Deck 8: Nonneoplastic Diseases of Bone

Question 1

Surgical treatment would most likely be recommended for a patient with ________ dysplasia.

A) periapical cemento-osseous
B) focal cemento-osseous
C) florid cemento-osseous
D) fibrous

Answer 1

fibrous

Question 2

Café au lait skin macules are associated with

A) monostotic fibrous dysplasia.
B) polyostotic fibrous dysplasia.
C) Paget disease of bone.
D) osteomalacia.

Answer 2

polyostotic fibrous dysplasia.

Question 3

A lesion of bone identical to the central giant cell granuloma and termed brown tumor occurs in patients with what type of disease?

A) Hyperparathyroidism
B) Peripheral giant cell granuloma
C) Hypothyroidism
D) Peripheral ossifying granuloma

Answer 3

Hyperparathyroidism

Question 4

Which statement is true of osteomalacia?

A) It is the result of a deficiency in phosphate.
B) In adults it may be related to various problems such as malabsorption syndrome.
C) It may be treated by the use of antacids.
D) Accelerated tooth eruption is associated with osteomalacia.

Question 5

Mosaic bone may be observed in a patient with Paget disease as a result of

A) lack of trabeculae.
B) prominent reversal lines resulting from resorption and deposition of bone.
C) the presence of "giant cells."
D) a "ground glass" appearance.

Question 6

Cementoma is a term once used for periapical cemento-osseous dysplasia. Because the disease does not represent a neoplasm, cementoma has been replaced with periapical cemento-osseous dysplasia.

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

Question 7

For which disease of bone is surgical recontouring most often recommended as its treatment modality?

A) Periapical cemento-osseous dysplasia
B) Florid cemento-osseous dysplasia
C) Polyostotic fibrous dysplasia
D) Focal cemento-osseous dysplasia

Question 8

Which type of lesions typically arises in the posterior mandible and appears as an isolated, well-delineated radiolucent-to-radiopaque lesion that is less than 1.5 cm in size?

A) Periapical cemento-osseous dysplasia
B) Focal cemento-osseous dysplasia
C) Florid cemento-osseous dysplasia
D) Monostotic fibrous dysplasia

Question 9

This 74-year-old patient presents with an enlargement of the maxilla, pain, and a chief complaint that his dentures no longer fit. Radiographic examination reveals a patchy radiolucency and radiopacity that resembles cotton wool. These findings are indicative of what disease of bone?

A) Osteomalacia
B) Paget disease of bone
C) Fibrous dysplasia
D) Florid cemento-osseous dysplasia

Question 10

Osteitis deformans and leontiasis ossea are other names for what chronic metabolic bone disease?

A) Central giant cell granuloma
B) Jaffe-Lichtenstein
C) Paget disease
D) Albright syndrome

Question 11

Which statement is true of periapical cemento-osseous dysplasia?

A) It is a neoplasm.
B) The lesion is painful and occurs most often in the posterior maxilla.
C) Teeth in the area are usually not vital.
D) Older lesions are primarily radiopaque.

Question 12

Fibrous dysplasia is characterized by

A) necrosis and sloughing of bony sequestra.
B) replacement of bone with normal fibrous connective tissue with no calcification.
C) replacement of bone with abnormal connective tissue with no calcification.
D) replacement of bone with abnormal connective tissue with varying amounts of calcification.

Question 13

Giant cell granulomas located in the gingiva or alveolar mucosa are referred to as central. Giant cell granulomas located within the maxilla or mandible are referred to as peripheral.

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 14

Paget disease of bone

A) typically occurs in children under the age of 18.
B) is painless.
C) may reveal a "cotton-wool" appearance on radiographs.
D) results in shrinkage of affected bone.

Question 15

The most common type of fibrous dysplasia, characterized by involvement of a single bone, is termed

A) Paget disease.
B) polyostotic fibrous dysplasia.
C) monostotic fibrous dysplasia.
D) central giant cell granuloma.

Question 16

All conditions are benign fibrous-osseous lesions that affect the maxilla and mandible except one. Which is the exception?

A) Periapical cemento-osseous dysplasia
B) Fibrous dysplasia
C) Florid cemento-osseous dysplasia
D) Gingival fibromatosis

Question 17

Light brown skin macules associated with polyostotic fibrous dysplasia are termed

A) Koplik spots.
B) café au lait spots.
C) brown tumors.
D) gritty tissue.

Question 18

Numerous gritty pieces of soft and hard tissue that contain fibrous connective tissue interspersed with bone trabeculae and cementum-like material is characteristic of which condition?

A) Focal cemento-osseous dysplasia
B) Central cementifying fibroma
C) Florid cemento-osseous dysplasia
D) Ossifying fibroma

Question 19

Characteristics of monostotic fibrous dysplasia include that

A) it is commonly diagnosed in middle-aged women.
B) the expanding nature of the lesion may lead to malocclusion, tipping, or displacement of adjacent teeth.
C) it involves a painful swelling or bulging of the buccal plate of the maxilla or mandible when seen orally.
D) it involves multiple bones.

Question 20

Which type of lesion occurs most often in black women older than age 40 and is characterized by disordered cementum and bone, typically affecting more than one quadrant of the maxilla and mandible in the posterior regions?

