Oral Pathology For The Dental Hygienist 7th Edition By Olga A. C. Ibsen – Test Bank
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Chapter 03: Immunity and Immunologic Oral Lesions
Ibsen: Oral Pathology for the Dental Hygienist, 7th Edition
MULTIPLE CHOICE
1. The breakdown
of cellular adhesion between epithelial cells is termed
|
a. |
cell-mediated immunity. |
|
b. |
acantholysis. |
|
c. |
Nikolsky sign. |
|
d. |
anaphylaxis. |
ANS: B
Acantholysis is the dissolution of the intracellular bridges of
the prickle cell layer of epithelium. Cell-mediated immunity is immunity in
which the predominant role is played by T-lymphocytes. Nikolsky sign occurs
when the superficial epithelium separates easily from the basal layer on
exertion of firm, sliding, manual pressure. Anaphylaxis is a severe type of
systemic hypersensitivity reaction.
REF: Pemphigus, page
101
OBJ:
1
2. Which
protein molecule is produced by plasma cells and is also termed an
immunoglobulin?
|
a. |
An autoimmune disease |
|
b. |
A natural killer (NK) cell |
|
c. |
Rheumatoid factor |
|
d. |
An antibody |
ANS: D
An antibody is a protein molecule, also called an
immunoglobulin, that is produced by plasma cells and reacts with a specific
antigen. An autoimmune disease is a disease characterized by tissue injury
caused by a humoral or cell-mediated response against constituents of the
body’s own tissues. An NK cell is a lymphocyte that is part of the body’s
innate immunity. Rheumatoid factor is a protein, immunoglobulin M (IgM), found
in serum and detected in laboratory tests. It is associated with rheumatoid
arthritis and other autoimmune diseases.
REF: Vocabulary, page 79 | B-cell Lymphocyte, page
81 OBJ: 1
3. Which
lymphocyte matures without passing through the thymus and later can develop
into a plasma cell that produces antibodies?
|
a. |
T-lymphocyte |
|
b. |
B-lymphocyte |
|
c. |
Macrophage |
|
d. |
LE cell |
ANS: B
The B-lymphocyte matures without passing through the thymus and
later can develop into a plasma cell that produces antibodies. The T-lymphocyte
matures in the thymus before migrating to tissues. A macrophage is a large
tissue-bound mononuclear phagocyte derived from monocytes circulating in the
blood. The LE cell is an atypical mature neutrophil characteristic of lupus
erythematosus and other autoimmune diseases.
REF: Vocabulary, page 79 | B-cell Lymphocyte, page
81 OBJ: 3
4. In
which type of immune response do B-lymphocytes and antibodies play the
predominant role?
|
a. |
Cell-mediated immunity |
|
b. |
Immune complex |
|
c. |
Humoral immunity |
|
d. |
Passive immunity |
ANS: C
In humoral immunity the B-lymphocytes and antibodies play the
predominant role. In cell-mediated immunity, the T-lymphocyte plays the
predominant role. The immune complex is a combination of antigen and antibody.
Passive immunity occurs when antibodies produced by another person are used to
protect an individual from an infectious disease.
REF: Major Divisions of the Immune Response, page
84 OBJ: 2
5. Which
is not a
specific component of immunity?
|
a. |
A humoral response |
|
b. |
A cell-mediated response |
|
c. |
Memory |
|
d. |
Pavementing |
ANS: D
Pavementing is the adherence of white blood cells to the walls
of a blood vessel during an inflammatory response. Humoral immunity involves
the production of antibodies. The B-lymphocyte is the predominant cell.
Cell-mediated immunity involves the T-lymphocyte. Memory is an important
function of the immune system. Certain lymphocytes retain the memory of an
antigen after an initial encounter, allowing for faster immune responses.
REF: Major Divisions of the Immune Response; Memory
and Immunity, pages 80, 84
OBJ: 6
6. An
example of natural passive immunity occurs when
|
a. |
antibodies from a mother
pass through the placenta to the developing fetus. |
|
b. |
a microorganism causes a
disease. |
|
c. |
a person receives a
vaccination. |
|
d. |
a person is immunized. |
ANS: A
Natural passive immunity occurs when antibodies from a mother
pass through the placenta to the developing fetus. Active immunity occurs
naturally when a microorganism causes a disease. Active acquired immunity
occurs as a result of vaccination. After vaccination, the immune system
produces a stronger response and prevents the development of the disease. This
production of acquired immunity is called immunization.
REF: Types of Immunity, page
85 OBJ: 7
7. Which
is an example of type I hypersensitivity?
|
a. |
Immune complexes formed
between microorganisms and antibody in the circulating blood |
|
b. |
Asthma |
|
c. |
Autoimmune hemolytic anemia |
|
d. |
Serum sickness |
ANS: B
Asthma is an example of type I hypersensitivity. In type III
hypersensitivity, immune complexes are formed between microorganisms and
antibody in the circulating blood. Autoimmune hemolytic anemia is a type II
hypersensitivity reaction. Serum sickness is a classic example of a type III
hypersensitivity reaction.
REF: Type I Hypersensitivity, page
85 OBJ: 8
8. Which
route of drug administration causes the most significant hypersensitivity
reaction?
|
a. |
Topical |
|
b. |
Patch |
|
c. |
Parenteral |
|
d. |
Oral |
ANS: C
When the reaction occurs after parenteral administration
(injection), it may be more severe because the allergen can be carried quickly
to many parts of the body through the bloodstream. It takes more time for
topically applied drugs to enter the bloodstream compared with parenterally
applied (injected) drugs. It takes more time for a drug to enter the
bloodstream via a patch compared with parenteral administration. It takes more
time for oral medications to enter the bloodstream than parenterally applied
drugs.
REF: Hypersensitivity to Drugs, page 86
OBJ: 8
9. Which
is a condition that involves a deficiency in number, function, or
interrelationships of the involved white blood cells and their products?
|
a. |
Autoimmune disease |
|
b. |
Leukocytosis |
|
c. |
Immunodeficiency |
|
d. |
Anaphylaxis |
ANS: C
Immunodeficiency is a type of immunopathologic condition that
involves a deficiency in number, function, or interrelationships of the
involved white blood cells and their products. Autoimmune disease is
characterized by tissue injury caused by a humoral or cell-mediated immune
response against constituents of the body’s own tissues. Leukocytosis is an
increase in the circulating white blood cells. It is a systemic sign of an
inflammatory response. Anaphylaxis is a severe type of hypersensitivity
reaction.
