NBDE Oral Pathology and Radiology 5

Question 1

The 'double cortical outline' sign on a panoramic radiograph of the mandibular canal is associated with:

Accepted Answer

Inferior alveolar nerve schwannoma

Answer

A schwannoma of the inferior alveolar nerve can expand the mandibular canal, creating a double cortical outline (canal-within-canal) appearance radiographically.

Question 2

Hairy leukoplakia of the tongue in an HIV-positive patient is caused by:

Accepted Answer

Epstein-Barr virus replication in epithelial cells

Answer

Oral hairy leukoplakia is caused by EBV replication in epithelial cells of the lateral tongue, producing corrugated white plaques that cannot be wiped off.

Question 3

The radiopaque structure overlying the roots of maxillary premolars most commonly misidentified as periapical pathology is:

Accepted Answer

Zygomatic process of the maxilla

Answer

The zygomatic process of the maxilla projects as a J-shaped or U-shaped radiopacity over the maxillary first premolar/molar roots and must not be confused with hypercementosis or condensing osteitis.

Question 4

Pemphigus vulgaris of the oral cavity is distinguished from mucous membrane pemphigoid by:

Accepted Answer

Suprabasilar acantholysis (intraepithelial clefting) versus subepithelial split

Answer

Pemphigus vulgaris shows suprabasilar acantholysis (loss of cohesion above the basal layer), while mucous membrane pemphigoid features a subepithelial blister below the intact epithelium.

Question 5

A painless, fluctuant, bluish sublingual swelling that displaces the tongue is best diagnosed as:

Accepted Answer

Ranula (retention phenomenon of sublingual gland)

Answer

A ranula is a mucous retention or extravasation pseudocyst arising from the sublingual gland, presenting as a translucent blue swelling in the floor of the mouth.

NBDE - National Board Dental Examination Practice Test

NBDE - National Board Dental Examination Practice Test

NBDE Oral Pathology and Radiology 5