Deck 9: Oral Manifestations of Systemic Diseases

Question 1

Insulin is manufactured by:

A)fatty tissue in long bones.
B)beta cells of the pancreas.
C)the liver.
D)the gallbladder.

Answer 1

beta cells of the pancreas.

Question 2

A megaloblastic anemia is characterized by red blood cells that are:

A)hypochromic and macrocytic.
B)hyperchromic and macrocytic.
C)microcytic and have nuclei.
D)macrocytic and have nuclei.

Answer 2

macrocytic and have nuclei.

Question 3

Which of the following statements is true concerning oral complications for adult patients with diabetes mellitus?

A)Patients with diabetes mellitus have a decreased response to plaque.
B)Slow wound healing and decreased susceptibility to infection occur as a result of the immunologic changes and defective collagen production.
C)The gingiva can be hyperplastic and erythematous.
D)Periodontal disease is not considered to be a complication of diabetes.

Answer 3

The gingiva can be hyperplastic and erythematous.

Question 4

Hyperparathyroidism may result in bone lesions that appear microscopically to be indistinguishable from a(n):

A)osteogenic sarcoma.
B)osteoma.
C)cemento-osseous dysplasia.
D)central giant cell granuloma.

Question 5

The most common cause of death among patients with diabetes is:

A)stroke.
B)gangrene.
C)heart attack.
D)kidney failure.

Question 6

Pernicious anemia is caused by a deficiency of intrinsic factor, which is secreted by:

A)beta cells of the pancreas.
B)parietal cells of the stomach.
C)the gallbladder.
D)the adrenal glands.

Question 7

Characteristics of acromegaly include:

A)an increase in growth hormone production before the closure of long bones.
B)a rapid and dramatic onset.
C)thinned lips and microglossia.
D)enlargement of the maxilla and mandible, resulting in separation of the teeth and malocclusion.

Question 8

Byetta is:

A)an oral product for the treatment of type 1 diabetes.
B)a form of insulin derived from pigs.
C)a medication that has the potential to help restore the response of the body's insulin-producing cells.
D)delivered with a pump that provides the medication on the hour over a 24-hour period.

Question 9

An enlarged tongue is associated with:

A)hyperpituitarism.
B)hyperthyroidism.
C)hypothyroidism.
D)hyperparathyroidism.

Question 10

Mediterranean or Cooley anemia:

A)is caused by a deficiency of vitamin B₁₂.
B)has a sex-linked inheritance pattern and occurs predominantly in males.
C)is called thalassemia major in the homozygous form.
D)is caused by a dietary deficiency of folic acid.

Question 11

Because of an abnormal type of hemoglobin in the red blood cells of a patient with sickle cell anemia, the cells develop a sickle shape in the presence of:

A)low blood sugar.
B)decreased oxygen.
C)wheat gluten.
D)increased carbon dioxide.

Question 12

Thalassemia is:

A)caused by an abnormal type of hemoglobin in red blood cells.
B)a disorder of hemoglobin synthesis.
C)caused by a severe depression of bone marrow activity.
D)caused by an increase in the number of circulating red blood cells.

Question 13

Advantages of an insulin pump for therapy of type 1 diabetes include:

A)blood sugar levels no longer need to be monitored.
B)the pump is internal.
C)the pump can maintain a more predictable control of blood sugar levels than multiple insulin injections.
D)the insulin dosage with the pump is limited to once-a-day dosing.

Question 14

Which of the following statements about type 1 diabetes is true?

A)It is called non-insulin-dependent diabetes mellitus.
B)About 30% of all patients with diabetes have type 1 diabetes.
C)The onset of this type of diabetes is gradual and usually occurs in patients who are 35 to 40 years of age or older.
D)It can be complicated by polydipsia, polyuria, and polyphagia.

Question 15

Which of the following statements is characteristic of hyperparathyroidism?

