Oral Diagnosis, Preparation for NBDE Part II

  • Category: Dental Pathology & Medicine and Dental Radiology
  • Aim: Revising for NBDE Part II
  • Questions: 25
  • Hint: No
  • Mutiple Opportunites: No
  • Time Limit: No
  • Answer Explaining: Yes

Oral Diagnosis

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Question 1
On a routine radiographic exam, a well-defined radiolucent lesion was seen in the body of the mandible of a 17-year-old boy. At the time of operation, it proved to be an empty cavity. This is a(an) ____.
A
Osteoporotic bone marrow
B
Aneurysmal bone cyst
C
Odontogenic keratocyst
D
Static bone cyst
E
Traumatic bone cyst
Question 1 Explanation: 
E. Traumatic bone cysts characteristically occur in the body of the mandible of teenagers. They are pseudocysts in that they have no epithelial lining. They are empty cavities.
Question 2
You are unsure of the location of an opaque mass seen over a molar root on a periapical view. A second view of the same region, made with the x-ray machine oriented more from the mesial, reveals that the object has moved mesially with respect to the molar roots on the first view. The location of the object is ____.
A
Buccal to the roots
B
Lingual to the roots
C
In the same plane as the roots
D
Insufficient information to form an opinion
Question 2 Explanation: 
B. Use the rule of “SLOB”: Same Lingual, Opposite Buccal.
Question 3
If your radiographs start coming out too light, it may be that ____            
A
Your exposure time is too long
B
Your developer needs changing
C
Your developer is too hot
D
The fixer needs changing
E
The films are not sufficiently washed
Question 3 Explanation: 
B. If proper processing procedures are followed, the developer will become depleted with age and need changing.
Question 4
X-ray film is composed of ____
A
Silver halide crystals suspended in plastic and coated on a gelatin base
B
Sodium thiosulphate crystals and suspended within a plastic base
C
A plastic base coated with silver halide crystals suspended in gelatin
D
Fluorescent particles that react to x-radiation
Question 4 Explanation: 
C. Silver halide is not fluorescent, and thus choices and 2 are incorrect.
Question 5
The long-term histopathologic consequences to an irradiated organ depend on ____.
A
The presence of oxygen at the time of irradiation
B
The sensitivity of the parenchymal component
C
The damage to the stromal component
D
All of the above
E
None of the above
Question 5 Explanation: 
D. Numbers 1, 2, and 3 are correct.
Question 6
A biopsy of the lower lip salivary glands showed replacement of parenchymal tissue by lymphocytes. The patient also had xerostomia and keratoconjunctivitis sicca. These findings are indicative of which of the following?            
A
Lymphoma
B
Crohn’s disease
C
Mumps
D
Sjogren’s syndrome
E
Mucous extravasation phenomenon
Question 6 Explanation: 
D. This triad of signs defines primary Sjogren’s syndrome. The patient has secondary Sjogren’s syndrome if rheumatoid arthritis or other autoim- mune disease is present.
Question 7
Acantholysis, resulting from desmosome weakening by autoantibodies directed against the protein desmoglein, is the disease mechanism attributed to which of the following?
A
Epidermolysis bullosa
B
Mucous membrane pemphigoid
C
Pemphigus vulgaris
D
Herpes simplex infections
E
Herpangina
Question 7 Explanation: 
C. In pemphigus vulgaris, autoantibodies attach to antigens (desmoglein) found in desmosomes that keep keratinocytes linked to each other.Cells eventually separate from each other (acan- tholysis), resulting in short-lived intraepithelial vesicles/bullae.
Question 8
Conservative surgical excision would be appropriate treatment and probably curative for which of the following?            
A
Nodular fasciitis
B
Fibromatosis
C
Fibrosarcoma
D
Rhabdomyosarcoma
E
Adenoid cystic carcinoma
Question 8 Explanation: 
A. Nodular fasciitis is a rapidly developing reactive lesion that typically does not recur following excision. Fibromatosis is an aggressive nonen- capsulated lesion that has significant recurrence potential. The other lesions listed are malignan- cies and require more than simple excision to prevent recurrence.
Question 9
