Chapter 3: White Lesions

Test Bank
MULTIPLE CHOICE
1. Three small (2 2 mm), nodular, nonulcerated, and asymptomatic lesions were found
in the floor of the mouth of a 21-year-old man. Microscopically, the lesions were
composed of a collection of normal mature lymphocytes with germinal centers. This
patient has:
a. Lymphoma
b. Mucous extravasation phenomenon
c. Fordyce granules
d. Dermoid cysts
e. Ectopic lymphoid tissue
ANS: E

REF: Chap 3 (Ectopic lymphoid tissue), p 110

2. Ectopic lymphoid tissue is commonly seen in which of the following sites?

a. Posterior lateral tongue
b. Floor of mouth
c. Soft palate
d. Tonsillar pillar
e. All the above
ANS: E

REF: Chap 3 (Ectopic lymphoid tissue), p 110

3. Which of the following disorders places the patient at risk for the appearance or
development of a malignancy?
a. Primary Sjgrens syndrome
b. Proliferative verrucous leukoplakia
c. Neurofibromatosis
d. MEN III
e. All the above
ANS: E
REF: Chap 3 (Preneoplastic and neoplastic lesions), pp 90-95 | Chap 7
(Neurofibroma/Mucosal neuromas of MEN III), pp 178-181 | Chap 8 (Sjgrens
syndrome), pp 196-199
4. Lupus erythematosus is caused by which of the following?
a. Coxsackie virus
b. Herpes simplex virus
c. Immunodeficiency
d. Vitamin A deficiency
e. Autoimmunity
ANS: E
REF: Chap 3 (Lupus erythematosus/Etiology and pathogenesis), p 104
5. Which of the following microscopic features accounts for the white appearance of
leukoedema?
Copyright 2012, 2008, 2003, 1999, 1993, 1989 by Saunders, an imprint of Elsevier Inc.

Test bank
a.
b.
c.
d.
e.

Hyperkeratosis
Acanthosis
Reduced vascular supply
Hydropic change of keratinocytes
Dyskeratosis

ANS: D

REF: Chap 3 (Leukoedema), pp 79-80

6. What is the most likely cause of lichen planus?

a. Coxsackie virus
b. One of the herpes viruses
c. A mycobacterium
d. Candida albicans
e. Immunologic defect
ANS: E
97-98

REF: Chap 3 (Lichen planus/Etiology and pathogenesis), pp

7. Which of the following benign conditions exhibits a clinical mucosal pattern that
seems to change or migrate over time?
a. Leukoedema
b. Median rhomboid glossitis
c. Fordyces granules
d. Geographic tongue
e. None of the above
ANS: D

REF: Chap 3 (Geographic tongue/Clinical features), pp 95-96

8. All of the following are a consequence of snuff dipping except:

a. Increased incidence of herpes simplex labialis
b. Mucosal opacification
c. Gingivitis
d. Dependence
e. Tooth abrasion
ANS: A
REF: Chap 3 (White lesions associated with smokeless tobacco), pp 83-85
9. Which of the following represents an opportunistic fungal infection?
a. Shingles
b. Aphthous stomatitis
c. Candidiasis
d. Herpangina
e. Syphilis
ANS: C

REF: Chap 3 (Candidiasis), pp 104-108

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10. On routine examination of a 52-year-old male pipe smoker, an asymptomatic tissue

change was found in his palate. The entire hard palate was white with occasional red
dots. He has:
a. Candidiasis
b. Nicotine stomatitis
c. Squamous cell carcinoma
d. Frictional hyperkeratosis
e. Major aphthous ulcer
ANS: B

REF: Chap 3 (Nicotine stomatitis), pp 85-86

11. Appropriate management of geographic tongue is:

a. Observation
b. Excisional biopsy
c. Incisional biopsy
d. Nystatin therapy
e. Antidepressant medication
ANS: A

