Chapter 4 Flashcards
Which condition does not occur in impetigo?
A) Itching
B) Pruritus
C) Regional lymphadenopathy
D) Fever
D) Fever
Fever and malaise do not occur in impetigo. Itching can occur in impetigo. Pruritus (itching) can occur in impetigo. Regional lymphadenopathy can occur in impetigo.
Which agent is used to treat impetigo?
A) Antiviral medications
B) Topical or systemic antibiotics
C) Corticosteroids
D) Nonsteroidal antiinflammatory agents
B) Topical or systemic antibiotics
Impetigo is caused by a bacterial infection; therefore, topical or systemic antibiotics are used to treat it. Antiviral medications are not used to treat impetigo. Corticosteroids are not used to treat impetigo. Nonsteroidal antiinflammatory agents are not used to treat impetigo.
Tonsillitis and pharyngitis are caused by group A β-hemolytic streptococci. These conditions are significant because of their relationship to scarlet fever and rheumatic fever. Which condition may be related to heart valve damage?
A) Rheumatic fever
B) Strawberry tongue
C) Scarlet fever
D) Geographic tongue
A) Rheumatic fever
Rheumatic fever can result in heart valve damage and the development of bacterial endocarditis. Strawberry tongue is associated with scarlet fever, but not specifically with heart valve damage. Heart valve damage is not a specific component of scarlet fever. Geographic tongue is not associated with heart valve damage.
Which antigen is injected into the skin to determine exposure and infection with Mycobacterium tuberculosis?
a. HLA-B27
b. PPD
c. VDRL
d. IgE
ANS: B
Purified protein derivative (PPD) is injected into the skin to determine whether the person has been exposed to and infected with Mycobacterium tuberculosis. HLA-B27 is an antigenic marker present in most patients with Reiter syndrome. VDRL is a serologic blood test used to confirm the diagnosis of syphilis. IgE in the immune response causes mast cells to release their granules containing histamine.
Which disease is caused by the spirochete Treponema pallidum?
A) Tuberculosis
B) Actinomycosis
C) Syphilis
D) Necrotizing ulcerative gingivitis (NUG)
C) Syphilis
Syphilis is caused by the spirochete Treponema pallidum. Tuberculosis is caused by Mycobacterium tuberculosis. Actinomycosis is an infection caused by a filamentous bacterium called Actinomyces israelii. NUG is caused by both a fusiform bacillus and a spirochete, Borrelia vincentii.
Involvement and enlargement of the submandibular and cervical lymph nodes in tuberculosis is called
A) miliary tuberculosis.
B) lymphadenopathy.
C) scrofula.
D) angioedema.
C) scrofula.
Scrofula is the name for the involvement and enlargement of the submandibular and cervical lymph nodes in tuberculosis. Miliary tuberculosis is when the bacteria are carried throughout the body, causing involvement of organs such as the kidney and liver. Lymphadenopathy is enlargement of lymph nodes associated with many illnesses and conditions. Angioedema is a diffuse swelling of tissue caused by vascular permeability of the deeper blood vessels.
Which condition is associated with scarlet fever?
A) Black hairy tongue
B) Median rhomboid glossitis
C) Scrofula
D) Strawberry tongue
D) Strawberry tongue
Strawberry tongue is associated with scarlet fever. Black hairy tongue occurs when elongation and black discoloration of the filiform papillae is present, often caused by tobacco, alcohol, hydrogen peroxide, or chemical rinses. Median rhomboid glossitis is thought to be associated with Candida organisms. Scrofula is involvement and enlargement of the submandibular and cervical lymph nodes in tuberculosis.
The most common site(s) for oral lesions in tuberculosis is(are) the
A) tongue and palate.
B) gingiva.
C) floor of the mouth and mucobuccal folds.
D) uvula and fauces.
A) tongue and palate.
The tongue and palate are the most common sites for oral lesions in tuberculosis. The gingiva is not a common site for oral lesions in tuberculosis. The floor of the mouth and mucobuccal folds are not common sites for oral lesions in tuberculosis. The uvula and fauces are not common sites for oral lesions in tuberculosis.
