Deck 17: Effects of Systemic Disease on Nutritional Status and Oral Health

Question 1

Clinically, the dental hygienist would expect to see each of the following except one in a patient with vitamin B₁₂ deficient megaloblastic anemia. Which one is the exception?

A) Angular cheilosis
B) Dark red oral mucosa
C) Recurrent aphthous ulcers
D) Erythematous mucositis

Answer 1

Dark red oral mucosa

Question 2

Individuals with loss of smell are inclined to do each of the following except one. Which one is the exception?

A) Use more spices.
B) Eat less.
C) Eat and drink more sweets.
D) Lose weight.

Answer 2

Eat and drink more sweets.

Question 3

Neurologic deficits can cause patients to be unaware of the presence of food in the mouth. Pocketed foods remain in the mouth, especially the vestibule, after meals in patients.

A) Both statements are true.
B) Both statements are false.
C) The first statement is true; the second is false.
D) The first statement is false; the second is true.

Answer 3

Both statements are true.

Question 4

The term appetite is applicable to each of the following statements except one. Which one is the exception?

A) Appetite is associated with enjoyment of food.
B) Most healthy people have very little appetite.
C) During illness, appetite can decrease because of pain, apathy, anorexia or drugs.
D) Poor intake can further lessen the desire to eat.

Question 5

The dental hygienist should encourage a patient who has gastroesophageal reflux to:

A) bring his or her blood glucose monitor.
B) avoid eating for two hours prior to the appointment.
C) avoid iron-rich foods.
D) drink orange juice before beginning treatment.

Question 6

A vegan dental patient with a nonheme iron anemia should take vitamin D supplements before invasive dental procedures because absorption of nonheme iron is enhanced by vitamin D.

A) Both the statement and the reason are correct and related.
B) Both the statement and the reason are correct but are not related.
C) The statement is correct, but the reason is not correct.
D) The statement is not correct, but the reason is correct.
E) Neither the statement nor the reason is correct.

Question 7

Each of the following should be recommended for patients with cardiovascular disease except one. Which one is the exception?

A) Salt substitutes
B) Xylitol
C) Fluoride
D) Nitrous oxide during dental treatment

Question 8

Cardiovascular disease (CVD) produces numerous oral effects. A causative relationship has been established between periodontal disease and CVD.

A) Both statements are true.
B) Both statements are false.
C) The first statement is true; the second is false.
D) The first statement is false; the second is true.

Question 9

Each of the following is a complication of neutropenia except one. Which one is the exception?

A) Mucositis
B) Stomatitis
C) Fungal infections
D) Viral infections
E) Candidiasis

Question 10

Dental hygienists are in a key position to assess and detect signs and symptoms of systemic disease because more than one third of the patients treated in a dental office frequently do not interact with a general healthcare provider.

A) Both the statement and the reason are correct and related.
B) Both the statement and the reason are correct but are not related.
C) The statement is correct, but the reason is not correct.
D) The statement is not correct, but the reason is correct.
E) Neither the statement nor the reason is correct.

Question 11

Each of the following is a gastrointestinal problem except one. Which one is the exception?

A) Gastroesophageal reflux disease
B) Hirsutism
C) Hiatal hernia
D) Esophagitis

Question 12

Taste perception, especially the intensity of sweet taste, declines with age. Individuals taking three or more medications are likely to have less taste sensitivity and require greater amounts of sodium and sugar to perceive these tastes.

A) Both statements are true.
B) Both statements are false.
C) The first statement is true; the second is false.
D) The first statement is false; the second is true.

Question 13

The type of medication most likely to induce xerostomia is:

A) antibiotics.
B) diuretics.
C) local anesthetics.
D) anticholinergic.

Question 14

All disease processes result from a combination of the following factors except one. Which one is the exception?

A) Failure to have an annual physical examination
B) Presence of an etiologic agent
C) Susceptibility of the host
D) Resistance of the host
E) Environmental factors

Question 15

Patients having experienced mini-strokes may have dysphagia, because gastronomy has impaired the swallowing reflex.

