Academic Affiliate Fellowship Practice Exam: 2018
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1 Academic Affiliate Fellowship Practice Exam: 2018
2 Current History: A patient presents to your practice complaining of a tight feeling in her perioral tissue area. She is unable to open her mouth fully since the tissues do not stretch. She is also wearing gloves today and the weather is quite warm outside. The dental history from records sent by her previous dental office are more than three years old and she has not been seen by a dentist or hygienist since she moved from her previous city. Medical History: The patient is 57 years old, post-menopausal, she is taking the following medications: Ranitidine 150mg for GERD, 50 mcg Synthroid, calcium 1200 mg., and muti-vitamins. She reports no prior drug
3 use, tobacco use and consumes alcohol on a limited basis. Hospital history has been limited to child birth. Oral Exam: The patient reports difficulty in swallowing at times and has limited oral opening of her mouth when eating sandwiches and burgers. The lip tissue appears lighter in color and the texture is smooth but very firm and not as pliable as normal lip tissue. She has some periodontal ligament widening in selected areas and a noted loss of attached gingiva with recession. Extra Oral Exam: Her fingers appear somewhat red at the tips of fingers and cool to touch. She tells you that she wears gloves a lot even in the summer while in air conditioned rooms. The fingers appear red at the tips and there is some distortion at the last joint of the third finger. Final Diagnosis: Systemic Sclerosis The following images are provided: Image #1: Lip exam (Nancy W. Burkhart, RDH, Ed.D.) Image #2: Fingers (Nancy W. Burkhart, RDH, Ed.D,) 1. Lip tightness and firmness (depicted in Fig#1) in scleroderma is caused by a. Excessive chewing on lips due to dryness b. Excessive calcium deposits of the skin/lip tissue c. Excessive blood calcium levels d. Decreases in collagen production
4 2. In figure #2, the pink/red finger tips are a result of. a. Restriction of blood flow to the finger tips b. An allergic type response to a medication c. Telangiectasia d. Osteopenia involving the fingers 3. In figure #2, the correct term for the reddened fingertips would be: a. Telangiectasia b. Raynaud s Phenomenon c. Calcinosis d. Sclerodactyly 4. Scleroderma has not been linked to which of the following. a. Pesticides b. Viral-Parvovirus B19 c. Benzene derivatives d. Blood dyscrasias 5. Which of the following would not be associated with scleroderma? a. Inflammation of the tissues with ulceration on fingertips b. microstomia c. Atrophy of nasal alae d. Hypertrophy of taste buds 6. A patient diagnosed with Scleroderma may experience all of those listed below except which one? a. Rigidity of the lips
5 b. Mask-like appearance c. Rigidity of the tongue d. Narrowing of the periodontal ligament 7. The localized thickened area of skin that may appear as a knife wound related to scleroderma is: a. En coup de sabre b. Leukoplakia c. CREST syndrome d. Sclerodactyly 8. The resorption of the terminal phalanges related to scleroderma is called? a. sclerodactyly b. Calcinosis cutis c. Acroosteolysis d. Osteonecrosis 9. The main reason that candida occurs in patients with scleroderma is because of which of the following? a. Fibrosis of the salivary glands b. Lack of blood circulation c. Restriction of the tongue d. A soft diet high in carbohydrates
6 10. Calcium channel blockers may be used in the treatment for scleroderma to promote blood vessel relaxation. This may produce which of the following: a. Increase in periodontal disease b. Gingival overgrowth c. Edema with exudate d. Excessive inflammation Answers: 1. B Burket s, 12 th ed.505 & A Neville 4 th ed. Page B DeLong/Burkhart 2 nd ed. Page D Burket s 12 ed. Page D DeLong/Burkhart 3 rd ed. page 621 & Neville,4 th ed. Page 744 & D Burket s 12 ed. Page A Neville 4 th ed. Page 746, DeLong/Burkhart 2nd ed. Page C Neville Page A Burket s 12 ed. Page A Burket s 12 th ed. Page 508
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