A)It is characterized by low blood levels of calcium.
B)It is characterized by high levels of blood phosphorus.
C)Primary hyperparathyroidism occurs when calcium is abnormally excreted by the kidneys and the parathyroid glands increase their production of parathyroid hormone to maintain adequate blood levels of calcium.
D)Kidney failure is the most common cause of secondary hyperparathyroidism.

Question 16

The most common cause of hyperthyroidism is:

A)hyperplasia of the gland.
B)benign and malignant tumors of the gland.
C)pituitary gland disease.
D)an autoimmune disorder.

Question 17

Excess production by the anterior pituitary gland is called:

A)hyperparathyroidism.
B)hyperthyroidism.
C)hyperpituitarism.
D)hyperglycemia.

Question 18

A "salt and pepper" effect may be noted on intraoral radiographs of a patient with which of the following types of anemia?

A)Sickle cell anemia
B)Aplastic anemia
C)Thalassemia
D)Pernicious anemia

Question 19

The most common cause of hyperpituitarism is:

A)hepatomegaly.
B)hypercalcemia.
C)pituitary adenoma.
D)hyperglycemia.

Question 20

Which of the following clinical features is associated with hyperthyroidism?

A)Gigantism
B)Exophthalmos
C)Myxedema
D)Hypercalcemia

Question 21

A reddish-blue or purple discoloration of the skin or mucosa that results from spontaneous extravasation of blood and is caused by an increase in capillary fragility or a deficiency in blood platelets is referred to as:

A)hemophilia.
B)Bruton disease.
C)purpura.
D)pernicious anemia.

Question 22

Polycythemia vera is caused by:

A)a neoplastic proliferation of bone marrow stem cells.
B)a physiologic response to decreased oxygen.
C)decreased plasma volume.
D)smoking.

Question 23

The normal laboratory value for prothrombin time is:

A)1 to 3 seconds.
B)11 to 16 seconds.
C)25 to 40 seconds.
D)1 to 6 minutes.

Question 24

Which of the following disorders of red blood cells and hemoglobin is associated with sensitivity to dietary gluten found in wheat and wheat products?

A)Aplastic anemia
B)Polycythemia vera
C)Secondary polycythemia
D)Celiac sprue

Question 25

Which of the following statements concerning polycythemia vera is true?

A)It may be caused by living at high altitudes or by an elevation in carbon monoxide.
B)Causes include use of diuretics, vomiting, diarrhea, and excessive sweating.
C)It occurs primarily in children.
D)The cause is unknown.

Question 26

Osteonecrosis of the maxilla and mandible is a complication associated with what type of drug?

A)Phenytoin
B)Nifedipine
C)Bisphosphonate
D)Cyclosporine

Question 27

Thrombocytopenic purpura results from a:

A)defect in the capillary walls.
B)disorder of platelet function.
C)severe reduction in circulating platelets.
D)reduction in white blood cells.

Question 28

The International Normalized Ratio (INR) is an expression of the ratio of prothrombin time to:

A)fibrinogen.
B)thromboplastin activity.
C)proaccelerin.
D)proconvertin.

Question 29

Which of the following statements is true concerning X-linked congenital agammaglobulinemia?

A)T cells do not mature.
B)Plasma cells are normal.
C)B cells do not mature.
D)B cells are normal.

Question 30

Leukopenia most commonly involves:

A)neutrophils.
B)basophils.
C)eosinophils.
D)monocytes.

Question 31

A "hair-on-end" pattern may be noted on skull radiographs of a patient with:

A)polycythemia.
B)aplastic anemia.
C)sickle cell anemia.
D)thalassemia.

Question 32

Which of the following drugs may be taken during the course of radiation treatment to reduce the severity of radiation-induced xerostomia?

A)Prednisone
B)Pilocarpine hydrochloride
C)Aspirin
D)Nonsteroidal antiinflammatory drugs

Question 33

A genetic disorder in which B cells do not mature, T cells are normal, plasma cells are deficient throughout the body, and patients are highly susceptible to autoimmune diseases is referred to as:

A)secondary immunodeficiency.
B)X-linked congenital agammaglobulinemia.
C)thymic hypoplasia.
D)DiGeorge syndrome.

