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ABOMP Oral Pathology study materials
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ABOMP Oral Pathology practice questions

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Question 1Clinical diagnosis of disease of the oral and maxillofacial region

A well-demarcated, fluctuant swelling of the lower lip that empties on pressure and refills after massage is most consistent with which diagnosis?

  1. Mucocele Correct answer.
  2. Fibroma
  3. Hemangioma
  4. Lipoma

Explanation

Mucoceles result from retention or extravasation of salivary secretion from minor glands, producing a fluctuant blue-tinged nodule that characteristically fluctuates in size with pressure. Fibromas are firm and do not empty.

Question 2Clinical diagnosis of disease of the oral and maxillofacial region

Which clinical feature most strongly suggests a malignant rather than benign ulcer of the oral mucosa?

  1. A history of recent trauma
  2. A yellow fibrin base
  3. Induration at the ulcer margin Correct answer.
  4. Pain on palpation

Explanation

Malignant ulcers typically show firm induration of the base and rolled or everted margins reflecting infiltrative tumor growth. Trauma, pain, and fibrin coating occur with benign ulcers as well.

Question 3Clinical diagnosis of disease of the oral and maxillofacial region

Leukoplakia is best defined clinically as which of the following?

  1. A red and white speckled lesion with induration
  2. A white patch that cannot be wiped off and cannot be clinically classified as any other disease Correct answer.
  3. A white lesion associated with a positive fungal smear
  4. Any white lesion of the oral mucosa

Explanation

Leukoplakia is a clinical diagnosis of exclusion: a predominantly white patch that cannot be rubbed off and does not fit another definable entity. Speckled lesions are erythroleukoplakia and are handled separately.

Question 4Clinical diagnosis of disease of the oral and maxillofacial region

A patient reports recurrent crops of painful vesicles on the keratinized mucosa of the hard palate that rupture to leave shallow ulcers. Which diagnosis fits best?

  1. Herpangina
  2. Aphthous major ulceration
  3. Erythema multiforme
  4. Recurrent intraoral herpes simplex infection Correct answer.

Explanation

Recurrent herpes simplex affects keratinized mucosa such as the hard palate and attached gingiva, beginning as clustered vesicles that rupture into small ulcers. Aphthous ulcers occur on nonkeratinized mucosa and are not vesicular.

Question 5Clinical diagnosis of disease of the oral and maxillofacial region

Which term describes a benign, self-limiting, reactive overgrowth of gingival tissue caused by plaque accumulation?

  1. Gingival fibromatosis
  2. Peripheral giant cell granuloma
  3. Pyogenic granuloma Correct answer.
  4. Gingival cyst

Explanation

Pyogenic granuloma is a reactive vascular proliferation often triggered by plaque or irritation, presenting as a red friable gingival mass. Gingival fibromatosis is a generalized fibrous enlargement, often drug-related or hereditary.

Question 6Clinical diagnosis of disease of the oral and maxillofacial region

A painless, slowly enlarging, firm swelling at the junction of the hard and soft palate that is fluctuant and yields a straw-colored fluid on aspiration is most likely which lesion?

  1. Palatal abscess
  2. Nasopalatine duct cyst
  3. Mucoepidermoid carcinoma
  4. Pleomorphic adenoma Correct answer.

Explanation

Pleomorphic adenoma is the most common benign salivary neoplasm and favors the palate, presenting as a firm, painless, slowly growing submucosal mass. Malignancy should be considered when there is ulceration, pain, or rapid growth.

Question 7Clinical diagnosis of disease of the oral and maxillofacial region

Which clinical finding is characteristic of oral candidiasis?

  1. White plaques that rub off leaving an erythematous base Correct answer.
  2. White plaques that cannot be removed
  3. A painless bony hard swelling
  4. A bluish fluctuant vesicle

Explanation

Pseudomembranous candidiasis forms white curd-like plaques that wipe away to reveal erythematous mucosa. Lesions that cannot be removed suggest leukoplakia or other keratotic disease.

Question 8Clinical diagnosis of disease of the oral and maxillofacial region

A fluctuant, bluish, dome-shaped swelling on the ventral tongue that is soft and compressible is most consistent with which diagnosis?

