitin sulfate is a major component of
which of the following?
A. Bacterial cell walls.
B, :\1.ucin.
C. lgA.
D. Cartllage.
E. Hair.
1. A. The inferior head of the lateral pterygoid muscle
attaches to the lateral surface of the lateral
r,terygoid plate of sphenoid bone. lts sur,erior
head attach•• to the inlratemporal crest of the
greater wing of sphenoid bone. The deep fibers
of the medial pterygoid muse.le attaches to the
medial surface of the lateral pterygoid plate,
2. D. The palatopharyngeus forms the posterior
tonsillar pillar. It also functions to close off
the nasopharynx and larynx during swallow-
ing. The anterior tonsillar pillar is formed by the
palatoglossus,
3, E. The superior and inferior ophthalmic veins
drain into the facial vein and cavernous sinus.
4. C. The masseter originates from the inferior border
of the zygomatic arch; specifically, its superficial
head and deep head originate from the anterior
two thirds or posterior one thlrd of the inferior
border, respectively. its superficial head inserts
into the lateral surface of the angle of the
mandibie; its deep head inserts lnto the ramus
and body of the mandible.
5. A. Lateral cricoarytenoid. The oblique and trans-
verse arytenoids and thyroartenoid also adduct
the vocal folds. The posterior cricoarytenoids
abducts the vocal cords. The cricothyroid mus-
cle raises the cricoid cartilage and tenses the
vocal cordsT
6, A. The site of cell division (mitosis) occurs in the
stratum basale (basal layer, stratum germina-
tivum) of oral epithelium.
7, D. After branching from the mandibular nerve
(CN V;;. the auricuiotemporal nerve travels pos-
teriorly and encircles the middle meningeal
artery, remaining posterior and medial to the,
condyle. It then continues up towards the TMJ,
external ear, and temporal region, pas.Jing
through the parotld gland and traveling wlth the
superfidal temporal artery and vein,
8. C. Intercalated discs are only found in cardiac mus-
cle, Multiple, peripl1erally po~itioned nuclei are
found ln the fibers of skeletal muscle, Smooth
muscle cells are tpindle-.'lhapecL
9. C. The hypoglossal (CN XU) nerve is not found in
the posterior triangie; it is, however, present \n
the 5ubmandibular triangle. Contents or the pos-
terior triangle include the e_x.ternal jugular and
subclavian vein and thelr trlbutaries, the sub-
clavian artery and its branches, branch-es of the
cervical plexus, CN XI, nerves to the upper limb
and muscles of the triangle floor, the phrenic
nerve, and the brachia] plexu5.
10. C. Denxygenated blood from the transverse sinus
drains to the sigmoid sinus, which empties into
the internal jugular veins. The transverse
sinuses receive blood from the confluence of
sinuses, which is locater! in the posterior era~
niurn,
11. A. The vestigial cle!t of Rathke's pouch is located
between the anterior m1<l posterior lobes-
spedfically. between the pars intermedia and
anterior lobe. It consists of cyst-llke spaces
(Rathk.e's cysts) and represents the vestigial
lumen of Rathke·s pouch,
12. B. The thymue: is active at birth and increases in
size until puberty (around age 12). after which it
gradually atrophies and is replaced by fatty tis-
sue.
13. C. The internal carotid artery is joined to the pos-
terior cerebral artery via the posterior commu-
nicating artery, which ls part of the circle of
Willis.
14, D. lt is a branch or the maxillary (CN V.,) nerve. The
maxillary nerve branches from o{e trlfleminal
ganglion and exits the skull through the forllrnen
rotundum. When lt reaches the pterygoplllali11~
ganglion, it tenninates ns the infraorbital ancl
zygomatk nerves.
349
3 SO .,, Answer Key Ana:ornic Stie:no:n
15. /\.. Of tlie cell types :iste,d, only smooth muscle <.:ells
are capable ol ceU dlv!sion.
16. C,The acinar units o: salivary glands are lined by
simp!e cuboirlal epithd:um. This type of epithe-
lium also lines ~he hrnr.chloles, thyroid gland.
and ovuy capsule.
17. B. The tendon of the ternmr tympani is attached lo
the lwnclle of the mal!eus ln the middle ear. Loud
sounds cause the tensor tympani to cor;tract,
pulling the malleus and tympanic membrane
inward to reduce vibrations ;md prevent damage
18. C The ratio of inorga,1k to organic matter in
mature dentin is Hpprm:imatdy 70::J0. ln enamel
and cemf'T1tum, it is .npproxim<1te£y 96:4 and
,S0:50. respectively.
19. D. Oligodendrocytes proc!uce the myelin sheath
around myt>linated axons in the cent ml nervous
system. Schwanr. cells make up the mye!in
slH:::nth around mye!inaled axons in the auto~
nornk: nervous system.
2(L D. The facla! nerve supplie!\ special ~,ensory (tasle)
to the anterior two thirds of the tongue, via one
of lts branches, the chorda tympanl (Fig, 1-25).
The chorda tympani branches from the facial
nerve, carrying both sensory fibers for taste and
preg;mglionic: parasympathetic fibers. It exits
from of the tempnral bone to jo!n the lingual
nerve (a bnrnch of CN VJ, as lt courses inferi-
orly toward the submandibular ganglion
Postgangl!nnic parasympathetic fibers tmerge
from the ganglion and continue toward the sub-
lingual and suhm,mdibular glands. Sensory
fibers also branch from the nerve and provide
taste sensation to the <mtE'rior t,No thirds. of the
tongue.
2L B. Oh!ique olv('>n!odent;-1J flhers rPsist ocdusal
forces that occur along the long axis of the
tooth. The rest of the a\veolodcnta! (POL)
fibers listed provide resistance against forcets
which pull the tooth in an occlusal dired!nn
(i.e .. forces that try to pull the tooth from Hs
socket),
22 A. When pulpal nerves Me stimnlatcd, ihey can
oniy transmit one sign;t!: p~in.
23. C. The mylnhyoid muscle formi the floor of the
mouth. RelaxaUon of this muscle would help the
dentist push the film down, to help ensure that
the i'\pical root is captured on the rctdiograph.
2-1. B. Fibers of the !atcrn! plerygolr! muscle are
attached to the anterior end of the dist.
Contraction of this muscle pulls the disc in an
anterior and medlal directior,
25. B. The sensory distrllmtinn for 1he maxillary nerve
(CN V.,) includes the cheek and uppe(· lip. and
lower ~Pyelid, uprwr lip, nas0ph11rynx, tonsils,
pnlate, and maxil!ary teeth. The sensory distri-
bution for the iong lmccal also include5 the
(lower) t:h~~k; however, it does not 1ndude the
upper lip" The long btH.:cal is a branch of the
m;mdibular nerve (CN V) and provides sensory
nerves lo the cheek, hucn.1! gin_~iva of the poste-
rior mandibular teeth, and bucc.a! mucosa.
26. A. The inferior alveolar nerve (;AN) courses
between the s.phcnomandibular ligament and
the ramus of the mandible before entering the
mandibular foramen. The sphenoman(iibular llg-
arnent may therefore be damaged during the
admlnistration oi an IAN hlock.
27. C, The lateral thoraclC wall of the a.xilla is covered
by the serratus anterior muscle. The anterior
wal; is. covered hy pectora.lls major and pec-
toralls minor. Latlssimus dors\ contributt>s to
the inferior aspect of the posterior wa!L
28. A. The tmchlea of the humerus articulate-B with the
u!na of the forearm, The capitulum of the humerus
bone articulates with the radius uf the forearm.
The coronoid fogs.a, located just superior to the
trochlea, fits the cornnoid proces:s of the ulna of
the forearm. The ,Jlecranon fo~sa of the humerus
flts tht> o!E;cranon of the ulna of lhe forearm. The
1nedial epkonclyle is on the humerus itself and
serves as an attachment site for musdes.
29. C. The trapezius musde i~ supplied by CN XI.
Latissimus dorsi is supplied by the thoraco<lor•
sal nerve, levator scapulae is supplied by the
dorsal scapular nerve, and the major and minor
rhomhol{I muscles are supplied by the dorsal
sc:apu!ar nerv~.
30. C. There are seven pairs of true ribs. meaning they
attach direrUy to the sternum via costal carti-
lages, The remaining five p~ir5 are called false
ribs because they attacl1 Indirectly to the ster-
num via costal cartilages. The last pair does not
attach at al!.
31, B. Thoraclc vertebrae are characterized by a bf'art~
shaped hody.
:~2. B. The sternal angle hctv,-een the manuhrinm and
the stermun marks the position of the second
rib, from this location ribs can be counted
externally, Th!s is important. hecause the first
rib cannot be palpated.
33. D. The rectus <1hdomlnu~ muscle nf the anterol;1t-
eral abdominal wall ls described a.s being belt~
or strap-like. The remaining three muscles of the
i'lnterolateral abdominal wn.H (E'Xternal oblique
musde, internal oblique muscle. and trans-
verses ahdom!nus muse!~) are all described .as
sheet-like, The quadratu.s lurnborum muscle is
part of the pol'itnlor nhdominal wall.
:S4. D. Tbe posterior and anterior vagal trunks pass
through the dlaphrni,;m through the esophageal
opening. The aorta enters the diaphragm
through the medlan arch, the inferlor vena c::rva
through its own oµeninl;l. in the central tendon,
the azy_go5 vein through the right crus, and the
~pl<'lndmic nerves through the crurn.
35. C. The inferior aspect of the diaphragm is supplied
with hlood by the inferlor phrenic arteries. The
median sacral artl"'ry 5upplie!i the anterior aspect
of the sacral are-a, and the lumbar arteries supply
the lower abdominal wall. The celiac: trunk and
superior mesenterlc arteries are both unpaired
branches to the gut and assodated glands.
36. D. Oral epithelium is composed of nonkeratinlzed,
stratified, squamous epithelium.
37. 0. The carHlage of the trachea is covered by a
perichondrium. The mucosa is covered with
respiratory epithelium. Hyaline cartilage ring5
lie deep to the submucosa. The open end of
the cartilage faces the posterior. Smooth mus~
cle extendS- across the open end of each carti•
!age.
38. B. Terminal bronchioles are characterized by cili-
ated cuboidal cells,
39, E. The most superficial layer of the epidermis ls
the stratum corneum. From deep to superficial,
the layers are basaie, spinosum,. granufosum,
lucidum, and corneum.
40. D, Langerhans celts are located primarily in stra-
tum spinos1.1m.
41. B. Arteriovenous anastomoses in deeper skin are
important in thermoregulation.
42. C. The frontal bone of the skull i1 formed by
intramembranous ossification. The humerus,
vertebrae, ribs, and clavide all are formed by
endochondral ossification.
43. B. Osteocytes are found in lacunae in mature bone.
44. B. Eplphyseal closure marks the end of growth ln
length of long hones.
45. B. The branchial arches disappear when the sec-
ond arch grows down to contact the fifth
branchial arch.
46. B. Facial nerves are derived from the second
branchial arch. The trigemfnal nerve is derived
from the first branchial arch,
47. E. in the liver, smooth endoplasmic reticulum is
involved in glycogen metabolism and detoxifica-
tion of various drugs and alcohols; it therefore,
contains P450 enzymes, which are cytochrome~
that are important in the detoxification process.
48. A. Type I collagen is the predominant collagen
found in cementum. Type lll collagen may be
present during the formation of cementum, but
it is largely reduced during maturation.
49, B. In smooth muscle, the binding of calcium to cal-
mondulin wiU activate the enzyme myosin light
chain kinase. This enzyme phosphorytates
myosin. llllowing it to bind to actin, and the mus-
cle contracts. For contraction in skeletal and
cardiac muscle, calcium binds to troponin C.
50. B, The mandibular incisors, as well as the lower lip,
floor of the mouth, tip of the tongue and chin,
prlmarily drain into the submental nodes. The
rest of the mandibular teeth (premolars and
molars) mainly drain into the submandibular
nodes,
51. C. Fibers of the superior head of the Jateral ptery-
gold musde attach to the anterior end of the
dlsc, which helps to baiance and stabilize the
disc during mouth closure.
Answer Key Anatomic Scieno;s Y 351
52. B. The s.uhment;,J artery is a branch uf the facial
artery. Branches of the mandibular division of
the maxillary artery include the inferior alveolar.
de-ep auricular, anterior tympanic, mylohytiid,
inclslve, mental and middle meningeal arteries.
5:J. D. The maxillary nerve (CN V.,) t~xits the skull
through the foramen rotundt~m. lt then passes
through the pterygopalatine fossa, where it com-
municates with the pterygnpalntine- ganglion
Contents of the superior orbital fissure indude
CN lll, JV, V 1 and VI and thi:: oph1halmic veins. CN
Vil and VHI pass through the internal acoustic
rneatus and C:'J V~ (the mandibulr.r nerve)
passes through the foramen ovalc. The foramen
spinosum i5 not associated with any cranial
nerves; It contains the middle meningeal ves~
sels.
54, E. The ahducens nerve (CN V[} provides innerva-
tion to the lateral rectus: muscle, which moves
the eyeball laterally, L,, abducts the eye. The
medial rectus muscle, which is innervated bv
the oculomotor nerve (CN UI), is responsible fo-r
adduction or the eyeball.
55. D. The nucleus amhiguus is found in the medulla of
the bralnstem. It contains the eel! bodies of
motor neurons for CN IX. X and XL The cell
bodies of CN VII, IX and X's sensory neurons are
contained !n the nucleus of the solitary tract.
56. A. The articulating surfaces ot the TMJ are covered
with fibrocartilage. dlrec:tly overlying perios-
teum. The non~artlculating surfaces of the TMJ
are covered with periosteum. The articulating:
surfaces of diarthrodial joints are covered with
hyi'lline cartilage.
57. C. The me~encephalic nucleus contain the nuclei
of the trigeminal sensory nerves (CN V)
hwoived in proprioception and the law ierk
reflex, including perlodo!ltal ligame~t fibers
involved in the reflex. lt is located in the mid~
brain ancl pons,
58. D. The red pulp of the spleen consists of cords,
containing numerous macrophages, and venous
sinusoids. lt is the site of hlood fl!tration. The
white puip of the spleen contains numerous T
and B lymphocytes.
59. R The two vertebral arteries join together at the
border of the pons to form the basilar artery.
Branches of the basilar provide blood supply to
the pons.
60. D. Calcitonin is secreted by parafollicular cells
(clear cells) that are located at the periphi!!'ry of
thyroid follicles in the thyroid gland. Calcitooin
play:,; an important role in the regulation of cnl·
cium and phosphi'lte~. It suppresses bone reah-
sorption, re:rnlting in decreased calcium imd
phosphate relea5e.
61. B. During metaphase, mitotic spindle's form,
Chromosornes attach to these spindles, \vith
their centromeres aligned wltll the equator of
the cell.
352 T Answer Key Ar1atomic Sciucc:~
62. B The oropharynx ls Hned by stratified squamous
epithelium. Thi!i- type ot eplthelium al5o lines the
oral cavity, Jaryngopharynx, esophagus, vaginal
canal and anal canal.
63. E. The mitochondria is surrounded by a double
(inner and oute-r) membrane. The nuclear mem-
brar.e (not listed), whith surrounds the nucleus,
also consists of a double (lnner and outer)
membrane.
(,4. A. The medulla of the thymua contains Hassall's
corpuscles, which consist of epithelial cells with
keratohyaline granules. The medulla is the
lighter-stainini;t (le5s dense) central area of the
gland, where T cells maturation occurs.
65. B, The fovea centralis only contains cone cells. lt is
located approximately 25 rnm lateral to the
optic disc: in an yellow-pigmented area (macu!a
luna). Vision is most acute from this area.
66. C. The roof of the orbit consists of lesser wing of
the sphenoid bone and the orbital plate of the
frontal hone (not listed),
67. D. The elongation and overgrowth of filiform
papillae results ln hairy tongue. Filiform papil-
lae are thin, pointy projectJons that make up
the most numerous papillae and gives the
tongue ·s dorsal surface its characteristic rough
texture. Note; a loss of fiHfonn papillae re~ults
in glossitus.
68. B. Tertiary dentin, or reactive/reparative dentin, is
dentin that is formed ln localized areas in
response to trauma or other stimuli, such as
caries, tooth wear or dental work Histologically.
its consistency and organization varies; it has no
defined dentinal tubule pattern.
69. E. Innervation to the maxlDary second molar, as
wen as the palatal and distobu,:cal root of the
maxlllary first molar and the maxillary sinus, is
provided by the Posterior superior a!veolar
nerve. The nerve is a branch of the maxillary
nerve (CN V,).
70. D. The suprarenal glands secrete epinephrine.
Specifically, chrornaffin cells of the the adrenal
medulla, which act as modified postganglionic
sympathetic neurons that synthesize. store and
secrete catecholamines, produce epinephrine. It
also produces norepinephrine.
7L D. The teres major muscle ls a shouJder muscle,
however, it is not a rotator muscle. AU of the
other four listed ln this question are rotator cuff
muscles.
72, D. The brachial plexus of nerves arises from five
roots from the anterior primary rami of spinal
nerves C5 through C8 and TL
73. B. The right subdavian artery arises from the bra-
chiocephalic artery, and the left subclavian
artery arises from the aortic arch. The subda~
vian artery becomes the axillary artery upon
crossing the first rib. The axillary artery
Answer Key Anatomic Sciences T 353
becomes the braehlal artery when lt leaves the 86. E. Crinary filtrate ls most hypotonk ln the distal coelem that will lead to development of the
axi!la. convoluted tubule. lt ls lsotonk in the proximal amnion, vitelline sac, and chorion,
74. B. The pulmonary vein of the lung carries oxy- convoluted tubule and thick descending llmb of 93. C. Tooth enamel is derived from ectoderm. Dentin
genated blood from the lungs to the left atrium Henle's loop. it becomes hypertonic M lt passes and pulp are der'1ved from mesoderm.
of the heart. The pulmonary artery tarries through the thin descending limb o! Henle, 94. C. The olecranon fossa is located on the posterior
unoxygen.ated blood from the right ventricle of loop, .and becomes hypotonlc as it pa~ae5 surface of the hume:·us.
the heart to the lungs. through the thick ascending segment of Henle's 95. D. The latisslmus clorsi muscl0 ls supplied by the
75. B. The left atrioventricular valve of the heart is loop. Finally, lt becomes increasingly hypotonic thoracnrlorsai nerve.
also known as the mitral valve. The right atri~ as it passes through the distal convoluted 96. C. The middle trnnk nf the brn.chial plexus of
oventricular valve of the heart is also known as tubule, nerves arises from C7.
the tricuspid valve. The aortic valve prevents 87. C. The inner enamel epithelium in the bell stage <lif- 97. A. The first rib cannot be palpated.
reguqJitation of blond from the aorta back into ferentlates into ameloblasts 9:-l. B. Odontogenic infections of a mandihutar indsor
the left ventricle and the pulmon?1.ry vaive pre- 88. B. The dental lamina arises from neural crest cells. with an apex belnw the mylohyoid muscle have
vents regurgitation of blood from the pulmonary 89. B. The correct order of tooth formation is the poten!ioJ to spread to the .submenta! space,
artery Lack into the right ventricle. ameloblasts form, Ddontoblasts form, odonto- lf the apex ls ahnve the mylohyoid muscle. the
76. C. The cricopharyogeus muscle prevent~ swallow~ blasts start to form dentin, ameloblasts start to infection would spread to the s11hlln_gual space.
ing air at the pharyngeal end of the esophagu~. form enamel. Both of these spaces communkate wHh the
77, A. The pancreas is enveloped at its head by the 90. C. The aurkular hmocks are derived from the first subman<ilbu!ar space.
first part of the duodenum. and second brnnchial arch. 99 D. From the retropharyngP.al sp.'lce, Le ... dlmger
78. A. The bile canaliculi drain bile to interlobular 91. C. Reduction division occurs during the first stage space, .. odontogenic infections c,;:in quickly
ducts. The interlobular ducts form right and left of meiosis. The second st.age mirrors mitosis. spread down this space into the thorax (po:.te•
hepatic ducts. These ducts join to form the com~ There is no third stage of meiosis, rlor mediastinurn) and cause possible death,
mon hepatic duct. The gallbladder' arises from 92. C. The embryo develops from the embryonic disc. 100. E. The superior, middle, and inferior constrictor
the common hepatic duct. The: morula, blastocyst, and trophoblast all muscles all insert into the median pharyngeal
79. C. The apex of .e. medullary pyramid in the kidney is include structures of the extraembryonlc raphe (the superior constrktor muscle was the
called the renal papilla. The cortex is the outer only one listed), however, thelr origins differ.
layer of the kidney. The medulla is the inner
layer. Minor calyces receive secretions from the
renal papillae. Several minor calyces join to form
a major calyx.
80. D. Ureters travel inferiorly just below the parietal
peritom:~um of the posterior body wall. TI1ey
pass anterior to the common iliac arteries as
they enter the pelvis.
81. A. The lumen of the: gastrointestinal tract is lined
with mucosa. The rest of the choices are in
order from lumen out. fibrosa and adventitia are
synonymous.
82. A. Gut-associated lymphoid tissue (GALD pro-
duces secretory lgA.
83. B. The muscularj!I: extema has a third layer in the
stomach. lt is an lnner oblique layer of smooth
muscle. In the rest of the digestive tract, the
muscularis externa has two layers; an inner cir-
cular layer and an outer lonaitudinal layer.