The most characteristic form of which disease is the formation of abscesses that tend to drain from the mandible to the skin by the formation of sinus tracts, with sulfur granules in the pus draining from the sinus tracts?
a. Actinomycosis
b. Tuberculosis
c. Syphilis
d. Impetigo
a. Actinomycosis
Actinomycosis is characterized by the formation of abscesses that tend to drain from the mandible to the skin by the formation of sinus tracts, with sulfur granules identified in the pus draining from the sinus tracts. It requires long-term antibiotic treatment. Tuberculosis is a primary infection of the lung. The signs and symptoms of this lung infection include fever, chills, fatigue, weight loss, and persistent cough. Syphilis is not characterized by abscesses and sulfur granules. Impetigo is a bacterial skin infection. The lesions are either vesicles or bullae.
In primary syphilis, the oral lesion is termed
A) mucous patch.
B) chancre.
C) gumma.
D) ulcer.
B) chancre.
A chancre is the lesion in stage I (primary) syphilis. A mucous patch is the lesion in stage II (secondary) syphilis. A gumma is the lesion in stage III (tertiary) syphilis. An ulcer is a general descriptive term and is not the specific term used to describe the lesions of syphilis.
Which statement is not true about syphilis?
A) Dark-field examination may be used to diagnose syphilitic lesions on the skin.
B) Syphilis is generally treated with penicillin.
C) The VDRL and fluorescent treponemal antibody absorption (FTA-ABS) tests are
D) commonly used to confirm the diagnosis of syphilis.
E) The antibody titer increases if treatment has been successful.
D) commonly used to confirm the diagnosis of syphilis.
The antibody titer decreases if the treatment has been successful. Dark-field examination is used to diagnose skin lesions. Syphilis is generally treated with penicillin. The VDRL and FTA-ABS tests are two serologic blood tests used to confirm the diagnosis of syphilis.
Pericoronitis is most often associated with
A) maxillary canines.
B) mandibular third molars.
C) maxillary second molars.
D) mandibular first molars.
B) mandibular third molars.
Pericoronitis most often involves the mucosal tissue associated with partially erupted mandibular third molars. Pericoronitis is not seen on maxillary canines. Pericoronitis is not seen on maxillary second molars. Pericoronitis is not seen on mandibular first molars.
Which is the name of the soft tissue flap that covers the distal-occlusal part of an incompletely erupted third molar?
A) Operculum
B) Gingival flap
C) Pericoronitis
D) Partial eruption flap
A) Operculum
The operculum is the soft tissue flap that covers the distal-occlusal part of an incompletely erupted third molar. The gingival flap is not an operculum. Pericoronitis is the inflammation of the mucosa around the crown of a partially erupted or impacted tooth. The term partial eruption flap does not exist.
Which statement is true concerning a positive reaction to the PPD skin test?
A) The patient has active tuberculosis.
B) The patient is contagious.
C) The patient has been infected previously with Mycobacterium tuberculosis.
D) The patient is in need of hospitalization.
C) The patient has been infected previously with Mycobacterium tuberculosis.
A positive skin reaction to PPD means that the patient was previously infected with the bacteria. A positive skin reaction to PPD does not mean that the patient has active tuberculosis. A positive skin reaction to PPD does not mean that the patient is contagious. A positive skin reaction to PPD does not require any hospitalization.
The gingivae shown are painful and erythematous. The interdental papillae appear as punched-out, necrotic, cratering areas. The overall sloughing of the necrotic tissue appears as a pseudomembrane over the tissues. The patient experiences a foul odor and metallic taste. On the basis of these features, which condition is suspected?
A) Acute marginal gingivitis
B) Primary herpes simplex infection
C) NUG
D) Pseudomembranous candidiasis
C) NUG
In NUG the gingiva are painful and erythematous, the interdental papillae are punched out and necrotic, and the patient experiences a foul odor and metallic taste. In acute marginal gingivitis there is no cratering and necrosis of the papillae. In primary herpes simplex infection there is no cratering and necrosis of the papillae. In pseudomembranous candidiasis a white curdlike material is present on the mucosal surfaces. The underlying mucosa appears erythematous.
Acute osteomyelitis of the jaws may commonly result from which condition?
A) Extension of a periapical abscess
B) Surgery
C) Fracture of the jaw
D) Paget disease
A) Extension of a periapical abscess
Acute osteomyelitis of the jaws commonly results from extension of a periapical abscess. Acute osteomyelitis can result from surgery, but this is not a common reaction. Acute osteomyelitis can result from fracture of the jaw, but again this is not a common reaction. Paget disease has been associated with chronic osteomyelitis.