  1. Hemangioma
  2. Squamous cell carcinoma
  3. Fibroma
  4. Ranula Correct answer.

Explanation

A ranula is a mucocele of the floor of the mouth arising from the sublingual gland, appearing as a bluish fluctuant swelling. Fibromas are firm and carcinomas are indurated and often ulcerated.

Question 9Clinical diagnosis of disease of the oral and maxillofacial region

A 60-year-old smoker presents with a painless, nonhealing ulcer on the lateral border of the tongue present for six weeks. Which is the most appropriate next step?

  1. Incisional biopsy of the lesion Correct answer.
  2. Prescribe an antifungal mouth rinse
  3. Reassure the patient and review in six months
  4. Prescribe a topical corticosteroid and review in two weeks

Explanation

Any ulcer persisting beyond two to three weeks, especially in a high-risk patient, requires biopsy to exclude malignancy. Empirical treatment delays diagnosis of oral squamous cell carcinoma.

Question 10Clinical diagnosis of disease of the oral and maxillofacial region

Which feature best distinguishes a benign migratory glossitis (geographic tongue) from candidiasis?

  1. Association with angular cheilitis
  2. A positive potassium hydroxide smear
  3. Presence of removable white plaques
  4. Depapillated red patches with raised white borders that migrate over time Correct answer.

Explanation

Geographic tongue shows migrating areas of depapillation with white keratotic borders and a changing pattern over days to weeks. Candidiasis produces removable plaques and responds to antifungals.

Question 11Clinical diagnosis of disease of the oral and maxillofacial region

A patient on long-term phenytoin therapy develops generalized firm gingival enlargement. Which diagnosis is most likely?

  1. Scurvy
  2. Drug-induced gingival overgrowth Correct answer.
  3. Pyogenic granuloma
  4. Leukemic infiltration

Explanation

Phenytoin, cyclosporine, and calcium channel blockers cause drug-induced gingival overgrowth, typically generalized and fibrous. Pyogenic granuloma is a localized vascular nodule.

Question 12Clinical diagnosis of disease of the oral and maxillofacial region

Which radiographic finding is most characteristic of a radicular cyst?

  1. A multilocular radiolucency at the mandibular angle
  2. A ground-glass radiopacity
  3. A well-circumscribed periapical radiolucency associated with a nonvital tooth Correct answer.
  4. A sunburst periosteal reaction

Explanation

Radicular cysts arise from inflammatory epithelial rests at the apex of a nonvital tooth, producing a well-defined periapical radiolucency. Multilocular angle lesions suggest ameloblastoma or keratocyst.

Question 13Clinical diagnosis of disease of the oral and maxillofacial region

A multilocular radiolucency with a soap-bubble appearance in the posterior mandible of a young adult is most suggestive of which diagnosis?

  1. Dentigerous cyst
  2. Osteoma
  3. Radicular cyst
  4. Ameloblastoma Correct answer.

Explanation

Ameloblastoma classically produces a multilocular soap-bubble radiolucency in the posterior mandible of adults. Dentigerous cysts are unilocular and surround the crown of an impacted tooth.

Question 14Clinical diagnosis of disease of the oral and maxillofacial region

Which clinical sign most suggests that a pigmented oral lesion should be biopsied to exclude melanoma?

  1. Uniform brown color present since childhood
  2. Bilateral symmetry
  3. Presence on the buccal mucosa only
  4. Irregular borders with recent change in size and color Correct answer.

Explanation

Melanoma warning signs include asymmetry, irregular borders, color variation, and recent change, paralleling the ABCDE criteria. Stable, uniform, symmetric pigmentation favors a benign macule.

Question 15Clinical diagnosis of disease of the oral and maxillofacial region

A patient reports sudden onset of unilateral facial paralysis with inability to close the eye and loss of taste on the anterior tongue. Which diagnosis is most likely?

  1. Trigeminal neuralgia
  2. Parotitis
  3. Bell palsy Correct answer.
  4. Temporomandibular joint disorder

Explanation

Bell palsy is an acute peripheral facial nerve palsy producing ipsilateral facial weakness, impaired eye closure, and often loss of taste from chorda tympani involvement. Trigeminal neuralgia causes lancinating pain, not paralysis.

