Home/Quiz/Board Exam MCQs on Diseases of Salivary Glands Board Exam MCQs on Diseases of Salivary Glands Welcome to your Board Exam MCQs on Diseases of Salivary Glands 1. A 45-year-old man has recurrent painful swelling beneath the jaw during meals. Imaging shows a salivary duct stone. Which gland is most commonly affected? Submandibular gland Parotid gland Sublingual gland Minor lingual glands Labial glands None Hint 2. A patient with a progressively enlarging parotid mass develops weakness of facial expression on the affected side. Which associated finding is most concerning for malignancy? Slow painless enlargement Firm nodular consistency alone Mild tenderness Facial paralysis A freely mobile mass None Hint 3. A patient has recurrent meal-related swelling in the floor of the mouth. Which statement is FALSE? Duct obstruction can cause meal-related swelling. A ranula is associated with the sublingual gland. The sublingual gland is the most common site of salivary gland neoplasia. Pleomorphic adenoma is the most common salivary gland neoplasm. Obstruction causes swelling when secretion increases. None Hint 4. A 55-year-old man has a painless parotid mass. Histology shows oncocytic epithelium, cystic spaces, and lymphoid stroma. What is the diagnosis? Warthin tumor Pleomorphic adenoma Mucoepidermoid carcinoma Adenoid cystic carcinoma Acinic cell carcinoma None Hint 5. A patient develops a painful ulcerated swelling on the posterior hard palate after local trauma. Biopsy shows salivary gland necrosis and ductal squamous metaplasia. What is the common site? Cheek Dorsum of tongue Palate Gingiva Lower lip None Hint 6. A young woman has a painless parotid mass. Histology shows epithelial and myoepithelial components in myxoid and chondromyxoid stroma. Which cell type is strongly associated? Myoepithelial cells Acinar cells only Connective-tissue fibroblasts Plasma cells Striated duct cells only None Hint 7. A patient has a painful palatal minor salivary gland mass caused by perineural invasion. Which malignant tumor is classically associated with this feature? Pleomorphic adenoma Adenoid cystic carcinoma Warthin tumor Adenolymphoma Canalicular adenoma None Hint 8. A patient has persistent bilateral enlargement of the lacrimal and major salivary glands, historically termed Mikulicz disease. Which category best describes it today? Nonimmune inflammation only Primary neoplasia Autoimmune or immune-mediated disease Acute viral infection Congenital anomaly None Hint 9. During evaluation of a suspected submandibular obstruction, one finger is placed intraorally while the other hand palpates beneath the mandible. This bimanual technique is used primarily to examine which gland? Submandibular gland Parotid gland Sublingual gland only Minor palatal glands Buccal glands None Hint 10. A patient has painless bilateral parotid enlargement without inflammation or a discrete tumor, associated with a systemic metabolic disorder. What is the term? Sialadenitis Sialosis Ptyalism Sialorrhea Sialolithiasis None Hint 11. A 42-year-old woman presents with a slow-growing, painless parotid mass. Fine-needle aspiration suggests a benign mixed tumor. Which is the most common salivary gland neoplasm? Pleomorphic adenoma Adenoid cystic carcinoma Cylindroma Epidermoid carcinoma Warthin tumor None Hint 12. A 40-year-old woman develops a painful, crater-like 1.5-cm ulcer on the hard palate over one week. The lesion clinically resembles a malignant ulcer, but biopsy demonstrates necrosis of minor salivary glands with squamous metaplasia. What is the most likely diagnosis? Actinomycosis Squamous cell carcinoma Pleomorphic adenoma Necrotizing sialometaplasia Mucoepidermoid carcinoma None Hint 13. A 35-year-old patient reports increased dental caries, difficulty swallowing dry food, and persistent oral dryness. Which oral condition most directly increases caries activity? Xerostomia Malignancy Hairy tongue Watery saliva Hyperactive salivary secretion None Hint 14. A patient with a painful parotid-region mass develops numbness and pain along the distribution of a cranial nerve. Which salivary gland malignancy is classically associated with perineural spread? Pleomorphic adenoma Adenoid cystic carcinoma Warthin tumor Ductal