Diseases of the Oral Cavity and Salivary Glands Indian Medical PG Practice Questions and MCQs
Practice Indian Medical PG questions for Diseases of the Oral Cavity and Salivary Glands. These multiple choice questions (MCQs) cover important concepts and help you prepare for your exams.
Diseases of the Oral Cavity and Salivary Glands Indian Medical PG Question 1: A 67-year-old man with Parkinson disease has experienced an increasingly dry mouth for the past 3 months, and this interferes with eating and swallowing. He has noted dry eyes as well. On physical examination, he has minimal tremor at rest; there are no other abnormal findings. Laboratory studies show no detectable autoantibodies. Which of the following is the most likely cause for his findings?
- A. Alcohol ingestion
- B. Anticholinergic drug use (Correct Answer)
- C. Candidiasis
- D. Sialadenitis with blockage of salivary duct
Diseases of the Oral Cavity and Salivary Glands Explanation: ***Anticholinergic drug use***- Many medications used to treat **Parkinson disease** have **anticholinergic effects**, which can lead to **dry mouth (xerostomia)** and **dry eyes (xerophthalmia)** due to reduced glandular secretions [1].- The patient's presentation of worsening dry mouth and dry eyes aligns well with the side effects of such medications.*Alcohol ingestion*- While chronic alcohol use can contribute to **dehydration** and indirectly affect salivary production, it is typically not the primary cause of such pronounced and progressive symptoms in this context, nor does it commonly cause dry eyes.- The patient's symptoms are more consistent with a direct pharmacological effect rather than general dehydration from alcohol.*Candidiasis*- Oral candidiasis usually presents with **white plaques** on the oral mucosa, **soreness**, or difficulty swallowing due to pain, not primarily dry mouth and dry eyes.- The physical examination did not reveal any other abnormal findings, making candidiasis less likely as the primary cause.*Sialadenitis with blockage of salivary duct*- **Sialadenitis** (inflammation of salivary glands) or salivary duct obstruction typically causes **pain**, **swelling**, and localized tenderness in the affected gland, often exacerbated by eating.- This condition generally affects salivation but does not explain the concurrent dry eyes, making it an unlikely sole cause for both symptoms.
Diseases of the Oral Cavity and Salivary Glands Indian Medical PG Question 2: A 20-year-old woman complains of a headache and discomfort in both sides of her jaw. Physical examination reveals enlarged parotid glands that are slightly tender on palpation. There is reddening of the orifice of Stensen's duct on intraoral examination; her temperature is 38.3°C, and the pulse rate is 80/min. Laboratory data show a hemoglobin level of 14 g/dL, a hematocrit of 40%, a white blood cell count of 11,000/mL, with 33% segmented neutrophils, 7% monocytes, and 60% lymphocytes. Which diagnostic test will help confirm the diagnosis of epidemic parotitis?
- A. Blood test for immunoglobulin G (IgG) antibodies
- B. complete blood count
- C. viral throat swab
- D. single blood test for specific immunoglobulin M (IgM) (Correct Answer)
Diseases of the Oral Cavity and Salivary Glands Explanation: ***Single blood test for specific immunoglobulin M (IgM)***
- A **single IgM** measurement is highly indicative of **acute or recent infection** with the mumps virus, which causes epidemic parotitis.
- Detecting mumps-specific IgM antibodies confirms the presence of an **active immune response** to the virus.
*Blood test for immunoglobulin G (IgG) antibodies*
- **IgG antibodies** indicate **past infection or vaccination** and do not confirm an active mumps infection.
- A **four-fold rise** in IgG over time (paired acute and convalescent sera) can suggest recent infection but is not as definitive for acute cases as IgM.
*Complete blood count*
- While the patient's WBC count shows **lymphocytosis**, which can be seen in viral infections like mumps, it is **non-specific** and does not confirm the diagnosis.
- The CBC provides general information about immune response but cannot identify the specific viral agent.
*Viral throat swab*
- A viral throat swab can be used for **PCR testing** or viral culture to detect the mumps virus, but it may have a **lower sensitivity** compared to serological tests, especially later in the illness.
- Collecting a proper throat swab can be uncomfortable for the patient and requires specific handling for viral detection.
Diseases of the Oral Cavity and Salivary Glands Indian Medical PG Question 3: A 45-year-old patient complained of pain on one side of the neck. She is afraid of eating food as it worsens the pain. An ultrasound of the salivary glands is shown below. What is the most likely diagnosis?
- A. Sialolithiasis (Correct Answer)
- B. Salivary gland foreign body
- C. Cervical lymphadenopathy
- D. Osteoma of the floor of the mouth
Diseases of the Oral Cavity and Salivary Glands Explanation: ***Sialolithiasis***
- The ultrasound image shows an **echogenic focus** with clear **posterior acoustic shadowing** within the salivary gland, which is characteristic of a salivary gland stone.
