MCQ DR. AHMED AL-ARFAJ AY 1426-1427 (2005-2006) 1. Most common malformation of head and neck region is: a. b. c. d.

cleft lip and palate* hemangioma preauricular cyst malformation of ear

2. Most common type of cleft in males is: a. b. c. d. unilateral cleft lip alone unilateral cleft palate alone unilateral lip and palate* Bilateral cleft lip

3. A patient presents with small yellow spots, present bilaterally on buccal mucosa opposite to posterior teeth without any other associated complaint. Most probable diagnosis of the condition is: a. b. c. d. Kopliks spot Fordyces granules* Melanotic macule White sponge nevus

4. A patient presented with asymptomatic, smooth, circumscribed red area in midline anterior to circumvallate papillae on the dorsum of tongue with microscopic evidence of epithelial hyperplasia. The most probable diagnosis of the condition is: a. b. c. d. geographic tongue hairy tongue median rhomboid glossitis* lingual thyroid

5. In hairy tongue, there is hypertrophy of: a. b. c. d. fungiform papillae filiform papillae* foliate papillae circumvallate papillae

6. A patient present with an asymptomatic soft, fluctuant swelling of the angle of mandible anterior to sternocleido-mastoid muscle which he stated to be present since his childhood days. Regional lymph nodes are nonpalpable with normal radiographic pictures of the area and normal blood and urine examination. Aspiration of swelling shows yellow-brown fluid. Most probable diagnosis in the condition is: a. b. c. d. thyroglossal duct cyst salivary gland tumor branchial cleft cyst* follicular ameloblastoma

7. Which of the following condition is characterized by generalized intestinal polyposis with pigmentation of face and oral mucosa: a. b. c. d. Peutz-Jeghens syndrome* Albright syndrome Gardner syndrome Neurofibromatosis

8. A 25-year al patient presents with an asymptomatic doughy soft, fluctuant swelling on lateral neck which was present for month but recently enlarged following an upper respiratory tract infection. Most likely diagnosis of the swelling is: a. b. c. d. scrofula lymphoma cervicofacial actinomycosis cervical lymphoepithelial cyst*

9. Most characteristic histopathologic feature of keratoacanthoma is: a. elevation of normal epithelium towards the central portion of the lesion with an abrupt change in normal epithelium as hyperplastic acanthotic epithelium is reached* b. hyperplastic squamous epithelium growing into underlying connective tissue c. occasional dysplastic features d. epithelium appears to be invading into connective tissue at deep leading margin of the tumor 10. A patient reported with an asympthomatic white patch on buccal mucosa which cannot be rubbed off. The patch was present for the last 3 months. Patient is a heavy cigarette smoker. Most probable diagnosis of the lesion is: a. b. c. d. Leukoplasia* Candidiasis Erythroplakia White sponge nevus 2

11. Site most commonly affected by basal cell carcinoma is: a. b. c. d. buccal mucosa skin of palm and exposed surface of arms skin of upper back area skin of middle third of face*

12. A patient with history of tobacco chewing presents with an asymptomatic, exophytic papillary growth on right buccal mucosa. Histologic examination of the lesion reveal marked epit helial proliferation without invasion into the connective tissue and parakeratin plugging. Most probable diagnosis is: a. b. c. d. epidermoid carcinoma basal cell carcinoma papilloma verrucous carcinoma*

13. A patient present with tender swelling in the palatal area. Associated teeth were normal. Radiographic examination of the area shows radiolucent area with honeycomb appearance. Excessive bleeding was encountered upon entering into the lesion. Most probable diagnosis of the lesion is: a. b. c. d. radicular cyst aneurysmal bone cyst* hemorrhagic bone cyst mid-palatal cyst

14. Skin lesions of the hereditary hemorrhagic telangiectasia are most common on: a. b. c. d. arms abdomen legs face*

15. Characteristic hemorrhagic lesions of the hereditary hemorrhagic telangiectasia occurs most often on a. b. c. d. Tongue Lips* Gingival Palate

16. A 70-year old patient present with small, elevated, crusted lesion on right side of nose which he stated to be present for last several months and never quite heals. The most likely diagnosis is: a. b. c. d. Epidermoid carcinoma Verrucous carcinoma Sebaceous cyst Basal cell carcinoma* 3