papilloma Canalicular adenoma None Hint 15. A biopsy is obtained from a minor salivary gland lesion. Which of the following is a salivary gland neoplasm rather than a tumor arising from another tissue lineage? Acinic cell carcinoma Granular cell tumor (granular cell myoblastoma) Chondrosarcoma All of the above Fibrosarcoma None Hint 16. A patient is being evaluated for reduced salivary flow. The clinician reviews systemic disorders, medications, and treatment history. In which situation is a reduction in salivary flow not generally considered a typical finding? Elderly patients with diabetes Patients undergoing head and neck radiation therapy Patients suffering from parkinsonism Patients taking phenothiazine drugs Patients taking medications with anticholinergic effects None Hint 17. A patient with recurrent swelling of the parotid gland undergoes contrast imaging of the salivary system. The study outlines the ductal system and glandular architecture. What is the principal diagnostic use of sialography? Detection of abnormalities in the salivary duct only Detection of abnormalities in the salivary gland only Detection of abnormalities involving the salivary gland and duct Definitive diagnosis of all salivary gland tumors Assessment of facial nerve function None Hint 18. A child presents with fever, malaise, and painful bilateral parotid swelling. No purulent material is expressed from the duct, and a viral prodrome is present. Which condition is classically associated with acute nonsuppurative sialadenitis? Acute bacterial sialadenitis Mumps Chronic bacterial sialadenitis Necrotizing sialometaplasia Sialolithiasis without inflammation None Hint 19. A bluish, fluctuant swelling is noted in the floor of the mouth beneath the tongue. It is caused by mucus extravasation or obstruction involving the sublingual gland. What is the most appropriate term? Mucocele Ranula Dermoid cyst Dentigerous cyst Nasolabial cyst None Hint 20. A 19-year-old patient develops a soft, bluish swelling of the lower lip after repeated lip biting. The lesion is fluctuant and contains pooled mucus. What is the most common mechanism of mucocele formation? Rupture of a salivary gland or duct Partial or complete compression of salivary acini Inflammation of glandular interstitial tissue Complete obstruction of a salivary duct by a calculus Malignant transformation of a minor salivary gland None Hint 21. A 19-year-old man develops fever and bilateral parotid swelling due to mumps. Which complication is classically recognized as a common complication in postpubertal males? Myocarditis Orchitis Uveitis Conjunctivitis Pancreatic pseudocyst None Hint 22. A pathology report describes a malignant salivary gland tumor with cribriform architecture and prominent perineural invasion. Which alternative name is associated with adenoid cystic carcinoma? Cylindroma Pindborg tumor Warthin tumor Pleomorphic adenoma Adenolymphoma None Hint 23. A patient has recurrent painful swelling of the submandibular gland during meals. Imaging demonstrates a sialolith lodged in the excretory duct. Which complication is most likely to develop if obstruction persists? Chronic sialadenitis Mucous retention cyst Pleomorphic adenoma Rupture of a cyst Adenoid cystic carcinoma None Hint 24. A 68-year-old patient shows diffuse fatty replacement within the parotid glands on imaging, without a discrete mass or acute inflammation. Which factor is a recognized association of parotid fatty change? Aging Alcoholism Malnutrition All of the above None of the above None Hint 25. A 52-year-old patient is diagnosed with a minor salivary gland tumor of the palate. Which tumor is generally not expected to arise in minor salivary glands? Pleomorphic adenoma Adenocarcinoma Mucoepidermoid carcinoma Warthin tumor Adenoid cystic carcinoma None Hint 26. A patient with chronic autoimmune salivary gland disease undergoes sialography. The image demonstrates a characteristic punctate and globular contrast pattern described as a 'fruit-laden tree' or 'cherry-blossom' appearance. Which condition is most likely? Mucoepidermoid carcinoma Acinic cell carcinoma Sjögren syndrome Pleomorphic adenoma Acute bacterial sialadenitis None Hint 27. A patient with Sjögren syndrome presents with