- The patient's symptoms of **pain on one side of the neck** and **worsening pain with eating** (likely due to salivary stimulation) are classic for **sialolithiasis**, as the stone obstructs salivary flow.
*Salivary gland foreign body*
- While a foreign body could present with similar pain, it would typically appear as a distinct object on ultrasound, but its echogenicity and shading characteristics might differ depending on the material.
- The history of a foreign body ingestion or insertion would be crucial, which is not mentioned here.
*Cervical lymphadenopathy*
- **Lymph nodes** on ultrasound typically appear as oval-shaped structures with a **hypoechoic cortex** and an **echogenic hilum**; they do not usually show significant acoustic shadowing unless calcified.
- While cervical lymphadenopathy can cause neck pain, it is not typically exacerbated by eating in the same way an obstructed salivary gland would be.
*Osteoma of the floor of the mouth*
- An **osteoma** is a **benign bone tumor** that would present as a very **dense, highly echogenic mass** with severe posterior acoustic shadowing on ultrasound, originating from bony structures.
- While an osteoma could cause pain, its location (floor of the mouth) and nature would not typically explain pain worsening specifically with eating due to salivary gland obstruction.
Diseases of the Oral Cavity and Salivary Glands Indian Medical PG Question 4: Oophoritis, Orchitis, Chipmunk cheeks seen in:
- A. Sialadenosis.
- B. Mumps. (Correct Answer)
- C. Mucocele.
- D. Sialadenitis.
Diseases of the Oral Cavity and Salivary Glands Explanation: ***Mumps***
- **Mumps** is a viral infection that commonly presents with **bilateral parotid gland swelling**, leading to the characteristic "chipmunk cheeks" appearance.
- It can also cause complications such as **oophoritis** (inflammation of the ovaries) in females and **orchitis** (inflammation of the testes) in males, which are key features seen in this clinical description.
*Sialadenosis*
- **Sialadenosis** refers to a non-inflammatory, non-neoplastic enlargement of the salivary glands, often the parotid glands.
- While it can cause swollen glands, it is typically associated with systemic conditions like **diabetes** or **alcoholism** and does not cause oophoritis or orchitis.
*Mucocele*
- A **mucocele** is a common lesion of the oral mucosa that results from either rupture of a salivary gland duct and spillage of mucin into the surrounding soft tissues (extravasation type) or obstruction of a salivary gland duct (retention type).
- It usually presents as a benign, fluid-filled swelling, most commonly on the **lower lip**, and is not associated with systemic inflammation or widespread glandular involvement.
*Sialadenitis*
- **Sialadenitis** is an inflammation of a salivary gland, often due to bacterial infection or duct obstruction (e.g., by salivary stones).
- While it can cause painful swelling of the salivary glands, it typically affects only one gland and does not lead to complications like oophoritis or orchitis.
Diseases of the Oral Cavity and Salivary Glands Indian Medical PG Question 5: Which of the following is the most important infiltrate in rheumatoid arthritis?
- A. Dendritic cells
- B. CD4+ Helper cells
- C. Macrophages (Correct Answer)
- D. Neutrophils
Diseases of the Oral Cavity and Salivary Glands Explanation: ***Macrophages***
- **Macrophages** are crucial in rheumatoid arthritis synovium due to their role in producing **pro-inflammatory cytokines** like TNF-̑, IL-1, and IL-6, which drive joint destruction [1], [2].
- They also contribute to the **pannus formation** and degrade cartilage and bone through the release of proteases [1].
*Dendritic cells*
- While present in the synovium, **dendritic cells primarily function as antigen-presenting cells**, initiating T-cell responses.
- Their direct contribution to tissue damage and chronic inflammation is less prominent than that of macrophages.
*CD4+ Helper cells*
- **CD4+ T helper cells** orchestrate the immune response by activating B cells and macrophages, but they are not the primary effector cells causing direct tissue damage [3].
- They secrete cytokines that promote inflammation but do not directly participate in tissue degradation.
*Neutrophils*
- **Neutrophils are abundant in the synovial fluid** during acute flares, contributing to inflammation and breakdown of cartilage through the release of enzymes.
- However, their role in the chronic, sustained synovial inflammation and tissue destruction characteristic of RA is less significant compared to macrophages.
**References:**
[1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Osteoarticular And Connective Tissue Disease, pp. 677-678.
[2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Inflammation and Repair, pp. 105-106.
[3] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Bones, Joints, and Soft Tissue Tumors, p. 1212.
More Diseases of the Oral Cavity and Salivary Glands Indian Medical PG questions available in the OnCourse app. Practice MCQs, flashcards, and get detailed explanations.
