AGD Oral Diagnosis and Pathology 5 — Questions and Answers
Question 1: Fordyce spots are best described as:
- Ectopic sebaceous glands visible as yellowish papules on the buccal mucosa (Correct answer)
- Minor salivary gland ducts
- Retention cysts of mucous glands
- Early manifestation of candidiasis
Correct answer: Ectopic sebaceous glands visible as yellowish papules on the buccal mucosa
Fordyce spots are ectopic sebaceous glands that appear as multiple, asymptomatic yellowish papules on the buccal mucosa and lips, representing a normal anatomic variant.
Question 2: A patient with a history of celiac disease presents with recurrent aphthous ulcers. The most appropriate first step is:
- Check serum ferritin, folate, B12, and zinc levels (Correct answer)
- Prescribe topical corticosteroids immediately
- Refer for biopsy
- Test for HSV antibodies
Correct answer: Check serum ferritin, folate, B12, and zinc levels
Celiac disease causes malabsorption of iron, folate, B12, and zinc, which are implicated in recurrent aphthous stomatitis; correcting deficiencies often reduces ulcer frequency.
Question 3: 'Cotton-wool' appearance on skull radiographs in an elderly patient with jaw pain and elevated serum alkaline phosphatase suggests:
- Paget disease of bone (Correct answer)
- Multiple myeloma
- Hyperparathyroidism
- Fibrous dysplasia
Correct answer: Paget disease of bone
Paget disease produces a mixed radiolucent-radiopaque 'cotton-wool' appearance due to alternating bone resorption and deposition, with elevated alkaline phosphatase.
Question 4: Hairy leukoplakia occurs predominantly on which oral site and is caused by which virus?
- Lateral tongue; Epstein-Barr virus (Correct answer)
- Buccal mucosa; HPV
- Floor of mouth; HSV-1
- Palate; CMV
Correct answer: Lateral tongue; Epstein-Barr virus
Hairy leukoplakia presents as white corrugated (hairy) lesions on the lateral tongue and is caused by EBV replication in immunocompromised patients.
Question 5: Which type of leukoplakia carries the highest risk of malignant transformation?
- Speckled (erythroleukoplakia) (Correct answer)
- Homogeneous
- Verrucous
- Flat homogeneous
Correct answer: Speckled (erythroleukoplakia)
Speckled leukoplakia (erythroleukoplakia) has the highest malignant transformation risk among leukoplakia subtypes due to its mixed white and red components.
Question 6: A radiolucency with a 'driven snow' calcification pattern within a multilocular jaw lesion in a teenager most likely represents:
- Calcifying odontogenic cyst (Gorlin cyst) (Correct answer)
- Cemento-ossifying fibroma
- Adenomatoid odontogenic tumor
- Complex odontoma
Correct answer: Calcifying odontogenic cyst (Gorlin cyst)
Calcifying odontogenic cyst (ghost cell odontogenic cyst) can show scattered calcifications within a cystic radiolucency, with ghost cell keratinization histologically.
Question 7: The most common intraoral location for a traumatic neuroma is:
- Mental foramen region (Correct answer)
- Hard palate
- Dorsal tongue
- Retromolar pad
Correct answer: Mental foramen region
Traumatic neuromas most commonly occur at the mental foramen area following extraction of mandibular premolars or trauma injuring the mental nerve.
AGD Oral Diagnosis and Pathology 5
Fordyce spots are best described as: