Oral Medicine (WELLS)

1. Cyanosis of the lips is a common finding in all except:

a. Cardiac congestion
b. Congenital heart defects
c. Iron deficiency anemia
d. Polycythemia
2. The most prominent oral sign of Gardner’s or Peutz-Jehgers syndrome is:
a. The presence of small numerous small polyps on the buccal mucosa
b. Small melatonic lesions small polyps on the buccal mucosa
c. Ulcerations on the tongue
3. Minutes yellow granules are readily detected on the buccal of approximately 80% of the population. These Fordyce’s
spots are one of the very few pathogomonic signs which enable a definitive diagnosis to be made because they are
known to be:
a. Aberrant tonsillar tissue
b. Hyperkeratoses due to trauma
c. Minor mucous glands
d. Ectopic sebaceous glands
4. A 38-year-old female brought her three teen-aged children for initial examination. On the buccal mucosa on each
were detected white, corrugated, firm, non-tender lesions. Although histologic examination is necessary for definitive
diagnosis, the strongest clinical suspicion to be entertained is that these lesions are:
a. Hyperkeratotic
b. An atypical form of lichen planus
c. Leukoedema
d. White sponge nevi
5. Leukoedema, occasionally observed on the buccal mucosa, is characterized by a clinical appearance of:
a. Raised, white lesion with an annular configuration
b. Erosions
c. A milky white, translucent coloration of the mucosa with minute “hanging” folds of tissue
d. White lesions with a lacelike configuration
6. Redness and enlargement of minor salivary glands orifices in the palate are clinical signs of early:
a. Papillary inflammatory hyperplasia
b. Nicotinic stomatitis
c. Primary syphilis
d. Secondary syphilis
7. Prolonged antibiotic administration is known to result in the presence of a:
a. Crenated tongue
b. Geographic tongue
c. Black hairy tongue
d. Median rhomboid glossitis
8. A 10-year-old female was brought in by her mother for restorative treatment. The history provided by the mother
included a recent evaluation for emotional difficulties and problems with school work. She also reported that the girl
had appeared rather listless for the past several years and that she was disposed to chew on her painted toys rather
than play them. Clinical examination disclosed pallor of the oral mucosa and a grayish blue discoloration of the
gingiva. These findings are most consistent with a clinical impression of:
a. Cherubism
b. Cretinism
c. The Pierre Robin syndrome
d. Plumbism
9. An 18-year-old female requested aesthetic improvement of her ‘brown teeth”. She reported that two of her four
brother’s teeth had a similar appearance. Some chipping of occlusal and incisal enamel, not attributable to caries
trauma, was apparent. Radiographs demonstrated an absence of pulp chamber and canals of most teeth and unusually
short tapering roots. These findings are characteristics of:
a. Amelogenesis imperfecta
b. Dentinogenesis imperfecta
c. Erythroblasts fetails
d. Fluorosis
10. Examination of a 4-year-old male patient’s dentition revealed a pronounced yellow green discoloration of crowns of
Oral Medicine (WELLS)

the entire dentition. The father reported multiple transfusions at the time of birth. These findings suggest that the most
likely, although rare, cause of the patient’s tooth discoloration is:
a. Amelogenesis imperfecta
b. Dentinogenesis imperfecta
c. Erythroblastosis fetails
d. Fluorosis
11. In the United States the most common cause of mottled enamel and tooth discoloration is:
a. Amelogenesis imperfecta
b. Dentinogenesis imperfecta
c. Erythroblastosis fetails
d. Endemic fluorosis
12. The earliest clinical sign of the initiation of dental caries, e.g., Class V caries, is most often:
a. Pain elicited by exploration
b. A change in color of the suspected area
c. An enamel defect detectable with an explorer
d. Radiographic appearance
13. Amber-colored tooth translucency, blue sclerae, and bone fragility suggested by a history of skeletal bone fractures
early in life are characteristics findings in :
a. Osteitis fibrosa cystica
b. Osteitis deformans
c. Osteogenesis impefecta
d. Osteoporosis
14. A 42-year-old female requested an evaluation of a “swelling” in the midline of the hard palate. She reported that she
had noticed this about a month ago on malignant because her father “died from mouth cancer”. Examination revealed
a 3x4 cm, very hard elevation with an intact mucosa. Observation, rather than immediate removal or biopsy, is in
indicated because these findings are characteristics of:
a. A cancer phobia on the part of the patient
b. An enostosis
c. A most common exostosis
d. A pleomorphic adenoma, the most common tumor of the palate
15. The chief complaint of a 19-year-old male was soreness in the area of the right temporomandibular joint and some
pain on mastication. He reported having received a “bump on the jaw” in a minor automobile accident a week ago. A
clinical sign of altered function which would substantiate the suspicion of a fracture on the right condyle is:
a. An inability to protrude the mandible
b. A deviation of the mandible to the right, on opening
c. A deviation of the mandible to the left, on opening
d. Inability to wink the right eye
16. In the absence of systemic disease, most infections originating within the oral cavity (e.g., pericoronitis, periapical
abscesses and acute necrotizing ulcerative gingivitis) usually remain localized and respond well to mechanical forms
of therapy alone. Signs and/or symptoms of systemic involvement which indicate treatment of these conditions with
antibiotics include all except:
a. Lymphadenopathy
b. Redness and tenderness of an operculum
c. Elevation of temperature
d. Trismus and/or pain on swallowing
17. A program of prevention is of utmost importance for the patient undergoing radiation therapy to the head and neck
area because of the known development of rampant caries shortly after such therapy. Rampant caries is of high
incidence in these patients because:
a. Of compromise of the blood supply to all the oral tissues
b. Of the direct effect of radiation upon the tooth
c. Gingival recession produced by the radiation exposes the cementum
d. Xerostomia invariably occurs and persists for about a year following treatment
18. A 40-year-old male patient reported that a tumor had been removed from his parotid gland 2 months ago. He now
experiences profuse sweating of a small area of the skin overlying his left temple. This occurs invariably when he eats
the spicy foods he enjoys. These findings are most characteristic of:
a. Albright’s syndrome
Oral Medicine (WELLS)

b. Behҫet’s syndrome
c. The auriculotemporal, or Frey’s, syndrome
d. Gardner’s syndrome
19. A 28-year-old female in her third trimester of pregnancy complained for a “growth on her gum”. She reported that it
had been present for about 2 weeks. Clinical examination revealed a red, sessile, exophytic lesion involving the
buccal gingiva in the area of the mandibular left first molar which bled readily upon moderate left first molar which
bled readily upon moderate finger pressure. These findings are most characteristic of:
a. A gingival cyst
b. A pyogenic granuloma
c. An irritation fibroma
d. Pregnancy gingivitis
20. Some dilatation of capillaries in the facial skin is a common finding in middle-aged patients. However, development
of multiple angiomas which may rapture spontaneously and are accompanied by a history of espistaxis are highly
suggestive of:
a. A gingival cyst
b. A pyogenic granuloma
c. An irritation fibroma
d. Pregnancy gingivitis
21. Petechiae involving the conjunctiva, yellow skin color, multiple unexplained bruises and a flushed, ruddy complexion
are all clinical findings which suggest:
a. Albright’s syndrome
b. Lobstein’s syndrome
c. The Rendu-Osler-Weber disease
d. Trotter’s syndrome
22. Angular cheilosis may be the result of infection, loss of vertical dimension, hypovitaminosis B 2, or iron deficiency
anemia. When it is the result of infection, the biologic agent most often responsible is:
a. Actinomyces bovis
b. A group A coxsackievirus
c. Candida albicans
d. Viridans streptococcus
23. Fovea palatinae, located in the midline at the junction of the soft and hard palate, are the result of:
a. Coalescence of mucous gland ducts
b. Fistula formation
c. Nicotinic stomatitis
d. The development of small fissural cleft cysts
24. Multiple small vesicles and/or ulceration which are characteristic of herpangania and infectious mononucleosis are
most often limited to the :
a. Buccal mucosa
b. Gingiva
c. Oropharynx and soft palate
d. Tongue
25. A 20-year-old female requested that her maxillary central incisor be replaced by a fixed bridge. She had been wearing
a removable appliance for about 2 years. Clinical examination revealed a red area in the palate covered appliance
with long hairlike projections extending from it. These findings are characteristics of
a. Multiple irritation fibromas
b. Nicotinic stomatitis
c. Papillary inflammatory hyperplasia
d. Stomatitis venenata
26. Ulceration of the oropharynx and oral mucosal surfaces is often an early sign of:
a. Anemia
b. Sensitivity to penicillin
c. Squamous cell carcinoma
d. Vincent’s infection
27. Persistence of the tuberculum impar in the course of development results in the presence of a smooth, red, diamond-
shaped area on the posterior dorsal aspect of the tongue. The location, shape, color, of this area are characteristic of:
a. The circumvallate papillae
Oral Medicine (WELLS)