17. A patient presents with a bilateral greyish white lesion on buccal mucosa which disappear when stretched. The most likely diagnosis is: a. b. c. d. Lichen planus Leukoplakia Leukoedema* White sponge nevus

18. All of the following diseases has been associated with Epstein-Barr virus EXCEPT: a. b. c. d. Burkitts lymphoma Malignant mixed tumor Oral hairy leukoplakia* Infectious mononucleosis

19. An elderly anemic patient complains of back pain. Numerous punched out radiolucencies are evident on skull radiograph. The patient should be suspected of having: a. b. c. d. Ewings sarcoma Thalassaemia Multiple myeloma* Malignant lymphoma

20. Basal cell carcinoma frequently involves normal tissues by spreading by way of: a. b. c. d. lymphatics arteries nerve sheaths direct invasion*

21. A benign neoplasm which appears as a non-painful slowly enlarging, submucosal mass with overlying epithelium exhibiting pseudoepitheliomatous hyperplasia is most likely a: a. b. c. d. fibroma granular cell tumor* papilloma keratoacanthoma

22. Examination of a child shows enlargement of left side of tongue showing small, elevated greyish-pink nodules some of which are fluid filled with rest of oral cavity being normal. Most likely diagnosis of the lesion is: a. b. c. d. neurofibromatosis lymphangioma* granular cell myoblastoma cystic fibrosis

23. Biopsy of a smooth, red, protruding lesion at lateral, border of tongue shows stratified squamous epithelium covering loose connective tissue that contains many thin-walled engorged, vascular space. Most likely diagnosis is: a. b. c. d. papilloma hemangioma* lymphangioma granular cell myoblastoma

24. Multiple lesions seen in patients suffering from von Recklinghaussens disease of skin are: a. b. c. d. neurofibromas* neurolemmomas hemangiomas griant cell tumors

25. Most common site of occurrence of salivary gland tumors is a. b. c. d. parotid gland* sub-maxillary gland sub-lingual gland minor salivary gland

26. Primary Sjogrens syndrome consists of keratoconjunctivitis sicca and: a. b. c. d. Xerostomia* Rheumatoid arthritis SLE Scleroderma

27. Triad of Sjogren syndrome consists of: a. b. c. d. conjunctivitis, stomatitis, rheumatoid arthritis keratoconjunctivitis, xerostomia, rherumatoid arthritis* keratoconjunctivitis, xerostomia, osteoarthritis conjunctivitis, stomatitis, urethritis

28. Radiographic appearance of salivary glands in Sjogrens syndrome is characteristically described as: a. b. c. d. sun-ray appearance cherry-blossom or branchless fruit laden tree appearance* honeycomb appearance onion-peel appearance

29. Patients affected by Sjogrens syndrome shows increased incidence of development of: a. b. c. d. osteosarcoma lymphoma* multiple myeloma adenocarcinoma 5

30. Majority of lymphomas developed in patients of Sjogens syndrome are of: a. b. c. d. Hodgkins lymphoma Burkitts lymphoma Non-hodgkin lymphoma of B-cell origin* Non-hodgkin lymphoma of T-cell origin

31. The common site of occurrence of adenoid cystic carcinoma is: a. b. c. d. parotid gland* palatal mucosa upper lip sub-mandibular gland

32. Most suggested etiology of necrotizing sialometaplasia is: a. b. c. d. trauma infection ischaemia* neoplastic changes

33. Which of the following salivary gland neoplasm is least likely to be found in minor salivary glands a. b. c. d. papillary cystadenoma lymphomatosum* adenoid cycstic carcinoma mucoepidermoid carcinoma pleomorphic adenoma

34. A 40-year old woman reports the development of painful crater like ulcer on mucosa of left hard palate within one week following the extraction of maxillary left second premolar. Most likely diagnosis is: a. b. c. d. pleomorphic adenoma squamous cell carcinoma necrotizing sialometaplasia* adenoid cystic carcinoma

35. An elderly woman present with swelling of lateral aspect of left side of neck which was present for last ten months but start increasing in size for the last two months and is now painful. There is small ulceration of skin overlying the mass with distortion of left facial region when patient speaks. Differential diagnosis will include all of the following EXCEPT: a. b. c. d. adenoid cystic carcinoma pleomorphic adenoma* mucoepidermoid carcinoma malignant mixed tumor

