Chapter 5: Pigmented Lesions

Test Bank
MULTIPLE CHOICE
1. In addition to multiple neurofibromas, what other lesions are seen as part of the
syndrome neurofibromatosis?
a. Traumatic neuromas
b. Mucosal vascular malformations
c. Intestinal polyps
d. Cutaneous pigmented patches
e. Odontogenic keratocysts
ANS: D

REF: Chap 5 (Caf-au-lait macules), p 138

2. Mucosal neuromas, pheochromocytoma, and medullary carcinoma of the thyroid

constitute which of the following syndromes?
a. Albrights syndrome
b. Sjgrens syndrome
c. von Recklinghausens disease of skin
d. Peutz-Jeghers syndrome
e. None of the above
ANS: E
REF: Chap 5 (Caf-au-lait macules), p 138 | Chap 8 (Sjgrens syndrome), pp 196199 | also Clinical Overview
3. Amalgam tattoo is a common oral lesion that must be differentiated through clinical
history or biopsy from which of the following?
a. Chronic infection
b. Squamous cell carcinoma
c. Early melanoma
d. Hereditary hemorrhagic telangiectasia
e. Gardners syndrome
ANS: C
REF: Chap 5 (Amalgam tattoo [focal argyrosis]/Differential diagnosis), p 145
4. Lateral or radial spread at the epithelialconnective tissue interface is a characteristic
growth feature of which of the following pigmented lesions?
a. Blue nevus
b. Ephelis
c. In situ melanoma
d. Invasive melanoma
e. Amalgam tattoo
ANS: C

REF: Chap 5 (Oral melanoma), p 142

5. Acquired oral melanin pigmented lesions may be associated with which of the
following?
a. Aspirin abuse
Copyright 2012, 2008, 2003, 1999, 1993, 1989 by Saunders, an imprint of Elsevier Inc.

Test bank
b.
c.
d.
e.

Penicillin ingestion
Chronic infection by C. albicans
Xerostomia
None of the above

ANS: E
REF: Chap 5 (Melanocytic lesionsentire topic/Box 5-3), pp 134-144
6. A 40-year-old woman presents with multiple melanotic macules of her lips and buccal
mucosa. If the patient is found to have adrenal insufficiency, which of the following
conditions should be considered?
a. von Recklinghausens disease of skin
b. McCune-Albright syndrome
c. Addisons disease
d. Peutz-Jeghers syndrome
e. None of the above
ANS: C
136-137

REF: Chap 5 (Oral melanotic macule/Clinical features), pp

7. Both in situ and invasive oral melanomas exhibit the same distinctive site
predilection. This is the:
a. Buccal mucosa
b. Palate
c. Lateral tongue
d. Lower lip
e. Tonsillar pillar
ANS: B

REF: Chap 5 (Oral melanoma), p 142

8. Oral mucosal lesions may exhibit a red to blue to black color for one of several
reasons. These would include all the following except:
a. Increased number of submucosal vessels
b. Submucosal extravasation of blood
c. Deposition of foreign material
d. Increased thickness of epithelium
e. Hyperemia (vascular congestion)
ANS: D

REF: Chap 5 (Melanocytic lesionsentire topic), pp 134-144

9. Which of the following can have clinical features that are similar to early superficial
or in situ melanoma?
a. Early Kaposis sarcoma
b. Amalgam tattoo
c. Drug-induced pigmentation
d. Melanotic macule
e. All of the above
ANS: E

REF: Chap 5 (Melanoma/Differential diagnosis), p 144

Copyright 2012, 2008, 2003, 1999, 1993, 1989 by Saunders, an imprint of Elsevier Inc.