A) Periapical cemento-osseous dysplasia
B) Focal cemento-osseous dysplasia
C) Florid cemento-osseous dysplasia
D) Monostotic fibrous dysplasia

Question 21

Asymptomatic florid cemento-osseous dysplasia usually requires no treatment. However, in an edentulous patient, the sclerotic masses may perforate the mucosa causing which complication?

A) Fibrous dysplasia
B) Aneurysmal bone cyst
C) Osteomyelitis
D) Central giant cell granuloma

Question 22

The aneurysmal bone cyst is a "pseudocyst" which means :

A) No epithelial lining exists.
B) The cyst does not appear on radiographic images.
C) The cyst is really a fibroma.
D) Malignant potential is present.

Question 23

Early lesions of periapical cemento-osseous dysplasia are well circumscribed and radiolucent and may resemble which condition?

A) Periapical abscess
B) Benign cementoblastoma
C) Odontoma
D) Osteoma

Question 24

Laboratory evaluation reveals that the serum _______________ level is significantly elevated in active Paget disease.

A) alkaline phosphatase
B) platelet
C) hematocrit
D) leukocyte

Question 25

All statements are characteristic of osteomalacia except one. Which is the exception?

A) It is the result of a deficiency in calcium.
B) In adults it may be related to the chronic use of antacids.
C) It is treated with vitamin D and calcium nutritional supplements.
D) The pattern of diseased bone is best described as mosaic bone.

Question 26

Osteomalacia is a disease of bone that develops over a long period of time as a result of deficiency of which substance?

A) Connective tissue
B) Calcium
C) Fluoride
D) Vitamin A

Question 27

The painless jaw swelling seen in monostotic fibrous dysplasia may cause all symptoms except one. Which is the exception?

A) Tooth mobility
B) Malocclusion
C) Displacement of adjacent teeth
D) Tipping of teeth

Question 28

_______________ fibrous dysplasia is characterized by endocrine abnormalities, including precocious puberty in females and stunting or deformity of skeletal growth in both sexes as a result of early epiphyseal plate closure.

A) Craniofacial
B) Jaffe-Lichtenstein type
C) Albright syndrome
D) Monostotic

Question 29

Characteristics of polyostotic fibrous dysplasia include the following except one. Which is the exception?

A) Most cases are asymptomatic.
B) Male predilection
C) Occurs in children under 10 years of age
D) Seen in association with skin lesions

Question 30

"Ground glass" is the classic radiographic description of _________________.

A) Osteomalacia
B) Paget disease of bone
C) Fibrous dysplasia
D) Florid cemento-osseous dysplasia

Question 31

An aneurysmal bone cyst contains the following except one. Which is the exception?

A) Fibrous connective tissue
B) Epithelial lining
C) Multinucleated giant cells
D) Blood-filled spaces

Question 32

Characteristics of periapical cemento-osseous dysplasia include the following except one. Which is the exception?

A) The lesions are seen in the anterior mandible.
B) The common patient complaint is pain upon chewing.
C) A predilection for black women exists.
D) The condition is discovered on routine radiographic examination.

Question 33

Why is treatment with radiation therapy for polyostotic fibrous dysplasia contraindicated?

A) It is too severe of a treatment for a young child.
B) An association exists with malignant transformation to osteosarcoma.
C) Because of the defined borders of the lesions, surgery is the treatment of choice.
D) The lesions remain asymptomatic and localized.

Question 34

All are likely complaints of a patient with Paget disease of bone except one. Which is the exception?

A) "My partial denture does not fit."
B) "I can't hear you, can you speak louder?"
C) "I have spaces between my teeth that I never had before."
D) "My tongue is always sore."

Question 35

Osteomalacia is a disease of bone that develops over a long period as a result of an iron deficiency. Delayed tooth eruption and periodontal disease are associated with osteomalacia.

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

Question 36

What is a common feature of the central giant cell granuloma?

A) Heat and cold sensitivity
B) Fast-growing lesion
C) High recurrence rate
D) Divergence of roots of teeth adjacent to the lesion

Question 37

Café au lait spots appear on the skin as which color(s)?

A) Reddish pink
B) Light brown
C) Yellow white
D) Black

Question 38

The serum alkaline phosphatase level is significantly elevated in persons with active Paget disease. This is detected through which diagnostic process?

A) Historical
B) Laboratory
C) Therapeutic
D) Differential

Question 39

When osteomalacia occurs in young children, it is usually caused by a nutritional deficiency in vitamin _____.

A) A
B) D
C) E
D) K

Question 40

What is one difference between the diagnosis of periapical cemento-osseous dysplasia and florid cemento-osseous dysplasia?

A) Florid cemento-osseous dysplasia usually affects more than one quadrant of the maxilla and mandible, including posterior regions.
B) Periapical cemento-osseous dysplasia affects black females; florid cemento-osseous dysplasia affects all ethnicities.
C) The two conditions have various radiographic appearances.
D) Symptoms of the two conditions vary from asymptomatic to extremely painful.

Question 41

Where does the disease extend when fibrous dysplasia involves the maxilla?

A) Nasal cavity
B) Orbits
C) Maxillary sinus
D) Periapical areas of maxillary molars

Question 42

The most severe form of polyostotic fibrous dysplasia is termed Albright syndrome. This condition is characterized by endocrine abnormalities such as precocious puberty that may begin at which age?

A) 2 years
B) 4 years
C) 6 years
D) 8 years