REF: Chap 3 (Geographic tongue), pp 95-97

12. Examination of an asymptomatic 27-year-old man reveals numerous circular white

lesions surrounding red atrophic patches on the dorsum of the tongue. The lesions
cannot be rubbed off with a gauze square. The patient most likely has:
a. Fissured tongue
b. Speckled leukoplakia
c. Benign migratory glossitis
d. Squamous cell carcinoma
e. Lichen planus
ANS: C

REF: Chap 3 (Geographic tongue/Etiology), p 95

13. A 14-year-old bone marrow transplant patient developed bilateral white lesions of the
lateral border of the tongue that measured 1 2 cm. Which of the following conditions
should receive serious consideration in a clinical differential diagnosis?
a. Hairy leukoplakia
b. White sponge nevus
c. Geographic tongue
d. Pemphigus vulgaris
e. Aphthous stomatitis
ANS: A

REF: Chap 3 (Hairy leukoplakia), pp 86-87

14. Biopsy of bilateral white buccal mucosa lesions showed hyperkeratotic epithelium
with basal cell destruction. The epithelium was supported by connective tissue
containing a dense lymphocytic infiltrate. This is descriptive of:
a. Erythema multiforme
b. Lichen planus
c. Pemphigoid
d. Pemphigus
e. White sponge nevus

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ANS: B
97-98

REF: Chap 3 (Lichen planus/Etiology and pathogenesis), pp

15. Which of the following occurs in the midline dorsum of the tongue?
a. Ectopic lymphoid tissue
b. Basal cell carcinoma
c. Secondary herpes simplex
d. Median rhomboid glossitis (candidiasis)
e. Peripheral giant cell granuloma
ANS: D

REF: Chap 3 (Candidiasis/Clinical features), pp 105-107

16. Clinical diagnosis of candidiasis is confirmed by:

a. Characteristic odor
b. Response to injection of vitamin B12
c. Response to administration of prednisone
d. Demonstration of mycelia and spores in scrapings
e. Demonstration of sulfur granules in exudates
ANS: D

REF: Chap 3 (Candidiasis/Histopathology), p 107

17. A 9-year-old boy has bilateral, white thickening of his buccal mucosa that extends
into the vestibules. The lesions have been present since birth. His brother has similar
lesions. Which of the following is suggested?
a. Lichen planus
b. Leukoedema
c. Mucous patches
d. White sponge nevus
e. None of the above
ANS: D

REF: Chap 3 (White sponge nevus/Box 3-1), p 80

18. The most common mucosal site for AIDS-related oral hairy leukoplakia is:
a. Conjunctiva
b. Soft palate
c. Lateral tongue
d. Lingual gingiva
e. Buccal mucosa
ANS: C
p 86

REF: Chap 3 (Hairy leukoplakia/Etiology and pathogenesis),

19. Which of the following is an autosomal-dominant disease?

a. White sponge nevus
b. Geographic tongue
c. Hemangioma
d. Pemphigus vulgaris
e. Median rhomboid glossitis

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ANS: A

5
REF: Chap 3 (White sponge nevus), p 80

20. Biopsy of a lesion of the buccal mucosa shows epithelial cells with hyperchromatic
and pleomorphic nuclei. Abnormal mitotic figures are found at all levels in the
epithelium. The basement membrane is intact. This is consistent with:
a. Lichen planus
b. Leukoplakia
c. Squamous cell carcinoma
d. Carcinoma in situ
e. Focal hyperkeratosis
ANS: D
94