Papillomavirus has been found in all of the following lesions except            
A
Oral papillomas
B
Verruca vulgaris of the oral mucosa
C
Condyloma acuminatum
D
Condyloma latum
E
Focal epithelial hyperplasia
Question 9 Explanation: 
D. Condyloma latum is one of the lesions that may be seen in secondary syphilis, which is caused by Treponema pallidum. All the other lesions listed may be associated with human papillomavirus.
Question 10
Radiographs of the pregnant patient ____.        
A
Should never be made
B
Cause fetal injury
C
Should only be made with triple leaded aprons on the mother’s lap
D
Should be made when there is a specific need
Question 10 Explanation: 
D. Prudence suggests that radiographic examinations of a pregnant patient should be kept to a minimum consistent with the mother’s dental needs.
Question 11
It is generally desirable that x-ray films be all of the following except ____.
A
High speed
B
Fine grain size
C
Coated with emulsion on both sides
D
Sensitive to visible light
Question 11 Explanation: 
D. Film is sensitive to visible light but this is not a desired characteristic like the other choices.
Question 12
The purpose of a high-voltage transformer in an x-ray machine is to ____.  
A
Decrease the tube current
B
Increase the wavelength of the x-rays
C
Improve timer accuracy
D
Increase the potential between the filament and the cathode
E
Regulate the rate of release of photons from the anode
F
Increase resistance in the filament
Question 12 Explanation: 
D. The high-voltage transformer increases the voltage from the line voltage to the high voltage between the anode and cathode necessary to impart sufficient energy to the electrons to convert some of their energy into photons at the target.
Question 13
A patient seeks help for recurrent palatal pain. She presents with multiple punctate ulcers in the hard palate that were preceded by tiny blisters. Her lesions typically heal in about 2 weeks and reappear during stressful times. She has ____            
A
Aphthous ulcers
B
Recurrent primary herpes
C
Recurrent secondary herpes
D
Erythema multiforme
E
Discoid lupus
Question 13 Explanation: 
C. Recurrent intraoral herpes simplex infections occur only in the hard palate and hard gingiva, with the exception of AIDS patients. Blister (vesicle) history and recurrence are also supportive of this diagnosis.
Question 14
The most radiosensitive of the following cells in terms of cell killing is the ____.
A
Salivary gland acinar cell
B
Basal epithelial cell
C
Endothelial cell
D
Neuron.
E
Polymorphonuclear leukocyte.
Question 14 Explanation: 
Basal epithelial cells are the most mitotically active of the cells on the list, and thus are the most radiosensitive.
Question 15
The mean energy of an x-ray beam is influenced by the  ____
A
Kilovoltage
B
Milliamperage
C
Voltage In the filament circuit
D
Quantity of electrons in the tube current
E
Amount of filtration
F
Two of the above
G
None of the above
Question 15 Explanation: 
The mean energy (wavelength) of an x-ray beam is influenced by the kilovoltage setting on the machine and the amount of built-in filtration that preferentially absorbs low-energy photons.
Question 16
The term ALARA refers to ____.
A
Reducing patient exposure to as low as is reasonably achievable
B
As little as Roentgen allowed, an algorithm for limiting patient exposure
C
A legal requirement to optimize occupational exposure in dental radiology
D
Optimizing image quality
E
Reducing the costs of radiographic examinations
Question 16 Explanation: 
ALARA (As Low As Reasonably Achievable) is a concept for minimizing patient and occupational exposure.
Question 17
A cutaneous maculopapulary rash of the head and neck preceded by small ulcers in the buccal mucosa would suggest which of the following?
A
Primary herpes simplex infection
B
Rubeola
C
Varicella
D
Primary syphilis
E
Actinomycosis
Question 17 Explanation: 
B. The maculopapulary rash of rubeola (measles) is preceded by the herald sign of Koplick’s spots (punctate ulcers of the buccal mucosa).
Question 18
The idiopathic condition in which destructive inflammatory lesions featuring necrotizing vasculitis are seen in the lung, kidney, and upper respiratory tract is known as ____.
A
Epidermolysis bullosa