84. C. The thin segment of Henle's loop contains
squamous epithelial cells, The proximal convo~
luted tubuie, also known as the thick descend-
ing limb of Henle's loop, the thick ascending
segment of Henle's loop, and the distal convo-
luted tubule all consist of cuboldal epithelial
cells.
85. E. The macula densa is a component of the }uAia~
g:Iomemlar apparatus which functions in regula- ·
tion of blood pressure. The proximal convoluted
tubule. dlstal convoluted tubule, Bowman's cap-
sule, and glomerulus all function in the produc~
tion of urine.
1. B. Cyclo-oxygenase includes tsoenzymes of
prostaglandin endoperoxida~e syntha,;e, which
is required tor the first step in the synthesis
of prostaglandins from arachidonic acid.
Phospholipase A 2, which ls involved in the syn-
thesis of arachidonic acid, is inhiblted by
steroidal anti-inflammatory agents.
2. A. The initial rate-limiting reaction involves the
removal of six carbons from cholesterol and
hydroxylation of the steroid nucleus to produce
pregnenolone. Pregnenotone can be further iso~
merized and oxidized to produce the other
steroid hormones.
3. A. A miceUe is a globular structure that forms when
the polar heads of an arnphipathic molecule
(fatty adds) interact with the aqueous external
environment and the nonpolar hydrocarbon
taUs are clustered inside.
4. B. A ketose sugar is on that contains a keto group.
Glyceraldehyde, mannose, glucose, and galac-
tose are all aldoses since they contain an alde-
hyde group.
5. B. Individuals suffering from mucopolysacchari-
doses have normal production of proteoglycans
and glycoseminogiycan~ but due to genetic
defects, Jack the enzymes which degrade
mucopolysaccharides.
6. E. Arginine is an amino acid that is deaminated to
form omithine primarily in the liver as part of
the urea cycle, Ornithine, argininosucclnate,
aspartate and c!trulilne are generated in the
urea cycle but do not provide free ammonia for
urea synthesis,
7. B.. Both epinephrine and glucagons result in activi-
ties which serve to increase (maintain) blood glu-
cose. Activation of glycogen phosphorylase wili
result in glycogen <legradatlon, ultimately provid-
ing a source of glucose, Glycogen synthase inhi-
bition results in decreased synthesi~ of glycogen,
8. D. Unlike in noncompetitive inhibition, the inhibitor
competes for the same site as the substrate. lt is
therefore possible ( with increased amounts of
substrate) to reach the V1,.._.. Apparent K.,., is
increused since more !ub:strnte is required to
reach 1/2 Vrn~x (the definition of K1,J
9. C. NADPH is required as a reducing agent for the
synthesis oi fatty adds. The hexose nwnophos-
phate pathway also produce.,;; ribose 5-pho~-
phate for nudeotid~ synthesis. No ATP or :\'ADM
is produced in the pathway. Fructose t,&.bis~
pho!'tpllat~ is pro-duced during glycoly1is.
10. D. Oxidatlon of fatty acids, glucagon reltase, and
glycogenolysis are all increased to provide
energy sources for exercising muscle. The syn-
the,sis oi lipid (llpoge:n~sls) would be decreased
during periods or exercise.
11. A. During a fast. catabolism is increased to provide
aidditionnl sources of energy. This ls eharacterH
!zed by increased utllization of fatty acids. When
the production of acetyl CoA {produced by
enhanced f}-oxidation) exceeds the oxidative
c.epacity of the citric acid cyde, ketone bodies
are formed. During fasting conditions, glucagon
concentrations are increased and glycog~ne~t8
is inhibited due to limited energy availability,
Acetyl CoA production in the liver is increast-d
due to enhanced ~-o'.'t:idntion.
12. C. Glucose 6Mphosphate dehydrogcnase and 6-
pho.,:phogluconate dehydrogenase are irre-
ver!ible enzymes in the pentose pho.r.phat~
pathway. Glucokinase is involved with phos-
phorylation of glucose when hepatic concentra-
tions of glucose are high. Glucoie 6-pho~phat~~e
hydrolyzes glucose 6-phospha.te to form free
glucol'e, as the final step~-~~- glucorwog_e_l]esi~.
13. B. Gluco,e transport in (h:~~~ a_g_~,~~
tissue is under the influcncf! of(in~utin-senti:i-
tive glucose transporters. AlthO.\i'gli sev1.~ral
355

metabolic pathways .are Influenced by insulm,
glucose uptake !nto the liver ls not affected by
insulin.
14 D. Phenylketonuria O>KU) is an inherlted disorder
of amino acid metaboli5m in which the affected
Individual lacks enzymes to metabolize ph-eny~
!alanine. Albinism is a condition that re5ult5 in a
defect in tyrosine metabolism and the inability
to produce melanin. Porphyria is an lnherited
disorcler lnvolving defects in heme synthesis.
Homocystinuria is a disorder in the metaholism
of homocysteine resulting ln high levels of
homocysteine and methionine in plasma and
urine.
15. B. Guanine base pairs with cytosine which, on a
molar basis, will also equal 30?4. of the DNA. If
guanine and cyto!.ine constitute a total of 60'.t) of
DNA, the remaining percentage (40%) must be
equally divided between the base pairs of ade~
nine and thymine (20':.; + 2()%_}.
Ht A. Restriction enzymes are also known as restric-
tion endonucleases. These enzymes cleave D>IA
at ,pecific sites to reiease fragments of DNA for
further analysis and charac:terization by com-
plementary probes.
17. B. Tetrahydrofolic acid is the coenzyme form of
folic acid required for the synthesis of nucleic
acids and normal cell division and replic.ntioo,
18. A. DNA liga!.'le is required to ligate the fragments
together. DNA and RNA pnlymernses are cata-
lysts that synthesize DNA and RNA in a continu-
ou5 proce&s. Reverse tnmicripta.,a~ i5 an enzyme
found in viruses that makes DNA by using viral
RNA.
19. C. RNA synthe!is. is not required for genetic
cloning. All the other enzymes are required to
synthe,-iiize and splice DNA
20. B. Vitamtn K is involved with the po~ttramdational
modification of glutamlc add to form y-carbox-y-
glutamic acid. This carboxylation permits pro-
thrombin to interact wlth platelets and ions in
the procesg of clot formation, Hydroxylntion of
praline requires ascorblc acid and iron.
2L D. Chondroitin sulfate is a gluco,aminoglycan
found tn ligaments, tendons, anrl cartilage, It is
the most abundant glucosnminog!ycan in the
body.
22. A. The a chain$ are polypeptides which character-
ize the collagen molecule. The most ahunda!1t
amino acids in collagen are praline and glycloe.
Proline (due to its lmino ring structure), inter-
rupts the a chain, resulting in thf: hending/twlst-
ing of the peptide. Glyclne (due to its small size)
fits Into the smaller spaces of the peptide and is
poi,itione1d at every third position in the chain.
2:1. C. Although fluoride may be incorporated in min-
eralized tissues, it ls not required for the miner-
alization process. Matrix vesicles produced by
osteoblasts are considered to be the initial site
of mineralization. Ame!ogenlns are matrix pro-
teir.s in enamel that regulate crystallite growth.
Phosphoryns are initiator proteins that bln<l
minerals to facilitate nucl~ation and crystal
growth.
24. E. The transport of gluco!-e into masde (and fat)
ceJls is due to the activity of glucose transporter~
(GLUT-4), which does not require ATP and Is inde-
pendent of any ionic concentration gradient ATP
is required for the activity of all other transport
mechanlsms listed in the question.
25. D. Facilitated diffusion does not require energy and
moves down a concentration gradient. Active
tran&port, in addition to utilizing energy, is often
coupled to transport ions in both directions
across the membrane. Both active transport and
facllit.ated dHfuslon are carrier-mediated and
therefore are influenced hy competitive inhibition.
26. B. The salivary glands are influenced by both the
sympathetic and parasympnthetic (gloMopha-
ryngeal and facial) branches of the ANS. The
oculomotor nerve (CN JH) carries parasympa¥
thetic fibers to the eye which. when stimulated,
produces constriction of the puplL The
para.sympathetic system innervates primarily
smooth and cardiac musde, resulting In ipecifk
activation and re~ponses,
27. B. Regulation of blood flow to skin is under the
control of factors acting locally (metaholites)
and u-adrenergk receptors. Slowing of the heart
and activation of gastrointestin~l motility are
mediated through the cholinergic system, a-
adrenergic receptors produce decreal:ed renal
blood flow.
28. ~ a r e the smallest of the sensory and
motor fibers, They are postganglion.ic, UJl!!!Yeli-
nated, and have the slowe"Slconduction velocity.
29. A. Calcium is stored a"ndrefeased from the sar-
coplasmic r-etlculum during excitation-contrac-
tion coupling. This provides an extensive
reservoir of calcium while permitting Intracellu-
lar free Ca2+ to be low when the muscle fiber is
at rest. The release of calcium is due to confor~
mational changes which open Ca2"' channels in
the :o.arcoplasrnic reticulum.
30. A. Calmodulin is a calcium ➔ hinding protein in
smooth muscle which, when bound to myosin,
initiates contraction, Calmodulin activates
myosin kinase, which results in myosin-ac-tin
crosslinklng and contraction of smooth muscle.
31. B. A motor llnit il'I composed of a single motor neu-
ron a?~-- the.. m1,1_scle fibe~_s_jt,ianerv~tes. _Since
the n,o!or neur9o·wilL1Hi11uli:1t~ a_ll_ ~':'s~I_e_fi.Ders
it tnrierVAle5, ;,f~act1005" oi a-motor ~unit C~nnot
be stimulated. The number of motor units
recruited, the number of muscle fibers contractD
ing, and the frequency of stimulation will all
aHe-ct the degree of muscle tension prnduced.
32. B. The sum total of the pre&.'iures moving fluid out of
the capillary is P, (37 mmHi) and x" (I mmHg)
at the arteriolar end and Pc (16 mmHg) and rr1i
(I mmHg) at the vemtl.ar encl. The sum total of
the pressures moving into the capillary is P.,
(0 mmHg) and r:P (_26 mmHg} The net exchange
pressure on the 21rterlolar end leads to ultrafH~
tration (12 mmHg). On the venular end, reabs-
orption occurs (9 mmHg). Overall net exchange
results in 3 mmHg of fluld los5 out of th~ capiH~ry.
33. C. Cardiac output is the volume of blood pumped
per minute by each ventricle, This is influenced
by cardiac rate and stroke volume ( end-diastolic
volume - end~systo!ic volume). The cardiac out-
put for this patient is 70 x 11n mL or 7,700 ml
per minute.
34. B. The velocity of blood !low is the rate of dis-
placement of blood per unit time. Velocity
chanies inversely with cross-sectional area
(cm 7). The greatt":r the area ln the vessels, the
lower the velocity. Since blood is alway·s flowing
due to the rlistensnbll!ty of the arterlal tree,
velocity is never zero,
35. D~ Decreasing total peripheral resistance would
produce greater reductions in blood press:ure.
Due to the: baroreceptor reflex, cardiac heart
rate would increase. lncrea5ed stroke volLJme
( due to increased venous return and sympa-
thetic stimulation of cardiac muscle) would al:to
occur. Increased cardiac output would occur
due to increased heart rate and stroke volume,
36. C. Although some CO2 is transported unchanged in
the plasma and in the red blood cells as car-
harninohemoglobin, most ls transported ln the
form of bicarbonate ion in the plasma.
37. D, The most potent stimu!ant of the respiratory
center that increases the rate oi breathing
(hvperventilatlon) is increased CO~ tension. CO,
is Permeab[e to the blood-brain b;rrier and ulti:
mately produces an increase in H"' of the cere-
bral spinal fluid. However. plasma H"' and HC(\-
are not permeable and thus have little direct
effect on the respiratory center. The respiratory
center is not sensitive to oxygen tension, unlik~
peripheral chemoreceptors.
38. A. Hemoglobin is a g\ohular protein responsible for
transporting most of the 0, in the blood. The
perc~nt saturation of hemogiohin i, n function of
the PO,, of the blood. The relation:,:hip of PO., and
hemoglobin saturation is not linear but, rather.
sigmoidal. Percent saturation increases greatly
at low PO> and less at higher PO,,. Increased
PCO2 , temPer~ture. diphosphog!yc-e;ate. and H'
decrease the affinity or hemoglobin for 0 1 but do
not alter the charaneristk slgmofdal m1ture of
the saturation curve.
39. E. Renal clearnnce is the volume of plasma com-
pletely de~red or ll substance by the kidneys per
unit of time. The renal clearance of glucose is
usually O since. although it i.s filtered, it is comM
pletely reabsorbed when the plasma glucose
concentration ls within normal levels. In the
uncontrnlle-rl diabetic, plasma glucose levels
Answer Key Sloche-rni~try and Pt;y,<ology .,. 357
excl!cd the reahsorptive capacity (T") and it
then appear~ in th1.:: urlne. Ur~a ls filtered amJ
passively n:nbsorbf'd to a slight degre0.
Creatinine is both freely filterNI atl(I secreted lo
a sHght extent. Sodium and water are Wtered
.and reab!)orhed to various degrees clue to phys•
iological regulatl0r: of aldosterone and ADH.
4(l D. In the ascending (distal; loop ot Henle, active
sodium absorption resu!ts ln an increased osmu~
larity of the interstitial fluid, which.i)fafs..a·m1e
in the retention of water under conditions of
deh)'(_~ratlO:n:
41. C. Under conditions of expan5in11 of txtracet-
lular volume (long-term hyperl~osion). renin
release and ald0s-terone secretion are reduced.
lm:rc-nsing ADH. i:mginten~in H, and increasing
sympathetic ncUvity would result in an
increase in blood pressure,
42. D. Potas;;ium is passively (via the cotran~port sys-
tem) secreted from the plasma into the distni
~nd cnrlectlng tubule~. Under conditions of aci~
dosis, an individual may become hyperktdemic
since the kidneys will retain K' and secrete H;.
Under conditions of aika\osis, K 1 sec-relion \Vi!l
be increased and H+ secretion reduced,
i3. C.
0 Saliva is formed by a prnce5s that first lnvolves
the formation of a solution by the at.:inar cells,
which !s subsequently modified by tiie·ifuCtTfe
cells to produce a more hypoton\c solution
(compnrecl to plasma). The modifiCatinn prima-
rily involvl'!"~ the reabsorptio1~. QLsodium. and
chloride and secretion 01 pi>tassium and bkar~
bonate. As s.ahvary flow incr~aset. the ductile
cells have less time to modlly the compositio:1
of saliva, which results ln greater conc-e_t~~rntions
of socliu.m-. mtd chlC?~~~Je. --· i(H\S. Bicarbonate
concentration increases as sal!vary f!O\V
increases due to the selective stimu!.ntinn of
bicarbonate by the parasyrnpMhetk: system.
The salivary glands are prii"!larily ur:der the
regulation ot' l::_.i}!h branches of the auton(11nlc
nervous system.
4·1. A. Secretory IgA i~ an lmrnunoglobulin tl:at is
unique to the oral C'~Wity. The secr~tory compo-
nent is synthesizt:d by s<1livary epitlu·lml celli
and complexe~ with lgA to form secretory JgA.
45. C. Vitamins are not d1gPstf'.<i by enzymes trom the
pancreas; hmvcTer, digC'~tion nf carbohydrntcs,
fats, and prot~in!'t rn.ay be required to n:1ui:~ vita~
mins 2ivai!t,hle for abso:ption. The pancreas
produces amy!Mt· for carbohydrate digestioa.
!ipl'l5e for lipid digestion, and sever;:;] prott:olytic
cn2yn1c3 (trypsinogen. chymotrypslnogen, and
procarhoxy--prptidase) for the dige:::;tion of protein.
46, B. St-cretin :c1tlmulates bicarbonate secretion from
the p,nncreatic ducts. Cholecystokinin (CCK) is
responsible for stimulating p;mcreatk enzym~
secretion and contraction of the gall bladder.
Chyrnotrypsi~ogen i~ activated by trypsin in the
lntestine.
358 • Answe-r Key
Answer Key Bioch,:smistry ,md Physiology T 359

D, 56. C. Acetyl CoA. !'vfo!onyl CnA is prnduced fnllowlng D. RNA polymerase is an enzyme that tra:1scribes syrn1v:th,,tic po:,;tgangllunic fibers innerval-
carhoxylalinn of CoA in the DNA into Rl\lA chains. Synthesis is similar to heart nor0p!nephrilw.
p:-ncess of fatty Ei\D and are DN \ reproduct!on since sv11theslzed ➔ 3~,
involvect acid oxidation but NADPH B. A probe is single strand
protein the source oi agents in the synthfsls of \Vith a ra<lioisotope that is crnnplimenlary to a
and inositol trispho{'ph~tte fatty acids. segment of DNA of interest.
release oi caklum from intracellular stores. 57. B. This complex cnn be analyzed ""'''"c'cjUC>" Ii, B.
D. Vasopressin, atso known as ADH (antldiuretic technique known as a
hormone), is a peptide secreted from the poste- !)hate. This irreversible reactlon by 66. A. DNA ls a double stranded moleculi;,,
to an increase in sernm ATP and citrate (indicators of energy abundance base to and
nHwemf'nt
osmnlarity. hormones !Jsted are syn• within the The reaction is stlmuiated by guanlne to respon:sibh 0

the.sized and secreted from AMP. amounts o respiration. The cerebral cortex
49. A, Estrogen is steroid hormone and C. Pyridoxal phosphate is the .:u:tive cot:nzyme of RNA or mf performs of perceptinn, cognition.
does not require a mernhrane pyridoxine, which is Involved in a numher of will higher motor iunctions, memory. and emotion.
second messenger cAMP. hormont:'.s essential for normal amino acid D, Th of 78. B. tn the of muscle ton traction, ATP bouud
directly enter the cell and stimulate intracellular Biotln is for carboxylation sugars ( deoxyrlhose or ribose) joined
receptors. Peptide hormones and those derived Tetrahv,lrofol,,to. the coenzyme form 68. B. Transl1:1tlon the conversion of information
from amino acids are not readily lipid-sol~ of fol!c acid, is required for the synthesis of from mRJ'\A into protein. Transduction Is the
uble 1uwnm•crn;uc of membranes) and thus n.udelc adds and lncorporation of gem?tic information carried by are :nvo1vc-d the exdt::ltion-con-
requ! and a second mes~ a virus into bacteria. tral'tion coupling process but do not a
seng etc.), of the 69. A. Nlnety-five percent of enamel is inorganic min- source of energy.
effec enirnent11·ine no1reninenhrine and sources eral with 84% in calculus, 70'}{, in 79, A. Stretching of muscle spindles results in reflex
all o dentin, 60'¼ in bone, that intended to adjust the muscle to its rest-
cAMP. Upolysisoxidation of free fatty 70. C. tRNA is not for the hydroxylntlon of by contracting the rnuscle in vvhich it
50. C. Phosr,hocliesterases are intracellular enzymes that adds are also unnecessary during this time. collagen since process occurs after transla- is The strPtehing of the
cyclic nucleotides, thus the Glucagon release is inhibited due to elevati;:d tion o! rnRNA and synthesls of affererit impulses to the spifml cord r,nd
of cA1\1P to a metabolite, 5" glucose. Gly\oiysis Is increased due to elevated Ascorbic acid is requfred to a monosynaptic reflf'x stimulates muscle con-
second rnessenge!'" properties of cAMP. imraceilular glucose. molecule by uyun>Aymuue permit traction via an alpha motor neuron.
Adenylate cydase is an that catalyzes the 60, A. In the Irreversible oxidative decarboxylation cross~llnking among 8{l A. Muscles are innervated by two types of motor
conversion ot ATP to Monoarnine oxldase of pyruvate to acetyl CoA by pyruvate 71. C. Substitution of most ions of neurons (alpha and gamma)" Tlw alpha motor
(MAO) is an enz_y111e !ocated in presynaptic nerve clelw,clrc,eena,,e. the five coenzymes llsterl are fluoride) will increase the solubllity of fibers
terminats that deb,rr;vle$ dopamine, norepinephr!ne, ta! structure. The ratio of calcium and gamma motor
and epinephrine to inactive substances. Aspirin 6] B. hy1:lroxy;ipatite is 1.67: L neurons innervate the n1usde spindles (intra-
inhibits prostaglandin synthesis inhlhiting the 72. B. fusal musck: fibers). The muscles oi the lrls me
found in cartilaginous structures" controlled
51. E. cn,ira,ctor,z,w as having tensile strength
hyperglycemia would result due to increased and found in skin. tendon, and dentin.
gliirCOne,,gcne;;;s in the liver. Glycogen break~ Type lli collagen is characterlstkally more dls-
connective tissue down be enhanced and glycogen synthe- tensib!e and is found in large biood vessels. system and regulatory in tile
such as cornea, chondro!tln sulfate in cartilage, sis decreased, Since insulin pmmotE's amino IV found ln basement membranes, Gl tracL
and tendons and dermatan sulfate in add uptake in the liver, lack of insulin would 73. C. acids are transported across the lumlnal 81, B. Nitric oxide a molecule produced in
result in decreased uptake. surface of the intestlne Na1 amino acid co- endothelia! cells th.:1t acls clin~ctly on smooth
62. A. Following a meal, chylomkrons are synthesized transr,oners in the nwmhrnne. This is
in the intestine to to the '.Iver. ~n- gradient established in the tlon.
would
53. B, lnhibi
human and therefore we require cell memt,rnr1es reduce blood presscre- since aJ1giote1~sin H
in the from plant or bacterial sources. molecule for storage and transport of stimulates aldoster resulting in
All of the othE'r amlno acids can be synthesized Phnspho!iplds are abundant they ;;ng10Hc1isi11 ll is also
humans from other cnmpou11f!s and there- is not elevated under concHtlons bilayer structure characterlstk of membr;uws.
are not classified as "essential.., t'levated ener1:,,,Y sources in the post-absorptive Proteins are present and serve various functions
5,L A. Aspartame is a derivative composed of state. as receptors, and trnnscrnters'rnrri• would blood pressure,
add phenylc1lanlnr,., 63, A. lnsulln !s a hormone that is secreted under con- cno1este1co1 stabilizes the the baroreceptnr would produce reflex that
5S. B. degrade purine nucleotides to uric acid. dltions of Increased sources of energy (glucose)' for the would reduce cardi~H' output and periplwrni
Xanthine is an intermPrllate in a series of reac- and thecforc results in increased uptake and spnmgn11p1,1s are m1nrnments
tions, hut the fln.:11 product in hurnans is uric storage the form of glycogen, In th~ insulates membranes neurons. 82. B.
acid which is excreted in the urine. is the process, glucose decreased. The trans- C. Monoamlne oxidase is an enzyme located in the
degradation product of cnmpotmds containing port of glucose into the brain is not affected by presynaptic nerve terminal, which degrades extrnc•,•Jl,.,10, fiuld: the other ions arc in gre,.,itt'r
amlno groups (amino acids). the hormone. dopamine, norepinephrine, .:1nd eplnephrine to concc-ntratlons in t:xtrace!!ular fluid corn\J:trvd
inactive substances. with values withln tile cell,

83. A. All the other factors will prodt:ce vasodilatlon
and hyperemia to increase the exchange oi
metabolites in the tissue.
