Deck 9: Oral Manifestations of Systemic Diseases

Question 1

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.

Answer 1

enlargement of the maxilla and mandible, resulting in separation of the teeth and malocclusion.

Question 2

The most common cause of hyperpituitarism is

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

Answer 2

pituitary adenoma.

Question 3

Excess production by the anterior pituitary gland is termed

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

Answer 3

hyperpituitarism.

Question 4

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 5

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 6

An enlarged tongue is associated with

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

Question 7

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.

Question 8

A "salt and pepper" effect may be noted on intraoral radiographic images of a patient with which type of anemia?

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

Question 9

Which statement 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 10

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 11

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 12

Which clinical feature is associated with hyperthyroidism?

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

Question 13

The most common cause of death among patients with diabetes is

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

Question 14

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 15

Which statement 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.

Question 16

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 17

Which statement 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 18

A "hair-on-end" pattern may be noted on skull radiographic images of a patient with

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

Question 19

Insulin is manufactured by

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

Question 20

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 21

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 22

The Philadelphia chromosome is associated with _____________________ leukemia.

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

Question 23

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 termed

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

Question 24

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

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

Question 25

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 26

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 27

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

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

Question 28

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

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

Question 29

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

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

Question 30

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 31

Which statement 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 32

Which 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 33

Which drug 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 anti-inflammatory drugs

Question 34

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 35

Which statement 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 36

Which statement 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 37

Which disorder 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 38

Leukopenia most commonly involves

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

Question 39

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 40

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

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

Question 41

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 42

Diabetes is characterized by abnormally high blood _________ levels.

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

Question 43

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

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

Question 44

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

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

Question 45

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

A) B₆
B) B₁₂
C) C
D) E

Question 46

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

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

Question 47

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 48

All terms describe a decrease in circulating red or white blood cells except one. Which is the exception?

A) Thrombocytopenia
B) Anemia
C) Hypochromic
D) Neutropenia

Question 49

All statements are true regarding type 2 diabetes mellitus except one. Which 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 50

Myxedema is caused by _____________ of the ____________ gland.

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

Question 51

Which system consists of a group of integrated glands and cells that secrete hormones?

A) Endocrine
B) Viral
C) Neoplastic
D) Immune

Question 52

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

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

Question 53

Which type 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 54

Which condition necessitates emergency intervention?

A) Hemostasis
B) Ketoacidosis
C) Insulin shock
D) Myalgia

Question 55

______________ is characterized by insufficient production of adrenal steroids.

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

Question 56

Which term describes an opposite condition to anemia?

A) Polycythemia
B) Arthralgia
C) Hemolysis
D) Neutropenia

Question 57

All are clinical features of gigantism except one. Which is the exception?

A) Headache
B) Chronic fatigue
C) Extreme height
D) Gastrointestinal issues

Question 58

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

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

Question 59

Which vitamin 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 60

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

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

Question 61

Persons with acromegaly may experience an enlargement of the maxillary sinuses that may lead to what condition?

A) Deeper voice
B) Nasal septum deformities
C) Perforation of the oral mucosa
D) Maxillary molars requiring endodontic treatment

Question 62

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 63

Secondary hyperparathyroidism occurs when calcium is abnormally excreted by the liver. The most common cause of secondary hyperparathyroidism is liver failure.

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

Question 64

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 65

Identify a common nutritional deficiency associated with anemia:

A) Calcium
B) Phosphorus
C) Iron
D) Vitamin D

Question 66

Physical characteristics of a person with type 1 diabetes include all except one. Which is the exception?

A) Peak age of 50 years
B) Thin body build
C) Polydipsia, polyuria, polyphagia
D) Abrupt onset

Question 67

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 68

Skin and mucosal pallor, angular cheilitis, and loss of filiform and fungiform papilla on the tongue are characteristics of what condition?

A) Type 1 diabetes
B) Cretinism
C) Graves' disease
D) Anemia

Question 69

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 70

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 71

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 72

Children affected with hyperthyroidism may demonstrate which characteristic?

A) Lack of energy
B) Fatigue
C) Hyperactivity
D) Dry skin

Question 73

When a patient is taking long-term antibiotic therapy, what is a common oral manifestation that may be seen?

A) Risk of candidiasis
B) Xerostomia
C) Tooth discoloration
D) Gingival enlargement

Question 74

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 75

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 76

Oral manifestations of a person with Addison disease include which finding?

A) Intraoral melanotic macules
B) Gingival hyperplasia
C) Tooth mobility
D) Macroglossia

Question 77

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 78

In infants, facial and oral changes in hypothyroidism include these characteristics except one. Which is the exception?

A) Thickened lips
B) Delayed eruption of teeth
C) Macroglossia
D) Exophthalmos

Question 79

Which condition may cause children to demonstrate premature exfoliation of the primary dentition as well as premature eruption of the permanent teeth?

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

Question 80

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