36. Toxin produced by streptococci which is responsible for causing scarlet fever is: a. b. c. d. first day illness second or third day of illness* fifth to seventh day of illness one week after appearance of other clinical signs and symptoms

37. In miliary tuberculosis, dissemination of microorganism occur usually via: a. b. c. d. lymphatics blood streams* saliva pulmonary fluid

38. A patient presents with mild fever, sore throat and ulceration of fascial pillars, posterior pharyngeal wall and soft palate. Most likely diagnosis is: a. b. c. d. Reiter syndrome Herpangina* Herpetis gingivostomatitis Recurrent rhomboid glossitis

39. A patient on antibiotic therapy for scarlet fever develops white plaques on his oral mucosa which when scraped with tongue blade leaves a painful bleeding surface, most probable diagnosis is: a. b. c. d. Blastomycosis Candidiasis* Herpes simplex infection Syphilis

40. Which of the following is most opportunistic infection? a. b. c. d. Candidiasis* Actinomycosis Histoplasmosis Blastomycosis

41. Sulfur granules are of diagnostic value is suspected cases of: a. b. c. d. Candidiasis Tuberculosis Actinomycosis* Histoplasmosis

42. A patient presents with slightly painful white lesions of oral mucosa which when wiped off shows the red surface underneath. The patient is on penicillin therapy for last 12 weeks. The most likely diagnosis of lesion is: a. b. c. d. Actinomycosis Candidiasis* Lichen planus Leukoplakia 7

43. Clinical diagnosis of candidiasis is confirmed by: a. response to vitamin B12 therapy b. demonstration of mycelia and spores on histologic examination of scrapings* c. sun-ray arrangement of fungal hyphae d. presence of characteristic sulfur granules 44. A patient with severe mycotic infection of head and neck characterized by triad of uncontrolled diabetes, orbital infection and meningoencephalitis most probably has: a. b. c. d. Candidiasis Actinomycosis Mucormycosis* Histoplasmosis

45. The organism most commonly implicated as causative agents in cases of cellulites is: a. b. c. d. Staphylococcus sp. Streptococcus sp.* Neisseria sp Pheumococcus sp.

46. A middle age patient presents swelling in the left maxillary area with mild pain on palpation. On examination, left maxillary first molar was missing and patient gives the history of traumatic extraction of the tooth about 10 year ago in which one of the root was displaced in the maxillary sinus which was then removed via Caldwell-Luc operation. Overlying skin and other teeth were normal. X-ray examination shows a radiolucent are in left maxilla which was separated from left maxillary sinus anatomically. Most probable diagnosis of the condition is: a. b. c. d. surgical ciliated cyst of maxilla* maxillary sinusitis carcinoma of maxillary antrum retention cyst of maxillary sinus

47. A patient presents with swelling in neck near the angle of mandible on right side which disappear on applying pressure to it. Intraorally a dome-shaped, bluish swelling present in floor of mouth on right side. Most likely diagnosis of the lesion is: a. b. c. d. mucocele dermoid cyst branchial cyst ranula*

48. Sialoliths are mainly composed of: a. b. c. d. calcium phosphate* calcium oxide calcium carbonate calcium suphate

49. Which of the following cells are most radioresistant? a. b. c. d. granulocyte muscle cell lymphocyte epithelial cell*

50. Which of the following tissue is mot sensitive to radiation induced carcinogenesis? a. b. c. d. Thyroid* liver salivary gland brain

51. Craniofacial dysostosis with syndactyly is also known as: a. b. c. d. Crouzons syndrome Apert syndrome* Treacher Collins syndrome Eranceschetti syndrome

52. Triangular frontal defect, parrots beak nose, hypertelorism and prognathic mandible are features of: a. b. c. d. mandibulofacial dysostosis craniofacial dysostosis* Pierre Robin syndrome Cleidocranial dysostosis

53. A female patient complains of pain in right ear radiating towards the angle of mandible. Clicking sounds were present in right temporomandibular joint. Results of palpation and radiographic examination are negative. The most probable diagnosis is: a. b. c. d. osteoarthritis rheumatoid arthritis myofacial pain dysfunction syndrome* traumatic arthritis

54. Which of the following groups of lymph nodes is first to exhibit lymphadenopathy in cases of infection monocucleous? a. b. c. d. axillary cervical* inguinal mediastinal 9