B
Stevens-Johnson syndrome
C
Sturge-Weber syndrome
D
Wegener’s granulomatosis
E
Secondary syphilis
Question 18 Explanation: 
D. Destructive inflammation in the three sites noted is characteristic of Wegener’s granulomatosis.
Question 19
To ensure high radiographic image quality, it is important to daily ____.          
A
Check the temperature of the processing solutions
B
Clean the processing equipment
C
Clean the intensifying screens
D
Calibrate the mA linearity
Question 19 Explanation: 
A. Daily check of the processing solution temperature, whether using automatic processing or manual tanks, and comparison with the manu¬facturer’s recommended values will improve image quality. The other procedures are useful but can be performed less frequently.
Question 20
The function of the filament is to ____.
A
Convert electrons into photons
B
Convert photons into electrons
C
Release photons
D
Release electrons
E
None of the above
Question 20 Explanation: 
When heated, the filament releases electrons (thermionic emission).
Question 21
If an unwrapped, nonprocessed x-ray film is exposed to normal light for just a second and then processed, it ____.            
A
May still be used but will be a little dark
B
May still be used but will be a little light
C
May still be used but will be brown
D
Will be completely black
E
Will be completely clear
Question 21 Explanation: 
D. Visible light will expose all the silver bromide crystals and the film will be black after processing.
Question 22
The odontogenic neoplasm, which is composed of loose, primitive-appearing connective tissue that resembles dental pulp, microscopically is known as .            
A
Odontoma
B
Ameloblastoma
C
Ameloblastic Fibroma
D
Ameloblastic fibro-odontoma
E
Odontogenic myxoma
Question 22 Explanation: 
E. Odontogenic myxomas are connective tissue neoplasms that contain little collagen. This gives them an embryonic look microscopically.
Question 23
Cone-cutting results from ____
A
Too great a target-film distance
B
Not selecting the proper kVp
C
Not enough time exposure
D
The x-ray machine being improperly aimed
Question 23 Explanation: 
D. Cone-cutting results from misalignment of the x- ray tube. Use a film-holding device with an external guide.
Question 24
A 21-year-old woman went to her dentist because of facial asymmetry. This had occurred gradually over a period of 3 years. The patient had no symptoms. A diffusely opaque lesion was found in her right maxilla. All lab tests (CBC, alkaline phosphatase, calcium) were within normal limits. Biopsy was interpreted as a fibro- osseous lesion. She most likely has ____
A
Cementoblastoma
B
Fibrous dysplasia
C
Cherubism
D
Osteosarcoma
E
Chronic osteomyelitis
Question 24 Explanation: 
C. Cherubism is a fibro-osseous lesion that occurs in teenagers. Characteristically, it presents with ill-defined margins and a “ground glass” appear¬ance radiographically. The other features described also support this diagnosis.
Question 25
Intranuclear viral inclusions are seen in tissue specimens of which of the following?
A
Solar cheilitis
B
Minor aphthous ulcers
C
Geographic tongue
D
Hairy leukoplakia
E
White sponge nevus
Question 25 Explanation: 
D. Hairy leukoplakia is viral in origin and shows intranuclear inclusions in infected epithelial cells. Hairy leukoplakia is caused by Epstein-Barr virus, a herpes virus. Intranuclear epithelial inclusions are also seen other herpes virus infections (e.g., herpes simplex virus infections).
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One thought on “Oral Diagnosis, Preparation for NBDE Part II

  1. keerthilatha

    A 21-year-old woman went to her dentist because of facial asymmetry. This had occurred gradually over a period of 3 years. The patient had no symptoms. A diffusely opaque lesion was found in her right maxilla. All lab tests (CBC, alkaline phosphatase, calcium) were within normal limits. Biopsy was interpreted as a fibro- osseous lesion. She most likely has ____
    A.Cementoblastoma
    B.Fibrous dysplasia
    C.Cherubism
    D.Osteosarcoma
    E.Chronic osteomyelitis
    Correct Answer for this question is B-Fibrous dysplasia

    Reply

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