Clinical and demographic overlaps among immunologically mediated oral diseases: a challenge for clinicians

Self-Instruction Exercise No. 345
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Exercise No. 345
Subject Code: 739
Diagnosis of Oral Pathology

The 15 questions for this exercise are based on the article, Clinical and demographic overlaps among immunologically mediated oral diseases: a challenge for clinicians, on pages 67-72. This exercise was developed by Merlin P. Ohmer, DMD, FAGD, in association with the General Dentistry Self-Instruction committee.

Reading the article and successfully completing the exercise will enable you to:

  • better understand immunologically mediated oral diseases;
  • perform a differential diagnosis; and
  • better understand the histopathology of vesiculobullous lesions.

Answers for this exercise must be received by December 31, 2014.
  1. All of the following lesions were discussed in the article except one. Which is the exception?

    A. mucous membrane pemphigoid
    B. pemphigus vulgaris
    C. bullous pemphigoid
    D. lichen planus

  2. Which of the following accounted for the highest incidence among the specimens studied?

    A. mucous membrane pemphigoid
    B. pemphigus vulgaris
    C. bullous pemphigoid
    D. lichen planus

  3. Which of the following vesiculobullous lesions is considered life-threatening?

    A. mucous membrane pemphigoid
    B. pemphigus vulgaris
    C. bullous pemphigoid
    D. lichen planus

  4. Which disease is characterized by apoptosis of the basal cell layer of the epithelium?

    A. mucous membrane pemphigoid
    B. pemphigus vulgaris
    C. bullous pemphigoid
    D. lichen planus

  5. The World Health Organization classifies lichen planus as a risk for

    A. spontaneous remission.
    B. malignant transformation.
    C. metastasis.
    D. Crohn’s disease.

  6. Mucous membrane pemphigoid exhibits primarily oral manifestations in ____% of cases.

    A. 75
    B. 80
    C. 85
    D. 90

  7. Pemphigus vulgaris is mediated mainly by _______ antibodies.

    A. IgA
    B. IgE
    C. IgG
    D. IgM

  8. In this retrospective study, autoimmune diseases represented ____% of the cases.

    A. 0.11
    B. 1.18
    C. 8.00
    D. 8.90

  9. Histologically, lichen planus exhibits all of the following features except one. Which is the exception?

    A. parakeratin
    B. orthokeratin
    C. infiltration of mast cells
    D. basal layer breakdown

  10. The most predominant sign of lichen planus is Wickam striae. Multiple lesions were reported in fewer than half of the cases.

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

  11. The majority of the lichen planus lesions were >1cm. The most common areas for extraoral lesions were the trunk and legs.

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

  12. One of the histopathologic hallmarks of pemphigus vulgaris is the presence of ______ cells.

    A. ghost
    B. Nikolsky
    C. Schwan
    D. Tzanck

  13. Pemphigus vulgaris exhibits chronic inflammation in the

    A. basilar layer.
    B. epithelium.
    C. connective tissue.
    D. glial cells.

  14. Extraoral manifestations of pemphigus vulgaris were reported in all of the following areas except one. Which is the exception?

    A. genitals
    B. trunk
    C. face
    D. arms

  15. Mucous membrane pemphigoid occurs twice as often in females than males. The mean age of the patients was approximately 50.

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

Evaluation
Please respond to the statements below, using the following scale:
1 Poor; 2 Below average; 3 Average; 4 Above average; 5 Excellent
Practicality of the content 1 2 3 4 5
Benefit to your clinical practice 1 2 3 4 5
Quality of illustrations 1 2 3 4 5
Clarity of objectives 1 2 3 4 5
Clarity of exercise questions 1 2 3 4 5
Relevance of exercise questions 1 2 3 4 5
 
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Did this article present new information? Yes No
How much time did it take you to complete this exercise? mins

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