Candidiasis is the result of an overgrowth of a
A) yeastlike fungus.
B) spirochete.
C) filamentous bacterium.
D) fusiform bacillus.
A) yeastlike fungus.
Candidiasis is the result of an overgrowth of a yeastlike fungus, Candida albicans. A spirochete, Borrelia vincentii, causes NUG. A filamentous bacterium called Actinomyces israelii causes actinomycosis. Fusiform bacilli are involved in the etiology of NUG.
Which condition does not contribute to the overgrowth of Candida albicans?
A) Antibiotic therapy
B) Dentures
C) Cancer chemotherapy
D) Angioedema
D) Angioedema
Angioedema is a type I hypersensitivity reaction and has nothing to do with Candida albicans. Antibiotic therapy can cause an overgrowth of Candida albicans. Dentures can contribute to an overgrowth of Candida albicans. Cancer chemotherapy can contribute to an overgrowth of Candida albicans.
The most common type of candidiasis affecting the oral mucosa is __________________.
A) pseudomembranous
B) erythematous
C) chronic atrophic
D) chronic hyperplastic
C) chronic atrophic
Chronic atrophic candidiasis, or denture stomatitis, is the most common type of candidiasis affecting the oral mucosa. Pseudomembranous candidiasis is a white curdlike material present on the mucosal tissues. The underlying mucosa is erythematous in appearance. It is not the most common type of oral mucosal candidiasis. Erythematous candidiasis is often painful and may be localized or generalized. It is not the most common type of oral mucosal candidiasis. Chronic hyperplastic candidiasis appears as a white lesion that does not wipe off. If it does not respond to antifungal therapy, a biopsy should be considered. It is not the most common type of candidiasis.
This lesion in the commissure is most likely caused by Candida albicans or a nutritional deficiency and is termed
A) pseudomembranous candidiasis.
B) angular cheilitis.
C) chronic mucocutaneous candidiasis.
D) chronic atrophic candidiasis.
B) angular cheilitis.
Angular cheilitis is a lesion seen in the commissure of the lips and is most likely caused by Candida albicans or a nutritional deficiency. Pseudomembranous candidiasis appears as a white curdlike material on the mucosal surface. The underlying mucosa is erythematous. Chronic mucocutaneous candidiasis is a severe form of candidiasis that occurs in patients who are severely immunocompromised. Chronic atrophic candidiasis, or denture stomatitis, is the most common type of oral candidiasis affecting the oral mucosa.
Deep fungal infections include all except
a. histoplasmosis.
b. coccidioidomycosis.
c. blastomycosis.
d. actinomycosis.
d. actinomycosis.
Actinomycosis is not a deep fungal infection. It is caused by a filamentous bacterium. Histoplasmosis is a deep fungal infection widespread in the Midwestern United States. Coccidioidomycosis is a deep fungal infection more prevalent in the Western United States. Blastomycosis is a deep fungal infection most common in the Ohio–Mississippi River basin area.
The initial infection and signs and symptoms of deep fungal infections, including histoplasmosis, coccidioidomycosis, and blastomycosis, are related to diseases in which location?
A) Lung
B) Kidney
C) Lymph nodes
D) Nasal cavity
A) Lung
Deep fungal infections are most commonly primary infections of the lung. The kidney is not the primary site for deep fungal infection. The lymph nodes are not the primary site for deep fungal infection. The nasal cavity may be a primary site for a rare fungal infection called mucormycosis.
Another name for verruca vulgaris is
A) condyloma acuminatum.
B) the common wart.
C) Heck disease.
D) focal epithelial hyperplasia.
B) the common wart.
Another name for verruca vulgaris is the common wart. Condyloma acuminatum is a benign papillary lesion sexually transmitted and caused by a human papillomavirus (HPV), which is different from the papillomavirus that causes verruca vulgaris. Heck disease is caused by an HPV that is different from the types of HPV that cause verruca vulgaris and condyloma acuminatum. The disease presents with multiple mucosal nodules and resolves spontaneously. Focal epithelial hyperplasia is another name for Heck disease.