b. Foliate papillae
c. Erythema migrans or the geographic tongue
d. Median rhomboid glissitis
28. Foliate papillae and lingual tonsils are common developmental anomalies often found on the lateral border of the
posterior third of the tongue. Their detection often arouses suspicion of a malignancy because:
a. Of their color
b. Of their consistency
c. They are often unilateral and in a site where a malignancy often develops
d. Of their size
29. An unusually high mandibular labial frenum attachment is often a primary etiologic factor in:
a. Development of caries involving the mandibular central incisors
b. Development of an irritation fibroma
c. Gingival recession on the labial incisors
d. Certain types of speech impairment
30. Examination of a 20-year-old male patient’s dentition revealed that the maxillary right lateral incisor occupied the
position normally occupied by the maxillary right cuspid and vice versa. The relative position of these two teeth
represents a common form of:
a. Malposition
b. Transposition
c. Apposition
d. Germination
31. During surgical removal of a malposed maxillary third molar for a 28-year-old male patient, its root was found to be
fused to that of one of the adjacent second molar roots. This condition is termed:
a. Fusion
b. Apposition
c. Concresence
d. Germination
32. Cervical radiolucencies, termed adumbration, are easily misconstrued as evidence of dental caries. One of the major
reasons for the appearance of these radiolucencies is:
a. The employment of faulty vertical angulation
b. The anatomy of the tooth in the area in which they appear
c. Excessive exposure time
d. The “mach-band” effect
33. Least frequently involved in Steven-Johnson’s syndrome is the :
a. Eye
b. Genitalia
c. Oral mucous membrane
d. Skin
34. Secondary syphilis maybe manifested clinically by:
a. Lip ulceration
b. Perforation of the palate
c. Oral mucous patches and a maculopapular skin rash
d. Vesicles involving the oropharynx and soft plate
35. Clinical and radiographic examination of a 19-year-old male patient revealed a retained mandibular left second
deciduous molar which was noncarious, vital, and nonmobile. A round, 1 cm, well-circumscribed, totally radioluscent
area immediately 5 mm apical to the bifurcation was demonstrated on the radiographs. These findings are most
suggest the presence of a(n):
a. Dentigerous cyst
b. Eruption cyst
c. Primordial cyst
d. Radicular cyst
36. Initial radiographic survey of a 32-year-old male revealed a well-circumscribed radiolucency between the maxillary
left lateral incisor and cuspid roots. Slight deviation of the root of these teeth suggested the presence of an expansile
type of lesion. Pulpal pathology was ruled out by examination. These findings suggest the presence of a:
a. Lateral periodontal cyst
b. Globulomaxillary cyst relatively early in its development
Oral Medicine (WELLS)

c. Nasopalatine cyst
d. Primordial cyst associated with a supernumerary tooth
37. Radiographically the midpalatine, globulomaxillary, and median mandibular cyst are most similar in respect to their:
a. Degree radiolucency
b. Having a characteristic location
c. Size
d. Having a characteristic configuration
38. A routine radiographic survey may provide the initial evidence of Albers- Schönberg disease primarily because:
a. Delayed eruption may be suggested
b. The bone pattern is exceedingly dense with loss of trabecular spaces
c. Pulp canals are most often absent
d. Hypercementosis is a common feature
39. Fibrous ankylosis of the temporomandibular joint is most often associated with:
a. Nocturnal bruxism
b. Congenital hypoplasia of the condyle
c. A fracture of the condyle
d. Rheumatoid arthritis
40. An exceptionally far forward attachment of the lingual frenum is responsible for:
a. Hypomobility due to ankyloglossia
b. Buccal caries
c. Glossopyrosis
d. Lingual varicosities
41. A 35-year-old male patient complained for increasing “soreness” of a tooth. Radiographs of this maxillary second
biscupid demonstrated a slight thickening of the periodontal ligament space in the apical area. The tooth was
noncarious, 2o mobile, and reacted within normal limits to pulpal stimuli. No other signs of periodontal disease were
present. The most likely cause of the patient’s complaint on the basis of these findings is:
a. Ankyolsis of the tooth
b. Pulpal death due to anachoresis
c. An occlusal discrepancy
d. Undiagnosed scleroderma
42. Ankylosis of a tooth is most definitively suggested by:
a. Absence of the periodontal ligament space on radiographs
b. A thickened periodontal ligament space on radiographs
c. A clear, ringing sound upon percussion
d. Inability to move the tooth buccolingually
43. The sign which indicates that a tooth is most severely periodontally involved is:
a. Radiographic evidence of 50% bone loss
b. Depressibility and/or rotatability
c. 3o mobility
d. A pocket depth of 5 mm
44. Dryness of the skin, lips, and fingernails; thin sparse head and eyebrow hair; and congenital absence of numerous
teeth are all associated with:
a. Albers- Schönberg disease
b. Gardner’s syndrome
c. Hereditary ectodermal dysplasia
d. Osteogenesis imperfecta
45. Precocious eruption of teeth is known to be associated with:
a. Hyperparathyroidism
b. Hyperthyroidism and hyperpituitarism
c. Hypoparathyroidism
d. Excessive vitamin A intake
46. Acrodynia, hyphosphatasia, and progeria are rare conditions in which:
a. Delayed eruption of teeth is common
b. Precocious eruption of teeth invariably occurs
c. Premature exfoliation of deciduous teeth is known to occur
d. Multiple supernumerary teeth are often present
Oral Medicine (WELLS)

47. Because it may involve bone only late on tis development, the cyst which is least apt to be demonstrated by
radiographic means is the:
a. Follicular cyst
b. Globulomaxillary cyst
c. Nasoalveolar cyst
d. Nasopalatine cyst
48. The most common extraoral cause of halitosis is:
a. Diabetes mellitus
b. Chronic sinusitis with postnasal drip
c. Indigestion
d. Kidney dysfunction
49. Match the synthetic condition list in the right column with the type of halitosis it may produce.
1. acetone odor a. rhinitis
2. “mousy” odor b. kidney disfunciton
3. ozena c. severe diabetes
4. uremic odor d. liver disease

50. The least objective clinical sign of periodontal disease is:

a. A pocket depth of 5 mm
b. The presence of halitosis
c. Moderate mobility (2o) of teeth
d. Presence of a purulent discharge
51. Initial examination of a 35-year-old male patient disclosed a pedunculated, free movable, 1x 1.5 cm lesion on the
buccal mucosa at the level of the occlusal plane. Its surface was intact and of the same color as the surrounding tissue.
It did not blanch on finger pressure. The patient reported that it caused him no pain and that he had been aware of its
presence for about 2 years. These findings are most characteristic of a(n)
a. Hemangioma
b. Irritation fibroma
c. Melanoma
d. Exophytic type of squamous cell carcinoma
52. A 35-year-old male complained of a “growth” in the floor of the oral cavity. He reported that he first noticed it about
3 weeks ago, but that it had not undergone any appreciable enlargement since. Clinically the lesion was observed to
be the right of the midline, slightly elevated, nonulcerated, and had a blue surface coloration. It was nontender,
movable, and had a palpable border. A viscid fluid was obtained on aspiration. The most likely, but presumptive,
diagnosis of this lesion is a(n)
a. Hemangioma
b. Mucocele
c. Ranula
d. Primordial cyst
53. A 73-year-old male was referred by his physician for evaluation of a lesion on the floor of the mouth. The history
included smoking of three packages of cigarettes and consumption of a minimum of 10 oz. alcoholic beverage per
day. There was also history of syphilis, treated 20 years ago. Clinical examination revealed an indurated, white
nontender, 1.5 x 1.5 cm lesion to the right of the midline in the floor of the mouth. No nodes were palpable. Until
proven otherwise by biopsy examination, this lesion must considered a:
a. Basal cell carcinoma
b. Fibrosarcoma
c. Dermoid cyst
d. Squamous carcinoma
54. A 23-year-old male complained of a swelling of the left cheek which had appeared “overnight”. He reported no other
symptoms. Palpation disclosed a fluctuant, nontender swelling without detectable borders. Clinical examination
revealed a severely carious maxillary left molar, with radiographic evidence of pronounced periapical radiolucencies.
These findings are most compatible with a diagnosis of:
a. Cellulitis
b. Chronic alveolar abscess
c. Ludwig’s angina
d. Vincent’s angina
Oral Medicine (WELLS)