REF: Immunodeficiency, page
87 OBJ:
8
10. What
is the most common precipitating factor in the development of aphthous ulcers?
|
a. |
Allergy |
|
b. |
Trauma |
|
c. |
Systemic disease |
|
d. |
Citrus foods |
ANS: B
Trauma is the most common precipitating factor in the
development of aphthous ulcers. Allergies do not cause aphthous ulcers.
Aphthous ulcers do occur in association with certain systemic diseases, but
they are not the most common precipitating factor. Citrus foods can trigger
episodes of aphthous ulcers, but they are not the most common precipitating
factor.
REF: Aphthous Ulcers, Recurrent Aphthous Ulcers,
page 87 OBJ: 11
11. Certain
recurrent ulcers appear on movable mucosa. These ulcers are discrete,
round-to-oval, 3 to 5 mm in diameter and exhibit a yellowish-white fibrin
center surrounded by an erythematous halo. These ulcers are termed
|
a. |
major aphthous ulcers. |
|
b. |
Sutton disease. |
|
c. |
herpetiform aphthous
ulcers. |
|
d. |
minor aphthous ulcers. |
ANS: D
Minor aphthous ulcers are recurrent and appear on movable
mucosa. They are 3 to 5 mm in diameter and have a yellowish-white fibrin center
surrounded by an erythematous halo. Major aphthous ulcers are deeper in the
tissue, are larger (5 to 10 mm), take much longer to heal, and often heal with
scarring. Sutton disease is the same as major aphthous ulcers. Herpetiform
aphthous ulcers are very tiny (1 to 2 mm). The size of this type of aphthous
ulcer is similar to the size of ulcers caused by the herpes simplex virus.
REF: Types of Aphthous Ulcers, page
87
OBJ: 11
12. Which
ulcer may require a biopsy to make the diagnosis?
|
a. |
Minor aphthous |
|
b. |
Major aphthous |
|
c. |
Herpetiform aphthous |
|
d. |
Behçet syndrome |
ANS: B
Major aphthous ulcers sometimes require a biopsy to rule out
other causes of ulceration such as squamous cell carcinoma or deep fungal
infections. Minor aphthous ulcers are diagnosed through clinical appearance,
location, and complete patient history. Herpetiform aphthous ulcers resemble
those associated with the herpes simplex virus, but there are no systemic signs
or symptoms as in primary herpes simplex infection. Behçet syndrome is a
multisystem disorder characterized by numerous clinical manifestations.
Although there are oral ulcerations, the diagnosis requires the presence of
other features such as genital, ocular, and skin lesions.
REF: Types of Aphthous Ulcers, page
87
OBJ: 11
13. Antihistaminic
drugs are the principal method of treatment for
|
a. |
urticaria. |
|
b. |
minor aphthous ulcers. |
|
c. |
herpetiform aphthous
ulcers. |
|
d. |
contact mucositis. |
ANS: A
Urticaria, also called hives,
appears as well-demarcated areas of swelling on the skin accompanied by
pruritus. The release of the chemical mediator histamine causes the increased
vascular permeability. Antihistaminic drugs are used to treat urticaria. Minor
aphthous ulcers heal spontaneously in 7 to 10 days. They may be treated with
topical corticosteroid or nonsteroidal antiinflammatory medications.
Herpetiform aphthous ulcers do not respond to antihistaminic drugs. They may
respond to corticosteroid therapy or topical liquid tetracycline. Contact
mucositis results from direct contact of an allergen with the mucosa. Treatment
begins with removal of the cause.
REF: Urticaria and Angioedema, Treatment and
Prognosis, page 90
OBJ: 13
14. A
prodromal period begins
|
a. |
1 week before the onset of
ulcers. |
|
b. |
1 to 2 days before the
onset of ulcers. |
|
c. |
the day the ulcers erupt. |
|
d. |
7 to 10 days before ulcers
erupt. |
ANS: B
The prodromal period occurs 1 to 2 days before ulcers appear.
There are a burning sensation and soreness where the ulcers will appear. The
prodromal period before ulceration is only 1 to 2 days. Prodromal symptoms
should not occur 1 week before ulceration. The prodromal period does not occur
on the day of ulceration. The prodromal period precedes ulceration by only 1 to
2 days. Prodromal symptoms should not occur 7 to 10 days before ulceration.
REF: Types of Aphthous Ulcers, page
87
OBJ: 11
15. A
condition thought to be a hypersensitivity reaction is characterized by skin
and mucous membrane lesions. The skin lesions are referred to as target, iris, or bull’s eye lesions. The lip and
mucosal lesions are more extensive and painful and often appear bloody and
crusted. The intraoral lesions are extensive superficial ulcerations. The onset
is explosive. On the basis of these clinical features, what condition is
suspected?
|
a. |
Erythema multiforme |
|
b. |
Fixed drug reaction |
|
c. |
Behçet syndrome |
|
d. |
Angioedema |
ANS: A
Erythema multiforme is a hypersensitivity reaction that affects
the skin and mucous membranes. Bloody crusted lips are a common presentation.
The onset is explosive, and the skin lesions are referred to as target, iris, or bull’s eye lesions. Fixed
drug eruptions are lesions that appear in the same site each time a drug is
introduced. There may be a single red patch or macule on the skin. Mucous
membranes are rarely involved. Behçet syndrome is a chronic recurrent autoimmune
disease consisting primarily of oral ulcers, genital ulcers, and ocular
inflammation. Angioedema appears as a diffuse swelling of tissue caused by
permeability of deeper blood vessels.
REF: Erythema Multiforme, page
91 OBJ: 14
16. Wickham
striae is a term used to describe the oral mucosal lesions of
|
a. |
linea alba. |
|
b. |
frictional keratosis. |
|
c. |
lichen planus. |
|
d. |
erythema multiforme. |
ANS: C
Wickham striae describe the slender
white lines seen in lichen planus. Linea alba is the white line on the buccal
mucosa that extends anteroposteriorly along the occlusal plane. Frictional
keratosis occurs when there is chronic cheek and tongue chewing and chewing on
edentulous ridges. Erythema multiforme is an acute self-limited disease that
affects the skin and mucous membranes. The skin lesions are described as iris, target, or bull’s eye lesions. The
mucosal lesions are superficial ulcerations.