Question 16Clinical diagnosis of disease of the oral and maxillofacial region

Which feature most reliably distinguishes recurrent aphthous stomatitis from recurrent intraoral herpes?

  1. Ulcers on nonkeratinized mucosa beginning as a small erosion without vesicles Correct answer.
  2. Involvement of the hard palate
  3. Unilateral distribution
  4. Presence of clustered vesicles

Explanation

Aphthous ulcers arise on nonkeratinized mucosa as a yellowish ulcer with an erythematous halo and no vesicular stage. Herpes begins as vesicles and favors keratinized mucosa.

Question 17Clinical diagnosis of disease of the oral and maxillofacial region

A diffuse, soft, fluctuant swelling of the submandibular region with fever, trismus, and elevation of the floor of the mouth suggests which condition?

  1. Ranula
  2. Ludwig angina Correct answer.
  3. Sialolithiasis
  4. Pleomorphic adenoma

Explanation

Ludwig angina is a rapidly spreading bilateral cellulitis of the submandibular and sublingual spaces causing floor-of-mouth elevation, trismus, and systemic toxicity. It is a surgical emergency.

Question 18Clinical diagnosis of disease of the oral and maxillofacial region

Which clinical presentation is most typical of oral lichen planus?

  1. Bilateral white reticular striae on the buccal mucosa Correct answer.
  2. Unilateral white plaque on the lateral tongue
  3. A solitary ulcer with rolled margins
  4. A fluctuant bluish nodule

Explanation

Oral lichen planus classically shows bilateral, symmetric Wickham striae, most often on the buccal mucosa. Unilateral solitary lesions raise concern for dysplasia or malignancy.

Question 19Clinical diagnosis of disease of the oral and maxillofacial region

A patient reports intermittent swelling of the submandibular gland that worsens with meals and is accompanied by colicky pain. Which diagnosis is most likely?

  1. Pleomorphic adenoma
  2. Mucoepidermoid carcinoma
  3. Sialolithiasis Correct answer.
  4. Sjogren syndrome

Explanation

Salivary stones obstruct the duct, causing mealtime swelling and colicky pain that subsides after secretion. Neoplasms cause persistent masses unrelated to meals.

Question 20Clinical diagnosis of disease of the oral and maxillofacial region

Which finding on examination most suggests a vascular rather than a solid lesion?

  1. Firm consistency on palpation
  2. Punctate bleeding on probing
  3. Yellowish surface discoloration
  4. Blanching on pressure with a positive diascopy test Correct answer.

Explanation

Vascular lesions blanch when pressure is applied because blood is displaced from the vascular spaces, a positive diascopy test. Solid lesions retain their color and firmness.

Question 21Clinical diagnosis of disease of the oral and maxillofacial region

A patient with a unilateral painless swelling of the parotid gland and a history of recurrent meals-related discomfort is evaluated. Which imaging study is most appropriate first-line for suspected ductal obstruction?

  1. Cone-beam CT of the mandible
  2. Panoramic radiograph
  3. Ultrasound of the gland and duct Correct answer.
  4. MRI of the brain

Explanation

Ultrasound is a noninvasive, readily available first-line study for evaluating salivary duct obstruction and glandular lesions. Panoramic films do not adequately visualize the parotid duct.

Question 22Clinical diagnosis of disease of the oral and maxillofacial region

Which feature best distinguishes a benign fibro-osseous lesion such as fibrous dysplasia from an odontogenic tumor on imaging?

  1. A multilocular soap-bubble appearance
  2. Root resorption with a sunburst pattern
  3. A well-defined corticated radiolucency
  4. A ground-glass opacity blending with surrounding bone Correct answer.

Explanation

Fibrous dysplasia produces a ground-glass opacity that blends with adjacent bone, whereas odontogenic tumors are typically well demarcated. Sunburst patterns and root resorption raise concern for malignancy.

Question 23Clinical diagnosis of disease of the oral and maxillofacial region

A patient presents with trismus, dysphagia, and a rapidly enlarging indurated mass in the tonsillar region with ipsilateral lymphadenopathy. Which diagnosis should be highest on the differential?