55. Defects in tooth structure in amelogenesis imperfecta are limited to the:

a. Crown and root form
b. Crown and pulp chamber
c. Dentin and pulp
d. Color, shape, and size of the crown
56. Examination of a 9-year-old male patient’s dentition revealed a bifid crown of the mandibular left lateral incisor. The
two developmental disturbances which should be considered as the possible etiologies of this condition are:
a. Dilaceration and fusion
b. Dilaceration and enamel hyperplasia
c. Fusion and gemination
d. Dilaceration and gemination
57. Examination of an 18-year-old male patient’s dentition revealed a severe enamel hypoplasia of only the mandibular
left second biscupid. This turner tooth is most likely to have developed as a result of:
a. Congenital syphilis
b. Periapical infection of its deciduous predecessor
c. An exanthematous fever during its calcification
d. A vitamin B deficiency
58. Taurodintism is characterized by a radiographic appearance of teeth which possess:
a. Bell-shaped crowns and short tapering roots
b. Large elongated pulp chambers and unusually short roots, particularly in the molar regions
c. Bifid root formation of teeth which are usually single rooted
d. Unusually large bulbous roots
59. Multiple unerupted teeth and deviations in size and shape of erupted permanent teeth are most commonly found in
association with:
a. Congenital syphilis and cleidocranal dysostosis
b. Cleidocranial and craniofacial dysostosis
c. Ectodermal dysplasia and cleidocranial dysostosis
d. Congenital syphilis and craniofacial dysostosis
60. Unerupted teeth which present a ghostlike radiographis appearance represent a form of:
a. Amelogenesis imperfecta
b. Dentinogenesis imperfecta
c. Regional odontodysplasia
d. Shell teeth
61. Recent clinical study has suggested that the least reliable diagnostic feature of sickle cell anemia is:
a. A “hair-on-end” appearance of the calvarium
b. A history of weakness, ready fatigability, headaches, and joint pain
c. Jaundice of the eyes
d. A characteristics radiographic appearance of the trabecular pattern
62. Match the type of cyst listed in the right-hand column with the feature assisting in its diagnosis.
1. involves only the a. hemorrhagic
crown of the tooth bone cyst
2. occasionally heart- b. globulomaxillary
shaped cyst
3. a history of trauma c. nasopalatine and
to the area incisive canal cyst
4. may be pear-shaped d. dentigerous cyst

Match the radiographic appearance listed in the right hand column with the condition with which they may be associated:
1. ameloblastoma a. “ground-glass”
cherubism radiopacity
2. ossifying fibroma b. “hair-on-end”
effect of the
(of the calvarium)
3. osteogenic sarcoma c. “soap bubble-like”
radiolucency
4. sickle cell anemia d. “sun-ray” radiopacity
Oral Medicine (WELLS)

63. Lower facial asymmetry, cafè-au-lait discolorations of the skin, and irregular
brown pigmentation of the lips are early signs of:
a. Addison’s disease
b. Albers- Schönberg disease
c. Albright’s disease
d. Paget’s disease

64. Marocheilia is one of the most common developmental anomalies of the lips. It may be associated with all of the following
conditions except:
a. Acromegaly
b. Cretinism
c. Hyperthyroidism
d. Myxedema
65. A maxillary labial frenum which extends exceptionally far lingually is often a primary etiologic factor in:
a. Caries involving the maxillary central incisors
b. A diastema between the central incisors
c. Labial gingival recession in the maxillary incisor region
d. Speech impairment
Characteristic clinical findings in hereditary gingival fibromatosis include all of the
following except:
a. Firm gingival consistency
b. Generalized gingival enlargement
c. Spontaneous gingival hemorrhage
d. A pink gingival color

66. Developmental disturbances which result in unusual size and/or shape of teeth most
frequently occur in:
a. Maxillary and mandibular incisors
b. Maxillary third molars and mandibular incisors
c. Third molars and maxillary lateral incisors
d. Third molar and mandibular second biscupids

67. Congenital syphilis may be responsible for a variety of anomalies in the permanent dentition.
The most constant of these is:
a. Congenitally missing teeth
b. Hutchinson’s incisors
c. Relatively short mandibular first molar roots
d. Mulberry-shaped molars

68. Hypercementosis may be associated with:

a. Acromegaly and Paget’s disease
b. Osteogenic sarcoma
c. Histiocytosis X diseases
d. von Recklinghausen’s disease of bone

69. A 29-year-old female was hospitalized with complaints of coldness of the hands and ulceration of two of her fingers which
had failed to heal. She was referred to the Dental Department for consultation. Her facial skin was observed to be taut and dry. A
complete mouth radiographic survey demonstrated unusually wide periodontal ligament spaces throughout the dentition. These
findings are most consistent with a diagnosis of:
a. Fibrous dysplasia
b. The Plummer-Vinson syndrome
c. Scleroderma
d. Sjögren’s syndrome

70. Crepitus (a crackling sound) elicited on palpation would be of greatest assistance in diagnosis of:
Oral Medicine (WELLS)

a. Ankylosis of the temporomandibular joint

b. A fracture of the mandible
c. Paget’s disease of bone
d. von Recklinghausen’s disease

71. A swishing or hissing sound detected at the initial opening and end of closing movement of the mandible is a finding most
often associated with:
a. Ankylosis of the temporomandibular joint
b. Hypoplasia of the condyles
c. Occlusal discrepancies
d. Ostheoarthritis involving the temporomandibular joint

72. Solitary ulceration of the oral mucosa are most often the result of:
a. Chemical burns
b. Intake of excessively hot liquids or foods
c. Trauma
d. Radiation therapy

73. Oral ulcers which are characteristically painless are those associated with:
a. Trauma
b. Tuberculosis
c. Primary herpes
d. Primary syphilis

74. Oral ulcerations which heal with clinical

evidence of scaring are known to be
associated with:
a. Chemical burns, e.g., an aspirin burn
b. Herpangina
c. Periadenitis mucosa necrotica recurrens
d. Trauma

75. Match the condition listed in the right-hand column with the abnormal deviation in vital
sign with which it may be associated.
1. tachycardia a. diabeted mellitus
2. hypertension b. primary herpetic
gingivostomatitis
3. erratic respi- c. hyperventilation
ratory rate
4. elevation of d. hyperthyroidism
temperature

76. Match the condition listed in the right-hand column with the abnormal deviation in vital
sign with which it may be associated.
1. bradycardia a. anxiety and/or syncope
2. hypotension b. emphysema
3. dyspnea c. myxedema
4. subnormal d. well-trained athlete
temperature

77. A 20-year-old male who has an outstanding

athlete had an essentially negative physical evaluation except for a systolic blood
pressure reading of 92. It is most likely that this latter finding is due to:
a. Early cardiovascular disease
b. Apprehension
c. An undiagnosed diabetic condition
Oral Medicine (WELLS)

d. Lack of a reliable history

78. A pronounced elevation of temperature is a major diagnostic feature of all except:

a. Herpangina
b. Ludwig’s angina
c. Primary herpes
d. Recurrent aopthous ulcers
79. A subnormal temperature is common to all except:
a. Angioneurotic edema
b. Anline intoxication
c. Myxedema
d. Syncope

