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1. A. B. * C. D. E. 2. A. B. C. D. * E. 3. A. B. * C. D. E. 4. A. B. C. * D. E. 5. A. B. C. * D. E. 6. A. B. * C. D. E. A 39-year-old, overweight man presents with suppurative periodontitis. From review his history, he is always hungry, drinks water almost every hour, and awakens four times each night to urinate. What systemic disease is most likely a cofactor in his periodontal disease? ischemic heart disease; diabetes mellitus; Addison-Biermer; menopause; hyperacidity gastritis. During exam of 14 year old patient a doctor reaveled the following symptoms: disorder of teeth eruption, hypodontiya, abnormalities of enamel development, increasing tongue and lips, swollen gums are pale. What pathology does have the listed above symptoms? adrenal pathology; liver pathology; hyperfunction of pituitary; thyroid hypofunction; cancer of the mandible. During oral exam a doctor reaveled an alveolar osteoporosis, expansion of periodontal fissure. The patient treated in endocrinologist. What gland pathology does have the listed above symptoms? parathyroid hypofunction parathyroid hyperfunction; hyperfunction of pituitary; thyroid hypofunction; pancreas hyperfunction. During oral cavity exam of 54 year old patient, a doctor reaveled desquamative gingivitis. The patient complains about burning tongue and lips. These symptoms indicate: hyperacidity gastritis; coronary heart disease; menopause; Addison’s disease; diabetes mellitus. A 34-year-old patient has developed alveolar bone resorption after long-term treatment of rheumatic disease. The cause of this pathology is: prolonged use of estrogens; accession of secondary infection; prolonged use of corticosteroids; menopause; disbacteriosis. During oral exam a doctor reaveled general puffiness, cyanosis of the oral mucosa and red lip fringe, dryness and swelling of mucouse membrane, tongue size is increased, on the buccal mucosa and tongue – teeth prints. These symptoms indicate: chronic hyperacidity gastritis; cardiovascular insufficiency with blood circulation; obesity; Addison’s disease; diabetes. 7. A. B. * C. D. E. 8. A. B. C. * D. E. 9. A. * B. C. D. E. 10. A. B. C. D. E. * 11. A. B. C. D. E. * 12. A. * B. C. During exam of 40-year-old engineer there were identified multiple telangiectasias, angiomatous growths on the nose, cheeks, lips, tongue lining and on the face, especially on the wings of the nose and earlobes. Patient complains about frequent profuse bleeding from the nose and oral mucosa. Platelet count bleeding time and blood's ability to coagulate are normally.These symptomth indicate: haemophilia; hemorrhagic anhiomatosis; hypertension; hemorrhagic diathesis; Addison’s disease. A 54 year old man arrived in the emergency department without consciousness. During examining of patient a doctor noticed cyanosis of oral mucosa, bright red tongue, erosions, ulcers, hemorrhages in the tongue tissues. These symptoms indicate: hypoglycemic shock; hyperglycemic shock; large focal myocardial infarction; stenocardia; hypertensive crisis. A patient is suffering from ischemic heart disease during 10 years. What is a color of mucous membrane on the soft palate at this pathology? bluish; intense red; yellowish; pink; spotty pink. 48 years old patient has a dysfunction of the gastrointestinal tract, blood forming and nervous systems. Skin and oral mucous membrane are pale, with yellow shade, sometimes there are dotted haemorrhage. Make a diagnosis. leukopenia; leukemia; trombocytopenic purpura; hypo avitaminosis C; B-12 (folate-) deficiency anemia. 57 years old man complains on regarding weakness, burning sensation in the tongue, taste disturbances. Objectively: skin and oral mucosa are pale, with a yellowish tinge. On the back of the tongue tip there are bright red spots. The back of the tongue is smooth, shiny - "polished". Blood analysis has a significant reduction of red blood cells number, a moderate decrease of hemoglobin and high color index, besides anizo and poikilocytosis, availability megalocytes megaloblasts. Failure of which factor in the body caused this disease: ascorbic acid; iron; niacin; riboflavin; cobalamin. The patient, 43 y.o., was diagnosed with pernicious anemia. What glossitis is one of the symptoms of that anemia? Henter-Miller glossitis desquvamative fissured D. E. 13. A. * B. C. D. E. 14. A. B. C. D. * E. 15. A. B. C. D. * E. 16. A. B. C. D. E. * rhomboid candidiasis of the tongue Patient A., 26 y.o., complains of burning, dryness and pain in area of the mucous membrane of the mouth, lips, tongue during eating. These symptoms are combined with weakness, rapid fatigue. OBJECTIVELY: oral mucosa is pale, slightly moist, tongue is swollen, increased in dimensions, papillaes are atrophied, especially at the tip of the tongue. Back of the tongue is bright red. Put the diagnosis. pernicious anemia, Addison-Biermer; hypochromic iron-deficiency anemia; desquamative glossitis; rhomboid glossitis; glossalgia. 41 years old man complains of pain and gums bleeding (especially during food taking), weakness, and pain in the limbs, chilliness unwarranted. He lives in the North during last 15 years. OBJECTIVELY: skin is dry, with brownish tinge, scaly, with symptom of “goose skin”. The mucous membrane of the gums is swollen, hyperemic with cyanotic tinge; gingival papillae are hypertrophied, covering the crowns of the teeth and bleeds after touching. Pathological tooth mobility of 1st degree is present. In the mucosa of the soft palate numerous petechiae was finded. Deficiency of which vitamin may cause this clinical picture: vitamin E; vitamin B12; vitamin A; vitamin C; vitamin B. A 25 year old patient complains about pain in the oral cavity induced by eating. He suffers from CHD. Objective examination revealed dyspnea, limb edema. Oral cavity isn't sanitated. On the mucous membrane, on the right, there is an ulcer with irregular edges covered with greyish-white necrotic deposit with low-grade inflammation around it. There is also halitosis. What is the most probable diagnosis? Cancerous ulcer Traumatic ulcer Tuberculous ulcer Trophic ulcer Ulcero-necrotic stomatitis A 26 year old homeless and unemployed patient complains about body temperature rise up to 39oC, pain during eating and deglutition, nasal haemorrhages. He has been suffering from this for 10 days. Objectively: herpetic rash on the lips, irregular-shaped erosions covered with fibrinous deposit on the mucous membrane of oral cavity; filmy deposits on the tonsils. Liver is enlarged and sclerotic. Blood count: erythrocytes - 4,5*1012l; hemoglobin - 120 g/l; ESR - 25 mm/h; leukocytes – 10*109l; eosinophils - 0; rod nuclear cells - 2; segmentonuclear leukocytes - 31, lymphocytes - 41; monocytes - 10; atypical mononuclears - 14%, plasmatic cells - 2. What is the most probable diagnosis? Acute leukosis Acute herpetic stomatitis Oropharyngal diphtheria AIDS Infectious mononucleosis 17. A. * B. C. D. E. 18. A. B. C. * D. E. 19. A. B. C. D. E. * 20. A. * B. C. D. E. 21. A. B. C. D. E. * A 32-year-old male patient consults a dentist about an ulcer on the hard palate. It appeared about a month ago. He has treated it by rinsing with herbal water, but the ulcer is gradually "creeping". Objectively: there is a shallow erethistic ulcer with uneven and undermined edges of soft consistency within the mucous membrane of hard palate. Granulations of the ulcer floor are also present. Yellowish granules are visible on the ulcer periphery. What is the most likely diagnosis? Tuberculous ulcer Trophic ulcer Cancerous ulcer Syphilitic ulcer Actinomycosis A 42 year old patient applied to a dental clinic for oral cavity sanation. Anamnesis data: mild case of diabetes. Objectively: mucous membrane of cheeks is unchanged, mainly in retromolar area there are symmetrically placed whitish papulae protruding over the mucous membrane and forming a lace-like pattern. On the upper jaw there are two soldered bridge dentures, the 47 tooth has an amalgam filling, the 46 tooth has a steel crown. What is the most probable diagnosis? Leukoplakia Secondary syphilis Lichen ruber planus Chronic atrophic candidosis Lupus erythematosus A 51-year-old patient was diagnosed with leucoplakia nicotinica Tappeiner. What pathohistological process predominates in histologic pattern of this disease? Papillomatosis Acanthosis Dyskeratosis Parakeratosis Hyperkeratosis A 17-year-old male patient complains about pain in the oral cavity, ulceration, body temperature up to 38oC, headache. Objectively: mucous membrane of the oral cavity is hyperemic and edematic. There are a lot of confluent erosions of polycyclic shape, covered with grey and white deposit, located on hard palate, gums, lips. What is your provisional diagnosis? Acute herpetic stomatitis Erythema multiforme Pemphigus vulgaris Aphthous fever Allergic stomatitis An 21-year-old patient complains about body temperature rise, weakness, pain induced by eating and deglutition. Objectively: mucous membrane of the oral cavity is erythematic with multiple petechia. Pharynx is hyperaemic. Regional lymph nodes are enlarged, mobile, painless. In blood: leukocytosis, monocytosis, atypic mononuclears, ESR is 30 mm/h. What is the leading factor of disease Immediate allergy development? Bacterial infection Autoimmune disorders Delayed allergy Viral infection 22. A. * B. C. D. E. 23. A. B. C. D. E. * 24. A. B. C. * D. E. 25. A. B. C. * D. E. 26. A. B. C. D. * E. A 26-year-old patient complains about a small ulcer on the red border of her lower lip that has been irresponsive to self-treatment for two weeks. Objectively: unchanged red border of lower lip has a circular ulcer of 2 mm in diameter with raised regular edges, its floor is of meat-like colour, dense, shiny, with "stearic film", with cartilaginoid infiltration, painless on palpation. Regional lymph node is enlarged, of tight elastic consistency, painless, mobile. What is the most likely diagnosis? Primary syphilis Decubital ulcer Cancerous ulcer Lupus erythematosus Tuberculous ulcer A 29-year-old male patient complains of dryness and burning of tongue back that appeared for about a week ago and get worse when he eats irritating food. The patient has a history of recent pneumonia. He had been treated in the in-patient hospital for 2 weeks, the treatment program included antibiotics. Now he doesn't take any drugs. Objectively: mucous membrane of the oral cavity is hyperemic, dry, glossy. Tongue back and palate have greyish-white plicae that can be easily removed. Threads of saliva trail behind the spatula. What is the most likely diagnosis? Chronic atrophic candidiasis Chronic hyperplastic candidiasis Acute atrophic candidiasis Medicamental stomatitis Acute pseudomembranous candidiasis A 30-year-old patient complains about itch, burning and edema of lips. He has been suffering from this for a week. Objectively: reddening of red border and skin, especially in the region of mouth corners, there are also vesicles, crusts, small cracks along with erythematous affection of red border. What is the most likely diagnosis? Acute herpetic cheilitis Multiform exudative erythema Acute eczematous cheilitis Allergic contact cheilitis Exudative form of exfoliative cheilitis A 18-year-old girl complains about having crusts, lip tenderness, especially at lip joining. Objectively: there are yellow-brown crusts on the lip red border from Klein zone to it's middle, after their removal bright red smooth surface without erosions appears. Mucous membrane in Klein zone is slightly hyperemic and edematic. What is the most likely diagnosis? Exudative form of cheilitis exfoliativa Epidermolysis bullosa Exudative form of cheilitis actinica Meteorological cheilitis Eczematous cheilitis A 61-year-old female patient was waiting for her turn at the dentist’s. Suddenly she fell down, her respiration became hoarse, she got convulsive twitching in her upper and lower limbs, face and neck turned cyanotic, eye pupils became mydriatic, reaction of eye to light was absent. Arterial pressure and pulse couldn’t be measured. Heart sounds couldn’t be auscultated. Involuntary urination was noted. What condition is characterized by such symptoms? Coma Epilepsy Shock Clinical death Collapse 27. A. B. C. * D. E. 28. A. B. C. D. E. * 29. A. B. * C. D. E. 30. A. B. C. D. E. * 31. A. B. C. * D. E. A 48-year-old female patient complains about sensation of tightness of buccal mucosa and roughness of the lateral surface of tongue. The patient undergoes regular check-up at a dispensary department for compensated form of diabetes mellitus. Objectively: there are white and grey areas in form of lacy pattern on the buccal mucosa on the right and on the lateral surface of tongue. The surface of affected region cannot be scraped off. What is the most likely diagnosis? Lupus erythematosus Secondary syphilis Lichen ruber planus Pseudomembranous candidiasis Leukoplakia A 29-year-old patient suffers from a disease without prodromal manifestations that declares itself through oral mucosa lesion consisting of 1-2 roundish elements 5-8 mm large which are circumscribed by a hyperemic rim and covered with yellow-grey coating. The disaese recurrence is observed quite regularly 3-4 times a year. These presentations are typical for the following disease: Papular syphilis Lichen ruber planus Chronic herpes recidivicus Erythema multiforme Chronic recurrent aphthous stomatitis A 55-year-old patient complains about dryness and burning of the lateral surface of her tongue. These sensations disappear during eating. She noted such sensations three months ago. She has a history of gastritis with reduced secretory function. Objectively: mucous membrane of tongue and oral cavity has no peculiarities. The back of tongue has thin white coating. Regional lymph nodes are unpalpable. Oral cavity is sanitized. What is the most likely diagnosis? Lingual nerve neuritis Glossodynia Candidiasis Desquamative glossitis Hunter-Moeller glossitis A 33-year-old woman complains about experiencing lip dryness and desquamation for a month. Application of indifferent ointments is ineffective. Objectively: red border of lower lip is of rich red color, it is moderately infiltrated, covered with closely adhering greyish scales, it bleeds and hurts in the attempt to remove them. Opacification of epithelium in form of white stripes is present in the nidus periphery, there is also an area of depression in the centre. What is the most likely diagnosis? Cheilitis exfoliativa Commissural cheilitis Lichen ruber planus Leukoplakia Lupus erythematosus A 44-year-old patient complains about a sensation of foreign body on his tongue, discomfort during talking, oral cavity dryness. Objectively: there are dark filiform papillae up to 5 mm long on the back of tongue. What is the most likely diagnosis? Benign migratory glossitis Median rhomboid glossitis Glossophytia Fissured tongue Acute glossitis 32. A. B. C. * D. E. 33. A. * B. C. D. E. 34. A. B. C. * D. E. 35. A. * B. C. D. E. 36. A. B. * C. D. E. A 21-year-old woman complains about severe pain in the mouth, body temperature up to 38oC, indisposition. The same condition occurs periodically for several years after catching a cold. Objectively: the lips are covered with bloody crusts, there are opened bladders and erosions, covered with fibrinogenous deposit on mucous membrane of lips and cheeks that is apparently hyperemic and edematic. Hypersalivation is present. What is the most likely diagnosis? Dermatitits multiformis, Duhring's disease Pemphigus vulgaris Erythema multiforme Nonacantholytic pemphigus Chronic herpes recidivicus A 32 year old woman complains about periodical appearance of small ulcers in the oral cavity. She has been suffering from this for 5 years, recurrences happen 4-5 times a year. The ulcer healing lasts for 10 days. Objectively: on a mucous membrane of lower lip there is a roundish lesion element 0,5 cm large covered with white deposit and surrounded by hyperemia border, very painful when touched. What is the most probable diagnosis? Chronic recurrent aphthous stomatitis Traumatic erosion Secondary syphilis Chronic recurrent herpes Duhring's herpetiform dermatitis A 62 year old patient complains of pain in the area of mucous membrane of hard palate on the left that is getting worse during eating with use of a complete removable denture. He has been suffering from this for 1,5 month. Objectively: left-sided hyperemia and edema of mucous membrane of hard palate; at the border of distal denture edge there is an ulcer with dense walls and fundus, surrounding tissues are infiltrated. The ulcer floor is tuberous,covered with fibrinous deposit; ulcer palpation is painful. What examination method is to be applied in the first place? Cytology Bacterioscopy Biopsy Allergic contact plastic test Serological reactions A 29-year-old patient complains about mouth soreness, body temperature rise up to 38,5oC, indisposition. Such condition has been occurring periodically for several years after the patient had had a cold. Objectively: lips are covered with haemorrhagic crusts, hyperaemic mucous membrane of lips and cheeks has erosions covered with fibrinous films. Hypersalivation is present. What is the most likely diagnosis? Multiform exudative erythema Pemphigus vulgaris Herpes recidivicus Herpetiform Duhring's dermatitis Stevens-Johnson syndrome A 30-year-old male patient complains about tongue pain that is getting worse during eating and talking. Objectively: there is a painful ulcer 0,6 cm large on the lateral surface of tongue. The floor is covered with grey deposit. The crown of the 47 tooth is destroyed. What is the most likely diagnosis? Trophic ulcer Decubital ulcer Hard chancre Tuberculous ulcer Cancerous ulcer 37. A. B. C. D. E. * 38. A. B. C. D. * E. 39. A. B. C. D. * E. 40. A. B. * C. D. E. 41. A. B. C. * D. E. A patient complains of burning, itch and lower lip enlargement. He has been suffering from this for a long time. Objectively: the patient's face is asymmetric due to the flattening of nasolabial fold. His lower lip is edematic, of normal colour, painless on palpation. The patient has plicated tongue. What is your provisional diagnosis? Granulomatous Miescher's cheilitis Quincke's edema Lymphangioma Hemangioma Melkersson-Rosenthal syndrome An 19 year old patient complains of gingival painfulness and haemorrhage, halitosis, temperature rise up to 38,6oC, general weakness, appetite loss. Objectively: mucous membrane of oral cavity is hyperemic and dry; tongue is covered with white fur, gingival papillae are edematic, their apices have areas of necrotic deposit that can be easily removed leaving bleeding surface beneath. Submaxillary lymph nodes are enlarged, palpatory painful. What is the causative agent of this disease? Virus of herpes simplex Streptostaphylococci Pale treponema Fusospirochetal symbiosis Candida fungi A 42-year-old patient complains about a rapidly growing formation on his lower lip. Examination of the red border of lips revealed a greyish-red nodule with a hollow in the centre which is filled with corneous masses that can be easily removed. The nodule is painless, mobile. What is your provisional Basal cell carcinoma diagnosis? Papilloma Nodulous verrucous precancer of red border Keratoacanthoma Localized precancerous hyperkeratosis of red border A young woman complained about having vesicles in oral cavity, painful ulcers, especially during talking and eating; muscle and joint pain, body temperature rise, indisposition, weakness. She fell suddenly ill 2 days ago. Objectively: to- 38,4oC. Vermilion border is covered with bloody crusts that stick together and impede mouth opening. Mucous membrane of lips, cheeks, mouth floor, tongue, soft palate is hyperemic and edematic; there are single vesicles and large painful erosions covered with fibrinous deposit on it. Regional lymph nodes are enlarged and painful. There is hypersalivation. Nikolsky's symptom is negative. What is the most probable diagnosis? Acantholytic pemphigus Multiform exudative erythema Secondary syphilis Acute herpetic stomatitis Non-acantholytic pemphigus A 27 y. o. steeplejack with a long record of service consults a dentist about dryness, burning and insignificant lip edema. The same symptoms were noted one year ago in autumn. What is the most likely diagnosis? Cheilitis glandularis Contact cheilitis Meteorogical cheilitis Manganotti's cheilitis Cheilitis exfoliativa 42. A. B. C. D. E. * 43. A. B. C. * D. E. 44. A. B. C. D. E. * 45. A. B. * C. D. E. 46. A. B. C. * D. E. A 39 year old patient applied to a dentist and complained about white caseous deposit on the dorsum of his tongue and burning sensation. It is known from the patient's anamnesis that he underwent treatment in an in-patient hospital on account of pneumonia. What is the most probable diagnosis? Lupus erythematosus Typical form of leukoplakia Lichen ruber planus Scarlet fever Acute pseudomembranous candidosis A patient complained about frequent haemorrhages from the mucous membrane of oral and nasal cavities, he mentioned also that his father had the same problems. Objectively: there are multiple telangiectasias and angimatous formations on face skin as well as on mucous membrane of nose, cheeks and lips. Blood count is normal. What is the most probable diagnosis? Vaquez disease Werlhof's disease Rendu-Osler-Weber disease Cushing's basophilism Addison-Biermer disease A 38-year-old builder complains about a condyloma on his lower lip. It appeared 1,5 month ago. It has been significantly growing throughout the last week. Objectively: the red border of the lower lip is cyanotic and infiltrated, it has some isolated closly adhering squamae. There is a well-defined hemispherical formation 8 mm in diameter and 4 mm high in the centre. The formation is of grey-and-blue-and-red colour, it has rough surface formed by thin, closely adhering and thick-based squamae. Regional lymph nodes are enlarged, mobile, dense and painless. What is the most likely Viral wart diagnosis? Verruciform precancer Pyogenic granuloma Keratoacanthoma Lower lip cancer A patient complains about pain in the oral cavity, burning and dryness. Examination revealed fiery-red dry mucous membrane. The tongue is crimson, dry, glossy, filiform papillae are atrophied. There is some deposit in tongue folds that is hard to be removed. The patient undergoes treatment for pneumonia, she takes antibiotics. What is the most likely diagnosis? Fastened erythema Acute atrophic candidiasis Pellagrous glossitis B2 hypovitaminosis Benign migratory glossitis Examination of a 26 year old patient revealed chronic candidosis of oral mucous membrane, generalized lymphadenopathy. Anamnesis data: the patient has been suffering from herpes for a year. Body temperature persistently rises up to 37,4-37,5oC, body weight has reduced by 8 kg over the last month. What disease can be indicated by this symptom group? Acute leukosis Infectious mononucleosis AIDS Chronic leukosis Candidosis 47. A. B. C. * D. E. 48. A. B. C. * D. E. 49. A. B. C. D. * E. 50. A. * B. C. D. E. 51. A. B. C. * D. E. A 23-year-old patient complains about acute pain in the mouth, headache, articular pain, body temperature rise up to 38,6oC. Red border of lips is covered with haemorrhagic crusts, mucous membrane of the oral cavity has big erosions and ulcers coated with greyish incrustation. Hand skin exhibits erythematous spots 1-1,5 cm in diameter with a vesicle in the middle. What is the most likely diagnosis? Lyell's syndrome Behcet's syndrome Stevens-Johnson syndrome Multiform exudative erythema Medicamentous stomatitis A 58-year-old patient complains of a painless formation on his tongue that appeared several months ago. Objectively: the patient has a lot of carious and completely decayed teeth, lateral surface of tongue exhibits a painless whitish formation 10x5 mm large with irregular surface in form of verrucae. Histological examination revealed thickening of corneal epithelial layer of intermittent keratinization type. What is the most likely diagnosis? Hyperplastic form of candidiasis Verrucous precancer Verrucous form of leukoplakia Hyperkeratotic form of lichen ruber planus Keratoacanthoma An 21-year-old patient complains about ulceration in the oral cavity, spontaneous bleeding of mucous membrane, pain during food intake and talking, nosebleeds. He has a history of: aggravation of general condition, weakness, body temperature rise up to 39oC, headache, joint pain. What method of diagnostics should be applied to confirm the diagnosis? HIV test Blood sugar test Immunogram Clinical blood analysis Allergy test A 27 year old patient applied to a clinic for the purpose of oral cavity sanitation. During preparation of the 45 tooth on account of chronic median caries the patient turned pale, there appeared cold clammy sweat on her forehead, nausea, ear noise. The patient lost consciousness. Objectively: pulse 50 bpm, AP - 80/60 mm Hg, shallow breath, miotic pupils. Make a diagnosis of this state: Syncope Anaphylactic shock Stenocardia Collapse Quincke's edema A 28-year-old patient was delivered to a traumatology centre with a dirty cut wound of her right foot. A doctor performed initial surgical d-bridement and made an injection of antitetanus serum. Some time later the patient’s condition got abruptly worse: she developed extreme weakness, dizziness, palpitation. Objectively: the skin is pale, the patient has cold sweat, frequent pulse of poor volume at a rate of 100 bpm, AP is 90/40 mm Hg. What is the cause of such aggravation? Pain shock Haemorrhagic shock Anaphylactic shock Infectious-toxic shock Drug disease (seroreaction) 52. A. B. C. D. E. * 53. A. B. C. * D. E. 54. A. B. * C. D. E. 55. A. B. * C. D. E. 56. A. B. C. D. * E. 57. A. B. * C. D. E. 58. A. * B. C. A 34-year-old man attended a glasshouse in a botanic garden. After he had smelt at an orchid he turned pale and lost consciousness. Objectively: heart rate is 115/min, arterial pressure is 50/0 mm Hg. What drug should be injected to the patient in the first place? Dimedrol Cordiamin Strophanthine Mesaton Prednisolone During patient examination doctor revealed white inclusions with the size of semolina grains or millet grain on the vestibule surface of lower lip. What can it be?: pink acne; Mikulych aphthae; Fordyce’s spots; salivary gland; chronic recurrent herpes. During taking patient anamnesis was revealed that patient is smoker. What is the color of the soft palate mucosa in smokers? bluish; deep red; yellow; pink; spotted pink. During patient examination was found small hemorrhages. They are: ecchymosis; petechiae; telangiectasia; roseola; erythema. During oral exam of 28 y.o. patient was found discoloration of the oral mucosa in a limited area (diameter 6 mm) which is not above the mucous level. What kind of element damage is in the patient? blisters; node; nodule; spot; aphtha. 