Case #30 (Questions 91-92) Age: 46 Sex: male Race:  Caucasian Medical History: Client noticed changes in pigmentation of his lips recently.  No other symptoms are noted. Clinical Appearance: Overall darker skin pigmentation with macules present on the facial tissues.  Lips have significantly increased in pigmentation levels over the past six months.  Picture30.jpg  91.This client was referred to his physician for an evaluation of Addison’s disease. What is deficient in a client who experiences this condition?

Case #16 (Questions 60-62) Age: 65 Sex: female Race: Caucasian Medical History: rheumatoid arthritis Chief Complaint: “I keep biting this purplish-colored lump on the inside of my bottom left lip and it is getting bigger.” Client reported she has always had this purplish-colored lesion on her labial mucosa. Clinical Appearance: An approximately 9 X 8 X 2mm round, raised, non-ulcerated lesion is noted. Picture16.jpg 62. When will this individual have the hardest time brushing his teeth and dentures?

Case #26 (Questions 82-83) Age: 56 Sex: female Race: Caucasian Medical History: Client has a history of type 2 diabetes mellitus and hypertension; going through menopause Medication: hydrochlorothyazide and glucophage Dental History: Client complained of a “red, bleeding sore” located distal to the gingival margin of tooth #27 that has been present for several weeks. Client wears a partial denture to replace mandibular teeth. Clinical Appearance: soft, erythematous, exophytic, sessile-based lesion measuring approximately 10 X 12 mm just distal to tooth #27. Picture26.jpg 83. If this lesion contains multinucleated giant cells, considering all demographics about the individual, which condition is this likely to be?

Case #5 (Questions 15-18) Age: 28 Sex: male Race: Caucasian Medical History: Ct. reports that he first tested positive for HIV 4 years ago.  He has not had any opportunistic infections Current Medications: no medications Chief Complaint: Ct. noticed a white lesion located on his tongue.  Clinical Appearance: It is an irregular shape located on the lateral and dorsal surfaces of the tongue.  It appears corrugated and cannot be wiped off.  Picture5.jpg 17. If this individual is progressing from stage 2 to stage 3, what level must his CD4+ T cells drop below to declare stage 3 infection?

Case #11 (Questions 37-42) Age: 38 Sex: female Race: African American Medical History: Client has a history of allergies to dust and pollen.  Current Medications: Takes Allegra® and receives allergy shots once a month Chief Complaint: “I get these ulcerations a few times each year.  They are painful and heal within 7-10 days.”  Clinical Appearance: A single, round ulceration with a yellow-white fibrin center surrounded by an erythematous halo; approximately 8 mm in size; located on the anterior of the floor of the mouth.  Picture11.jpg  37. The painful ulcer located on the floor of the mouth is…

Case #12 (Questions 43-46) Age: 32 Sex: female Race: Hispanic Medical History: Client reported a history of alcohol use disorder and a previous episode of a sexually transmitted disease accompanied by regional lymphadenopathy. Chief Complaint: “For several weeks I have had a painless sore on my tongue that is not healing.” Clinical Appearance: A discrete round ulcer with rolled borders is located on the right border of the dorsal surface of the tongue. Picture12.gif 46. If a child is infected with syphilis in utero or during the birthing process, what dental anomaly might be present when the primary teeth erupt?

Case #14 (Questions 51-55) Age: 35 Sex: female Race: Caucasian Medical History: Client has been under higher levels of stress due to a divorce.  She has gained 9 pounds in the past five months, but was specifically trying to avoid overeating due to stress. Chief Complaint: “I have had headaches off and on for the past three weeks.  My right ear hurts when I chew.” Clinical Appearance: Scooped out appearances on the occlusal and incisal cusp tips of the teeth. Radiographic Appearance: The right condyle appears to be flattened off in areas.  Picture14(1).jpg 54. Which health condition might explain why she is gaining weight?

Case #32 (Questions 96-97) Age: 48 Sex: male Race: Hispanic Dental History: This client hasn’t been to the dentist for years Chief Complaint: Slight swelling on the mandibular right facial tissue  Picture32.jpg 97. What is the primary concern for an individual affected by Gardner syndrome?

Case #11 (Questions 37-42) Age: 38 Sex: female Race: African American Medical History: Client has a history of allergies to dust and pollen.  Current Medications: Takes Allegra® and receives allergy shots once a month Chief Complaint: “I get these ulcerations a few times each year.  They are painful and heal within 7-10 days.”  Clinical Appearance: A single, round ulceration with a yellow-white fibrin center surrounded by an erythematous halo; approximately 8 mm in size; located on the anterior of the floor of the mouth.  Picture11.jpg 39. Treatment for these lesions aims to _______ the lesions and symptoms.

Case #29 (Questions 89-90) Age: 9 Sex: female Race: Caucasian Medical History: Client’s mother states she had multiple fevers and ear infections as an infant.  She had to take many medications to treat the ear infections at that time.  Chief Complaint: Her daughter’s teeth are discolored and difficult to brush. Clinical Appearance: Generalized brown and white spotting of the permanent anterior dentition. Picture29.jpg  89. Childhood illness and/or vitamin deficiency can cause deformative formation of enamel. This is called