ADAT Oral Pathology & Diagnosis 2 — Questions and Answers
Question 1: What is the most common site for oral squamous cell carcinoma (OSCC) in the United States?
- Hard palate
- Dorsal tongue
- Lateral and ventral tongue and floor of mouth (Correct answer)
- Attached gingiva
Correct answer: Lateral and ventral tongue and floor of mouth
The lateral/ventral tongue and floor of mouth are the most common sites for OSCC in the US, likely due to pooling of carcinogens in saliva at these locations.
Question 2: A patient has recurrent crops of small, round ulcers with a yellow-gray pseudomembrane and erythematous halo that heal without scarring in 7–14 days. What is the diagnosis?
- Herpes simplex virus (HSV) recurrence
- Minor aphthous ulcers (recurrent aphthous stomatitis) (Correct answer)
- Behçet's syndrome
- Traumatic ulcer
Correct answer: Minor aphthous ulcers (recurrent aphthous stomatitis)
Minor aphthous ulcers are the most common recurrent oral ulceration, characterized by small (<1 cm), round, non-herpetiform ulcers on non-keratinized mucosa that heal without scarring.
Question 3: The Epstein-Barr virus (EBV) is etiologically associated with which oral lesion?
- Hairy leukoplakia (Correct answer)
- Oral lichen planus
- Herpangina
- Focal epithelial hyperplasia (Heck's disease)
Correct answer: Hairy leukoplakia
Oral hairy leukoplakia is caused by EBV replication in oral epithelial cells, most commonly seen in HIV-positive patients as a white corrugated lesion on the lateral tongue.
Question 4: Which feature most strongly suggests a mucocele rather than a salivary gland tumor?
- Firm consistency and slow progressive growth
- Blue-tinged fluctuant swelling on the lower lip that may rupture and recur (Correct answer)
- Painless swelling on the hard palate lateral to the midline
- Bilateral swelling of the parotid glands
Correct answer: Blue-tinged fluctuant swelling on the lower lip that may rupture and recur
Mucoceles are blue-tinged, fluctuant, often recurrent lesions on the lower lip caused by mucus extravasation or retention from minor salivary gland trauma.
Question 5: Which bone pathology shows a 'ground glass' radiographic appearance and commonly affects one quadrant of the jaw in young patients?
- Paget's disease of bone
- Fibrous dysplasia (Correct answer)
- Cherubism
- Central giant cell granuloma
Correct answer: Fibrous dysplasia
Fibrous dysplasia replaces normal bone with fibrous tissue containing woven bone trabeculae, producing the classic 'ground glass' or 'orange peel' radiographic appearance.
Question 6: A patient with xerostomia, bilateral parotid enlargement, and dry eyes most likely has which systemic condition?
- Sjögren's syndrome (Correct answer)
- Sarcoidosis
- Chronic alcoholism
- Bulimia nervosa
Correct answer: Sjögren's syndrome
Sjögren's syndrome is an autoimmune condition characterized by lymphocytic infiltration of salivary and lacrimal glands, causing xerostomia and xerophthalmia.
ADAT Oral Pathology & Diagnosis 2
What is the most common site for oral squamous cell carcinoma (OSCC) in the United States?