REF: Chap 3 (Idiopathic leukoplakia/Histopathology), pp 93-

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

a. Foliate
b. Filiform
c. Fungiform
d. Circumvallate
e. Interdental
ANS: B

REF: Chap 3 (Hairy tongue), p 88

22. Chronic exposure to sunlight has been implicated in the pathogenesis of which of the
following?
a. Basal carcinoma
b. Squamous cell carcinoma of the skin
c. Actinic cheilitis
d. Carcinoma of the lower lip
e. All the above
ANS: E
REF: Chap 2 (Squamous cell carcinoma/Carcinoma of the lower lip), p 56 | Chap 3
(Actinic cheilitis/Box 3-8), pp 90-91
23. A middle-aged man developed multiple flat ulcers in his palate, tongue, and buccal
mucosa. The lesions measured approximately 1 cm in diameter and were preceded
briefly by bullae. The lesions have been persistent for 6 weeks. He has no skin, eye, or
genital lesions. Biopsy shows acantholysis with intraepithelial separation. He most
likely has:
a. Erythema multiforme
b. Discoid lupus erythematosus
c. Primary herpes simplex infection
d. Mucous membrane pemphigoid
e. None of the above
ANS: E
REF: Chap 1 (Herpes simplex infection/Mucous membrane pemphigoid), pp 1-6,
15-17 | Chap 2 (Erythema multiforme), pp 43-46 | Chap 3 (Discoid lupus
erythematosus), p 102

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24. The bullous eruption of attached gingiva mediated by autoantibodies directed against
basement membrane antigens is known as:
a. Pemphigus vulgaris
b. Lupus erythematosus
c. Erythema multiforme
d. Behets syndrome
e. None of the above
ANS: E
REF: Chap 1 (Pemphigus vulgaris), pp 11-15 | Chap 2 (Erythema
multiforme/Behets syndrome), pp 42-46 | Chap 3 (Lupus erythematosus), pp 102104
25. Ingestion of certain drugs is known to occasionally precipitate which of the
following?
a. Herpetiform aphthous ulcers
b. Geographic tongue
c. Cicatricial pemphigoid
d. Mucous patches
e. None of the above
ANS: E
REF: Chap 1 (Mucous membrane pemphigoid), pp 15-17 | Chap 2 (Herpetiform
aphthous ulcers), p 39 | Chap 3 (Geographic tongue), pp 95-97 | Chap 4
(Erythroplakia), pp 121-122
26. The keratinocyte desmosome complex is the pathologic target in which of the
following diseases?
a. Discoid lupus erythematosus
b. Systemic lupus erythematosus
c. Tuberculosis
d. Pemphigoid
e. None of the above
ANS: E
REF: Chap 1 (Mucous membrane pemphigoid/Bullous pemphigoid), pp 15-18 |
Chap 2 (Tuberculosis), pp 29-32 | Chap 3 (Discoid lupus erythematosus/Systemic
lupus erythematosus), p 102
27. Circulating autoantibodies can be demonstrated in which of the following diseases?
a. Minor aphthae
b. Major aphthae
c. Systemic lupus erythematosus
d. Discoid lupus erythematosus
e. Recurrent herpes simplex
ANS: C

REF: Chap 3 (Systemic lupus erythematosus), p 102

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28. Lesions of immunologic origin are seen in the heart, kidney, and joints in which of the
following diseases?
a. Behets syndrome
b. Wegeners granulomatosis
c. Systemic lupus erythematosus
d. Pemphigus
e. Epidermolysis bullosa
ANS: C

REF: Chap 3 (Systemic lupus erythematosus), p 102

29. A positive ANA test would most likely be seen in which of the following?
a. Primary syphilis
b. Primary herpes simplex
c. Systemic lupus erythematosus
d. Erythema multiforme
e. Pemphigoid
ANS: C

REF: Chap 3 (Systemic lupus erythematosus), p 102

30. Systemic (acute) lupus erythematosus:

a. Represents an autoimmune disease in which patients develop multiple
antibodies against nuclear and cytoplasmic proteins
b. Usually does not develop from preexisting discoid disease
c. May affect kidneys, heart, and joints
d. Has a predilection for middle-aged women
e. All the above
ANS: E

