MFDS Oral Medicine 2

Question 1

A patient presents with vesicles and ulcers on the palate and gingiva, preceded by prodromal tingling.
Culture confirms herpes simplex virus type 1 (HSV-1).
This is the patient's third episode in six months.
What is the most appropriate management?

Accepted Answer

Prescribe systemic aciclovir 200 mg five times daily for 5 days for each episode and consider prophylactic aciclovir 400 mg twice daily if recurrences continue

Answer

Prescribe topical corticosteroids to reduce inflammation

Answer

No treatment is needed as recurrent herpes is self-limiting

Answer

Prescribe systemic fluconazole 50 mg daily

Question 2

Which oral condition is most characteristically associated with Crohn's disease?

Accepted Answer

Orofacial granulomatosis with lip swelling, mucosal cobblestoning, and linear ulceration in the buccal sulcus

Answer

Oral lichen planus

Answer

Geographic tongue

Answer

Oral hairy leukoplakia

Question 3

A 28-year-old woman presents with a burning sensation of the tongue and mouth. Clinical examination reveals no abnormality. Blood tests are normal. She reports the symptoms are worst in the evening and absent on waking. What is the most likely diagnosis?

Accepted Answer

Burning mouth syndrome (BMS)

Answer

Iron deficiency anaemia

Answer

Oral candidiasis

Answer

Trigeminal neuralgia

Question 4

Pemphigus vulgaris and mucous membrane pemphigoid are both vesiculobullous conditions affecting the oral mucosa. What is the key histological difference between them?

Accepted Answer

Pemphigus vulgaris shows intraepithelial (suprabasal) blistering with acantholysis; mucous membrane pemphigoid shows subepithelial blistering with an intact basal layer

Answer

Pemphigus vulgaris shows subepithelial blistering; pemphigoid shows intraepithelial blistering

Answer

Both conditions show identical histological features

Answer

Pemphigus vulgaris shows granulomatous inflammation; pemphigoid shows eosinophilic infiltrate

Question 5

A patient taking carbamazepine for epilepsy develops a widespread erythematous rash with targetoid lesions, oral ulceration, and conjunctivitis. What is the most likely diagnosis?

Accepted Answer

Erythema multiforme / Stevens-Johnson syndrome

Answer

Drug-induced lupus erythematosus

Answer

Allergic contact dermatitis

Answer

Viral exanthem

Question 6

What are the characteristic features of Behçet's disease and which diagnostic criteria are used?

Accepted Answer

Recurrent oral ulceration plus at least two of: recurrent genital ulceration, eye lesions, skin lesions, or positive pathergy test; diagnosed by International Study Group criteria

Answer

Recurrent parotid gland swelling and xerostomia; diagnosed by Sjögren's criteria

Answer

Unilateral facial swelling and trismus; diagnosed by CT imaging

Answer

White mucosal patches and dysphagia; diagnosed by biopsy

A patient presents with vesicles and ulcers on the palate and gingiva, preceded by prodromal tingling.Culture confirms herpes simplex virus type 1 (HSV-1).This is the patient's third episode in six months.What is the most appropriate management?

A patient presents with vesicles and ulcers on the palate and gingiva, preceded by prodromal tingling.
Culture confirms herpes simplex virus type 1 (HSV-1).
This is the patient's third episode in six months.
What is the most appropriate management?