44-year-old patient was diagnosed with herpes infection in his lower lip. During examination a few pustules was revealed. Pustule is: small bubble with serous content, located on the mucosa; little bubble with purulent content placed on the skin and lips red border up to 5 mm; without cavity formation tends to suppurate, viral etiology; without cavity formation with hemorrhagic content larger than 5 mm; without cavity formation of purulent hemorrhagic content located intraepithelial. During examination of 27-year-old painter cavernous element, filled with liquid was detected. What is that? blister; crack; aphthae; D. E. 59. A. B. C. * D. E. 60. A. B. C. D. * E. 61. A. * B. C. D. E. 62. A. B. C. D. E. * 63. A. * B. C. D. E. 64. A. * B. C. D. E. erosion; tubercle. During patient examination doctor decided to use additional exam methods. Find the additional examination method in the list. palpation; overview of the patient; stomatoscopy; life history; complaints. During examination of 29 y.o. patient symmetrical hillocks near 6th maxillary molars were detected. What can it be?: sweat glands; Mikulych aphthae; sebaceous glands; parotid maxillary duct; atsynoz glands. 25 years old man applied to a dental clinic for oral cavity sanation. Anamnesis data: mild case of diabetes. Objectively: mucous membrane of cheeks is unchanged, mainly in retromolar area there are symmetrically placed whitish papulae protruding over the mucous membrane and forming a lace-like pattern. On the upper jaw there are two soldered bridge dentures, the 47 tooth has an amalgam filling, the 46 tooth has a steel crown. What is the most probable Lichen ruber planus Secondary syphilis Leukoplakia Chronic atrophic candidosis Lupus erythematosus Roentgenological examination of a patient revealed a cyst in the area of a premolar that contained a tooth in its cavity. Microscopical examination reveals that the cyst wall is represented by connective tissue and lined with multistratal squamous cell epithelium. Specify the diagnosis: Primordial cyst Granuloma Epulis Follicular cyst Radicular cyst A patient is diagnosed with herpetic stomatitis provoked by immunosuppression. What medicine can provide antiviral effect? Acyclovir Remantadinum Amoxicillin Methisazonum Levamisole A doctor needs to anaesthetize the anterior part of mucous membrane of hard palate. What nerves should he block? Nasopalatine nerves Inferior alveolar nerves Pharyngeal nerves Zygomatic nerves Suborbital nerves 65. A. B. * C. D. E. 66. A. B. C. * D. E. 67. A. * B. C. D. E. 68. A. * B. C. D. E. 69. A. * B. C. D. E. 70. A. B. C. * D. E. Dentists widely apply local anaesthesia adding adrenalin to an anaesthetic solution. What is the purpose of this method? Local reduction of vascular resistance Local vasoconstriction Microcirculation improvement Local vasodilatation Lowering of arterial pressure Being at a dentist a patient had an attack of stenocardia. What drug from the nitrate group should be applied in this case? Menthol Iodine Nitroglycerine Hydrogen peroxide Paracetamol Soft palate arches were taken for bioptic examination because of suspected tumour (macroscopical examination revealed an ulcer with dense floor). Biopsy revealed necrosis of mucous membrane along with infiltration of submucous layer by lymphocytes, epithelioid cells, plasmatic cells, single neutrophils. There is also evident endo- and perivasculitis. What disease are the described changes typical for? Ulcerative necrotic stomatitis (Vincent's stomatitis) Aphthous stomatitis Pharyngeal diphtheria Primary syphilis Ulcerative stomatitis A doctor used novocaine as an anaesthetic during surgical manipulations. 10 minutes after the patient became pale, he got dyspnea and hypotension. What type of allergic reaction is it? Anaphylactic Cell-mediated Cytotoxic Stimulating Immune complex Mucous membrane of a patient's oral cavity has a greyish-white focus, the mass is dense and protrudes above the mucous membran E. Histological examination revealed hyperkeratosis, parakeratosis and acanthosis of epithelium in this are A. What pathological process was revealed in the mucous membrane? Leukoplakia Hyalinosis Inflammation Focal ichthyosis Leukoderm 27 year old patient complains of gum bleeding, itching in oral cavity, angular cheilitis, teeth mobility. It’s know from the anamnesis that last two years patient spent in Siberia. Deficiency of what vitamin can cause this changes? A B1 C D3 PP 71. A. B. C. * D. E. 72. A. B. C. D. * E. 73. A. B. C. * D. E. 74. A. B. C. D. E. 75. A. B. C. D. * E. 76. A. * B. C. D. E. 31 y.o. patient was diagnosed with scurvy. Deficiency of what vitamin can cause this changes? A B12 C PP B1 A 23 y.o. patient has been taking antibiotics on account of bronchopneumonia for a long time. There appeared pain and burning in the area of mucous mebrane of his lips and tongue. Objectively: mucous membrane of lips and tongue has caseous and white plaques that can be easily removed by a spatula leaving hyperemia foci on their spot. Microscopical examination of the plaques revealed mycelium. What is the most probable diagnosis? Leukoplakia Manganotti's cheilitis Angular cheilitis Candidous stomatitis Contact allergic cheilitis A 20 y.o. patient has been taking antibiotics on account of bronchopneumonia for a long time. There appeared pain and burning in the area of mucous mebrane of his lips and tongue. Objectively: mucous membrane of lips and tongue has caseous and white plaques that can be easily removed by a spatula leaving hyperemia foci on their spot. Microscopical examination of the plaques revealed mycelium.Patient was diagnosed with candidous stomatitis. What medicine should we use for its treatment? Antibiotics Antihistamines Antifungal Antiseptics Antiviral 25 year old female patient was diagnosed with meteorological cheilitis. What will be the treatment? Antibiotics Antiseptics Ointments Surgical treatment Antiviral 19 year female patient complains on lip burning and redness which she noticed after new lipstic using. What will be the diagnosis? Angular cheilitis Actinic cheilitis Rhomboid glossitis Allergic cheilitis Exfoliative cheilitis 17 year female patient complains on lip burning and redness which she noticed after new lipstic using. What will be the treatment in that case? Antihistamine ointment Antiviral medicine Antiseptic medicine No treatment is needed Antibiotics for 7 days 77. A. B. C. D. * E. 78. A. B. * C. D. E. 79. A. * B. C. D. E. 80. A. B. * C. D. E. 81. A. B. * C. D. E. 82. A. B. * C. D. E. During additional examination of 44 year old male patient was found positive Wassermann test. What will be the diagnosis at that case? AIDS HIV Tuberculosis Syphilis Gonorrhea During additional examination of 24 year old student with oral mucous membrane pathology Тreponema pallidum was revealed. What will be the diagnosis? Leprosy Syphilis Gonorrhea AIDS Flu 24 year old patient was diagnosed with syphilis. What microorganism was found during microbiological examination? Тreponema pallidum Candida albicans Streptococcus mutans Bacillus Kochii Retrovirus During editional examination of 27 years old patient Nikolskyy sign was used. What will be results of positive Nikolskyy sign? Purulent exudate can be revealed after blisters cutting The outer epidermis separates easily from the basal layer on exertion of firm sliding manual pressure The outer epidermis become pale after weak pressure Gums are bleeding after weak pressure with probe No correct answer During editional examination of 31 years old patient was performed Nikolskyy sign, which was negative. What will be results of positive Nikolskyy sign? Purulent exudate can be revealed after blisters cutting The outer epidermis separates easily from the basal layer on exertion of firm sliding manual pressure The outer epidermis become pale after weak pressure Gums are bleeding after weak pressure with probe No correct answer Patient complains about pain during swallowing, weakness, body temperature rise up to 39,6C, swelling of submental lymph nodes. Objectively: high body temperature, mucous membrane of oral cavity is brightly hyperaemic and edematic with haemorrhages and ulcerations. Pharynx is brightly hyperemic, lacunae are enlarged and have necrosis areas. Regional, cervical, occipital lymph nodes are painful, enlarged and dense. What is the most likely diagnosis? Acute herpetic stomatitis Infectious mononucleosis Lacunar tonsillitis Herpetic angina Necrotizing ulcerative gingivostomatitis 83. A. B. * C. D. E. 84. A. * B. C. D. E. 85. A. B. * C. D. E. 86. A. B. C. D. * E. 87. A. B. C. D. E. * 88. A. B. A 65-year-old patient complains about pain in the oral cavity induced by eating. He suffers from CH-Objective examination revealed dyspnea, limb edem-Oral cavity isn't sanitate-On the mucous membrane on the right, there is an ulcer with irregular edges covered with greyish-white necrotic deposit with low-grade inflammation around it. There is also halitosis. What is the most probable Tuberculous diagnosis? ulcer Trophic ulcer Cancerous ulcer Traumatic ulcer Ulcero-necrotic stomatitis A 27-year-old male complains of pain, bad breath, body temperature rise up to 38,0o-Objectively: the patient is pale, adynamic. Regional lymph nodes are enlarged and painful. Gums are edematic, hyperaemic, ulcerated, covered with necrotic plaque. There is an excessive buildup of calculus. What additional study should be done in the first place? Complete blood count X-ray of jaws Test for HIV infection Blood sugar test Microscopy of gingival plaque A 36-year-old patient complains of discoloration of the vermilion border of the lower lip that he noticed about 4 months ago. Objectively: in the center of the vermilion border of the lower lip there is an irregular homogeneous grayish-white area 1x1,5 cm large that doesn't rise above the vermilion border and has distinct outlines. Palpation of this area is painless. The film cannot be removed when scrapes. Upper incisors are covered with dentures. What is the most likely diagnosis? Lupus erythematosus Leukoplakia Premalignant circumscribed hyperkeratosis Lichen ruber planus Candidous cheilitis A 37-year-old female patient complains of inability to eat hot and cold food, as well as of intense pain caused by sour, sweet and salty food. Objectively: Probing and cold test of all teeth cause acute pain. What is the most likely diagnosis? Enamel necrosis Pathological abrasion of dental hard tissues Enamel erosion Hyperesthesia of dental hard tissues Enamel hypoplasia During taking of impressions (by gyps) patient presented with the following symptoms: paroxysmal cough, cyanosis, vomiting, clapping sound during inspiration. Make the diagnosis: Attack of bronchial asthma Hypersensitive gag reflex Tracheitis Acute bronchitis Aspiration of a foreign body A patient complains of burning, itch and lower lip enlargement. He has been suffering from this for a long time. Objectively: the patient's face is asymmetric due to the flattening of nasolabial fol-His lower lip is edematic, of normal colour, painless on palpation. The patient has plicated (fissure) tongue. What is your provisional diagnosis? Hemangioma Quincke's edema C. D. E. * 89. A. * B. C. D. E. 90. A. B. C. D. E. * 91. A. B. C. * D. E. 92. A. B. C. D. E. * 93. A. * B. C. D. E. Granulomatous Miescher's cheilitis Lymphangioma Melkersson-Rosenthal syndrome A 51-year-old female patient complains of dry mouth, taste impairment, burning and pricking sensations in the tongue that disappear during eating but intensify at the end of the day. For the first time such problems arose 2 years ago after a psychic traum-She has a history of anacid gastritis. Objectively: the general condition is satisfactory, the patient is restless, tearful. Oral mucosa is pale pink, dry; filiform papillae on the dorsum of tongue are normal. Pharyngeal reflex is dramatically reduced. There is segmetal disturbance of facial skin sensation. What is the most likely diagnosis? Glossodynia Desquamative glossitis Chronic atrophic candidous glossitis Ganglionitis of sublingual ganglions Hairy tongue At a dentist's appointment a patient complained of weakness, nausea, blackout, and then he lost consciousness. Make a diagnosis: Collapse Shock Insult Coma Syncope Analysis of the contents of periodontal pockets revealed a significant contamination with Candida yeast fungi. Which of the following drugs should be used for instillations? Biseptol Diclofenac sodium Clotrimazole Paracetamol Ibuprom During the preparation of a tooth a patient had an epileptic attach. What was doctors mistake at that case? Skipped psychological preparation of the patient Did not apply one of the types of local anesthesia Violated the rules of preparation Didn't apply general anaesthesia Didn't collect complete history data A 32-year-old patient complains of a neoplasm on the tip of the tongue which he hurts with his teeth. The neoplasm sometimes increases, and sometimes decreases in size. Objectively: on the tip of tongue there is a roundish neoplasm 0,5 cm in diameter with distinct borders and broad base and looks like cauliflower. The neoplasm is the same colour as the mucosa of tongue. What is the most likely diagnosis? Papilloma of tongue Chancre of the tongue Abscess of tongue Cancer of the tongue Hairy tongue 94. A. B. C. D. * E. 95. A. B. C. D. E. * 96. A. B. C. D. E. * 97. A. B. C. D. E. * 98. A. B. * C. D. E. A 28-year-old teacher consulted a doctor about thirst, massive gingival haemorrhages, dry mouth, mobility and shifting of teeth, purulent discharges from the gums, bad breath. According to the patient, these presentations turned up about 2 months ago. Before the diagnosis can be made, the following tests should be done in the first place: Immunological studies Acute-phase reactants tests Allergological tests Blood sugar test Serologic studies A 33-year-old male patient complains of dryness and burning of tongue back that appeared for about a week ago and get worse when he eats irritating food. The patient has a history of recent pneumonia. He had been treated in the in-patient hospital for 2 weeks, the treatment program included antibiotics. Now he doesn't take any drugs. Objectively: mucous membrane of the oral cavity is hyperemic, dry, glossy. Tongue back and palate have greyish-white plicae that can be easily removed. Threads of saliva trail behind the spatul-What is the most likely diagnosis? Chronic hyperplastic candidiasis Acute stomatitis Allergic stomatitis Medicamental stomatitis Acute pseudomembranous candidiasis A patient working as a bricklayer complains of itching, burning, soreness of lips that show up only in the summer period. He has been ill for 3 years. Objectively: vermilion border of the lower lip is hyperemic, edematic, covered with blisters and painful erosions 2 mm in diameter, crusts, cracks. What is the most likely diagnosis? Angular cheilitis Exfoliative cheilitis, exudative form Contact allergic cheilitis Eczematous cheilitis, exudative form Actinic cheilitis, exudative form A 17-year-old patient presents with weakness, pain in throat when swallowing, body temperature rise up to 38,0 C. Examination of the the oral cavity revealed massive hyperaemia of the mucous membrane of the soft palate, palatine arches, tonsils, uvula; there were also single vesicles and erosions extremely painful when touched. Regional lymph nodes are enlarged, painful on palpation. What is the most likely diagnosis? Chickenpox Infectious mononucleosis Mycotic angina Diphtheria Herpangina A 42-year-old male patient complains of fatigue and headache, limb numbness, dry mouth, burning and pain in the tongue. Objectively: skin and oral mucosa are pale. There are painful cracks in the corners of mouth. Dorsum of tongue is smooth, glossy, with bright red stria-In blood: Hb- 70 g/l, RBCs - 1,5*1012/l, color index - 1,6, leukopenia, thrombocytopenia, lymphocytosis. What is the most likely diagnosis? Iron deficiency anemia Addison-Biermer anemia Chronic posthaemorrhagic anemia Aplastic anemia Late chlorosis 99. A. B. C. D. E. * 100. A. * B. C. D. E. 101. A. B. * C. D. E. 102. A. B. * C. D. E. 103. A. B. * C. D. E. A 38-year-old patient complains of a significant enlargement of the upper lip and eyelids, which developed within a few minutes (during cleaning the house with a detergent). Objectively: there is an edema of the upper part of face, upper lip and eyelids. Palpation is painless. What disease are these symptoms typical for? Melkersson-Rosenthal syndrome Glandular cheilitis Lymphedema Macrocheilitis Angioneurotic Quincke's edema A 24-year-old patient complains of mouth soreness, body temperature rise up to 38,5oC, indisposition. Such condition has occurred periodically for several years after the patient had had a col-Objectively: lips are covered with haemorrhagic crusts, hyperaemic mucous membrane of lips and cheeks has erosions covered with fibrinous films. Hypersalivation is present. What is the most Multiform exudative erythema likely diagnosis? Herpetiform Duhring's dermatitis Stevens-Johnson syndrome Pemphigus vulgaris Herpes recidivicus A 45-year-old patient complains of subfebrile temperature and a growing ulcer on the gingival mucosa around the molars; looseness of teeth in the affected area, cough. Objectively: gingival mucosa in the region of the lower left molars has two superficial, extremely painful ulcers with undermined edges. The ulcers floor is yellowish, granular, covered with yellowish pink granulations. The ulcers are surrounded by the tubercles. Dental cervices are exposed, there is a pathological tooth mobility. Regional lymph nodes are enlarged and make dense matted together groups. What is the Syphilis most likely diagnosis? Tuberculosis Decubital ulcer Infectious mononucleosis Acute aphthous stomatitis An 26-year-old musician complains about body temperature rise, weakness, pain induced by eating and deglutition. Objectively: mucous membrane of the oral cavity is erythematic with multiple petechies. Pharynx is hyperaemic. Regional lymph nodes are enlarged, mobile, painless. In blood: leukocytosis, monocytosis, atypic mononuclear cells, ESR is 30 mm/h. What is the leading factor of disease development? Immediate allergy Viral infection Delayed allergy Autoimmune disorders Bacterial infection Objective examination of a 19 years old girl revealed that her lower lip was slightly hyperemic, infiltrated, dry, covered with small scales. Architectonics of lips is changed. Patient complains of dryness and a feeling of tense lips, especially in autumn and winter. She also had a bad habit of lip sucking. What is the most likely diagnosis? Allergic cheilitis Meteorological cheilitis Microbial cheilitis Atopic cheilitis Exfoliative cheilitis 104. A. B. C. D. E. 105. A. B. C. * D. E. 106. A. B. * C. D. E. 107. A. B. C. D. * E. 108. A. B. C. D. * E. 109. A 32 year old manager complains about itch, burning and edema of lips. She has been suffering from this for a week. Objectively: reddening of vermilion border and skin, especially in the region of mouth corners, there are also vesicles, crusts, small cracks along with erythematous affection of vermilion border. What is the most likely diagnosis? Acute herpetic cheilitis Exudative form of exfoliative cheilitis Acute eczematous cheilitis Fungal stomatitis Multiform exudative erythema Parents of an 9-year-old child complain about a painful formation in the child's oral cavity that obstructs food intake. The same complaints were registered two years ago. Mucous membrane of lateral tongue surface is hyperemic and edematic. There is an oval erosion over 0,7 cm large covered with yellow greyish deposit. Erosion edges are hyperemic and painful on palpation. The child has a history of chronic cholecystocholangitis. What is the most likely diagnosis? Erythema multiforme Stevens-Johnson syndrome Chronic recurrent aphthous stomatitis Traumatic erosion Behcet's syndrome During tooth extraction a 24-year-old patient presented with sudden weakness, pale skin, cold sweat, weak pulse, a significant AP drop (diastolic pressure - 40 mm Hg). What complication developed in the patient? Anaphylactic shock Collapse Attack of stenocardia Syncope Traumatic shock During the examinations and everyday orthopaedic manipulations a dentist uses a dental mirror. What is the way of dental mirrors sterilization? In the 6% hydrogen peroxide solution for 6 hours In the 0,5% ethyl spiritus solution for 20 minutes In the dry heat sterilizer at 180oC for 10 minutes In the triple solution for 30 minutes In the 0,01% chloramine solution for 2 minutes A 43-year-old gallerist complains of pain under the dental bridge. After its removal the patient has been found to have an ulcer 0,3x0,5 cm large on the alveolar process. The ulcer is slightly painful and soft, the surrounding mucosa is hyperaemic, submandibular lymph nodes are not enlarged. What is a provisional diagnosis? Tuberculous ulcer Trophic ulcer Cancerous ulcer Decubital ulcer Sutton aphtha A 70-year-old musician complains of pain in the lower jaw region on the right. He has been using complete removable dentures for the upper and lower jaw for 12 years. He is smoker. Objectively: the right retromolar region exhibits a 1,51,2 cm large proliferation of mucous membrane in form of cauliflower, here and there there are dense fissured - like ulcers. The surrounding mucous membrane is cyanotic, infiltrated. When the teeth are closed, the mentioned formation contacts with the posterior edges of the dentures. What is the provisional diagnosis: A. * B. C. D. E. 110. A. B. C. * D. E. 111. A. B. C. D. * E. 112. A. B. C. * D. E. 113. A. B. C. D. E. * 114. A. B. C. * D. Cancer of the mucous membrane Hypertrophic gingivitis Decubital ulcer Leukoplakia Syphilis ulcer A 20 year old girl complains about burning and painfulness of her tongue, especially during eating spicy food. Objectively: there are oval red spots on the tip and dorsum of tongue. Filiform papillae are not present in the affected area. The girl mentions that the spots become periodically larger and have migratory nature. What is the most probable diagnosis? Raspberry tongue Median rhomboid glossitis Glossitis areata exfoliativa Candidosis Lingua plicata (fissured tongue) A 25 year old patient complaines about painfulness of his lower lip. He has been suffering for two months. Objectively: mucous membrane of lower lip is hyperemic, excretory ducts of minor salivary glands are dilated, "dew" symptom is present. What is the most probable diagnosis? Contact allergic cheilitis Meteorological cheilitis Cheilitis exfoliativa Cheilitis glandularis Microbal cheilitis During tooth extraction a 53 year old patient felt dull pain behind her breastbone, got a sense of compression. A dental surgeon diagnosed her with a stenocardia attack. What medication should be given this patient in order to arrest this state? Analgin Ketanov Nitroglycerine, validol Baralgin Dimedrol A 33 year old designer applied to a dental clinic for oral cavity sanation. Anamnesis data: mild case of diabetes. Objectively: mucous membrane of cheeks is unchanged, mainly in retromolar area there are symmetrically placed whitish papulae protruding over the mucous membrane and forming a lace-like pattern. On the upper jaw there are two soldered bridge dentures, the 37 tooth has an amalgam filling, the 36 tooth has a steel crown. What is the most probable diagnosis? Leukoplakia Secondary syphilis Chronic atrophic candidosis Lupus erythematosus Lichen ruber planus A 46 year old patient complained about painful ulcer on the lateral surface of his tongue. Objectively: left lateral surface of tongue has a roundish ulcer with undermined soft overhanging edges, palpatory painful, ulcer floor is slightly bleeding and covered with yellowish nodules. What is the most probable diagnosis? Syphilis Traumatic ulcer Tuberculosis Actinomycosis E. 115. A. B. C. D. E. * 116. A. B. C. * D. E. 117. A. B. * C. D. E. 118. A. B. C. D. * E. 119. A. * B. C. D. Trophic ulcer A 63 year old patient complains of pain in the area of mucous membrane of hard palate on the left that is getting worse during eating with use of a complete removable denture. He has been suffering from this for 1,5 month. Objectively: left-sided hyperemia and edema of mucous membrane of hard palate; at the border of distal denture edge there is an ulcer with dense walls and fundus, surrounding tissues are infiltrated. The ulcer floor is tuberous, covered with fibrinous deposit; ulcer palpation is painful. What examination method is to be applied in the first place? Allergic contact plastic test Cytology Serological reactions Bacterioscopy Biopsy A 40 year old homeless and unemployed patient complains about body temperature rise up to 39oC, pain during eating and deglutition, nasal haemorrhages. He has been suffering from this for 10 days. Objectively: herpetic rash on the lips, irregular-shaped erosions covered with fibrinous deposit on the mucous membrane of oral cavity; filmy deposits on the tonsils. Liver is enlarged and scleroti C. Blood count: erythrocytes - 4,5*1012/l; hemoglobin - 120 g/l; ESR - 25 mm/h; leukocytes – 10*109/l; eosinophils - 0; rod nuclear cells - 2; segmentonuclear leukocytes - 31, lymphocytes - 41; monocytes - 10; atypical mononuclears .What is the diagnosis? Acute leukosis Acute herpetic stomatitis Infectious mononucleosis AIDS Oropharyngal diphtheria A 29 year old woman complains about periodical appearance of small ulcers in the oral cavity. She has been suffering from this for 5 years, recurrences happen 4-5 times a year. The ulcer healing lasts for 10 days. Objectively: on a mucous membrane of lower lip there is a roundish lesion element 0,5 cm large covered with white deposit and surrounded by hyperemia border, very painful when touched. What is the most probable diagnosis? Secondary syphilis Chronic recurrent aphthous stomatitis Chronic recurrent herpes Traumatic erosion Duhring's herpetiform dermatitis Examination of a 40 year old patient revealed chronic candidosis of oral mucous membrane, generalized lymphadenopathy. Anamnesis data: the patient has been suffering from herpes for