Question 34

Which of the following statements about primary aplastic anemia is true?

A)It is caused by a virus.
B)The bone marrow failure is the result of a drug or chemical agent.
C)It is associated with chemotherapy, radioactive isotopes, radium, or radiant energy.
D)The cause is unknown.

Question 35

A malignant neoplasm of the hematopoietic stem cells and characterized by an excessive number of abnormal white blood cells is:

A)leukemia.
B)hemophilia.
C)thrombocytopenic purpura.
D)DiGeorge syndrome.

Question 36

Which of the following medications can decrease the severity of radiation-induced xerostomia in patients with oral cancer?

A)Bisphosphonates
B)Cyclosporine
C)Indomethacin
D)Pilocarpine hydrochloride

Question 37

Bisphosphonate therapy is used to treat all of the following diseases except one. Which one is the exception?

A)Hyperparathyroidism
B)Osteoporosis
C)Multiple myeloma
D)Metastatic breast cancer

Question 38

The Philadelphia chromosome is associated with _____ leukemia.

A)acute lymphoblastic
B)acute nonlymphoblastic
C)chronic lymphoblastic
D)chronic granulocytic

Question 39

Type A hemophilia is less common than type B hemophilia. Type A hemophilia is caused by a deficiency of the clotting factor called plasma thromboplastinogen or factor VIII.

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 40

Which of the following statements is true concerning acute lymphoblastic leukemia versus acute myeloblastic leukemia?

A)Acute lymphoblastic leukemia primarily affects children and young adults and has a poor prognosis.
B)Acute myeloblastic leukemia primarily affects children and young adults and has a poor prognosis.
C)Acute lymphoblastic leukemia primarily affects children and young adults and has a good prognosis.
D)Acute myeloblastic leukemia primarily affects children and young adults and has a good prognosis.

Question 41

Which of the following is not a chronic disorder associated with sensitivity to dietary gluten?

A)Celiac disease
B)Gluten-sensitive enteropathy
C)Celiac sprue
D)Sickle cell trait

Question 42

A platelet count of less than _____/mm³ is considered thrombocytopenia.

A)20,000
B)100,000
C)150,000
D)400,000

Question 43

_____ is characterized by insufficient production of adrenal steroids.

A)Addison disease
B)Addison syndrome
C)Cushing disease
D)Cushing syndrome

Question 44

Which of the following vitamins is needed for deoxyribonucleic acid (DNA) synthesis and, when lacking, affects the development of rapidly dividing cells in bone marrow and epithelium?

A)Thiamin
B)Vitamin B₁₂
C)Riboflavin
D)Vitamin C

Question 45

Myxedema is caused by _____ of the _____ gland.

A)hypersecretion; thyroid
B)hyposecretion; thyroid
C)hypersecretion; adrenal
D)hyposecretion; adrenal

Question 46

Elevated blood levels of calcium, low levels of blood phosphorus, and abnormal bone metabolism are characteristic of which type of endocrine disorder?

A)Hyperpituitarism
B)Hyperthyroidism
C)Hypothyroidism
D)Hyperparathyroidism

Question 47

MATCHING
For each vocabulary word below, select the corresponding definition from the list provided.

Hepatomegaly

A)Severe pain in a joint
B)Reduction of the number of red blood cells
C)Chronic excessive thirst and intake of fluid
D)Small, flat, hemorrhagic patch larger than a petechia on the skin
E)Cell surface protein to which a specific molecule (e.g., a hormone) can bind
F)Stoppage or cessation of bleeding
G)Decrease in number of granulocytes
H)Muscle pain
I)Insoluble protein that is essential for the clotting of blood
J)Platelet
K)Enlargement of the liver
L)Increase in the total red blood cell mass in the blood
M)Abnormal rarefaction of bone
N)Decrease in the number of platelets in circulating blood

Question 48

The recommended treatment for folic acid and vitamin B₁₂ deficiency anemias is:

A)surgery.
B)dietary supplements.
C)medications.
D)radiation therapy.