The image shows an oral condyloma acuminatum presenting in a child. The presence of condyloma acuminatum in a child suggests
A) hypersensitivity.
B) genetic predisposition.
C) sexual abuse.
D) autoimmune disease.
C) sexual abuse.
.
The HPV that causes condyloma acuminatum is almost always transmitted by sexual contact. The presence of condyloma acuminatum in a child suggests sexual abuse. Hypersensitivity is not the cause of condyloma acuminatum. Genetic predisposition has nothing to do with the cause of condyloma acuminatum. Condyloma acuminatum is not an autoimmune disease.
The most common form of recurrent herpes simplex infection is termed
A) herpes zoster.
B) herpetic whitlow.
C) herpes labialis.
D) type 2 herpes.
C) herpes labialis.
Herpes labialis is the most common form of recurrent herpes simplex virus infection. Herpes zoster is caused by the varicella-zoster virus and is characterized by unilateral vesicles along a sensory nerve. Herpetic whitlow occurs when herpes simplex infection involves the fingers. Type 2 herpes simplex is most commonly associated with genital infections. Genital herpes simplex infections may be primary or recurrent.
The varicella-zoster virus causes a highly contagious disease in children termed
a. shingles.
b. chickenpox.
c. mumps.
d. measles.
b. chickenpox.
Chickenpox is a highly contagious disease in children caused by the varicella-zoster virus. Shingles is a recurrent form of the varicella-zoster virus. It is most commonly seen in older adults and in immunocompromised individuals. Mumps is caused by a paramyxovirus and is a viral infection of the salivary glands. Measles is a highly contagious disease caused by a paramyxovirus and is seen most commonly in children.
The highly contagious intraoral lesion seen in patients with measles is termed
A) minor salivary gland swelling.
B) generalized painful gingivitis.
C) Koplik spots.
D) candidiasis.
C) Koplik spots.
Koplik spots are erythematous macules with white necrotic centers that may occur in the oral cavity in patients with measles. Minor salivary gland swelling is not associated with measles. Generalized painful gingivitis occurs in primary herpes simplex infection. Candidiasis is one of the most common oral manifestations associated with patients who have human immunodeficiency virus (HIV).
Which virus is associated with infectious mononucleosis?
A) Herpes simplex virus
B) HPV
C) Epstein-Barr virus
D) Varicella-zoster virus
C) Epstein-Barr virus
Infectious mononucleosis is caused by the Epstein-Barr virus. Herpes simplex virus causes primary herpetic gingivostomatitis and recurrent herpes simplex virus infections. HPV is responsible for several oral viral conditions. Varicella-zoster virus causes chickenpox and shingles.
Herpangina is characterized by fever, dysphagia, erythematous pharyngitis.
It is caused by which virus?
A) Herpes simplex virus
B) Epstein-Barr virus
C) Varicella-zoster virus
D) Coxsackievirus
D) Coxsackievirus
Herpangina is caused by the coxsackievirus. Herpes simplex virus causes primary herpetic gingivostomatitis and recurrent herpes simplex virus infections. Epstein-Barr virus causes mononucleosis. Varicella-zoster virus causes chickenpox and shingles.
In testing for HIV infection, which antibody test is performed initially before the confirmatory Western blot test?
A) VDRL
B) ELISA (EIA)
C) FTA-ABS
D) CBC
B) ELISA (EIA)
The ELISA (enzyme-linked immunosorbent assay [also called EIA]) is the routine initial test used to identify HIV infection. When positive, this test is repeated, and positive results are confirmed with another laboratory test called the Western blot. VDRL is a blood test performed to diagnose syphilis. FTA-ABS is the fluorescent treponemal antibody absorption test performed to diagnose syphilis. CBC is a complete blood count and not specific for the diagnosis of HIV.
In HIV infection, which test identifies the viral titer rather than circulating antibody?
A) VDRL
B) ELISA
C) Western blot
D) PCR
*** Double check this card with slide #82***
D) PCR
In evaluating patients with HIV infection, the PCR (polymerase chain reaction) identifies virus circulating in the blood and not circulating antibody. VDRL tests for syphilis. The ELISA tests for antibodies to HIV. The Western blot test follows two positive ELISA tests for antibodies to HIV.
The most reliable method of diagnosis for this condition of the tongue is the isolation of the Epstein-Barr virus. This condition is
A) white hairy tongue.