a year. Body temperature persistently rises up to 37,4-37,5oC, body weight has reduced by 8 kg over the last month. What disease can be indicated by this symptom group? Infectious mononucleosis Candidosis Acute leukosis AIDS Chronic leukosis A 24 year old patient applied to a dentist and complained about white caseous deposit on the dorsum of his tongue and burning sensation. It is known from the patient's anamnesis that he underwent treatment in an in-patient hospital on account of pneumoni A. What is the most probable diagnosis? Acute pseudomembranous candidosis Typical form of leukoplakia Scarlet fever Lichen ruber planus E. 120. A. B. C. D. * E. 121. A. B. C. D. * E. 122. A. B. C. * D. E. 123. A. B. * C. D. E. 124. A. Lupus erythematosus An 20 year old patient complains of gingival painfulness and haemorrhage, halitosis, temperature rise up to 38,6oC, general weakness, appetite loss. Objectively: mucous membrane of oral cavity is hyperemic and dry; tongue is covered with white fur, gingival papillae are edematic, their apices have areas of necrotic deposit that can be easily removed leaving bleeding surface beneath. Submaxillary lymph nodes are enlarged, palpatory painful. What is the causative agent of this disease? Pale treponema Candida fungi Virus of herpes simplex Fusospirochetal symbiosis Streptostaphylococci A young woman complained about having vesicles in oral cavity, painful ulcers, especially during talking and eating; muscle and joint pain, body temperature rise, indisposition, weakness. She fell suddenly ill 2 days ago. Objectively: to- 38,4oC. Vermilion border is covered with bloody crusts that stick together and impede mouth opening. Mucous membrane of lips, cheeks, mouth floor, tongue, soft palate is hyperemic and edematic; there are single vesicles and large painful erosions covered with fibrinous deposit on it. Regional lymph nodes are enlarged and painful. There is hypersalivation. Nikolsky's symptom is negative. What is the most probable diagnosis? Acantholytic pemphigus Non-acantholytic pemphigus Acute herpetic stomatitis Multiform exudative erythema Secondary syphilis A 34 year old patient applied to an oral surgeon for the purpose of oral cavity sanitation. After anesthetization the patient felt sudden attack of nausea, weakness, he got the sense of compression behind his breastbone, heart pain; he began vomiting. The patient lost consciousness, there appeared convulsions. Objectively: the patient's skin is pale, covered with cold clammy sweat, pupils don't react to the light. The pulse is thready, arterial pressure cannot be detected. What is the most probable diagnosis? Syncope Anaphylactic shock Collapse Traumatic shock Epileptic attack A 26-years-old patient complains about a small ulcer on the red border of her lower lip that has been irresponsive to self-treatment for two weeks. Objectively: unchanged red border of lower lip has a circular ulcer of 2 mm in diameter with raised regular edges, its floor is of meat-like colour, dense, shiny, with "stearic film", with cartilaginoid infiltration, painless on palpation. Regional lymph node is enlarged, of tight elastic consistency, painless, mobil e. What is the most likely diagnosis? Cancerous ulcer Primary syphilis Tuberculous ulcer Decubital ulcer Lupus erythematosus An 17-year-old student complains of roughness and dryness of mucous membrane of the oral cavity. He always bites uncontrolledly off mucous membrane along the line of teeth joining. The patient suffers from chronic cholecystitis, he is smoker. Hygiene index is 2,3. Objectively: mucous membrane along the line of teeth joining is quaggy, edematic, whitish. What is the leading factor of this disease development? Unsatisfactory level of oral cavity hygiene B. * C. D. E. 125. A. B. * C. D. E. 126. A. * B. C. D. E. 127. A. B. C. D. * E. 128. A. * B. C. D. E. 129. A. * B. C. Habitual biting of mucous membrane of the oral cavity Xerostomia Smoking Somatic pathology A 54-year-old patient complains about a rapidly growing formation on his lower lip. Examination of the red border of lips revealed a greyish-red nodule with a hollow in the centre which is filled with corneous masses that can be easily removed. The nodule is painless, mobil e. What is your Nodulous precancer of red border provisionalverrucous diagnosis? Keratoacanthoma Basal cell carcinoma Localized precancerous hyperkeratosis of red border Papilloma Preventive examination of a 19-year-old schoolboy revealed unremovable grey-and-white layerings on the mucous membrane of cheek along the line of teeth joining. Mucous membrane is slightly hyperaemic, painless on palpation. The boy is emotionally unbalanced, bites his cheeks. What is the most likely diagnosis? Mild leukoplakia Lichen ruber planus Multiform exudative erythema Chronic candidous stomatitis Chronic recurrernt aphthous stomatitis A 53-year-old patient complains about a nonhealing ulcer on his lower lip. The patient is smoker. He hasn’t ever consulted a doctor about it. In the region of red border of the lower lip a roundish ulcer is present. It is up to 2,0 cm in diameter. The ulcer edges are thickened and a little bit raised in form of a whitish swelling. In the left submandibular region palpation revealed enlarged, painless, dense lymph nodes with limited mobility. What is the most likely diagnosis? Fibroma of the lower lip Erosive verrucous leukoplakia Syphilitic ulcer Cancer of the lower lip Keratoacanthoma A 65-year-old female patient was waiting for her turn at the dentist’s. Suddenly she fell down, her respiration became hoarse, she got convulsive twitching in her upper and lower limbs, face and neck turned cyanotic, eye pupils became mydriatic, reaction of eye to light was absent. Arterial pressure and pulse couldn’t be measured. Heart sounds couldn’t be auscultate d. Involuntary urination was noted. What condition is characterized by such symptoms? Clinical death Collapse Coma Epilepsy Shock A 28-year-old patient complains about acute pain in the mouth, headache, articular pain, body temperature rise up to 38,6oC. Red border of lips is covered with haemorrhagic crusts, mucous membrane of the oral cavity has big erosions and ulcers coated with greyish incrustation. Hand skin exhibits erythematous spots 1-1,5 cm in diameter with a vesicle in the middl e. What is the most likely diagnosis? Multiform exudative erythema Lyell's syndrome Medicamentous stomatitis D. E. 130. A. * B. C. D. E. 131. A. B. C. * D. E. 132. A. B. C. D. * E. 133. A. B. C. D. E. * 134. A. * B. C. D. E. Stevens-Johnson syndrome Behcet's syndrome An 19-year-old patient complains about body temperature rise, weakness, pain induced by eating and deglutition. Objectively: mucous membrane of the oral cavity is erythematic with multiple petechi a. Pharynx is hyperaemi c. Regional lymph nodes are enlarged, mobile, painless. In blood: leukocytosis, monocytosis, atypic mononuclears, ESR is 30 mm/h. What is the leading factor of disease Viral infection development? Immediate allergy Delayed allergy Bacterial infection Autoimmune disorders A 26-year-old patient complains of heavy gingival haemorrhages, pain in the oral cavity, weakness, fatigue, fever up to 38°C. These presentations appeared a week ago. Objectively: the patient is pale, adynamic. Examination of the oral mucosa reveals multiple haemorrhages, friable gums, necrotic areas on the tops of gingival papillae, as well as enlarged, soft, painless lymph nodes. The oral mucosal lesion can be a symptom of the following disease: Vincent stomatitis Chronic leukemia Acute leukemia Hypovitaminosis C Intoxication with heavy metal salts A 25-year-old male complains of pain, bad breath, body temperature rise up to 38°C. Objectively: the patient is pale, adynamic. Regional lymph nodes are enlarged and painful. Gums are edematic, hyperaemic, ulcerated, covered with necrotic plaque. There is an excessive buildup of calculus. What additional study should be done in the first place? Blood sugar test Test for HIV infection X-ray of jaws Complete blood count Microscopy of gingival plaque A 68-year-old patient complains of burning pain in the corners of mouth. Objectively: the folds of mouth corners have erosions, covered with white coating that can be easily removed, mucous membrane of mouth corners is macerated, white. There is pathological tooth wear and decreased vertical dimension of occlusion. What is your provisional diagnosis? Streptococcal angular cheilitis Syphilitic angular cheilitis Atopic cheilitis Chronic recurrent labial fissure Angular cheilitis candidiasis 26-year-old patient consulted a doctor about massive gingival haemorrhages, dry mouth, mobility and shifting of teeth, purulent discharges from the gums, bad breath. According to the patient, these presentations turned up about 2 months ago. Before the diagnosis can be made, the following tests should be done in the first place: Blood sugar test Allergological tests Serologic studies Acute-phase reactants tests Immunological studies 135. A. B. C. * D. E. 136. A. B. * C. D. E. 137. A. B. C. D. E. * 138. A. B. C. * D. E. 139. A. B. C. * D. E. A 34-year-old patient complains of gingival haemorrhages, fatigue, indisposition. The symptoms have appeared quite recently. Objectively: the skin and oral mucosa are pale. Gums bleed when touched. There are petechiae on the mucous membrane of cheeks, lips and palate. What laboratory test will allow to make a diagnosis? Blood test for Vitamin C Blood test for sugar Complete blood count Bleeding time test Immunogram 21-year-old patient complains of general weakness, fever, headache. These presentations appeared three days ago. Objectively: the regional lymph nodes are enlarged, painful on palpationl, body temperature is 37,8°C, oral mucosa is hyperemic and edematous. Mucous mebrane of lips, palate, gums, cheeks presents single erosions of polycyclic irregular shape, covered with grayish-white film, painful. Which drugs should be administered for the local treatment of the early disease? Diet Antiviral Corticosteroid ointments Keratoplastic agents Antiseptics A 30-year-old female patient complains of peeling, dryness and burning of the lower lip. Objectively: on the vermilion border of lip there are multiple gray scales with tightly attached center and peeling off edges. The scales are found all across the mouth and from the wet-dry line to the middle of the lip. The skin is not affected. Scales removal doesnt lead to erosions. The patient has the lability of psycho-emotional sphere. What is the most likely diagnosis? Eczematous cheilitis Actinic cheilitis Exfoliative cheilitis, exudative form Meteorological cheilitis Exfoliative cheilitis, dry form A 46-year-old patient complains about itch, burning and edema of lips. These presentations occured a week ago. Objectively: there is reddening of vermilion border and skin, especially in the region of mouth corners, there are also vesicles, crusts, small cracks along with erythematous affection of vermilion border. What is the most likely diagnosis? Acute herpetic cheilitis Multiform exudative erythema Acute eczematous cheilitis Allergic contact cheilitis Exudative form of exfoliative cheilitis A 45-year-old male patient complains of fatigue and headache, limb numbness, dry mouth, burning and pain in the tongue. Objectively: skin and oral mucosa are pale. There are painful cracks in the corners of mouth. Dorsum of tongue is smooth, glossy, with bright red striae. Blood count: Hb - 70 g/l, RBCs - 1,5x1012/l, colour index - 1,6, leukopenia, thrombocytopenia, lymphocytosis. What is the most likely diagnosis? Late chlorosis Chronic posthaemorrhagic anemia Addison-Biermer anemia Iron deficiency anemia Aplastic anemia 140. A. B. C. * D. E. 141. A. B. C. * D. E. 142. A. B. * C. D. E. 143. A. * B. C. D. E. 144. A. * B. C. D. E. 25 female patient complains about having crusts, lip tenderness, especially at lip joining. Objectively: there are yellow-brown crusts on the lip red border from Klein zone to its middle, after their removal bright red smooth surface without erosions appears. Mucous membrane in Klein zone is slightly hyperemic and edematic. What is the most likely diagnosis? Epidermolysis bullosa Exudative form of cheilitis actinica Exudative form of cheilitis exfoliativa Meteorological cheilitis Eczematous cheilitis A 29 y.o. male patient complains of a painless nonhealing mouth ulcer. Objectively: regional lymph nodes are enlarged, painless, of cartilaginous consistency. On the buccal mucosa there is a round ulcer 1 cm in diameter with regular raised edges and a dense elastic infiltrate at the base. The ulcer surface is of red colour, painless on palpation. What is the most likely diagnosis? Secondary tuberculosis Primary tuberculosis Primary syphilis Cancer Secondary syphilis A 53-year-old patient complains of a painful ulcer in the mouth that is getting bigger and does not heal over 1,5 months. Objectively: on the buccal mucosa there is a shallow soft ulcer 2 cm in diameter with irregular undermined edges. The ulcer floor is uneven and covered with yellow-gray coating. The ulcer is surrounded by many small yellowish tubercles. Regional lymph nodes are elastic, painful, matted together. Which disease is characterized by such symptoms? Ulcerative necrotizing stomatitis Tuberculosis Lichen planus Syphilis Cancer A 31 y.o. patient complains of general weakness, pain in the gums, halitosis. Objectively: the patient is pale, adynamic, body temperature is 38,5°C, submandibular lymph nodes are enlarged, painful on palpation. Interdental gingival papillae are inflamed, their tops are "detruncated", covered with gray-yellow necrotic incrustation. Radiography of alveolar process and blood count reveal no apparent changes. What is the most likely diagnosis? Acute ulcerous gingivitis Acute leukosis Localized periodontitis Agranulocytosis Generalized periodontitis A 62-year-old patient complains of burning tongue, a metallic taste in mouth. Three months ago she got a dental bridge made of gold and supported by the 16, 14 teeth. Oral cavity exasmination reveals no objective changes. The 36, 37, 46 teeth are sealed with amalgam fillings. What is the most likely cause of this condition? Galvanic currents Neurologic disorder Mechanic trauma Chemical factors Allergy 145. A. B. C. D. * E. 146. A. B. C. D. * E. 147. A. B. C. * D. E. 148. A. * B. C. D. E. 149. A. B. * C. D. E. 150. A. A 31-year-old patient complains of general weakness, spasmodic neuralgic pain in the right side of face, rash in the mouth and on the skin. Objectively: lip and chin skin is markedly hyperemic, there are numerous vesicles with clear exudate on the right. The right cheek mucosa is hyperemic, there is a string of erosions covered with fibrinous pellicle. What is the provisional diagnosis? Acute herpetic stomatitis Allergic stomatitis Aphthous fever Herpes zoster Pemphigus vulgaris A 23-year-old patient complains of roughness and dryness of mucous membrane of the oral cavity. He always bites uncontrolledly off mucous membrane along the line of teeth joining. The patient suffers from chronic cholecystitis, he is smoker. Hygiene index is 2,3. Objectively: mucous membrane along the line of teeth joining is quaggy, edematic, whitish. What is the leading factor of this disease development? Unsatisfactory level of oral cavity hygiene Xerostomia Smoking Habitual biting of mucous membrane of the oral cavity Somatic pathology A chemical plant worker consulted a dentist about an oral mucosa burn caused by caustic soda. Which of the following medications should be chosen for emergency care? 0,1% liquid ammonia 50% ethyl alcohol 0,5% acetic acid solution 3% sodium chloride solution 2% citric acid solution A 19-year-old student suffers from a disease without prodromal manifestations that declares itself through oral mucosa lesion consisting of 1-2 roundish elements 5-8 mm large which are circumscribed by a hyperemic rim and covered with yellow-grey coating. The disaese recurrence is observed quite regularly 3-4 times a year. These presentations are typical for the following disease: Chronic recurrent aphthous stomatitis Chronic herpes recidivicus Papular syphilis Erythema multiforme Lichen ruber planus A 57-year-old female patient complains about dryness and burning of the lateral surface of her tongue. These sensations disappear during eating. She noted such sensations three months ago. She has a history of gastritis with reduced secretory function. Objectively: mucous membrane of tongue and oral cavity has no peculiarities. The back of tongue has thin white coating. Regional lymph nodes are unpalpable. Oral cavity is sanitized. What is the most likely diagnosis? Hunter-Moeller glossitis Glossodynia Candidiasis Lingual nerve neuritis Desquamative glossitis A 46-year-old patient complains about a sensation of foreign body on his tongue, discomfort during talking, oral cavity dryness. Objectively: there are dark filiform papillae up to 5 mm long on the back of tongue. What is the most likely diagnosis? Acute glossitis B. * C. D. E. 151. A. B. C. D. E. * 152. A. B. C. * D. E. 153. A. B. * C. D. E. 154. A. B. * C. D. E. 155. Glossophytia (hairy tongue) Benign migratory glossitis Median rhomboid glossitis Fissured tongue 33-year-old woman complains about severe pain in the mouth, body temperature up to 38°C, indisposition. The same condition occurs periodically for several years after catching a cold. Objectively: the lips are covered with bloody crusts, there are opened bladders and erosions, covered with fibrinogenous deposit on mucous membrane of lips and cheeks that is apparently hyperemic and edematic. Hypersalivation is present. What is the most likely diagnosis? Nonacantholytic pemphigus Chronic herpes recidivicus Flu Dermatitits multiformis, Duhrings disease Erythema multiforme 28 year old driver complains of acute pain in his mouth and sore throat, difficult ingestion, indisposition, temperature rise up to 38,6°C. These symptoms appeared after exposure to cold. He has been ill for a day, in the evening he has to go to work. Objectively: gums in the area of inferior frontal teeth as well as pharynx mucous membrane are hyperemic, edematic; gingival edge is necrotic, tonsills are enlarged. Results of bacterioscopy: fusospirochetal symbiosis. In blood: erythrocytes - 4,5x1012/l; leukocytes - 7,2x109/l; ESR - 18 mm/h. What actions should a To give him antake? order for hospitalization in oral department stomatologist To prescribe a medication and allow to go to work To prescribe a medication and give a sick-list To refer him to an infectious disease specialist To refer him to an otolaryngologist 71 year old patient complains of pain in the area of mucous membrane of hard palate on the left that is getting worse during eating with use of a complete removable denture. He has been suffering from this for 1,5 month. Objectively: left-sided hyperemia and edema of mucous membrane of hard palate; at the border of distal denture edge there is an ulcer with dense walls and fundus, surrounding tissues are infiltrated. The ulcer floor is tuberous, covered with fibrinous deposit; ulcer palpation is painful. What examination method is to be applied in the first place? Serological reactions Biopsy Blood test Bacterioscopy Allergic contact plastic test A 35-year-old writer patient complains of mouth soreness, body temperature rise up to 38,5°C, indisposition. Such condition has occurred periodically for several years after the patient had had a cold. Objectively: lips are covered with haemorrhagic crusts, hyperaemic mucous membrane of lips and cheeks has erosions covered with fibrinous films. Hypersalivation is present. What is the most likely diagnosis? Stevens-Johnson syndrome Multiform exudative erythema Herpes recidivicus Pemphigus vulgaris Herpetiform Duhrings dermatitis Preventive examination of a 55-year-old man revealed a well-defined area of opaque mucosal epithelium of the left cheek that didnt protrude above the surrounding tissues and could not be removed on scraping. Crowns of the 34, 35, 36 teeth were strongly decayed and had sharp edges. What is the most likely diagnosis? A. B. C. D. * E. 156. A. B. C. * D. E. 157. A. B. C. * D. E. 158. A. B. * C. D. E. 159. A. B. C. * D. E. 160. A. * B. C. D. Lichen ruber planus Candidiasis Soft cancer Leukoplakia Lupus erythematosus A 53-year-old male patient complains about tongue pain that is getting worse during eating and talking. Objectively: there is a painful ulcer 0,6 cm large on the lateral surface of tongue. The floor is covered with grey deposit. The crown of the 47 tooth is destroyed. What is the most likely diagnosis? Hard chancre Trophic ulcer Decubital ulcer Tuberculous ulcer Cancerous ulcer A 51-year-old male patient complains of dry mouth, taste impairment, burning and pricking sensations in the tongue that disappear during eating but intensify at the end of the day. For the first time such problems arose 2 years ago after a psychic trauma. He also has a history of anacid gastritis. There is segmetal disturbance of facial skin sensation. What is the most likely diagnosis? Ganglionitis of sublingual ganglions Moller-Hunter glossitis Glossodynia Chronic atrophic candidous glossitis Desquamative glossitis A young woman complained about having vesicles in oral cavity, painful ulcers, especially during talking and eating; muscle and joint pain, body temperature rise, indisposition, weakness. She fell suddenly ill 2 days ago. Objectively: to- 38,4°C. Vermilion border is covered with bloody crusts that stick together and impede mouth opening. Mucous membrane of lips, cheeks, mouth floor, tongue, soft palate is hyperemic and edematic; there are single vesicles and large painful erosions covered with fibrinous deposit on it. Regional lymph nodes are enlarged and painful. There is hypersalivation. Nikolskys symptom is negative. What is the most probable diagnosis? Non-acantholytic pemphigus Multiform exudative erythema Secondary syphilis Acantholytic pemphigus Acute herpetic stomatitis A 33 year old policeman applied to a dentist and complained about white caseous deposit on the dorsum of his tongue and burning sensation. It is known from the patients anamnesis that he underwent treatment in an in-patient hospital on account of pneumonia. What is the most probable Lichen ruber planus diagnosis? Typical form of leukoplakia Acute pseudomembranous candidosis Scarlet fever Lupus erythematosus Unused stomatological instruments were left on a sterile table at the end of the working day. What measures should be taken in order to provide sterility of these instruments? Sterilization without preliminary processing Disinfection, presterilization treatment, sterilization Disinfection only Presterilization treatment, sterilization E. 161. A. B. C. * D. E. 162. A. B. * C. D. E. 163. A. B. * C. D. E. 164. A. B. C. D. E. * 165. A. * B. C. D. E. Disinfection, sterilization A 51-year-old patient complains about a condyloma on his lower lip. It appeared 1,5 month ago. It has been significantly growing throughout the last week. Objectively: the red border of the lower lip is cyanotic and infiltrated, it has some isolated closly adhering squamae. There is a well-defined hemispherical formation 8 mm in diameter and 4 mm high in the centre. The formation is of grey-and-blue-and-red colour, it has rough surface formed by thin, closely adhering and thick-based squamae. Regional lymph nodes are enlarged, mobile, dense and painless. What is the most likely Pyogenic diagnosis?granuloma Verruciform precancer Lower lip cancer Keratoacanthoma Viral wart 44-year-old patient complains of a painless formation on his tongue that appeared several months ago. Objectively: the patient has a lot of carious and completely decayed teeth, lateral surface of tongue exhibits a painless whitish formation 10x5 mm large with irregular surface in form of verrucae. Histological examination revealed thickening of corneal epithelial layer of intermittent keratinization type. What is the most likely diagnosis? Keratoacanthoma Verrucous form of leukoplakia Hyperplastic form of candidiasis Verrucous precancer Hyperkeratotic form of lichen ruber planus A patient being at a dentist presented suddenly with tachycardia, sweating, trembling, nausea, hunger. The patient is conscious. He suffers from diabetes mellitus. What aid should be rendered by the dentist? The dentist should make intravenous injection of corticosteroids The dentist should break the procedure off and give the patient sugar in any form The dentist should give the patient nitroglycerine in form of spray or sublingually The dentist should lay the patient down on a flat surface, lower cephalic pole, open the windows The dentist should make intramuscular injection of adrenaline (0,5-1,0 mg) An 19-year-old patient complains about ulceration in the oral cavity, spontaneous bleeding of mucous membrane, pain during food intake and talking, nosebleeds. He has a history of: aggravation of general condition, weakness, body temperature rise up to 39°C, headache, joint pain. What method of diagnostics should be applied to confirm the diagnosis? HIV test Allergy test Blood sugar test Immunogram Clinical blood analysis A 24 year old female patient applied to a clinic for the purpose of oral cavity sanitation. During preparation of the 45 tooth on account of chronic median caries the patient turned pale, there appeared cold clammy sweat on her forehead, nausea, ear noise. The patient lost consciousness. Objectively: pulse - 50 bpm, AP - 80/60 mm Hg, shallow breath, miotic pupils. Make a diagnosis of Syncope this state: Stenocardia Quinckes edema Collapse Anaphylactic shock 166. A. B. * C. D. E. 167. A. * B. C. D. E. 168. A. B. C. * D. E. 169. A. B. * C. D. E. 170. A. B. C. * D. E. Rising from a chair after a dental procedure, a 67-year-old patient felt retrosternal pain radiating to the left arm, nausea, weakness. Objectively: the patient is pale, his face is sweaty. AP is 90/60 mm Hg, pulse is arrhythmic, of poor volume, 100/min. Heart sounds are muffled, vesicular breathing is present. What is your provisional diagnosis? Pulmonary artery thrombosis An attack of coronary artery disease Hypertensic crisis Myocardial infarction Stenocardia A man was found in a street in unconscious state and delivered to the sanitary inspection room. At small intervals the man presents with recurrent attacks of tonic and clonic convulsions of the upper and lower limbs. Objectively: the patient is unconscious, his