Question 49

Iron-deficiency anemia may first result in loss of _____ papillae on the dorsum of the tongue because they have the highest metabolic requirement.

A)filiform
B)fungiform
C)circumvallate
D)foliate

Question 50

MATCHING
For each vocabulary word below, select the corresponding definition from the list provided.

Myalgia

A)Severe pain in a joint
B)Reduction of the number of red blood cells
C)Chronic excessive thirst and intake of fluid
D)Small, flat, hemorrhagic patch larger than a petechia on the skin
E)Cell surface protein to which a specific molecule (e.g., a hormone) can bind
F)Stoppage or cessation of bleeding
G)Decrease in number of granulocytes
H)Muscle pain
I)Insoluble protein that is essential for the clotting of blood
J)Platelet
K)Enlargement of the liver
L)Increase in the total red blood cell mass in the blood
M)Abnormal rarefaction of bone
N)Decrease in the number of platelets in circulating blood

Question 51

Plummer-Vinson syndrome can develop as a result of long-standing _____ anemia.

A)pernicious
B)iron-deficiency
C)thalassemia
D)aplastic

Question 52

In aplastic anemia, patients experience a dramatic decrease in all the circulating blood cells because of a severe depression of bone marrow activity.

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

Question 53

The production of adrenal steroids is normally stimulated by release of _____ hormone from the pituitary gland.

A)follicle-stimulating
B)luteinizing
C)adrenocorticotropic
D)growth

Question 54

Diabetes is characterized by abnormally high blood _____ levels.

A)phosphorus
B)calcium
C)glucose
D)neutrophil

Question 55

All of the following statements are true regarding type 2 diabetes mellitus except one. Which one is the exception?

A)It is non-insulin-dependent.
B)The majority of patients are diagnosed with type 2 diabetes.
C)Contributing factors include a decrease in metabolic rate and weight gain.
D)Complications include polydipsia, polyuria, and polyphagia.

Question 56

Which of the following types of hyperparathyroidism is the result of an overproduction of parathyroid hormone (PTH) in response to long-term decreased levels of serum calcium often associated with chronic renal disease?

A)Primary hyperparathyroidism
B)Secondary hyperparathyroidism
C)Tertiary hyperparathyroidism
D)Familial hyperparathyroidism

Question 57

Type A hemophilia is caused by a deficiency of factor _____.

A)VII
B)VIII
C)IX
D)X

Question 58

The red blood cells appear _____ and _____ in cases of iron-deficiency anemia.

A)microcytic; hypochromic
B)microcytic; hyperchromic
C)macrocytic; hypochromic
D)macrocytic; hyperchromic

Question 59

The Schilling test detects an inability to absorb an oral dose of vitamin _____.

A)B₆
B)B₁₂
C)C
D)E

Question 60

_____ is an autosomal-dominant inherited disorder of platelet function.

A)Bruton disease
B)von Willebrand disease
C)DiGeorge syndrome
D)Hemophilia

Question 61

MATCHING
For each vocabulary word below, select the corresponding definition from the list provided.

Thrombocytopenia

A)Severe pain in a joint
B)Reduction of the number of red blood cells
C)Chronic excessive thirst and intake of fluid
D)Small, flat, hemorrhagic patch larger than a petechia on the skin
E)Cell surface protein to which a specific molecule (e.g., a hormone) can bind
F)Stoppage or cessation of bleeding
G)Decrease in number of granulocytes
H)Muscle pain
I)Insoluble protein that is essential for the clotting of blood
J)Platelet
K)Enlargement of the liver
L)Increase in the total red blood cell mass in the blood
M)Abnormal rarefaction of bone
N)Decrease in the number of platelets in circulating blood

Question 62

MATCHING
For each vocabulary word below, select the corresponding definition from the list provided.