  1. Aphthous ulcer
  2. Peritonsillar abscess
  3. Oropharyngeal squamous cell carcinoma Correct answer.
  4. Pleomorphic adenoma

Explanation

An indurated, rapidly enlarging mass with lymphadenopathy in a high-risk site suggests malignancy, most commonly squamous cell carcinoma. Abscesses are fluctuant and inflammatory rather than indurated.

Question 24Clinical diagnosis of disease of the oral and maxillofacial region

A patient with a history of a treated oral squamous cell carcinoma develops a new firm, fixed submandibular node. Which is the most appropriate interpretation?

  1. Suspicious for metastatic disease requiring urgent evaluation Correct answer.
  2. A normal finding after treatment
  3. A benign lipoma of the neck
  4. A reactive lymph node requiring no action

Explanation

A new firm, fixed node in a patient with prior oral cancer raises high suspicion for metastasis and warrants urgent imaging and fine-needle aspiration. Reactive nodes are typically tender and mobile.

Question 25Clinical diagnosis of disease of the oral and maxillofacial region

Which clinical scenario most warrants urgent referral for suspected oral malignancy?

  1. A traumatic ulcer from a sharp cusp resolving after adjustment
  2. A recurrent aphthous ulcer healing within ten days
  3. A white patch unchanged for years
  4. A nonhealing ulcer with induration persisting beyond three weeks in a smoker Correct answer.

Explanation

Persistent indurated ulcers beyond two to three weeks, especially in smokers, require urgent referral to exclude carcinoma. Self-resolving ulcers and stable lesions are managed differently.

Question 26Clinical diagnosis of disease of the oral and maxillofacial region

A patient has a 3 mm white patch on the buccal mucosa that cannot be rubbed off and has no identifiable cause. What is the most appropriate clinical term for this lesion?

  1. Candidiasis
  2. Linea alba
  3. Leukoplakia Correct answer.
  4. Lichen planus

Explanation

Leukoplakia is a clinical diagnosis of exclusion: a predominantly white patch that cannot be characterized as any other definable disease. Rubbing it off would suggest a pseudomembrane such as candidiasis rather than a true keratotic plaque.

Question 27Clinical diagnosis of disease of the oral and maxillofacial region

Which clinical feature most strongly suggests that an oral ulcer is traumatic in origin?

  1. A history of recurrent crops of ulcers
  2. A sharp cuspid or restoration adjacent to the ulcer Correct answer.
  3. Ulceration confined to the keratinized attached gingiva
  4. Bilateral symmetric involvement of the buccal mucosa

Explanation

Traumatic ulcers occur at sites of repeated mechanical injury, so an identifiable source such as a sharp tooth or restoration adjacent to the lesion supports the diagnosis. Resolution after removal of the cause confirms it.

Question 28Clinical diagnosis of disease of the oral and maxillofacial region

Which clinical test best confirms that a mucosal swelling is fluid-filled rather than solid?

  1. Auscultation over the mass
  2. Fluctuation on gentle bidirectional palpation Correct answer.
  3. Transillumination of the swelling
  4. Percussion of the adjacent teeth

Explanation

Fluctuation is elicited when a fluid-filled cavity transmits pressure in two directions under the fingers, distinguishing a cyst or abscess from a solid mass. Transillumination indicates fluid that transmits light but is less reliable for differentiating consistency.

Question 29Clinical diagnosis of disease of the oral and maxillofacial region

A patient reports a burning sensation of the tongue and oral mucosa, and examination shows a smooth, red, depapillated tongue with angular cheilitis. Which deficiency is most likely?

  1. Vitamin C deficiency
  2. Vitamin B12 deficiency Correct answer.
  3. Iron overload
  4. Vitamin D deficiency

Explanation

Vitamin B12 deficiency causes megaloblastic change with glossitis, mucosal burning, and angular cheilitis, and the tongue becomes smooth and red from loss of papillae. Folate deficiency produces a similar picture.

Question 30Clinical diagnosis of disease of the oral and maxillofacial region

Which clinical finding is most characteristic of a mucocele of the lower lip?