REF: Lichen Planus, page
93
OBJ: 15
17. The
diagnosis of lichen planus is made on the basis of
|
a. |
clinical and radiographic
appearance. |
|
b. |
clinical and histologic
appearance. |
|
c. |
history of the condition. |
|
d. |
therapeutic medication. |
ANS: B
Diagnosis of lichen planus is made on the basis of clinical
appearance and histologic findings of biopsy tissue. Radiographic findings do
not contribute to the diagnosis of lichen planus. History of the condition is
not definitive enough for the diagnosis of lichen planus. Topical and systemic
corticosteroids have been used in the treatment of lichen planus but not to
establish the diagnosis.
REF: Types of Lichen Planus, Diagnosis, page
94
OBJ: 15
18. Which
condition is not a
component of Reiter syndrome?
|
a. |
Arthritis |
|
b. |
Geographic tongue–like
lesions |
|
c. |
Urethritis |
|
d. |
Wickham striae |
ANS: D
Wickham striae are associated with lichen planus. Arthritis is a
component of Reiter syndrome. Oral mucosal lesions that resemble geographic
tongue have been described in patients with Reiter syndrome. Urethritis is
associated with Reiter syndrome.
REF: Reactive Arthritis (Reiter Syndrome), page
95
OBJ: 16
19. An
antigenic marker termed HLA-B27 is present in most patients with
|
a. |
lichen planus. |
|
b. |
Reiter syndrome. |
|
c. |
erythema multiforme. |
|
d. |
Stevens–Johnson syndrome. |
ANS: B
An antigenic marker called HLA-B27 is present in most patients
with Reiter syndrome. Lichen planus is diagnosed through the clinical and
histologic appearance of biopsy tissue. Erythema multiforme is thought to be a
hypersensitivity reaction involving the skin and mucous membranes.
Stevens–Johnson syndrome is the most severe form of erythema multiforme.
REF: Reactive Arthritis (Reiter Syndrome), page
95
OBJ: 16
20. The acute
disseminated form of Langerhans cell disease is termed
|
a. |
eosinophilic granuloma. |
|
b. |
Hand–Schüller–Christian
disease. |
|
c. |
Letterer–Siwe disease. |
|
d. |
Reiter syndrome. |
ANS: C
Letterer–Siwe disease is the acute disseminated form of Langerhans
cell disease. Eosinophilic granuloma is a solitary or chronic localized form of
Langerhans cell disease. Hand–Schüller–Christian disease is the chronic
disseminated or multifocal form of Langerhans cell disease. Reiter syndrome is
not a form of Langerhans cell disease.
REF: Langerhans Cell Histiocytosis (Langerhans Cell
Disease), page 96
OBJ: 17
21. Which
form of Langerhans cell disease resembles lymphoma, affects children younger
than age 3, and has a rapidly fatal course?
|
a. |
Letterer–Siwe disease |
|
b. |
Hand–Schüller–Christian
disease |
|
c. |
Eosinophilic granuloma |
|
d. |
Chronic localized form |
ANS: A
Letterer–Siwe resembles lymphoma, affects children under 3
years, and has a rapidly fatal course. It is the most severe form of Langerhans
cell disease. Hand–Schüller–Christian disease is the multifocal form of
Langerhans cell disease. It occurs in children younger than 5 years. A classic
triad is seen in 25% of patients. Eosinophilic granuloma affects older children
and young adults. The chronic localized form is the same as eosinophilic
granuloma.
REF: Langerhans Cell Histiocytosis (Langerhans Cell
Disease), page 96
OBJ: 17
22. The
classic triad of symptoms seen in 25% of patients with Hand–Schüller–Christian
disease includes all conditions except
|
a. |
well-defined or punched-out
radiolucent areas in the skull. |
|
b. |
exophthalmos. |
|
c. |
cyclic neutropenia. |
|
d. |
diabetes insipidus. |
ANS: C
Cyclic neutropenia is an inherited disorder characterized by a
cyclic decrease in the number of circulating neutrophils. Aphthous ulcers,
gingival recession, and alveolar bone loss can be seen in association with this
systemic condition. Well-defined or punched-out radiolucent areas in the skull
are part of the triad of symptoms in chronic disseminated
Hand–Schüller–Christian disease. Exophthalmos is a part of the triad of
symptoms in chronic disseminated Hand–Schüller–Christian disease. Diabetes
insipidus is part of the triad of symptoms in chronic disseminated
Hand–Schüller–Christian disease.
REF: Langerhans Cell Histiocytosis (Langerhans Cell
Disease), page 96
OBJ: 12
23. Sjögren
syndrome is a(n)
|
a. |
autoimmune disease that
affects the salivary and lacrimal glands. |
|
b. |
allergic reaction. |
|
c. |
form of aphthous ulcers. |
|
d. |
type of Langerhans cell
disease. |
ANS: A
Sjögren syndrome is an autoimmune disease that affects the
salivary and lacrimal glands. Sjögren syndrome is not an allergic reaction.
Sjögren syndrome is not a form of aphthous ulcers. Sjögren syndrome is not a
type of Langerhans cell disease.
REF: Sjögren Syndrome, page
97
OBJ: 18
24. The
most common oral manifestation of Sjögren syndrome is
|
a. |
xerostomia. |
|
b. |
xerophthalmia. |
|
c. |
epimyoepithelial islands. |
|
d. |
aphthous ulcers. |
ANS: A
Xerostomia, or dry mouth, is the most common oral manifestation
of Sjögren syndrome. Xerophthalmia is dry eyes caused by lack of lacrimal flow.
Epimyoepithelial islands are seen histologically in Sjögren syndrome, but are
not the most common oral manifestation. Aphthous ulcers are not associated with
Sjögren syndrome, but are seen more commonly in Behçet syndrome, another
autoimmune disease.
REF: Sjögren Syndrome, page
97
OBJ: 18
25. Primary
Sjögren syndrome occurs when
|
a. |
another autoimmune disease
accompanies salivary and lacrimal gland involvement. |
|
b. |
only salivary and lacrimal
gland involvement occurs without the presence of another autoimmune disease. |
|
c. |
rheumatoid arthritis is
present. |
|
d. |
Raynaud phenomenon is
present. |
ANS: B
Primary Sjögren syndrome occurs when there is only salivary and
lacrimal gland involvement without the presence of another autoimmune disease.
Secondary Sjögren syndrome occurs when another autoimmune condition accompanies
the salivary and lacrimal gland involvement. Rheumatoid arthritis is an
autoimmune disease that can be a component of secondary Sjögren syndrome.