Fibrin

A)Severe pain in a joint
B)Reduction of the number of red blood cells
C)Chronic excessive thirst and intake of fluid
D)Small, flat, hemorrhagic patch larger than a petechia on the skin
E)Cell surface protein to which a specific molecule (e.g., a hormone) can bind
F)Stoppage or cessation of bleeding
G)Decrease in number of granulocytes
H)Muscle pain
I)Insoluble protein that is essential for the clotting of blood
J)Platelet
K)Enlargement of the liver
L)Increase in the total red blood cell mass in the blood
M)Abnormal rarefaction of bone
N)Decrease in the number of platelets in circulating blood

Question 63

MATCHING
For each vocabulary word below, select the corresponding definition from the list provided.

Polydipsia

A)Severe pain in a joint
B)Reduction of the number of red blood cells
C)Chronic excessive thirst and intake of fluid
D)Small, flat, hemorrhagic patch larger than a petechia on the skin
E)Cell surface protein to which a specific molecule (e.g., a hormone) can bind
F)Stoppage or cessation of bleeding
G)Decrease in number of granulocytes
H)Muscle pain
I)Insoluble protein that is essential for the clotting of blood
J)Platelet
K)Enlargement of the liver
L)Increase in the total red blood cell mass in the blood
M)Abnormal rarefaction of bone
N)Decrease in the number of platelets in circulating blood

Question 64

MATCHING
For each vocabulary word below, select the corresponding definition from the list provided.

Thrombocyte or mucous membrane

A)Severe pain in a joint
B)Reduction of the number of red blood cells
C)Chronic excessive thirst and intake of fluid
D)Small, flat, hemorrhagic patch larger than a petechia on the skin
E)Cell surface protein to which a specific molecule (e.g., a hormone) can bind
F)Stoppage or cessation of bleeding
G)Decrease in number of granulocytes
H)Muscle pain
I)Insoluble protein that is essential for the clotting of blood
J)Platelet
K)Enlargement of the liver
L)Increase in the total red blood cell mass in the blood
M)Abnormal rarefaction of bone
N)Decrease in the number of platelets in circulating blood

Question 65

MATCHING
For each vocabulary word below, select the corresponding definition from the list provided.

Ecchymosis

A)Severe pain in a joint
B)Reduction of the number of red blood cells
C)Chronic excessive thirst and intake of fluid
D)Small, flat, hemorrhagic patch larger than a petechia on the skin
E)Cell surface protein to which a specific molecule (e.g., a hormone) can bind
F)Stoppage or cessation of bleeding
G)Decrease in number of granulocytes
H)Muscle pain
I)Insoluble protein that is essential for the clotting of blood
J)Platelet
K)Enlargement of the liver
L)Increase in the total red blood cell mass in the blood
M)Abnormal rarefaction of bone
N)Decrease in the number of platelets in circulating blood

Question 66

MATCHING
For each vocabulary word below, select the corresponding definition from the list provided.

Hemostasis

A)Severe pain in a joint
B)Reduction of the number of red blood cells
C)Chronic excessive thirst and intake of fluid
D)Small, flat, hemorrhagic patch larger than a petechia on the skin
E)Cell surface protein to which a specific molecule (e.g., a hormone) can bind
F)Stoppage or cessation of bleeding
G)Decrease in number of granulocytes
H)Muscle pain
I)Insoluble protein that is essential for the clotting of blood
J)Platelet
K)Enlargement of the liver
L)Increase in the total red blood cell mass in the blood
M)Abnormal rarefaction of bone
N)Decrease in the number of platelets in circulating blood

Question 67

MATCHING
For each vocabulary word below, select the corresponding definition from the list provided.