  1. A soft, bluish, fluctuant nodule that may rupture and recur Correct answer.
  2. A deep, punched-out ulcer with a yellow base
  3. A diffuse bilateral swelling of the lip
  4. A firm, white, keratotic plaque

Explanation

Mucoceles arise from retention or extravasation of salivary secretion and present as soft, bluish, fluctuant nodules that often rupture and refill. The lower lip is the most common site.

Question 31Clinical diagnosis of disease of the oral and maxillofacial region

Which clinical feature best supports a diagnosis of primary herpes simplex gingivostomatitis rather than recurrent aphthous stomatitis?

  1. Ulcers that begin as a prodrome of tingling at the same site each time
  2. Grouped vesicles that rupture to leave small erosions on keratinized mucosa Correct answer.
  3. Round ulcers with a yellow fibrin center and red halo on nonkeratinized mucosa
  4. A history of similar episodes recurring several times per year

Explanation

Primary herpes infection produces grouped vesicles that rupture into small erosions, often on keratinized mucosa such as the gingiva and palate, accompanied by systemic symptoms. Aphthous ulcers are round, shallow, and favor nonkeratinized mucosa.

Question 32Clinical diagnosis of disease of the oral and maxillofacial region

Which clinical sign most suggests that a diffuse gingival enlargement is drug-induced?

  1. Firm, generalized enlargement with a history of a causative medication Correct answer.
  2. Localized enlargement confined to a single interdental papilla
  3. A painful, erythematous swelling with spontaneous bleeding
  4. A bluish, translucent vesicle on the attached gingiva

Explanation

Drug-induced gingival enlargement, classically from phenytoin, calcium channel blockers, or cyclosporine, is generalized and firm and improves after drug substitution. Localized lesions suggest a different cause such as a pyogenic granuloma or periodontal abscess.

Question 33Clinical diagnosis of disease of the oral and maxillofacial region

Which clinical finding is most typical of a ranula?

  1. A painful ulcer on the lingual frenum
  2. A soft, fluctuant swelling of the floor of the mouth that transilluminates Correct answer.
  3. A white, corrugated plaque on the ventral tongue
  4. A firm, fixed mass in the posterior tongue

Explanation

A ranula is a mucocele of the floor of the mouth arising from the sublingual gland and presents as a soft, fluctuant, bluish swelling that transilluminates. It is usually painless and displaces rather than invades.

Question 34Clinical diagnosis of disease of the oral and maxillofacial region

A patient has a well-defined radiolucency at the apex of a nonvital maxillary incisor, and the crown is discolored. Which diagnosis is most likely?

  1. Radicular cyst Correct answer.
  2. Odontogenic keratocyst
  3. Dentigerous cyst
  4. Ameloblastoma

Explanation

A periapical radiolucency associated with a nonvital, discolored tooth is most consistent with inflammatory disease of endodontic origin, including a radicular cyst. The loss of vitality links the lesion to the necrotic pulp.

Question 35Clinical diagnosis of disease of the oral and maxillofacial region

Which clinical presentation most suggests a diagnosis of oral lichen planus?

  1. Diffuse gingival erythema with desquamation limited to the maxilla
  2. Bilateral white reticular striae with erosive areas on the buccal mucosa Correct answer.
  3. A unilateral white plaque with a verrucous surface
  4. Multiple shallow ulcers with a yellow base on the soft palate

Explanation

Oral lichen planus classically presents with bilateral, symmetric reticular white striae, often with erosive or atrophic areas, most commonly on the buccal mucosa. Symmetry and the striae pattern distinguish it from unilateral keratotic lesions.

Question 36Clinical diagnosis of disease of the oral and maxillofacial region

A patient describes intermittent meals-related swelling of the submandibular gland with colicky pain that subsides between meals. Which diagnosis is most likely?

  1. Sialolithiasis with obstructive sialadenitis Correct answer.
  2. Sjögren syndrome
  3. Mucoepidermoid carcinoma
  4. Pleomorphic adenoma

Explanation

Meals-related swelling with colicky pain reflects obstruction of salivary flow, most often by a sialolith, with the gland enlarging during stimulation and subsiding afterward. The submandibular gland is the most common site because its secretion is more viscous and its duct is longer.