Twenty percent of patients with Sjögren syndrome have Raynaud phenomenon. It is
characterized by pallor of the skin that results from vasoconstriction and
reduced blood flow. The toes and fingers are affected.
REF: Sjögren Syndrome, page
97
OBJ: 18
26. The
eye damage that occurs in Sjögren syndrome is termed
|
a. |
xerophthalmia. |
|
b. |
keratoconjunctivitis sicca. |
|
c. |
conjunctivitis. |
|
d. |
burning eyes. |
ANS: B
Keratoconjunctivitis sicca is damage to the eye in Sjögren
syndrome. It is confirmed by eye examination. Xerophthalmia, or dry eyes, may
be present in Sjögren syndrome. Conjunctivitis is inflammation of the
conjunctiva. Burning eyes may also be a component of Sjögren syndrome.
REF: Sjögren Syndrome, page
97
OBJ: 18
27. Diagnosis
of systemic lupus erythematosus (SLE) is made on the basis of
|
a. |
skin lesions. |
|
b. |
multiorgan involvement and
the presence of antinuclear antibodies in the serum. |
|
c. |
arthritis and arthralgia. |
|
d. |
shortness of breath. |
ANS: B
Diagnosis of systemic SLE is made on the basis of multiorgan
involvement and the presence of antinuclear antibodies in the serum. Skin
lesions occur in 85% of individuals, but the diagnosis is not made on the basis
of skin lesions. Arthritis and arthralgia may be components of SLE, but are not
sufficient to make the diagnosis. Shortness of breath may be a component of
SLE, but is not significant to the diagnosis.
REF: Systemic Lupus Erythematosus, Diagnosis, page
99 OBJ: 18
28. The
most characteristic skin lesion in SLE is described as
|
a. |
a blister. |
|
b. |
urticaria. |
|
c. |
a butterfly rash. |
|
d. |
a bulla. |
ANS: C
The classic skin lesion in SLE is described as a butterfly rash.
A blister is not the classic skin lesion in SLE. Urticaria is associated with a
hypersensitivity reaction. A bulla may occur in SLE, but it is not the most
characteristic skin lesion.
REF: Systemic Lupus Erythematosus, Diagnosis, page
99 OBJ: 18
29. The
histologic appearance of lesions in SLE may resemble
|
a. |
an ulcer. |
|
b. |
lichen planus. |
|
c. |
pemphigus vulgaris. |
|
d. |
erythema multiforme. |
ANS: B
The histologic appearance of lesions in SLE may resemble lichen
planus. An ulcer appears as a break in the epithelium and is histologically
nonspecific for SLE or lichen planus. Pemphigus vulgaris is a severe
progressive autoimmune disease characterized by intraepithelial blister
formation that results from breakdown of the cellular adhesion between
epithelial cells. In erythema multiforme, the microscopic appearance is
nonspecific.
REF: Systemic Lupus Erythematosus, Diagnosis, page
99 OBJ: 18
30. Which
one is not a
characteristic feature of pemphigus vulgaris?
|
a. |
Epithelial acantholysis |
|
b. |
Bullae |
|
c. |
Tzanck cells |
|
d. |
Occurrence most commonly in
females |
ANS: D
No sex predilection exists in pemphigus vulgaris. Epithelial
acantholysis occurs in pemphigus vulgaris. Bullae do appear in pemphigus
vulgaris. Tzanck cells, or acantholytic cells, appear in pemphigus vulgaris as
rounded epithelial cells and are present in the area of separation of epithelial
cells.
REF: Pemphigus Vulgaris, pages
101-102
OBJ: 18
31. Treatment
for pemphigus vulgaris involves
|
a. |
high doses of systemic
corticosteroids. |
|
b. |
antihistamines. |
|
c. |
antibiotics. |
|
d. |
antiviral drugs. |
ANS: A
High doses of systemic corticosteroids are used in the treatment
of pemphigus vulgaris. Antihistamines are not used to treat pemphigus vulgaris.
Antibiotics are not used to treat pemphigus vulgaris. Antiviral drugs are not
used to treat pemphigus vulgaris.
REF: Pemphigus Vulgaris, Treatment and Prognosis,
page 102
OBJ: 18
32. The
most common oral site for cicatricial pemphigoid is the
|
a. |
floor of the mouth. |
|
b. |
gingiva. |
|
c. |
palate. |
|
d. |
tongue. |
ANS: B
The gingiva is the most common site for cicatricial pemphigoid.
The floor of the mouth is not a common site for cicatricial pemphigoid. The
palate is not a common site for cicatricial pemphigoid. The tongue is not a
common site for cicatricial pemphigoid.
REF: Mucous Membrane Pemphigoid, page
102
OBJ: 18
33. The
diagnosis of cicatricial pemphigoid is made on the basis of
|
a. |
the clinical appearance of
the lesions. |
|
b. |
Nikolsky sign. |
|
c. |
biopsy and histologic examination. |
|
d. |
response to
corticosteroids. |
ANS: C
Biopsy and histologic examination are used to diagnose
cicatricial pemphigoid. The clinical appearance of lesions is not sufficient
for the diagnosis of cicatricial pemphigoid. The Nikolsky sign is not
sufficient to determine the diagnosis of cicatricial pemphigoid. Although
corticosteroids are the recommended treatment for cicatricial pemphigoid,
diagnosis of the condition is not made through therapeutic diagnosis.
REF: Mucous Membrane Pemphigoid, Diagnosis, page
102 OBJ: 18
34. Pemphigus
vulgaris differs histologically from cicatricial pemphigoid in that pemphigus
vulgaris involves
|
a. |
degeneration of the
epithelium. |
|
b. |
connective tissue
fragmentation. |
|
c. |
significant numbers of inflammatory
cells. |
|
d. |
scarring. |
ANS: A
The lesions of pemphigus vulgaris histologically exhibit
acantholysis, which is degeneration of the epithelium. In pemphigus vulgaris,
the basal cells of the epithelium and the basement membrane remain attached to
the underlying connective tissue. Inflammatory cells are present in both
cicatricial pemphigoid and pemphigus vulgaris. Scarring occurs in lesions
associated with cicatricial pemphigoid.
REF: Pemphigus Vulgaris, page
101 OBJ: 18
35. The
diagnosis of Behçet syndrome requires which considerations?
|
a. |
Two of the three principal
manifestations |
|
b. |
The presence of all three
manifestations |
|
c. |
A biopsy |
|
d. |
A history of pemphigus
vulgaris |
ANS: A
Behçet syndrome is a chronic recurrent autoimmune disease
consisting primarily of oral ulcers, genital ulcers, and ocular inflammation.
