Pathology Clinical Pathologic Correlations 7th Edition by Regezi – Test Bank
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Chapter 5: Pigmented Lesions
MULTIPLE CHOICE
1. In addition to multiple neurofibromas, what other lesions are seen as part of the syndrome neurofibromatosis?
a . Traumatic neuromas
b Mucosal vascular malformations
c Intestinal polyps
d . Cutaneous pigmented patches
e . Odontogenic keratocysts
ANS: D
REF: Chap 5 (Café-au-lait macules), p 138
2. Mucosal neuromas, pheochromocytoma, and medullary carcinoma of the thyroid constitute which of the following syndromes?
a Albright’s syndrome
b . Sjögren’s syndrome
c . von Recklinghausen’s disease of skin
d Peutz-Jeghers syndrome
e . None of the above
ANS: E
REF: Chap 5 (Café-au-lait macules), p 138 | Chap 8 (Sjögren’s syndrome), pp 196-199 | also Clinical Overview
3. Amalgam tattoo is a common oral lesion that must be differentiated through clinical history or biopsy from which of the following?
a Chronic infection
b Squamous cell carcinoma
c . Early melanoma
d . Hereditary hemorrhagic telangiectasia
e . Gardner’s syndrome
ANS: C
REF: Chap 5 (Amalgam tattoo [focal argyrosis]/Differential diagnosis), p 145
4. Lateral or radial spread at the epithelial–connective tissue interface is a characteristic growth feature of which of the following pigmented lesions?
a Blue nevus
b . Ephelis
c . In situ melanoma
d . Invasive melanoma
e . Amalgam tattoo
ANS: C REF: Chap 5 (Oral melanoma), p 142
5. Acquired oral melanin pigmented lesions may be associated with which of the following?
a . Aspirin abuse
b . Penicillin ingestion
c . Chronic infection by C. albicans
d . Xerostomia
e None of the above
ANS: E
REF: Chap 5 (Melanocytic lesions—entire topic/Box 5-3), pp 134-144
6. A 40-year-old woman presents with multiple melanotic macules of her lips and buccal mucosa. If the patient is found to have adrenal insufficiency, which of the following conditions should be considered?
a . von Recklinghausen’s disease of skin
b . McCune-Albright syndrome
c . Addison’s disease
d Peutz-Jeghers syndrome
e . None of the above
ANS: C REF: Chap 5 (Oral melanotic macule/Clinical features), pp 136-137
7. Both in situ and invasive oral melanomas exhibit the same distinctive site predilection. This is the:
a . Buccal mucosa
b . Palate
c . Lateral tongue
d Lower lip
e . Tonsillar pillar
ANS: B REF: Chap 5 (Oral melanoma), p 142
8. Oral mucosal lesions may exhibit a red to blue to black color for one of several reasons. These would include all the following except:
a . Increased number of submucosal vessels
b . Submucosal extravasation of blood
c . Deposition of foreign material
d Increased thickness of epithelium
e Hyperemia (vascular congestion)
ANS: D REF: Chap 5 (Melanocytic lesions—entire topic), pp 134-144
9. Which of the following can have clinical features that are similar to early superficial or in situ melanoma?
a . Early Kaposi’s sarcoma
b . Amalgam tattoo
c Drug-induced pigmentation
d . Melanotic macule
e . All of the above
ANS: E
REF: Chap 5 (Melanoma/Differential diagnosis), p 144
10. Pigmented nevi are commonly seen in skin but are relatively rare in the oral mucosa. Intraorally, they are most likely to be found in which of the following locations?
a . Tongue
b . Buccal mucosa
c . Floor of mouth
d Lower lip
e Palate
ANS: E
REF: Chap 5 (Nevomelanocytic nevus/Clinical features), p 140
11. A 30-year-old woman presents with recently acquired generalized tanning of the skin and multiple intraoral pigmented
macules. Oral biopsy showed excessive melanin pigment in basal keratinocytes. This patient should be suspected of having:
a . Addison’s disease
b . Sunburn
c . Kaposi’s sarcoma
d . Leukemia
e . Melanoma
ANS: A REF: Chap 5 (Oral melanotic macule/Histopathology), p 137
12. Café-au-lait macules (more than five) and multiple neurofibromas are typically seen in which of the following conditions?
a Lichen planus
b . Crohn’s disease
c . Addison’s disease
d . Peutz-Jeghers syndrome
e . None of the above
ANS: E REF: Chap 5 (Café-au-lait macules), p 138
13. All of the following are known to have the capacity to cause oral mucosal pigmentation except:
a Amalgam
b . Bismuth
c . Mercury vapors
d . Penicillin
e . Minocycline
ANS: D REF: Chap 5 (Nonmelanocytic lesions—entire topic), pp 145-147
14. Which of the following pigmented lesions of oral mucosa is most commonly encountered in dental patients?
a Freckles (ephelides)
b . Intramucosal nevus
c . Melanoma
d . Amalgam tattoo
e Bismuth line
ANS: D REF: Chap 5 (Amalgam tattoo/Clinical features), p 145
15. A 37-year-old man presents with a blue-black macule (1 ´ 1 cm) in his palate. The area is covered with intact epithelium and there was no apparent inflammatory response. Biopsy shows deposits of black foreign material. This suggests which of the following?
a . Kaposi’s sarcoma
b Melanoma
c Amalgam tattoo
d . Erythroplakia
e . Melanotic macule
ANS: C REF: Chap 5 (Amalgam tattoo), p 145
16. The characteristic oral manifestation of Peutz-Jeghers syndrome is:
a Bilateral reticular white lesions in the buccal mucosa
b . Red patch in the palate
c . Nodular yellow-white lesions in the buccal mucosa
d Perioral pigmented macules
e Red patch on midline dorsum of the tongue
ANS: D REF: Chap 5 (Oral melanotic macule/Clinical features), pp 136-137
17. All the following suggest the possibility of intraoral melanoma except:
a . Rapid increase in size
b . Satellite lesions
c . Ulceration
d Bilateral symmetric lesions
e Darkening color
ANS: D REF: Chap 5 (Oral melanoma—entire topic), pp 142-143
18. A 34-year-old man presents with an asymptomatic 1 ´ 1 cm pigmented lesion in the right side of his palate. It is flat, and it is asymptomatic. Biopsy shows melanin pigment within a collection of
benign-appearing spindle-shaped cells in the submucosa. This is consistent with:
a . Melanoma
b . Amalgam tattoo
c . Blue nevus
d . Melanotic macule
e . Physiologic pigmentation
ANS: C REF: Chap 5 (Nevomelanocytic nevus—entire topic), pp 139-141
19. Oral melanomas are classified into microscopic subtypes based primarily on which of the following feature?
a . Evidence of invasion of lymphatic vascular spaces
b . Microscopic growth pattern
c . Number of mitotic figures
d . Nuclear pleomorphism
e Evidence of lymph node metastasis
ANS: B REF: Chap 5 (Oral melanoma), pp 142-143
20. All the following drugs are known to have the ability to cause pigmentation of the oral mucosa except:
a . Dilantin
b . Minocycline
c Cytoxan
d . AZT (zidovudine)
ANS: A REF: Chap 5 (Drug-induced pigmentations), pp 145-146
21. Generally, which of the following has the worst prognosis?
a . Oral verrucous carcinoma
b Cutaneous basal cell carcinoma
c Cutaneous melanoma
d . Oral melanoma
e . Oral erythroplasia
ANS: D REF: Chap 5 (Oral melanoma), p 142