REF: Chap 3 (Systemic lupus erythematosus), p 102

31. Degranulation of IgE-coated mast cells is associated with which of the following
conditions?
a. Hereditary angioedema
b. Lupus erythematosus
c. Erythema multiforme
d. Contact allergy
e. None of the above
ANS: E
REF: Chap 2 (Angioedema/Erythema multiforme/Contact allergies), pp 43-49 |
Chap 3 (Lupus erythematosus), pp 102-104
32. All of the following conditions affect oral and perioral tissues and are self-limiting
(i.e., heal or disappear without therapeutic intervention) except:
a. Varicella
b. Herpangina
c. Erythema multiforme
d. Hand-foot-and-mouth disease
e. Lupus erythematosus
ANS: E

REF: Chap 3 (Lupus erythematosus/Treatment), p 104

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33. Cutaneous lesions may be seen in all the following except:

a. Erythema multiforme
b. Chronic lupus erythematosus
c. Hairy leukoplakia
d. Secondary herpes simplex infections
e. Primary herpes simplex infections
ANS: C
REF: Chap 3 (Hairy leukoplakia/Clinical features/Box 3-6), pp 86-87
34. Epstein-Barr virus is responsible for which of the following?
a. Hereditary benign intraepithelial dyskeratosis
b. Hairy leukoplakia
c. Hairy tongue
d. Oral squamous cell carcinoma
e. None of the above
ANS: B
p 86

REF: Chap 3 (Hairy leukoplakia/Etiology and pathogenesis),

35. Median rhomboid glossitis is a chronic white and/or red lesion occurring in the
midline dorsum of the tongue anterior to the circumvallate papillae that is believed to
be caused by:
a. Epstein-Barr virus
b. Herpes simplex virus
c. Autoantibodies
d. Smokeless tobacco products
e. None of the above
ANS: E

REF: Chap 3 (Candidiasis/Clinical features), pp 105-107

36. The cells that are believed to mediate the destructive basal cell changes seen
microscopically in lichen planus are:
a. Plasma cells
b. T lymphocytes
c. B lymphocytes
d. Langerhans cells
e. Keratinocytes
ANS: B
97-98

REF: Chap 3 (Lichen planus/Etiology and pathogenesis), pp

37. The white lesion known as idiopathic leukoplakia clinically is most frequently
diagnosed microscopically as:
a. Hyperkeratosis
b. Moderate dysplasia
c. In situ carcinoma
d. Invasive carcinoma
e. Leukoedema

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Test bank

ANS: A

REF: Chap 3 (Idiopathic leukoplakia), pp 91-95

38. Leukoplakia, located in which of the following sites, would be regarded as having the
highest risk for malignant transformation?
a. Floor of mouth
b. Upper lip
c. Buccal mucosa
d. Gingiva
e. Palate
ANS: A
91-93

REF: Chap 3 (Idiopathic leukoplakia/Clinical features), pp

39. Purple to red pruritic patches on lower legs and forearms are the typical cutaneous
manifestation of which of the following?
a. Mucocutaneous candidiasis
b. Lupus erythematosus
c. Hereditary benign intraepithelial dyskeratosis
d. Lichen planus
e. Erythema multiforme
ANS: D

REF: Chap 3 (Lichen planus/Clinical features), pp 98-99

40. Hairy tongue:

a. Is a pre-AIDS sign
b. Is an opportunistic Epstein-Barr virus infection
c. Typically occurs bilaterally on the lateral surfaces of the tongue
d. Has malignant potential
e. None of the above
ANS: E

REF: Chap 3 (Hairy tongueentire topic/Box 3-7), pp 88-89

41. Oral mucosal petechiae and/or ecchymoses would be a clinical sign of all the
following except:
a. Hemophilia
b. Trauma
c. Idiopathic thrombocytopenia
d. Monocytic leukemias
e. Lupus erythematosus
ANS: E
104