84, D. C~pillary bluod flmv is propNtiona! tD changes
m the radius (r;-) of the vessel. Decreasing the
radius would produce increa:;ed vascular pres-
sure. Viscosity of the blood depends primarily
on the hematocrit (percentage of red blood
cells) and would not be ;::hanged by changes ln
the radius of the vessels.
85. D. Under conditions of increased intracrnnia! pre~-
sure, lhe vasomotor regions of the medulla are
stlmu!ated due to localized ischemia resulting ln
an increase in systemic blood pres.sure.
Ventricular fibri!lation is irregular. rapid, unco-
ordinated contractions of the ventricle that do
not resuH in effecting blood movement.
Anaphylactic shock is caused by severe allergic
reactions, widespread release of hista;:nlne, and
subsequent vasodHatation.
86 A. Surf;H~tant is synthesized by alveolar cells and
functions to r~duce the surfac,: tension of the
alveoli. This reduction of surface tension
increases pulmonary compllance and decreases
the work oi breathing, lt wili also decrease the
tendency of the lungs to collapse. Lack of sur-
factant results in neonatal respiratory distress
~yndrome.
87. C. Residual volume is the volume of air remaintng
after a maximal forced expiration. Tidal volume
ls the amount of air exchanged (expiration and
inspiration) during normal quiet breathing.
Functional r~sidual capacity is a combination of
the expired reserve volume (forced expiration)
pins the residual volume. Vital capacity is the
volume of alr expired after maxim-al inspiration.
88. B. The regulatory centers for respiration are in the
brain stem-specifically. the medulla, The
medulla contains three groups of neurons
(medullary respiratory center, apneustlc center
and pneumotaxlc center). The cerebral cortex
may influence the medullary centers but does
not totally control respiration.
89. A. Atdosterone secretion is mediated through the
renin-~ngioten5in system. Anglotensln H stJmu-
lates the ~ynthesis and release of aldosterone
from the adrenal ~land. lt acts on the distal
tubule and collecting ducts to increase sodium
reabsorption and potassium S<"CTf'tion,
90, A. Net filtration depen<l,i: on the hydrostatic pre$-
sures in the glomerular capillary, the hydro~
static pressures in bowman's space, and the
oncotic pressures in the capillary and bowman's
capsule. Reducing the plasmn protein (reducing
the oncotic rressure) will lower the tendency to
retain fluid in the capillary, Thls would result in
a net increase in filtration.
91. B. Increasing the hydrostatic pressure within the
glom~rulus woutcl decrease the net uitrafiltra-
Answer Key Biod,ernfotry and Physiobgy Y 36 1
tlnn pressure, Reduced plasma protein concen- and target tissue. Paracrine refers to the target !ol!k,:hlr phase. During menstruation there un:
tration decreases the oncotic pressure ln the tissu~ as a cell in close proximity to the secret~ sharp declines in ~strogcn an<! progcsternnt'
plasma which would increase llltration. ing tissue. Aotocrlne stimulation refers to cell due to reduced secretion of LH a~1d FSiL
Vasodilation of the afferent arterioles would 100. C. Glucagon is secreted from tlw pancreas m
that release!'!: a fat.tor (hormone") whirh stimu~
increase capillary -pressure .- resu-Hing •---In~
!ates the cell frorn which it was released. respons0 to rNluccd plasma glucose due to
incre_ased-- fHtratior. .. lnulin, although used to faslint.l and exerdse. !t functions to mobilize
Endocrine tactors are hormones that have an
mea:;uri? g!omcru!ar filtration, does not affect .
effect at a distal site in the body. energ}-' stores (glucose) and return hloud glu~
glo01erular fjltration .ra~~:_ .. :·· ----. cose to r.nrmal level!.. Glycogen iynthesis
9ft. B. Proge5terone ctJncentration in blood is highest
92. C. Under normal conditions, an :il~C~;s·e-,s--rca1)M rollmv!ng the surge or LH (leuteinizing hormone) (glycogene5is) will not occur in respon,e to
sorbed by both secondary active tnmsport sysM glucagon.
fofinwing ovulation, Ouring ovulation, estrogen
tems and racilitated diffusion utilizing GLUT 1 surges due to pos:tive feedback during the
and 2 carriers. Ca)dum is passlve!y reabsorbed,
hut its reabsorptlon is aiso reguiated by
parathyroid hormone in the distal tubule, Not al!
urea is reahsorbed but ahout halt is excreted. Its
permeabllity ls altered by c:hanges in vnsoM
preMin. Phosphate reabsorptino is also regu-
late{! by p~r-l'lthyrnid hormone
93. C. The movement of the tongue against the palate
is the only voluntary process among the four
pos~ib!e answers,
94. A. The gastrointestinal tract is regulated by both
the sympathetic and parasympathetic brnncl.es
of the autonomic nervous system. The parasym-
pathetic system is stimulatory and the sympa~
thetic system inhibitory. The CNS does influence
motility and secretory activity through the auto-
nomic nervous system. Numerous endocrine
factors (secretin, gastrin, chole-cystokinin, etc,)
are also involved with the regulation of gastroin-
testinal activity.
95, C. The salivary glands are under the influence of
both the sympathetic: and parasympathetic
nervous sy·-stem. Parasympathetic stimulation
results in a more watery secretion compared
wjth sympathetic stimulatlon, which produces
incr~ased amounts of proteln with reduced vol-
urne. The vagus is parasympathetic. which in
gener?il is stimulatory to gastrointestinal tract.
In general. sympathetics are inhibitory to the
gastrointestinal trncL (The exceptions are sail-
vary gla:-ids.)
9G. C. Fat in the intestine, low pH, and increased osmo-
larity of intestinal contents will reduce ga5trk
emptying. This reflex is mediated thro,1gh neu-
ronal and endocrlne factors comprising the
enterogastric reflex. Salme in the intestine will
not affect gastric emptying.
97, B. Thyroxine an<! triiodnthyroninf' are formed by the
cleavage of thyroglobulin following stlmulatinn
by TSH. Most thyroxine is converted to tri-
iodnthyronine in liver ,;1nd kidney. Thyroglobulin
i.s the storage form of thyroid hormone. TSH (thy~
roid-stimulat!ng hormone) is prnrltKed in the
anterlor pituitary. a is not a hormone secreted
from the thyroid hut acts to stimulate the synthe~
sis and secretion of thyroid hormones.
98. A. The terminology U6ed is a classical descriptor of
the relationship between the hormone source
l. B. Neutmphils are quick to arrive to the ~ite of
infection or injury and are therefore t\ssociated
with acute inflammiltion. All of the other cells
listed afe mediators of chronic lnflammzition
2. C. Dust cells. along with he.art fail cells, are
macrophages that are found in the lungs, They
are part of the reticuloendothelial system.
3, E. Bacteria that are phhgocytosed by macrophages
are kept in m~mhrane~bound vacuoles called
p!wgosomes, A phagosome will fuse with a iyso-
some, which contains many degradatlve enzymes.
including lysozyme.
4. C. Although lgE is the least prevalent immunoglobu-
lin in the body. lt is the major antibody mediAtor
of type I hypersensitive reactions. These reac-
tions are caused primarily by prior sensitization
and the acr:umulation of lg£ to a specific allergen.
S. B, DlGeorge·s !'lyndromc is characterized by a defl~
ciency of T cells. It is caused by the failu1·e of the
third and fourth brachia! pouches to develop
normalfy, resulting in a lack of thymus -,nd
parathyroid development.
6. C. lntraoral Streptococcu.'f ;Jiridans is the most com-
mon cause of subacute e-ndncarditis. Staphy-
lococcus uureus is the most common cause oi
acute endocardltfs.
7. D, Aschoff bodles are the classic lesions observed
in rheumatlc fever. They are areas of foc:al necro-
si~ surrounded by a dense inflammatory infiltra~
lion and may be observed in heart tissues.
8. A. Fndotoxln or lipopolysaccharide is found in the
cell walls of gram-nt-gative bacteria,
9. D. Endocarditis 1S most corr:monly caused by
group B, ct-hemolytic streptococcl, such as S.
oirirfons, S. matans, S. sanguis, and S..m!icarius.
All of the other conditlor.s ztre associated wlth
group A. !)-hemolytic ~treptococ('a! infections,
such a~ S. pyogcnc•;.
10. A. Tile only disease llsted that is related to an
abnorm.ul number of chrornn~omes is
Klineklter's syndrome, This disease is charw::-
terlzed by t\vo or mnre X chromosomes and one
or more Y thromosnme. TypkaUy, those aHected
have 47 chromo.$Otnes witll a karyotype of XXY.
l l. C. Po!':mphigus is an m1tolmmunc (lisease wherein
autnantihodics against -epidermi~ cells are pro~
duced. Ht:o;tologk:aily, a. phennnwnnf' called acon-
tholysis, wherein epidermal cells ilfJl)E"ar lo detach
and separate from each other. is observed
12. E. Chronic brnnf'hitls prerlispnses those r(ffected
to squ.:unuus neop!asia of the bronchi;:il epithe-
llum (Le., hronchngenlc carcinoma)
B. A, Chmn!c gram1iomatosis results from neutropbils
with D defective NAPDH oxidase system, This
afft·cts their ability to kill mlcrnorg~rnisms, since
they an: 1.mahli~ to produce siqwmxide radical!>
14. B. Dys plastic cells are ahnnrm;il in appearance and
organization. The potential to develop lnto a
nrnllgnant tumor l~ pres{"llt; hmn'ver, tll!s risk
varit>s.
15. 0. HiV's enveiopt' contains two g!ycoprntelns,
gpl~O and gp4L gp120 binds specifically with
CD4 surf;;.(·e receptors,
lfi. A. The most common cause o! gastroenteritis in
children i~ tht• rnt,wirn,. lt is found in the
reovinis Family.
R Radlogrnph!c flndingi;. of a cotton-wool appear-
;111,e ls common in p,1:iell!H dic1gno~ed with
rniteltis clefonrnui:> or Pag~~i':-. disease.
18. B. lwtodavcs ftrncthm by denaturing proteins.
They c.rc eifective agalnst spores.
19. B. Ehiers-Dmilos syndro1m:s are dwracterized hy
defects in collagen (i.e., cnrmective tis:-ues)
363

20, R increased levels of alkaline ph(Jsphatase n:ay
be observed in diseases that di6pl~y extensive
bone loss. Osteoporosis is characterized by a
decrease in bone mass. There ar~ either nor~
ma! or decreased levels of alkaline phos-
phatase ln patients diagnosed with this
disea:se.
2L C The leading cause of death for diabetic patients
is cardiovascular disease. Other complicalion5
include retinopathy, nephropathy, and perlph-
eral neuropathy.
22. A Neuramlnldase is found on the surface envelope
of influenza viruses. lt functions to attach the
virus to the host ce]L
23, D. Actinic keratosis f}roduces dry, scaly plaques
with an erythematous base. They may be pre-
maHgnant Both compound and intraepldermal
nevi are benign. As to nevi, only junctional nevi
are considered to be premaJlgnant.
24, A. Hepatitis A is spread via oral-anal/fecal contam~
inatlon. The other hepatitis viruses can he trans-
mitted through blood, sexual contact, and/or
perinatally.
25. E. Cardiac tamponade is a serious condition
caused by accumulation of fluid in the peri-
cardium, This can result in impaired ventricular
filUng and can rapidly lead to decrea~ed cardiac
output and dealh.
26. C. Pyelonephriti1 ls usually caused by gram-n.ega-
tive, rod-shaped bacteria that are part of the
normal flora of the enterk tract. lt is most com-
monly caused by Escherichia coli, fot!nwed by
Proteus, K!efuiella, and £ntemhacter.
27. D. Polycystic kidney disease is characterized by
the formlltion of cysts in kldney. U is commonly
associated with berry aneurysms.
28. D. Squamous cell carcinoma is the most common
oral cancer, occurring in 90'.Y, of all cases, it is a
cancer of squamous epithelium, speclfical!y a
tumor of keratinocvtes.
29. E. Both Epidermoph}·um and Trichophyton can
cause tinca pedis.
30. A. Steno.sis describes fibrotic and thickened
valves, resulting in reduced blood flow through
the valve.
31. c. Cyilk fibrosis results from an ahnormal chlo-
ride channel that affects all exocrine glands,
32. B Trisomy 21, which is also known as Down .~yn•
drome, is a disorder affecting autnsomes. It is
generally caused hy meiotic nondisjunction in
the mother. which results in an extra copy of
chromosome 21 (trisomy 21).
33. D. These oral findin1:s can be observed ln patients
with hyperthyroidism. The oniy endocrlne dis-
order listed that ls relnted to hyperthyrolcHsm is
Ptummer·s disease. It is caused hy a nodular
growth or adenoma of the thyroid.
34. D, Poststreptococcal glomerulonephritls is a clas-
sic example of nephritic syndrome, which
occurs after a Streptococcus infection ( e.g., strep
throat), lt is characterized by al! of the symp-
toms listed except po!yuria. A decrease in urlna-
Uon is usually observed.
35. B. O,;te-omyetitis, or an infection of bone, i5 most
commonly caused by Staphylococcus aureus.
Symptoms indude pain and systemic signs of
infection (i.e., fever, malaise).
36, E. All of the features listed are commonly observed
in malignant cells, except a low nuclear- cytoplas~
mic ratio. Due to the large nuclei present, there i!
usually a high nucicar<ytoplasrnic ratio.
37. E, Carcinoma in situ. Although the cells have not
yet lnvaded the basement membrane, the likeli-
hood of invasive growth is presumed to be high.
38. D. The Western blot tests !or HIV protem•. The
ELISA tests for HIV antibodies. When these two
tests are used together, a 99'¼ accuracy rate is
achieved.
39. C. Since 90'X, of hlood transfusion-related hepatitis
cases are caused by hepatitis C, and the patient
has a history of having had a blood tran~fusion,
the answer is C.
40. D. Opportuni~tic infectlnns are a serious problem
with patients infected with HIV, Th.is patient's
intraoral thrush is such an infection. which is
caused by Candida a!bicans. Treatment for can-
dld!asis Includes oystatin.
41. C. The H!V is an RNA virus thnt contains three
enzymes: reverse tnmscripta!'Je, integra1e, and
protease, Neuramlnldase ls a protein found on
the surface of the influenza virns.
42. C. Although all of the microbes Hsted cause pneu-
monia, the most common cause oi pneumonia in
patients wlth AIDS is P. jiroveci ( carinii).
43. A. McCune-Albright's syndrome is a type of fibrous
dysplasla that presents with a triad of sympM
toms indudlng polyo5totic fibrous dy5plasia,
cate au lait spot~, and endocrine abnormalities.
44, B. Fibrous dysplasia is caused by replacement of
normal bone with an irret,rular bone containing
fibrous connective tissue. This gives the radi-
ographs a characteristic ground glass appear-
ance.
4S. B. Fibrous dysplasia is caused by replacement of
normal bone with an irregulnr bone containing
fibrous cnrmective tissue. Therefore, the pathol-
ogy report usuc.lly de-scribes abnorn1ally shapt!!d
trabecula.e in loos~ly arran~ed fibrous tissue.
L16, D. The panial thromhopla~tin time (PTT) test
measures the intrinsic and common pathways of
the co<11'ulation cascade. A prolonged PTT could
result from a dcfidency of factor V, VIII, IX, X, XI,
or Xfl or of prothrombin or fibrinogen.
47 C Hemophilia A is caused by a de.fidency of factor
8 (<t0tihemo11hllic factor).
48. C. Hemophilia A is a hereditary disorder thal Is X-
Hnked; thus, lt only affects mal-es. However,
females can be carriers.
49. B. ~!lie only way to distinguish hemophilia A from
hemophilia B is to assay the levels of c.oagula~
tion factors. HemophHia A is cau.sed by a clefi-
clency or factor 8. while hf'mophilia Bis caused
bv a deficiencv of factor 9.
50. C. G~mmas are g~anulomas that may be seen inter-
tiary syphilis. Since syphills is caused by
Treponem,o pa!lidum, the correct answer is C.
Granulnmas may also be seen in tuberculosis, an
infection caused by Mycobacterium tuberctJiosis:
however. in this disease, they are known as
tuhercles.
51. A, CD8 lymphocytes recognize class l MHC mole-
cules on antigen-pre~~nting cells. CD4 lympho-
cytes recognize cla.,;5 U MHC mnlecules on
antigen.presenting cells,
52. E. IL-5 is released by helper T cells to stirnula:e B
lymphocytes to differentiate into plasma cells, It
also activates eosinophils and increases the
production of fgA.
53. B. Tuberculin reaction (Le. PPD skin te,t). is an
example of a type IV delayed (cell-mediated)
hypersensitivity. Type rv reactions are the only
type of hyp~uengitivity immune reartions that
are nDt mediated by antibodie~. They are mainly
mediated by T cells.
54. D. Mast cells contain dense granules with inflam~
matory mediators, inrludlng histamine and SRS-
A, which is a leukotriene.
55. C. Symptom~ of a myocardial infarction lndude
chest paln, shortness of breath, diaphoresis
(sweating), clammy hands, nausea, and vomit-
inir:.
56. B. A quelling reaction occurs in a laboratory when
the polysaccharide c:npsule of a bacterium swells
after being treated with antisen1m or antjbodies.
57. E. DipicoUnic acid i6 only found in spores. Since
C1ostridium is the only ~pore-forming mkroor-
ganJ5m listed, the correct answer is E.
58. D. Dextran:s consist of glucose molecules linked
together. Th~y not only act as the structural
component of pJaque, but they also contribute
to the retention of lactic add near the tooth.
Fructans or levans are also found in plaque;
however. they contain fructose.
59, C. The most common r;;use of bacterial menln_gltis
in newborns ls Escherichia coli. Haernophilus
influen.:.:.ue and Neisseria mcningitide,1 are the
most common cause of bacterial men!ngit!s in
lnfants/children or young adults, tespective:ly.
60. D. Teichoic acid may be found only in the cell
walls of gram-positive bacteria and contain
antigenic properties. All of the other answers
IJ:"'lted are found in the cell walls of gram-nega-
tive bacteria,
6 L B. The tetanus vaccine consists of tetanus to:xoid.
It is part of the DPT vaccine and should he glven
about every 10 years.
62. A, lgA is found in mucosa! secretions of the geni-
tourinary, intestinal, and respiratory tracts,
including tears, saliva and colostrums.
Answer Key Micr-obiology and P11thology 'f' 365
G3. D. flBeAg is present when lhere is active vim! repli·
caUt,n and the carrier is. highly mff'ctious.
64. C Opportuni~ric infrx:tions are seen in p<'llients wlth
AIDS. AH of the following microhE's re-prt'sent
opportunistic organ is mt except coxsackievlrus.
65. L Rl1r11m~1toid arthritis is characterized by inflam-
mation of the synovla\ membrane. Granulatinn
tissue will form in the :i;ynovium and expand
over the 1:1rtkuiar cartilage. This causes the
destruction of the underlying cartilage and
results !n flbrotlc changes or ankyln5i5,
66. A. The most common form of bre,1s.t cancer ls ade-
nocarcinoma arising from the duct;:il epithelium.
-67, £. Both tetracycline and streptomycin, an arnlno-
glycoside. inhibit proteir: synthesis in bacteria.
Streptomycin, however. is hacterictdnl, not ba<>
teriostatk.
68. D, Rickets ls a vitamin D deficiency seen ln Infants
and children. Oral findings indude a delayed
eruption 0f teeth mKl abnormal dentin.