pupils are mydriatic, don’t react to light. The tongue has teeth indentations. Involuntary urination was noted. Examination revealed no symptoms of focal cerebral lesion. AP is 140/90 mm Hg. The patients head can be freely brought to the chest. Specify the most probable pathology: Epilepsy, status epilepticus Cerebral infraction Acute meningoencephalitis Tetanus Parenchymatous hemorrhage During transportation of a 63-year-old patient an emergency doctor noted aggravation of his general condition, pulselessness, mydriatic pupils, absence of respiratory movements. It will take 5 minutes to get to the admission ward. What actions should the doctor take in the first place? Make an intracardiac injection of adrenaline Deliver the patient to the hospital as soon as possible Start cardiopulmonary resuscitation Facilitate oxygen inhalation Make an intravenous injection of polyglucinum 26 year old patient complains about pain during swallowing, weakness, body temperature rise up to 39,5oC, swelling of submental lymph nodes. Objectively: high body temperature, mucous membrane of oral cavity is brightly hyperaemic and edematic with haemorrhages and ulcerations. Pharynx is brightly hyperemic, lacunae are enlarged and have necrosis areas. Regional, cervical, occipital lymph nodes are painful, enlarged and dense. What is the most likely diagnosis? Acute herpetic stomatitis Infectious mononucleosis Lacunar tonsillitis Herpetic angina Necrotizing ulcerative gingivostomatitis A 25-year-old patient complains about sensation of tightness of buccal mucosa and roughness of the lateral surface of tongue. The patient undergoes regular check-up at a dispensary department for compensated form of diabetes mellitus. Objectively: there are white and grey areas in form of lacy pattern on the buccal mucosa on the right and on the lateral surface of tongue. The surface of affected region cannot be scraped off. What is the most likely diagnosis? Stomatitis Secondary syphilis Lichen ruber planus Pseudomembranous candidiasis Leukoplakia 171. A. B. C. * D. E. 172. A. B. * C. D. E. 173. A. B. * C. D. E. 174. A. B. C. D. E. * 175. A. B. C. D. E. * 176. A. B. C. * A 64 year old patient arrived to the dentist for caries treatment. After anesthetization the patient felt sudden attack of nausea, weakness, he got the sense of compression behind his breastbone, heart pain; he began vomiting. The patient lost consciousness, there appeared convulsions. Objectively: the patient's skin is pale, covered with cold clammy sweat, pupils don't react to the light. The pulse is thready, arterial pressure cannot be detected. What is the most probable diagnosis? Syncope Anaphylactic shock Collapse Traumatic shock Epileptic attack A 54-year-old male patient complains about pain in the oral cavity induced by eating. He suffers from chronic heart disease. Oral cavity isn't sanitated. On the mucous membrane on the right, there is an ulcer with irregular edges covered with greyish-white necrotic deposit with low-grade inflammation around it. There is also halitosis. What is the most probable diagnosis? Tuberculous ulcer Trophic ulcer Cancerous ulcer Traumatic ulcer Ulcero-necrotic stomatitis A 37-year-old patient complains of discoloration of the vermilion border of the lower lip that he noticed about 3 months ago. Objectively: in the center of the vermilion border of the lower lip there is an irregular homogeneous grayish-white area 1x1,5 cm large that doesn't rise above the vermilion border and has distinct outlines. Palpation of this area is painless. The film cannot be removed when scrapes. Upper incisors are covered with braces (2 year). What is the most likely diagnosis? Lupus erythematosus Leukoplakia Premalignant circumscribed hyperkeratosis Lichen ruber planus Candidous cheilitis Before anestetic injection, in dental clinic, patient complained of weakness, nausea, blackout, and then he lost consciousness. Make a diagnosis: Collapse Shock Insult Coma Syncope Before anestetic injection, in dental clinic, patient complained of weakness, nausea, blackout, and then he lost consciousness. Patient was diagnosed with syncope. With what other condition should we differentiate it? Collapse Shock Insult No correct answer Answers A and B are correct Before anestetic injection, in dental clinic, patient complained of weakness, nausea, blackout, and then he lost consciousness. Patient was diagnosed with syncope. What should doctor do at that case? Inject insuline Inject adrenaline 0,5ml IV Give patient some air and to smell medicine with strong odour D. E. 177. A. B. C. * D. E. 178. A. B. C. D. E. * 179. A. B. C. D. E. * 180. A. B. C. * D. E. 181. A. B. C. D. E. * To pour glass of water in patient’s face To give patient a nitroglicerine Analysis of the contents of periodontal pockets of 21 year old patient revealed a significant contamination with Candida yeast fungi. Which of the following drugs should be used for instillations? Biseptol Diclofenac sodium Clotrimazole Paracetamol Ibuprom During the preparation of a tooth becouse of caries treatment, 23 y.o. patient had an epileptic attach. What was doctor mistake at that case? Skipped psychological preparation of the patient Did not apply one of the types of local anesthesia Violated the rules of preparation Didn't apply general anaesthesia Didn't collect complete history data A 31-year-old male patient complains of dryness and burning of tongue back that appeared for about a week ago. The patient has a history of recent pneumonia. Objectively: mucous membrane of the oral cavity is hyperemic, dry, glossy. Tongue back and palate have white plicae that can be easily removed. Threads of saliva trail behind the spatule.What is the most likely diagnosis? Chronic hyperplastic candidiasis Acute stomatitis Allergic stomatitis Medicamental stomatitis Acute pseudomembranous candidiasis A 31-year-old male patient complains of dryness and burning of tongue back that appeared for about a week ago. The patient has a history of recent pneumonia. Objectively: mucous membrane of the oral cavity is hyperemic, dry, glossy. Tongue back and palate have white plicae that can be easily removed. Threads of saliva trail behind the spatule.Patient was diagnosed with acute pseudomembranous candidiasis. What will be the key medicine in the treatment? Preccribe antibiotics again. Oral washing with antiseptics Antifungal medicine Corticosteroids Antihistamines A 26-year-old male patient presents with weakness, pain in throat when swallowing, body temperature rise up to 38,0 C. Examination of the the oral cavity revealed massive hyperaemia of the mucous membrane of the soft palate, palatine arches, tonsils, uvula; there were also single vesicles and erosions extremely painful when touched. Regional lymph nodes are enlarged, painful on palpation. What is the most likely diagnosis? Chickenpox Infectious mononucleosis Mycotic angina Diphtheria Herpangina 182. A. B. C. D. E. 183. A. B. C. D. E. * 184. A. * B. C. D. E. 185. A. * B. C. D. E. 186. A. B. * C. D. E. A 31-year-old male patient complains of dryness and burning of tongue back that appeared for about a week ago. The patient has a history of recent pneumonia. Objectively: mucous membrane of the oral cavity is hyperemic, dry, glossy. Tongue back and palate have white plicae that can be easily removed. Threads of saliva trail behind the spatule. Patient was diagnosed with acute pseudomembranous candidiasis. What diseases should we differentiate candidiasis with? Leukoplakia Necrotic gingivitis Lichen planus No correct answer Answers A, B, C are correct A 25 y.o. patient, complains of a significant enlargement of the upper lip and eyelids, which developed within a few minutes after bee sticking. Objectively: there is an edema of the upper part of face, upper lip and eyelids. Palpation is painless. What disease are these symptoms typical for? Melkersson-Rosenthal syndrome Glandular cheilitis Lymphedema Macrocheilitis Angioneurotic Quincke's edema A 26 y.o. patient, complains of a significant enlargement of the upper lip and eyelids, which developed within a few minutes after bee sticking. Objectively: there is an edema of the upper part of face, upper lip and eyelids. Palpation is painless. Patient was diagnosed with Quincke's edema. What will be the treatment at that case? Inject adrenaline, corticosteroids and antihistamines Prescribe antihistamines in form of pills Prescribe antibiotics Prescribe antiinflammatory drugs and analgetigs Put a cold on the lip A 45-year-old patient complains of mouth soreness, body temperature rise up to 38,5oC, indisposition. Such condition has occurred periodically for several years after the patient had had a col-Objectively: lips are covered with haemorrhagic crusts, hyperaemic mucous membrane of lips and cheeks has erosions covered with fibrinous films. Hypersalivation is present. What is the most Multiform exudative erythema likely diagnosis? Herpetiform Duhring's dermatitis Stevens-Johnson syndrome Pemphigus vulgaris Herpes recidivicus A 47-year-old patient complains of subfebrile temperature and a growing ulcer on the gingival mucosa around the molars; looseness of teeth in the affected area, cough for 2 month. Objectively: gingival mucosa in the region of the lower left molars has two superficial, extremely painful ulcers with undermined edges. The ulcers floor is yellowish, granular, covered with yellowish granulations. What is the most likely diagnosis? Syphilis Tuberculosis Decubital ulcer Infectious mononucleosis Acute aphthous stomatitis 187. A. B. C. D. E. 188. A. B. * C. D. E. 189. A. B. * C. D. E. 190. A. * B. C. D. E. 191. A. B. * C. D. E. 192. A. B. * C. D. E. A 46-year-old patient complains of subfebrile temperature and a growing ulcer on the gingival mucosa around the molars; looseness of teeth in the affected area, cough for 2 month. Objectively: gingival mucosa in the region of the lower left molars has two superficial, extremely painful ulcers with undermined edges. The ulcers floor is yellowish, granular, covered with yellowish granulations. Patient was diagnosed with tuberculosis. What should be the dentist tactics at that case? Oral cavity sanitation, ulcer treatment Treatment of the ulcrers, direction to the tuberculosis dispensary Recommendation for ulcrers treatment, direction to the tuberculosis dispensary Just direction to the tuberculosis dispensary Oral cavity sanitation 67 year old patient was diagnosed with decubital ulcer. What is the main causative factor for this lesion?trauma Acute Chronic trauma Infection Alcohol Low immunity Patient was diagnosed with decubital ulcer. What will be the treatment? Surgical treatment Antiseptics for 7 days Antibiotics for 7 days Antiviral for 7 days Laser treatment After 56 year old patient examination he was diagnosed with decubital ulcer. What should doctor do at that case? Remove causative factor, prescribe oral washing for 7 days, if it’s not helpful – take byopsy Remove causative factor, prescribe oral washing for 7 days, if it’s not helpful – for 1 month Prescribe biopsy immediately Prescribe antibiotic treatment No treatment is needed A 28-year-old patient complains about body temperature rise, weakness, pain induced by eating and deglutition. Objectively: mucous membrane of the oral cavity is erythematic with multiple petechies. Pharynx is hyperaemic. Regional lymph nodes are enlarged, mobile, painless. In blood: leukocytosis, monocytosis, atypic mononuclear cells, ESR is 30 mm/h. What is the leading factor of disease development? Immediate allergy Viral infection Delayed allergy Autoimmune disorders Bacterial infection Objective examination of 18 years old female patient revealed that her lower lip was slightly hyperemic, dry, covered with small scales. Patient complains of dryness and a feeling of tense lips, especially in autumn and winter, at the wind. What is the most likely diagnosis? Allergic cheilitis Meteorological cheilitis Microbial cheilitis Atopic cheilitis Exfoliative cheilitis 193. A. B. * C. D. E. 194. A. B. C. * D. E. 195. A. B. C. * D. E. 196. A. B. * C. D. E. 197. A. B. C. D. * E. 198. A. B. Objective examination of 16 years old female patient revealed that her lower lip was slightly hyperemic, dry, covered with small scales. Patient complains of dryness and a feeling of tense lips, especially in autumn and winter, at the wind. Patient was diagnosed with meteorological cheilitis. What will be the treatment? Antibiotics taking Using some lip oinment at that period Antiseptic using at that periods Surgical removing of scales with antiinflammatory drugs after Antiinflammatory therapy A 23 year old patient complains about itch, burning and edema of lips. She has been suffering from this for a week. Objectively: reddening of vermilion border and skin, especially in the region of mouth corners, there are also crusts, small cracks along with erythematous affection of vermilion border. What is the most likely diagnosis? Acute herpetic cheilitis Exudative form of exfoliative cheilitis Acute eczematous cheilitis Fungal stomatitis Multiform exudative erythema Patient complains about a painful formation in the oral cavity that obstructs food intake. The same complaints were noticed two years ago. Mucous membrane of lateral tongue surface is hyperemic and edematic. There is an oval erosion over 0,7 cm large covered with yellow greyish deposit. Erosion edges are hyperemic and painful on palpation. Patient has a history of chronic cholecystocholangitis. What is the most likely diagnosis? Erythema multiforme Stevens-Johnson syndrome Chronic recurrent aphthous stomatitis Traumatic erosion Behcet's syndrome During tooth extraction a 31 y.o. patient presented with sudden weakness, pale skin, cold sweat, weak pulse, a significant AP drop (diastolic pressure - 40 mm Hg). What complication developed in the patient? Anaphylactic shock Collapse Attack of stenocardia Syncope Traumatic shock During everyday therapeutic manipulations dentist uses a dental mirror. What is the way of dental mirrors sterilization? In the 6% hydrogen peroxide solution for 6 hours In the 0,5% ethyl spiritus solution for 20 minutes In the dry heat sterilizer at 180oC for 10 minutes In the triple solution for 30 minutes In the 0,01% chloramine solution for 2 minutes A 48 y. o. male patient complains of pain under the dental bridge. After its removal the patient has been found to have an ulcer 0,3x0,5 cm large on the alveolar process. The ulcer is slightly painful and soft, the surrounding mucosa is hyperaemic, submandibular lymph nodes are not enlarged. What is a provisional diagnosis? Tuberculous ulcer Trophic ulcer C. D. * E. 199. A. B. C. D. E. * 200. A. B. C. * D. E. 201. A. B. C. D. * E. 202. A. B. C. * D. E. 203. A. B. C. D. E. * Cancerous ulcer Decubital ulcer Sutton aphtha A 47 y. o. male patient complains of pain under the dental bridge. After its removal the patient has been found to have an ulcer 0,3x0,5 cm large on the alveolar process. The ulcer is slightly painful and soft, the surrounding mucosa is hyperaemic, submandibular lymph nodes are not enlarged. Patient was diagnosed with decubital ulcer. What should these lesion be differentiated with? Tuberculous ulcer Trophic ulcer Cancerous ulcer Syphilis ulcer All answers are correct A 26 year old male patient complains about burning and painfulness of her tongue, especially during eating spicy food. Objectively: there are oval red spots on the tip and dorsum of tongue. Filiform papillae are not present in the affected area. Patient mentions that the spots become periodically larger and have migratory nature. What is the most probable diagnosis? Raspberry tongue Median rhomboid glossitis Geographic tongue Candidosis Fissured tongue A 30 year old patient complaines about painfulness of his lower lip. He has been suffering for two months. Objectively: mucous membrane of lower lip is hyperemic, excretory ducts of minor salivary glands are dilated, "dew" symptom is present. What is the most probable diagnosis? Contact allergic cheilitis Meteorological cheilitis Cheilitis exfoliativa Cheilitis glandularis Microbal cheilitis During pulpitis deep caries treatment a 63 year old patient felt dull pain behind her breastbone, got a sense of compression. A dentist diagnosed her with a stenocardia attack. What medication should be given this patient in order to arrest this state? Analgin Ketanov Nitroglycerine, validol Baralgin Dimedrol A 36 year old patient applied to a dental clinic for oral cavity sanation. Anamnesis data: mild case of diabetes. Objectively: mucous membrane of cheeks is unchanged, mainly in retromolar area there are symmetrically placed whitish papulae protruding over the mucous membrane and forming a lace-like pattern. What is the most probable diagnosis? Leukoplakia Secondary syphilis Chronic atrophic candidosis Lupus erythematosus Lichen ruber planus 204. A. B. C. * D. E. 205. A. B. C. D. E. * 206. A. B. * C. D. E. 207. A. B. C. * D. E. 208. A. B. C. D. * E. A 46 year old patient businessman complained about painful ulcer on the lateral surface of his tongue. Objectively: left lateral surface of tongue has a roundish ulcer with undermined soft overhanging edges, palpatory painful, ulcer floor is slightly bleeding and covered with yellowish nodules. What is the most probable diagnosis? Syphilis Traumatic ulcer Tuberculosis Decubital ulcer Trophic ulcer A 75 year old patient complains of pain in the area of mucous membrane of hard palate on the left that is getting worse during eating with use of a complete removable denture. He has been suffering from this for 1,5 month. Objectively: left-sided hyperemia and edema of mucous membrane of hard palate; at the border of distal denture edge there is an ulcer with dense walls and fundus, surrounding tissues are infiltrated. The ulcer floor is tuberous, covered with fibrinous deposit; ulcer palpation is painful. What examination method is to be applied in the first place? Allergic contact plastic test Blood test Serological reactions Bacterioscopy Biopsy A 25 year old woman complains about periodical appearance of small ulcers in the oral cavity. She has been suffering from this for 3 years, recurrences happen 4-5 times a year. The ulcer healing lasts for 7 days. Objectively: on a mucous membrane of lower lip there is a roundish lesion element 0,5 cm large covered with white deposit and surrounded by hyperemia border, very painful when touched. What is the most probable diagnosis? Secondary syphilis Chronic recurrent aphthous stomatitis Chronic recurrent herpes Traumatic erosion Duhring's herpetiform dermatitis A 32 year old woman complains about periodical appearance of small ulcers in the oral cavity. She has been suffering from this for 3 years, recurrences happen 4-5 times a year. The ulcer healing lasts for 7 days. Objectively: on a mucous membrane of lower lip there is a roundish lesion element 0,5 cm large covered with white deposit and surrounded by hyperemia border, very painful when touched.She was diagnosed with cronic reccurent aphthous stomatitis. What will be the treatment at Antibiotics that case? for 7 days Antiviral for 10 days Antiseptics and analgetics symptomaticly Surgical treatment of the ulcer Corticosteroid therapy Examination of a 53 year old patient revealed chronic candidosis of oral mucous membrane, generalized lymphadenopathy. Anamnesis data: the patient has been suffering from herpes for a year. Body temperature persistently rises up to 37,4-37,5oC, body weight has reduced by 8 kg over the last month. What disease can be indicated by this symptom group? Infectious mononucleosis Candidosis Acute leukosis AIDS Chronic leukosis 209. A. * B. C. D. E. 210. A. B. C. D. * E. 211. A. B. C. * D. E. 212. A. B. C. * D. E. 213. A. B. C. * D. E. A 51 year old patient applied to a dentist and complained about white caseous deposit on the dorsum of his tongue and burning sensation. It is known from the patient's anamnesis that he underwent treatment in an in-patient hospital on account of pneumonia. What is the most probable diagnosis? Acute pseudomembranous candidosis Typical form of leukoplakia AIDS Lichen ruber planus Lupus erythematosus An 41 year old patient complains of gingival painfulness and haemorrhage, halitosis, temperature rise up to 38,6oC, general weakness, appetite loss. Objectively: mucous membrane of oral cavity is hyperemic and dry; tongue is covered with white fur, gingival papillae are edematic, their apices have areas of necrotic deposit that can be easily removed leaving bleeding surface beneath. Submaxillary lymph nodes are enlarged, palpatory painful. What is the causative agent of this disease? Treponema Candida albicans Virus of herpes simplex Fusospirochetal symbiosis Streptostaphylococci A 28 year old female patient complains about itch, burning and edema of lips. These presentations occured a week ago. Objectively: there is reddening of vermilion border and skin, especially in the region of mouth corners, there are also crusts, small cracks along with erythematous affection of vermilion border. What is the most likely diagnosis? Acute herpetic cheilitis Multiform exudative erythema Acute eczematous cheilitis Allergic contact cheilitis Exudative form of exfoliative cheilitis A 39 y.o. patient complains of a painless nonhealing mouth ulcer. Objectively: regional lymph nodes are enlarged, painless, of cartilaginous consistency. On the buccal mucosa there is a round ulcer 1 cm in diameter with regular raised edges and a dense elastic infiltrate at the base. The ulcer surface is of red colour, painless on palpation. What is the most likely diagnosis? Secondary tuberculosis Primary tuberculosis Primary syphilis Cancer Secondary syphilis A 37 y.o. patient complains of a painless nonhealing mouth ulcer. Objectively: regional lymph nodes are enlarged, painless, of cartilaginous consistency. On the buccal mucosa there is a round ulcer 1 cm in diameter with regular raised edges and a dense elastic infiltrate at the base. The ulcer surface is of red colour, painless on palpation. Patient was diagnosed with prymary syphilis. What should be the doctor tactics at that case? Professional oral hygiene, antiseptics for ulcer treatment Antiseptics for ulcer treatment, antibiotics for syphilis treatment Direction to venereologist, symptomatic treatment precription Direction to venereologist No treatment is needed 214. A. B. * C. D. E. 215. A. B. C. * D. E. 216. A. B. C. D. * E. 217. A. * B. C. D. E. 218. A. * B. C. D. E. A 55 year old male patient complains of a painful ulcer in the mouth that is getting bigger and does not heal over 1,5 months. Objectively: on the buccal mucosa there is a shallow soft ulcer 2 cm in diameter with irregular undermined edges. The ulcer is surrounded by many small yellowish tubercles. Regional lymph nodes are elastic, painful, matted together. Which disease is characterized Ulcerative necrotizing stomatitis by such symptoms? Tuberculosis Lichen planus Syphilis Cancer A 56 year old male patient complains of a painful ulcer in the mouth that is getting bigger and does not heal over 1,5 months. Objectively: on the buccal mucosa there is a shallow soft ulcer 2 cm in diameter with irregular undermined edges. The ulcer is surrounded by many small yellowish tubercles. Regional lymph nodes are elastic, painful, matted together. Patient was diagnosed with tuberculosis. What should be a doctor tactic at that case? Professional oral hygiene, antiseptics for ulcer treatment Antiseptics for ulcer treatment, antibiotics for tuberculosis treatment Direction to T.B. prophylactic centre (dispensary) , symptomatic treatment precription Direction to T.B. prophylactic centre (dispensary) No treatment is needed A 56 year old male patient complains of a painful ulcer in the mouth that is getting bigger and does not heal over 1,5 months. Objectively: on the buccal mucosa there is a shallow soft ulcer 2 cm in diameter with irregular undermined edges. The ulcer is surrounded by many small yellowish tubercles. Regional lymph nodes are elastic, painful, matted together. Patient was diagnosed with tuberculosis. What additional method of examination is needed to clarify the diagnosis? Biopsy X-ray Histological Bacteriological Nikolskyy sign A 38 y.o. patient complains of general weakness, pain in the gums, halitosis. Objectively: the patient is pale, adynamic, body temperature is 38,5°C, submandibular lymph nodes are enlarged, painful on palpation. Interdental gingival papillae are inflamed, their tops are "detruncated", covered with gray-yellow necrotic incrustation. Radiography of alveolar process and blood count reveal no apparent changes. What is the most likely diagnosis? Acute ulcerous gingivitis Acute leukosis Localized periodontitis Agranulocytosis Generalized periodontitis A 66 year old patient complains of burning tongue, a metallic taste in mouth. Three months ago he got a dental bridge made of gold and supported by the 16, 14 teeth. Oral cavity exasmination reveals no objective changes. The 36, 37, 46 teeth are sealed with amalgam fillings. What is the most likely cause of this condition Galvanic currents Neurologic disorder Mechanic trauma Chemical factors Allergy 219. A. B. C. D. * E. 220. A. B. C. D. * E. 221. A. B. C. * D. E. 222. A. * B. C. D. E. 223. A. B. C. D. * E. 224. A. B. C. * Patient complains of general weakness, spasmodic neuralgic pain in the right side of face, rash in the mouth and on the skin. Objectively: lip and chin skin is markedly hyperemic, there are numerous vesicles with clear exudate on the right. The right cheek mucosa is hyperemic, there is a string of erosions covered with fibrinous pellicle. What is the provisional diagnosis? Acute herpetic stomatitis Allergic stomatitis Aphthous fever Herpes zoster Pemphigus vulgaris 33 y.o. patient complains of general weakness, spasmodic neuralgic pain in the left side of face, rash in the mouth and on the skin. Objectively: lip and chin skin is markedly hyperemic, there are numerous vesicles with clear exudate on the left. The left cheek mucosa is hyperemic, there can be visible vesicles that looks like bunch of grapes. What will be the diagnosis? Acute herpetic stomatitis Allergic stomatitis Aphthous fever Herpes zoster Pemphigus vulgaris 26 year old chemical plant worker consulted a dentist about an oral mucosa burn caused by caustic soda. Which of the following medications should be chosen for emergency care? 0,1% liquid ammonia 50% ethyl alcohol 0,5% acetic acid solution 3% sodium chloride solution 2% chlorhexidine solution A 28 year old DJ suffers from a disease without prodromal manifestations that declares itself through oral mucosa lesion consisting of 1-2 roundish elements 5-8 mm large which are circumscribed by a hyperemic rim and covered with yellow-grey coating. The disaese recurrence is observed quite regularly 3-4 times a year. These presentations are typical for the following disease: Chronic recurrent aphthous stomatitis Chronic herpes recidivicus Papular syphilis Erythema multiforme Lichen ruber planus Preventive examination of a 58 year old man revealed a well-defined area of opaque mucosal epithelium of the left cheek that didnt protrude above the surrounding tissues and could not be removed on scraping. Crowns of the 34, 35, 36 teeth were strongly decayed and had sharp edges. What is the most likely diagnosis? Lichen ruber planus Candidiasis Soft cancer Leukoplakia Lupus erythematosus A 53 year old male patient complains about tongue pain that is getting worse during eating and talking. Objectively: there is a painful ulcer 0,6 cm large on the lateral surface of tongue. The floor is covered with grey deposit. The crown of the 47 tooth is destroyed. What is the most likely diagnosis? Hard chancre Trophic ulcer Decubital ulcer D. E. 225. A. B. C. D. E. 226. A. B. C. D. E. * 227. A. * B. C. D. E. 228. A. B. * C. D. E. 229. A. B. C. D. * E. 230. Tuberculous ulcer Cancerous ulcer A 63 year old male patient complains about tongue pain that is getting worse during eating and talking. Objectively: there is a painful ulcer 0,6 cm large on the lateral surface of tongue. The floor is covered with grey deposit. The crown of the 47 tooth is destroyed. What will be the key in decubital ulcer treatment? 