A) Both the statement and the reason are correct and related.
B) Both the statement and the reason are correct but are not related.
C) The statement is correct, but the reason is not correct.
D) The statement is not correct, but the reason is correct.
E) Neither the statement nor the reason is correct.

Question 16

Pain in the tongue is called:

A) glossopharyngeal.
B) glossitis.
C) glossodynia.
D) macroglossia.

Question 17

Blood pressure consistently 140/90 mm Hg or higher is stage 1 hypertension. Diuretics are frequently prescribed for patients with hyperlipidemia.

A) Both statements are true.
B) Both statements are false.
C) The first statement is true; the second is false.
D) The first statement is false; the second is true.

Question 18

Each of the following is a chronic disease or condition associated with poor nutrient absorption except one. Which one is the exception?

A) Crohn disease
B) Ulcerative colitis
C) Gluten-sensitive enteropathy
D) Celiac disease
E) Ischemia

Question 19

Typical symptoms of all anemias are flushed skin and erythematous oral tissues. The type of anemia can be determined only after evaluation of blood tests.

A) Both statements are true.
B) Both statements are false.
C) The first statement is true; the second is false.
D) The first statement is false; the second is true.

Question 20

A blood clot blocking an artery that is capable of causing a cerebrovascular accident is called an aneurysm. Atherosclerosis, caused by an accumulation of fatty materials, results in narrow and rough arterial walls.

A) Both statements are true.
B) Both statements are false.
C) The first statement is true; the second is false.
D) The first statement is false; the second is true.

Question 21

The dental hygienist should have three or four glucose tablets available because some oral diabetes medications are often combined with an oral agent that causes hypoglycemia.

A) Both the statement and the reason are correct and related.
B) Both the statement and the reason are correct but are not related.
C) The statement is correct, but the reason is not correct.
D) The statement is not correct, but the reason is correct.
E) Neither the statement nor the reason is correct.

Question 22

A generalized malignant disease characterized by distorted proliferation and development of white blood cells (WBCs) is called:

A) leukoplakia.
B) leukemia.
C) human papillomavirus.
D) micrognathia.

Question 23

Nutrients potentially harmful to renal (kidney) patients on dialysis include each of the following except one. Which one is the exception?

A) Phosphorus
B) Magnesium
C) Protein
D) Some vitamins

Question 24

Individuals with bulimia may be described as achievement-oriented perfectionists. Bulimia, which is synonymous with anorexia nervosa, is characterized by intentional and controllable secret periods of overeating usually followed by purging.

A) Both statements are true.
B) Both statements are false.
C) The first statement is true; the second is false.
D) The first statement is false; the second is true.

Question 25

For a patient with megaloblastic anemia caused by folic acid deficiency, which of the following suggestions are appropriate for a dental hygienist to provide? (Select all that apply.)

A) Daily intake of folate is necessary.
B) Take oral vitamin B₁₂ or iron supplements without food.
C) Patients with permanent gastric or ileal damage need vitamin B₁₂ supplementation for several months.
D) Vitamin B₁₂ shots are always indicated for "tired blood."
E) Raw vegetables are a better source of folate than cooked vegetables.

Question 26

Few dental and periodontal changes and no oral mucosal changes are observed in well-controlled diabetes. The fruity-smelling breath characteristic of diabetes is more common in type 2 diabetes.

A) Both statements are true.
B) Both statements are false.
C) The first statement is true; the second is false.
D) The first statement is false; the second is true.

Question 27

Which statement most accurately reflects current thinking on prescription of bisphosphonates as they relate to osteonecrosis?

A) All patients taking bisphosphonates develop osteonecrosis.
B) The risk of osteonecrosis in patients taking bisphosphonates is negligible.
C) Patients at risk for osteonecrosis have a history of large doses of intravenous bisphosphonates.
D) Osteonecrosis occurs in 1 of 10 people taking bisphosphonates.

