DMD - Doctor of Medicine in Dentistry Oral Pathology and Diagnosis Questions and Answers — Questions and Answers
Question 1: A 55-year-old male, a heavy smoker for 30 years, presents with a persistent, well-demarcated white patch on the lateral border of his tongue that cannot be wiped off. Histopathological examination reveals hyperkeratosis and moderate epithelial dysplasia. What is the MOST likely diagnosis?
- Lichen Planus
- Leukoplakia (Correct answer)
- Candidiasis
- Frictional Keratosis
Correct answer: Leukoplakia
Leukoplakia is a clinical term for a white patch that cannot be characterized as any other disease. Its association with smoking and the presence of dysplasia on biopsy are key diagnostic features. Lichen planus typically presents with Wickham's striae, candidiasis can be wiped off, and frictional keratosis is related to chronic irritation without dysplasia.
Question 2: A panoramic radiograph of a 22-year-old male reveals a well-defined, unilocular radiolucency surrounding the crown of an impacted mandibular third molar. The lesion is asymptomatic. Which of the following is the most probable diagnosis?
- Ameloblastoma
- Odontogenic Keratocyst
- Radicular Cyst
- Dentigerous Cyst (Correct answer)
Correct answer: Dentigerous Cyst
A dentigerous (or follicular) cyst is a developmental odontogenic cyst that characteristically forms around the crown of an unerupted or impacted tooth. While ameloblastoma and odontogenic keratocyst can appear similarly and in the same location, the classic presentation described is most indicative of a dentigerous cyst. A radicular cyst is associated with a non-vital tooth.
Question 3: A 45-year-old female patient complains of a dry mouth and a burning sensation on her tongue. Clinical examination reveals atrophic glossitis and angular cheilitis. She also reports dry eyes. This combination of signs and symptoms is most characteristic of which systemic condition?
- Sjögren's Syndrome (Correct answer)
- Pemphigus Vulgaris
- Crohn's Disease
- Lupus Erythematosus
Correct answer: Sjögren's Syndrome
Sjögren's Syndrome is an autoimmune disorder that primarily affects the salivary and lacrimal glands, leading to xerostomia (dry mouth) and keratoconjunctivitis sicca (dry eyes). Oral manifestations like atrophic glossitis and angular cheilitis are common consequences of the reduced salivary flow.
Question 4: Which of the following oral lesions has the highest potential for malignant transformation?
- Leukoplakia
- Erythroplakia (Correct answer)
- Oral Lichen Planus
- Oral Submucous Fibrosis
Correct answer: Erythroplakia
Erythroplakia, a red patch on the oral mucosa, has the highest malignant transformation rate among potentially malignant disorders. Histopathological examination of erythroplakia often reveals severe dysplasia, carcinoma in situ, or invasive squamous cell carcinoma.
Question 5: A biopsy of a soft, pedunculated, raspberry-like growth on the gingiva of a pregnant patient reveals a highly vascular proliferation of connective tissue with numerous inflammatory cells. What is the most likely diagnosis?
- Traumatic Fibroma
- Peripheral Giant Cell Granuloma
- Pyogenic Granuloma (Correct answer)
- Squamous Papilloma
Correct answer: Pyogenic Granuloma
A pyogenic granuloma is a common reactive lesion that is not a true granuloma and is not caused by pyogenic organisms. It is a capillary hemangioma of lobular subtype that often occurs on the gingiva, especially in pregnant individuals due to hormonal changes, and is characterized by a highly vascular and inflammatory histologic appearance.
Question 6: A patient presents with painful, blistering lesions on the buccal mucosa and soft palate. A positive Nikolsky's sign is elicited. Histologically, acantholysis and intraepithelial bullae are observed. This clinical and histological picture is characteristic of:
- Bullous Pemphigoid
- Pemphigus Vulgaris (Correct answer)
- Erythema Multiforme
- Herpetic Gingivostomatitis
Correct answer: Pemphigus Vulgaris
Pemphigus vulgaris is an autoimmune blistering disease characterized by the formation of intraepithelial bullae due to acantholysis (loss of cohesion between keratinocytes). A positive Nikolsky's sign (induction of blistering on normal-appearing skin with gentle pressure) is a classic clinical finding.
DMD - Doctor of Medicine in Dentistry Oral Pathology and Diagnosis Questions and Answers
A 55-year-old male, a heavy smoker for 30 years, presents with a persistent, well-demarcated white patch on the lateral border of his tongue that cannot be wiped off.
Histopathological examination reveals hyperkeratosis and moderate epithelial dysplasia.
What is the MOST likely diagnosis?