NBDE Oral Pathology and Radiology Questions and Answers

Question 1

A panoramic radiograph of a 25-year-old male reveals a well-defined, unilocular radiolucency in the posterior mandible, extending anteroposteriorly along the bone with minimal buccolingual expansion.
The lesion appears to scallop between the roots of the adjacent teeth, but no significant root resorption is noted.
Which of the following is the most likely diagnosis?

Accepted Answer

Odontogenic Keratocyst (OKC)

Answer

Ameloblastoma

Answer

Radicular Cyst

Answer

Dentigerous Cyst

Question 2

A biopsy of a painful oral erosion is performed. Histopathologic examination reveals an intraepithelial split just above the basal cell layer, with the basal cells remaining attached to the underlying connective tissue, creating a 'tombstone' appearance. Cytology shows rounded acantholytic keratinocytes (Tzanck cells). What is the most likely diagnosis?

Accepted Answer

Pemphigus vulgaris

Answer

Bullous pemphigoid

Answer

Erythema multiforme

Answer

Lichen planus

Question 3

A 28-year-old female patient presents with a chief complaint of recurrent, painful oral ulcers. Clinical examination reveals multiple aphthous-like ulcers, diffuse mucosal erythema, and a 'cobblestone' appearance of the buccal mucosa. Her medical history is significant for intermittent abdominal pain and diarrhea. Which systemic condition is most likely associated with these oral findings?

Accepted Answer

Crohn's disease

Answer

Behçet's syndrome

Answer

Systemic Lupus Erythematosus

Answer

Pemphigus vulgaris

Question 4

A panoramic radiograph of a 16-year-old male shows an ill-defined, mixed radiolucent-radiopaque lesion in the body of the mandible. Fine spicules of bone are seen radiating from the surface of the lesion, creating a 'sunburst' or 'sunray' appearance. This radiographic finding is most characteristic of which of the following malignancies?

Accepted Answer

Osteosarcoma

Answer

Squamous cell carcinoma

Answer

Chondrosarcoma

Answer

Multiple myeloma

Question 5

A 60-year-old patient presents with a solitary, asymptomatic, blue-black, flat lesion on the gingiva adjacent to a large amalgam restoration. A periapical radiograph of the area reveals no bone involvement but may show tiny, radiopaque fragments. What is the most likely diagnosis?

Accepted Answer

Amalgam tattoo

Answer

Melanotic macule

Answer

Melanocytic nevus

Answer

Malignant melanoma

Question 6

Which of the following best describes the core principle of ALARA in dental radiology?

Accepted Answer

Minimizing radiation dose to the patient while still obtaining a diagnostically acceptable image.

Answer

Using the highest possible exposure settings to ensure a perfect image.

Answer

Taking radiographs on a fixed schedule, regardless of clinical findings.

Answer

Mandating the use of a lead apron for extraoral imaging only.