80. The most common condition encountered in dental practice in which a subnormal temperature is invariably found is:
a. Aniline intoxication
b. Cretinism
c. Myxedema
d. Syncope

81. The most common complaint of gingival bleeding upon tooth brushing is the result of:
a. Diabetes mellitus
b. Monocytic leukemia
c. Local irritating factors
d. A vitamin C deficiency

82. A 20-year-old female complained of recent spontaneous gingival bleeding and “sore, tender gums.” She reported that she
had ceased any effort regarding oral hygiene because of this. Clinical examination revealed a white slough of the marginal
gingiva throughout the mouth, and a fetid breath odor was obvious. There were no other remarkable findings. The most likely
diagnosis of the patient’s gingival bleeding is:
a. Diabetic gingivitis
b. Leukemic gingivitis
c. Acute necrotizing ulcerative gingivitis
d. Marginal gingivitis

83. An 18-year-old male reported recent spontaneous gingival bleeding. Multiple petechaie were
apparent in clinical examination of the oral mucosa. Local irritating factors seemed to be absent. Possible etiologies od the
patient’s gingival bleeding include all of the
following except:
a. Drugs
b. Exposure to chemicals
c. Hemophilia
d. Leukemia

84. A 42-year-old female complained of “streaks

of” blue grayish black discoloration of the floor of the mouth, buccal mucosa, and palate. She reported a sudden appearance of
these discoloration 2 days previously. Further questioning revealed that her physician had
“taken her off cortisone for arthritis.” These findings suggest that the reason for the
patient oral pigmentation is probably:
a. Hypoadrenalism
b. Hypoparathyroidism
c. Hypopituitarism
d. Hypothyroidism

85. A 19-year-ols male complained of a “soft

piece of skin growing out of my tooth”.
Clinical examination revealed severe carious destruction of maxillary left first molar with
Oral Medicine (WELLS)

what appeared to be granulation tissue

extending from the exposed pulp chamber.
The correct diagnosis with these findings is:
a. Acute pulpitits
b. Chronic suppurative pulpitis
c. Chronic open hyperplastic pulpitis
d. An irritation fibroma involving the
pulp

86. Patient that have been taking prescribed antihistamines (e.g.; amphetamine sulfate [Benzedrine]), ataractics, (e.g.,
chlordiazepoxide hydrochloride [Librium])
or muscle relaxants (e.g., methocarbamol
[Robaxin]) are most apt to report
a. Spontaneous gingival bleeding
b. Gingival swelling
c. Delayed healing following a recent extraction
d. Xerostomia

87. A 23-year-old female complained of bilateral stiffness and soreness in the area of temporomandibular joint. Symptoms had
occurred daily for the past week and were most pronounced on awakening in the morning but always diminished and
disappeared during the day. History and physical findings were unremarkable. The most likely cause of the patient’s problem is:
a. Fibrous ankylosis of temporomandibular joint
b. Nocturnal bruxism
c. Sudden development of a malocclusion
d. Early osteoarthritis

88. The primary complaints of a 19-year-old male were pain, mild trismus, and inefficiency in mastication which he believed to
be due to an erupting mandibular third molar. Further questioning disclosed frequent headaches of some loss of hearing on the
affected side. Clinical examination revealed congenital absence of third molars and no tooth or soft tissue pathology. Restricted
movement of the soft palate was noted. These findings suggest prompt medical consultation because they are characteristic of:
a. Meniere’s disease
b. The Plummer-Vinson syndrome
c. A tumor of the nasopharynx as a cause of Trotter’s syndrome
d. A psychogenic disturbances

89. The primary complaints of a 19-year-old male were pain, mild trismus, and inefficiency in mastication which he believed to
be due an erupting mandibular third molar. Further questioning disclosed frequent headaches and some loss of hearing on the
affected side. Clinical examination revealed congenital absence of third molars and no tooth or soft tissue pathology. Restricted
movement of the soft palate was noted. These findings suggest prompt medical consultation because they are characteristic of:
a. Meniere’s disease
b. The Plummer-vinson syndrome
c. A tumor of the nasopharynx as a cause of Trotter’s syndrome
d. A psychogenic disturbance
90. A 28-year-old male complained of a right-
side unilateral facial paralysis. Examination
revealed inability to wink the right eye and excessive lacrimation. He reported that the symptoms appeared quite suddenly 2 days

ago on awakening. These are characteristic

signs of:
a. Angioedema
b. The auriculotemporal syndrome
c. Bell’s palsy
d. Trigeminal neuralgia

91. The form of the lichen planus which is most

often responsible for symptoms of pain is
Oral Medicine (WELLS)

the:
a. Atrophic
b. Erosive
c. Keratotic
d. Vesiculobullous

92. A 50-year-old male complained of a “sore

mouth” of 3 days duration he had been on prolonged course of penicillin prescribed by
his physician. Clinical examination revealed ill-defined white areas on the buccal mucosa
and soft palate. When these areas were wiped firmly with a gauze sponge, a raw, red,
bleeding, tender surface was exposed. These findings are most consistent with a diagnosis
of:
a. An idiosyncrasy
b. Candidiasis
c. Secondary syphilis
d. A toxic reaction to penicillin

93. A 19-year-old male complained of pain and

tenderness upon mastication in the area of an erupting mandibular third molar. He had
applying aspirin tablets to the area. The
result of this was manifested clinically by a
white excoriation tissue overlying the
erupting tooth. This type of chemical insult
to the tissue is most accurately described as:
a. An allergic reaction
b. A factitial injury
c. An idiosyncrasy
d. A toxic reaction

94. Periodontal abscesses, alveolar osteites following tooth extraction, and acute alveolar abscesses are most apt to develop
without apparent cause in a patient with :
a. Albers- Schönberg
b. Diabetes mellitus
c. Hand-Schüller-Christian disease
d. Letterer-Siwe’s disease

95. Bacterial invasion of the pulp as a result of caries is the most common general cause is:
a. Chemical irritation
b. Anachoresis or blood transmission of bacteria to the pulp
c. Thermal irritation
d. Trauma

96. A 20-year-old female complained of a severe “toothache” which she reported had kept her awake for the past two nights.
Clinical examination revealed caries involving a mandibular bicuspid which was markedly sensitive to slight percussion. A
radiograph disclosed no periapical radiolucency. These findings are sufficient to make a diagnosis of:
a. Acute suppurative pulpitis
b. Acute pulpal hyperemia
c. Irreversible pulpal change with progression towards development of an abscess
d. Partial pulpitis

97. A -19-year-old patient complained of a severe “toothache” involving a maxillary lateral incisor. The tooth was noncarious,
but a deep cingulum pit was detected upon exploration. Radiographs demonstrated a pronounced periapical radiolucency and
what appeared to be an extension of an enamel into the middle third of the pulp canal. These findings are most characteristics of :
a. Concrescence
b. Pulpal death as a result of a dens in dente
c. Pulpal death as a result of a denticle formation
Oral Medicine (WELLS)

d. Pulpal death as a result of

anachoresis

98. A 20-year-old male required post operative care subsequent to extraction of

a mandibular third molar 5 days ago. He reported onset of a dull, persistent pain in the
area “yesterday” which was becoming increasingly severe. Clinical examination
revealed exposed bone in the alveolar and a fetid breath odor. Treatment of this alveolar
osteitis is:
a. Based on the assumption that the patient dislodged the clot
b. Based on the assumption that the vasoconstrictor in the anesthetic solution prevented clot formation
c. Of necessity empirical since no single cause of “dry socket has been yet determined
d. Based on the assumption that preexisting infection has prevented healing

99. A 43-year-old female complain of a dull persistent radiating pain in the site of her last extraction 3 years ago. She was now
edentulous. Clinical examination of the mandibular right molar area revealed an incompletely healed extraction site from which
a suppurative discharge could be
expressed. A radiograph disclosed a 2x2 cm, ill-fined, “worm-eaten” area of bone. These
findings are most compatible with a diagnosis
of:
a. An infected residual cyst
b. A chronic alveolar osteitis
c. Chronic osteomyelitis
d. An osteogenic sarcoma