69. D. 12 hours is requir~ci.
?n. C. Cretinism is hypothyroidism ln children. Oral
findings include macroglossla, prolonged reten-
tion of primary teeth, and delayed eruption of
permanent teeth.
71. A. In general, plaque b first colonized by grnm-pos~
itive, cocci bact-e-ria, such af: Streptococci, They
are followed by gram-negative, rod-shaped
anaerobes, like Bocteroides, Frtsoba(·terium,
Porphymrrwnas, Prcuote!!a, and then filament•
type h3cteria. such M Actitwmyces.
72. A, Peutz-Jeghers syndromP is n hereditary disease
that ls transmitted by <mtosomal domlnr1nce.
73. C. Although all of the structures listf'd are commnn
sites for oral cancer, the lower vermllion border
of the lip is the most common oral site.
74. C, Auer rods lire observed in blast cells character-
istic of acute myelogenous leukemia.
75. A. Complications of Barrett's esophagus include:
t1denocarcinoma, stricture formation, or hemor-
rhage (ulceration).
76. A. M-protein is an import,mt virulent factor found
only in the spedes Stn.•ptococrn5 pyog('nes.
77. D. An infection by molds, such as mucormycosis.
results in thP lnvaslon oi blood vessel cndotlw-
limn, Thls leads to hemorrh;igic iniarction ,md
Ussue necrosis,
78. 0. Chronic lymphocyti-:· l0,ukemia ls charnctel'ized
bv Uw proliferation of B cells. It is both the most
c;Hnmnn and least m,1:!ignant type of leukc-mi<1.
79. B. Consequences of asbestosis include mesothe-
lioma an<! bronchngcnic carcinoma.
80 D. J<1rn1flke Ls characterized by yellowness of tls~
sues, including skin, eyes. and mucous mem-
branes. I! is caused by diseases that increase
serum conjugated and/or 111\tonjug<.HNl billru~
bin. These conditions include liver {liM.ase, such
as cirrhosis or hepatitis; he-mnlyl.lc anemias:
obstruction of the common bile duct, as caused
 by gailstones or cholelithlasis; and carcinoma
involving the head of the pan..:reas.
81. D. Asthma is an obstructive lung disease caused by
narrowing: of the airways. Common symptoms
indude dy!pne-a, wheezing on expiration, and a
dry cough.
82. C. Sy~temic lupus ervthemato~us, also known as
lupus, is com~ider'ed an autoimmune disease,
althou2h the exact cause is unknown. It is char~
acterized by the presence of antinuclear anti~
bodies (ANA). Common ANA findings mdi;de
anti-D1~A. anti-RNA, and anti~Sm antigen.
83. A. Due to the excessive l:evels of serum calcium,
osseous changes, such as metastatic calcific:a~
tions and kidney stones, will occur in patlents
with hyperparathyroidiinn.
84. C. Osteopetrosls. also known as Alben-SchOnberg
disease or marble bone disease, ls caused by
abnormal osteoclasts, The lack of bone resorp-
tion results in defective bone remodeling and
increased bone density, which may invade into
the bone marrow space.
85. A. Whooping cough is caused by Borderella pertus~
sis. All of the factors listed contribute to lts viru-
lence except lgA protease. This enzyme is
produced by Haemophilus influenzae, another
gram-neiative, rod-shaped bacteria.
86. E. Ce:liac sprue ls characterized by malabsorptlon
and mucosal lesions of the small intestines that
is caused by an allergy to gluten. A complication
of this disease incJudes T-cell lymphomas.
87, B. Tuberculosis ls caused by the bacteria
fl.1ycobacterium tuberculosis. These bacteria can-
not be Gram stained due to their waxy cell walls.
Therefore, to Identify these bacteria. ll:11 acid-fast
stain must be ordered.
88. D. iii. tuberculosis infects macrophages, which are
initially unable to kill the phagocytosed bacteria.
89. A. Cord factor is a glycolipld found on the surface
of M. Wberculosis,
90, 0. Type IV delayed type hypersensitivity reactions
are the only type of hypersensitivity immune
reactions that are not media1ed bv antibodles,
They are mainly mediated by T cells.
91. E. Treatment for tuberculosis includes a multi-
drug therapy. Rifampin, isoniazid, and ethambu-
tol are three of the first~line drugs used.
92. E. Ghon complex describes the calcified scar that
remains following the primary infection. It is
usually found in the lung and includes the pri~
mary lesion and its regional lyinph node.
93, A. Given the patient's history of rheumatic fever,
the heart murmur is most likely from a dysfunc~
tioning mitrai valve. Rheumatic fever most com~
monly affects the mitral valve, resulting in
mitral vaive stenosis, regurgitation, or both.
94. B. Rheumatic fever ts usually preceded by a group
A streptococcus respiratory infection (e.g.,
strep throat or pharyngitis).
95. A. The most common cause of subacute endocardi-
tis is Streptococcus viddans. S. viridans is a a-
hemolytic streptococci, representing incomplete
lysis of red blood cells in laboratory
culture-,.
96. E. During subacute endocarditis, vegetations, or
thrombi, form on previously damaged heart
valves. Complication! can arise if the thrombus
embolizes. (i.e. when a fragment separates and
enters the circulation), causing septic Infarcts.
Other complications include valvular dysfunc-
tion or abscess Jormatlon.
97. C. Aminoglycosides block the 30S ribosomal sub,
unit to lnhiblt protein synthesis.
98, C. Burkitt's lymphoma is an aggressive lymphoma
that affects B lymphocytes.
99. E. Hlstologic evaluation of Burkitt's lymphoma
reveals a characteristic "starry-sky" appear-
ance, which results from the lighter-colored
macrophages present.
100. A. Epstein-Barr virus is responsible for causing
mononucleosis, a disease that also affects B
lymphocytes.
L C. Universal tooth numbering system for primary
dentition. A though T.
2. A. Said to be the most atypical of human molars.
3. C. A, Smaller in all dimensions; B. AH roots seen from
buccal aspect; D, roots nearly the same length.
4. D. Mesia! aspect: A, Pronounced convexity present;
B. Curvature ln an occlusal direction; C,
Cervical third greater occlusal third; D,
Mestolingual cusp longer and sharper than
mesiobuccal cusp.
5. D. Lingual aspect: D, Well-Oefined developmental
groov~ separating ML and DL cusps. A, ML cusp
large and well-developed; B, DL cusp well-devel-
oped, more so than that of the primary first
molar; C, There is a supplemental cusp apical to
the ML cusp, but poorly developed.
6. D. A developmental depre5~ion but not a groove
divides the two buccal cusps. A, It does not
resemble other primary teeth; B, 1t has a rhom-
boidal outline from the occlusal a,;;pect: C, The
mesial buccal cu:i,;p is larger.
7. A. The MB. DB. and distal (D) cusps are almost
equal in size, whereas the D cusp of the perma-
nent molar ls smaller. B, The primary molar
crown is narrower, not wider BL: C The primary
molar outline is somewhat rectangular; D, The
ratio of crown/root not the same,
8. B. Comparative1Y, roots of primary anterior teeth
are narrower and longer. A. Crowns of anterior
primary teeth are wider, not narrower; C, Cervical
ridge& of prirnary anterior teeth more prominent;
D, B, and L surt2!lces are more flat, not less flat,
9. B. The overall average length of the primary
mandibular central incisor is 14 mm (Black GV,
cited by Ash and Nelson, 2003); lfi mm (Woelfel
and Scheid. 2002); 14 mm (Kraus et al.. 1969).
The anwer is 14 to 16 mm, not 16 to 17 mm.
10. A. Greater MD di.:i.meter reiatlve to crown height
than permanent teeth. B, Squat appearance, not
elongated appearance; C, Crowns are a milk-y
white, not translucent white; D, There is no root
trunk.
11. C. Chronologies from textbooks vary so that a~e of
eruption for the primary m.Andibular central ind~
!Or may be given l'l:5 6 months (Woelfel and Scheid,
2002); 6.5 months (Kraus et al., 1969); 7.5 months
(Charlick et al.); or 8 {6 to 10) months (Ash and
Nelson. 2003).
12. C. The most favorable !'lequence for prevention of
malocclusion.
13. B. Textbook chronologies indicate that the maxillary
primary second molar is most commonly tl1e last
to empt: 24 months (Woellel and Scheid, 2002): 20
to 30 months (Kraus et al., 1969); 25 to 33 months
(Ash and Nelson. 200'l).
14. C. The length of the prlmary maxiilary central inci-
sor ls I 6 mm (Black -GV, cit(",d by Ash and Nelson,
2003); 16 mm (Kraus et al., 1969) or 17.2 mm
(Woelfel and Sc.:heicL 2002). The permanent max~
illary incisor is 23.6 mm ( A_.,_h and Nelson, 2003):
23.5 mm (Kraus et al., 1969); 2:16 mm (Woelfel
and Scheid. 2002). ! 6i23.5 • 0.68 or 68~,; 17 .2/23.6
0. 73 or 73'¾,. The answer is about 70'/4',.
l!i C. The correct answer for A would be about 1.5
months or 6 weeks; B, About 4 lo 5 years: C, About
25 months ot JO weeks; D, About 4 lo 5 ,Yf!ars.
16. A. (Ash and Nelson. 2003; Woeliel and Schied. 2()()2).
17. C. No, or almost never does the mesia! marginal
development;il groove cross the mesial mar-
gina( ridge.
18. B. M,: DB height equal• MR height; M,. Dll msp
height !'!lightly less than MB cusp height; M::'.
DB cusp height much shorter Lhan MB cusp
height.
19. D. Marked a:n-mmetrv of mesia1 and distal halves.
20, D. From MD- aspect, all posterior teeth have a
trapeznlda! outline with shortest unevi;:;n side
toward the occlusa! surface. A, Present prima-
367
3 68 Y Answer Key Denial Anato;r.y i>r:d Ocdus!on
rily on first premolar; B, E..xceptlons may be the
DB root of the maxillary second molar; C, From
mesial and distal a5pect, al! posterior mandlhu-
lar teeth, not maxJilary posterior reeth, have a
rhombn1clal outline.
2L C. Be!ow the apices, 6:)'X) of the time.
22. C. Greater than 5'.f, (even up to 40';/,_) in populations
with Mongollan trai::s. A, Does not exceed 4.2'1,
in Caucasians: B, Less than 5'.K, in Eurasian and
Asian populations; D, Less than 3\!;', in African
populations.
23. D. G~neral:y a jaw~closing muscle. May stabilize
and act with lateral jaw movements.
2 ◄. A. ln the earliest phase, the condyle moves forward
in cona~rt with the disc, not before.
25. D. Occlusal contact relations do not interfere with
jaw opening, but TM.I and muscle disorders mav.
26. C. Mediotrusive contact, but may be called a no~-
worki)lg (balancing) contact
27. D. Temporomandibuiar (TMJ) (Ash and Nelson,
2003); craniomandihufar (\Voelfel and Scheid,
2002).
28. A. Vertical component not seen on horizontal
traclng.
29. C. Height of contour on lingual surfaces of molars
and ptf:!molan is at the cervical or middle
third.
30. C. Transverse ridge connecting MB and ML cu~ps.
31. B. Mandlbular first premolar is most likely to have
a single pulp horn.
32. A. Bifurcated roots are nol a normal feature of
mandibular incisors.
:33. D. Height of contour on distal ~urface of permanent
mandibular central incisors is at the incisal
third).
34, C. The dimension of the penmment maxillary
canine at the widest \1D diameter is 75 mm r7.5
mm (Ash and Nelson, 2003); 7.6 mm [6.3 to '9.5
mm (Wo~llel and Scheid, 2002)]).
:15. B. DO development.al groove is not found on
mancl!holar second molars.
36-. D. Y-shaped central developmental groove is found
on tht? mandibular second premol~r.
37, D. In lhe cusp-embrasure occlusal relationship.
the maxmary first 1ucmolar is most likely to
articulate wHh the first and second pr<?molars.
38. C. Equal bilateral contraction of the lateral ptery-
goid muscles results in protrusion of the
mandible.
39. D. Molecul<lf tests like the polymerase chain reac-
tion have a fast, not slow, tumarou1HI time.
40. A. RHampin causes orange, not green. urine, tears.
and s,.veat
'1 L B. The drugs binds tightly only to prokaryntic Rl\A
polymera~e. D, RH1'mpin induces activity of
hepatic mlxed oxidases.
42. C. Naproxen (naprosyn) has not been reported to
exacerbate bruxism,
43. C. The mech::misrns of the two type!'!- of head.aches
are quite different A, 8. and D are considered
true.
44. B. ~-amyloid deposits are a component of
Ah:heimer disease hut not of migraint" headaches.
45, A. (Montgnrnery et aL, 1996 j
46. B. Infection is most likely to involve the submaxn.
lary space. con~id".::ring the cHnica! findings.
47. A. Given the clinlcal findings and the Involved
molar position, !t is the lateral upper deep
cervkal node group that would most likely be
the first involved with lymph drainage.
48. B. Oral Tl3 most often involves the tongue
49. B. Langerhans' giant cells, epitheliod cells, and
caseous necrotic areas are highly suggestive of
TB; however, 5pedal stains for acid•fa:st hacilll
(AFB) and isolation of M. tuberculosis may be
necesary, keeping in mind that staining may not
differentiate TB from other mycobnclerial infec-
tions. Other molecular tests may be indicated.
50 D. There is no evidence of a connection between
tnyositis and bruxing.
51 C. The antico;lguiant effect of warfarin is inhibited
by rifampin. A, Rifampin dPcreases the anlicoag~
ulation eHect of warfarin; B, Rifamp!n interferes
with cyclic conversion; D, Rifampin increuses the
metahohc clearance.
52. B. Combination name for jolning buccal and lingual
cusp triangular ridges.
53. B, C, D. For A, the crown outline converges only lin-
gually, B. The small transverse ridge has 1:>ieen
called an oblique ridge.
54. D. A. The mic•siolingual cusp is most prominent; B,
The disto!ingual cusp is poorly defined; C, The
distobuccal cusp may be seen because it is
longer.
55, C. The central groove is well-defined. A, The pri-
mary maxillary second molar does have a well~
defined mesial triangular fossa; B, The oblique
ridge is prom;nent; D, The supplementary cusp is
not well-developed.
S6, A. B, !t bas four well.developed cusps; C, lt has only
one 5;upplementary cusp; D, lt has a well-devel-
oped me5i21I triangular fnssa.
S7, A. 11, The outline of the crown converges dL•ually:
C, The three buccal cusps are similar in slze; D,
Welt-defined triangular ridges extend from the cusp
tip~.
58. C. A, Enamel cap thfnner and more consistent in
depth: B, Comparatively greater thickness; D,
Puip horns are higher in primary molars.
59. D. A, Enamel rods slope occfww!Jy. not gingivally. in
the primary mo!ars: 8, Enamel rods at cervix
slope gingica!ly, not occlusa!ly, in permanent
molars; C, The buccal cervical ridge is more pro-
nounced.
Gtl B. The total of avt>ragc overall mesiodlstal din.me~
ter5' of primary maxillary crowns is 682 mm
(B!ack GV, cited by Ash and J\:elson, 200'.1); 76.X
nun (\Vo(:!fel ant! Scheid. ZOU2).
61. A. On average, the height of curvature is 3.5 m:n on
the nH:•sial and 2.S mm on the clista! of the max•
illarv central indsot; lt ls ::Ln mm on the rnfisla.l
and ·2.0 mm on the distal of the rn:ind'.bu!or cen-
tral incisor.
62. 0. The width and deplh of arch <1.re more or le.t55
constant aHer 9 months of D:ge. However, a sub-
stantial increase in the anterior-posterior dis-
tance occurs for penmment molars.
63. C. These are the most common 5equenccs of
eruptlon.
64. A. First evidern:e of the maxillary central incisor
cakifkation Is given as 14 (1:3 to 1G) weeks by
Kraus and Jordon, 1965 and by Ash and Nelson,
2003; this is givt:n as 4 months by \h/oelfei and
Scheid, p, I 11.
65. B. (Kraus et aL, J 969)
6G. A. The correct answer (7 to 8 years) is based on
d1Tonologi~s in Ash and Nelson, :,;003 and
Woelfel and Scheid, 2002, whlc-h are bast.. d on
orlginal chronologies by Schour am! Mnssler,
modified for permanent dentition by Kronfekl
(Bur) and by Krnnield an<l Schorn· (1939) for
deciduou,; teeth, Also, with slight modific;-1tions.
by McCall and Schour (cited by Orban. 1931).
67. B. The permanent maxillary first premolar usually
has two roots but they are buccal and lingual,
not mesial and distal.
fl8. D. (Ash and Nelson, 2003)
69. C. The labiollngunl diameter of crown near the
cervix ii greater than in mandflmlar canine.
7(L D. The labial, mesiofnctsal angle of tooth 8 and 9
(central incisors) is a sharp, right angle, not
5,IJghtly rounded. The labial, me~ioincisal angle
of tooth 7 and 1i1 (lateral lndsors) ls ~lightly
rounded, not a sharp rlght angle.
7L C. Distal to the second premolar, 56 1\;.
72. A. (McCauley. 1943; Ash and Nelson, 200:1)
73, D. Internal aprmeuros-es do move and deform.
74. A. B, Tooth grinding in sleep brux!sm lasts up
to 5 minutes., not 20 minutes; C. Sleep bru.xism
often eoin..-:ldes with passage from deeper
to lighter sleep, not iighter to deep sleep: D.
Sleep bruxism occurs approximately ev12ry 90
minutPs, not every 2D minutes ln the sleep
cycle.
75. A. Bruxism ls now thought to be mainly regulatt•d
centrally, not peripherally
76 D. Ma11dibul<'lr suppOliing cusps are buccal cusps.
77. A. To measure horizontal overlap, measure from
!abl.i.l of mandibular central incisor to labial of
maxillary central incisor
78. B. (Ash and Nelson, 2003)
Answer Key Deni<>! An<)t-omy and Ocdusio-n -. 369
19 A. The :rnric:1liltF1~1pt)r;1! nf•rv~ provkles prlmary
innervation tu tti>:.' T!\1.L
80. D, The DL cusp !~ sm:dles: 011 a five~lohecl
n:andibular s0cond ;Jrt·rnoi{:.r.
SL D. The primary m;rndihulor first mnlm typlr.:illy
Jws four pulp ho:·ns.
8') D. Clink:-dly iu !'f•!dlon to intenKclusai space
83. C. (Ash and Nefaon, 200::n
84. B. Root bHutc<i~ior. ls more Hkely ln the mandlhular
camne.
8S. O. All postf>rlor tee-th viewed from dishil a-sped ha-ve
a rhl)mhnklal outline
86. A. A distinct den,!opnwntal groove, prom\nt•nt
buccal trinngular ridge. two ,:osps. and clisttnct
nwslal and di~tal occ!usal pits an:~ rnost charac-
teristic of the mandibular first premnlm,
87. A. From the incisal aspect, the maxillary central
incisor has a greater MD dlameter (8.5 mm)
than FL diameter Cf.ll mn1), B. The MD c!iarneter
ls 7.5 mm and the FL diameter is 8J} rnm; C. The
MD ditrnwter is 7.0 mm ar:d the FL diameter is
7.5 rnm; D, The iV1D diametf•r is S,5 mm and the
FL diameter is 6.0 mm
&">. A. Maximum conrly!ar mtation takes place with rnax-
lmum i-'W op~nlng.
89. R Use of tht> formula indicates on the basis of :r 6
months that the ADF is 2 to 3 years.
90. C, A and Hare correct.Dis per tht' m,mn!rictur<'rls
recomrncndatJc,ns on prndtKt, 2005.
91. B. Sys.temic etiologic factors for hypopl;1~i;1 are
thought to occur possibly after birth and belore
G years nf age,
92. C. Me~1~lf'5 is not known to <:,rnse eiuune1 l1ypopfo.*
sia.
9:l D. lntcrmedlute filament is a smooth musde fila-
ment. Conn-ectin is another nnme for titin.
Statenwnts rC'lativc to A, B, and Care true and
refer to sl::.eietaf muscle rnaments.
94. D. Masscter muscles prnvide mo$l of the for('.<.'
between molar teeth with clcnd,lng in the lnter-
cuspal po.,ition.
95. D. lndivid11als who br;Jx during the day do not
nece5i-larlly brnx at night.
!)6. D. Sequential changes trom ;rntorwmi.::-
carcllac/hrain cortlcal acrivitics prPCt'lfr SB-
related jav,r motor activity.
97, D. Malocdw1ion has not heen s11ggest0d as caus~
ing or aggrava! ing broxism.
98. D. Fluoro5i~ versus NF opi:icHies nwy he difficult
to di;1gnose dln!Cally
99. B. Thick :md thin filaments do not change in length.
100. C. SHLP helps stabi!!ze- the head ,and conclyl(i
again~a tile ,errincnce in denching; A, B. and Il
are trne.
L D. Mandibular supporting cusps ate buccal cusps.
2. A. The lnferlor head of the lateral pteryg:oid muscle
attaches to the lateral surface of the lateral
ptery~oid plate of sphenoid bone. Its is.uperior
head attachc, to the infratemporal crest of the
greater wlng of sphenoid bone. The deep fibers
of the medial pterygoid muscle attaches to the
medial surface of the lateral pterygoid platt-.
3. B. Combln<:1tion name for jolning buccal and lingual
cusp triangular ridges.
4, B. Consequences of asbestosis include mesothe--
lioma and bronchogenic carcinoma.