Test bank

10. Pigmented nevi are commonly seen in skin but are relatively rare in the oral mucosa.
Intraorally, they are most likely to be found in which of the following locations?
a. Tongue
b. Buccal mucosa
c. Floor of mouth
d. Lower lip
e. Palate
ANS: E
140

REF: Chap 5 (Nevomelanocytic nevus/Clinical features), p

11. A 30-year-old woman presents with recently acquired generalized tanning of the skin
and multiple intraoral pigmented macules. Oral biopsy showed excessive melanin
pigment in basal keratinocytes. This patient should be suspected of having:
a. Addisons disease
b. Sunburn
c. Kaposis sarcoma
d. Leukemia
e. Melanoma
ANS: A

REF: Chap 5 (Oral melanotic macule/Histopathology), p 137

12. Caf-au-lait macules (more than five) and multiple neurofibromas are typically seen
in which of the following conditions?
a. Lichen planus
b. Crohns disease
c. Addisons disease
d. Peutz-Jeghers syndrome
e. None of the above
ANS: E

REF: Chap 5 (Caf-au-lait macules), p 138

13. All of the following are known to have the capacity to cause oral mucosal
pigmentation except:
a. Amalgam
b. Bismuth
c. Mercury vapors
d. Penicillin
e. Minocycline
ANS: D
147

REF: Chap 5 (Nonmelanocytic lesionsentire topic), pp 145-

14. Which of the following pigmented lesions of oral mucosa is most commonly
encountered in dental patients?
a. Freckles (ephelides)
b. Intramucosal nevus
c. Melanoma
d. Amalgam tattoo
e. Bismuth line

Copyright 2012, 2008, 2003, 1999, 1993, 1989 by Saunders, an imprint of Elsevier Inc.

Test bank

ANS: D

REF: Chap 5 (Amalgam tattoo/Clinical features), p 145

15. A 37-year-old man presents with a blue-black macule (1 1 cm) in his palate. The
area is covered with intact epithelium and there was no apparent inflammatory
response. Biopsy shows deposits of black foreign material. This suggests which of the
following?
a. Kaposis sarcoma
b. Melanoma
c. Amalgam tattoo
d. Erythroplakia
e. Melanotic macule
ANS: C

REF: Chap 5 (Amalgam tattoo), p 145

16. The characteristic oral manifestation of Peutz-Jeghers syndrome is:

a. Bilateral reticular white lesions in the buccal mucosa
b. Red patch in the palate
c. Nodular yellow-white lesions in the buccal mucosa
d. Perioral pigmented macules
e. Red patch on midline dorsum of the tongue
ANS: D
136-137

REF: Chap 5 (Oral melanotic macule/Clinical features), pp

17. All the following suggest the possibility of intraoral melanoma except:
a. Rapid increase in size
b. Satellite lesions
c. Ulceration
d. Bilateral symmetric lesions
e. Darkening color
ANS: D

REF: Chap 5 (Oral melanomaentire topic), pp 142-143

18. A 34-year-old man presents with an asymptomatic 1 1 cm pigmented lesion in the

right side of his palate. It is flat, and it is asymptomatic. Biopsy shows melanin
pigment within a collection of benign-appearing spindle-shaped cells in the
submucosa. This is consistent with:
a. Melanoma
b. Amalgam tattoo
c. Blue nevus
d. Melanotic macule
e. Physiologic pigmentation
ANS: C
141

REF: Chap 5 (Nevomelanocytic nevusentire topic), pp 139-

19. Oral melanomas are classified into microscopic subtypes based primarily on which of
the following feature?
a. Evidence of invasion of lymphatic vascular spaces

Copyright 2012, 2008, 2003, 1999, 1993, 1989 by Saunders, an imprint of Elsevier Inc.

Test bank
b.
c.
d.
e.

Microscopic growth pattern

Number of mitotic figures
Nuclear pleomorphism
Evidence of lymph node metastasis

ANS: B

REF: Chap 5 (Oral melanoma), pp 142-143

20. All the following drugs are known to have the ability to cause pigmentation of the
oral mucosa except:
a. Dilantin
b. Minocycline
c. Cytoxan
d. AZT (zidovudine)
ANS: A

REF: Chap 5 (Drug-induced pigmentations), pp 145-146

21. Generally, which of the following has the worst prognosis?

a. Oral verrucous carcinoma
b. Cutaneous basal cell carcinoma
c. Cutaneous melanoma
d. Oral melanoma
e. Oral erythroplasia
ANS: D

REF: Chap 5 (Oral melanoma), p 142

Copyright 2012, 2008, 2003, 1999, 1993, 1989 by Saunders, an imprint of Elsevier Inc.