dry mouth, dry eyes, and arthralgia. Which of the following is not a core clinical feature or recognized association of the syndrome? Xerostomia Keratoconjunctivitis sicca Arthritis or arthralgia Lymphoma Acute bacterial parotitis as a defining feature None Hint 28. A patient presents with painful swelling beneath the mandible that becomes worse during meals. Examination suggests obstruction of Wharton duct. What is the most likely cause? Ludwig angina Sialolithiasis Reactive lymphadenopathy All of the above Pleomorphic adenoma None Hint 29. A patient with recurrent salivary gland inflammation develops ductal dilation associated with epithelial atrophy after repeated inflammatory or infectious episodes. Which term best describes inflammation of a salivary duct? Sialodochitis Sialadenitis Sialolithiasis Mucocele Sialosis None Hint 30. A patient receives a medication that stimulates muscarinic cholinergic receptors. What effect on salivary secretion is expected? Increased salivary flow Reduced salivary flow Complete cessation of secretion No effect on salivary glands Production of only thick mucus None Hint 31. A patient undergoes excision of a pleomorphic adenoma, but several years later develops multiple small nodules in the operative region. Which factor most commonly contributes to recurrence? Presence of an incomplete capsule Mixed cellular origin Complete absence of a capsule in every case Perineural spread Hematogenous metastasis None Hint 32. A patient presents with xerostomia, dry eyes, and bilateral enlargement of the salivary and lacrimal glands. Which diagnosis best fits this clinical presentation? Sicca syndrome only Sjögren syndrome Mikulicz disease Acute viral parotitis Chronic sialolithiasis None Hint 33. A child is evaluated for congenital absence or underdevelopment of salivary glands. Which syndrome is classically associated with salivary gland aplasia or hypoplasia? Hemifacial microsomia LADD syndrome Treacher Collins syndrome All of the above Sjögren syndrome None Hint 34. A 50-year-old patient has a slow-growing parotid mass. Histopathology demonstrates serous acinar differentiation with cytoplasmic zymogen granules. Where do acinic cell carcinomas most commonly arise? Parotid gland Minor salivary glands Submandibular gland Sublingual gland Lacrimal gland None Hint 35. A patient with primary Sjögren syndrome develops systemic symptoms. Which of the following is NOT generally considered an extraglandular manifestation or recognized complication? Raynaud phenomenon Arthritis or arthralgia Lymphoma Thrombocytopenia Acute traumatic ulceration None Hint 36. A patient is diagnosed with a benign mixed salivary gland tumor composed of epithelial and myoepithelial elements. Which statement is correct? It is most common in the submandibular gland It is usually malignant It is most common in the parotid gland It is characteristically associated with calculi It arises exclusively from minor glands None Hint 37. A patient reports a dry mouth after starting medication and has increased dental caries. Which condition is NOT a typical cause of xerostomia? Anticholinergic medication Dehydration Sjögren syndrome Oral sepsis Head and neck radiotherapy None Hint 38. A biopsy of a minor salivary gland tumor shows a cribriform, honeycomb, or Swiss-cheese architecture with pseudocystic spaces. Which diagnosis is most likely? Adenoid cystic carcinoma Pleomorphic adenoma Acinic cell carcinoma Clear cell carcinoma Warthin tumor None Hint 39. A child presents with a slowly enlarging painless parotid mass. Which is generally considered the most common salivary gland tumor in children? Lymphoma Pleomorphic adenoma Adenoid cystic carcinoma Mucoepidermoid carcinoma Acinic cell carcinoma None Hint 40. A pathology report describes a benign parotid tumor containing oncocytic epithelial cells and lymphoid stroma. The lesion is also called adenolymphoma. What is the diagnosis? Adenocarcinoma Adenocystic lymphoma Warthin tumor Pleomorphic adenoma Adenoid cystic carcinoma None Hint 41. A biopsy of an oral malignant neoplasm shows highly pleomorphic spindle-shaped malignant cells and areas of conventional squamous differentiation. Spindle cell carcinoma is considered a variant of which tumor? Pleomorphic