Two of these three principal manifestations must be present for the diagnosis.
Only two principal manifestations must be present for the diagnosis of Behçet
syndrome. A biopsy is not necessary for the diagnosis of Behçet syndrome.
Pemphigus vulgaris is another severe progressive autoimmune disease. Pemphigus
vulgaris is not associated with Behçet syndrome.
REF: Behçet Syndrome, Diagnosis, page 103
OBJ: 18
36. The
classic appearance of what condition shown below is a pattern of
interconnecting slender lines referred to as Wickham striae?
|
a. |
Lichen planus |
|
b. |
Linea alba |
|
c. |
Erythema multiforme |
|
d. |
Reiter syndrome |
ANS: A
The classic clinical appearance of lichen planus is a pattern of
slender white interconnecting lines referred to as Wickham striae. Linea
alba is the white line that develops on the buccal mucosa along the occlusal
plane; it is more prominent in patients with clenching or bruxism habits.
Erythema multiforme is an acute self-limiting disease affecting the skin and
mucous membranes; it is thought to be a hypersensitivity reaction. The oral
lesions in Reiter syndrome are characterized by aphthous-like ulcerations,
erythematous lesions, and geographic tongue–like lesions.
REF: Lichen Planus, page
93
OBJ: 15
37. In
which condition is the Langerhans cell not the
proliferating cell?
|
a. |
Lichen planus |
|
b. |
Letterer–Siwe disease |
|
c. |
Hand–Schüller–Christian
disease |
|
d. |
Eosinophilic granuloma |
ANS: A
In lichen planus, there is degeneration of the basal cell layer,
sawtooth rete ridges, and a broad band of lymphocytes in the connective tissue
immediately subjacent to the epithelium. Letterer–Siwe disease is an acute
disseminated form of Langerhans cell disease. Hand–Schüller–Christian disease
is a chronic disseminated or multifocal form of Langerhans cell disease.
Eosinophilic granuloma is the solitary or chronic localized form of Langerhans
cell disease.
REF: Langerhans Cell Histiocytosis (Langerhans Cell
Disease), page 96
OBJ: 15
38. The
onset of this condition is explosive. It is characterized by skin and mucosal
lesions. The skin lesions are referred to as target, iris,
or bull’s eye
lesions. The mucosal lesions affect the buccal mucosa, lips,
and tongue and appear as superficial ulcerations. The lip lesions are
ulcerated, encrusted, and bloody. On the basis of this description, which
condition is suspected?
|
a. |
Lichen planus |
|
b. |
Erythema multiforme |
|
c. |
Contact dermatitis |
|
d. |
SLE |
ANS: B
The skin lesions of erythema multiform are described as target, iris, or bull’s eye lesions. The
mucosal lesions are superficial ulcerations. The lip lesions are bloody and encrusted.
In lichen planus, skin lesions are 2- to 4-mm papules. In contact dermatitis,
skin lesions result from direct contact with the allergen. The lesions may be
erythematous with swelling and vesicles. In SLE, the most classic skin lesion
appears on the face and is described as a butterfly rash. The erythematous rash
involves the cheeks and the bridge of the nose.
REF: Erythema Multiforme, page
91 OBJ: 15
39. This
patient has Sjögren syndrome and severe xerostomia. Which clinical feature most
appropriately describes the changes on the tongue in this patient?
|
a. |
Dryness |
|
b. |
Candidiasis |
|
c. |
Loss of filiform and
fungiform papillae |
|
d. |
Fissures |
ANS: C
Loss of filiform and fungiform papillae is the main clinical
feature that is responsible for the appearance of this patient’s tongue. The
entire mouth is dry, but this is not the main clinical feature involving
changes in the tongue. Candidiasis may be present, but it does not describe the
changes seen in this patient’s tongue. Fissures can occur as a result of the
dryness, but they are not the main clinical feature involving the tongue.
REF: Sjögren Syndrome, page
97
OBJ: 18
40. A
cell product produced by the cells involved in the immune response is a(n)
|
a. |
attenuation. |
|
b. |
cytokine. |
|
c. |
dendritic cell. |
|
d. |
Langerhans cell. |
ANS: B
A cytokine is a cell product produced by cells involved in the
immune response. Attenuation describes
the reduction in the severity of a disease or the virulence of a pathogenic
agent, as is done in the development of certain vaccines. A dendritic cell is a
white blood cell that acts as an antigen-processing cell in the skin and
mucosa. A Langerhans cell is a specialized dendritic cell, found in skin and
mucosa, that is involved in the immune response.
REF: Cellular Involvement in the Immune Response,
page 81 OBJ: 1
41. The
immune response differs from the inflammatory response because it has the
capacity for memory and responds more quickly to a foreign substance if
encountered again.
|
a. |
Both the statement and
reason are correct and related. |
|
b. |
Both the statement and
reason are correct but not related. |
|
c. |
The statement is correct
but the reason is not. |
|
d. |
Neither the statement nor the
reason is correct. |
ANS: A
The immune response differs from the inflammatory response
because it has the capacity for memory and responds more quickly to a foreign
substance if encountered again. Both the statement and reason are correct and
related.
REF: Acquired Immune Response, pages
80-81
OBJ: 2
42. The
three main types of lymphocytes active during an immune response include the
following except one.
Which one is the exception?
|
a. |
T-cell |
|
b. |
NK cell |
|
c. |
B-cell |
|
d. |
C-cell |
ANS: D
The C-cell is not a type of lymphocyte active during an immune
response. The T-cell is a type of lymphocyte active during an immune response.
The NK cell is a type of lymphocyte active during an immune response. The
B-cell is a type of lymphocyte active during an immune response
REF: Cellular Involvement in the Immune Response,
page 81 OBJ: 3
43. The
various types of T-cell lymphocytes include the T-helper cell, the T-suppressor
cell, the cytotoxic cell, and what other type of cell?
|
a. |
T-enhancement cell |
|
b. |
Virulence cell |
|
c. |
Memory cell |
|
d. |
Oral cell |
ANS: C
The memory cell is a type of T-cell lymphocyte. The
T-enhancement cell is not a type of T-cell lymphocyte. The virulence cell is a
not a type of T-cell lymphocyte. The oral cell is not a type of T-cell
lymphocyte.