47 tooth restoration. Antibiotics prescribing Antiseptics prescribing Analgetics prescribing Improving the oral hygiene During the anamnesis taking of 65 year old patient diabetes was revealed. Deficiency of which hormone, described below, leads to diabetes: Cortisone Calcitonin Parathyroid hormone Thyroxine Insulin During 29 y.o. patient examination doctor revealed hyperplastic candidiasis and mild form of Kaposi's sarcoma. From anamnesis is known, that patient has 37,5-37,6 C temperature for a month and weight loss. What test should patient do to identify the diagnosis? ELISA Blood test Insulin test FTR test Bacteriological finding During 26 y.o. patient examination doctor revealed hyperplastic candidiasis and mild form of Kaposi's sarcoma. From anamnesis is known, that patient has 37,5-37,6 C temperature for a month and weight loss. What will be the provisional diagnosis in that case? Tuberculosis AIDS Chronic candidiasis Chronic leukosis Chronic stomatitis A 56-year-old female patient was waiting for her turn at the dentist’s. Suddenly she fell down, her respiration became hoarse, she got convulsive twitching in her upper and lower limbs, face and neck turned cyanotic, eye pupils became mydriatic, reaction of eye to light was absent. Arterial pressure and pulse couldn’t be measured. Heart sounds couldn’t be auscultated. Involuntary urination was noted. What condition is characterized by such symptoms? Coma Epilepsy Shock Clinical death Collapse A 40-year-old patient complains about mouth soreness, body temperature rise up to 38,5oC, indisposition. Such condition has been occurring periodically for several years after the patient had had a cold. Objectively: lips are covered with haemorrhagic crusts, hyperaemic mucous membrane of lips and cheeks has erosions covered with fibrinous films. Hypersalivation is present. What is the most likely diagnosis? A. * B. C. D. E. 231. A. B. C. D. E. * 232. A. * B. C. D. E. 233. A. B. C. * D. E. 234. A. B. C. D. E. * 235. A. B. Multiform exudative erythema Pemphigus vulgaris Herpes recidivicus Herpetiform Duhring's dermatitis Stevens-Johnson syndrome A 23-years-old woman complained about having vesicles in oral cavity, painful ulcers, especially during talking and eating; muscle and joint pain, body temperature rise, indisposition, weakness. She fell suddenly ill 2 days ago. Objectively: to- 38,4oC. Vermilion border is covered with bloody crusts that stick together and impede mouth opening. Mucous membrane of lips, cheeks, mouth floor, tongue, soft palate is hyperemic and edematic; there are single vesicles and large painful erosions covered with fibrinous deposit on it. Regional lymph nodes are enlarged and painful. There is hypersalivation. Nikolsky's symptom is negative. What is the most probable diagnosis? Acantholytic pemphigus Multiform exudative erythema Secondary syphilis Acute herpetic stomatitis Non-acantholytic pemphigus A 28 year old patient applied to a clinic for the purpose of oral cavity sanitation. During preparation of the 45 tooth on account of chronic median caries the patient turned pale, there appeared cold clammy sweat on her forehead, nausea, ear noise. The patient lost consciousness. Objectively: pulse 50 bpm, AP - 80/60 mm Hg, shallow breath, miotic pupils. Make a diagnosis of this state: Syncope Anaphylactic shock Stenocardia Collapse Quincke's edema A 23-year-old patient was delivered to a traumatology centre with a dirty cut wound of her right foot. A doctor performed initial surgical d-bridement and made an injection of antitetanus serum. Some time later the patient’s condition got abruptly worse: she developed extreme weakness, dizziness, palpitation. Objectively: the skin is pale, the patient has cold sweat, frequent pulse of poor volume at a rate of 100 bpm, AP is 90/40 mm Hg. What is the cause of such aggravation? Pain shock Haemorrhagic shock Anaphylactic shock Infectious-toxic shock Drug disease (seroreaction) A 28-year-old man attended a glasshouse in a botanic garden. After he had smelt at an orchid he turned pale and lost consciousness. Objectively: heart rate is 115/min, arterial pressure is 50/0 mm Hg. What drug should be injected to the patient in the first place? Dimedrol Cordiamin Strophanthine Mesaton Prednisolone After injection of anaesthetic solution to 27-years-old man, doctor noticed the swelling of patient face, which started from upper lip and rapidly progressed, wheezing and difficulty breathing. What is the most likely diagnosis? Idiopathic face edema Anaphylactic shock C. * D. E. 236. A. * B. C. D. E. 237. A. B. C. * D. E. 238. A. B. C. * D. E. 239. A. B. C. D. * E. 240. A. B. C. * D. E. 241. A. B. Quincke’s edema (angioedema) Syncope Asthma After injection of anaesthetic solution to 39 year old patient before caries treatment, doctor noticed the swelling of patient face, which started from upper lip and rapidly progressed, wheezing and difficulty breathing. What doctors mistake can cause this complication? Incorrect anamnesis taking. Incorrect caries treatment. Incorrect patient choosing Incorrect anaesthetic injection All answers are wrong After injection of anaesthetic solution to 28 year old patient before pulpitis treatment, doctor noticed the swelling of patient face, which started from upper lip and rapidly progressed, wheezing and difficulty breathing. What will be the key medication in the treatment of this disease? Antibiotics Anti-inflammatory Antihistamines Corticosteroids Antiviral 46-year-old woman complaines about swelling of her upper lip, wheezing and voice change which started half an hour ago after bee bites. What is the most likely diagnosis? Idiopathic face edema Anaphylactic shock Quincke’s edema (angioedema) Syncope Melkersson-Rosenthal syndrome During the examination of 29-year-old patient the subcutaneous allergy test was made. 5 minutes later after injection small red spots on the foream were revealed. Patient feel itch at those areas. What does this reaction mean? Erythema multiforme Anaphylactic shock – allergic reaction after injection Quincke’s edema – complication after injection Nettle rash – allergy reaction after injection Red idiopathic erythema During the examination of 25-year-old woman the subcutaneous allergy test was made. 5 minutes later after injection small red spots on the foream were revealed. Patient feel itch at those areas. What will be your tactics at that case? To try another syringe To do additional allergic test To choose another anaeathetic To use analgetic spray in that area To do nothing and to continue treatment 5 year old boy complains about painful mouth sores, which he noticed few days ago. From the parents words this sores comes periodically, trice a year. Objectively: on the tongue and lower lip there are two sores (0,7 mm in diameter) with hyperemic membrane, covered with grey-whitish deposits. Food allergy in anamnesis. What is the most likely diagnosis? Acute herpetic stomatitis Erythema multiforme C. D. * E. 242. A. * B. C. D. E. 243. A. B. C. D. * E. 244. A. * B. C. D. E. 245. A. B. C. D. E. * 246. A. * B. Chronic herpetic stomatitis Chronic aphthous stomatitis Pre-cancer 18 year old yougster complains about painful mouth sores, which he noticed few days ago. From the parents words this sores comes periodically, thrice a year. Objectively: on the tongue and lower lip there are two sores (0,7 mm in diameter) with hyperemic membrane, covered with grey-whitish deposits. Food allergy in anamnesis. What will be the treatment in that case? Oral rinsing with antiseptics Antibiotics for 5 days Antibiotics for 7 days Surgical treatment Oral rinsing with corticosteroids 60-year-old male patient was waiting for her turn at the dentist’s. Suddenly he fell down, his respiration became hoarse, he got convulsive twitching in his upper and lower limbs, face and neck turned cyanotic, eye pupils became mydriatic, reaction of eye to light was absent. Arterial pressure and pulse couldn’t be measured. Heart sounds couldn’t be auscultated. Involuntary urination was noted. What condition is characterized by such symptoms? Coma Epilepsy Shock Clinical death Collapse 38-year-old patient complains about mouth soreness, body temperature rise up to 38,5 C, indisposition. Such condition has been occurring periodically for several years after the patient had had a cold. Objectively: lips are covered with haemorrhagic crusts, hyperaemic mucous membrane of lips and cheeks has erosions covered with fibrinous films. Hypersalivation is present. What is the most likely diagnosis? Multiform exudative erythema Pemphigus vulgaris Herpes recidivicus Herpetiform Duhring's dermatitis Stevens-Johnson syndrome Patient complains about having vesicles in oral cavity, painful ulcers, especially during talking and eating; muscle and joint pain, body temperature rise, indisposition, weakness. He fell suddenly ill 2 days ago. Objectively: temperature - 38,4 C. Vermilion border is covered with bloody crusts that stick together and impede mouth opening. Mucous membrane of lips, cheeks, mouth floor, tongue, soft palate is hyperemic and edematic; there are single vesicles and large painful erosions covered with fibrinous deposit on it. Regional lymph nodes are enlarged and painful. There is hypersalivation. Nikolsky's symptom is negative. What is the most probable diagnosis? Acantholytic pemphigus Multiform exudative erythema Secondary syphilis Acute herpetic stomatitis Non-acantholytic pemphigus A 37 year old patient applied to a clinic for the purpose of oral cavity sanitation. During preparation of the 45 tooth on account of chronic median caries the patient turned pale, there appeared cold clammy sweat on her forehead, nausea, ear noise. The patient lost consciousness. Objectively: pulse 50 bpm, AP - 80/60 mm Hg, shallow breath, miotic pupils. Make a diagnosis of this state: Syncope Anaphylactic shock C. D. E. 247. A. B. C. * D. E. 248. A. B. C. D. E. * 249. A. B. C. * D. E. 250. A. * B. C. D. E. 251. A. B. C. D. * E. 252. A. Stenocardia Collapse Quincke's edema Patient R., 25 y.o. was delivered to the traumatology center with a dirty cut wound of her right foot. A doctor performed initial surgical d-bridement and made an injection of antitetanus serum. After some time later the patient’s condition got abruptly worse: she developed extreme weakness, dizziness, palpitation. Objectively: the skin is pale, the patient has cold sweat, frequent pulse of poor volume at a rate of 100 bpm, AP is 90/40 mm Hg. What is the cause of such aggravation? Pain shock Haemorrhagic shock Anaphylactic shock Infectious-toxic shock Drug disease (seroreaction) A 24 y.o. man attended a glasshouse in a botanic garden. After he had smelt at an orchid he turned pale and lost consciousness. Objectively: heart rate is 115/min, arterial pressure is 50/0 mm Hg. What drug should be injected to the patient in the first place? Dimedrol Cordiamin Strophanthine Mesaton Prednisolone After injection of anaesthetic solution to 31 year old patient before caries treatment, doctor noticed the swelling of patient face, which started from upper lip and rapidly progressed, wheezing and difficulty breathing. What is the most likely diagnosis? Idiopathic face edema Anaphylactic shock Quincke’s edema (angioedema) Syncope Asthma After injection of anaesthetic solution to 36 year old man, doctor noticed the swelling of patient face, which started from upper lip and rapidly progressed, wheezing and difficulty breathing. What doctors mistake can cause this complication? Incorrect anamnesis taking. Incorrect caries treatment. Incorrect patient choosing Incorrect anaesthetic injection All answers are wrong After injection of anaesthetic solution to 28 year old patient before pulpitis treatment, doctor noticed the swelling of patient face, which started from upper lip and rapidly progressed, wheezing and difficulty breathing. What will be the key medication in the treatment of this disease? Antibiotics Anti-inflammatory Antihistamines Corticosteroids Antiviral Patient complains about swelling of her upper lip, wheezing and voice changing which started half an hour ago after bee bites. What is the most likely diagnosis? Idiopathic face edema B. C. * D. E. 253. A. B. C. D. * E. 254. A. * B. C. D. E. 255. A. B. C. D. E. * 256. A. * B. C. D. E. 257. A. Anaphylactic shock Quincke’s edema (angioedema) Syncope Melkersson-Rosenthal syndrome A 57-year-old female patient was waiting for her turn at the dentist’s. Suddenly she fell down, her respiration became hoarse, she got convulsive twitching in her upper and lower limbs, face and neck turned cyanotic, eye pupils became mydriatic, reaction of eye to light was absent. Arterial pressure and pulse couldn’t be measured. Heart sounds couldn’t be auscultated. Involuntary urination was noted. What condition is characterized by such symptoms? Coma Epilepsy Shock Clinical death Collapse Patient complains about mouth soreness, body temperature rise up to 38,5oC, indisposition. Such condition has been occurring periodically for several years after the patient had had a cold. Objectively: lips are covered with haemorrhagic crusts, hyperaemic mucous membrane of lips and cheeks has erosions covered with fibrinous films. Hypersalivation is present. What is the most likely Multiform diagnosis? exudative erythema Pemphigus vulgaris Herpes recidivicus Herpetiform Duhring's dermatitis Stevens-Johnson syndrome Woman complains about having vesicles in oral cavity, painful ulcers, especially during talking and eating; muscle and joint pain, body temperature rise, indisposition, weakness. She fell suddenly ill 2 days ago. Objectively: to- 38,4oC. Vermilion border is covered with bloody crusts that stick together and impede mouth opening. Mucous membrane of lips, cheeks, mouth floor, tongue, soft palate is hyperemic and edematic; there are single vesicles and large painful erosions covered with fibrinous deposit on it. Regional lymph nodes are enlarged and painful. There is hypersalivation. Nikolsky's symptom is negative. What is the most probable diagnosis? Acantholytic pemphigus Multiform exudative erythema Secondary syphilis Acute herpetic stomatitis Non-acantholytic pemphigus A 43 year old patient applied to a clinic for the purpose of oral cavity sanitation. During preparation of the 45 tooth on account of chronic median caries the patient turned pale, there appeared cold clammy sweat on her forehead, nausea, ear noise. The patient lost consciousness. Objectively: pulse 50 bpm, AP - 80/60 mm Hg, shallow breath, miotic pupils. Make a diagnosis of this state: Syncope Anaphylactic shock Stenocardia Collapse Quincke's edema A 34-year-old man was delivered to a traumatology centre with a dirty cut wound of her right foot. A doctor performed initial surgical d-bridement and made an injection of antitetanus serum. Some time later the patient’s condition got abruptly worse: she developed extreme weakness, dizziness, palpitation. Objectively: the skin is pale, the patient has cold sweat, frequent pulse of poor volume at a rate of 100 bpm, AP is 90/40 mm Hg. What is the cause of such aggravation? Pain shock B. C. * D. E. 258. A. B. C. D. E. * 259. A. * B. C. D. E. 260. A. B. C. * D. E. 261. A. * B. C. D. E. 262. A. B. C. * D. E. 263. A. B. C. * Haemorrhagic shock Anaphylactic shock Infectious-toxic shock Drug disease (seroreaction) A 26-year-old woman attended a glasshouse in a botanic garden. After she had smelt at an orchid he turned pale and lost consciousness. Objectively: heart rate is 115/min, arterial pressure is 50/0 mm Hg. What drug should be injected to the patient in the first place? Dimedrol Cordiamin Strophanthine Mesaton Prednisolone During caries treatment of 27 y.o. patient doctor decided to use an anaesthesia. What is the technique of scratch test which can be used for allergy detecting? Test is done by placing a drop of a solution containing a possible allergen on the scratched skin. Test is done by injecting the allergen under the skin Test is done by a drop of a solution containing a possible allergen on the normal skin. Test is done by scratching the normal skin by infected tool. No correct answer. After injection of anaesthetic solution to 18 year old student before pulpitis treatment, doctor noticed the swelling of patient face, which started from upper lip and rapidly progressed, wheezing and difficulty breathing. What is the most likely diagnosis? Idiopathic face edema Anaphylactic shock Quincke’s edema (angioedema) Syncope Asthma After injection of anaesthetic solution to 28 year old engineer before caries treatment, doctor noticed the swelling of patient face, which started from upper lip and rapidly progressed, wheezing and difficulty breathing. What doctors mistake can cause this complication? Incorrect anamnesis taking. Incorrect caries treatment. Incorrect patient choosing Incorrect anaesthetic injection All answers are wrong After injection of anaesthetic solution to 30 year old patient, doctor noticed the swelling of patient face, which started from upper lip and rapidly progressed, wheezing and difficulty breathing. What will be the key medication in the treatment of this disease? Antibiotics Anti-inflammatory Antihistamines Corticosteroids Antiviral 43 year old patient complains about swelling of her upper lip, wheezing and voice change which started half an hour ago after bee bites. What is the most likely diagnosis? Idiopathic face edema Anaphylactic shock Quincke’s edema (angioedema) D. E. 264. A. B. C. D. * E. 265. A. B. C. * D. E. 266. A. B. C. D. * E. 267. A. * B. C. D. E. 268. A. B. C. D. * E. Syncope Melkersson-Rosenthal syndrome During the examination of 27 year old woman the subcutaneous allergy test was made. 5 minutes later after injection small red spots on the foream was revealed. Patient feel itch at those areas. What does this reaction mean? Erythema multiforme Anaphylactic shock – allergic reaction after injection Quincke’s edema – complication after injection Nettle rash – allergy reaction after injection Red idiopathic erythema During the examination of 22 year old patient the subcutaneous allergy test was made. 5 minutes later after injection small red spots on the foream was revealed. Patient feel itch at those areas. What will be your tactics at that case? To try another syringe To do additional allergic test To choose another anaeathetic To use analgetic spray in that area To do nothing and to continue treatment 40 year old male complains about painful mouth sores, which he noticed few days ago. From the parents words this sores comes periodically, thrice a year. Objectively: on the tongue and lower lip there are two sores (0,7 mm in diameter) with hyperemic membrane, covered with grey-whitish deposits. Food allergy in anamnesis. What is the most likely diagnosis? Acute herpetic stomatitis Erythema multiforme Chronic herpetic stomatitis Chronic aphthous stomatitis Pre-cancer 54 year old patient complains about painful mouth sores, which he noticed few days ago. From the parents words this sores comes periodically, thrice a year. Objectively: on the tongue and lower lip there are two sores (0,7 mm in diameter) with hyperemic membrane, covered with grey-whitish deposits. Food allergy in anamnesis. What will be the treatment in that case? Oral rinsing with antiseptics Antibiotics for 5 days Antibiotics for 7 days Surgical treatment Oral rinsing with corticosteroids 39 year old patient was waiting for her turn at the dentist’s. Suddenly she fell down, her respiration became hoarse, she got convulsive twitching in her upper and lower limbs, face and neck turned cyanotic, eye pupils became mydriatic, reaction of eye to light was absent. Arterial pressure and pulse couldn’t be measured. Heart sounds couldn’t be auscultated. Involuntary urination was noted. What condition is characterized by such symptoms? Coma Epilepsy Shock Clinical death Collapse 269. A. * B. C. D. E. 270. A. B. C. D. E. * 271. A. * B. C. D. E. 272. A. B. C. * D. E. 273. A. B. C. D. E. * Patient complains about mouth soreness, body temperature rise up to 38,5 C, indisposition. Such condition has been occurring periodically for several years after the patient had had a cold. Objectively: lips are covered with haemorrhagic crusts, hyperaemic mucous membrane of lips and cheeks has erosions covered with fibrinous films. Hypersalivation is present. What is the most likely Multiform diagnosis? exudative erythema Pemphigus vulgaris Herpes recidivicus Herpetiform Duhring's dermatitis Stevens-Johnson syndrome 33 year old patient complains about having vesicles in oral cavity, painful ulcers, especially during talking and eating; muscle and joint pain, body temperature rise, indisposition, weakness. He fell suddenly ill 2 days ago. Objectively: temperature - 38,4 C. Vermilion border is covered with bloody crusts that stick together and impede mouth opening. Mucous membrane of lips, cheeks, mouth floor, tongue, soft palate is hyperemic and edematic; there are single vesicles and large painful erosions covered with fibrinous deposit on it. Regional lymph nodes are enlarged and painful. There is hypersalivation. Nikolsky's symptom is negative. What is the most probable diagnosis? Acantholytic pemphigus Multiform exudative erythema Secondary syphilis Acute herpetic stomatitis Non-acantholytic pemphigus Patient G., applied to a clinic for the purpose of oral cavity sanitation. During preparation of the 45 tooth on account of chronic median caries the patient turned pale, there appeared cold clammy sweat on her forehead, nausea, ear noise. The patient lost consciousness. Objectively: pulse - 50 bpm, AP 80/60 mm Hg, shallow breath, miotic pupils. Make a diagnosis of this state: Syncope Anaphylactic shock Stenocardia Collapse Quincke's edema 37 y.o. patient was delivered to the traumatology centre with a dirty cut wound of her right foot. A doctor performed initial surgical d-bridement and made an injection of antitetanus serum. Some time later the patient’s condition got abruptly worse: she developed extreme weakness, dizziness, palpitation. Objectively: the skin is pale, the patient has cold sweat, frequent pulse of poor volume at a rate of 100 bpm, AP is 90/40 mm Hg. What is the cause of such aggravation? Pain shock Haemorrhagic shock Anaphylactic shock Infectious-toxic shock Drug disease (seroreaction) A 30 y.o. male attended a glasshouse in a botanic garden. After he had smelt at an orchid he turned pale and lost consciousness. Objectively: heart rate is 115/min, arterial pressure is 50/0 mm Hg. What drug should be injected to the patient in the first place? Dimedrol Cordiamin Strophanthine Mesaton Prednisolone 274. A. B. C. * D. E. 275. A. * B. C. D. E. 276. A. B. C. * D. E. 277. A. B. C. * D. E. 278. A. B. C. D. * E. 279. A. * B. C. D. E. After injection of anaesthetic solution to 40 year old patient before caries treatment, doctor noticed the swelling of patient face, which started from upper lip and rapidly progressed, wheezing and difficulty breathing. What is the most likely diagnosis? Idiopathic face edema Anaphylactic shock Quincke’s edema (angioedema) Syncope Asthma After injection of anaesthetic solution to 65 year old patient, doctor noticed the swelling of patient face, which started from upper lip and rapidly progressed, wheezing and difficulty breathing. What was doctors mistake can cause this complication? Incorrect anamnesis taking. Incorrect caries treatment. Incorrect patient choosing Incorrect anaesthetic injection All answers are wrong After injection of anaesthetic solution to 38 year old patient, doctor noticed the swelling of patient face, which started from upper lip and rapidly progressed, wheezing and difficulty breathing. What will be the key medication in the treatment of this disease? Antibiotics Anti-inflammatory Antihistamines Corticosteroids Antiviral Patient A., 34 y.o., complaines about swelling of her upper lip, wheezing and voice changing which started half an hour ago after bee bites. What is the most likely diagnosis? Idiopathic face edema Anaphylactic shock Quincke’s edema (angioedema) Syncope Melkersson-Rosenthal syndrome A 34 years old patient came to the dentist for sanation. The doctor found signs of catarrhal gingivitis and the dark fringe on the gum free edge beside of front teeth' neck. From the anamnesis — the patient works in printing office for years. What disease we suspect? Addison's disease Mercury stomatitis Necrotizing stomatitis Lead stomatitis Galvanosis A 27 years old patient complains on gray-black spots in the red lip rim area and acompanying weakness and headache. Is treated at an endocrinologist about the violation of adrenal hormones. What disease we suspect? Addison's disease Lead stomatitis Mercury stomatitis Bismuth stomatitis