Receptor

A).Severe pain in a joint
B)Reduction of the number of red blood cells
C)Chronic excessive thirst and intake of fluid
D)Small, flat, hemorrhagic patch larger than a petechia on the skin
E)Cell surface protein to which a specific molecule (e.g., a hormone) can bind
F)Stoppage or cessation of bleeding
G)Decrease in number of granulocytes
H)Muscle pain
I)Insoluble protein that is essential for the clotting of blood
J)Platelet
K)Enlargement of the liver
L)Increase in the total red blood cell mass in the blood
M)Abnormal rarefaction of bone
N)Decrease in the number of platelets in circulating blood

Question 68

MATCHING
For each vocabulary word below, select the corresponding definition from the list provided.

Agranulocytosis

A)Severe pain in a joint
B)Reduction of the number of red blood cells
C)Chronic excessive thirst and intake of fluid
D)Small, flat, hemorrhagic patch larger than a petechia on the skin
E)Cell surface protein to which a specific molecule (e.g., a hormone) can bind
F)Stoppage or cessation of bleeding
G)Decrease in number of granulocytes
H)Muscle pain
I)Insoluble protein that is essential for the clotting of blood
J)Platelet
K)Enlargement of the liver
L)Increase in the total red blood cell mass in the blood
M)Abnormal rarefaction of bone
N)Decrease in the number of platelets in circulating blood

Question 69

MATCHING
For each vocabulary word below, select the corresponding definition from the list provided.

Anemia

A)Severe pain in a joint
B)Reduction of the number of red blood cells
C)Chronic excessive thirst and intake of fluid
D)Small, flat, hemorrhagic patch larger than a petechia on the skin
E)Cell surface protein to which a specific molecule (e.g., a hormone) can bind
F)Stoppage or cessation of bleeding
G)Decrease in number of granulocytes
H)Muscle pain
I)Insoluble protein that is essential for the clotting of blood
J)Platelet
K)Enlargement of the liver
L)Increase in the total red blood cell mass in the blood
M)Abnormal rarefaction of bone
N)Decrease in the number of platelets in circulating blood

Question 70

MATCHING
For each vocabulary word below, select the corresponding definition from the list provided.

Polycythemia

A)Severe pain in a joint
B)Reduction of the number of red blood cells
C)Chronic excessive thirst and intake of fluid
D)Small, flat, hemorrhagic patch larger than a petechia on the skin
E)Cell surface protein to which a specific molecule (e.g., a hormone) can bind
F)Stoppage or cessation of bleeding
G)Decrease in number of granulocytes
H)Muscle pain
I)Insoluble protein that is essential for the clotting of blood
J)Platelet
K)Enlargement of the liver
L)Increase in the total red blood cell mass in the blood
M)Abnormal rarefaction of bone
N)Decrease in the number of platelets in circulating blood

Question 71

MATCHING
For each vocabulary word below, select the corresponding definition from the list provided.

Osteoporosis

A)Severe pain in a joint
B)Reduction of the number of red blood cells
C)Chronic excessive thirst and intake of fluid
D)Small, flat, hemorrhagic patch larger than a petechia on the skin
E)Cell surface protein to which a specific molecule (e.g., a hormone) can bind
F)Stoppage or cessation of bleeding
G)Decrease in number of granulocytes
H)Muscle pain
I)Insoluble protein that is essential for the clotting of blood
J)Platelet
K)Enlargement of the liver
L)Increase in the total red blood cell mass in the blood
M)Abnormal rarefaction of bone
N)Decrease in the number of platelets in circulating blood

Question 72

MATCHING
For each vocabulary word below, select the corresponding definition from the list provided.

Arthralgia

A)Severe pain in a joint
B)Reduction of the number of red blood cells
C)Chronic excessive thirst and intake of fluid
D)Small, flat, hemorrhagic patch larger than a petechia on the skin
E)Cell surface protein to which a specific molecule (e.g., a hormone) can bind
F)Stoppage or cessation of bleeding
G)Decrease in number of granulocytes
H)Muscle pain
I)Insoluble protein that is essential for the clotting of blood
J)Platelet
K)Enlargement of the liver
L)Increase in the total red blood cell mass in the blood
M)Abnormal rarefaction of bone
N)Decrease in the number of platelets in circulating blood