REF: T-cell Lymphocyte, page
83 OBJ:
4
44. Along
with phagocytosis, the macrophage acts to process antigen material and present
it on its surface to the T-helper cell. This stimulates both types of lymphocytes
to travel from the lymphoid tissue or surrounding blood vessels to the injury
site.
|
a. |
Both statements are true. |
|
b. |
Both statements are false. |
|
c. |
The first statement is
true; the second is false. |
|
d. |
The first statement is
false; the second is true. |
ANS: A
Both statements are true.
REF: Macrophage, page
83
OBJ:
5
45. The
major divisions of the immune response are the cell-mediated and humoral
responses. Both of these responses originate from what type of cell?
|
a. |
Plasma cell |
|
b. |
Stem cell |
|
c. |
T-lymphocyte |
|
d. |
B-lymphocyte |
ANS: B
Both the cell-mediated response and the humoral response
originate from the stem cell. The plasma cell is part of the humoral response,
but not the cell-mediated response. The T-lymphocyte is part of the
cell-mediated response, but not the humoral response. The B-lymphocyte is part
of the humoral response, but not the cell-mediated response.
REF: Major Divisions of the Immune Response, Fig. 3.6,
page 84
OBJ: 6
46. Antibodies
pass through the placenta to a developing fetus and protect the newborn infant
from disease; this is termed ____________ immunity.
|
a. |
natural active |
|
b. |
acquired passive |
|
c. |
acquired active |
|
d. |
natural passive |
ANS: D
Natural passive immunity is acquired when antibodies pass
through the placenta to a developing fetus and protect the newborn infant from
disease. Natural active immunity is acquired when a pathogenic microorganism
causes the disease. Acquired passive immunity occurs through an injection of
antibodies. Acquired active immunity occurs through immunization.
REF: Types of Immunity, page
85 OBJ: 7
47. Anaphylaxis
occurs as a result of what type of hypersensitivity?
|
a. |
I |
|
b. |
II |
|
c. |
III |
|
d. |
IV |
ANS: A
Type I, or anaphylactic type, hypersensitivity is a reaction
that occurs immediately, within minutes of exposure to a previously encountered
antigen or allergen. Type II, or cytotoxic type, hypersensitivity occurs when
an antibody combines with an antigen that is bound to the surface of tissue
cells. Type III, or immune complex type, hypersensitivity is marked by the
formation of immune complexes between microorganisms and antibody in the
circulating blood. Type IV, or cell-mediated type, hypersensitivity involves a
cell-mediated immune response rather than a humoral response that produces
antibodies.
REF: Type I Hypersensitivity, page
86 OBJ: 8
48. An
example of an immunopathologic condition in which one’s own body cells are no longer
tolerated is
|
a. |
contact mucositis. |
|
b. |
angioedema. |
|
c. |
autoimmune disease. |
|
d. |
contact dermatitis. |
ANS: C
Autoimmune disease occurs when one’s own body cells are no
longer tolerated. Contact mucositis results from direct contact of an allergen
with the oral mucosa or skin. Angioedema is a skin and oral mucosal
hypersensitivity. Contact dermatitis occurs as a result of direct contact of an
allergen with the oral mucosa or skin.
REF: Autoimmune Diseases, page
86 OBJ: 9
49. Each
condition is an example of an oral immunologic disorder except one. Which
one is the exception?
|
a. |
Aphthous ulcers |
|
b. |
Erythema multiforme |
|
c. |
Fixed drug eruptions |
|
d. |
Osteomyelitis |
ANS: D
Osteomyelitis is an example of an infectious disease. Aphthous
ulcers are an example of an oral immunologic disorder. Erythema multiforme is
an example of an oral immunologic disorder. Fixed drug eruptions are an example
of an oral immunologic disorder.
REF: Aphthous Ulcers, page 87 | Erythema Multiforme,
page 91 | Drug Eruption, page 91
OBJ: 10
50. The
diagnosis of the type of aphthous ulcers is made on the basis of their
distinctive clinical appearance, the location of the lesion, and a
|
a. |
patient history. |
|
b. |
therapeutic result. |
|
c. |
radiographic examination. |
|
d. |
laboratory test. |
ANS: A
A complete patient history is part of the final diagnosis of
aphthous ulcers. Therapeutic results do not aid in the diagnosis of aphthous
ulcers. Radiographic examinations are not diagnostic for aphthous ulcers.
Laboratory results are not specific for any form of aphthous ulcer.
REF: Types of Ulcers, Diagnosis, pages 87,
89
OBJ: 10
51. Which
is a systemic disease associated with aphthous ulcers?
|
a. |
Stafne bone cyst |
|
b. |
Necrotizing sialometaplasia |
|
c. |
Behçet syndrome |
|
d. |
Erythema multiforme |
ANS: C
Behçet syndrome is a disease characterized by aphthous ulcers,
genital ulcers, ocular inflammation, and arthritis. Stafne bone cyst is a developmental
disorder and is not considered a systemic disease. Necrotizing sialometaplasia
is an inflammatory condition of the salivary glands. Erythema multiforme is not
a systemic disease.
REF: Behçet Syndrome, page
103
OBJ: 12
52. A patient
presents with a diffuse swelling of the upper lip caused by permeability of
deeper blood vessels. The skin covering the swelling appears normal and not
accompanied by itching. This is characteristic of what pathologic condition?
|
a. |
Minor aphthous ulcer |
|
b. |
Lichen planus |
|
c. |
Angioedema |
|
d. |
Sjögren syndrome |
ANS: C
This description is indicative of angioedema. Minor aphthous
ulcers are round-to-oval ulcers that exhibit a yellowish-white fibrin surface
surrounded by a halo of erythema. Lichen planus appears as interconnecting
white lines and circles on the oral mucosa or skin. Sjögren syndrome is
characterized by a decrease in salivary gland secretion.
REF: Urticaria and Angioedema, page
89
OBJ: 13
53. Each
statement about lichen planus is true except one.
Which statement is false?
|
a. |
The tongue is most commonly
affected. |
|
b. |
It is an idiopathic
condition. |
|
c. |
It is a benign condition. |
|
d. |
It is a chronic condition. |
ANS: A
Lichen planus occurs on the skin and oral mucosa; in the latter
case, the buccal mucosa is most frequently affected. Many factors have been
implicated in lichen planus; however, the cause remains unknown. Lichen planus
is considered benign. Lichen planus is a chronic disease.