100.The most common cause of unilateral paresthesia of the lower lip is:
a. Impingement of an overextended
denture flange upon the mental
nerve
b. Osteomyelitis
c. Trauma to the inferior alveolar nerve in the course of extraction of a mandibular third molar
d. A tumor of the fifth nerve

100.A 28-year-old male patient complained of hyperesthetic sensations resulting from inadvertent biting of a small nodular
swelling on the lower lip. Examination revealed a very firm, white, 0.5 x 0.5 mm, elevated growth on the lower lip in the area of
the mandibular left lateral incisor. The patient reported first noticing the lesions about 2 months ago, shortly after he had a slight
contusion in the area. These findings most suggest the presence of:
a. An irritation fibroma
b. An hemangioma
c. A mucocele
d. A neuroma

101.A 32-year-old male complained of a swelling which involved the moist mucous membrane of the lower lip in the area of the
left cuspid. He reported involuntary biting of these lesion twice during the past year which had cause it to “disappear for a
while”. Inspection and palpation revealed a spherical, well-defined, 0.5 cm, slightly elevated lesion which had a bluish green
surface discoloration. This findings are most suggestive of a:
a. Residual cyst
b. Mucocele
c. Ranula
d. Traumatic neuroma

102.A 42-year-old male requested reconstruction of a maxillary full denture which was now “loose”. Clinical examination
revealed a red, exophytic, fissured, 3x1 cm, nontender lesion in the maxillary anterior vestibule. A biopsy report would be
expected to confirm a strong clinical impression of:
a. An epulis fissuratum
b. Papillomatosis
c. A pyogenic granuloma
Oral Medicine (WELLS)

d. Squamous cell carcinoma

103.A 25-year-old male was in acute distress with pain, elevation of temperature, and a firm,
bilateral mandibular swelling. This swelling apparently elevated the tongue and caused
some difficulty in swallowing and breathing. He reported that that his symptoms had
appeared 3 days after he had an “abscessed”lower molar tooth extracted 1 week ago. These findings indicate prompt institution
of antibiotic therapy because they are
characteristics of:
a. An alveolar osteitis
b. Ludwig’s angina
c. Herpangina
d. Vincent’s angina

104.A 26-year-old female complained a loud snapping or cracking sound when she opened her mouth. She produced this unusual
sound only on extended or full opening. She reported
that although pain was not associated with this condition, it was often socially
embarrassing. Thorough clinica examination ruled out occlusal discrepancies
as a possible cause. These findings suggest:
a. Ankylosis of the temporomandibular joint
b. Hypoplasia of the condyles
c. That the head of the condyle is rapidly passing over a prominence of the meniscus
d. Rheumatoid arthritis

105.A 32-year-old male complained primarily of pain in the area of the incisive papilla and
occasional “salty taste” in the mouth. He reported trauma and pain sensations primarily when he ate toast. Examination revealed
an unusually large, slightly reddened incisive papilla and a spherical radiolucency close to the alveolar crest between the
maxillary incisors. These findings are most characteristics of a:
a. Globulomaxillary cyst
b. Median cyst
c. Nasoalveolar cyst
d. Nasopalatine cyst

106.The complaint of a metallic taste reported by dental patients is most frequently associated with:
a. Acute necrotizing ulcerative gingivitis
b. Bismuthosis
c. Galvanism
d. Mercurialism

107.The most important procedure in diagnosis is :

a. Elicitation of the chief complaint
b. Conduct of a thorough examination
c. Development of a case history
d. Proper interpretation of a radiographic findings

108.The primary purpose in obtaining an accurate history is to:

a. Determine how healthy the patient may be
b. Uncover the undiagnosed systemic condition
c. Provide a basis for determining how the patient’s status may be affected by dental therapy
d. Assist the physician in management of a medical problem

109.Correct diagnosis in which the examination findings play the major role are most often
the result of:
a. Brilliance on the part of the examiner
b. A complete and thorough examination
c. Skill in examination technique
d. Perception of a particular finding as being abnormal
Oral Medicine (WELLS)

110.The significance of a positive examination finding is that it may:

a. Corroborate the history
b. Be present in the absence of symptoms
c. Be the first manifestation of an abnormal condition
d. All of the above

111. A patient with Letterer-Siwe’s disease is not apt to consult a dentist because:
a. The primary symptoms relate to skeletal bone destruction
b. The head and neck are never involved
c. This condition rarely occurs after
the age of 2 years
d. This condition invariably runs a
rapid and fatal course

112.Most commonly associated with trigeminal neuralgia is:

a. A tumor of the fifth cranial nerve
b. Involvement of the left side of the face
c. Its occurrence after the age of 30
d. That attacked are separated by longer time intervals as the conditions progresses

113.It is most rare for a patient to have:

a. Acute necrostizing ulcerative gingivitis
b. Chronic disquamative gingivitis
c. Chronic gingivitis
d. Periodontics

114.Female patients are known to be far more predisposed to develop:

a. Dental caries
b. Periapical cementifying fibromas (cementomas)
c. Periapical abscesses
d. Periodontistis

115.Ethnic background is a known presidposing factor in:

a. Hemophilia
b. Iron deficiency anemia
c. Pernicious anemia
d. Thalassemia

116.In the elicitation of the chief complaint and

throughout the history-taking procedure, it is
most important for the examiner to:
a. Appear to be concerned
b. Direct the questioning
c. Be unhurried
d. Be seated

117.The chief complaint should be recorded

initially by a notation:
a. Concerning its mode of development
b. As to when the symptoms were first noticed
c. Of it in the patient’s own words
d. Of any previous treatment of the symptoms

118.By far the most common (and often difficult to evaluate) chief complaint of the dental patient is:
a. Glossodynia
Oral Medicine (WELLS)

b. Inability to wear their dentures

c. Inefficiency in mastication
d. Odontalgia

119.A 20-year-old female complained a severe “toothache.” She had unable to sleep for the past two nights and had applied ice
cubes to allay the pain. The mandibular left first molar was severely involved with caries and markedly sensitive to percussion.
These are cardinal findings characteristic of:
a. Acute pulpal hyperemia
b. A developing periapical granuloma
c. Irreversible pulpla change
d. Mild periodontitis

120.Complains of occasional sporadic sensitivity of a tooth to cold alone are more characteristic of:
a. Irreversible pulpal change
b. Pulpal hyperemia
c. An occlusal discrepancy
d. A suppurative pulpitis

121.The chief complaint is best analyzed by obtaining a detailed history of the present illness. These details include all except:
a. The approximate date or time of onset of symptoms
b. Inciting factors and mode of development of symptoms
c. A familial history of the condition
d. Any professional or attempted self-treatment

122.A 20-year-old male developed urticaria approximately 8 days subsequent to parental administration of penicillin for a nose
infection a year ago. This history is exceedingly important and should be made special note of because:
a. Indicates that the patient has a drug idiosyncrasy
b. The patient may have received toxic dose
c. It suggest that the sensitizing dose was received and that an anaphylactic reaction could follow administration of penicillin
in any form or by any other route
d. Penicillin is the antibiotic of choice in treatment of the vast majority of oral infections

123.An asymptomatic red tongue lesion was detected in the course of initial examinatio of a 43-year-old female patient. The
level of s suspicion that these lesion must be squamous
cell carcinoma would be most increase with the past medical history of the:
a. Airucoletemporal syndrome
b. Papillon-Lefèvre syndrome
c. Pierre Robin syndrome
d. Plummer-Vinson syndrome

124.It is most important to limit treatment of pregnant woman to emergency procedure

only
a. During the first trimester
b. If there is a history of spontaneous abortion
c. During the third trimester
d. During the morning

125.A 28-year-old female brought her 5-year-old son for initial examination. The
history provided by the mother included a report or rubella (German measles) during
pregnancy. The condition most certain to be manifested in the child’s dentition is:
a. Dentinogenesis imperfecta
b. Moderate to severe enamel hypoplasia
c. Shell teeth
d. Taurodontism