Question 28

Dental hygienists should encourage patients with eating disorders such as bulimia to brush immediately after vomiting because self-induced vomiting causes erosion of tooth enamel and dentin hypersensitivity.

A) Both the statement and the reason are correct and related.
B) Both the statement and the reason are correct but are not related.
C) The statement is correct, but the reason is not correct.
D) The statement is not correct, but the reason is correct.
E) Neither the statement nor the reason is correct.

Question 29

Which of the following are associated with diabetes mellitus? (Select all that apply.)

A) Oral candidiasis
B) Severe periodontitis
C) Bradykinesia
D) Micrognathia
E) Resistance to infections

Question 30

Which of the following are describe oral conditions diabetic patients and dental hygienists should watch for? (Select all that apply.)

A) Changes in the fit of partial denture or bridges
B) Pain when chewing
C) Pale gingiva
D) Teeth feeling "tight"
E) Gingival hyperplasia

Question 31

Patients receiving dialysis are likely to be deficient in each of the following vitamins and minerals except one. Which one is the exception?

A) Vitamin K
B) B-complex vitamins
C) Vitamin C
D) Iron
E) Zinc

Question 32

Crowded teeth resulting from retarded growth of the mandible occur in hyperparathyroidism. Systemic bone disturbances are reflected orally in patients with hypopituitarism by jaw enlargement.

A) Both statements are true.
B) Both statements are false.
C) The first statement is true; the second is false.
D) The first statement is false; the second is true.

Question 33

Childhood hypopituitarism results in diastemata between most teeth because increased skeletal growth results in enlargement of both the mandible and the maxilla.

A) Both the statement and the reason are correct and related.
B) Both the statement and the reason are correct but are not related.
C) The statement is correct, but the reason is not correct.
D) The statement is not correct, but the reason is correct.
E) Neither the statement nor the reason is correct.

Question 34

Which of the follow accurately describe function and disease of the kidneys? (Select all that apply.)

A) The kidney is second to the liver in the elimination of waste products.
B) Progressive loss of nephrons leads to acute kidney failure.
C) During kidney dysfunction, complications arise as by-products accumulate from protein metabolism.
D) Calcium-phosphorus imbalances cause various changes in bone.
E) Odynophagia results from alterations in electrolyte and pH levels.

Question 35

Which of the following is correct and advisable for patients with gastrointestinal problems? (Select all that apply.)

A) Avoid foods that increase the likelihood of reflux.
B) Limit caffeine, chocolate, alcohol, and carbonated beverages.
C) Commonly called heartburn, enzyme tablet supplementation is advisable.
D) Eating small meals throughout the day is advisable.
E) Nitrous oxide during dental treatment decreases the likelihood of an episode.

Question 36

Oral manifestations of renal (kidney) disease include each of the following except one. Which one is the exception?

A) Delayed eruption
B) Enamel hypoplasia
C) Pulp calcifications
D) Dysphagia
E) Tooth mobility

Question 37

Chemotherapeutic drugs cause each of the following detrimental effects except one. Which one is the exception?

A) Hypogeusia
B) Anosmia
C) Slow cellular turnover rate in alimentary tract
D) Stomatitis
E) Mucositis

Question 38

Which condition can be caused by inadequate iodine and results in short stature, poor muscle tone, and intellectual disabilities when it occurs at birth or in young children?

A) Hypothyroidism
B) Hyperparathyroidism
C) Parkinson disease
D) Kaposi sarcoma

Question 39

Each of the following is true of blood glucose levels except one. Which one is the exception?

A) Before dental treatment, blood glucose level should be between 70 and 200 mg/dL.
B) Long and stressful appointments may require testing during the appointment.
C) A glycated hemoglobin A1c is less than 6.5%, indicating that diabetes is well controlled.
D) The dental hygienist should have injectable glucose available.

Question 40

Intake of which nutrients is most frequently cited as being negatively affected by oral problems and dentate status? (Select all that apply.)