5. C. Under normal conditions, all giucnse is reab-
sorbed by both !econrlary active tran5port ~ys~
terns and facilitated diffusion utilizing GLUT 1
and 2 carrlers. Calcium ls pas5ively reabsorbed.
but its reabsorption i~ hh,o regulatect by parathy-
roid hormone !n thie distal tubule. Not all ure~ is
reabsorbed but about half Is excreted. lts per~
me,1bllity ls altered by changes ln vasopre.ssin
Phosphate reabsorption is also regulated by
parathyroid hormone.
6. C. Although lgE is the !east prevalent imrnunogloh-
uHn in the body, it is the major antihody media-
tor of type l hypersensitive reactlnns. These
reactions are caused primarily by prior sensiti~
zation and the accumulation of lgE to a specific
allergen.
7. A, Since DNA ls a clouhle stranded motecu!e, cyto-
.sioe wlil always be base paired to guanine and
guanine to cytosine. Therefore there wlll be
~qua! amounts of these compounds. It !s uniikt:•ly
that RNA or mRNA. being a single-stranded mol-
ecule, will have equal ammmts of these bases.
8. B. The branchial arches disappear when the sec~
ond arch grows down to contact the fifth
branchial arch,
9. C. Glucag:on is secreted from the pancreas in
response to reduced plasma gluco.se due to
fasting and exercise. It fundi{lns to mohllizf'
energy stores (glucose) 0.nd return blood glucose
to normal levets. Clycogen synthesis (_glycogeneM
sis) wm not ocetir in response to glucagon.
10. D. Unlike in noncompNltive inhibition, the
inhlbltor cmnpc:"tett for the samf' site as the sub-
strate. ll is thererore possible (with increased
amounts of sub::-trate) tn reach the V,..,,~·
Apparent Km is incrertsed !-Ince more :-ubstrate
is required to reach 1/2 V,,1.. x (the dcfo1ition of
Kml.
i 1. D. The primary rn:indibu!m lirsl mola;" typically
has four puip hurns.
12. C. Burk:itt'i lymphoma is an aggrc3~ivc !ymphorn0
that affects B lymphocytes.
13. E. i-Hstologic r,,.alualion of Burkrtt's lymphoma
reveals a characteristic "starry-~ky .. appear-
ance, which results from the lighter-colored
rmwrophagt•s present.
14. A. Epste-in-Barr virus ls ret'-pons.i!)le for causing
monnnuc!eosis. a diseas(' that also affects B lym-
phocytes.
15, A. To me;:1:nrrc horizontal overlap, mcastirc from
labial ol mandibular central indsur lu 1ahi.al of
maxii!ary cf"ntral lndsor (Ash and Nelson, :2003:
Woelfel and Scheid. 2002_;.
16, D, Capillary blood flow is propor!iona! ln changes
in the radius (r-1) nf tht:> vessel. Oecn.•,Hing the
radlus would produn:: incT('.i:tsed vascular pres-
sure. VlscosUy of the blood depends prirn;i.rily
on the hernatocrit (p~rcentagc of red blood
cells) and would not be changed by changes in
the radius of the vessels.
17. D. The facial nerve supplies specia! sensory {taste;
to the anterlor two thirds of the tongue, vla one
of its branches. the c-horda tympanL The chorda
tympani bnmche-s from the facial rn;rvl>, carry-
ing both sensory fibers for taste and prt'g<m-
glionk p,1n1sympathE'tic fibers. !t exit~ from ol
371
37 2 'f SampJe [xam Answer Key
the lemporal bone to join the lingual nerve (a
branch of CN V3). as it courses infcriorlv toward
the suhmandibular ganglion {Tig~ 1-19),
Postganglionic paruympathetic fibers emerge
from the ganglion and continue toward the sub-
lingual and submandibular glands (Fig. 1-20).
Sensory fibers also branch from the nerve and
provide taste sensation to the anterior two
thirds of the tongue.
IR C. The lahiolingual diamet~r of crown near the
cervlx is great~r than In mandibular canine
(Kraus et ol., 1969).
19, A. The gastrointestinal tract is regulated by both
the sympathetic and parasympathetic branches
of the autonomic nervous system. The parasym~
pathetic system is stimulatory and the l'5yrnpa-
thetic system inhibitory. The CNS does tnfluence
motility and secretory activity through the auto-
nomic nervous system. Numerous endocrine
!actors (secretin, gastrin, cholecystokinln, etc,)
are also involved with the regulation of gastroin-
testinal activlty.
20. C. Although all of the structures listed are common
sites for oral cancer, the lower vermilion horder
of the lip is the most common oral site,
21. A. Vertie•! component not seen on horizonlel tracing.
22. D. The palatopharynge:us forms the posterior ton-
sillar pillar. It also functions to close of! the
nasopharynx and larynx during swallowing. The
anterior tonsillar pillar is formed by the
p:1letoglossus,
23. D. Decrea6ing total peripheral resistance woul-cl
produce greater reductions in blood pressure.
Due to the baror~ceptor reflex, cardiac heart
rate would increase, Increa~ed stroke volume
(due to increased venous return and sympa-
thetic stimulation of cardiac mue;cle) would also
occur, Increased cardiac output would occur
due to increased heart rate and stroke volume.
24, 8. Insulin is a polypeptide hormone that promotes
energy storage when it is readily available. The
lack of insulin would interfere with this proce!!!s.
Therefore, under conditions of reduced insulin,
hyperglycemia would result due to increased
gluconeogene,ri:il!: in the llver. Glycogen break-
down would be enhanced and glycogen synthe-
sis decreased, Since 1nsulin promote:$ amino
acid uptake in the liver, lack of insulin would
result in decreased uptake.
25. D. 12 hours is required.
26. C. The roof of the orbit consists of lesser wing of
the spheno!d bone and the orbital plate of the
frontal bone (not listed).
27. C. The dimension of the pf:":rmanent maxillary
canine at the widest MO diameter is 7.5 mm (7.5
mm, Ash and Nelson. 2003; 7.6 mm [6.3 to 9.5
mm] Woelfel and Scheid, 2002).
28. D. Facilitated diflusion does not require energy and
moves down a concentration gradient. Active
transport, in addition to utilizing energy, is often
coup!e<l to transport ions in both directions
across the membrane. Both active transport and
facilitated diffusion are carrier~mediated and
therefore are inftuenced by competitive inhi-
bition,
29. A. ln genera!, plaque ls first colonized by gram-pos-
itive, cocci bacteria, such as Streptococci. They
are foHowed by gram-negative, rod-shapt:d
anaerobes, like Bact~roides. Fusobacterium,
Porphymmonm, Preootefla, and then filament-
type b.acteria, such as ,4.ctinom)1ces.
30. D. Triacylglycerol is not commcmly a component of
cell membranes since It serves primarily as a
molecule for storage and transport of fatty
acids. Phospholipicls are abundant since they
form the bilayer structure characteristic of
membranes. Proteins are present and serve var-
ious functions as enzyme:5, receptors, and trans~
porters/carriers. Cholesterol stabilizes the
membrane and is responsible for the mainte-
nance of fluidity. Sphingolipids are components
of myelin, which insulates membranes in
neurons.
31. A. Lateral cricoarytenold. The oblique and trans-
verse arytenoid.5 and thyroarytenoid also
adduct the vocal folds. The posterior cricoary-
tenoids abducts the vocal cords. The cricothy,
rold muscle raises the cricoid cartilage and
tenses the vocai cords.
32. E, Carcinoma in situ. Although the cells have not
yet lnvaded the basement membrane, the likeli-
hood of invasive growth is presumed to be high.
33, D. The rectos ahdominus muscle of the anterolat-
eral abdominal wall ls described as being beltor
strap-like, The remttining three muscles of the
anterolatern.l abdominal wall (external oblique
ruusde. internal oblique muscle, and trans-
verses abdominus mu~cle) are all described as
sheet-like. The quadratus lumborum muscle is
part of the posterior abdominal wall.
34. D. A, Enamel rods slope ocdusally, not gingivally, in
the primary molars; B, Enamel rods. at cervix
slope gingil,afly, not occlu~~lly, in permanent
molars: C, The buccal cervical ridge is more pro-
nounced.
35. A McCune-Aibright's syndrome is a type of
fibrous dysplasia that presents with a triad
of symptom~ including polyostotic fibrous
dysplasia, cafe au lait spots. and endocrine
abnormalities.
36. B. Fibrous dysplasia is caused by replacement of
normal bone with an irregular bone containing
fibrous connective tissue. This gives the radiM
ographs a characteristic ground glass appear-
ance.
37. B, Fibrous dysplasia is caused by replacement of
normal bone with an irregular bone
fibrous connective tissue. Therefor~. the
38. B. The overall average length of the primary
mandibular central incisor Is 14 mm (Black GV.
cited by A.1-1'. and Nelson, 2003): J 6 mm (Woelfel
and Scheid, 2002); 14 mm (Kraus et aL, 1969).
The answer is 14 to 16 mm. not 16 to l 7 mm.
39. A. Stenosis describes fibrotlc and thickened
valves, resulting ln reciuc~d blood flnw through
the valve.
40. A. B, It has four well••developed cusp!; C, Tt has
only one supplementary cusp; D, It has a welf-
deudoped mesia! triangular fossa.
4L A, All the other factors will produce vasodllatinn
and hyperemia to increase the exchange of
metabolites in the tissue.
42. C. The inferior aspect of the diaphragm ls supplied
with blood by the inferior phrenic arteries. The
median sacral artery supplit>s the anterior
aspect of the sacral area, and the lumbar arter-
ies supply the lower abdominal walL The celiac
trunk: and superior mesenterk arteries are both
unpaired branches to the gut and associated
glands.
43. C. Pyridoxa! phosphate is the active coenzymt" of
pyri<loxine, whlch is involved in a number of
enzyme systems essential for normal amino acid
metabolism. Biotin is re-qllired for carboxylation
reactions. Tetrahydrofolate, the coenzyme form
of folic acid, ?s required for the :isynthesi~ of
nucleic adds and porphyrin. Niacin participates
in eneq:,1y met.?lboli~m (oxidation-reductfon reac~
tions)
44. C. Equal bilateral contraction of the lateral ptery-
gold muscles results In protrusion of the
mandible.
45. D. Oligodendrocytes produce the myeiin sheath
around myelin~ted axons in the central nervous
system. Schw11.nn cells make up the myeHn
sheath around mye!inated axons in the parasym-
pathetic nervous system.
46. A. Ninety-five percent of enamel is inorganic mln-
enll compared with 8•1% in calculus, 70:X, in
dentin, and 60% in bone.
47. D. Poststreptococc.al glomerulonephritis is a clas-
sic example of nephritic syndrome, which
occurs after a Streptococcus infection (e.g., strep
thro-,:t). It is characterized by all of the symp-
toms listed except polyuria. A clecrease In urina~
tion is usually observed.
48. D. ln the cusp-embrasure occlusal relationship,
the maxillary first premolar is most likely to
articulate with the first and second premoln.rs.
49. C. Unlvetsal tooth numbering system for primary
dentition, A though T.
50. B. Oblique alveolodental fibers resist occ!usal
forces tha1 occur along the long axis of the
tooth, The rest of the alveolode-ntal (PDL)
fibers listed provide resistance against forces
which pull the tooth in an occlusal direction
(Le., forces that try to pull the tooth from its
socket).
Sample Exam Answer Key • 37 3
51. A. \\'hen pulpa! 111".:rves ~tre stimu!att-d, they can
only transmit one .sign<1!: paio
s•) C. Th~ mylnhynid mu$clt:: forms the floor of the
mouth. Rt>laxation of this r:rnscie would help th-e
denfo•t push !he i\!rn clown. to help ensure Urnt
lhe apical ro0t ls captured on thr! radingraph.
53, B. Fibers of the lateral pterygoid rnuscle are
attached to the anterior end n-f the dlsc.
Contraction uf this muscle pulls the disc in an
anterior and medial direction.
54. B. The sem;ory distribution for lhe maxillary
nerve (CN Y2) includes lhe cheek and upper
lip, and lower eyelid, upper lip, nasopharynx,
tonsils, palate, and maxillary teeth. The sen~
sory distribution for the long buccal alS(J
includes the (lower) cheek; however. it does
not include the upper lip. The long bucca! i5 a
branch of the mandibular nerve (C~ V3) and
provides sensory nerves to the cheek, buccal
gingiva of the pnsterior m;;ndihulM teeth, and
buccal mucosa.
55, A. The inferior alveolar nerve (JAN) courses
heh\'een the ,,;phcnomandilrnfar ligament and
the rarnus of the mandible before entering thl:''
nrnncHbular foramen. The sphe:nomandibt!IM lig-
ament may therefore he dam<11,;ed during the
.'ldmlnlstration of an IAN block.
56. D. Polycy~tic kidney disease is charncterized by
the formation of cysts in kidney, It ls cnmrnn-n!y
associated wlth berry aneurysms.
57. B. The nropharynx is lined by stratified sq11amous
epithelium. This type of e1)itbdium also lines the
oral cavity, laryngophmynx, es0phngus, vagln.al
canal and anal canal.
58. C. Phosphodiesterase$ are intracellular enzymes
that degrade cyclic nudeotklt>s, thus catalyzing
the hy(lrolysis of cAMP to a metabolite. 5· AMP,
whlch lack~ the ;<wcond messenger properties of
cAl'vlP. Adenyintt:~ cyclase is an enzyme thnt cat~
alyzes the com·ersion of ATP to cAMP.
Monoamine oxid.ase (MAO) ls an enzyme
located ln presynaptic nerve t€rminals lhat
degrade5 dopamine, norepint~phrine. and epi-
nephrine to inactive substances. Aspirin inhibits
prnstaglandin synthesis by inhibiting the
cyclon:'(ygenase enzyme.
59. A. Said to be the most atypical of human molars.
60. B. O::itr"omye!iti:-:., or an infN:tinn of hone, is mnst
commonly caused by ~'~raphy!nco<X1.H <Wr('us.
Symptom~ include pain and .systemic signs of
infection (i.e,, fever, malaise).
61. C. lntercalated discs are: only found in cardi<.1c mus-
cle. Multiple, periphernlly positioned nuclei are
found in the fibers of skeletal muscle. Smooth
muscle cells ar(· hpindle-shapecL
62. D. The DL cusp is snrn!!est on a five-loherl mandibu-
lar second premolar.
63. C. Although fluoride may be incorporated ln min~
eraiized tissues, it is not required for the miner-
ali2atlon process. Matrix vesicles p:mducec! by
374 .., Sample f:xam Ans,n::s hey
osteob!asts !Ire considered to be the lnitlal site
of mineralization. Amt!logenins are matrix pro-
teins in enamel that regulate crystallite growth.
Phosph-oryns are initiator protein• that bind
minerals to facliitate nudeation and crvstal
growth. ~ musdes all insert into the median pharyngeal
64. E. Celiac sprue ls characterized by malabsorption
and mucosa! lesions of the small intestines that
is caused by an allergy to gluten. A complication
of this disease includes T<ell lymphom,15,
65. E. Renal clearance is the volume of plasma com~
pletely cleared of a substance by1he kidneys per
unit of time. The renal clearance of glucost is
usually O since, although it ls filtered, lt ts com-
pletely reabsorbed when the plasma glucose
concentration is within normal levels. ln the
uncontrolled diabetic, plasma glucose levels
exceed the reabsorptive capacity (Tm) and it
then appear~ in the urine, Urea is filtered and
paMively reabsorbed to a sliw:ht degree.
Creatinine is both freely filtered and secreted to
a slight extent Socllum and water are filtered
and reabsorbed to various degrees due to phys-
iological regulation of aldosterone and ADH.
66. R DiGeorge'ia .~:yndrome is characterized by a defi-
ciency of T cells. It is caused by the failure of the
third and fourth brachial pouches to develop
normally, resulting 1n a lack of thymus and
parathyroid development.
67, A. Restriction enzymes are also known as restric-
tion endonucleases. These enzymes deave DNA
at specific sites to release fragments of DNA for
further analysis and characterization by com~
plementary probes,
68. A. The bile canaticuH drain bile to interlobular
ducts. The interlobular duds form right and left
hepatic ducts, These ducts join to form the com-
mon hepatic duct. The gallbladder arises from
the common hepatic duct.
69. D. There is no evidence of a connection between
myositis and bruxing.
70. E. The superior and inferior ophthalmic veins
drain into the facial vein and cavernous sinus.
7!. D. The partial lhromboplastin time (PTT) test
measures the intrinsic and common pathways of
the coagul.~tion cascade. A prolonged PTT could
result from a deficiency of factor V, VIII. IX, X, XI,
or XH or of prothrombln or fibrinogen.
72. C. Hemophilia. A is caused by a deficiency of factor
8 (•n!ihemophilic factor).
73. C. Hemophilia A is a hereditary disorder that is X-
linked; thus, it only affects males. However,
females can be carriers.
74. B. The only way to distinguish hemophilia A from
hemophilia B is to assay the levels of coagula-
tlon factors. Hemophilia A 1s caused by a defi-
ciency of factor 8, white hemophilia B is caused
hy a deficiency of factor 9.
75. E. Arginine is an amino acid that is deaminatetl to
form omithine primarily in the tiver as part of
the urea cycle. Ornithine. arginlnosuccinate,
aspartate and dtrulline are generated tn the
urea cycle but do not provide free ammonia for
urea synthesis.
76, E. The superior, middle and lnferior constrictor
ra1Jhe (the superior constrictor muscle was the
only one H~ted), however. their origins dHfer.
77. C. The most favorable sequence for prevention of
malocclusion.
78, D. lmmedi,1t~ly following a meal, energy sources
are high. Glycogenolysis (slycogen breakdown)
is reduced. Lipolysis and oxidation of free fatty
acids are also unnec-essary during this time.
G!ucagon reiease is inhibited due to elevated
glucoie. Glycolysis is increased due to elevated
intracellular glucose.
79. A. Hepatitis A is spread via oral-anal/fecal contam-
!nation. The other hepatitis viruses can be trans~
mitted through blood, sexual contact, and/or
perinatally.
80. 8. Guanjne base pairs with cytosine which, on a
molar basJs, will also equal 30:Xi of the DNA lf
guanine and cytosine constitute a total of 6mt of
DNA, the remaining percentage ( 40'?0,) must be
equally divided between the base pairs of ade-
nine and thymine (20% + 209[;).
8L B. The muscularis externa has a thlrd iayer in the
stomach. It is an inner oblique layer oJ smooth
muscle. In the rest of the dige~tive tract, the
muscuiaris extema has two layers: an inner dr~
cular layer and an outer longitudinal Jayer.
82. C. Gummas are granulomas that may be seen in ter~
tiary syphilis. Since syphilis is caused by
Treponema pallidum, the correct answer is C,
Granulomas may also be seen in tuberculosis, an
infection caused by Mycohacten·um tuberculosis;
however, in this disease, they are known as
tubercles.
83. A. The medulla of the thymus contains Hassa.ll's
corpuscles, which conslst of epithelial cells with
keratohyaline granules. The medulla is the
llghter-staining (less dense) central area of the
gland, where T cells maturation occurs.
84. C. The mass-eter originates from the inferior border
of the zygomatic arch; specifi.cally, its superficial
head and deep head originate from the anterior
two thirds or posterior one third of the inferior
border, respectively. Its superficlaJ head inserts
into the lateral surface of the angle of the
mandible; its deep head Inserts into thf': rarnus
and body of the mandible.
85. D. The width and depth of arch are more or less
constant after 9 months of age. However, a sub~
stantlal increase ln the anteriorwposterlor dis-
tance occurs for permanent molars.
86. A. Hemoglobin is a globular protein responsible for
transporting most of the o. in the blood. The
percent :,aturation of hemoglobin is a function of
the PO, of the blood. The relationship of PO2 and
hemoglobin saturation Is not linear but, rather,
sigmoidal. Percent saturation increases gr~aUy
at !ow PO., and less at higher PO.,. Increased
PCO.,, temPerature, diphosphoglycefate, and H'
decrease the affinity of hemoglobin tor 0 .., but do
not alter the characteristic sigmoldal n~ture of
the saturation curve.
87. A. On average, the height of curvature ls 3.5 mm on
the mesial and 25 mm on the distal of the max-
il!ary central incisor; it is 3,0 mm on the mesial
and 2.0 mm on the dlsta! of the mandibular cen-
tral incisor,
88. B. Dysplastic cells are abnormal in appearance and
organization. The potential to develop into a
malignant tumor is present; however, this risk
varies.
89. D. Generally !'l jaw-closing musde, May stablltze
and act with laternl jaw movements.
90. D, An infection by molds, such as mucormycosis:,
results in the invasion of blood vessel endothe-
lium. This leads to hemorrhagic infarction and
tissue necrosis.
91. A. The first rib cannot be palpated.
92. D. Mast cells contain de-nse granules with inflam-
matory mediators, including histamine and
SRSA. ~hich is a leukotriene,
93. B. The hypothalamus coordinates many acUvities
mediated by the ANS, including food intake.
thirst, and temperature regulation. The cerebel-
lum functions to regulate movement and pos~
ture. The medulla Is rciponsible for coordinating
respiration, The cerebral cortex performs func·
tions of perceptlon, cognition, higher motor func-
tions. memory, and emotion.
94. E, Chronic bronchitis predisposes those affected
to squamou~ neoplasia of the bronchial epithe-
lium (i.~ .• bronchogenic carcinoma).