126.A 45-year-old female reported a family history of a bleeding tendency and that her
Oral Medicine (WELLS)

father was a hemophiliac. A week, later upon examination of a relative, indications were found for the extraction of two teeth.
One would be most concerned and seek medical consultation prior to performing these extractions if this patient’s was the
woman’s.
a. Brother
b. Mother
c. Sister
d. Son

127.Baker’s, cooks, and food handlers most likely to develop:

a. Gingival pigmentation
b. Rampant caries
c. Severe abrasion of teeth
d. Vague dental pain

128.Plumbism is a condition most commonly found in a patient whose occupation is that of:
a. Mill worker
b. Painter
c. Plumber
d. Poultry farmer

129.The level of suspicion that a lesion might be a squamous cell carcinoma of the floor of the oral cavity would be most
increase with the history of:
a. High alcoholic beverage consumption and syphilis
b. Syphilis and excessive smoking
c. High alcoholic beverage consumption and excessive tobacco use
d. Diabetes and high alcoholic beverage consumption

130.Symptoms which suggest the presence of cardiovascular disease include all except:
a. Ankle edema
b. Dyspnea on exertion
c. Jaundice of the eyes
d. Substernal chest pain

131.A history of frequent counseling for emotional problem is often associated with all except:
a. Acute necrotizing ulcerative gingivitis
b. Aphthous ulcers
c. Gingival pigmentation
d. Glossodynia and glossopyrosis

132.By far the greatest amount of diagnostic information is obtained by means of two of
the four general classical methods of physical diagnosis. These two methods are:
a. Inspection of palpation
b. Inspection of percussion
c. Gingival pigmentation
d. Glossodynia and glossopyrosis
133.Inspection of the patient’s hands may provide clues to the diagnosis. Match the finding listed in the right hand column with
the condition with which it may be associated.
1. neurofibromatosis a. bullae
2. Parkinson’s disease b. nodules
3. Pemphigus c. pigmentation
4. Addison’s disease d. tremor

134.Match the sign listed in the right-han column in the condition of the eyes with which it may be associated.
1. Bell’s palsy a. exophthalmos
2. Grave’s disease b. blue sclerae
3. Congenital syphilis c. inability to wink
Oral Medicine (WELLS)

4. Osteogenesis d. interstitial keratitis

135.A 43-year-old male had a fistulating of the left side of the neck. He reported
intermitted fever and night sweats for the past month. He also reported that a mandibular left molar had been extracted six
months ago. Firm palpation of the swell revealed small yellow flecks in an exudate arising from the fistula. These findings are
most suggestive of a:
a. Cellulitis
b. Syphilitic lesion
c. Lesion of actinomycosis
d. Tuberculous lesion

136.At the present time the key to reducing the mortality rate as a result of oral malignancy
is considered:
a. Public education in the danger of smoking and high alcoholic beverage consumption
b. Early detection
c. The discovery of more effective chemotherapeutic agents
d. Improvement in surgical technique(s)

137.A 44-year-old male presented with a fractured lingual cusp of the maxillary left first biscupid. Inspection revealed that the
fracture was of the shearing type and that the tooth had apparently never been restored. The patient reported no history and
severe trauma and that he had “ broken it biting on a piece of bread.” This common finding in mature patients is due to:
a. Ankylosis and dentinal sclerosis of teeth
b. Development of a bruxing habit
c. Change in the occlusion as a result of interproximal wear and increased brittleness of teeth
d. Dentinal sclerosis and pulpal calcification

138.A diagnosis of acute suppurative pulpitis can only be made by:

a. Analysis of symptoms
b. Findings pus on opening into the pulp chamber(s)
c. Radiographic examination
d. Subjecting the tooth to thermal, electric and percussive stimuli

139.Radiographic examination, which is an integral part of the examination of the dental patient, is essentially examination by
means of:
a. Auscultation
b. Inspection
c. Palpation
d. Percussion

140.In the right-hand column are listed the primary factors governing the diagnostic quality of the radiograph. Match them with
the item which has the greatest influence on their production.
1. kilovoltage a. density
2. incorrect angulation b. contrast
3. exposure time c. definition
4. object-film distance d. distortion

141.Radiographs with patients with heavy, dense bone are apt to be insufficiently dense for diagnostic purposes. In order to
produceradiographs of sufficient density for thesepatients, and at the same time minimize patient exposure, it is most desirable
to:
a. Increase the exposure time
b. Employ a high kilovoltage
c. Employ a long cone paralleling technique
d. Process the film for a longer period of time

142.If a radiograph possesses either or excessive or insufficient density, it will also primarily:
a. Present “blurred” images
Oral Medicine (WELLS)

b. Lack sufficient contrast quality for diagnosis

c. Require further fixing
d. Present marked distortion of images

143.In order to produce a radiograph of long gray scale contrast quality, it is necessary to:
a. Decrease the exposure time
b. Employ a kilovoltage of 70 or greater
c. Employ a kilovoltage of lessthan 70
d. Employ a paralleling technique

144.Readability of radiographs produced by means of high kilovoltage (70 or above)

techniques is most enhanced by:
a. Maximum collimation
b. Proper filtration
c. Use of a long rather than a short cone
d. Elimination of all incident light

145.A low (below 70) kilovoltage technique is most advantageous in demonstrating:

a. Alveolar crestal bone resorption
b. Early or small carious lesions
c. Periapical lesions
d. A retained root

146.Greater object-film distances are required in a paralleling technique than in a bisecting

technique. As a result, the use of a long cone is indicated in order to:
a. Reduce exposure time
b. Produce a radiograph of long gray scale contrast quality
c. Minimize distortion
d. Prevent loss of definition and/or detail

Definitions and detail are terms which are often used synonymously. Technically, detail refers to:
a. Image density
b. Lack of image distortion
c. Reproduction of very small objects
d. Image sharpness

147.Production and use of faster film has been a major factor in reducing a patient exposure. However, the fastest film
manufactured has not been used routinely by clinicians because:
a. A long gray scale contrast cannot be obtained
b. The image(s) are often distorted
c. Images appear granular and lack definition
d. It requires more careful processing

148.A major advantage of the periapical radiograph as compared with a pantomograph is that:
a. Distortion is totally absent
b. Greater image sharpness can be obtained
c. It is quicker and easier to produce
d. Landmarks are never superimposed

149.Mark elongation because the vertical angulation was excessive is most apt to result in:
a. Burn-out of structures of minimum density
b. Misinterpretation of alveolar crestal bone height as being less than it actually is
c. Misinterpretation of alveolar crestal bone height as being greater than it actually is
d. Production of tooth images which suggest very short root length

150.Marked foreshortening because the vertical angulation was excessive is most apt to result in:
Oral Medicine (WELLS)

a. Misinterpretation of alveolar crestal bone height as being greater than it actually is

b. Burn-out of structures of maximum density
c. An appearance of osteoporosity of the trabecular pattern
d. Misinterpretation of an abscess or granuloma

151.A paralleling technique produces a radiograph of greater diagnostic value than a bisecting technique does for all of the
following reasons except one. Which one?
a. A more accurate anatomic relationships of structures is demonstrated
b. Distortion of images is minimized
c. Problems in film placement are reduced
d. Superimposition of landmarks is less likely

152.Excessive film fog which impairs the diagnostic quality of the radiograph is most
often the result of:
a. An inherent quality of the film
b. Improper, too rapid processing at an excessively high temperature
c. Employment of insufficient exposure time
d. Improper storage of film prior and subsequent to exposure

153.Burn-out is the most significant factor in diagnosis of:

a. The presence of an abscess, granuloma or cyst
b. Early small interproximal caries and integrity of the alveolar crest
c. Carious exposure of the pulp
d. The presence or absence of a retained root

154.Aids in the differentiation of radiographic landmarks which are atypical in size,

location, and /or shape from abnormal conditions include all except:
a. The production of anotherradiograph at a markedly altered angulation
b. Comparing the radiograph with one of the contracteral side
c. Increasing the exposure time
d. Employment of a paralleling technique in order to avoid superimposition