Question 37Clinical diagnosis of disease of the oral and maxillofacial region

Which clinical finding most suggests that a pigmented oral lesion is a melanoma rather than a benign melanotic macule?

  1. Small size under 5 mm with uniform color
  2. A history of the lesion being present unchanged for many years
  3. Irregular, spreading borders with variable pigmentation Correct answer.
  4. Bilateral symmetric macules on the buccal mucosa

Explanation

Melanoma is suggested by asymmetry, irregular borders, variegated color, and change over time, which warrant biopsy. Benign macules are typically small, uniform, and stable.

Question 38Clinical diagnosis of disease of the oral and maxillofacial region

A patient has a unilateral painless parotid swelling that has slowly enlarged over two years and is firm but mobile. Which diagnosis is most likely?

  1. Pleomorphic adenoma Correct answer.
  2. Mumps
  3. Sialolithiasis
  4. Acute suppurative parotitis

Explanation

A slow-growing, painless, mobile parotid mass in an adult is most often a pleomorphic adenoma, the most common salivary gland neoplasm. Facial nerve function is typically preserved.

Question 39Clinical diagnosis of disease of the oral and maxillofacial region

Which clinical feature best distinguishes fibrous dysplasia from an odontogenic tumor on imaging?

  1. Displacement of the inferior alveolar canal with a sclerotic rim
  2. A well-defined corticated border separating it from bone
  3. A ground-glass bone pattern that blends with surrounding bone Correct answer.
  4. A multilocular soap-bubble radiolucency

Explanation

Fibrous dysplasia produces a poorly defined, ground-glass or orange-peel bone texture that blends into adjacent bone rather than a discrete corticated lesion. Odontogenic tumors usually have definable margins.

Question 40Clinical diagnosis of disease of the oral and maxillofacial region

A patient presents with trismus, dysphagia, and a rapidly enlarging indurated mass of the tonsillar region with a fixed ipsilateral cervical node. Which diagnosis is most likely?

  1. Infectious mononucleosis
  2. Squamous cell carcinoma of the oropharynx Correct answer.
  3. Recurrent aphthous stomatitis
  4. Peritonsillar abscess

Explanation

A rapidly enlarging indurated mass with fixation and regional lymphadenopathy in the oropharynx is highly suspicious for squamous cell carcinoma. Trismus and dysphagia reflect infiltration of adjacent structures.

Question 41Clinical diagnosis of disease of the oral and maxillofacial region

A patient with a previously treated oral squamous cell carcinoma develops a new firm, fixed submandibular node. What is the most appropriate interpretation?

  1. A reactive lymph node from recent dental infection
  2. A sialolith of the submandibular gland
  3. A benign lipoma of the neck
  4. Suspected regional metastasis requiring prompt staging and biopsy Correct answer.

Explanation

A new firm, fixed node in a patient with a history of oral cancer is suspicious for regional metastasis and requires prompt evaluation with imaging and tissue sampling. Fixation suggests extranodal spread or infiltration.

Question 42Clinical diagnosis of disease of the oral and maxillofacial region

A patient reports sudden unilateral facial paralysis with inability to close the eye, loss of taste on the anterior tongue, and ear pain. Which diagnosis is most likely?

  1. Temporomandibular joint disorder
  2. Bell palsy Correct answer.
  3. Trigeminal neuralgia
  4. Parotid malignancy with facial nerve invasion

Explanation

Acute unilateral lower motor neuron facial palsy with taste loss and retroauricular or ear pain is characteristic of Bell palsy, which is idiopathic and typically self-limited. Involvement of taste indicates the lesion is proximal to the chorda tympani.

Question 43Clinical diagnosis of disease of the oral and maxillofacial region

A patient has a diffuse, soft, fluctuant submandibular swelling with fever, trismus, and elevation of the floor of the mouth. What is the most appropriate immediate action?

  1. Sialography of the submandibular duct
  2. Observation with analgesics alone
  3. Incisional biopsy of the swelling
  4. Urgent airway assessment and surgical drainage with antibiotics Correct answer.

