MCQDR. AHMED AL-ARFAJAY 1426-1427 (2005-2006)

1. Most common malformation of head and neck region is:

a. cleft lip and palate*b. hemangiomac. preauricular cystd. malformation of ear

2. Most common type of cleft in males is:

a. unilateral cleft lip aloneb. unilateral cleft palate alonec. unilateral lip and palate*d. 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. Koplik’s spotb. Fordyce’s granules*c. Melanotic maculed. 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. geographic tongueb. hairy tonguec. median rhomboid glossitis*d. lingual thyroid

5. In hairy tongue, there is hypertrophy of:

a. fungiform papillaeb. filiform papillae*c. foliate papillaed. circumvallate papillae

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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. thyroglossal duct cystb. salivary gland tumorc. branchial cleft cyst*d. follicular ameloblastoma

7. Which of the following condition is characterized by generalized intestinal polyposis with pigmentation of face and oral mucosa:

a. Peutz-Jeghens syndrome*b. Albright syndromec. Gardner syndromed. 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. scrofulab. lymphomac. cervicofacial actinomycosisd. 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 featuresd. 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. Leukoplasia*b. Candidiasisc. Erythroplakiad. White sponge nevus

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11. Site most commonly affected by basal cell carcinoma is:

a. buccal mucosab. skin of palm and exposed surface of armsc. skin of upper back aread. 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. epidermoid carcinomab. basal cell carcinomac. papillomad. 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. radicular cystb. aneurysmal bone cyst*c. hemorrhagic bone cystd. mid-palatal cyst

14. Skin lesions of the hereditary hemorrhagic telangiectasia are most common on:

a. armsb. abdomenc. legsd. face*

15. Characteristic hemorrhagic lesions of the hereditary hemorrhagic telangiectasia occurs most often on

a. Tongueb. Lips*c. Gingivald. 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. Epidermoid carcinomab. Verrucous carcinomac. Sebaceous cystd. Basal cell carcinoma*

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17. A patient presents with a bilateral greyish white lesion on buccal mucosa which disappear when stretched. The most likely diagnosis is:

a. Lichen planusb. Leukoplakiac. Leukoedema*d. White sponge nevus

18. All of the following diseases has been associated with Epstein-Barr virus EXCEPT:

a. Burkitt’s lymphomab. Malignant mixed tumorc. Oral hairy leukoplakia*d. 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. Ewing’s sarcomab. Thalassaemiac. Multiple myeloma*d. Malignant lymphoma

20. Basal cell carcinoma frequently involves normal tissues by spreading by way of:

a. lymphaticsb. arteriesc. nerve sheathsd. 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. fibromab. granular cell tumor*c. papillomad. 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. neurofibromatosisb. lymphangioma*c. granular cell myoblastomad. cystic fibrosis

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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. papillomab. hemangioma*c. lymphangiomad. granular cell myoblastoma

24. Multiple lesions seen in patients suffering from von Recklinghaussen’s disease of skin are:

a. neurofibromas*b. neurolemmomasc. hemangiomasd. griant cell tumors

25. Most common site of occurrence of salivary gland tumors is

a. parotid gland*b. sub-maxillary glandc. sub-lingual glandd. minor salivary gland

26. Primary Sjogren’s syndrome consists of keratoconjunctivitis sicca and:

a. Xerostomia*b. Rheumatoid arthritisc. SLEd. Scleroderma

27. Triad of Sjogren’ syndrome consists of:

a. conjunctivitis, stomatitis, rheumatoid arthritisb. keratoconjunctivitis, xerostomia, rherumatoid arthritis*c. keratoconjunctivitis, xerostomia, osteoarthritisd. conjunctivitis, stomatitis, urethritis

28. Radiographic appearance of salivary glands in Sjogren’s syndrome is characteristically described as:

a. sun-ray appearanceb. cherry-blossom or branchless fruit laden tree appearance*c. honeycomb appearanced. onion-peel appearance

29. Patients affected by Sjogren’s syndrome shows increased incidence of development of:

a. osteosarcomab. lymphoma*c. multiple myelomad. adenocarcinoma

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30. Majority of lymphomas developed in patients of Sjogen’s syndrome are of:

a. Hodgkin’s lymphomab. Burkitt’s lymphomac. Non-hodgkin lymphoma of B-cell origin*d. Non-hodgkin lymphoma of T-cell origin

31. The common site of occurrence of adenoid cystic carcinoma is:

a. parotid gland*b. palatal mucosac. upper lipd. sub-mandibular gland

32. Most suggested etiology of necrotizing sialometaplasia is:

a. traumab. infectionc. ischaemia*d. neoplastic changes

33. Which of the following salivary gland neoplasm is least likely to be found in minor salivary glands

a. papillary cystadenoma lymphomatosum*b. adenoid cycstic carcinomac. mucoepidermoid carcinomad. 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. pleomorphic adenomab. squamous cell carcinomac. necrotizing sialometaplasia*d. 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. adenoid cystic carcinomab. pleomorphic adenoma*c. mucoepidermoid carcinomad. malignant mixed tumor

