MJDF Oral & Dental Pathology 4

Question 1

What is the most likely diagnosis when a patient presents with multiple painless cervical lymphadenopathy and persistent oral ulcers not healing after 3 weeks?

Accepted Answer

Oral squamous cell carcinoma until proven otherwise — urgent 2-week wait referral required

Answer

Persistent oral ulceration exceeding 3 weeks with cervical lymphadenopathy raises strong suspicion for oral malignancy; urgent referral via the 2-week wait pathway is mandatory.

Question 2

What systemic disease is associated with multiple periapical radiolucencies without obvious dental causes?

Accepted Answer

Multiple myeloma

Answer

Multiple myeloma can present with multiple punched-out radiolucencies throughout the jaw that mimic periapical pathology; systemic investigation including serum electrophoresis is required.

Question 3

What is the most common benign tumour of the gingiva?

Accepted Answer

Fibrous epulis (fibroma)

Answer

A fibrous epulis (gingival fibroma) is the most common benign gingival swelling, resulting from chronic irritation causing fibroblastic proliferation; it is firm, pale, and usually near the gingival margin.

Question 4

What is the significance of Stafne's bone cavity (static bone cyst) on a dental radiograph?

Accepted Answer

A developmental depression of the lingual mandibular surface (normal variant) — no treatment required

Answer

Stafne's cavity is a developmental lingual cortical depression below the inferior alveolar canal, typically seen as a well-defined radiolucency — it is a normal variant requiring only confirmation by CT, not treatment.

Question 5

What is the mechanism of action of bisphosphonates that predisposes to osteonecrosis of the jaw (MRONJ)?

Accepted Answer

Inhibit osteoclast function and promote osteoclast apoptosis, impairing normal bone remodelling and healing

Answer

Bisphosphonates inhibit farnesyl pyrophosphate synthase in osteoclasts, causing their apoptosis; without normal bone remodelling, avascular necrosis develops, particularly after dentoalveolar surgery.

MJDF Part 1 Practice Test

MJDF Part 1 Practice Test

MJDF Oral & Dental Pathology 4