95. A. The MB, DB, and distal (D) cusps are almost
equal in size, whPreas the D cusp of the perma-
nent molar is smaller. B, The primary molar
crown Is narrower, not wider BL; C, The primary
molar outline is somewhat rectangular; D,
The ratio of crown/root not the same.
96. B. ln smooth muscle, the binding of calcium to cal-
mondutin wlH activate the enzyme rnyosin light
chain kinase. This enzyme pho5phorylate5
myosin, allowing it to bind to actin, and the mus-
cle ('0ntracts. For contraction in skeletal and car-
diac muscle, calcium binds to troponin C,
97. A. Estrogen is a steroid hormone and therefore does
not require a membrane receptor and the second
messenger cAMP, Steroid hormones diredly enter
the cell and stimulate intraceBular receptors.
Peptlde hormones and those derived from single
amino acids are not readily lipid-soluble (charac-
teristic of membranes) and thus require mem-
brane receptors and a "second m~senger system
(cAMP, IP3, etc.). Many of the effects of epineph-
rine and norepinephrine and all of the effects of
glucagon are mediated by cA1v1P.
Sample Exam Answer Key • 375
98, D. The Western blot tests for HIV prott:ins. The
£USA tests for HlV antibodies. V-/hen the~e two
tests are used together, a 99'K, <:1ccuracy rate is
achieved
99. C. Since ~10';;, ot blood transJus'inn.related ht~patil:ls
cases are cau!Sed by h~patitis C and the 1u1tient
has a history of having had a hl0od transfusion,
the answer ls C.
100. D. Opportunistic infections art a serious problem
with patients infected with HlV Thls patient's
intraora! thrush is such an inff:ction, which is
caused by Candida afbirnm. Treatment for c;rnw
dldiasi.::: includes nystaUn.
lOL C. The HIV is an RNA virus that contains three
enzymes: reverse trJnscripti'\se, integ:rasc, and
proteas.e. Neurnrninidase i~ a protein foond on
the surface of the influenza virus.
102. C. Although all of the microbes listed cause pneu
monia. the rn()St comn,on cause of pnemnoni<, in
oatlents with AIDS is P jirooeci ( carinil).
103. C. ·A, Smaller in all climensious; B. All roots seen from
buccal aspect: D, roots nearly the same length.
Hi4. B. Cells degrade purine nuc!eotldes to uric acitL
Xanthlne is an intermediate in a series of reac~
tions, but the final product in humans ls uric
acid which is excreted in the urine. Urea is the
degradation product of compounds containing
amino groups (.amino acids).
105. B. An essential amlno add is one that cannot be
5ynthe.~.ized by hum;,n an<l therefore we require
them in the diet from plant or bacterial sources.
All of the nther amino acids can he synthesized
by humans from other compounds and there-
fore are not classified as "essential.,.
W6, 8. The fovea central!s only contains cone cells. lt is
located approximat...,1y 2,5 mm lateral to the
optic disc in an yeHow~pigmented area ~macu!a
!una). Vision is 1nost acute from this area,
107, C. The middle trunk of the brachia! j)lexus of
nerves arlses from C7.
l 08. E. Both F,pidermorh.~1on and Trichophytnn can
cause tlnea pccli!'.
109. B. Comparatively, roots of primary anterior teeth
are narrower nnd longer. A, Crowns of anterior
primary teeth are wider, not narrower; C.
Cervical ridges of primary anterior teeth mnre
prominent; D, B. and L surfaces are rrwre fiat.
not less flat.
110. C. Cystic fibro::;ls results from an abnormal chto-
rlde channel that affE>cts all exocrine glands.
111, A. The site of cell dlvjsion (mitosis) occurs in the
stratum basale (basal layer, stratum gerrnlna-
tivum) of oral epithelium.
112. A. IgA b;. found ln mucosJl sccn~tl0r.s of the gcni~
tnurinary, lnlestinal, and respiratory tract;-;,
including tears, saliva and colostrums.
113. A, Chronk' granulnm,,to5is results from neutrophils
wlth a defectivP. NAPDH oxidase system. This
affects their ability to kill micrnorganisms. since
they are unable to produce supernxlde radicals,
376 v Sample Exam An:-;wer KeJ
114. B. Tdrahydrofo!k acid ls the coenzvrue form of
folic acid requlred for the synthe;is of nucleic
acid" and normal cell divtsi(;n and replication_
115. 0, Plwnylketonuria (PKUJ is an inherited disorder
Df amino acid metabolism in whict: the affected
individual lacks enzymes to metaboUze pheny~
lalanlne. Albinism is a conclition that results in a
defect in tyrosine metabolism and the inability to
produce melanin. Porphyrla is an lnherlted di~-
order irwolving defects In heme svr:thei,is.
Ho,wxyst!nurla is a disorGer in the m;tatmlism
of homocysteine resulting ln high levels of homo-
cytteine and methionine Jn plasma and urine.
JI 6. D. Molecular tests llke the polymerase chain reac-
tion have a fast. not slow, turnaround time.
I l 7. A. RJfampin causes orange, not green, urine, tears,
and sweat.
118. B. The drugs binds tightly only to prokaryotrc R'.>!A
polymerase, D, Rifampin induces activity of
hepatic mixed ox!dases.
I 19. C. Naproxen (naprosyn) has not been reported to
exacerbate bruxlsm. For A, refer to Romane!H
et al., 1996; B. Reier to Gerber and Lynd, 1998; D.
Refer to Milosevic; et al., 1999.
1'.W. C. The mechanisms of the two types of headaches
are quite different. A, B, and Dare considered true.
121. B. ,B-arnyloid dt-posit& are a romponent of AJzheimer
disease but not of migraine headaches.
122. A. (Montgomery et al., 1996).
123. B. Infection is most likely to involve the submaxil-
lary space, considering the clinical findingiiL
l 2,1. A. Given the clinical finding~ and the involved molar
position, it is the lateral upper d~ep cervical node
group that would most likely be the first involved
with lymph drainage (Shaler et al.. l98:l),
125. B. Oral TB most often involves the tongue.
126. B. L.c1.ngerhans giant cells. ep1theliod cells, and
caseous necrotic areas are highly 5ugge5tive of
TB; however, special stains (or acid-fast bacilli
(AFB) and i:o:olatton of M. tuberculosis may be
necesary, keeping in mind that staining may not
differentiate TB from other mycobacteri<:11 infec~
Hons, Other molecular tests may be indicated.
127, C. The anticoagulant effect oJ warfarin is inhihtted
by rifampin. A Rifornpin decreases the anticoag-
ulation effect of warfarin; B, Rifampln interferes
with cyclic conversion; D. Rifampin increases
the metabolfc clearance,
128. A. Gut-assoclated lymphoid tissue (CAL1) pro-
duces s:ecretory IgA.
129, C, Systemlc lupus ery!lwmatosus, also known as
lupus, ls considered an autoimmune disease.
although the exact cause is unknown. Il is char-
acten.zed by the presence of antinndear anti-
bodies (ANA). Common A'.'IA findings include
anti-DN.-'., anti-RNA, and anti-Sm antigen.
J;!O. D. The backbone of DNA and RNA is composed of
5ugars (deoxyribose or ribose) joined 3' ➔ 5'.
1:-n. C. The hypoglossa! (CN XII) nerve is not found in
the posterior triangle~ lt is, however, present 1n
the s:Jhmandihular triangle. Contents of the
poslerior t!"langle include the external jugular
and subc!avian vein and their tributaries, the
subclavian artery and Its branches, branches of
the cervical plexus, CN XL nerves to the upper
limb and muscles of the triangle floor, the
phrenic nerve, and the brachial plexu5.
132. A. The a-chains are polypeptide5 which character~
ize the tollagen molecule. The most abundant
amino aclds ln collagen are proline and glycine.
Proline (due to its amino ring structure), lnter-
rupts the a-chain, resulting in the bending/twist-
ing of the peptide. Glyclne (due to its small size)
flts into the smaller spaces of the peptide and ls
positioned at every third position in the chain,
133, 8. Increasing the hydrostatic pressure within the
glomcrnlus would decrease the nee uftrafiltra.
tion pre~sure. Reduced plasma protein concen-
tration decreases the oncotic pressure in the
plasma which would increase filtration.
Vasodilation of the afferent arterioles would
increase capHlary pressure resulting fn
increased Hltration. lnulin, although used to
rneasure glomerular filtration, does not affect
glomerular flltration rate.
134. A. The mo5t common form of breast cancer is ade-
nocarcinoma aristng from the ductal epithelium,
] :35. D. The labial, mesioincisal angle of tooth #8 and #9
(central incisors) is a sharp, right angle, not
slightly rounded. The labial, mesioincisal angle
of tooth #7 and #10 (lateral lndsors) is slightly
rounded, not a sharp right angle.
136. C. The apex of a medullary pyramid in the kidney is
called the renal papilla. The cortex is the outer
layer o( the kfdney. The medulla i~ the inl)er layer.
Minor calyces receive secretions from the renal
pap!Hae. Several mlnor calyces join to form a
major cal:yx.
137. D. Endocarditi~ is most commonly caused by
group B. ct-hemolytic streptococcl, such as -5'.
viridanJ, S mutans, S sanguis, and S. salwarius.
All of the other conditions are associal ed with
group A j3-,.l1~molytic streptococcal infections.
such a5 5. pyogene:c
138. D. After branching from the mandibular nerve (CN
V3), the atiriculotemporal nerve travels posteri-
orly and encircles th_. middle meninge;,I artery,
remaining posterlor and medial to the condyle.
It then continues up towards the TMJ, e>,;ternaI
ear, and temporal region, passing through the
parotid gland and traveling wlth the superficial
temporal artery and vein,
139. A. Given the patient's history of rheumatic fever,
the heart murmur ls most likely from a dysfunc-
tioning mitra.1 valve. Rheumatic fever most com~
monly affects the mitral valve, resulting in
mitra! valve slenosis, regurgitation. or both.
140. B. Rheumatic fever is usually 1Jreceded by a group
A streptococcus respiratory infection (e,g.,
strep throat or pharyngitis}
]4 L A. The most common cause of subacute endo-
carditis is Strept-:JCo<:cus viridon.-;. S. viridons is a
n-hemolytk streptococci, representing incom~
µ!ete lysis o! red blood cells in laboratory
cultures.
142. E. During subacute end0c1Jrditls, vegetations, or
thrombi. form on previously dam~ged heart
valves. Compiicati..ons: can arise if the thrnmbu,
embo!izes. (Le. when a fragment separates and
enters the circulation), causing septi-c infarct5.
Other complications include valvular dysfunc-
tion or ahscess fom1ation.
143. C. Aminoglycosides block the 30S ribosomal sub-
unlt to inhibit protein synthesis.
144. 8. Translation ls the conversion of information
from mRNA into a protein. Transduction is the
incorporation of genetic information carried by
a virus into bacteria,
145. A. Maximum condylar rotation takes place with
maximum jaw opening.
146. B. The right subclavian artery arises from the bra-
chiocepha!ic artery, and the left subdavian
artery arises from the aortic arch. The subcla-
vian artery becomes the axmary artery upon
crossing the first rib. The axillary artery
becomes the brachia! artery when it leaves the
axilla.
147. D. Clinically ln relatlon to lnterocclusa\ space.
148. B. The concentratioo of potas5ium ions within
cells is approximately 30 times greater than the
extracellular fluid~ the other ions are ln greater
concentrations in extraceUular fluid compared
with values within the cell,
149, B. Neutrophils are quick to arrive to the site of
infection or injury and are therefore associated
with acute inflammation. AH of the other cells
Hsted are mediators of chronic inflammation.
150, A. The correct answer (7 to 8 years) is based on
chronologll~5 in Ash and Nelson, 2003 and
Woelfel and Scheid, 2002, which are based on
original chronologies by Schour and Massler.
modified for p~rm,enent dentition by Kronfeld
(Bur) and by Kronfeld and Schour (193~) for
(leciduou~ teeth. Also, with slight modifica-
tions, by McCall and Sch our ( cited by Orban,
1981).
151. E. Heparin, an anticoagulant is unlike the other gly-
co5.tuninoglycans since it is an extrace[lufar
compound. Hyaluronic acid is found in synovial
fluid, kerat8n sulfate in loo::;e connective tissue
such as cornea. chon<lroltin sulfate in cartilage,
ligament5, and tendons and dermatan sulfate in
skin and blood vessels.
152. A. The pancreas ls enveloped at its head by the
first part of the dundenum.
153. B. lndivirluat~ s11fferingfrorn mucopolysaccharidoses
have normal production of prnteoglyc.ans and gly-
eosaminoglyc.ins but, due to genetic defects, Jack
the enzymes which degrade mucopnlysaccha-
rides.
Sample Exam Answer Key ,. 377
1:14, A. The terminology nsed is a classical d<.:sz:riptor
oi tht: relationship hetweP.n the hormone source
and target tissue. Paracrine refers tn the target
tissue as a cell ln close proximity to !ht.~ secn~t-
ing tissue. Autocrine stimul.:.1tion n.•fers to cell
tha! releases ;:i factor (hormone) which sUmu-
iates the cell from which it was released,
Endocrine factors l'lre twrmoncs that ht:ve an
effect at a distal site in the body.
155, C. Pye!onephritis ls usually caused by gram-neg.1~
Eve, rod~shaped )Jacteria that are pcirt oi the
normal flora of the enteric tract lt is most com-
monly ..::aused hy E,;cherichia cori, followed by
Proten,;, fi;.7ehswlla. nn<l Entemhacter.
156. C. The salivary gland~ are lined by simple cuboid.al
epitheHurn. This type o! epithelium al~n lines the
bronchiole~, thyroid gland, and ovary capsule,
157. E. The macula dens.a is a component of the juxt.a-
glomerular .apparatus which functions in regul.a-
tion of blood pres:.ur~. The proximal conv0lut,-xl
tubule, diMal convolut12d nibule, Bo-wrnan's cap•
sule, and glomerulus all function in the produc-
tion of urine.
I58. D. internal aponeurose5 do mov(~ <1nd deform.
159. C. The cricopharyngeus rnuscle prevents swallow~
ing air at the pharyngeal end of the esophagus,
IGO. C. The most common cause of bacterial mcningit1,
in newborns ls E'>cherichia coli. Hocmnphtlu,tt
influenzae and N(:iss.eria meningitides are the
most common cause of bi'lcterial m<"ningiti::; in
infonts;children or young adults, respectively.
Hil. B. Glucose transport tn muscle und acll[)ose tis~
sue is under the influence of ins.u!in-s-ensitive
glucose transporters. Although several meta-
bolic pathwr;ys are influenced by insuHn. glu-
cose uptake intn the llver is not affected by
insulin.
162. C. UeOA'}'genated blood from the transverse sinus
drains to the sigmoid sinus. which empties into
the internal jugular veins, The transverse
sinuses receive blood from the confll!('nce of
s[nuses, which is located in the posterior cra-
nium.
16:i. C. The cf;'ntral groove- is well--<leflned. A, The pri-
mary maxillary second molar does have a well~
defined me~ial triangular fossa; !3-, The oblique
ridge is promineni; D. The supplerr:entmy cusp
is not wcll-developt>d.
I 64. B. Facial nerves are derived from the second
branchial arch. The tri~E-rninal nerve is derivPd
from the first branchial arch.
165, B, A probe is a single strand of DNA synthe-sized
with a rndloisotope tlwt ls comrlimentary to a
segment of DNA of interest. The radio-labeled
complex can be analyzed snhsequently on a gel
by a technique knmvn a~ a Southern Blot
166. A. B, 'The outline of the c?'O\\'tt converges di_-;tai!y:
C, The three buccd cusps are simffot in size; D,
Well--defincd triangular ridges extend from the
cusp tips.
378 v- Sample Exam An'.'.wer i\ey
167. B. '.\11: DB height equals MB height: Jv12: DB cusp
height slightly less than iv1B cusp height: M3; OB
cu~p height much shorter than MB cusp height.
168. B. Radiographk findings oi a cotton-wool a1)pear-
a:1ce is commou in patients dia.gnos~d with
osteitis deformuns or Pagefs disease,
1-69. B. /:1 tbe process of muscle contraction, KfP bound
to myo,ln i! cleaved to form ADP and PL l'vlyosin
is rdeas.t"d to blnd to a new actin site producing
a force-generating stroke. Sodium influx and cal-
cium binding are involved in the excitation-con•
traction coupling 1>rocess but do not serve as a
source of ener1;,ry
170. A. C fibers are the smallest of the sensory and
motor fibers. They are postg.:mglionic, unmyeH-
nated, and have the slowest comhl(:·tion velocity.
171. B. The tendon of the tensor tympani is attached to
the hanct!e of the mctlleus in the middle eac
Lou<I sounds cause the tensor tympani to con-
tract, pulling the malleu.s ancl tympnnlc mem-
brane inward to reduce vibrations and prevent
damage.
172. B. Increased levels of alkaline phosphatase may be
observed ln diseases that diso!av extensive
bone loss. Osteoporosis is cha;acterized by a
decrease in bone mass. There are either normal
or decreased levels of alkaline phosphata~e in
patient! diagnosed with this disease.
173. A. Peutz-Jeghers syndrome is a hereditary disease
that is transmitted by autosomal dominance.
174. I). Ternporomandibular (T:VIJ) (Ash and Nelson,
2003): craniomandibulr11 (Woelfel and Scheid.
2002).
175, B. Tuberculosis ls caused by the bacteria
:'v!ycobacteriwn toberc11{0.,is. These bacteria can~
not be Gram stalned due to their waxy cell walls,
Therefore, to identify these bacteria, an acid~
fast stain must be ordered.
17G, D. M tuberculosis Infects rnanophages, whkh are
initlally unable to kill the phagoc-ytosed bacteria.
177, A. Cord factor i.s a glycnlipid found on the surface
of ilJ tubf'rculnsis.
l 7R D. Type IV delayed type hypersensiti\'ity reactions
are the only type of hypt""nH~nsitivity immune
reactions that are not mediated by antibodies,
They are mainly mediated hy T cell5.
179. E. Treatment !or tuherculnsls includes a multl~
drug therapy. RHampin, i~oniazid, and ethamhu-
tol are three of the first-line drugs used.
180. E. Ghon complex describes the caldfied scar l hat
remains following the primary infection. It is
usually found ln the lung and includes the pri-
mary lesion and its region.al lymph node.
181. B, Odontogenic inft:ctions of a mandibular incisor
wlth an apex helow the mylohyoid muscle have
the pot<·ntlal to spread to the suhmental space,
H the apex is above the mylohyoi<l muscle, the
infedlon would spread to the subHngual ,pace.
Both of these spaces communicate with the
::.tihmandihular space-.
18~ D. PhfJspholipas.e C, activaled by a t:ompont>nt
IJf the- G-protein (Ga) complf!Xed with GTP, cat-
alyzes the prc,cluction of diacylglycerol and
inositol trisphosphate. Diacylglycerol activates
proteln kinases. which phosphorylMes pro~
teins, and inositol trisphosphate produces
increas~d release of calcium from intracellular
stores.
183. E. JL.S is released by helpe:r T cells to stimulate !3
lymphocytes to differentiate into plasma cells
It :,lso activates eos!nophils and increases the
production of lgA.
184. B. The salivary gl.lmds are influenced by both the
sympathetk and para~ympathetic (glossopha-
ryngeal and facial) branches of the ANS, The
oculomotor nerve (CN Ill) carries pant:!lympl'l-
tbetic fihers to the eye which, when ~tlmulnted,
prnduces constriction of the puptL The
parasympathetic system innervates primarily
smooth and cardiac muscle, resulting in specific
activation and responses,
185. A. from the incisa! aspect, the maxillary central
incisor has a greater MD diameter (8.5 mm)
than FL diameter (7.0 mm). B, The MD di,i_meter
is 7.5 mm and the FL diameter is 8.0 mm; C, The
l'vlD diameter is 7.0 mm and the FL diameter is
7.5 mm; D, The MD diameter is 5.5 mm and the
FL diameter is 6.0 mm.
186, A. The ve5tlgial cleft of Rathke's pouch is located
between the anterior and posterior lobes-
specifically, hetween the pars interrned!a and
anterior lobe. lt consists of cyst-like spaces
(R..lthke"s cysts) and represents the vestjgial
lumen of Rl'lthke'! pouch.
187. C. A, Enamel cap thinner and more consistent in
rtepth; B, Compartttively greater thickness; D,
Pulp horns are higher 1n primary molars.
188. B. The regulatory centers for respiration are in the
brain stem-spetificatly, the medulla, The
medulla contains three groups of neurons
( nwdullary respiratory center, apneustic center
and pneumotaxic center). The cerebral cortex
may influence the medullary centers but does
not totally control respiration.
189. D. The brachia! plexus of nerves arises from flve
roots from the anterior primary rnmi of spinal
nerves CS through CS and Tl.
190. D, A,;choff bodies are the cl,:issic lesions observed in
rheumatic: fever. They are areas of focal necrosis
surrounded by a dense inflammatory infiltration
and may be observed in heart tissues.
l9L B. Cydo-oxygenase includes isoenzymes of
prostaglandin endoperoxiclase synthase, which
is required for the first step in the synthesis of
prn5taglanclin,; from arachidonic acid.
Phospholipa!'le A2. which is involved in the syn-
thesis of arachidonic acid. is lnhlbitecl by
steroidal antl~inf1ammatory agents.
192. B. Terminal bronchioles are characterized by
ciliated cuboida! cells.