REF: Lichen Planus, pages
92-93
OBJ: 15
54. Which
conditions are not appropriately
paired?
|
a. |
Reactive arthritis—Reiter
syndrome |
|
b. |
Aphthous ulcer—canker sore |
|
c. |
Urticaria—hives |
|
d. |
Lichen planus—Sjögren
syndrome |
ANS: D
No association exists between lichen planus and Sjögren
syndrome. Reactive arthritis is another name for Reiter syndrome. An aphthous
ulcer is also called a canker sore. Urticaria is also referred to as hives.
REF: Lichen Planus, pages 92-93 | Sjögren Syndrome,
page 97 OBJ:
16
55. Which
form of Langerhans cell disease occurs in children younger than 5 years, is
multifocal, and a classic triad is seen in 25% of patients?
|
a. |
Letterer–Siwe disease |
|
b. |
Hand–Schüller–Christian
disease |
|
c. |
Eosinophilic granuloma |
|
d. |
Chronic localized form |
ANS: B
Hand–Schüller–Christian disease is the multifocal form of
Langerhans cell disease. It occurs in children younger than 5 years. A classic
triad is seen in 25% of patients. Letterer–Siwe disease resembles lymphoma,
affects children younger than 3 years, and has a rapidly fatal course. It is
the most severe form of Langerhans cell disease. Eosinophilic granuloma affects
older children and young adults. The chronic localized form is the same as eosinophilic
granuloma.
REF: Langerhans Cell Histiocytosis, page
96
OBJ: 17
56. In
the mildest form of this autoimmune disease, oral lesions appear as
erythematous plaques or erosions. White striae radiating from the center of the
lesion are also commonly present.
These oral lesions are indicative of what autoimmune disease?
|
a. |
Mucous membrane pemphigoid |
|
b. |
Pemphigus vulgaris |
|
c. |
Lupus erythematosus |
|
d. |
Behçet syndrome |
ANS: C
In the mildest form of lupus erythematosus, oral lesions appear
as erythematous plaques or erosions. White striae radiating from the center of
the lesion are also commonly present. Oral lesions in mucous membrane
pemphigoid are clinically described as desquamative gingivitis. The oral
lesions in pemphigus vulgaris range from shallow ulcers to fragile vesicles or
bullae. The oral ulcers that occur in Behçet syndrome are very similar in
appearance to aphthous ulcers.
REF: Systemic Lupus Erythematosus, page
99
OBJ: 18
57. This
patient presents with an intraepithelial bulla from breakdown of the cellular
adhesion between epithelial cells. The bulla rupture, resulting in a painful
itching ulcer. The correct diagnosis for this progressive autoimmune disease is
|
a. |
pemphigus vulgaris. |
|
b. |
Reiter syndrome. |
|
c. |
aphthous ulcers. |
|
d. |
Langerhans cell disease. |
ANS: A
Acantholysis (breakdown of the cellular adhesion between
epithelial cells) is characteristic of pemphigus vulgaris. Reiter syndrome does
not present with a bulla that ruptures, resulting in an ulcer. Aphthous ulcers
are not a progressive autoimmune disease. Oral manifestations of Langerhans
cell disease include loss of bone support, sore mouth, halitosis, gingivitis,
and sore teeth.
REF: Pemphigus Vulgaris, page
101 OBJ: 18
58. Behçet
syndrome is an acute, nonrecurring autoimmune disease consisting mainly of oral
ulcers, genital ulcers, ocular inflammation, and skin lesions. Systemic and
topical corticosteroids, as well as immunosuppressive drugs, are used in the
management of Behçet syndrome.
|
a. |
Both statements are true. |
|
b. |
Both statements are false. |
|
c. |
The first statement is
true; the second is false. |
|
d. |
The first statement is
false; the second is true. |
ANS: D
Behçet syndrome is chronic and recurring; and systemic and
topical corticosteroids, as well as immunosuppressive drugs, are used to treat
it. The first statement is false: Behçet syndrome is not acute and it does
recur. The second statement is true: systemic and topical corticosteroids, as
well as immunosuppressive drugs, are used to treat it. The first statement is
false; the second is true.
REF: Behçet Syndrome, page
103
OBJ: 20
59. Decreased
salivary flow that results in xerostomia is also known as
|
a. |
hyposalivation. |
|
b. |
mucositis. |
|
c. |
pruritus. |
|
d. |
anaphylaxis. |
ANS: A
Hyposalivation is the decreased salivary flow that may result in
dry mouth, or xerostomia. Mucositis refers to mucosal inflammation because of a
disease process. Pruritus is another term for itching. Anaphylaxis is a severe
or immediate type of hypersensitivity in which an exaggerated immunologic
reaction occurs.
REF: Vocabulary, page
79
OBJ:
1
60. NK
cells have the ability to destroy foreign cells. NK cells are active against a
variety of cells except one.
Which is the exception?
|
a. |
Cancer cells |
|
b. |
HIV and AIDS |
|
c. |
Viruses |
|
d. |
NK cells are active against
A, B, and C |
ANS: B
NK cell function is abnormal in HIV-related acquired
immunodeficiency syndrome. NK cells are active against cancer cells. NK cells
are active against most viruses. NK cells are active against most viruses and
cancer cells, but not HIV-related AIDS.
REF: Cellular Involvement in the Immune Response,
page 83 OBJ: 3
61. Which
statement is false about
the T-cell lymphocyte?
|
a. |
The T-cell lymphocyte
develops from a bone marrow stem cell. |
|
b. |
The T-cell lymphocyte
travels to the liver and is processed into a mature cell. |
|
c. |
The T-cell lymphocyte has a
special receptor on its surface. |
|
d. |
The T-cell lymphocyte
increases the functioning of the B-cell. |
ANS: B
The T-cell lymphocyte does not travel to the liver to be
processed into a mature cell; the cell travels to the thymus. The T-cell
lymphocyte develops from a bone marrow stem cell. The T-cell lymphocyte has a
special receptor on its surface. The T-cell lymphocyte increases the
functioning of the B-cell.
REF: Cellular Involvement in the Immune Response,
pages 82-83
OBJ: 3
62. In
addition to a clinical diagnosis, which additional category is used in
diagnosing aphthous ulcers?
|
a. |
Laboratory |
|
b. |
Differential |
|
c. |
Historical |
|
d. |
Therapeutic |
ANS: C
The diagnosis of aphthous ulcers is made on the basis of their clinical
appearance and a complete patient history. Laboratory results are not specific
for any form of aphthous ulcer. The thoroughness and data collection of a
differential diagnosis is not necessary to diagnose aphthous ulcers. A
therapeutic diagnosis is not necessary to diagnose aphthous ulcers.