REF: Chap 3 (Lupus erythematosusentire topic), pp 102-

42. Oral candidiasis presents in which of the following ways?

a. White plaques that can be removed, leaving a red bleeding surface
b. Red patch
c. Red or white lesion in the midline of the tongue anterior to the circumvallate
papillae
d. Cracking and fissuring of the angles of the mouth

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10

e. All the above

ANS: E

REF: Chap 3 (Candidiasis/Clinical features), pp 105-107

43. A 42-year-old man presents with a 1 1 cm white patch on the lateral surface of his
tongue. Based solely on this information, clinical differential diagnosis should
include:
a. Frictional hyperkeratosis
b. Hairy leukoplakia
c. Idiopathic leukoplakia
d. All the above
e. None of the above
ANS: D
REF: Chap 3 (Frictional hyperkeratosis/Hairy leukoplakia/ Idiopathic leukoplakia),
pp 82-83, 86-87, 91-95
44. A 31-year-old man presents for a routine dental examination. Soft tissue examination
shows that both sides of his tongue have several circular red nonulcerated lesions of
approximately 1 cm in diameter. The red patches are surrounded by white
hyperkeratotic margins. He is asymptomatic and is otherwise in good health. He most
likely has:
a. Bilateral squamous cell carcinomas
b. Hairy leukoplakia
c. Median rhomboid glossitis
d. Leukoedema
e. Geographic tongue
ANS: E

REF: Chap 3 (Geographic tongue/Box 3-11), pp 95-97

45. A 47-year-old woman presented with painful ulcers and white lesions on her gingiva,
tongue, and buccal mucosa of 6 months duration. Biopsy of one of the white areas
showed hyperkeratosis, basal cell destruction, and an intense lymphocytic infiltrate
subjacent to the epithelium. This patient most likely has:
a. Lichen planus
b. Mucous membrane pemphigoid
c. Pemphigus vulgaris
d. White sponge nevus
e. Behets syndrome
ANS: A

REF: Chap 3 (Lichen planusentire topic), pp 97-102

46. Although hairy tongue is often idiopathic, some cases are believed to be associated
with which one of the following?
a. Systemic antibiotic therapy
b. Infection by HHV8
c. Trauma
d. Vitamin C deficiency
e. Hot, spicy foods

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ANS: A

11
REF: Chap 3 (Hairy tongue/Etiology), p 88

47. Elevated white plaques are seen in the palate of an HIV-positive patient. Under the
microscope, scrapings show hyphae and spores among superficial keratinocytes. This
confirms which of the following?
a. Idiopathic leukoplakia
b. Lichen planus
c. Hairy leukoplakia
d. Candidiasis
e. None of the above
ANS: D

REF: Chap 3 (Candidiasisentire topic), pp 104-108

48. Which of the following oral lesions most likely results from chronic friction?
a. Vascular malformation
b. Pigmented nevus
c. Focal hyperkeratosis
d. Secondary herpes
e. Leukoedema
ANS: C
82-83

REF: Chap 3 (Focal [frictional] hyperkeratosis/Etiology), pp

49. Oral candidiasis is an opportunistic infection that may be associated with one of
several predisposing factors. These include all the following except:
a. Prolonged use of oral topical corticosteroids
b. Therapeutic irradiation
c. Antibiotic therapy
d. Smokeless tobacco use
e. AIDS
ANS: D

REF: Chap 3 (Candidiasis), pp 104-108

50. Dysplastic changes of oral epithelium can be seen in biopsies of:

a. Idiopathic leukoplakia
b. Leukoedema
c. Melanotic macules
d. Hairy leukoplakia
e. Mucous membrane pemphigoid
ANS: A
REF: Chap 3 (Idiopathic leukoplakia/Histopathology/Box 3-9), pp 92-95
51. Biopsy of a white lesion from the lower lip of an 82-year-old man showed
hyperkeratosis, basophilic change of collagen, numerous telangiectasias, and
epithelial atrophy. This is indicative of which of the following:
a. Lip biting
b. Squamous cell carcinoma
c. Idiopathic leukoplakia
d. Lichen planus