55. An early oral manifestation of infectious mononucleosis is; a. b. c. d. palatal petechiae* oral ulceration inflammation of mucous membrane edema of soft palate and uvula

56. Philadelphia chromosome is characteristically seen in: a. b. c. d. acute lymphocytic leukaemia acute monocytic leukaemia chronic lymphocytic leukaemia chronic myeloid leukaemia*

57. Most common form of leukaemia in children is: a. b. c. d. acute lymphocytic leukaemia* chronic myeloid leukaemia acute monocytic leukaemia chronic lymphocytic leukaemia

58. In thrombocytopenic purpura: a. b. c. d. bleeding time is normal, clotting time is prolonged Both bleeding and clotting time are prolonged Bleeding time is prolonged, clotting time is normal* Both bleeding time and clotting time are norma

59. Hemophilia A is caused to deficiency of: a. Factor VIII* b. Factor IX c. Factor V d. Factor X 60. In hemophilia A: a. Prothrombine time (PT) is normal, plasma thromboplastin time (PTT) is normal b. PT is prolonged, PTT is prolonged c. PT is normal, PTT is prolonged* d. PT is prolonged, PTT is normal 61. A patient presents with spontaneous necrotizing ulcers of oral cavity. On laboratory examination, RBC count was normal but WBC count was 2,000 with lymphocytes 65% neutrophils 5%, monocytes 28%, eosinophils 2% and basophils 0%. The most likely diagnosis is: a. b. c. d. infectious mononucleosis agranulocytosis* cyclic neutropenia leukaemia 10

62. A patient presents with petechiae on oral mucosa with gingival bleeding. Blood examination shows platelet count of 30,000/mm3 with increase in bleeding time and clot retraction time, RBC, TLC are normal. Most probable diagnosis is: a. b. c. d. hemophilia infectious mononucleosis thrombocytopenic purpura* anemia

63. A middle-aged patient complains of periodic burning of her buccal mucosa. Oral examination shows slightly raised, linear, grayish-white plaque on buccal mucosa. Biopsy of the lesion shows acanthosis, surface keratosis with vacuolation of cells of basal cell layer with cellular inflammatory infiltrate localized to subepithelial connective tissue. Most likely diagnosis is: a. b. c. d. Lichen planus* Leokoedema Luekoplakia Pemphigoid

64. Sudden development of intensely red, wheal-like lesions on oral mucosa which progress to form thin-walled vesicles which ruptures to form ulceration covered by yellowish-white membrane suggests a diagnosis of: a. b. c. d. Reiters syndrome Behcets syndrome Erythema multiforme* Pemphigus

65. A patient presents with an asymptomatic white corrugated patch present bilaterally on his buccal mucosa. He also reports the occurrence of same kind of lesion in his mother and younger brother. Most likely diagnosis is: a. b. c. d. Pemphigus Leukoedema Candidiasis White sponge nevus*

66. An elderly patient complains of burning, aching pain, paresthesia, and itching on one side of face. On examination, small white scars are seen in preauricular region. Most likely diagnosis is: a. b. c. d. Sphenopalalatine neuralgia Bells palsy Auriculotemporal syndrome Post-herpetic neuralgia*

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67. Dysphagia, sore throat, pharyngeal pain which occurs due to elongated styloid process exerting pressure on pharyngeal wall is known as: a. b. c. d. Trotters syndrome Eagles syndrome* Glossopharyngeal neuralgia Orofacial dyskinesia

68. A patient presents with an asymptomatic submucosal lump in his tongue. On histopathologic examination, it shows cells with extremely granular eosinophillic cytoplasm. Pseudoepitheliomatous hyperplasia was also present. Most likely diagnosis of the lesion is: a. b. c. d. lymphangioma granular cell myoblastoma* hemangioma lingual thyroid

69. In which of the following condition, serum alkaline phosphatase levels are increased? a. b. c. d. Paget;s disease* Osteogenesis imperfecta Osteopetrosis Cherubism

70. Diffuse white lesions are seen in the mouth of a 6-month old child who is on antibiotic therapy for the cystic fibrosis. The white patches could be stripped off leaving a raw, red surface. The most likely diagnosis of the condition is: a. b. c. d. acute herpetic stomatitis diphtheria oral thrush* herpangina

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