REF: Oral Immunologic Lesions and Diseases, page
89 OBJ:
12
63. What
is the common name for urticaria?
|
a. |
Hives |
|
b. |
Dermatitis |
|
c. |
Dry socket |
|
d. |
Jaundice |
ANS: A
Urticaria is also known as hives. Dermatitis (eczema) is the
inflammation of the skin. Dry socket (alveolar osteitis) is a postoperative
complication of tooth extraction. Jaundice (icterus) is an abnormal
accumulation of bilirubin in the blood and manifested by a yellowish discoloration
of the skin.
REF: Oral Immunologic Lesions and Diseases, page
89 OBJ:
14
64. What
is the group of medications used to treat patients with urticaria and
angioedema?
|
a. |
Barbiturates |
|
b. |
Antihistamines |
|
c. |
Antidepressants |
|
d. |
Corticosteroids |
ANS: B
Antihistamines (e.g., Benadryl) are the standard drugs used to
treat urticaria and angioedema. Barbiturates are not useful when treating
urticaria and angioedema. Antidepressants are not needed when treating patients
with urticaria or angioedema. Corticosteroids are not the drugs of choice when
treating urticaria or angioedema.
REF: Oral Immunologic Lesions and Diseases, page
90 OBJ:
14
65. Skin
lesions, called target or bull’s eye lesions, are characteristic of persons
with erythema multiforme. If the oral cavity is also involved, which conditions
are typically seen?
|
a. |
Gingival inflammation |
|
b. |
Periodontal disease |
|
c. |
Oral ulcers on the tongue
and lips |
|
d. |
Xerostomia |
ANS: C
Oral lesions are usually ulcers that frequently form on the
lateral borders of the tongue. Crusting and bleeding lips are also often seen.
Gingival involvement with erythema multiforme is rare. Since gingival
involvement is rare, periodontal issues are not common with erythema
multiforme. Xerostomia is not an oral manifestation of erythema multiforme.
REF: Oral Immunologic Lesions and Diseases, page
91 OBJ:
15
66. What
is a clinical difference between lichen planus and linea alba?
|
a. |
Lichen planus may be removed
with a gauze square; linea alba cannot be removed. |
|
b. |
Lichen planus appears more
bluish; linea alba appears white. |
|
c. |
Lichen planus may appear on
the buccal mucosa as well as the tongue, lips, and floor of the mouth; linea
alba is confined to the buccal mucosa. |
|
d. |
Lichen planus is
asymptomatic; linea alba may cause erosions, bullae, or ulcers. |
ANS: C
Lichen planus can occur in numerous regions of the oral cavity,
whereas linea alba is best seen on the buccal mucosa. Lichen planus is not removed
with a gauze square. Lichen planus does not carry a blue appearance. Lichen
planus may be associated with erosions, bullae, or ulcers. Linea alba is
asymptomatic.
REF: Oral Immunologic Lesions and Diseases, page
92 OBJ:
16
67. Patients
with Sjögren syndrome who experience xerostomia are at a high risk of the
following conditions except one.
Which is the exception?
|
a. |
Melanotic macules |
|
b. |
Dental caries |
|
c. |
Oral candidiasis |
|
d. |
Periodontal disease |
ANS: A
Patients with Sjögren syndrome are not prone to the development
of melanotic macules. Patients with xerostomia are at a high risk for the
development of dental caries. Patients with xerostomia are at a high risk for
the development of oral candidiasis. Patients with xerostomia are at a high
risk for the development of periodontal disease.
REF: Autoimmune Disease With Oral Manifestations,
page 97
OBJ: 19
68. Some
patients with Sjögren syndrome will also demonstrate the Raynaud phenomenon,
which is a disorder that affects the
|
a. |
joints. |
|
b. |
fingers and toes. |
|
c. |
lacrimal glands. |
|
d. |
eyelids. |
ANS: B
Raynaud phenomenon is a disorder affecting the fingers and toes,
usually triggered by cold and emotional stress. Raynaud phenomenon does not affect
the joints of the patient. The lacrimal glands are not affected by Raynaud
phenomenon. The eyelids are not affected by Raynaud phenomenon.
REF: Autoimmune Disease With Oral Manifestations,
page 98
OBJ: 19
69. A
person with SLE may have oral manifestations similar to which other condition?
|
a. |
Lichen planus |
|
b. |
Angioedema |
|
c. |
Minor aphthous ulcers |
|
d. |
Mucous membrane pemphigoid |
ANS: A
Oral lesions appear as erythematous plaques or erosions with
white striae radiating from the center, resembling lichen planus. Angioedema
appears as a diffuse swelling of tissue caused by permeability of deeper blood
vessels. Minor aphthous ulcers are discrete, punched-out, round to oval ulcers
surrounded by a halo of erythema. Mucous membrane pemphigoid demonstrates
desquamative gingivitis, which is a range of ulceration and erythema involving
the marginal and attached gingiva.
REF: Autoimmune Disease With Oral Manifestations,
page 99
OBJ: 19
70. Oral
lesions accompanying skin lesions may occur in the following diseases except one. Which
is the exception?
|
a. |
SLE |
|
b. |
Pemphigus vulgaris |
|
c. |
Lichen planus |
|
d. |
Aphthous ulcers |
ANS: D
Aphthous ulcers are not seen on skin but may develop in the oral
cavity. Oral lesions accompany skin lesions in about 25% of patients with SLE.
Pemphigus vulgaris is a severe, progressive autoimmune disease that affects
both the skin and mucous membranes. Several forms of lichen planus have been
described. In addition to oral lesions, skin lesions of itching and pruritus
have been noted.
REF: Autoimmune Disease With Oral Manifestations,
page 87
OBJ: 19
71. What
is the most common precipitating factor seen in the development of aphthous
ulcers?
|
a. |
Tobacco use |
|
b. |
Trauma |
|
c. |
Emotional stress |
|
d. |
Infection |
ANS: B
Trauma is the most commonly reported precipitating factor in the
development of aphthous ulcers (e.g., toothbrush trauma, x-ray film or sensor
placement, injection site of local anesthetics). Tobacco use is not considered
a precipitating factor in the development of aphthous ulcers. Nonsmokers report
aphthous ulcer development. Emotional stress has been suggested as a contributing
factor of the development of aphthous ulcers. Infection is not typically
associated with the development of aphthous ulcers.
REF: Oral Immunologic Lesions and Diseases, page
87 OBJ:
12
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