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12

e. Actinic cheilitis
ANS: E

REF: Chap 3 (Actinic cheilitis/Histopathology), p 90

52. Benign migratory glossitis:

a. Is not associated with any risk of malignant transformation
b. Represents a self-limited viral infection
c. Responds to systemic acyclovir
d. Typically affects the ventral surface of the tongue
e. Is commonly seen in children
ANS: A
REF: Chap 3 (Geographic tongue/Treatment and prognosis), pp 96-97
53. A 27-year-old man presents for a routine oral examination. Both sides of his buccal
mucosa exhibit a filmy white opacity that disappears when the cheek is stretched.
There is no pain, and the tissue feels normal to palpation. This would most likely be:
a. Squamous cell carcinoma
b. Hairy leukoplakia
c. Nicotine stomatitis
d. Leukoedema
e. Benign migratory glossitis
ANS: D

REF: Chap 3 (Leukoedema/Clinical features), p 79

54. Ectopic sebaceous glands:

a. Are known as Fordyces granules
b. Appear as yellow-white nodules intraorally
c. Do not need to be biopsied
d. Have no malignant potential
e. All the above
ANS: E

REF: Chap 3 (Fordyces granules), p 110

55. Which of the following clinical abnormalities in a white lesion associated with the use
of smokeless tobacco would indicate the need for biopsy?
a. Mass
b. Induration
c. Ulceration
d. Red patch
e. All the above
ANS: E
REF: Chap 3 (White lesions associated with smokeless tobacco/Etiology), p 84
56. Opaque white lesions cover right and left buccal mucosae, vestibules, and floor of the
mouth of a 15-year-old girl. The lesions do not rub off and are asymptomatic. Biopsy
showed intracellular edema and perinuclear condensation of keratin in keratinocytes.
There is no inflammatory cell infiltrate of submucosa. This description suggests
which of the following?

Copyright 2012, 2008, 2003, 1999, 1993, 1989 by Saunders, an imprint of Elsevier Inc.

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a.
b.
c.
d.
e.

13

Leukoedema
Cheek chewing
Idiopathic leukoplakia
Lichen planus
White sponge nevus

ANS: E

REF: Chap 3 (White sponge nevus/Box 3-1), p 80

57. Candidiasis is also known by which of the following synonyms?

a. Thrush
b. Candidosis
c. Perleche
d. Yeast infection
e. All the above
ANS: E

REF: Chap 3 (Candidiasis/Box 3-13), pp 104-108

58. Atrophy of the tongue papillae may be seen in all the following except:
a. Pernicious anemia
b. Hairy tongue
c. Geographic tongue
d. Iron deficiency anemia
e. Vitamin B deficiency
ANS: B

REF: Chap 3 (Hairy tongueentire topic), p 88

59. The use of smokeless tobacco is:

a. Related to the development of opportunistic oral infections
b. More prevalent among young women than young men
c. Associated with the development of oral ulcers
d. A good substitute for smoking cigarettes
e. None of the above
ANS: E
REF: Chap 3 (White lesions associated with smokeless tobaccoentire topic/Box 33), pp 83-85
60. Which of the following oral lesions has malignant potential?
a. Snuff dippers pouch
b. Leukoplakia associated with smoking
c. Epithelial dysplasia
d. Actinic cheilitis
e. All the above
ANS: E
REF: Chap 3 (White lesions associated with smokeless tobacco/Leukoplakia/Actinic
cheilitis), pp 83-85, 90-95
61. All the following oral diseases have a relatively short (days to weeks) self-limited
course except:

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a.
b.
c.
d.
e.