155.Panorex, Orthopantomograph, Panelipse, and Panex all:

a. Describe radiographic techniques involving employment of a moving source of radiation and film
b. Are better techniques than the paralleling technique
c. Are names of pantomographic machines
d. Are names of radiographs

156.The most outstanding advantage of pantomography as compared with a periapical with a periapical survey is that:
a. There is greater definition of images
b. There is less image distortion
c. The anatomic scope pf examination is greater
d. It is more useful in patient education

157.A panotomograph is of particular value in initial evaluation because it:

a. Is so easily and rapidly produced
b. Demonstrate all structures with maximum definition
c. Demonstrate all hard tissues of primary concern with minimum distortion
d. Demonstrate all hard tissues of primary concern with a “reasonable” degree of definition and lack of distortion

158.On initial examination of a 20-year-old female, a pantomograph revealed a foreign body in the mandibular right molar
region. Its configuration and the history suggested that it was a retained orthodontic wire. When attempts were made to localize
it by means of the shift sketch technique, the object appeared to move distally (or posteriorly) as the area was radiographed from
a 45o greater (anterior) horizontal angulation. This indicates that the object is:
a. More apical to the tooth than the pantomograph indicates
b. Buccal to the tooth
Oral Medicine (WELLS)

c. In the cheek rather than in the bone

d. Lingual to the tooth

159.The most difficult and challenging technique for localization of fractures, cysts,
tumors, foreign bodies, etc. to perform is production of a:
a. Right angle view
b. Shift sketch
c. Sialogram
d. Stereoscopic view

160.The principal disadvantage of using a pointed cone rather than an open cone is that:
a. The primary beam cannot be adequately filtered
b. Patients are subjected to greater amounts of scatter radiation
c. A paralleling technique cannot be used in conjunction with it
d. The primary beam is decreased in intensity

161.Screens are commonly incorporated in extraoral film casettes primarily for the
purpose of:
a. Increasing the contrast quality
b. Enhancing image definition
c. Reducing distortion
d. Reducing patient radiation dosage

162.Protection of the patient from possible deleterious genetic of radiation is

accomplished primarily by:
a. Adequate collimation of the beamto a maximum of a 3-in. diameter atthe skin entrance area
b. Proper filtration by addition of atleast 0.5 mm aluminum
c. Draping the patient with a lead apron
d. Use of Class D film speed

163.The most frequent and definite indicationfor siologram is:

a. The presence of an acute submandibular swelling with no clueto its etiology
b. Suspected sialolithiasis
c. The patient’s complaint of a salty taste
d. The patient’s complaint of xerostomia

164.A sialogram may provide information of significance in diagnosis of Sjögren’s syndrome because it may demonstrate
a. Cyst in the parotid glands
b. Characteristics reduction in end arborization of salivary acini
c. Malignant tumors of the parotid
d. Which salivary glands are involved

165.On initial examination of a 20-year-old male, palpable cervical lymph nodes were detected. The history and other physical
findings were unremarkable. No oral lesions were detected. All of the following should be considered except:
a. Acute leukemia
b. Angioedema
c. Infectious mononucleosis
d. Hodgkin’s disease

166.Patients who have received low.level (e.g., 200-400 rad) radiation therapy to head and/ or neck should be given a most
meticulous examination of the neck by means of palpation because:
a. They are known to develop hodgkin’s disease
b. The incidence of thyroid malignancy is far greater in these patients than in the general population
c. They are most prone to develop von Recklinghausen’s disease
d. They are predisposed to develop an osteogenic sarcoma
Oral Medicine (WELLS)

167.The least significant finding in palpation of the neck for nodes is:
a. Their degree in firmness
b. Whether they are fixed or movable
c. Their size
d. Whether or not they are tender

168.A white, film, slightly ulcerated lesion of the lower lip of a 55-year-old male was detected in the course of initial
examination. The patient was fair-skinned and reported that he had worked out-of-doors most of his life. A sign which would
raise the level of suspicion that this lesion is a squamous cell carcinoma is the presence of firm palpable.
a. Axillary nodes
b. Deep cervical nodes
c. Preauricular nodes
d. Submental nodes

169.A 1x1 cm, nontender, white lesion on the lateral border of the tongue was detected in
the course of initial examination of a 43-year-old female. Upon palpation, the lesion felt indurated and “bound down”. This latter
sensation suggests:
Dyskeratosis
a. Hyperkeratosis
b. Infiltration of cells into the deeper tissues
c. Parakeratosis
170.A 44-year-old male complained of pain in the maxillary left quadrant. Several period
dental consultations had provided no solution, and his physician ruled out sinusitis. Radiographs and clinical examination
revealed no caries or periodontal disease and all teeth responded
within normal limits to electric and thermal tests. Careful questioning revealed that pain
occurred primarily on mastication, with occasional sporadic thermal sensitivity which had become increasingly severe over
course of the past 8 months. A most meticulous examination by means of
exploration is indicated because these findings are commonly associated with:
a. The auriculotemporal syndrome
b. The “cracked tooth” syndrome
c. The myofacial pain dysfunction syndrome
d. Trotter’s syndrome

171.A tooth which is severely carious, markedly sensitive to percussion, and unresponsive to electric stimuli:
a. May be reactive to cold stimuli
b. Is indicated for extraction
c. May or may not possess a periapical radiolucency

172.Marked sensitivity of a tooth percussion suggest that:

a. A chronic alveolar abscess is present
b. A cyst has formed
c. The periodontal ligament and/or bone is already involved
d. The pulp is beginning to degenerate

173.A wheezy type of respiration is most often associated with:

a. Bronchial asthma
b. Cardiovascular disease
c. Emphysema
d. Tuberculosis
174.Mediate auscultation is of greatest value in oral diagnosis in detection of:
a. Ankylosis of teeth
b. Hypertension
c. Inflammation of the periodontal ligament
d. Most type of periapical pathology

175.If the percussion test with the handle of an explorer produces a clear ringing sound rather than a dull thud, the tooth is most
Oral Medicine (WELLS)

likely to:
a. Be ankylosed
b. Be periodontally involved
c. Possess a periapical lesion
d. Be a sound tooth with a viable periodontal ligament

176.The most favorable prognosis can be provided for a tooth which:

a. Responds within normal limits to electric stimulation
b. Is sensitive to heat stimuli, but relieved by cold
c. Is sensitive percussion
d. Is markedly responsive to cold only during time of application

177.A tooth which responds markedly to heat and cold only during time of application is considered to be affected by:
a. An acute pulpitis
b. A chronic pulpitis
c. Pulpal hyperemia
d. Partial pulpitis

178.Odontalgia which is incited by heat stimulation by relieved by cold application

provides evidence that the pulp:
a. Is acutely inflamed
b. Is hyperemic
c. Has undergone irreversible change
d. Is beginning to necrose

179.Pain which persist following removal ofthermal stimuli to a tooth is considered to be

a cardinal sign of an irreversible pulpitis.However, these teeth has been successfully
treated without resorting to endodontic therapy by:
a. Application of strontium chloride densensitizing paste
b. Elimination of a high spot on a restoration, providing the toothhas been recently restored
c. Treating a 5-mm pocket on the distal
d. Treating a carious lesion withzinc oxide-eugenol

180.Electric pulp testing is of primary value in determining:

a. The degree of pulp vitality
b. Whether or not any pulp vitality remains
c. The type of pulpitis which may bepresent
d. Whether or not pulp change may be reversible

181.A 43-year-old male was hospitalized with complaints of increasing frequency of

headaches, sweating, and loss of libido.He had been taking tolbutamide. (Orinase)
for diabetes for the past 2 years. The patient reported increasing difficulty in mastication
and incising. Photographs divided by the patient taken over the past 5 years suggested
development of pronounced of supraorbital ridges, enlargement of the nose and lips, and
mandibular prognathism. These findings areconsistent consistent with an impression of:
a. Craniofacial dysostosis
b. Acromegaly
c. Hyperthyroidism
d. Paget’s disease