B) hairy leukoplakia.
C) mononucleosis.
D) Kaposi sarcoma.
B) hairy leukoplakia.
Hairy leukoplakia is caused by the Epstein-Barr virus. White hairy tongue is a condition in which there is elongation of the filiform papillae; it is commonly caused by tobacco, hydrogen peroxide, chemical rinses, alcohol, or certain foods. Mononucleosis is caused by the Epstein-Barr virus, but is not a condition of the tongue. Kaposi sarcoma is a vascular neoplasm that occurs in some patients with HIV infection.
Which does not occur as a manifestation of the immune deficiency caused by HIV infection?
A) Candidiasis
B) Hairy leukoplakia
C) Kaposi sarcoma
D) Bilateral parotid atrophy
D) Bilateral parotid atrophy
Bilateral parotid enlargement, not atrophy, has been reported in patients who are HIV positive. Candidiasis is seen commonly in patients who are HIV positive. Hairy leukoplakia is often seen in patients who are HIV positive. Kaposi sarcoma is a neoplasm seen in HIV-positive patients.
The patient is HIV seropositive. The most common intraoral locations for this lesion are the gingiva and palate. When diagnosed, this vascular lesion meets the criteria for the diagnosis of acquired immune deficiency syndrome (AIDS). What is the name of the vascular lesion seen in this image?
A) Non-Hodgkin lymphoma
B) Kaposi sarcoma
C) Thrombocytopenia
D) Hemangioma
B) Kaposi sarcoma
Kaposi sarcoma is a vascular neoplasm seen on the palate or gingiva of an HIV-infected patient. Oral Kaposi sarcoma is an indication of severe immune deficiency. Non-Hodgkin lymphoma is a malignant tumor that occurs in association with HIV infection. Thrombocytopenia is a bleeding disorder associated with many systemic conditions. Hemangioma is a benign developmental proliferation of capillaries.
The lesions seen in this illustration are not commonly found in HIV-infected patients. Which is the likely diagnosis?
A) Candidiasis
B) Hairy leukoplakia
C) Herpes simplex
D) Heck disease
D) Heck disease Heck disease (focal epithelial hyperplasia) is caused by a HPV and is most commonly seen in children. Rare cases have also been described in HIV-seropositive patients. Candidiasis is commonly seen in patients who are HIV positive. Hairy leukoplakia is a common oral manifestation of HIV infection. Herpes simplex is a common component of HIV infection.
Verruca vulgaris closely resembles a papillary benign tumor of squamous epithelium termed
A) fibroma.
B) papilloma.
C) lipoma.
D) Heck disease.
B) papilloma.
Verruca vulgaris resembles the papilloma, which is a focal papillary benign tumor of squamous epithelium. A fibroma is a reactive lesion that is composed primarily of dense fibrous connective tissue surfaced by epithelium. A lipoma is a benign tumor of fat cells. Heck disease is caused by a HPV and is characterized by the presence of multiple white-to-pink nodules distributed throughout the mucosa.
In herpes labialis, the amount of virus present is highest in the __________ stage.
a. crusted
b. prodromal
c. vesicle
d. healing
c. vesicle
In herpes labialis, the amount of virus present is greatest in the vesicle stage. The crusted stage occurs after the vesicles break. Few viral particles remain at this stage. The prodromal stage occurs a few days before eruption of the vesicles. Viral particles are released at the epithelium but are fewer in number than at the vesicle stage. The healing stage occurs after the vesicles have broken. Less virus is present at this stage compared with the vesicle stage.
The type of candidiasis that appears as a white lesion that does not wipe off and does not respond to antifungal therapy is
A) pseudomembranous.
B) erythematous.
C) chronic atrophic.
D) chronic hyperplastic.
D) chronic hyperplastic.
Chronic hyperplastic candidiasis appears as a white lesion that does not wipe off. If it does not respond to antifungal therapy, a biopsy should be considered. Pseudomembranous candidiasis is a white curdlike material present on the mucosal tissues. The underlying mucosa is erythematous in appearance. Erythematous candidiasis is an erythematous, often painful mucosa that may be localized or generalized. Chronic atrophic candidiasis or denture stomatitis presents as erythematous mucosa with lesions that vary from petechiae-like to more generalized and granular.