14

Secondary herpes
Erythema multiforme
Lichen planus
Aphthous ulcers
Herpes zoster

ANS: C

REF: Chap 3 (Lichen planus/Clinical features), pp 98-99

62. A 57-year-old patient presents with bright red mucosa under her 10-year-old maxillary
denture. The tissue is painful and has been present for several weeks. The remainder
of her examination is negative. This is most likely which of the following?
a. Allergy to her denture material
b. Chronic candidiasis
c. Erythroplasia
d. Hemangioma
e. None of the above
ANS: B

REF: Chap 3 (Candidiasis/Clinical features), pp 105-107

63. The white appearance associated with acute pseudomembranous candidiasis is due to
which of the following?
a. Focal decrease in vascularity
b. Edema of keratinocytes
c. Hyperkeratosis
d. Fungal colonies growing in and on the superficial keratin
e. Acanthosis
ANS: D

REF: Chap 3 (Candidiasis/Histopathology), p 107

64. Oral epithelial dysplasia may:

a. Appear white clinically
b. Appear red clinically
c. Be seen on any mucosal surface
d. Progress to invasive squamous cell carcinoma
e. All the above
ANS: E

REF: Chap 3 (Idiopathic leukoplakiaentire topic), pp 91-95

65. The hard palate and gingiva are the characteristic sites for the appearance of all the
following except:
a. Oral pigmented nevus
b. Lichen planus
c. Oral melanoma
d. Kaposis sarcoma
e. Secondary herpes simplex
ANS: B
97-98

REF: Chap 3 (Lichen planus/Etiology and pathogenesis), pp

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15

66. Bilateral buccal mucosa white lesions would least likely be seen in which of the
following?
a. Lichen planus
b. Cheek chewing
c. Hereditary benign intraepithelial dyskeratosis
d. White sponge nevus
e. Idiopathic leukoplakia
ANS: E
91-93

REF: Chap 3 (Idiopathic leukoplakia/Clinical features), pp

67. A 21-year-old African American man presents for a routine examination. Both sides of
his buccal mucosa exhibit a filmy white opacity. There is no pain, and the tissue feels
normal to palpation. This could be which of the following?
a. Squamous cell carcinoma
b. Hairy leukoplakia
c. Nicotine stomatitis
d. Leukoedema
e. Geographic stomatitis
ANS: D

REF: Chap 3 (Leukoedema/Clinical features), p 79

68. The microscopic feature that accounts for the white clinical appearance of lichen
planus is:
a. Fibrin membrane over a chronic ulcer
b. Intracellular edema of keratinocytes
c. Acanthosis
d. Hyperkeratosis
e. Vasculitis
ANS: D

REF: Chap 3 (Lichen planus), pp 97-102

69. The clinical differential diagnosis for chronic red gingival patches would include:
a. Atrophic lichen planus
b. Contact hypersensitivity
c. Lupus erythematosus
d. Chronic candidiasis
e. All the above
ANS: E
REF: Chap 3 (Lupus erythematosus/Differential diagnosis/Lichen
planus/Differential diagnosis), pp 101, 104
70. The etiology of hairy tongue is associated with:
a. Systemic antibiotic therapy
b. Oral hydrogen peroxide abuse
c. Therapeutic irradiation to the head and neck
d. All the above
e. None of the above

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ANS: D

16
REF: Chap 3 (Hairy tongue/Etiology), p 88

71. Actinic cheilitis:

a. Is quite harmless if Vaseline is used to protect the lip
b. Is due to infrared radiation
c. Has no malignant potential
d. Is seen predominantly in the lower lip
e. None of the above
ANS: D

REF: Chap 3 (Actinic cheilitis), pp 90-91

72. All the following are effective in the treatment of acute oral candidiasis except:
a. Mycelex troches
b. Lotrimin tablets
c. Acyclovir tablets
d. Nystatin pastilles
e. Mycostatin oral suspension
ANS: C

