Deck 9: Systemic Pathology and Oral Manifestations of Systemic Diseases

Question 1

The most common cause of hypothyroidism is an autoimmune condition known as:

A) Lupus erythematosus
B) Sjögren syndrome
C) Hashimoto thyroiditis.
D) Type 1 diabetes mellitus

Answer 1

Hashimoto thyroiditis.

Question 2

Patients with Hashimoto thyroiditis have an increased susceptibility to other autoimmune diseases including all of the following EXCEPT:

A) Sjögren syndrome
B) Pituitary adenoma
C) Lupus erythematosus
D) Type I diabetes mellitus

Answer 2

Pituitary adenoma

Question 3

All of the following are head and neck manifestations of thyrotoxicosis EXCEPT:

A) Decreased susceptibility to caries and periodontal disease
B) Goiter
C) Burning oral pain
D) Osteoporosis of the jaws

Answer 3

Decreased susceptibility to caries and periodontal disease

Question 4

Hormone secretion is controlled by:

A) The blood-brain barrier
B) A negative feedback loop
C) Dilution in the bloodstream
D) Sequestration in the bone marrow

Question 5

All the following hormones are secreted by the anterior pituitary EXCEPT:

A) Melanocyte-stimulating hormone (MSH)
B) Adrenocorticotrophic hormone (ACTH)
C) Oxytocin
D) Growth hormone (GH)

Question 6

All of the following are examples of endocrine glands EXCEPT:

A) Pancreas
B) Parathyroid glands
C) Thyroid
D) Salivary glands

Question 7

Hypothyroidism in older children or adults is known as:

A) Cretinism
B) Addison's disease
C) Thyrotoxicosis
D) Myxedema

Question 8

Thyroid-stimulating hormone (TSH) is secreted by which of the following glands?

A) Adrenal
B) Thyroid
C) Posterior pituitary
D) Anterior pituitary

Question 9

Parathyroid hormone (PTH) acts to elevate the serum calcium in all of the following ways EXCEPT:

A) Mobilizing calcium from bone
B) Enhancing adsorption of calcium from the small intestine
C) Decreasing calcium loss in the urine
D) Mobilizing cortisol from the adrenal glands

Question 10

Triiodothyronine (T3) and thyroxin (T4) are hormones secreted by the:

A) Hypothalamus
B) Pituitary gland
C) Thyroid gland
D) Adrenal gland

Question 11

Clinical features of Graves' disease include all of the following EXCEPT:

A) Alopecia
B) Weight gain despite decreased appetite
C) Exophthalmos
D) Enlarged thyroid

Question 12

The endocrine system acts to control metabolism, growth, and tissue functions by secreting which one of the following?

A) Hormones
B) White blood cells
C) Platelets
D) Enzymes

Question 13

Untreated thyrotoxicosis can lead to thyroid storm, a life-threatening condition that results in a(n):

A) Underactive thyroid
B) Hypometabolic state
C) Hypermetabolic state
D) Underactive anterior pituitary

Question 14

Use of which of the following drugs is contraindicated in uncontrolled hyperthyroidism?

A) Morphine
B) Acetaminophen
C) Diphenhydramine
D) Epinephrine

Question 15

The parathyroid glands:

A) Are important in the regulation of serum calcium and bone health
B) Have functions closely related to the thyroid gland
C) Are important in the regulation of sodium levels in peripheral blood
D) Have functions closely related to magnesium clearance

Question 16

Elevation of GH levels in children, before they reach their normal growth potential, result in:

A) Acromegaly
B) Gigantism
C) Graves' disease
D) Cretinism

Question 17

Cretinism is hypothyroidism that develops in:

A) Infancy or early childhood
B) The elderly, greater than 65 years
C) Adults with chronic debilitating diseases
D) Young adults 20-35 years

Question 18

Clinical effects caused by excess thyroid hormones in the blood are known as:

A) Addison's disease
B) Cretinism
C) Paget's disease
D) Thyrotoxicosis

Question 19

Reduction in growth hormone production or lack of response to the hormone results in:

A) Dwarfism
B) Gigantism
C) Acromegaly
D) Addison's disease

Question 20

All of the following statements are characteristic of acromegaly EXCEPT:

A) There is enlargement of the tongue and protrusion of the mandible.
B) Gradually enlarging hands, feet, and head are common.
C) There is widening of interproximal spaces between normal sized teeth.
D) Blood tests reveal decreased growth hormone levels.

Question 21

Patients with Cushing's syndrome most commonly exhibit all of the following clinical features EXCEPT:

A) Moon facies
B) Buffalo hump
C) Mandibular prognathism
D) "Moon on stick" appearance

Question 22

Which of the following is NOT known to play a role in the development of type 2 diabetes mellitus?