A) Protein
B) Vitamin C
C) Fiber
D) Vitamin D
E) Vitamin K

Question 41

It is important that the dental hygienist understand the effects of systemic disease on nutritional status and oral health. Match each disease, condition, or medication with its most appropriate description.
Can occur secondarily to a tumor, head trauma, or infection in the brain

A)Phantom taste
B)Pernicious anemia
C)Neutropenia
D)Bisphosphonates
E)Goitrogens
F)Hypopituitarism
G)Brown tumors
H)Osteosclerosis
I)Neoplasia

Question 42

Which of the following are oral complications of acquired immunodeficiency disease? (Select all that apply.)

A) Candidiasis
B) Lipodystrophy
C) Oral hairy leukoplakia
D) Necrotizing ulcerative gingivitis
E) Polyphagia

Question 43

It is important that the dental hygienist understand the effects of systemic disease on nutritional status and oral health. Match each disease, condition, or medication with its most appropriate description.
Replace bone in hyperparathyroidism

A)Phantom taste
B)Pernicious anemia
C)Neutropenia
D)Bisphosphonates
E)Goitrogens
F)Hypopituitarism
G)Brown tumors
H)Osteosclerosis
I)Neoplasia

Question 44

It is important that the dental hygienist understand the effects of systemic disease on nutritional status and oral health. Match each disease, condition, or medication with its most appropriate description.
Abnormal mass of tissue

A)Phantom taste
B)Pernicious anemia
C)Neutropenia
D)Bisphosphonates
E)Goitrogens
F)Hypopituitarism
G)Brown tumors
H)Osteosclerosis
I)Neoplasia

Question 45

It is important that the dental hygienist understand the effects of systemic disease on nutritional status and oral health. Match each disease, condition, or medication with its most appropriate description.
Osteonecrosis

A)Phantom taste
B)Pernicious anemia
C)Neutropenia
D)Bisphosphonates
E)Goitrogens
F)Hypopituitarism
G)Brown tumors
H)Osteosclerosis
I)Neoplasia

Question 46

It is important that the dental hygienist understand the effects of systemic disease on nutritional status and oral health. Match each disease, condition, or medication with its most appropriate description.
Diminished number of white blood cells

A)Phantom taste
B)Pernicious anemia
C)Neutropenia
D)Bisphosphonates
E)Goitrogens
F)Hypopituitarism
G)Brown tumors
H)Osteosclerosis
I)Neoplasia

Question 47

It is important that the dental hygienist understand the effects of systemic disease on nutritional status and oral health. Match each disease, condition, or medication with its most appropriate description.
Hypothyroidism

A)Phantom taste
B)Pernicious anemia
C)Neutropenia
D)Bisphosphonates
E)Goitrogens
F)Hypopituitarism
G)Brown tumors
H)Osteosclerosis
I)Neoplasia

Question 48

It is important that the dental hygienist understand the effects of systemic disease on nutritional status and oral health. Match each disease, condition, or medication with its most appropriate description.
Lingering unpleasant taste even though nothing is in the mouth

A)Phantom taste
B)Pernicious anemia
C)Neutropenia
D)Bisphosphonates
E)Goitrogens
F)Hypopituitarism
G)Brown tumors
H)Osteosclerosis
I)Neoplasia

Question 49

It is important that the dental hygienist understand the effects of systemic disease on nutritional status and oral health. Match each disease, condition, or medication with its most appropriate description.
Megaloblastic anemia associated with vitamin B₁₂ deficiency

A)Phantom taste
B)Pernicious anemia
C)Neutropenia
D)Bisphosphonates
E)Goitrogens
F)Hypopituitarism
G)Brown tumors
H)Osteosclerosis
I)Neoplasia

Question 50

It is important that the dental hygienist understand the effects of systemic disease on nutritional status and oral health. Match each disease, condition, or medication with its most appropriate description.
Hardening or abnormal density of bone

A)Phantom taste
B)Pernicious anemia
C)Neutropenia
D)Bisphosphonates
E)Goitrogens
F)Hypopituitarism
G)Brown tumors
H)Osteosclerosis
I)Neoplasia