Cadmium stomatitis 280. A. B. * C. D. E. 281. A. B. C. * D. E. 282. A. B. * C. D. E. 283. A. B. C. D. * E. 284. A. B. C. * D. E. 285. A. B. C. D. E. * A 46 years old patient who works at gas station complains on unpleasant metallic taste in a mouth, difficulty chewing, indigestion and feeling unwell. Objectively: there is a dark, grey-blue strip around bottom teeth necks and yellow spots in the sky. The skin is earthy-grey. What disease we suspect? Addison's disease Lead stomatitis Zinc stomatitis Mercury stomatitis No correct answer A patient (35 y.o.) who works at mirror manufacturing complains on headache, malaise, feeling the heat, salivation violation, severe throbbing pain in mouth. There is grey-black border around teeth necks, hyperemic swollen gums. What metal will be detected after the urine analysis? Lead Bismuth Mercury Zinc No correct answer A patient complains on increased salivation, headache, unpleasant metallic taste in a mouth, throbbing pain in gums. Man works at mirror manufacturing. What disease we suspect? Galvanosis Mercury stomatitis Vegetative vascular dystonia Endemic parotitis Purulent necrotic angina of oral cavity bottom The patient complains on metallic taste in the mouth, feeling the heat, acute throbbing pain in the mouth and headache. Gums are hyperemic and swollen. The patient works on mirror manufacturing. What is the diagnosis? Bismuth stomatitis Ulcer-necrotizing gingivitis Catarrhal gingivitis Mercury stomatitis Galvanism A patient complains on unpleasant taste in the mouth, specific breath, dark spots on lips and tongue. Objectively: the skin is grey-ground. In the mouth - catarrhal gingivitis and there is a blue-black strip around front teeth necks from the vestibular side. Poisoning by which metal makes such changes? Tin Zinc Lead Mercury Argentum Mercury stomatitis was diagnosed on 24 y.o. patient. What should we prescribe for treating chronic intoxication? D-penicillamine Vitamin C Potassium iodide Polyvitamins All answers are correct 286. A. * B. C. D. E. 287. A. B. C. * D. E. 288. A. B. C. D. E. * 289. A. B. C. * D. E. 290. A. B. C. D. * E. 291. A. * B. C. D. E. The patient (28 y.o.) complains on metallic taste, unpleasant specific taste, dark spots on lips and tongue, difficulty chewing. In the mouth - catarrhal gingivitis and there is a blue-black strip around front teeth necks from the vestibular side. Local treatment of this disease is carried by the scheme as: Treatment of ulcerative necrotic stomatitis Treatment of catarrhal gingivitis Treatment of chronic generalized periodontitis Treatment of parotitis Treatment of acute pseudomembranous candidiasis 33 y.o. woman complains on unpleasant specific taste, dark spots on lips and tongue, difficulty chewing. In the mouth - catarrhal gingivitis and there is a blue-black strip around front teeth necks from the vestibular side. What is one of the first symptoms of this desease? Wrinkled kidney symptom Difficulty chewing andtrismus Metallic taste and specific lead breath Optic atrophy Nervous system damage (paresthesia, anesthesia, paralysis) The patient (40 y.o., a painter) complains on metallic taste, difficulty chewing, weakness, indigestion. Objectively: the skin is fround-grey, dark-blue strips around teeth necks, yellow spots in the sky. What medication is used for this desease? Dimercaprol EDTA Succimer Penicillamine All answers are correct 42 y.o. patient is diagnosed with mercury stomatitis. What medication is used for removing mercury from the body? Mineral water Smecta Unithiolum Atropine All these drugs complex A 32 years old patient came to the dentist for sanation. The doctor found signs of catarrhal gingivitis and the dark fringe on the gum free edge beside of front teeth' neck. From the anamnesis — the patient works in printing office for years. What disease does we suspect? Addison's disease Mercury stomatitis Necrotizing stomatitis Lead stomatitis Galvanosis A 26 years old patient complains on gray-black spots in the red lip rim area and acompanying weakness and headache. Is treated at an endocrinologist about the violation of adrenal hormones. What disease we suspect? Addison's disease Lead stomatitis Mercury stomatitis Bismuth stomatitis Cadmium stomatitis 292. A. B. * C. D. E. 293. A. B. C. * D. E. 294. A. B. * C. D. E. 295. A. B. C. D. * E. 296. A. B. C. * D. E. 297. A. B. C. D. E. * A 43 years old patient who works at gas station complains on unpleasant metallic taste in a mouth, difficulty chewing, indigestion and feeling unwell. Objectively: there is a dark, grey-blue strip around bottom teeth necks and yellow spots in the sky. The skin is earthy-grey. What disease we suspect? Addison's disease Lead stomatitis Zinc stomatitis Mercury stomatitis No correct answer A patient (36 y.o.) who works at mirror manufacturing complains on headache, malaise, feeling the heat, salivation violation, severe throbbing pain in mouth. There is grey-black border around teeth necks, hyperemic swollen gums. What metal will be detected after the urine analysis? Lead Bismuth Mercury Zinc No correct answer A 30-year-old patient complains on increased salivation, headache, unpleasant metallic taste in a mouth, throbbing pain in gums. Man works at mirror manufacturing. What disease we suspect? Galvanosis Mercury stomatitis Vegetative vascular dystonia Endemic parotitis Purulent necrotic angina of oral cavity bottom The patient complains on metallic taste in the mouth, feeling the heat, acute throbbing pain in the mouth and headache. Gums are hyperemic and swollen. The patient works on mirror manufacturing. What is the diagnosis? Bismuth stomatitis Ulcer-necrotizing gingivitis Catarrhal gingivitis Mercury stomatitis Galvanism A 46 year old manager patient complains on unpleasant taste in the mouth, specific breath, dark spots on lips and tongue. Objectively: the skin is grey-ground. In the mouth - catarrhal gingivitis and there is a blue-black strip around front teeth necks from the vestibular side. Poisoning by which metal makes such changes? Tin Zinc Lead Mercury Argentum Mercury stomatitis was diagnosed in 26 y.o. accounter. What should we prescribe for treating chronic intoxication? D-penicillamine Vitamin C Potassium iodide Polyvitamins All answers are correct 298. A. * B. C. D. E. 299. A. B. C. * D. E. 300. A. B. C. D. E. * 301. A. B. C. * D. E. 302. A. B. C. * D. E. 303. A. B. * C. D. E. The patient (26 y.o.) complains on metallic taste, unpleasant specific taste, dark spots on lips and tongue, difficulty chewing. In the mouth - catarrhal gingivitis and there is a blue-black strip around front teeth necks from the vestibular side. Local treatment of this disease is carried by the scheme as: Treatment of ulcerative necrotic stomatitis Treatment of catarrhal gingivitis Treatment of chronic generalized periodontitis Treatment of parotitis Treatment of acute pseudomembranous candidiasis 25 year old nurse complains on unpleasant specific taste, dark spots on lips and tongue, difficulty chewing. In the mouth - catarrhal gingivitis and there is a blue-black strip around front teeth necks from the vestibular side. What is one of the first symptoms of this desease? Wrinkled kidney symptom Difficulty chewing andtrismus Metallic taste and specific lead breath Optic atrophy Nervous system damage (paresthesia, anesthesia, paralysis) The patient (42 y.o., a painter) complains on metallic taste, difficulty chewing, weakness, indigestion. Objectively: the skin is fround-grey, dark-blue strips around teeth necks, yellow spots in the sky. What medication is used for this desease? Dimercaprol EDTA Succimer Penicillamine All answers are correct 43 y.o. patient is diagnosed with mercury stomatitis. What medication is used for removing mercury from the body? Mineral water Smecta Unithiolum Atropine All these drugs complex 45-years old waiter is diagnosed with erosive form of leukoplakia. What kind of therapy should we apply? Phototherapy Hydrotherapy Cryotherapy Radiotherapy Vacuum therapy 62-years old patient suffers from high sunlight sensitivity. There are red spots on the face, which have developed with atrophic changes. In these areas skin became thin. The shiny spots, that look like leaves-like, and the warts have appeared. Diagnosis? Senile keratosis Xeroderma pigmentosum Bowen's disease Erythroplasia of Queyrat Erysipelas 304. A. B. C. * D. E. 305. A. B. * C. D. E. 306. A. B. C. D. E. * 307. A. B. C. * D. E. 308. A. B. C. D. * E. 309. A. * B. C. Semispherical dense formation was found above the lower lip in the 60-years professor. In the central part of it there is the crater filled with keratinized gray mass. The formation is grey-brown. Kerarinized mass is easy to remove, and we can see dry bottom with papillary excrescence and tight shaft on the edge of the crater. No bleeding after mass removal is observed. Formation is not soldered to the surrounding tissues. What is the diagnosis? Syphilitic ulcer Squamous cell carcinoma Keratoakantoma limited hyperkeratosis red lip rims warty precancer The presumptive diagnosis of 49-years old patient is limited inhyperkeratosis of lower lip red border. What method of diagnosis should we use in this case? X-ray Biopsy Puncture Smear-mark Scraping of the surface formation There is keratinized area on the cheek mucosa along the interdigitation line. It rises above the surrounding tissues. Also it's grayish-white, dense to the touch, filled with erosion and cracks. What is the preliminary diagnosis? simple leukoplakia verrucous leukoplakia Lichen planus lupus erythematosus erosive and ulcerative form of leukoplakia Patient L. (69 years old) two years ago found keratinized ledge on the chin. This ledge is conical, tapering top. Put diagnosis. warty leukoplakia Keratoakantoma Skin corner Nodular skin precancer Erythroplasia of Queyrat 41-year old patient complains on burning lower lip mucosa, presence of granular formation for several months. Objectively: there is painless formation on the lower lip mucosa, rightside in Klein area. This formation (6x14 mm) rises on surrounding tissues with grayish tight warts. What is the most likely diagnosis? Chronic hyperplastic candidiasis Viral wart Papilloma with keratinization verrucous leukoplakia warty precancer The patient (59 years old) complains on color change of the lower lip red rim. Changes have started 4 months ago. Objectively: missing 31, 32, 41, 42. On the center of lower lip red rim there is irregular shaped area (grey-white, 8x14 mm) which is on the same level as red rim. Palpation is painless, the surrounding tissue isn't changed. When scraping pellicle is not removing. What is the most likely diagnosis? leukoplakia Limited precancerous hyperkeratosis Red flat lichen D. E. 310. A. B. * C. D. E. 311. A. * B. C. D. E. 312. A. * B. C. D. E. 313. A. B. C. D. * E. 314. A. B. C. * D. E. 315. A. B. C. D. Candida cheilitis lupus erythematosus 82-years old patient complains on ulcer on the lower lip red rim, which have appeared three month ago. Objectively: there is irregular shaped erosion (8x12 mm) on the lower lip red rim. It's covered with bloody crust and lightly bleeding after removing it. Palpation is painless, no signs of inflammation around, regional lymph nodes are not enlarged. What additional research should be Serological held? Histological Immunological fluorescent Bacterioscopic 53-years old patient complains on pathological changes of the lower lip. Objectively: the lip is purplish-red; there are erythematous spots and erosions on the red rim. Wasting areas in the center of affection, on the periphery - epithelium dimmed areas in the form of irregular white stripes. Oral mucosa are intact. What additional research should be appeal? Histological Serological blood Immunological Cytological 47-years old patient, smokes excessively. The mouth cavity is not treated. Verrucous leukoplakia was diognosed. How will look like the mucous membrane of this patient? presence of warty excrescence of the epithelium presence of epithelium atrophy presence of crack epithelium presence of whitish spot presence of limited swelling Mr G. (53 y.o.) complains on heartburn in the mouth. He is smoker for 30 years. Objectively: there is triangle-like hyperceratozic plaque on the cheek mucosa, on the hard palate there is greyish keratinized area. Non-keratinized areas are just round ducts of minor salivary glands. Diagnosis? Red flat lichen lupus erythematosus Hyperplasic candidiasis leukoplakia smokers Atrophic candidiasis The patient is 62 years old, smokes over 20 years. There is black hyperceratozic plaque on the mucosa palate. On this background we can see dilated ducts of minor salivary glands. Diagnosis? Red flat lichen lupus erythematosus smokers leukoplakia Hyperplasic candidiasis There is no right answer There are plaques on the cheek mucosa of the 55 years old male. Recently, cracks and sores appeared on the affected areas, painful while eating. What is the most likely diagnosis? Leukoplakia, a typical form Red flat lichen Chronic aphthous stomatitis There is no right answer E. * 316. A. B. C. D. * E. 317. A. B. C. D. * E. 318. A. B. C. D. * E. 319. A. B. C. D. * E. 320. A. B. C. D. E. * Leukoplakia, erosive and ulcerative form The patient (60 y.o.) has a rare warty globular neoplasm (diameter 8 mm) on the left cheek. It's clearly separated from the healthy skin. Surface is granular, grayish-brown, no hair. At the touch is soft, easily movable relative to the skin. It has appeared 6 years ago. What is the most likely diagnosis? skin corner neurofibromas rodent ulcer skin papilloma There is no right answer 52 y.o. patient complains on formation appearance on the lower lip. After the survey there was established diagnosis of precancerous hyperkeratosis. What treatment shold we apply? Keratoplastic means Antibiotic Anti-inflammatory therapy Surgical removal Medical observation without treatment The patient (45 y.o.) complains on feeling burning, tightness of buccal mucosa, roughness, uncomfortable feeling. Objectively: there is a dense grayish-white area on the lower lip red rim and hyperemic cheek mucosa. This area rises over the mucous membrane in the form of white warty growths. Dental plaque. Put the most likely diagnosis: Verrucous leukoplakia Red flat lichen Leukoplakia, flat shape Chronic hyperplastic candidiasis Galvanic stomatitis. A 49 year old patient complains about pain in the oral cavity induced by eating. He suffers from CHD. Objective examination revealed dyspnea, limb edema. Oral cavity isn't sanitated. On the mucous membrane, on the right, there is an ulcer with irregular edges covered with greyish-white necrotic deposit with low-grade inflammation around it. There is also halitosis. What is the most probable diagnosis? Cancerous ulcer Traumatic ulcer Tuberculous ulcer Trophic ulcer Ulcero-necrotic stomatitis A 45 year old homeless and unemployed patient complains about body temperature rise up to 39oC, pain during eating and deglutition, nasal haemorrhages. He has been suffering from this for 10 days. Objectively: herpetic rash on the lips, irregular-shaped erosions covered with fibrinous deposit on the mucous membrane of oral cavity; filmy deposits on the tonsils. Liver is enlarged and sclerotic. Blood count: erythrocytes - 4,5*1012l; hemoglobin - 120 g/l; ESR - 25 mm/h; leukocytes – 10*109l; eosinophils - 0; rod nuclear cells - 2; segmentonuclear leukocytes - 31, lymphocytes - 41; monocytes - 10; atypical mononuclears - 14%, plasmatic cells - 2. What is the most probable diagnosis? Acute leukosis Acute herpetic stomatitis Oropharyngal diphtheria AIDS Infectious mononucleosis 321. A. * B. C. D. E. 322. A. B. C. * D. E. 323. A. B. C. D. E. * 324. A. * B. C. D. E. 325. A. B. C. D. E. * A 34-year-old male patient consults a dentist about an ulcer on the hard palate. It appeared about a month ago. He has treated it by rinsing with herbal water, but the ulcer is gradually "creeping". Objectively: there is a shallow erethistic ulcer with uneven and undermined edges of soft consistency within the mucous membrane of hard palate. Granulations of the ulcer floor are also present. Yellowish granules are visible on the ulcer periphery. What is the most likely diagnosis? Tuberculous ulcer Trophic ulcer Cancerous ulcer Syphilitic ulcer Actinomycosis A 39 year old patient applied to a dental clinic for oral cavity sanation. Anamnesis data: mild case of diabetes. Objectively: mucous membrane of cheeks is unchanged, mainly in retromolar area there are symmetrically placed whitish papulae protruding over the mucous membrane and forming a lace-like pattern. On the upper jaw there are two soldered bridge dentures, the 47 tooth has an amalgam filling, the 46 tooth has a steel crown. What is the most probable diagnosis? Leukoplakia Secondary syphilis Lichen ruber planus Chronic atrophic candidosis Lupus erythematosus A 49-year-old patient was diagnosed with leucoplakia nicotinica Tappeiner. What pathohistological process predominates in histologic pattern of this disease? Papillomatosis Acanthosis Dyskeratosis Parakeratosis Hyperkeratosis A 17-year-old male patient complains about pain in the oral cavity, ulceration, body temperature up to 38oC, headache. Objectively: mucous membrane of the oral cavity is hyperemic and edematic. There are a lot of confluent erosions of polycyclic shape, covered with grey and white deposit, located on hard palate, gums, lips. What is your provisional diagnosis? Acute herpetic stomatitis Erythema multiforme Pemphigus vulgaris Aphthous fever Allergic stomatitis A 16-year-old patient complains about body temperature rise, weakness, pain induced by eating and deglutition. Objectively: mucous membrane of the oral cavity is erythematic with multiple petechia. Pharynx is hyperaemic. Regional lymph nodes are enlarged, mobile, painless. In blood: leukocytosis, monocytosis, atypic mononuclears, ESR is 30 mm/h. What is the leading factor Immediate allergy of disease development? Bacterial infection Autoimmune disorders Delayed allergy Viral infection 326. A. * B. C. D. E. 327. A. B. C. D. E. * 328. A. B. C. * D. E. 329. A. B. C. * D. E. 330. A. B. C. D. * E. A 23-year-old patient complains about a small ulcer on the red border of her lower lip that has been irresponsive to self-treatment for two weeks. Objectively: unchanged red border of lower lip has a circular ulcer of 2 mm in diameter with raised regular edges, its floor is of meat-like colour, dense, shiny, with "stearic film", with cartilaginoid infiltration, painless on palpation. Regional lymph node is enlarged, of tight elastic consistency, painless, mobile. What is the most likely diagnosis? Primary syphilis Decubital ulcer Cancerous ulcer Lupus erythematosus Tuberculous ulcer A 31-year-old male patient complains of dryness and burning of tongue back that appeared for about a week ago and get worse when he eats irritating food. The patient has a history of recent pneumonia. He had been treated in the in-patient hospital for 2 weeks, the treatment program included antibiotics. Now he doesn't take any drugs. Objectively: mucous membrane of the oral cavity is hyperemic, dry, glossy. Tongue back and palate have greyish-white plicae that can be easily removed. Threads of saliva trail behind the spatula. What is the most likely diagnosis? Chronic atrophic candidiasis Chronic hyperplastic candidiasis Acute atrophic candidiasis Medicamental stomatitis Acute pseudomembranous candidiasis A 35-year-old patient complains about itch, burning and edema of lips. He has been suffering from this for a week. Objectively: reddening of red border and skin, especially in the region of mouth corners, there are also vesicles, crusts, small cracks along with erythematous affection of red border. What is the most likely diagnosis? Acute herpetic cheilitis Multiform exudative erythema Acute eczematous cheilitis Allergic contact cheilitis Exudative form of exfoliative cheilitis A 19-year-old girl complains about having crusts, lip tenderness, especially at lip joining. Objectively: there are yellow-brown crusts on the lip red border from Klein zone to it's middle, after their removal bright red smooth surface without erosions appears. Mucous membrane in Klein zone is slightly hyperemic and edematic. What is the most likely diagnosis? Exudative form of cheilitis exfoliativa Epidermolysis bullosa Exudative form of cheilitis actinica Meteorological cheilitis Eczematous cheilitis A 64-year-old female patient was waiting for her turn at the dentist’s. Suddenly she fell down, her respiration became hoarse, she got convulsive twitching in her upper and lower limbs, face and neck turned cyanotic, eye pupils became mydriatic, reaction of eye to light was absent. Arterial pressure and pulse couldn’t be measured. Heart sounds couldn’t be auscultated. Involuntary urination was noted. What condition is characterized by such symptoms? Coma Epilepsy Shock Clinical death Collapse 331. A. B. C. * D. E. 332. A. B. C. D. E. * 333. A. B. * C. D. E. 334. A. B. C. D. E. * 335. A. B. C. * D. E. A 50-year-old female patient complains about sensation of tightness of buccal mucosa and roughness of the lateral surface of tongue. The patient undergoes regular check-up at a dispensary department for compensated form of diabetes mellitus. Objectively: there are white and grey areas in form of lacy pattern on the buccal mucosa on the right and on the lateral surface of tongue. The surface of affected region cannot be scraped off. What is the most likely diagnosis? Lupus erythematosus Secondary syphilis Lichen ruber planus Pseudomembranous candidiasis Leukoplakia A 27-year-old patient suffers from a disease without prodromal manifestations that declares itself through oral mucosa lesion consisting of 1-2 roundish elements 5-8 mm large which are circumscribed by a hyperemic rim and covered with yellow-grey coating. The disaese recurrence is observed quite regularly 3-4 times a year. Which presentations are typical for the following disease? Papular syphilis Lichen ruber planus Chronic herpes recidivicus Erythema multiforme Chronic recurrent aphthous stomatitis A 56-year-old patient complains about dryness and burning of the lateral surface of her tongue. These sensations disappear during eating. She noted such sensations three months ago. She has a history of gastritis with reduced secretory function. Objectively: mucous membrane of tongue and oral cavity has no peculiarities. The back of tongue has thin white coating. Regional lymph nodes are unpalpable. Oral cavity is sanitized. What is the most likely diagnosis? Lingual nerve neuritis Glossodynia Candidiasis Desquamative glossitis Hunter-Moeller glossitis A 35-year-old woman complains about experiencing lip dryness and desquamation for a month. Application of indifferent ointments is ineffective. Objectively: red border of lower lip is of rich red color, it is moderately infiltrated, covered with closely adhering greyish scales, it bleeds and hurts in the attempt to remove them. Opacification of epithelium in form of white stripes is present in the nidus periphery, there is also an area of depression in the centre. What is the most likely diagnosis? Cheilitis exfoliativa Commissural cheilitis Lichen ruber planus Leukoplakia Lupus erythematosus A 46-year-old broker complains about a sensation of foreign body on his tongue, discomfort during talking, oral cavity dryness. Objectively: there are dark filiform papillae up to 5 mm long on the back of tongue. What is the most likely diagnosis? Benign migratory glossitis Median rhomboid glossitis Glossophytia Fissured tongue Acute glossitis 336. A. B. C. * D. E. 337. A. B. C. D. E. 338. A. B. C. * D. E. 339. A. * B. C. D. E. 340. A. B. * C. D. E. A 23-year-old woman complains about severe pain in the mouth, body temperature up to 38oC, indisposition. The same condition occurs periodically for several years after catching a cold. Objectively: the lips are covered with bloody crusts, there are opened bladders and erosions, covered with fibrinogenous deposit on mucous membrane of lips and cheeks that is apparently hyperemic and edematic. Hypersalivation is present. What is the most likely diagnosis? Dermatitits multiformis, Duhring's disease Pemphigus vulgaris Erythema multiforme Nonacantholytic pemphigus Chronic herpes recidivicus A 35 year old teacher complains about periodical appearance of small ulcers in the oral cavity. She has been suffering from this for 5 years, recurrences happen 4-5 times a year. The ulcer healing lasts for 10 days. Objectively: on a mucous membrane of lower lip there is a roundish lesion element 0,5 cm large covered with white deposit and surrounded by hyperemia border, very painful when touched. What is the most probable diagnosis? Chronic recurrent aphthous stomatitis Traumatic erosion Secondary syphilis Chronic recurrent herpes Duhring's herpetiform dermatitis A 64 year old patient complains of pain in the area of mucous membrane of hard palate on the left that is getting worse during eating with use of a complete removable denture. He has been suffering from this for 1,5 month. Objectively: left-sided hyperemia and edema of mucous membrane of hard palate; at the border of distal denture edge there is an ulcer with dense walls and fundus, surrounding tissues are infiltrated. The ulcer floor is tuberous, covered with fibrinous deposit; ulcer palpation is painful. What examination method is to be applied in the first place? Cytology Bacterioscopy Biopsy Allergic contact plastic test Serological reactions A 31-year-old patient complains about mouth soreness, body temperature rise up to 38,5oC, indisposition. Such condition has been occurring periodically for several years after the patient had had a cold. Objectively: lips are covered with haemorrhagic crusts, hyperaemic mucous membrane of lips and cheeks has erosions covered with fibrinous films. Hypersalivation is present. What is the most likely diagnosis? Multiform exudative erythema Pemphigus vulgaris Herpes recidivicus Herpetiform Duhring's dermatitis Stevens-Johnson syndrome A 32-year-old male patient complains about tongue pain that is getting worse during eating and talking. Objectively: there is a painful ulcer 0,6 cm large on the lateral surface of tongue. The floor is covered with grey deposit. The crown of the 47 tooth is destroyed. What is the most likely diagnosis? Trophic ulcer Decubital ulcer Hard chancre Tuberculous ulcer Cancerous ulcer 341. A. B. C. D. E. * 342. A. B. C. D. * E. 343. A. B. C. D. * E. 