A) Genetics
B) Height
C) Obesity
D) Sedentary lifestyle

Question 23

The oral manifestations of diabetes mellitus may include all of the following EXCEPT:

A) Impaired wound healing
B) Burning mouth
C) Fissured tongue
D) Increased risk of infections

Question 24

The adrenal medulla is responsible for the production of:

A) Aldosterone
B) Sex steroid androgens such as testosterone
C) Epinephrine and norepinephrine
D) Cortisol

Question 25

The adrenal glands are located:

A) Within the medulla oblongata
B) On the superior pole of each kidney
C) Over the superior lobe of the liver
D) Superior to the posterior pituitary gland

Question 26

A 65-year-old female with prolonged history of type 2 diabetes mellitus comes in for her regular recall appointment. She reports she did not have time for breakfast this morning, but took her insulin on time. During the dental procedure, the hygienist observes the patient to be confused and shaky with some sweating. What should the dental hygienist do first?

A) Stop the procedure and provide fast-releasing glucose.
B) Stop the procedure and activate the emergency response system.
C) Continue the treatment, but raise the back of the dental chair so that the patient is upright.
D) Try to complete the appointment as quickly as possible.

Question 27

Which of the following is a trademark of uncontrolled diabetes?

A) Hyperthyroidism
B) Hypercortisolism
C) Hypoglycemia
D) Ketoacidosis

Question 28

Diabetic neuropathy is:

A) The result of repeated opportunistic infections
B) A painful condition of the extremities
C) Associated with an increased risk of myocardial infarction
D) A result of ketoacidosis

Question 29

The adrenal glands are involved in the production of all of the following EXCEPT:

A) Cortisol
B) Catecholamines
C) Vitamin D
D) Aldosterone

Question 30

Hypercortisolism, characterized by prolonged elevated levels of cortisol in the body, is also known as:

A) Acromegaly
B) Cushing's syndrome
C) Grave's disease
D) Gigantism

Question 31

Patients with Cushing's syndrome:

A) Have a decreased risk of osteoporosis and depression
B) Are prone to develop hypoglycemia
C) Have decreased levels of cortisol in the body
D) Prone to infection due to immune suppression

Question 32

Thalassemias are a group of inherited blood disorders that are characterized by:

A) Sickle-shaped red blood cells
B) Defective production of hemoglobin
C) Excessive production of white blood cells
D) Decreased production of platelets in the bone marrow

Question 33

The most common cause of acanthosis nigricans is:

A) Type 1 diabetes mellitus
B) Type 2 diabetes mellitus
C) Hypocalcaemia
D) Hyperparathyroidism

Question 34

Brown tumors of hyperparathyroidism have a microscopic appearance similar to:

A) Adenomatoid odontogenic tumors
B) Central giant cell granulomas
C) Metastatic disease
D) Squamous cell carcinoma

Question 35

Hypocortisolism, a condition of adrenal insufficiency, is also known as:

A) Addison's disease
B) Grave's disease
C) Cushing's syndrome
D) Cretinism

Question 36

Dark, thick, velvety skin in body folds and creases, and zones of papillomatosis are characteristic of:

A) Cretinism
B) Acromegaly
C) Hyperparathyroidism
D) Acanthosis nigricans

Question 37

The most common cause of secondary hyperparathyroidism is:

A) Cardiac insufficiency
B) Liver toxicity
C) Chronic renal failure
D) Pulmonary edema

Question 38

Insulin is a hormone produced in response to:

A) Decreased blood glucose
B) Increased triiodothyronine
C) Decreased thyroxin
D) Elevated blood glucose

Question 39

Which of the following features is characteristic of primary Addison's disease?

A) Enlargement of the liver and spleen
B) Hyperpigmentation of the skin and oral mucosa
C) Kidney failure
D) Hypopigmentation of the skin and oral mucosa

Question 40

Clinical manifestations of hypoparathyroidism most often include all of the following EXCEPT:

A) Myocardial infarction and stroke
B) Seizures
C) Numbness and tingling sensations of the lips and fingers
D) Muscular spasms of the distal extremities or respiratory tract

Question 41

Polycythemia vera increases the risk of:

A) Thrombus formation
B) Hemochromatosis
C) Aplastic anemia
D) Hemophilia

Question 42

Vitamin B₁₂ deficiency and pernicious anemia are related to:

A) Impaired vitamin D absorption
B) Decreased risk for developing gastric cancer
C) Increased risk for developing sickle cell anemia
D) Destruction of parietal cells in the stomach

Question 43

Which of the following is NOT an oral manifestation associated with iron deficiency?

A) Atrophic glossitis
B) Oral candidiasis and angular cheilitis
C) Burning sensation on tongue
D) Spontaneous gingival hemorrhage

Question 44

Which of the following is the most common inherited bleeding disorder in the United States?

