MFDS Oral Pathology 2

Question 1

What is the significance of epithelial dysplasia in a biopsy of an oral white patch, and which histological features indicate severe dysplasia?

Accepted Answer

Dysplasia indicates disordered epithelial maturation with potential for malignant transformation; severe dysplasia features include drop-shaped rete ridges, abnormal mitoses in the upper epithelium, loss of polarity, and marked nuclear pleomorphism extending into the upper third

Answer

Dysplasia is a normal finding in oral epithelium and has no clinical significance

Answer

Dysplasia refers to excessive keratinisation and is always benign

Answer

Dysplasia only occurs in epithelium overlying malignant tumours

Question 2

A patient presents with multiple jaw cysts. Genetic testing reveals a mutation in the PTCH1 gene. What syndrome is this patient likely to have?

Accepted Answer

Gorlin-Goltz syndrome (naevoid basal cell carcinoma syndrome)

Answer

Gardner syndrome

Answer

Peutz-Jeghers syndrome

Answer

McCune-Albright syndrome

Question 3

What are the characteristic histological features of oral verrucous carcinoma?

Accepted Answer

A well-differentiated, exophytic, broad-based squamous neoplasm with a verrucous surface, pushing (rather than infiltrating) deep margins, minimal cytological atypia, and keratin-filled clefts

Answer

Poorly differentiated cells with frequent mitoses invading deeply into muscle

Answer

Basaloid cells arranged in nests with peripheral palisading

Answer

Spindle cells with extensive areas of necrosis

Question 4

A biopsy from a gingival swelling in a 25-year-old female shows a proliferation of multinucleated giant cells in a vascular stroma. Serum calcium and parathyroid hormone levels are normal. What is the most likely diagnosis?

Accepted Answer

Peripheral giant cell granuloma

Answer

Brown tumour of hyperparathyroidism

Answer

Osteosarcoma

Answer

Aneurysmal bone cyst

Question 5

What is the WHO classification of salivary gland tumours with regard to mucoepidermoid carcinoma, and what determines its grading?

Accepted Answer

It is the most common malignant salivary gland tumour, graded as low, intermediate, or high based on the proportion of cystic spaces, mucous cells, epidermoid cells, neural invasion, necrosis, and mitotic rate

Answer

It is always classified as benign regardless of histological features

Answer

It is classified as a benign tumour that never recurs

Answer

It is always high-grade and requires radical surgery

Question 6

Which viral infection is most strongly associated with oral hairy leukoplakia, and on which part of the oral mucosa does it typically present?

Accepted Answer

Epstein-Barr virus (EBV) on the lateral borders of the tongue

Answer

Human papillomavirus (HPV) on the palate

Answer

Herpes simplex virus (HSV) on the lips

Answer

Cytomegalovirus (CMV) on the gingiva