The unilateral eruption of vesicles along the distribution of a sensory nerve seen in this adult patient is characteristic of
A) recurrent intraoral herpes simplex.
B) minor aphthous ulcers.
C) varicella-zoster or chickenpox.
D) herpes zoster or shingles.
D) herpes zoster or shingles.
Herpes zoster or shingles appears as a unilateral eruption of vesicles along the distribution of a sensory nerve. Recurrent intraoral herpes simplex occurs in the oral cavity. Minor aphthous ulcers appear in the oral cavity and not along the distribution of a sensory nerve. Varicella-zoster or chickenpox appears as vesicular and pustular eruptions of the skin and mucous membranes.
An erythematous, often rhombus-shaped, flat-to-raised area on the midline of the posterior dorsal tongue describes
A) median rhomboid glossitis.
B) geographic tongue.
C) recurrent herpes simplex infection.
D) hairy leukoplakia.
A) median rhomboid glossitis.
Median rhomboid glossitis appears as a rhombus-shaped, flat-to-raised area on the midline of the posterior dorsal tongue. It is sometimes associated with an infection from Candida albicans. Geographic tongue displays diffuse areas devoid of filiform papillae with erythematous patches surrounded by a yellow or white perimeter. Recurrent herpes simplex infection does not involve the tongue. Hairy leukoplakia is an irregular white patch seen on the lateral borders of the tongue.
Intraoral lesions of Kaposi sarcoma are often found in which two sites?
A) Labial mucosa and interdental papilla
B) Gingiva and floor of the mouth
C) Palate and gingiva
D) Uvula and posterior 1/3 of the tongue
C) Palate and gingiva
The most common locations for the appearance of Kaposi sarcoma in a person with HIV infection are the palate and gingiva.
What is a pink, papillary lesion(s), more diffuse than papilloma?
A) Condyloma acuminatum
B) Actinomycosis
C) Impetigo
D) Syphilis
A) Condyloma acuminatum
Draining abscesses, “sulfur granules”
A) Condyloma acuminatum
B) Actinomycosis
C) Impetigo
D) Syphilis
B) Actinomycosis
What condidtion is characrterized by vesicles or bullae, more often on skin of face and extremities?
A) Condyloma acuminatum
B) Actinomycosis
C) Impetigo
D) Syphilis
C) Impetigo
Multiple tiny vesicles that progress to form painful ulcers
Primary herpetic gingivostomatitis
Granulomatous lesions with primary infection to the lungs characterize what condition?
Tuberculosis
What condition is characrterized by white, papillary exophytic lesion resembling a papilloma?
Verrucous vulgaris
Irregular corrugated white lesion most commonly occurring on the lateral border of the tongue
Hairy leukoplakia
Vesicles on the soft palate along with fever, malaise, sore throat, dysphagia, and erythematous pharyngitis are characteristics of what condition?
Herpangina
Hyperplastic lymphoid tissue of the soft palate or tonsillar pillars appears as yellowish or dark pink nodules are characteristics of what condition?
Acute lymphonodular pharyngitis
What is charaterized by Koplik spots in the oral cavity and skin rash that results from a paramyxovirus?
Measles
What is characterized by and epidemic of the bilateral swelling of the parotid glands?
Mumps
The ulcer on the tongue tested postitive for ____ organisms.
This type of oral ulcereation is rare.
Tuberculosis
_____ is a rare fungal infection that often involves the nasal cavity, sinus and hard palate.
Mucormycosis (Phycomycosis)
What virus is characterized by sore throat, fever, generalized lymphadenopathy, enlarged spleen, malaise, fatigue and petechiae may appear on the palate?
Epstein-Barr Virus: Infectious Mononucleosis
Which virus is characterized by an irregular, corrugated, white lesion most commonly occuring on the lateral border of the tongue? It occurs most commonly in patients infected with HIV.
Epstein-Barr Virus: Hairy Leukoplakia
What is this?
Oral candidiasis (Thrush)
What is shown in photograph?
Herpes Simplex Infection
(meets the criteria for AIDS)
This photograph shows a malignant tumor that may occur in association with HIV infection. It appears as a nonulcerated, necrotic, or ulcerated mass that may be surfaced by ulcerated or normal-colored erythematous mucosa.
Lymphoma