182.Study models are greatest value in:

a. Determining the presence of a malocclusion
b. Evaluation of the extent of periodontitis
c. Analyzing the forces of occlusion
d. Determining whether a fixed or removable appliance is indicated
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183.If a patient is suspected of being sensitive to acrylic, the test most helpful in diagnosis is the:
a. Heterophil antibody
b. Patch
c. Scratch
d. Tourniquet

184.Formation of a bulla following stroking of intact skin or mucosa contributes a positive reaction in the attempt to elicit:
a. Bobinski’s skin
b. Chvotek’s sign
c. Nikolsky’s sign
d. Romberg’s sign

185.Associate the condition listed in the right-hand column with the special method of an examination which may assist in its
diagnosis.
1. Dermatographia a. thrombocytopenia
2. Nikolsky’s sign b. sensitivity to denture base material
3. Patch test c. angioedema
4. Tourniquet test d. chronic desquamative gingivitis

186.Blood chemistry values determined by sequential multiple analyzer most often provide:
a. Cardinal sign of abnormality
b. Information which contributes to a diagnosis
c. Pathognomonic sign of disease
d. Questionable information

187.Match the condition listed in the right-hand column with the abnormal deviation in the blood chemistry with which it may
be associated.
1. Elevated BUN a. Cardiovascular (Blood Urea disease Nitrogen)
2. Elevated b. diabetes cholesterol
3. Elevated glucose c. acute hepatitis
4. Elevated SGOT d. renal disease (Serum Glutamic Transaminase)

188.Match the condition listed in the right-hand column with the abnormal deviation in
blood chemistry with which it may be associated.
1. Low BUN a. Addison’s disease
2. Low cholesterol b. Uncontrolled diabetes
3. Low glucose c. epilepsy
4. Low SGOT d. liver disease

189.Paget’s disease, fibrous dysplasia, and hyperparathyroidism are most likely to

provide blood chemistry findings of an elevated:
a. Serum calcium
b. Serum calcium phosphatase
c. Serum glutamic oxalacetic transaminase
d. Uric acid
190.A 49-year-old male reported both a family history and symptoms suggestive of diabetes.
The most reliable means of establishing adiagnosis is a:
a. Urinalysis
b. Fasting blood sugar determination
c. Glucose tolerance test
d. Confirmation of the patient’s historyof polyuria by collection of a 24-hr urine sample

191.The glucose tolerance test is considered to indicate the presence of a mild diabetic
condition when the blood sugar:
a. Returns to a normal value within 1 hour
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b. Returns to the base fasting level in 2 hours

c. Reaches a peak level in 2 hours
d. Reaches a peak level in 1 hour
e. Is a lower at the 2nd hour reading than the first

192.A 50-year-old female reported chronic thirst and frequent, vague chest and joint pain. A pantomograph demonstrated
generalized osteoporosis and an elliptical 1 x 2 cm radiolucency in the body of the mandible. An elevated (greater than 13
mg/100 ml) calcium blood level would substantiate a clinical impression of:
a. Albers-Schönberg disease
b. Hyperparathyroidism
c. Paget’s disease
d. von Recklinghausen’s disease bone

193.a 42-years-old female patient reported “gnawing” head pains, loss of weight, and ready fatigability over the course of the
past 6 months. A pantomograph demonstrated multiple multilocular rediolucencies. Blood chemistry tests revealed high serum
calcium, low serum phosphates within the range of normalcy. These findings are most compatible with a clinical impression of:
a. Addison’s disease
b. Hyperparathyroidism
c. Paget’s disease
d. von Recklinghausen’s disease bone

194.A 65-year-old male complained that his maxillary denture had become “tight” and no longer “fit”. A pantomograph
demonstrated an aberrant suggestive of a cotton wool appearance. Laboratory studies revealing an elevated serum alkaline
phosphatase and calcium and phosphate levels within the range of normalcy would substantiate the clinical impression of:
a. Albers- Schönberg disease
b. Hyperparathyroidism
c. Paget’s disease
d. von Recklinghausen’s disease of bone

195.Blood studies were requested for a 20-year-old female because the clinical findings
suggested a possible bleeding tendency. The laboratory report included:

Hematocrit : 45%
WBC: 6240/ml
Platelets: 275,000
Differential: Segs: 64% Monos : 3
Bands :2 Eos: 2
Lymph: 28 Bas: 1
These findings suggest:
a. Acute infection
b. Anemia
c. Lymphocytic leukemia
d. No disease process since all of the findings are within the range of normalcy

196.The primary laboratory findings associatedwith agranulocytosis is a:

a. Decrease in white cell count
b. Decrease in platelets
c. Decrease in red cell count
d. Increase in white cell count

197.Ninety-five percent of all disorder of hemostasis are detectable by means of:

a. Bleeding time determination
b. Platelet count
c. Both bleeding time determination and platelet count
d. Prothrombin time determination
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198.A clotting time within the range of normalcy, abnormal clot reaction, and prolonged time are associated with:
a. Hemophilia A
b. Scurvy
c. Thrombocytopenia
d. von Willebrand’s disease

199.Prolonged clotting time is a manifestation of all the following except:

a. A fibrinogen deficiency
b. Hemophilia A
c. Hageman (factor XII) deficiency
d. Scurvy

200.A platelet deficiency is associated with all of the following except:

a. Acute myelogenous leukemia
b. Aplastic anemia
c. Hereditary hemorrhagic telangiectasia
d. Idiopathic thrombocytopenic purpura

201.Partial thromboplastin time (PTT) and prothrombin time (PT) tests will detect 95% of all coagulation disorders. A factor
deficiency identification test (FDIT) is indicated when:
a. The PT is abnormal
b. Both the PT and PTT yield abnormal results
c. The PTT is abnormal
d. The PT and PTT yield normal results

202.A 37-year-old-female reported spontaneous gingival bleeding of 3 months’ duration. A platelet counts disclosed 20,000/ ml.
The test result which would be expected to be within the range of normalcy is the:
a. Bleeding time
b. Capillary fragility
c. Clot retraction
d. Prothrombin time

203.A vitamin K deficiemncy is indicated by:

a. An FDIT
b. A low platelet count
c. An increased PT
d. A decreased PT

204.A 23-year-old student whose classmate was hospitalized 2 weeks ago with infectious mononucleosis complained of fatigue,
headaches,and chills. Petechaiae were clinically obsevable on the soft palate. If this patient had concentrated the disease, a
peripheral blood smear would likely demonstrate:
a. An increase in abnormal mononuclear cells
b. An absence of lymphocytes
c. Hypochromic red cells mycrocytic red cells
d. Macrocytic red cells

205.Partial thromboplastin time (PTT) and prothrombin time (PT) tests will detect 95% of all coagulation disorders. A factor
deficiency identification test (FDIT) is indicated when:
e. The PT is abnormal
f. Both the PT and PTT yield abnormal results
g. The PTT is abnormal
h. The PT and PTT yield normal results

206. A 37-year-old-female reported spontaneous gingival bleeding of 3 months’ duration. A platelet counts disclosed 20,000/ ml. The
test result which would be expected to be within the range of normalcy is the:
e. Bleeding time
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f. Capillary fragility
g. Clot retraction
h. Prothrombin time

206.A vitamin K deficiemncy is indicated by:

e. An FDIT
f. A low platelet count
g. An increased PT
h. A decreased PT

207.A 23-year-old student whose classmate was hospitalized 2 weeks ago with infectious mononucleosis complained of fatigue,
headaches,and chills. Petechaiae were clinically obsevable on the soft palate. If this patient had concentrated the disease, a
peripheral blood smear would likely demonstrate:
e. An increase in abnormal mononuclear cells
f. An absence of lymphocytes
g. Hypochromic red cells mycrocytic red cells
h. Macrocytic red cells

208.A diagnosis of infectious mononucleosis is most firmly established by a blood examination finding of:
a. Abnormal mononuclear cells
b. An absence of lymphocytes
c. Hypochromic red cells mycrocytic red cells
d. Macrocytic red cells
Oral Medicine (WELLS)