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Paper A RevisionUpdated 202610 min read

Oral Pathology & Microbiology for ORE Part 1

High-yield guide to odontogenic cysts, salivary neoplasms, oral candidiasis, and plaque biofilm microbiology for ORE Part 1.

Key Syllabus Concepts Tested in Oral Pathology & Microbiology

  • Odontogenic keratocysts (OKC thin 6-8 cell lining), dentigerous cysts, and ameloblastoma histology
  • Salivary gland tumors: Pleomorphic adenoma, Warthin tumor, Adenoid cystic carcinoma (Swiss-cheese)
  • Oral microbiology: Pioneer S. mitis/oralis, S. mutans glucans, and Socransky Red Complex
  • Bone lesions: Paget disease ('cotton-wool'), Fibrous Dysplasia (GNAS mutation), and Cherubism

Sample SBA Practice Questions

Sample Question 1 (Paper A)

A 55-year-old female presents with painful, bilateral white lacy striations (Wickham striae) on her buccal mucosa. Histological examination shows a band-like lymphocytic infiltrate and Civatte bodies. What is the diagnosis?

  1. Oral lichenoid contact reaction
  2. Oral discoid lupus erythematosus
  3. Oral lichenoid drug reaction
  4. Oral lichen planus (idiopathic)

Correct Answer: Oral lichen planus (idiopathic)
Explanation: Wickham striae, subepithelial T-cell band infiltrate, hydropic degeneration of basal cells, and Civatte bodies are pathognomonic for Oral Lichen Planus.
Clinical Pearl: The lingual nerve lies within 2mm of the lingual crest near mandibular third molars.

Sample Question 2 (Paper A)

A panoramic radiograph reveals a multilocular, 'soap-bubble' radiolucency in the posterior mandible causing cortical expansion and root resorption. What is the diagnosis?

  1. Odontogenic myxoma of the mandible
  2. Central giant cell granuloma of the mandible
  3. Odontogenic keratocyst of the mandible
  4. Ameloblastoma of the posterior mandible

Correct Answer: Ameloblastoma of the posterior mandible
Explanation: Ameloblastoma classic radiographic appearance is a multilocular ('soap-bubble') radiolucency causing cortical expansion and root resorption.
Clinical Pearl: Lingual nerve (V3) supplies general sensation to the anterior 2/3 of the tongue.

Sample Question 3 (Paper A)

Which autoimmune disease is characterized by lymphocytic destruction of exocrine glands resulting in dry mouth (xerostomia) and dry eyes?

  1. Sarcoidosis (Heerfordt syndrome), with non-caseating granulomas in salivary and lacrimal glands
  2. IgG4-related disease (Mikulicz disease), with plasma-cell infiltration of salivary and lacrimal glands
  3. Chronic graft-versus-host disease, with donor T-cell injury to salivary and lacrimal glands
  4. Sjögren syndrome, with focal lymphocytic sialadenitis of salivary and lacrimal glands

Correct Answer: Sjögren syndrome, with focal lymphocytic sialadenitis of salivary and lacrimal glands
Explanation: Sjögren syndrome is a systemic autoimmune exocrinopathy targeting salivary and lacrimal glands.
Clinical Pearl: Depositing LA into the parotid gland capsule during IANB causes transient CN VII facial palsy.

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