Explanation

A rapidly spreading submandibular infection with floor-of-mouth elevation and trismus threatens the airway and requires urgent assessment, drainage, and antibiotics. Delay risks deep neck space spread.

Question 44Clinical diagnosis of disease of the oral and maxillofacial region

A patient has a well-circumscribed, bluish, compressible swelling of the lower lip that blanches on pressure. Which diagnosis is most likely?

  1. Venous malformation Correct answer.
  2. Mucocele
  3. Squamous papilloma
  4. Fibroma

Explanation

A bluish, compressible lesion that blanches with pressure suggests a vascular malformation rather than a solid or cystic lesion. Diascopy blanching indicates blood-filled spaces.

Question 45Clinical diagnosis of disease of the oral and maxillofacial region

A patient reports a burning mouth with no visible mucosal abnormality, and symptoms are absent during sleep. Which diagnosis is most likely?

  1. Oral lichen planus
  2. Oral candidiasis
  3. Burning mouth syndrome Correct answer.
  4. Geographic tongue

Explanation

Burning mouth syndrome presents with chronic oral burning without identifiable mucosal lesions, often sparing sleep and worsening through the day. Absence of clinical findings distinguishes it from mucosal disease.

Question 46Clinical diagnosis of disease of the oral and maxillofacial region

A patient has a painless, slowly enlarging, firm swelling at the junction of the hard and soft palate that is fluctuant and yields a straw-colored fluid on aspiration. Which diagnosis is most likely?

  1. Mucoepidermoid carcinoma
  2. Palatal abscess
  3. Nasopalatine duct cyst Correct answer.
  4. Pleomorphic adenoma

Explanation

A fluctuant midline palatal swelling yielding straw-colored fluid is characteristic of a nasopalatine duct cyst, a developmental cyst of the incisive canal. Aspiration helps distinguish it from a solid neoplasm.

Question 47Clinical diagnosis of disease of the oral and maxillofacial region

A patient has a firm, nontender swelling of the hard palate lateral to the midline with normal overlying mucosa. Which diagnosis should be considered first?

  1. Palatal torus
  2. Salivary gland neoplasm of the minor palatal glands Correct answer.
  3. Median palatal cyst
  4. Nasopalatine duct cyst

Explanation

A firm, unilateral palatal swelling with intact mucosa raises concern for a minor salivary gland neoplasm, which is common in the palate. Palatal salivary tumors are often malignant and require biopsy.

Question 48Clinical diagnosis of disease of the oral and maxillofacial region

A patient has a diffuse, nonulcerated gingival enlargement that is firm and painless and involves both arches, with no identifiable local irritants. Which systemic condition should be considered?

  1. Vitamin C deficiency
  2. Pregnancy
  3. Primary herpetic gingivostomatitis
  4. Leukemia Correct answer.

Explanation

Diffuse firm gingival enlargement without local cause can be a manifestation of systemic disease such as leukemia, particularly when accompanied by bleeding or pallor. A complete blood count is warranted.

Question 49Clinical diagnosis of disease of the oral and maxillofacial region

A patient has a painless, well-defined radiolucency in the anterior maxilla that is associated with a vital incisor and causes divergence of the roots. Which diagnosis is most likely?

  1. Radicular cyst
  2. Odontoma
  3. Nasopalatine duct cyst Correct answer.
  4. Dentigerous cyst

Explanation

A well-defined midline anterior maxillary radiolucency with root divergence and vital adjacent teeth is characteristic of a nasopalatine duct cyst. Vitality helps exclude an inflammatory periapical lesion.

Question 50Clinical diagnosis of disease of the oral and maxillofacial region

A patient has a chronic, painless, well-demarcated red patch on the ventral tongue with no identifiable cause. What is the most appropriate management?

  1. Biopsy to exclude dysplasia or carcinoma Correct answer.
  2. Reassurance and review in one year
  3. Cauterization of the lesion
  4. Topical antifungal therapy without sampling

Explanation

An idiopathic erythroplakia is a high-risk lesion for dysplasia or carcinoma and requires biopsy rather than observation. The absence of an identifiable cause is what makes it clinically significant.