193. C. Greatei· than 5'.;;~ (even up to 40'';;) in pnpulfltinns
with Mongolian traits, A, Does not exceed 4,.'.!'X
in Caucasians: B, Le..ss than 5'X. in Eurasiar: and
Asian populations; D, Less than :n, In African
populatio1:s.
194. C. The salivary glands are under the Influence of
both the sympathetic and p-0rasympathetic
nervous system. Parasympathetic stimulation
results in a more watery secretion c:omparto:d
wlth sympathetic .1timulation, which prnduces
inuea5ed amounts of protein with reduced
volume, The vagus ts parasympathetic. which ln
general is ~timulatory to gastrointestinal tract.
In general, sympathetics are inhibitory to the
gastrointestinal tract. (The exceptions are sali~
vary glands).
195. C. Transverse ridge connecting MB and ML cusps.
] 96, D. Jaundice is char,icterized by yellowness of tis-
sues, including skin, eye"s, and mucous mem~
branes. It is caused by diseases that increase
serum conjugated and/or unconjugated biliru-
bln. These conditions include liver disease,
such as cirrhosis or hepatitis; hemolytic ane~
mias; obstruction of the common bile duct,
as caused by gallstones or cholelithlasis; and
carcinoma involving the head of the µanc:reas.
197. B. Arteriovenous anastomoses in deeper skin are
lmportant in thermoregulation.
198. A. Complications of Barrett's esophagus include:
adenocarcinoma, stricture formation, or hemor-
rhage (ulceration).
199, D. The elongation and overgrowth of fiHform
papillae results in hairy tongue. Filiform papil-
lae are thin, pointy projections that make up
the most numerous papillae and give:!I the
tongue's dorsal surface its chllracteri5tlc rough
texture. Note: a loss of fl!Horm papillae results
in giossitus.
200. B. Tertic.iry dentin, or reactive/reparative dentin, is
dentin that is formed in localized areas in
respon5e to trauma or other stimuli, such as
caries, tooth wear or dental work, Hi5tologically,
its consistency and organization varies; it bas no
defined dentinal tubule pattern.
201. E. Innervation to the maxillary second molar, as
well as the palatal and cHstobuccal root of the
maxillary first molar and the maxHlary sinus, is
provided by the Posterior superior alveolar
nerve. The nerve ls a branch ,nf the maxiH,c1ry
nerve (CN V2).
202. D. The supraren<:1! glands secrete epinephrine.
Specifically, chromaffin cells of the the adrenal
medulla, which act as modified post-ganglionic
sympathetic neurons that synthe5ize, store and
secrete catecholamines. produce epinephrine. !t
a!so produces norepin~phrine.
203. A. The most common cause of gastroenteritis in
children ls the rotavirus. ft ls found in tbe
reovirus family,
204. C. (Ash and '.'!elson, 2003.)
Sample Exam Answer Key .- 379
205. D. Ureters travel inferiorly ju,;t below tl"w p;i,rleial
periton-e-um of the postt;rior body wall. They
pass anterior to the common iliac Mlt:·ries .:is
they er:ter the pelvis.
20(i A. Aspartame i,i; il peptldf' rieriYntive con:pn-.t·d of
aspartic acid and phenylalcrninc
207. E. The abducens ne.-rve 1CN VI) provides innerva~
tion to the lateral rectus muscle, which moves
the eyeball latera!iy, Le. abducts the eye. The
medial rectus muscle, which is Innervated by
the ocu!omotor nerve (CN II!\ i:l responsihlP for
adduction of the eyeball.
208, D. Potassium is passively (via the co1 mm.port sys-
tem) secreted from !he: plasma into th~ distal
and coll~cting tubules. Under conditions of aci-
dosis, an individual may become hyperkalemk:
since the klclneys v..-m retain K and secrete M.
Under conditions of alkalosis, K secretion will
be increased and B secretion reduced.
209, B. Eplphyseal closure marks the end of growth ln
length of long bone.<J..
210. A. Mhprotein is 1.111 important virulent factor found
nnly in the species Strepf(Kocn1s r,yngcnes.
211. A. The initi<1! rate~limltlng n:::,actlon involves the
removal of six carbons from cholesterol and
hydroxylifttinn of the steroid nudeus to produce
pregnf'nn!on,?, Pregnenolone can be further iso--
merizecl and oxidized to produce the other
steroid h,;rmones.
212. D. Use of the formula indicates on the basis of± 6
months that the ADF is 2 to 3 years.
213. C. A and Bare correct Dis per the manufaC'turer·s
recommendalions on product, 200S.
214. B. Systemic etiologic factors for bypopla~ia are
thought to occur possibly a!tcr birth and
before 6 years of age.
215. C. Measles ls not known to cause enamel hypoplasia.
2.16. D. Intermediate fllument is a smooth muscle fHa-
ment. Cnnnectln is another name for titin.
Stntements relative to A, B. and C are true and
refer to sln'!ctaf muscic filaments,
217. 0. l\.fasseter muscles providf;' most of lhc force
between molar teeth with dcnd1ing ln the inter•
cuspal position.
218. D. lmiiv1du.il5. who brnx during llw cl~iy dn r~ot n:?"c-
essarily brux .at night,
219. D. Sequential changes froru autonomic cardiac;
brain cortkal <"Crivitie-~ pn:'cede SB~relat0d jaw
motor activity.
22fL D. Maiocclus!on has not ber~n sug~csn:d as caus-
ing or a~gravz1tlug bruxism.
22!. D. Fhmrosis versus NF opacJtlc~ rnay ht.' diffkuit to
diagnose clinkally.
222. B. Thick and thin fliaments do not change in lenglh.
223. C SHLP help, stahilize the he.ad and condyle
a1-;ainst tlw eminence in clenching; A. B, and D
are true.
224. D. In the asn•nding ( disU11) loop of Henle, activt'
sodium ab~orplion results in an irH'ffa.sed
osnwlctrlty of the interstitial fluid, which plays a
380 T Sample exam Answer hey
role ln the retention of water undE-r conditions
oi dehydrat:on.
22:1. C. Under ..:onclltions of expansion of extracellular
volume (longAerm hype;tension). renin relea5e
and a\do5terone secretion are reduced.
increasing ADH, angiotensln II. and increasing
sympathetic activlty woulrl result ln an increase
ln blood pressure.
226. E. The most superficial layer of th~ epldermis is
the stratum corneum. From deep to superficial,
the layers are basale, splnosum, g:Jndosum,
lucidurn, and corneurn
227, D Calcitonin is secrett:d by parafo!llcular cells
(clear cells) that are located at the periphery of
thyroid follicles in the thyroid gland. Calcitonin
plays an important role in the regulation of cal~
cium and phosphMe-s. lt suppresses bone reab-
sorption, re5uJting in decreased calcium and
pho5phate reiease.
228. C. The ratio of inorganic to organic matter Jn
mature dentin is approximately 70:30. in enamel
and cementum, it is api,rnx!mately 96:4 and
50:50, respectively.
229. B. Tuberculin reaction (Le, PPD skin te:Jt), is an
example of a type IV delayed (cell-mediated)
hypersensitivity. Type lV reactions are the only
type of hypers~n!itivity imm'Jne reactions lhat
are not mediated by antibodles, They are mainly
rnerHated by T cells.
230. C. Vitamins are not digested by enzymes from the
pancrea5; however, digestion of carbohydrates.
fl1ts, and proteins may be requlred to mak~ vita-
mins avtiilable for absorption. The pancreM
produces amylase for c-arbohydr.!!ite digestion,
lipase for lipid digestion, and several prote-
olytic enzymes (tryp5inogen, chymotrypsino-
gen, and procarboxypeptidase) ror the <lig:e!-tion
of protein.
231. C. The me:u.•ncephalic nucleus contain the nuclel of
the trigcminat sensory nerve:s (CN V) involved in
proprioception anfl the jaw jerk reflex, including
periodontal ligament fiber!'I Involved in the
reflex. It is located in the mldhrain and pons.
232. A. Aldostcrone secretion is mediated through the
renin-nngiotensin system. Angiotensin Il stimu~
!ates the :synthesis and release o! aldosterone
from the adreru~I gland. It acts on the distal
tubule anrl collecting ducts to increase sodium
re,i,ibtwrption an<l pota~sium -secretion,
233. A. First evldence of the maxi!lary central incisor
calclflcation is givf'!n as 14 (13 to 16) \.\leeks by
Kraus and Jordon, 1965, and by A5h and Nelson,
2003; this is given as 4 months by Woelfel and
Scheid, 2003.
23-1, D. Lingua! aspect: D, Well-defined developmental
groove $eparating ML and DL cusps. A. ML cusp
large and well-developed; 8, DL cusp well-devel-
oped, more so than that of tbe primary first
mol"-r; C, There is a supp!ementzil cusp apical to
the ML cusp, but poorly developed.
235. B. Cretinism is hypothyroidism ln children. Oral
fincling5 include macroglossia, prolonged reten-
tion of primary teeth, and delayed eruption of
permanent teeth.
236. A. Surfllctant ls synthesized by alveolar ceHs and
functions to reduce the surface tension of th~
alveoli. This reduction of surface tension
increases pulmonary compliance and decreases
the work of breathing. It will afso decrea.,e: the
tC'ndency of the lungs to collapse. Lack of sur~
faz::tant results in neonatal respiratory distress
syndrome.
2:n. D. The red pulp of lhe spleen consists of cords,
containlng numerous mncrophages, and venous
sinusoids. !t is the site of blood filtration. The
whlte pulp of the spleen contains numerous T
and B lymphocytes.
238. B. The velocity of blood flow ls the rate of dis~
placement of blood per unit time. Velocity
changes inversely with cross-sectional area
(cm:;). Tht greater the area in the vessels, the
lower the velocity. Since blood is always flowing
due to the distensnhllity oi the arterial tree,
velocity is never zero,
239, A. Neuramini<lase i~ fotrnd on the surface envelope
of infhienza viruses, It functions to attach the
virus to the host cell.
240. C. These are the most common sequences of erup-
tion.
241. E. All of the features listed are commonly observed
in ml1lignant cells, except a low nuclear-cytoplas-
mic ratio, Due to the large nude? present, there is
usually a high nuclear-cytoplasmic ratio.
242. B. The two vertebra! arteries join together at the
border of the pons to form the basilar artery,
Branches of the bastlar provide blood supply to
the pons.
24:i, C. R~A synthesis is not required tor genetic
cloning. All the other enzymes are required to
synthesize and splice DNA.
244. D. The most potent stimulant of the respiratory cen-
ter that increases the rate oi breathing: (hyper-
ventilation) is increased C(J, tension. co._, is
permeable to the blood-brairl barrier and lllti-
mat0ly p!"oduces nn increase ln H' of the cerebral
splnal fluid. However, plasma Wand HCO., are
not permeable rind thu5 have little direct eff;ct on
the respiratory center. The resplratory center is
not sensitive to oxygen tension, unlike peripheral
chemoreceptors.
245, D. It is a branch uf the maxillary (CN V2) nerve.
The maxillary nerve branches from the trigemi-
nal ganglion and exits tbe skull through the
foramt>n rntundum, When it reaches the ptery-
gopalatine ganglion, it terminates as the in.fraor~
bital and zygomatic nerves.
2·16. B. Root bifurcation is more likely in the mandlbu-
lar canine.
24 7. B. A ketose sugar is on that contains a keto group.
Glyceraidehycle, mannose. glucose, and galac-
tose are all aldoses 5ince they contain an alde-
hyde group.
248, E. Both tetracycline and snepto1nycin, an amino-
glycoside, inhibit proteln synthesis in bacteria.
Streptomycin, however, is bactericidal. not hac~
teriostatic
249. C. The auricular hillocks ate derived from the first
and second branchial arch.
250. C. The 1-ength of the primary m/\xillary central inci-
sor is 16 mm (Blbck GV, cited in Ash and Nelson.
2003;; 16 mm (Kraus et al.. 1969)·, or 17,2 mm
(Woelfel and Scheid. 2002). The permanent max-
illary incisor is 23.6 mm (Ash and Nelson, 2003);
23.5 mm (Kraus et al., I 969); 23.6 mm (Woelfel
and Scheid, 2002). 16/23.5 = 0.68 or 68~,;
17,2/23.6 ... (t73 or 73:t. The answer is about
70%.
25L B. Ehlers·Danlos syndromes are characterized by
defects in collagen (Le., connective tissues).
252. C. Acetyl CoA. Malonyl CoA ls produced following
carboA-ylation of ac:ctyl CoA in the :,;ynthetic
process of fatty acids. FAD and NAD are involved
in fatty acid oxidation but NADPH ls the source of
reducing agents ln the synthesis of fatty acids.
25:l A. Insulin i~ a hormone that is secreted under con-
ditions of increased sources of energy (glucose)
and therefore results in increased uptnke and
storage of glucose in the form of glycogen. In
the process, blood glucose ls decreased. The
transport of glucose into the brain is not
affected by the hormone,
254. B. Osteocytes are found Jn lacunae in mature bone.
255. D. From MD aspect, all posterior teeth have a
trapnoidal outline with shortest uneven side
toward the ocdusai surface. A, Present prima-
rily on first premolar; B, Exceptions may be the
DB root of the maxillary second molar; C, From
mesial and distal aspect, all posterior mandibu-
lar teeth, not maxillary posterior teeth, have a
rhomboidal outline.
256, A. Due to the excessive levels of serum calcium.
osseous changes, such as metastatic calcifka-
tions and kidney stones, wilt occur in patients
with hyperparathyroidi~m.
257, B. This enzyme catalyzos the pho~phorylation of
fructose &.pho•phate to fructose l,&.bispho•-
phate. This irreversible reaction is inhlblted by
ATP 11.nd citrate (indicators of energy abundance
within the cell). The reaction is stimulated by
AMP.
258, B. Type II coHagen is one of the fibril-forming col-
lagens found in cartilaginous structures, Type i
is characterized as having high ten.sHe &trength
and found in skin, tendon, bone, and dentin.
Type m collagen ls characterlstically more dls-
tensible and ii found in large blood vessels.
Type IV is found ln basement membranes.
259. B. (Kraus et al., 1969.)
260. D. From the retropharyngeal space, Le. "danger
space," odontogenic infections can quickly
Sample Exam Answer Key ~ 381
spread down this space intn the thorax (poste~
rlor ir.ecli.astinum) and cause possible de11.th.
26L B, Trlsomy 21, which is also known as Down syn•
drome, is a disorder affecting autosomes. 1t is
generally caused by meiotic nonriisjtmction in
the mother, v,.·hlch results in an extra copy of
chromosome 21 (trisomy 21),
262. A. Type I coi1agen is the predominant c:nllagen
forn~d ln cementum, Type lll collagen may be
present during the formation of cementum, but
it is largely reduted during m.ituration.
263. A. Net filtration depends on the hydrostatic pres-
sures in the glome:rular capiilary, the hydro~
static- pre5sure5 in bownrnn·s space, imd the
oncot\c pressures in the capillary and bow-
man's capsule. Reducing the pliit:!tma protein
(reducing the oncotic pressure) will lower the
tendency to retain fluld in the capillary. This
wou!d result in a net increase in filtration.
264. C. Auer rods a.re observed in blast cells character-
istic of acute myelogenous leukemia.
265. D. Vasopressin, also known as ADH (antidiuretic
hormone), ls a pepUde secreted from the poste-
rior pituitary in response to an increase in
serum osmolartty. The other hormones listed
are synthesized and secreted from the anterior
pituitary.
266. A. Secretory lgA is an fmmunoglobulin that is
unique to the oral cavity. The secretory com-
ponent is synthesized by salivary -epitheHal
cells and complexes with lgA to form secretory
lgA.
26-7. D. Marked asymmetry of mesial and rlistal halves.
268. D. Oxidation oi fatty adds, glucagon release, and
i:;lycog~noly,ls are all increa.5ed to provide
energy sources for exercising muscle, The syn-
the:-;i~ of llpid (lipogenesi5-) would be decreased
during periods or exercise.
269. B. The thymus is active at birth and increa~e~ in size
until puberty (around age t2). after which it grad-
ually atrophies and is replaced by fa.tty tissue.
270, C. Monoamine oxldase Is an enzyme located in lhe
presynaptic nerve terminal, which degrades
dopamine, norepinephrine, mid epinephrine to
inactive substances
271. A. B, Tooth grinding in sleep bruxism lasts up to 5
minutes, not 20 minutes; C, Sleep bruxism often
coincides with p<tssage from deeper to lighter
sleep, not lighter to deep ~leep: D. Sleep brux-
ism occurs apprmdmt\tP!y every 90 minute,, not
every 20 minutes ln the sleep cycle
272. D. These oral findings can be ob!erved in patients
wlth hypNthyroi<lisrn. The only endocrine dis-
order iisted that is related to hy1wrthyroidism
is Plummer·s diseast'. It is c.,msed by a nodular
growth or adenoma of the thyroid.
273. C. Fat in the intestine, low pH:, and increased osmo-
larlty of intestinal contents will reduce gastric
emptying, This reflex is mediated through neu-
ronal and endocrine factors comprising the
382 .- Sample Exam Answer i\cy
C'nterog:astrk reflex. Sa!ine ln the intestine will
nol affect gastric emptying.
274. D. Occiusal contact relations do not interfere with
jaw opening. but TM.! and muscle disorders
may.
275. C The o!ecrannn fossa is located on the posterior
surface of the humerus.
276. D. Chronic lymphocytk leukemia is characterized
by the proliferation of B cells. It is both the most
common a:1.d least maiignant type of leukemia,
277, C. tRNA is not required for the hydroxylation of
collagen since the process occurs after trans!a-
tion of mRNA and synthesis of collagen,
Ascorbic add is required to modify the collagen
molecule by hydroxylating prolln~ to permit
cross-linking among collagen in tissues.
278. C. Distal to the second premolar, 56'Jf),
279. D. A, The mesio!ingua! cusp is most prominent: 8,
The dij/olingoa! cusp ls poorly defined; C, The
distobuccal cusp may ~ seen bec,111.se it is
longer,
280. D. The posterior and anterior vaga! trunks pass
through the diaphragm through the
esophageal opening. The aorta enters the
diaphragm through the median arch. the infe-
rior vena cava through its own opening in the
central tendon, the azygos vein through the
right crus, and the ,ptanchnic nerves through
the crura.
281. B. The sympathetic postganglionic fibers lnnervatw
ing the heart release norepinephrlne.
Acetylcholine is neurotransmitter in sympaw
thetic preganglionic fibers, parMympathetic
po5tganglionic fibers, and parasympathetic
preg2t.nglionic fibers.
282. C. o,t~opetro5iis, also knmvn as A!bets.SchOnberg
disease or marble bone disease, is caused by
abnormal osteodasts, The lack of bone resorpw
tion results ln defective bone remodeling llnd
increased bone density, which may invade into
the bone marrow space.
2&1, D. Langerhans cells are located primarily in stra~
tum splnnsum,
284. B. Nitric oxide is a molecule produced in
endothelial cells that acts directly on smooth
muscle to produce relaxation and vasodilata-
tion. Therefore, inhihition of its synthesis
would be expected to .raise blood pressure.
Inhibitors of angintensin 11 synthesis should
reduce blood pressure since angiotensin II
stimulates aldosterone 5ynthe~is resulting ln
increased fluid retention. Angioten!\.in II is also
a potent vasoconstrictor. Blod:fni vasopress:n
(also a potent vasoconstrictor) receptors
would reduce blood pre~sure. St!mu!ation of
the haroreceptor would produce a reflex that
would reduce cardiac output and peripheral
sympathetic tone,
285. A. (Ash and Nelson, 2003: Woel!el and Scheid.
2002.)
286. C. The movement of the tongue against the palate
ls the only voluntary prm;ess among the four
pos5ible answers.
287, A. CDS lymphocytes recognize class I MHC mo!e--
cules on antigen~pre~enting cells. CD4 lymphoM
cytes recognize cla>s 11 MHC molecules on
~nt!g:en-pre&t-nting cells,
288. A. Bifurcated roots are not a normal feature of
mandibular incisors.
289. C. The inner enamel epithelium in the bell stage
differentiates into ameloblasts
290. D. The cartilage of the trachea is covered by a peri,
chondrium. The mucosa ls covered with re!pi-
ratory epltheiium. Hyaline cartilage rings lie
cteep to the submucosa. The open end of the
cartilage faces the posterior, Smooth muscle
extend• across the open end of each cartilage.
291. C. Pemphigus is an ,1utoimrmme dtsease wherein
autoantibodies against epiderm.ls cells are pro-
duced. Hisfolog:ically, a phenomenon <'alled
acantho{ysis, wherein epidermal cells appl':ar to
detach and separate from each other, is
observed.
292, A. following a meal, chy!omicrons are synthesized
in the intestine to tran,iport Hpid to the liver.
Aceto.:icetate (ketone body} is found under con~
ditions of increased II oxidation (!a,ting).
Glucagon is secreted in response to reduced
b!ood sugar. which usuaHy is not present fol-
lowing a meal. Lactate, a product of anaerobic
glycolys.is, is not elevat~d under conditions of
elevated energy sources in the post-absorptive
state.
293. A. Bruxlsm is now thought to be mainly regulated
centrally, not peripherally.
294. A. A di!.tinct deveh)pmental groove. prominent
buccal triangulll.r ridge, two cusps, and distinct
mesial and distal occlusal pits are most charac-
teristic of the mandibular first premolar.