REF: Chap 3 (Candidiasis/Treatment and prognosis), p 108

73. Which of the following provides a patient with increased risk for the development of
oral squamous cell carcinoma?
a. Idiopathic leukoplakia
b. Erythroplakia
c. Submucous fibrosis
d. Lichen planus
e. All the above
ANS: E
REF: Chap 3 (Idiopathic leukoplakia/Submucous fibrosis/Lichen planus), pp 91-95,
97-102, 109-110 | Chap 4 (Erythroplakia), pp 121-122
74. Fluconazole is a systemically taken drug that is particularly effective in the treatment
of which of the following?
a. Candidiasis
b. Syphilis
c. Actinomycosis
d. Tuberculosis
e. Zoster
ANS: A
REF: Chap 3 (Candidiasis/Treatment and prognosis/Box 3-16), p 108
75. Idiopathic leukoplakia:
a. May recur after excision
b. Is caused by papillomavirus
c. Is clinically diagnostic and therefore requires no biopsy
d. Is most commonly seen in children and young adults
e. None of the above

Copyright 2012, 2008, 2003, 1999, 1993, 1989 by Saunders, an imprint of Elsevier Inc.

Test bank
ANS: A
prognosis), p 95

17
REF: Chap 3 (Idiopathic leukoplakia/Treatment and

76. Hairy leukoplakia:

a. May be seen in non-HIV immunosuppressed patients
b. May appear as a flat or papillated lesion
c. Occurs most commonly on the tongue
d. May be bilateral
e. All the above
ANS: E

REF: Chap 3 (Hairy leukoplakia), pp 86-87

77. A 32-year-old man presented with a 1 2 cm macular red-blue lesion in his hard
palate. The lesion was asymptomatic and had been present for an unknown duration.
He had no dental abnormalities and no significant periodontal disease. This could be
all the following except:
a. Vascular malformation
b. Nicotine stomatitis
c. Ecchymosis
d. Kaposis sarcoma
e. Erythroplasia
ANS: B

REF: Chap 3 (Nicotine stomatitisentire topic), pp 85-86

78. Oral white patches that are of unknown cause, cannot be rubbed off, and cannot be
clinically diagnosed as any other condition should be:
a. Ignored
b. Treated symptomatically if painful
c. Observed
d. Biopsied
e. None of the above
ANS: D

REF: Chap 3 (White lesionsentire chapter), pp 79-111

79. A 55-year-old man presents with a 1 1 cm white lesion of his edentulous alveolar
ridge. The clinical differential diagnosis should include:
a. Lichen planus
b. Hairy leukoplakia
c. Ectopic lymphoid tissue
d. Frictional hyperkeratosis
e. All the above
ANS: D

REF: Chap 3 (Focal [frictional] hyperkeratosis), pp 82-83

80. Which of the following typically presents clinically as a yellow submucosal nodule?
a. White sponge nevus
b. Squamous cell carcinoma
c. Ectopic lymphoid tissue
d. Amalgam tattoo
e. None of the above

Copyright 2012, 2008, 2003, 1999, 1993, 1989 by Saunders, an imprint of Elsevier Inc.

Test bank

ANS: C

18

REF: Chap 3 (Ectopic lymphoid tissue), p 110

81. Which of the following microscopic features is responsible for the clinical appearance
of Wickhams striae?
a. Fibrin deposition
b. Reduced vascularity
c. Acantholysis
d. Hyperkeratosis
e. Intracellular keratinocyte edema
ANS: D

REF: Chap 3 (Lichen planus/Clinical features), pp 98-99

82. Circulating antibodies directed against nuclear and cytoplasmic proteins are seen in
which of the following conditions?
a. Discoid lupus erythematosus
b. Systemic lupus erythematosus
c. Primary syphilis
d. Mucous membrane pemphigoid
e. Hereditary epidermolysis bullosa
ANS: B

REF: Chap 3 (Systemic lupus erythematosus), pp 102-103

Copyright 2012, 2008, 2003, 1999, 1993, 1989 by Saunders, an imprint of Elsevier Inc.