344. A. B. * C. D. E. 345. A. B. C. * D. E. 346. A patient complains of burning, itch and lower lip enlargement. He has been suffering from this for a long time. Objectively: the patient's face is asymmetric due to the flattening of nasolabial fold. His lower lip is edematic, of normal colour, painless on palpation. The patient has plicated tongue. What is your provisional diagnosis? Granulomatous Miescher's cheilitis Quincke's edema Lymphangioma Hemangioma Melkersson-Rosenthal syndrome An 17 year old patient complains of gingival painfulness and haemorrhage, halitosis, temperature rise up to 38,6oC, general weakness, appetite loss. Objectively: mucous membrane of oral cavity is hyperemic and dry; tongue is covered with white fur, gingival papillae are edematic, their apices have areas of necrotic deposit that can be easily removed leaving bleeding surface beneath. Submaxillary lymph nodes are enlarged, palpatory painful. What is the causative agent of this disease? Virus of herpes simplex Streptostaphylococci Pale treponema Fusospirochetal symbiosis Candida fungi A 44-year-old patient complains about a rapidly growing formation on his lower lip. Examination of the red border of lips revealed a greyish-red nodule with a hollow in the centre which is filled with corneous masses that can be easily removed. The nodule is painless, mobile. What is your provisional Basal cell carcinoma diagnosis? Papilloma Nodulous verrucous precancer of red border Keratoacanthoma Localized precancerous hyperkeratosis of red border A young woman complains about having vesicles in oral cavity, painful ulcers, especially during talking and eating; muscle and joint pain, body temperature rise, indisposition, weakness. She fell suddenly ill 2 days ago. Objectively: to- 38,4oC. Vermilion border is covered with bloody crusts that stick together and impede mouth opening. Mucous membrane of lips, cheeks, mouth floor, tongue, soft palate is hyperemic and edematic; there are single vesicles and large painful erosions covered with fibrinous deposit on it. Regional lymph nodes are enlarged and painful. There is hypersalivation. Nikolsky's symptom is negative. What is the most probable diagnosis? Acantholytic pemphigus Multiform exudative erythema Secondary syphilis Acute herpetic stomatitis Non-acantholytic pemphigus A steeplejack with a long record of service consults a dentist about dryness, burning and insignificant lip edema. The same symptoms were noted one year ago in autumn. What is the most likely diagnosis? Cheilitis glandularis Contact cheilitis Meteorogical cheilitis Manganotti's cheilitis Cheilitis exfoliativa A 41 year old patient applied to a dentist and complained about white caseous deposit on the dorsum of his tongue and burning sensation. It is known from the patient's anamnesis that he underwent treatment in an in-patient hospital on account of pneumonia. What is the most probable diagnosis? A. B. C. D. E. * 347. A. B. C. * D. E. 348. A. B. C. D. E. * 349. A. B. * C. D. E. 350. A. B. C. * D. E. 351. A. Lupus erythematosus Typical form of leukoplakia Lichen ruber planus Scarlet fever Acute pseudomembranous candidosis A patient complained about frequent haemorhages from the mucous membrane of oral and nasal cavities, he mentioned also that his father had the same problems. Objectively: there are multiple telangiectasias and angimatous formations on face skin as well as on mucous membrane of nose, cheeks and lips. Blood count is normal. What is the most probable diagnosis? Vaquez disease Werlhof's disease Rendu-Osler-Weber disease Cushing's basophilism Addison-Biermer disease A 41-year-old builder complains about a condyloma on his lower lip. It appeared 1,5 month ago. It has been significantly growing throughout the last week. Objectively: the red border of the lower lip is cyanotic and infiltrated, it has some isolated closly adhering squamae. There is a well-defined hemispherical formation 8 mm in diameter and 4 mm high in the centre. The formation is of grey-and-blue-and-red colour, it has rough surface formed by thin, closely adhering and thick-based squamae. Regional lymph nodes are enlarged, mobile, dense and painless. What is the most likely Viral wart diagnosis? Verruciform precancer Pyogenic granuloma Keratoacanthoma Lower lip cancer A patient complains about pain in the oral cavity, burning and dryness. Examination revealed fiery-red dry mucous membrane. The tongue is crimson, dry, glossy, filiform papillae are atrophied. There is some deposit in tongue folds that is hard to be removed. The patient undergoes treatment for pneumonia, she takes antibiotics. What is the most likely diagnosis? Fastened erythema Acute atrophic candidiasis Pellagrous glossitis B2 hypovitaminosis Benign migratory glossitis Examination of a 22 year old patient revealed chronic candidosis of oral mucous membrane, generalized lymphadenopathy. Anamnesis data: the patient has been suffering from herpes for a year. Body temperature persistently rises up to 37,4-37,5oC, body weight has reduced by 8 kg over the last month. What disease can be indicated by this symptom group? Acute leukosis Infectious mononucleosis AIDS Chronic leukosis Candidosis A 24-year-old patient complains about acute pain in the mouth, headache, articular pain, body temperature rise up to 38,6oC. Red border of lips is covered with haemorrhagic crusts, mucous membrane of the oral cavity has big erosions and ulcers coated with greyish incrustation. Hand skin exhibits erythematous spots 1-1,5 cm in diameter with a vesicle in the middle. What is the most likely diagnosis? Lyell's syndrome B. C. * D. E. 352. A. B. C. * D. E. 353. A. B. C. D. * E. 354. A. * B. C. D. E. 355. A. B. C. * D. E. 356. A. B. C. D. Behcet's syndrome Stevens-Johnson syndrome Multiform exudative erythema Medicamentous stomatitis A 61-year-old patient complains of a painless formation on his tongue that appeared several months ago. Objectively: the patient has a lot of carious and completely decayed teeth, lateral surface of tongue exhibits a painless whitish formation 10x5 mm large with irregular surface in form of verrucae. Histological examination revealed thickening of corneal epithelial layer of intermittent keratinization type. What is the most likely diagnosis? Hyperplastic form of candidiasis Verrucous precancer Verrucous form of leukoplakia Hyperkeratotic form of lichen ruber planus Keratoacanthoma An 17-year-old student complains about ulceration in the oral cavity, spontaneous bleeding of mucous membrane, pain during food intake and talking, nosebleeds. He has a history of: aggravation of general condition, weakness, body temperature rise up to 39oC, headache, joint pain. What method of diagnostics should be applied to confirm the diagnosis? HIV test Blood sugar test Immunogram Clinical blood analysis Allergy test A 24 year old patient applied to a clinic for the purpose of oral cavity sanitation. During preparation of the 45 tooth on account of chronic median caries the patient turned pale, there appeared cold clammy sweat on her forehead, nausea, ear noise. The patient lost consciousness. Objectively: pulse 50 bpm, AP - 80/60 mm Hg, shallow breath, miotic pupils. Make a diagnosis of this state: Syncope Anaphylactic shock Stenocardia Collapse Quincke's edema A 22-year-old patient was delivered to a traumatology centre with a dirty cut wound of her right foot. A doctor performed initial surgical d-bridement and made an injection of antitetanus serum. Some time later the patient’s condition got abruptly worse: she developed extreme weakness, dizziness, palpitation. Objectively: the skin is pale, the patient has cold sweat, frequent pulse of poor volume at a rate of 100 bpm, AP is 90/40 mm Hg. What is the cause of such aggravation? Pain shock Haemorrhagic shock Anaphylactic shock Infectious-toxic shock Drug disease (seroreaction) A 27-year-old man attended a glasshouse in a botanic garden. After he had smelt at an orchid he turned pale and lost consciousness. Objectively: heart rate is 115/min, arterial pressure is 50/0 mm Hg. What drug should be injected to the patient in the first place? Dimedrol Cordiamin Strophanthine Mesaton E. * 357. A. * B. C. D. E. 358. A. * B. C. D. E. 359. A. B. C. D. E. * 360. A. B. C. D. E. * 361. A. * B. C. D. E. 362. Prednisolone To the dentist clinic appealed patient (20 years old), with the aim of oral rehabilitation. There are main and auxiliary methods of examination of patients. What methods of examination in therapeutic dentistry are main? examination, palpation, percussion, probing percussion, probing X-ray Termo-test All answers are correct The patient, 34 year old, complains of a constant aching pain in the 25tooth, which enhanced while biting. Objectively: the chewing surface of the cavity of 25-th communicates with the cavity of the tooth.The folder in the transition area above 25-th tooth are edematous, hiperemic, painful at palpation, percussion of 25-th is sharply painful. What method of research is necessary to conduct for the diagnosis? X - ray Kulazhenko’ test blister test reoparodontographia Provocative tests. Patient, 18 years old, complains of heartburn in the mouth, pain when eating. In anamnesis treatment of pneumonia with large doses of antibiotics. On hiperemic mucosa of tongue and cheeks there are white patches, which can be easily removed. What research method is used for diagnosis? X- ray Kulazhenko’ test blister test reoparodontographia microbiological investigation. Patient K., 37 years old, complains of dryness and edema of oral mucosa. She took antibiotics becouse of the treatment of somatic pathology. On the back of the tongue there are white-yellowish plaques that are difficult to remove. What examination is necessary to conduct for clarifing the Xray diagnosis? Kulazhenko’ test blister test reoparodontographia microbiological investigation. The patient O., 62 years old appealed to the dentist with complaints of pain and the presence of ulcers under the tongue. The patient uses removable prostheses(dentures), 3 months ago he noticed a tumor under the tongue. On examination - at the bottom of the oral mucosa is infiltrated ulcer. Regional lymph nodes are not changed. What auxiliary investigation should be conducted? A biopsy of the tumor Clinical analysis of blood X-ray of the mandible Puncture of the tumor Ultrasonography of the neck The patient V., 33 years old appealed to the dentist with complaints of pain in 37 tooth, which amplifies while biting and irradiates over the course of the trigeminal nerve. The tooth was treated previously. Examination: the crown of 37 is destroyed at 1/3, percussion is positive, oral mucosa above 37 tooth is hyperemic, edematous, painful on palpation. What kind of investigation is needed for the setting of the final diagnosis? A. B. C. * D. E. 363. A. B. C. * D. E. 364. A. B. * C. D. E. 365. A. * B. C. D. E. 366. A. * B. C. D. E. Probing of the 37-th tooth cavity Determination of the degree of 37-th tooth mobility X-ray of 37-th tooth Determine the depth of gum pockets in 37-th tooth Electroodontodiagnosis of 37-th tooth The patient F., 18 years old, complains on increased sensitivity to sweet and sour. Objectively: on the cervical parts of 14, 13, 12, 23, 24 are chalky-liked, dull spots with indistinct edges. What additional method of examination should be undertaken to clarify the diagnosis? Elektroodontodiagnosis Thermometry methylene blue coloring Probing X-ray 51 year old patient appealed to the clinic with complains of the pain in the lower right lip, which amplifies while taking food and during conversation. The first symptoms appeared about a month ago. On examination: on the lower lip in the region of 42.43 is a deep mucosal defect rounded 0.8 cm in diameter, on the basis it is infiltrated, with elevated edges, flat bottom, covered with fibrinous plaque, coarsen on the edge, painful. Crowns of 41,42,43 are destroyed, have sharp edges. What additional examination is necessary to conduct to determine the tactics of the treatment? allergological Cytological Biochemical Microbial Immunological Patient A., 35 year old, complains of burn of the tongue tip, which increases during meals and dryness of oral mucosa. In the anamnesis - pneumonia 2 months ago. OBJECTIVE: dryness, hyperemia and edema of the mucous membrane of mouth, on the back of the tongue yellowish caseous layers are revealed. Sharp edges of the cavities of 26, 34,35 and 46 teeth are visible. Hygiene index by Fedorov - Volodkina - 2.6 points. What investigation should be conducted to establish the Microbial final diagnosis? General blood test Blood test for glucose Biomicroscopic Analysis of immunological parameters of mixed saliva During examination the 45 year old patient there were noticed mild edema and hyperemia of the marginal gum throughout. Periodontal pocket with the depth of 3-6 mm with a purulent exudate. GI-2,1 points. Traumatic occlusion in the area of lateral teeth. Radiologically: resorption of interdental membranes from 1/3 to 1/2 lengths of the tooth root. What should be considered, when causal therapy is assigned? Microbiological investigation of contents of periodontal pockets Age of the patients Concomitant somatic disease Data Kulazhenko test General blood test 367. A. * B. C. D. E. 368. A. * B. C. D. E. 369. A. B. * C. D. E. 370. A. B. C. * D. E. 371. A. B. C. D. * E. 372. A. B. Patient K., 22 years old complains of pain in the gums that amplifies when eating, foul odor from mouth, bad state of health. Temperature - 38.8 C. Consider himself ill for 2 days, after the removal of 28 teeth. OBJECTIVE: mucosa of gums is hiperemic, swollen, bleeds easily when probing. Gum region in 23, 24, 25, 26 and 27 teeth covered with gray necrotic bloom. Significant dental deposits. Regional lymph nodes are enlarged, painful on palpation. At what additional investigation it is necessary to direct the patient? X-ray of 28 tooth hole Fluorescent Microscopy Transillumination Serological Patient Z., 44 year old, complaints of bleeding gums. OBJECTIVE: gums edge is swollen, hiperemic, bleeding of the mild touch. It is defined periodontal pockets of 3-3.5 mm. On the neck of the teeth – hard dental deposits. At what additional investigation it is necessary to direct the patient? X-ray of jaws Schiller-Pisarev test Assessment of tooth mobility Determination of capillary resistance Determination of periodontal index Patient K., 18, applied with household face trauma. On examination, the timer of 21-st tooth on 1/3 of the crown, probing through fracture is painful, reaction to cold causes intermittent pain, percussion painless. What research is primarily to hold for the diagnosis and selection of treatment? EDI X-ray Palpation of the apex of the root projection Metulen- blue coloring Termotest Patient S., 23 years old, complains of sharp pain in the gums, inability to eat, bad smell from the mouth, raising the temperature to 38oC, general weakness. On examination: the patient is pale, with enlarged lymph nodes. Edema, hyperemia of gum papillae, some ulcers are covered with necrotic bloom. What additional research is necessary to clarify the diagnosis? General blood test urine test Panoramic X-ray allergological tests serological tests Patient A., appealed to the dentistry clinic, where she was diagnosed with folded tongue. What is a module according to ICD-10 diseases? K14.1; K14.3; K14.4; D. K14.5; K14.6. A girl, 17 year old, complains about deterioration and appearance of rashes on the lips. From history: the same rashes occurred one year ago in the same place. Objectively: body temperature is 37.1 C, on the edge of the red border of the upper lip and the skin are grouped vesicles with a diameter of 1-3 mm with clear contents. Indicate the most likely diagnosis. herpes zoster; acute herpetic stomatitis; C. D. E. * 373. A. B. * C. D. E. 374. A. * B. C. D. E. 375. A. B. C. D. * E. 376. A. B. * C. D. E. 377. A. B. C. D. E. * stomatitis at measles; stomatitis at chicken pox; chronic recurrent aphthous stomatitis. A patient, 57 year old, has symptoms of galvanosis. Objectively: there are gold, metal crowns on the teeth and couple amalgam fillings in the mouth; the oral mucosa is hyperemic and swollen. Which way can prevent the occurrence of galvanosis? replacement of amalgam fillings; using of homogeneous metal for prosthesis; taking of vitamins A and E; rinsing with antiseptics; desynsebilizition drugs. An 19 year old boy was under treatment in the infectious disease department. He was taking ampicillin. On the 6th day of treatment the white deposits similar of caseous films were revealed on the hyperemic mucous membrane in the area of gingival torus, cheeks and on the tongue. The films can be removed leaving hyperemic surface underneath. General condition is satisfactory. Body temperature is 36,7oC. What is the provisional diagnosis? acute candidiasis stomatitis; drug-induced stomatitis; chronic candidiasis stomatitis; acute herpetic stomatitis; mild form of leukoplakia. A 64 year old patient has a complete removable denture and complains of pain in the area of mucous membrane of hard palate on the left that is getting worse during eating. He has been suffering from this for 1,5 month. Objectively: left-sided hyperemia and edema of mucous membrane of hard palate; at the border of distal denture edge there is an ulcer with dense walls, surrounding tissues are infiltrated. The ulcer floor is tuberous, covered with fibrinous deposit; ulcer palpation is painful. What kind of examination methods will be applied in the first place? allergic contact plastic test; cytology; serological reactions; bacterioscopy; biopsy. A 23 year old patient complains about high body temperature, halitosis. Objectively: gingiva is swollen, easy bleeds by touching, apexes of interdental papillae affected by necrosis and remind beheaded cones. At cytology detected fuzo-spirochetes symbiosis. The diagnosis is: leukemia; Vincent’s ulcer-necrotic stomatitis; allergic stomatitis; secondary syphilis; avitaminosis. A 62 year old patient complains of fever to 38C, burning pain, presence of vesicles on the tongue to the left. Objectively: there are bubbles on the hyperemic edematous mucosa of the tongue on the left as a chain filled with serous fluid, regional lymphadenitis. What is a diagnosis? blister-vascular syndrome; primary herpetic infection; recurrent herpes; multiform exudative erythema; shingles. 378. A. B. C. D. E. * 379. A. B. C. D. * E. 380. A. B. C. * D. E. 381. A. B. C. D. E. * 382. A. B. C. D. * E. 383. A. * B. In 19 year old young man on buccal mucosa and tongue was detected a cheesy white film that is easily removed. It began appeared 4 days ago. The young man held a long course of antibiotic therapy. What is a probable diagnosis? chronic aphthous stomatitis; chronic candidiasis; exudative erythema multiforme; acute herpetic stomatitis acute candidiasis. A 30 year old patient complains of headache, fever to 39C, general weakness and the appearance of the oral mucosa cruel painful erosions. Objectively: on the buccal, lips mucosa--- multiple group erosions 2-3mm in diameter with scalloped edge covered with grayish-white bloom. The surrounding mucosa is hyperemic, regional lymph nodes are enlarged, painful on palpation. At cytology identified giant multinuclear cells, macrophages. What is the final diagnosis? erosive stomatitis; vulgar pemphigus; exudative erythema multiforme; herpetic stomatitis; shingles. A 21 year old man complains about presence of painful ulcers in the mouth. Similar symptoms were noted six months ago. Objectively: on the lateral surface of the tongue and at the bottom of the oral cavity detected two erosions circular form, covered with grayish-white bloom. Erosions have hyperemic border. Its edges slightly raised above the mucosa. What is the most likely diagnosis? syndrome Behcheta; exudative erythema multiforme chronic recurrent aphthous stomatitis; Stevens-Johnson syndrome; recurrent herpetic stomatitis A 51 year old patient complains of burning and dryness of the tongue that appeared about 10 days ago and intensified when taking spicy food. Two weeks ago was in the hospital and received large dose antibiotics. On the hyperemic and edematous cheeks and tongue mucosa gray-white color crumbs like plaque that are easily removed by erasure. What are found on smears from lesions during giant multinuclear cells; microscopy? single cell fungi form; threads of mycelium; giant cells Lanhansa; numerous cells of fungi. A 23 year old man notes available on the palate wound that appeared after the session intrachannel electrophoresis of 26 tooth by 5% solution of iodine. Objectively: on the hard palate mucosa to the left is the lesion area dashed form with whitish-gray surface. What is the probable cause of lesions? chemical injury; mechanical trauma; thermal damage; electrical injury; galvanism. A 75 year old patient complains about appearance of rash on the face and oral mucosa, severe neuralgic pains. After examination was determined diagnosis - shingles. What is the typical clinical picture for this disease? sharply painful blisters and erosions in a chain over the course of the branches of the trigeminal nerve; rash blisters and vesicles in different parts of the skin, lips red border and the mouth; C. D. E. 384. A. B. C. D. E. * 385. A. B. C. D. * E. 386. A. B. C. D. E. * 387. A. B. C. D. * E. 388. A. B. * C. D. E. 389. rash with blisters and bubbles with serous and serous-hemorrhagic exudates; polymorphism of elements lesions; single painful round erosions with red border and fibrous plaque. A 44 year old patient complains regarding low-grade fever, malaise, bleeding gums, difficult meal. Objectively: gum edge and top of interdental papillae are covered with dirty-gray plaque, edge of ulcers rough under dig, bad breath, increased regional nodes. The diagnosis is: scarlet fever; diphtheria; measles; herpangina; Vincent’s ulcer-necrotic stomatitis. A 77 year old patient complains about appearance of rash on the face and oral mucosa, severe neuralgic pains. After examination was determined diagnosis-shingles. In the absence of complications the disease continues average: 1-3 days; 8-12 days; 2-3 months; 2-3 weeks; 1-2 weeks. A 35 year old patient complains about appearance of ulcer under the tongue. From history: pathology of the gastrointestinal tract. Objectively: under his tongue is a round aphthae 5-7 mm surrounded by a rim of inflammatory hyperemia covered with fibrinous plaque, sharply painful to the touch. What is a diagnosis? syndrome Behcheta; recurrent herpes; stomatitis Settona; secondary syphilis; chronic recurrent aphthous stomatitis. A 62 year old patient complains of fever to 38C, burning pain, the presence of vesicles on the tongue to the left. Objectively: on the hyperemic edematous mucosa of the tongue on the left are bubbles as a chain filled with serous fluid, regional lymphadenitis. What is a diagnosis? blister-vascular syndrome; primary herpetic infection; recurrent herpes; shingles; exudative erythema multiforme. A 62 year old patient complains about pain, appearance of ulcer in the mouth. During 12 years the patient used a mandible partial denture and suffering from ischemic heart disease, PI-3.0. After examination was determined diagnosis: decubital ulcer of mouth floor. Which of the following will help to eliminate the cause of the disease? treatment in cardiology; production of a new partial denture; cutting sores; application of kerato plastic products; improve an oral hygiene. A 31 year old patient complains about appearance of pain ulcer on lower lip mucosa that appeared before. The patient suffers from chronic enterocolitis. On the lower lip mucosa (right side) is a surface rounded defect tissue surrounded by the whisk of hyperemia covered with fibrous plaque, palpation painful. The diagnosis is: A. * B. C. D. E. 390. A. B. * C. D. E. 391. A. B. C. D. E. * 392. A. B. C. D. * E. 393. A. B. * C. D. E. 394. A. B. C. D. E. * 395. chronic recurrent aphthous stomatitis; traumatic erosion; recurrent herpes; stomatitis Settona; secondary syphilis. A 54 year old patient complains of mouth burning, pain during meal, whitish patches on the cheeks and tongue. From history the patient for a long time treated with antibiotics regarding pneumonia. On hyperemic buccal and tongue mucosa is a white film that is difficult to be removed. What kind of the additional methods can clarify the diagnosis? histological; bacterioscopic; serological; allergological tests; stomatoskopy. A girl is sick couple days, her body temperature is normal. Objectively: on the hyperemic edematous mucosa of cheeks and tongue dorsum is a white film like a cottege cheese. After its removal remains bright hyperemic surface with hemorrhages. The patient was treated with antibiotics. What is a previous diagnosis? mild form of leuckoplakiy; acute herpetic stomatitis; chronic candidiasis stomatitis; recurrent aphthous stomatitis; acute candidiasis stomatitis. A 68 year old patient appealed to the dentist with complaints of rash on the face and oral mucosa, severe neuralgic pains. After examination was diagnosed—shingles. For local treatment of the disease are used: metronidazole; ointments: nistatynova, levorinov; Solcoseryl-jelly, aerosol “Livian”; bonafton, acyclovir, Zovirax-ointments; nysoral, suprastin, multivitamins. A 35 year old patient has diagnosis erosive stomatitis. Which group of drugs should be used at the final stage of treatment? antibiotics; keratoplastics; glucocorticosteroids; antioxidants; proteolytic. The patient in 55 year old with diabetes mellitus uses removable dentures and complains of heartburn, dry mouth, pain during eating. At survey on buccal and tongue mucosa, hard palate is lean hyperemic plaque that taking off hardly. After its removal appears a visible erosive surface. What is a probable diagnosis? acute aphthous stomatitis; acute pseudomembranous candidiasis; erosive form of leuckoplakiy; red lichen planus, erosive form; chronic atrophic candidiasis. A patient is diagnosed with Vincent ulcerative-necrotic stomatitis based on clinical and laboratory findings. What treatment does need to prescribe to the patient? A. B. C. D. * E. 396. A. B. C. D. * E. 397. A. * B. C. D. E. 398. A. B. C. D. E. * 399. A. B. C. * D. E. 400. A. B. C. D. E. * multivitamins; antibiotics, corticosteroids, antiseptics; proteolytic enzymes, antiseptics; antiviral, immunomodulators. A 24 patient complains of a painful rash on the mucosa of the upper and lower lip, raising body temperature to 39C. Easy bleeding, hyperemic swollen gums are painful. The mucous has rash blisters and erosions. What is a diagnosis? measles; ulcer-necrotic stomatitis; chronic recurrent herpetic stomatitis; acute herpetic stomatitis, mild form; scarlet fever. A 67 year old patient appealed to the dentist with complaints of rash on the face and oral mucosa, severe neuralgic pains. After examination was diagnosed—shingles. What kind of additional methods can clarify the diagnosis? histological; bacterioscopic; virus isolation; determination of immunity; biopsy. An 17 year old girl complains about the pain in the mouth, increasing the body temperature until 38,5C. After the exam was diagnosed with acute herpetic stomatitis. What will to be found in the cytological study of erosion surface? elements of the reticuloendothelial system; akantolityc cells; atypical cells; cells of Pirogov-Lanhansa; giant multinuclear cells. A 24 year old patient applied on the second day from the disease beginning and was diagnosed with acute herpetic stomatitis. Which ointment is necessary to apply the first for treatment of elements lesions? ointment with corticosteroids; ointment with antibiotics; antiviral; ointment wityh sulfonamides; ointment with proteolytic enzymes. A 51 year old patient complains about mouth dryness and white plaque on the tongue, cheecks that appeared after taking of antibiotics dose. The dry oral mucosa has bright red color and covered with white color crumbs like plaque that removed by cotton roll. What is a probable diagnosis? lupus erythematosus; leukoplakia of the mucous; red plane lichen; syphilitic papules; chronic candidiasis stomatitis. 