A) Hemophilia A
B) von Willebrand disease
C) Hemophilia B
D) Hereditary hemorrhagic telangiectasia

Question 45

All of the following describe petechiae EXCEPT:

A) Pinpoint hemorrhages of capillaries
B) Less than 3 mm in size
C) Clusters of tiny red-purple spots
D) Bruises or hematomas greater than 1 cm

Question 46

Christmas disease is also known as:

A) Hereditary hemorrhagic telangiectasia
B) Hemophilia A
C) von Willebrand disease
D) Hemophilia B

Question 47

Clinical features of thalassemia major (Cooley anemia) include all of the following EXCEPT:

A) "Chipmunk facies"
B) Growth retardation
C) Thyrotoxicosis
D) "Hair on end" appearance on skull radiographs

Question 48

Hemostasis refers to:

A) An insufficient amount of hemoglobin
B) Elevated levels of hemoglobin
C) Stoppage of blood loss from a damaged blood vessel
D) Elevated levels of blood calcium

Question 49

All clotting factors, except for factor VIII and von Willebrand factor, are produced in the:

A) Lymph nodes
B) Liver
C) Spleen
D) Bone marrow

Question 50

Hereditary hemorrhagic telangiectasia is an inherited disorder of abnormal blood vessel formation that is also known as:

A) Osler-Weber-Rendu disease
B) von Willebrand disease
C) Ehlers-Danlos syndrome
D) Plummer-Vinson syndrome

Question 51

Which of the following is the most common type of hemophilia?

A) von Willebrand disease
B) Hemophilia B
C) Hemophilia A
D) Hemophilia C

Question 52

Oral manifestations of sickle cell anemia include all of the following EXCEPT:

A) Loss of papillae on the dorsum of the tongue
B) Striae of Wickham
C) Oral ulcers
D) Osteomyelitis of the jaw

Question 53

The main difference between Crohn's disease and ulcerative colitis is the:

A) Severity of the signs and symptoms
B) Etiology
C) Location of inflammatory changes within the gastrointestinal tract
D) Type of inflammatory response present

Question 54

Increased numbers of tiny red vascular lesions on the vermillion zone of the lips, tongue, and buccal mucosa are characteristic of:

A) Hemophilia A
B) Hereditary hemorrhagic telangiectasia
C) von Willebrand disease
D) Hemophilia B

Question 55

Diseases of hemoglobin are known as:

A) Hemaglobulinopathies
B) Leukocytosis
C) Leukopenia
D) Thrombocytopenic purpura

Question 56

Plummer-Vinson syndrome presents most often in:

A) Postmenopausal women
B) Infants
C) Elderly males
D) Young adults

Question 57

Which of the following vitamins is needed for the production of hemoglobin?

A) Vitamin C
B) Vitamin A
C) Vitamin B₁₂
D) Vitamin D

Question 58

The etiologic agents of iron deficiency anemia include all of the following EXCEPT:

A) Excessive acute or chronic blood loss
B) Impaired absorption of iron
C) Excessive intake of iron rich foods
D) Increased demand of iron by the body

Question 59

Glossitis, dysphagia, and iron deficiency anemia are components of which of the following?

A) Hemophilia
B) Plummer-Vinson syndrome
C) Sickle cell disorder
D) Thalassemia major

Question 60

Yellow pustules with a "snail-track" appearance on the oral mucosa are characteristic of:

A) Hyperbilirubinemia
B) Pyostomatitis vegetans
C) von Willebrand disease
D) Hereditary hemorrhagic telangiectasia

Question 61

Increased elasticity of the skin and extremely flexible joints are characteristic of someone with:

A) Crohn's disease
B) CREST syndrome
C) von Willebrand disease
D) Ehlers-Danlos syndrome

Question 62

What is the most common oral manifestation of amyloidosis?

A) Macroglossia
B) Hypodontia
C) Fissured tongue
D) Gingival hypoplasia

Question 63

Raynaud's phenomenon is characterized by:

A) Neonatal hyperbilirubinemia
B) Vasoconstriction of blood vessels underlying the skin
C) Jaundice of the conjunctiva and skin
D) Intrinsic staining of the primary teeth

Question 64

Thiamine (vitamin B₁) deficiency leads to the condition known as:

A) Beriberi
B) Scurvy
C) Spina bifida
D) Pellagra

Question 65

Which of the following is NOT a cardinal sign of CREST syndrome?

A) Esophageal dysmotility
B) Sclerodactyly
C) Spontaneous pneumothorax
D) Telangiectasia

Question 66

Niacin (vitamin B₃) leads to the condition also known as:

A) Beriberi
B) Pernicious anemia
C) Spina bifida
D) Pellagra

Question 67

Deficiency of vitamin D in children produces the condition known as:

A) Scurvy
B) Hypervitaminosis
C) Osteomalacia
D) Rickets

Question 68

Which of the following is NOT a fat-soluble vitamin?

A) Vitamin A
B) Vitamin D
C) Vitamin C
D) Vitamin E

Question 69

What medical treatment increases the risk of amyloidosis?

A) Radiation therapy
B) Renal dialysis
C) Botox injections
D) Electromyography