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36. Toxin produced by streptococci which is responsible for causing scarlet fever is:

a. first day illnessb. second or third day of illness*c. fifth to seventh day of illnessd. one week after appearance of other clinical signs and symptoms

37. In miliary tuberculosis, dissemination of microorganism occur usually via:

a. lymphaticsb. blood streams*c. salivad. 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. Reiter syndromeb. Herpangina*c. Herpetis gingivostomatitisd. 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. Blastomycosisb. Candidiasis*c. Herpes simplex infectiond. Syphilis

40. Which of the following is most opportunistic infection?

a. Candidiasis*b. Actinomycosisc. Histoplasmosisd. Blastomycosis

41. “Sulfur granules” are of diagnostic value is suspected cases of:

a. Candidiasisb. Tuberculosisc. Actinomycosis*d. 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. Actinomycosisb. Candidiasis*c. Lichen planusd. Leukoplakia

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43. Clinical diagnosis of candidiasis is confirmed by:

a. response to vitamin B12 therapyb. demonstration of mycelia and spores on histologic examination of

scrapings*c. sun-ray arrangement of fungal hyphaed. 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. Candidiasisb. Actinomycosisc. Mucormycosis*d. Histoplasmosis

45. The organism most commonly implicated as causative agents in cases of cellulites is:

a. Staphylococcus sp.b. Streptococcus sp.*c. Neisseria spd. 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. surgical ciliated cyst of maxilla*b. maxillary sinusitisc. carcinoma of maxillary antrumd. 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. mucoceleb. dermoid cystc. branchial cystd. ranula*

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48. Sialoliths are mainly composed of:

a. calcium phosphate*b. calcium oxidec. calcium carbonated. calcium suphate

49. Which of the following cells are most radioresistant?

a. granulocyteb. muscle cellc. lymphocyted. epithelial cell*

50. Which of the following tissue is mot sensitive to radiation induced carcinogenesis?

a. Thyroid*b. liverc. salivary glandd. brain

51. Craniofacial dysostosis with syndactyly is also known as:

a. Crouzon’s syndromeb. Apert syndrome*c. Treacher Collin’s syndromed. Eranceschetti syndrome

52. Triangular frontal defect, parrot’s beak nose, hypertelorism and prognathic mandible are features of:

a. mandibulofacial dysostosisb. craniofacial dysostosis*c. Pierre Robin syndromed. 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. osteoarthritisb. rheumatoid arthritisc. myofacial pain dysfunction syndrome*d. traumatic arthritis

54. Which of the following groups of lymph nodes is first to exhibit lymphadenopathy in cases of infection monocucleous?

a. axillaryb. cervical*c. inguinald. mediastinal

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55. An early oral manifestation of infectious mononucleosis is;

a. palatal petechiae*b. oral ulcerationc. inflammation of mucous membraned. edema of soft palate and uvula

56. “Philadelphia chromosome” is characteristically seen in:

a. acute lymphocytic leukaemiab. acute monocytic leukaemiac. chronic lymphocytic leukaemiad. chronic myeloid leukaemia*

57. Most common form of leukaemia in children is:

a. acute lymphocytic leukaemia*b. chronic myeloid leukaemiac. acute monocytic leukaemiad. chronic lymphocytic leukaemia

58. In thrombocytopenic purpura:

a. bleeding time is normal, clotting time is prolongedb. Both bleeding and clotting time are prolongedc. Bleeding time is prolonged, clotting time is normal*d. Both bleeding time and clotting time are norma

59. Hemophilia A is caused to deficiency of:

a. Factor VIII*b. Factor IXc. Factor Vd. Factor X

60. In hemophilia A:

a. Prothrombine time (PT) is normal, plasma thromboplastin time (PTT) is normal

b. PT is prolonged, PTT is prolongedc. 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. infectious mononucleosisb. agranulocytosis*c. cyclic neutropeniad. leukaemia

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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. hemophiliab. infectious mononucleosisc. thrombocytopenic purpura*d. 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. Lichen planus*b. Leokoedemac. Luekoplakiad. 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. Reiter’s syndromeb. Behcet’s syndromec. Erythema multiforme*d. 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. Pemphigusb. Leukoedemac. Candidiasisd. 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 pre-auricular region. Most likely diagnosis is:

a. Sphenopalalatine neuralgiab. Bell’s palsyc. Auriculotemporal syndromed. 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. Trotter’s syndromeb. Eagle’s syndrome*c. Glossopharyngeal neuralgiad. 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. lymphangiomab. granular cell myoblastoma*c. hemangiomad. lingual thyroid

69. In which of the following condition, serum alkaline phosphatase levels are increased?

a. Paget;s disease*b. Osteogenesis imperfectac. Osteopetrosisd. 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. acute herpetic stomatitisb. diphtheriac. oral thrush*d. herpangina

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