401. A. B. C. * D. E. 402. A. * B. C. D. E. 403. A. B. C. D. * E. 404. A. * B. C. D. E. 405. A. B. C. D. * E. 406. A. A 29 year old patient complains of headache, fever to 39C and appearance on the lips mucosa cruel painful erosions. Objectively: on the edge of a red border and skin of the upper lip there are multiple group erosions 1-3mm in diameter with serous fluid, covers of some bubbles have destroyed. The surrounding mucosa is hyperemic, regional lymph nodes are enlarged, painful on palpation. At cytology identified giant multinuclear cells. Which drug of local action should be used for etiotropic phenylbutazone; treatment? klotrimazol; Zovirax; lorinden A; solcoseryl. A 52 year old patient complains about dryness, burning of the mouth that increase during meal. Objectively: partial denture in upper jaw, tongue is swollen and smooth, there are prints of teeth on the lateral tongue surfaces, atrophied papillae. The tongue folds have baldly plaque that removes with efforts. What is the final diagnosis? chronic atrophic candidiasis; acute atrophic candidosis; diamond-shaped glossitis; desqumative glossitis; leukoplakia. After the flu a 31 year old patient complains about general weakness, gums pain, their bleeding and halitosis. Objectively: regional lymph nodes are enlarged, painful on palpation, the hyperemic, swollen gingiva has numerous necrotic ulcers covered with grayish-green plaque. What will be found on smears from lesions during microscopy? neuthrophils, epithelial cells, cocci; erythrocytes, leukocytes, fungi Candida; neyseriyi, veylonely bacteria collie; significant number of fuzobacterias, spirochetes; lactobacilli, gonococci, erythrocytes. A patient complains about pain in the tongue duiring meal, talk. Sick 2 weeks ago. The lateral surface of the tongue mucosa has irregular ulcer with hyperemic edges covered with necrotic plaque. Its palpation is painful. Crowns of 46 and 47 teeth are destroyed. What are the priority actions of dentist? of traumatic factors; removal analgesia lesions; application of anti-inflammatory drugs; application of kerato plastic drugs; surgery. A 25 year old patient complains of fever to 38,5C, pain duiring meal. There are small vesicles with clear fluid and bright red erosions with scalloped outlines covered with plaque on the lips and cheecks mucosa. Regional nodes are painful. The diagnosis is: erosive stomatitis; exudative erythema multiforme; shingles; herpetic stomatitis; malignant pemphigus. A patient complains about an ulcer that appears periodically on the mucous membrane of the mouth. He is sick on pancreatitis, enterocolitis. On the left surface of the tongue is defined oval ulcer covered with whitish-yellow plaque surrounded by edge of hyperemia, painful on palpation.What is most likely diagnosis? aphtha Settona; B. C. * D. E. 407. A. B. C. D. E. * 408. A. B. * C. D. E. 409. A. * B. C. D. E. 410. A. B. C. D. * E. 411. A. B. * C. D. chronic recurrent herpetic stomatitis; chronic recurrent aphthous stomatitis; secondary syphilis; traumatic errosion. A girl, 19 year old, complains about deterioration and appearance of rashes on the lips. From history: the same rashes occurred one year ago in the same place. Objectively: body temperature is 37.1C, on the edge of the red border of the upper lip and the skin are grouped vesicles with a diameter of 1-3 mm with clear contents. Indicate the likely diagnosis. herpes zoster; acute herpetic stomatitis; stomatitis at measles; stomatitis at chicken pox; chronic recurrent aphthous stomatitis. A patient, 56 year old, has symptoms of galvanosis. Objectively: there are gold, metal crowns on the teeth and couple amalgam fillings in the mouth; the oral mucosa is hyperemic and swollen. Which way can prevent the occurrence of galvanosis? replacement of amalgam fillings; using of homogeneous metal for prosthesis; taking of vitamins A and E; rinsing with antiseptics; desynsebilizition drugs. An 19 year old boy was under treatment in the infectious disease department. He was taking ampicillin. On the 6th day of treatment the white deposits similar of caseous films were revealed on the hyperemic mucous membrane in the area of gingival torus, cheeks and on the tongue. The films can be removed leaving hyperemic surface underneath. General condition is satisfactory. Body temperature is 36,7oC. What is the provisional diagnosis? acute candidiasis stomatitis; drug-induced stomatitis; chronic candidiasis stomatitis; acute herpetic stomatitis; mild form of leukoplakia. A 63 year old patient has a complete removable denture and complains of pain in the area of mucous membrane of hard palate on the left that is getting worse during eating. He has been suffering from this for 1,5 month. Objectively: left-sided hyperemia and edema of mucous membrane of hard palate; at the border of distal denture edge there is an ulcer with dense walls, surrounding tissues are infiltrated. The ulcer floor is tuberous, covered with fibrinous deposit; ulcer palpation is painful. What kind of examination methods will be applied in the first place? allergic contact plastic test; cytology; serological reactions; bacterioscopy; biopsy. A 26 year old patient complains about high body temperature, halitosis. Objectively: gingiva is swollen, easy bleeds by touching, apexes of interdental papillae affected by necrosis and remind beheaded cones. At cytology detected fuzo-spirochetes symbiosis. The diagnosis is: leukemia; Vincent’s ulcer-necrotic stomatitis; allergic stomatitis; secondary syphilis; E. 412. A. B. C. D. E. * 413. A. B. C. D. * E. 414. A. B. C. D. E. 415. A. B. C. D. E. 416. A. B. C. D. E. 417. avitaminosis. A 61 year old patient complains of fever to 38C, burning pain, presence of vesicles on the tongue to the left. Objectively: there are bubbles on the hyperemic edematous mucosa of the tongue on the left as a chain filled with serous fluid, regional lymphadenitis. What is a diagnosis? blister-vascular syndrome; primary herpetic infection; recurrent herpes; multiform exudative erythema; shingles. A 47 year old patient complains about pain in the oral cavity induced by eating. He suffers from CHD. Objective examination revealed dyspnea, limb edema. Oral cavity isn't sanitated. On the mucous membrane, on the right, there is an ulcer with irregular edges covered with greyish-white necrotic deposit with low-grade inflammation around it. There is also halitosis. What is the most probable diagnosis? Cancerous ulcer Traumatic ulcer Tuberculous ulcer Trophic ulcer Ulcero-necrotic stomatitis Patient , 43 year old, complains of cracks in the corners of his mouth , also of photophobia, lacrimation, weakness, loss of appetite, burning sensation in the tongue. OBJECTIVE: lips are red, swollen, cracked in the corners of the mouth (which are covered with crusts). Red border of lips are dry, scaly, similar to peeling of the skin around the lips. Tongue is red, shiny, filiform papillae are atrophied. What can be the cause of this disease: Hypovitaminosis PP Hypovitaminosis B6 Hypovitaminosis A Hypovitaminosis B12 Hypovitaminosis B1 42 y.o. woman complains of pain, burning the tongue tip, taste disturbances. Also, fatigue, headache, tinnitus, dyspnea. Skin and mucous membranes are pale, with a lemon-yellow colour. Henter-Miller tongue. What will be the diagnosis? Hypovitaminosis of vitamin B1 desquamative glossitis diamond tongue There is no right answer Pernicious anemia During the examination of 31 y.o. patient, doctor found symmetrical erythema on exposed areas of the body, dark pigmentation and keratinization. Oral mucous is hyperemic, with hyperemic swollen tongue, filiform papillae are atrophied. The patient complains of headache, insomnia, loss of appetite and loose stools. Deficiency of what vitamin can cause these changes? Riboflavin. Ascorbic acid. Retinol. Nicotinic acid. Thiamine. Patient complains on dry mouth, cracks in the corners of the mouth, pain during food taking. There is gastritis in anamnesis. During examination - lips are swollen, with erosion and cracks in the corners of the mouth. Tongue is shiny, smooth, covered with furrows. What will be the diagnosis? A. B. C. D. E. 418. A. B. C. D. E. 419. A. B. C. D. E. 420. A. B. C. D. E. 421. A. B. C. D. E. 422. A. B. C. Hypovitaminosis B2 Hypovitaminosis C Hypovitaminosis PP Hypovitaminosis A Hypovitaminosis B1 Patient, 34 y.o., complains of dry skin and oral mucosa. From anamnesis - last month intensively trained in the gym, and then visited a solarium. During examination: oral mucosa sufficiently hydrated, salivation is reduced, buccal epithelium is thinned. Red border of lips are dry and flaky. What is the most likely diagnosis? Hypovitaminosis E Hypovitaminosis B2 Hypovitaminosis A Hypovitaminosis C Hypovitaminosis PP Patients, 42 y.o., complains of a burning sensation and pain in the tongue, loss of appetite, fatigue, loss of memory. In anamnesis – exacerbation of chronic hastritis. OBJECTIVELY: on the skin of the face and neck there are erythematous patches with peel. In the mucosa of the mouth can be seen areas of hyperemia and normal mucosa. Tongue is swollen, bright red, shiny, filiform papillae are atrophied. Deficiency of what vitamin can cause this pathology? Vitamin B1 Vitamin A Vitamin B2 VitaminuV12 Vitamin C Patient, 49 y.o., was diagnosed with pernicious anemia.What glossitis is one of the symptoms of that anemia? Henter-Miller glossitis Desquvamative Fissured Rhomboid Candidiasis of the tongue Patient complains of burning, dryness and pain in area of the mucous membrane of the mouth, lips, tongue while eating. These symptoms are combined with weakness, rapid fatigue. OBJECTIVELY: oral mucosa is pale, slightly moist, tongue is swollen, increased in dimensions, papillaes are atrophied, especially at the tip of the tongue. Back of the tongue is bright red. Put the diagnosis. Pernicious anemia, Addison-Biermer Hypochromic iron-deficiency anemia Desquamativ glossitis Rhomboid glossitis Glossalgia A 41 year old man complains of pain and gums bleeding (especially during food taking), weakness, pain in the limbs, chilliness unwarranted. He live in the North during last 15 years. OBJECTIVELY: skin is dry, with brownish tinge, scaly, with symptom of “goose skin”. The mucous membrane of the gums is swollen, hyperemic with cyanotic tinge, gingival papillae are hypertrophied, covering the crowns of the teeth and bleeds after touching. Pathological tooth mobility of 1th degree is present. In the mucosa of the soft palate numerous petechiae was finded. Deficiency of which vitamin may cause vitamin E picture: this clinical Vitamin B12 Vitamin A D. E. 423. A. B. C. D. E. 424. A. B. C. D. E. 425. A. B. C. D. * E. 426. A. B. * C. D. E. 427. A. B. * C. D. E. 428. A. B. C. D. E. * Vitamin C Vitamin B 48 y.o. patient complains of painful rash on the lips, which are burning, itching and aggravated during meals. His condition was deteriorated in recent months. OBJECTIVELY: on edematous red lips border and surrounding skin erythematous patches can be seen with erosions, fissures and peels. Between them there are atrophic scars. What is the most likely diagnosis: Exfoliative cheilitis, exudative form Erosive-ulcerative form of leukoplakia Erosive-ulcerative form of lupus Abrasive prekantseroznyy cheilitis Manganotti Erosive-ulcerative form of lichen ruber planus During 24 y.o. patient examination, the redness in the corners of the mouth was found. A few days after in these areas painful cracks were revealed. Objectively: lips are red, swollen, with cracks and erosion, there is glossitis, accompanied by a sharp pain. With a lack of a vitamin such symptoms occur? Select the one correct answer B2. PP. B1. S. A. 25 year woman complains about enlargement, itching and dryness of her lips. These changes she noticed after using of new lipstick. Objectively: lips are edematous, compact-grained, palpation is painless. Regional lymph nodes are not enlarged. What can be the diagnosis? Lip cancer Exfoliative cheilitis Actinic cheilitis Allergic cheilitis Toxic cheilitis 45 year old patient was diagnosed with “hairy tongue”. What is the main symptom of this disease? Enlargement of the tongue Enlargement of the filiform papillae Enlargement of the fungiform papillae Brown tongue as a result of smoking Hair in the middle part of the tongue 54 year old patient was diagnosed with glossophytia. What medicine will be included in the treatment? Antibiotics Antiseptics Antihistamines Analgetics Vitamins During the examination of 34 year old woman angular cheilitis was diagnosed. What can be the reason of this cheilitis? Low immunity Virus Fungal infection Trauma All answers are right 429. A. * B. C. D. E. 430. A. B. C. D. E. * 431. A. B. C. * D. E. 432. A. * B. C. D. E. 433. A. B. * C. D. E. 434. A. B. * 22 year old boy complains about swelling and eversion of his lower lip. Objectively: enlargement of the lower lip caused by mucous gland hyperplasia. The “dew” symptom is positive. What can be the diagnosis? Cheilitis glandularis Cheilitis exfoliative Actinic cheilitis Allergic cheilitis Cheilitis granulomatouz A 42 year old patient applied to a dentist and complained about white caseous deposit on the dorsum of his tongue and burning sensation. It is known from the patient's anamnesis that he underwent treatment in an in-patient hospital on account of pneumonia. What is the most probable diagnosis? Lupus erythematosus Typical form of leukoplakia Lichen ruber planus Scarlet fever Acute pseudomembranous candidosis A 52-year-old patient complains about dryness and burning of the lateral surface of her tongue. These sensations disappear during eating. She noted such sensations three months ago. She has a history of gastritis with reduced secretory function. Objectively: mucous membrane of tongue and oral cavity has no peculiarities. The back of tongue has thin white coating. Regional lymph nodes are unpalpable. Oral cavity is sanitized. What is the most likely diagnosis? Lingual nerve neuritis Glossodynia Candidiasis Desquamative glossitis Hunter-Moeller glossitis A 19-year-old girl complains about having crusts, lip tenderness, especially at lip joining. Objectively: there are yellow-brown crusts on the lip red border from Klein zone to it's middle, after their removal bright red smooth surface without erosions appears. Mucous membrane in Klein zone is slightly hyperemic and edematic. What is the most likely diagnosis? Exudative form of cheilitis exfoliativa Epidermolysis bullosa Exudative form of cheilitis actinica Meteorological cheilitis Eczematous cheilitis A 35-year-old patient complains about itch, burning and edema of lips. He has been suffering from this for a week. Objectively: reddening of red border and skin, especially in the region of mouth corners, there are also vesicles, crusts, small cracks along with erythematous affection of red border. What is the most likely diagnosis? Acute herpetic cheilitis Multiform exudative erythema Acute eczematous cheilitis Allergic contact cheilitis Exudative form of exfoliative cheilitis 16 year old female patient complains about enlargement, itching and dryness of her lips. These changes she has noticed after using of new lipstick. Objectively: lips are edematous, compact-grained, palpation is painless. Regional lymph nodes are not enlarged. Which ointment can With analgineto the patient? you prescribe With prednisolone C. D. E. 435. A. B. * C. D. E. 436. A. * B. C. D. E. 437. A. * B. C. D. E. 438. A. * B. C. D. E. 439. A. B. C. D. E. 440. A. With erythromycin With antibiotics With steroids A patient complains about pain in the oral cavity, burning and dryness. Examination revealed fiery-red dry mucous membrane. The tongue is crimson, dry, glossy, filiform papillae are atrophied. There is some deposit in tongue folds that is hard to be removed. The patient undergoes treatment for pneumonia, she takes antibiotics. What is the most likely diagnosis? Fastened erythema Acute atrophic candidiasis Pellagrous glossitis B2 hypovitaminosis Benign migratory glossitis A 41 year old patient applied to a dentist and complained about white caseous deposit on the dorsum of his tongue and burning sensation. It is known from the patient's anamnesis that he underwent treatment in an in-patient hospital on account of pneumonia. What was the doctors mistake in pneumonia treatment? He should prescribe the eubiotics and probiotics during the antibiotic course The course of antibiotics was too long The course of antibiotics was too short He should prescribe oral antibiotics additionally He should prescribe antihistamines additionally 26 year old man, builder, complains about itch and burning lip pain during every summer last three years. In other time of the year this symptoms disappeared. What can be the diagnosis? Meteorological cheilitis Exfoliative cheilitis Cheilitis glandular Atrophic candidiasis Meteorological glossitis Woman complains about white deposits which she has noticed a week ago after pleuritis treatment. Microscopic examination revealed abundance of yeast fungus. Blood tests are normal. What medicine can cause this complication? Antibiotics Antihistamines Vitamins Antifungal No correct answer Woman complains about white deposits which she noticed a week ago after pleuritis treatment. Microscopic examination revealed abundance of yeast fungus. Blood tests are normal. What is the most probable diagnosis? Candidiasis Hairy tongue Cancer Leukoplakia Herpes 60 year old patient complains about mouth dryness, bad breath, sensation of a foreign body on his tongue. Objectively: 5 mm long brown papillae on the upper surface of tongue. What is the most likely diagnosis? Granulomatous cheilitis B. * C. D. E. 441. A. B. C. D. E. * 442. A. B. C. * D. E. 443. A. B. C. D. * E. 444. A. B. C. * D. E. 445. A. B. * C. D. E. 446. A. * B. C. Hairy tongue Actinic cheilitis Meteorological cheilitis Geographic tongue During the examination of 17 year boy, few areas of desquamation was revealed.This areas (from the patients words) are present from early childhood and looks like map. Patient feels no pain or other complains. What is the most likely diagnosis? Granulomatous cheilitis Hairy tongue Actinic cheilitis Meteorological cheilitis Geographic tongue 46 year old patient complains about painful lower lip. This pain he noticed 6 month ago. Objectively: deep fissure in the middle part of lower lip and red border with brown crust and dense borders. What will be the treatment in that case? Antibiotics Antiseptics Surgical treatment Corticosteroids Proteolytic enzymes 24 year old woman was diagnosed with eczematous cheilitis. What will be the treatment? There is no need to prescribe the medicine, only to avoid the cause. To avoid the cause and prescribe topical corticosteroids To prescribe topical corticosteroids To avoid the cause, to prescribe topical corticosteroids and antihistamines No correct answer 26 year old patient complains about swelling, redness and dryness of his lips. Objectively: the skin of the lipsin vermillion area is thinned and red, presense of scaly pathes can be noticed. From anamnesis: he works as a beach lifeguard. What should be the doctors tactics at that case ? To take the biopsy first To prescribe antibiotics To prescribe topical retinoids Laser therapy Cryotherapy A steeplejack with a long record of service consults a dentist about dryness, burning and insignificant lip edema. The same symptoms were noted one year ago in autumn. He was diagnosed with meteorological cheilitis. What recommendation can you give at that case? To improve his oral hygiene To use oil liniment at that time To use antiseptics To use analgetics All answers are right 22 year old patient applied to a dentist and complained about white caseous deposit on the dorsum of his tongue and burning sensation. It is known from the patient's anamnesis that he underwent treatment in an in-patient hospital on account of pneumonia. What was the doctors mistake in He should prescribe the eubiotics and probiotics during the antibiotic course pneumonia treatment? The course of antibiotics was too long The course of antibiotics was too short D. E. 447. A. B. * C. D. E. 448. A. B. * C. D. E. 449. A. B. C. * D. E. 450. A. * B. C. D. E. 451. A. * B. C. D. E. 452. A. * B. C. He should prescribe oral antibiotics additionally He should prescribe antihistamines additionally Patient, 23 y.o., female, complains about pain in the oral cavity, burning and dryness. Examination revealed fiery-red dry mucous membrane. The tongue is crimson, dry, glossy, filiform papillae are atrophied. There is some deposit in tongue folds that is hard to be removed. The patient undergoes treatment for pneumonia, she takes antibiotics. What is the most likely diagnosis? Fastened erythema Acute atrophic candidiasis Pellagrous glossitis B2 hypovitaminosis Benign migratory glossitis Woman complains about enlargement, itching and dryness of her lips. This changes have been noticed after using of new lipstick. Objectively: lips are edematous, compact-grained, palpation is painless. Regional lymph nodes are not enlarged. Which ointment can you prescribe to the patient? With analgine With prednisolone With erythromycin With antibiotics With steroids The patient complains of existing painful sores in the mouth. From history: deterioration of health, weight loss, fever up to 37.1, diarrhea that lasts for three weeks. Which test should pass the patient? general blood test; test for markers of hepatitis; test ELISA; fungal tests; examination of salivary glands. The patient complains about the discomfort in the mouth, weight loss, temperature 37.1 that doesn’t decrease within 2 months. Objectively: there are white hair growths on the tongue edge. What is the preliminary diagnosis? hairy leukoplakia; chronic hyperplastic candidiasis; acute hyperplastic candidiasis; hairy tongue; soft leukoplakia. At the clinical examination in 50 years old male revealed a chronic mucosal candidiasis, generalized lymphadenopathy. During the year he concerned regarding chronic recurrent herpes, fever to 37,4-37,5, body weight decreased by 8 pounds in the last month. This clinical picture indicates: AIDS; infectious mononucleosis; acute leukemia; chronic leukemia; lymphogranulomatosis. At the clinical examination of 44 years old patient revealed a chronic mucosal candidiasis, generalized lymphadenopathy. During the year he concerned regarding chronic recurrent herpes, fever to 37,4-37,5, body weight decreased by 8 pounds in the last month. This clinical picture AIDS; indicates: infectious mononucleosis; acute leukemia; D. E. 453. A. B. C. D. E. * 454. A. * B. C. D. E. 455. A. * B. C. D. E. 456. A. B. C. D. * E. 457. A. B. C. D. E. chronic leukemia; lymphogranulomatosis. The patient A., 40 years old, has a disfunction of the gastrointestinal tract, blood forming and nervous systems. Skin and oral mucous membrane are pale, with yellow shade, sometimes there are dotted haemorrhage. Make a diagnosis. leukopenia; leukemia; trombocytopenic purpura; hypo avitaminosis C; B-12 (folate-) deficiency anemia. 32 y.o. patient was diagnosed with pernicious anemia. What glossitis is one of the symptoms of that anemia? Henter-Miller glossitis desquvamative fissured rhomboid candidiasis of the tongue The patient complains of burning, dryness and pain in area of the mucous membrane of the mouth, lips, tongue during eating. These symptoms are combined with weakness, rapid fatigue. OBJECTIVELY: oral mucosa is pale, slightly moist, tongue is swollen, increased in dimensions, papillaes are atrophied, especially at the tip of the tongue. Back of the tongue is bright red. Put the pernicious diagnosis. anemia, Addison-Biermer; hypochromic iron-deficiency anemia; desquamative glossitis; rhomboid glossitis; glossalgia. A 42 year old man complains of pain and gums bleeding (especially during food taking), weakness, and pain in the limbs, chilliness unwarranted. He lives in the North during last 15 years. OBJECTIVELY: skin is dry, with brownish tinge, scaly, with symptom of “goose skin”. The mucous membrane of the gums is swollen, hyperemic with cyanotic tinge; gingival papillae are hypertrophied, covering the crowns of the teeth and bleeds after touching. Pathological tooth mobility of 1st degree is present. In the mucosa of the soft palate numerous petechiae was finded. Deficiency of which vitamin may cause this clinical picture: vitamin E; vitamin B12; vitamin A; vitamin C; vitamin B. During 21 y.o. patient examination, the redness in the corners of the mouth was found. A few days after in these areas painful cracks was revealed. Objectively: Lips are red, swollen, with cracks and erosion; there is glossitis, accompanied by a sharp pain. With a lack of a vitamin such symptoms occur? Select the one correct answer. B2; PP; B1; C; A.