295. B. Autodaves function by denaturing proteins. ft is
effective again~t spores.
296. D. In the initial stPp of the synthesls of porphyrin,
sucdnyl CoA and glycine are condensed in a
rate limiting ~tep in the liver.
297. B. The dental lamina arises from neural crest cells.
298. A. The only disease listed that is related to an
abnormal number of chromosomes is
Klinefelter·s svndrnme. This disease is charac-
terized by twC: or more X chromosomes and one
or more Y chromosome. Typically, those
affected have 47 chromosomes with a karym
otype of XXY.
299. A. Stretchlng of muscle spindles results in a reflex
that is intended to adjust the muscle to !ts rest-
ing length by contracting the musde in which
It is found. The stretching of the :!lpindle in-
creases afferent lmpulses to the spinal cord and
through a monosynaptic reflex stimulates mus-
cle contraction via an alpha motor neuron.
300. C. Below the apices, 63'¾, of the time.
I
30!. E. Urinary filtrate is most hypotonk in the distal
com-oluted tubnle, lt is isotonic in the proxlma!
convoluted tubule and thick descendlng limh of
Henle's loop. lt becomes hypertonic as it pa55e~
through the thin descending limb of Henle's
loop, and becomes hypotnnic as it passes
through the thick a11cending segment of Henle's
loop. Flna!ly, lt becomes increasingly hypotonic
as H passes through the distal cn;ivoleted
tubule.
302. C. There are seven pairs of true ribs, meaning they
attach directly to the sternum via coital carti-
lages, The rernalning flve pa!rs are called false
ribs because they attach Jndlrectly to the ster-
num via costal cl'.\rtilages. The last pair does not
attach at al!.
303. B. The total of average overall mesiodistal diame~
ters of primary maxill.11ry crowns is 68.2 mm
(Black GV, cited by Ash and Nelson. 2003): 76.8
mm (Woelfel and Scheid, 2002),
304. C. Symptom! of a myocardial Infarction lndude
chest pain, shortness of hreath, diaphoresis
(sweating), clammy hands, nausea, and vomit-
ing,
305. C. Amino acids are transported across the luminal
surface of the tntesllne by Na' amino acid
cotran5porten1 in the apical membrane. Th.ls is
facilitated by the Na' g:adient established In the
intestinal cells.
306, A. Of the cell type! Hsted, only smooth muscle
cells are caoable of cell division.
307. B. Vltamin Ki~ involved with the po5ttrnnslatiomtl
modifi<'ation of glutamjc acid to form y-car-
boxyglutamic add. This carboxylation permits
prol hrombin to interact with platelets and ions
in the proce54 of dot formation. Hydroxylation
of prolin~ requires ascorbic acid and iron.
30R D. Squamous cell carcinoma is the most common
oral cancer, occurring in 90'.)(- of all cases. It is a
cancer of squamous epithelium, spedfically a
tumor of keratlnocytes,
309. B. The permanent maxillary first premo[ar usually
has two roots but they are lluccal and linguBL
not mesial and distal.
330. D. Actinic keratosls produces dry, scaly plaques
with an erythematous base, They may be pre-
malignant. Both compound and lntraepidermal
nevi are benign, Only jLmctiona! nevi are con~
s!dered to be premaligmi.nt.
31L B. Secretin stimulates bicarbonate secretion from
the pancreatic ducts. Cholccystoklnin (CCK) is
responsible for stimulating pancre.atic l':nzyrne
secretion and contraction of the gall bladder.
Chymotrypsinogen ls activated by trypsin in the
intestine.
312. B. Textbook chronologies indicate that the maxil-
lary primary second molar is most commonly
the iagt to erupt: 24 months (\Noelfel and Scheid,
2002): 20 to 30 months (Kraus et al., 1969): 2S to
33 months (Ash and Nelson, 20(13).
Sample Exam Answer Key T 383
31:1. D, The l.l.ti:-slmus dorsl niuscle is ::supptic:d by the
thoracndorsa! nerve,
314. B. Regula.tion of blood flow to skin is under the
control of factors acting locally (metaho-lites)
and (f-Mirenerglc receptors. Slowing oi tlie
hea:t nnd actl\'at:,)n of gastrointcsti.ial mntilitv
are medlatecl t!mrngl1 the- cholln<'rgic systen~.
a-,:uircncrgic receptors produce decreased
renal hlood flow.
315. A. The auriculot(•mpornl nerve provides primary
lnnervation to the TM.L
3lfi, B. The subm,;:nl;1[ artery is a branch of the iacla!
artery. Branches of the rn,:indiht1im division of
the maxillary artery include the Inferior alveow
lar, deep auricular. anterlor tympanlc, mylohy-
oid, incisive. mental and middle mrninge,:d
arteries.
317. E. Rh0umatoid arthritis. is chnractc!"ized by lnflam-
matlon of the s.ynovial nwmhrnne. Grnm:lntion
tissue wtll form. in the synovium and expand
over the articul<)r cartUage. This causes the
destruction of the underlying cartilage and
results in flbrotic chan!{es or anky!osls.
318. D. (A•h and Nelson. 2003.)
319. C. The trapezius muscle is ~upplic-ci by CN XL
Latis.simus dorsi is supplied by the thorac:odor-
saI nerve, !evator scapulae is !.upplied by lhe
dorsal scapn!ar nerve. and the major and minor
rhomboid muscles are supplied by the dorsal
$Capular nerve.
320. B. A quelllng reaction occurs in a laboratory wben
the poly~.-.ccharide capsule of a bacterium swells
after being treated with antiserum or antibodies.
321. D. l.'nder conditions of Increased intra.cranial pres~
3Ure, th~ vasomotor rl?gi()ns of the medulla are
stimulalect due to localized iscllemla resulting
in an increase in systemic bloocl pres,ure.
Ventricular fibrnlation i5 !rregul,ar, rapid. unco-
ordinated contractions of the ventnde that do
not result in efff'cting blood movemc-nL
Anaphyliiclie shock is caused by severe t1llergic
reactions, wirlespread release of hi3Uunine, and
subsequ0nt vasodilatatinn.
322. D. Teichoic acid may be found only in the ePll walls
of gram-positive bact£:>ria and contain antig.Pn!t"
properties. All of the other answers listed ure
found in the cell walls of gram-negative bacteria.
323. A. The articut;:iting ,urfaces. of the TM.I are cov~
ered witl1 fibrocartilzige, directly over!ying
perioste-um. Thf> no1Htrticuialing ,urfacet- oi the
TM.I are covered wlth periosteum. The artku-
latin!:! surfac~s of diarthrodial joints are covered
with hy11Jine cartilage,
'.J24. B. Both epinephrine and glucagons result in aclivi~
ti~s which serve to increase {mnlntaln·) blood
glucose. Activation of giyrogcn phosphorylase
wili r.::sult in glycogen cle-grndat!on. ul!irnately
providing a source of ~lucose. Glycogen sy1;-
thase lnhibitkm results in d0creascd synthesis
of g!ycoge:n.
 Sample Ex:;nn Answer h. cy -.. 385

A. hy lfrm!r-'teff:1 perrus :1s1. C. a rf'ducing agent tor the A. A :niccl:e i~ a gloilu!;ir structure
\Vorking ( balancing) factors contribute to it.s vir- adds- The mo:r.ophos~ wlwn the pn!ar he;id:, of m,
intern;;! carotid ar!er:,- jni:H:d t(l rhe pos~ lgA prnte<tsc. Thi:,:; c·uzynie also produces ribose (fatty acids·: !ntPrfif't with .:iqueous
the ;Jnsreriur nu('l0otide synthesis, Ni, ATP or envlrnnnw11t th.::· r;(lJlJJnbr hvdro-
part /Jf the of is produced in the 1;;,\tlv.vay. Fructose l,(i-bis~ dustered insld(, -
Wil:is C. produced during
::t'.:7, E. intl, (and fat) C. ,\tr,entw·,,m,s t'iriduns
cells ls due to the activlty of glucose lrnnsporters ume ctfl)mmt of air exdrnr.ged \ exp!ra- endocasdltis. Sraphy-
\•/hkh (ioes not require ATP and l ion and ii1spiratli'1l) norm.Jl qult't fococcus aurew; c-orrunc111 cause 1Jf
pendent of any ionic cr-:wt'nl r;;tlnn h:eat!1ing. Function;1I acutt· endneardltis for-
is requir0d !or the actlvity of ali combir.ation of the expired for the crnwn outline converges on!y not before.
(fnrced t::<piratl<rn) plus the residual volume. R has h0t>n '.:\6K A. Emlntnx!n is found in frw
C. Vital capacity the vo!;mw of expired z:dt,::r ridge ceU wails of g:rnnH10g;;:tive
inspiration. as well as th,~ lower A.. The trm·h!e.a of tlie hunwrus art'lcu\ates with
3-12, D. ,ih:sful aspect: A, Pronounced convexity present and the ulna nf the /o;earn), The of the•
3'29. C. (Ash ;rnd chi;;1, primarl!y drain into the lrnrnerus bnne articu1nt(•$ oi the
devE:lnpmental groove the rnesiai marginal The rest of the mandihuiar teeth (premolars and fon;arm. The cornnoid fossa, located just sulH'~
ridge-. occlusal third: D, !'v1e-slollngual longer and molars) mainly <lrnin Into the suhnrnnriibul0r rior to ihe- trochiea, fits the coron-old proce~s of
330. D. A!l posterior teeth vi(~wed irorn distal aspect sharper than mesiohuccal cusp, nodes. the ulna the forearm. The olccranon of
have a rhnmboldal rnJtltne. 34'.t C. The deve!ops from 355 D. Rickets ls a vHamin D deficie-ncv seen in infants the hurncrn.s Hts the nlecrnnon of the ulna of the
D. Dextrans t1H1leeu!0s ilnked The blastocyst, and tcr,nhnhh,t and children. Ora! findings lnducle delayed furean;1. The medial epicnndv!e on tlie
the structurn! include structures of of teeth i.lml abnormal dentin. humerus itself and serves a.s :ittachment
contribute to cnelern Uwt v.·m lead to devt:'•lnpment A. In irreversible oxidative for muscles
near the tooth. amnion, vitellin<.'. sac. and chnrion. pyruvate to acetyt CoA 370. A. During a fast, catahnlism ls: increased to provide
Fructans or lev.ans are al.so found Ill plaque; how~ :344_ C. lmmnln"•ics SO that of nase, the five additional smm:es of enerh'Y· This i.s ch<ffacter~
ever, they contain fructose . central 357. D. A oe,;eHmrncrlf,11 increasrd utilization of laHy aclcls, When
a32. C. Substitution of most ions (wlth the of inctsor months (Woelfel and divides the production of acetyl CoA (produced by
fluoride) will increase the !;o!ubillly of Scheif!, months (Kraus et al., 1969): 8, It has a rtwm- enhanced the oxidative
ta! structure, The ratio of calcium and 7.5 months (Charlick or 8 (6 t-o 10) The
lmiro:n,anatite is l.67: I. months (Ash and Nelson. mesia! buccal cusp is
C. from ectodenn. Dentin 345. It Prr,c,estemr,c entrntion ln blood is highest 358. D. Fibers of the superior of the lateral and u!vrnc·em,sis
are derived from rnesode,m. of U-1 (leutcini?ing hormone) muscle attach to the anterior encl of inhibited due to !imHed enc-rg:y
'.t34, of Henle's loop contains sqiw- which to balance and stabilize the CoA production in the liver is
mous cells. The prf1 xim:1! convoluted disc closure. Pnlrnncc,d ;J-m:idation
tubule, also known the thick descending limb 359. B. (Ash and 2003.) :HJ, D. The nu deus is found in ! he medulla
of Hen!e's loop, the thick segment of 360. D. HBe-Ag is present when there is active vlrnl contnins the eel! bodies of
Henle's Ioop. and the di~ta! tubule replication and the rarrier is motor neurons for CN lX. X and Xl The cc•il bod•
all of cnhnld:1! epithelial cells. B. left ,itriovPntrlcnlM valve of the he,1rt is also C. Saliva Is fornwd by involves ies of CN Vil, IX and x·s
df'h_ydrogenase and known the mitral The the fonnatlon of solutlon contained in the nudeus of
(ir-hyc!rogena!H'. are irre- trkul.:,r valve of the heart is also which is subsequently A. Calclurn is storf:d and released from sar~
verslble enz:•it:nH~s in the pcntose phnspilr!le tricuspld va!ve. The aortic valve prevents cells to a more hypotonic solution rPtknlum during excilatlon-<:ontrac~
ivi.thway, Gluc0kinase is i:woh.:t~d with gitatinn of hlood from the aorta h<Kk into The modification pri:na· This an extensive
rylatlon of glucose when ventride and pulmonary valve of $Odium and pi:•rmitting lntr;K<-l!u-
of high. Glucose 6-!Jl1ospli,1taf.e regurgitt1Hon of blood from the and s(~cretiN1 potassium and bicar~ !ar free ca::, to be lnw when the mus-de fiber is
6-phosplrnlP- to form artery bark Jntn the ventricle. bonate. As salivarv flow increases, thr: riuctilf: at rest. The rele<1s(• of calcium is due to confnr-
final step in '.i/47, C. The leading cause of cells have l(~ss tlmf'~ to modify the composition of matinn;i! chrmges tvlllch opens ch•rnnds in
33fi. D. of contour on dislal is can:!iovnsr:u!nr dlsease. Other rnmn11c,,,t1,rns saliva, \.•,;hkh results gret1ter concentrations of lhe sarcop!asmlc retictd11rn.
include retinopathy, nephrupathy, ;md periph· sodium and chloride ions, Bicarbonate concen- 373. B. The vaccine consists of tetanus toxold
'.J'.57. E. Caf'diac tarnponad(~ is a .<:H:rious eonclltion em! ne11ropathy. tration incn,ascs salivary flow increases due 1t is part of the DPT vaccine aml should be i.;iw:11
caused by an::un1ttlatinn of fluid the peri- '.):18, C. The corr('d answer for A would be abnut 1.5 to the st imul<tilon of bicarbonate by about everv rn
cardium. This can r<·sul1 in impnlred ventricnl.ar months or 6 weeks: About 4 to C, the pr1rasympt1thNic The salivary C. of c~_mtnur on lingual surfaces of mo!ars
filling and rnn lead to denPascd cardiac About 2.5 monlhs or JO n:eel:.s.' D, About to 5 glands are prcinnl:irs is at thC' cervical or rnidt!Ie thinl.
output rmd branches 375. A. \1usclcs are innervated by two lype~ ot motor
'.1:38 B. The correct order of tooth formati,m D. centrnl deve·lopmental groove is ~162. B. The oxy- netirons (~1lpha and g;;mnrn). The alpha rno\1):i-
arneloblasts fnrrn. od,mtnblnsts form. <,donto- found on {he mandtbulilr second premotnr. :wurons innervate musde ill1r•rs
blast.s start to form dentin, ;1rnf:'!(lblasts start !.o :):10. B. Tht' sternal between rile manubrium and (ex1rafusnl skeletal m;1scle.s).
form enamel. the sternum marks tlie position of second iwuron;'-. innervate the ;rrnsde
]'.19. C. Reduction dlvlslon o(:curs during the first stage rib. Frnm this location ribs c;m be (·01mtecl fusnl musd<• filwrs"}. inuscks (lf lh<:' irio-
of mt•ioSais. The second stag0 mirrors mitosis exlernal!y. This Is bt?cmise the first 363, are characterized by <'I contr0Hed both sympatl!clic i11nerva!io11
Tlwre ls no third of mt::iosis. rib cannot be heart-shaped body. (di lat inn) par;1sympntl1et!c innervation (ron-
386 .., Sample Exam Answer Key
striction). The pyloric sphincter in the stomach
is regulated primarily by the enteric nervous sys~
tem and regul.tilory hormones in the GI tracts
376. E. The mitochondria is surrounded by a double
(inner and out.er) membrane. The nuclear mem-
brane (not listed), v,1hich surrounds the nucleus,
aiso consists of a double (inner and outer)
membrane.
377. A. Calmodulin is a calcium-binding protein in
smooth muscle which, when bound to myosin,
initiates contraction, Calmoduiln activates
myosin kinase, which results in myosin-actln
crosslinking and contraction of smooth muscle.
378. A. The fumen of the gastrointestinal tract ls lined
with mucosa. The rest of the choices are in
order from ]umen out. Ffbrosa and adventitia
are synonymous.
379, B. DB developmental groove is not found on
mandibular second mot.a.rs.
380. E. Bacteria that are phagocytosed by macrophage,
are kept in membrane-bound vacuoles called
phagosome.s. A phagosome will iuse with a lyso-
some, which contains many de.gradative
enzymes, including lysozyme.
381. B. During metaphase, mitotic spindles form.
Chromosomes attach to these spin-dies, with
their centmrneres aligned with the equator of
the cell.
382. A. DNA ligase is required to ligate the fragments
together, DNA and RNA polymeraiea are c-ata~
lysts that synthesize DNA and RNA in a continu-
ous process. Reverse. transcriptase is an
enzyme found In viruses that makes DNA by
using viral RNA
383. D. The maxillary nerve (CN V2) exits the skull
through the foramen rotundum. It then passes
through the pterygopalatine fossa, where it
communicates with the pterygopalatine gan-
glion. Contents of the superior orbital fissure
include CN III, IV, VJ and VI and the ophthalmic
veins. CN VU and VIII pass through the internal
acoustic meatus and CN V3 (the mandibular
nerve) passes through the foramen ovale. The
foramen spinosum is not associated with any
cranial nerves: it contains the middle meningeal
vessels.
384, D..A.sthma is an obstructive Jung disease caused
by narrowing of the airways, Common symp-
toms include dyspnea, wheezing on explraUon,
and a dry cough.
385. A. Greater MD diameter relative to crown height
than permanent teeth, B, Squat appe,inmce, not
elongated appearance; C, Crowns are a miik'Y
white. not translucent white: D, There is no root
trunk.
386. D. The teres major muscle is a shoulder musde,
however, it is not a rotator muscle. All of the
other four listed in this question are rotator cuff
muscles,
Sample Exani Answer Key 'f 387
387. B. A motor unit is composed of a single motor neu* anterior wall is covered by pectoralis major 399. D. Ora! epithelium is composed ot nonkernt!nizcd,
ron and the muscle fibers lt innervates, Since
and pectoralis minor. Latissimus dorsi con- :stra!iflect, squamous epithelium.
the motor neuron will stimulate all muscle tributes to the inferior aspect of the posterior 400. D. Chondroitin sulfate is a gluco!'>aminoglycan
fibers it innervates, ""fractions" of a motor unit wall. found ln !lgaments, tendons, and cartilage. It is
cannot be stimulated. The number of motor 398. C. Although some CO., is transported unchanged in the most abundant glucosaminoglycan in the
units recruited. the number of muscle fibers the plasma and in- the red biood cells as car~ body.
contracting, and the frequency of stimulation
baminohemoglobin, most is transported in the
wm all affe-c:t the degree of muscle tension form of bic1.1rbon~te ion in the plasma.
produced.
38-8. E. In the Ever, smooth endopla~mic reticulum Is
involved in glycogen metaboH,rn and detoxifi-
cation of various drug~ and alcohols; it there~
fore, contains P450 enzymes, which are
cytochromes that are important in the detoxifi-
cation process,
389. C. Cardiac output is the volume of blood pumped
per minute by each ventricle. This is influenced
by cardiac rate and stroke volume (end-diM-
tolic volume - endMsystolic volume). The car-
diac output for this patient is 70 x I 10 mL or
7700 ml per minute,
390. B. Mandibular first premolar is most likely to have
a gingle pulp horn.
391. E. Dipicolinic acid is only found in spores. Since
C1o.stridiom is the only spore~lorming microor-
ganism listed, the correct answer is E.
392. D. RNA polymerase is an enzyme that transcribes
DNA Into RNA chains. Synthesis Is similar to
ONA reproduction since it 1s synthesized 5' ➔3~.
393. C. The frontal bone of the skull is lormecl by
intramembranot1s ossification. The humerus,
vertebrae, ribs, and clavicle all are formed by
endochon-dral ossification.
394. B, The sum total of the pressures moving fluid
out of the capillary is P" (37 mmHg) and rc11
(1 mmHg) at the arteriolar end and P, (16
mmH&J and >:11 (I mmHg) at the venular encl, The
sum total of the pressure~ moving into the
cap!llary is P., (0 mmHg) and rr, (26 mmHg} The
net exchange pressure on the arteriolar end
leads to ultraflltratlon (12 mmHg), On the venu-
lar end, reabsorption occurs {9 mmHg). Overall
net exchange results in 3 mmHg of [luid loss out
ol the capillary.
395. B. Thyroxine and triiodothyronine are formed by
the cleavage of thyroilobulin following stimu-
lation by TSH. Most thyrm::ine is converted
to triiodothyronine in liver and kidney.
Thyroglobulin is the storage form of thyroid
hormone, TSH {thvroid-~tlmulating hormone) is
produced in th"'e ~nterior pituitary. It is not a
hormone secreted from the thyroid hut acts to
stimulate the synthesis and seeretion of thyroid
hormones.
3%. C. Dust cells, along with heart fail cells. are
macrophages that are found ln the lungs. They
are part of the reticuloendothelial system,
397, C. The lateral thoracic wall of the axiHa is cov-
ered by th-e serratus anterior muscle. The