adenoma Adenoid cystic carcinoma Basal cell carcinoma Squamous cell carcinoma Mucoepidermoid carcinoma None Hint 42. A patient presents with a mass in an unusual location outside the major salivary glands. Among the following sites, which is the commonest location reported for an ectopic salivary gland tumor? Tongue Cheek Palate Neck Floor of the mouth None Hint 43. A hospitalized patient develops bilateral parotid swelling after exposure to iodinated contrast or iodine-containing medication, without evidence of viral infection. Which term is synonymous with chemical mumps? Iodine mumps Epidemic parotitis Nutritional mumps Nonspecific mumps Autoimmune parotitis None Hint 44. A patient with suspected Sjögren syndrome reports dry, gritty eyes. The ophthalmologist applies fluorescein and measures the time until the tear film first breaks up. Which test is being performed? Break-up time test Schirmer test Rose bengal staining only Visual field testing Tonometry None Hint 45. A patient experiences recurrent swelling and sharp pain in the submandibular region whenever eating. Imaging identifies a salivary duct calculus. Which statement is correct? They commonly produce pain during eating. They are most common in the parotid duct. They are never associated with acute parotitis. They are specifically caused by hypercalcemic states. They occur only in minor salivary glands. None Hint 46. A calcified mass is identified within Wharton duct in a patient with recurrent meal-related swelling. Salivary stones are primarily composed of which mineral component? Hydroxyapatite Potassium chloride Unidentified phosphate compounds only Calcium chloride Magnesium sulfate None Hint 47. A patient with marked xerostomia has increased dental caries and oral mucosal discomfort. Which change in salivary chemistry is most expected? Salivary pH is unaffected in all cases Salivary pH is low Salivary pH is high Salivary pH always increases in the morning Salivary pH is unrelated to salivary flow None Hint 48. A slowly growing parotid mass is diagnosed as pleomorphic adenoma. The tumor contains epithelial and myoepithelial elements with variable stromal differentiation. Which description best reflects its proposed cellular origin? Mature teratomatous tissue Neuroendocrine cells Multiple unrelated ectopic tissues Myoepithelial or ductal reserve-cell origin Only mature acinar cells None Hint 49. A patient with Sjögren syndrome has xerostomia, keratoconjunctivitis sicca, and recurrent gland enlargement. Which statement is INCORRECT? MRI may show a salt-and-pepper appearance. Lacrimal gland enlargement may occur. Minor salivary gland biopsy can support diagnosis. Pilocarpine may be used to relieve residual glandular dryness. Minor salivary gland biopsy is never useful for diagnosis. None Hint 50. A painless parotid lesion contains cystic spaces filled with thick brown or chocolate-colored fluid. Histology demonstrates oncocytic epithelial lining and lymphoid stroma. Which lesion is most consistent with this finding? Dentigerous cyst Odontogenic keratocyst Unicystic ameloblastoma Papillary cystadenoma lymphomatosum Radicular cyst None Hint 51. A 42-year-old patient presents with a slow-growing, painless, firm mass on the posterior hard palate. Imaging shows a well-circumscribed lesion, and biopsy confirms a benign pleomorphic adenoma arising from a minor salivary gland. What is the usual intraoral site of pleomorphic adenoma? Buccal mucosa Upper lip Floor of the mouth Palate Ventral tongue None Hint 52. A 58-year-old man has a painless parotid swelling. Histopathology reveals papillary and cystic structures lined by a double layer of epithelial cells surrounded by a prominent lymphoid stroma containing germinal centers. Which diagnosis is most likely? Pleomorphic adenoma Mucoepidermoid carcinoma Acinic cell carcinoma Warthin tumor Adenoid cystic carcinoma None Hint 53. A 35-year-old woman reports persistent dry eyes, dry mouth, difficulty swallowing dry food, and recurrent dental caries. Autoimmune destruction of the salivary and lacrimal glands is suspected. Which type of glands is primarily affected in Sjögren syndrome? Exocrine glands Paracrine glands Endocrine glands Autocrine glands Neuroendocrine glands None Hint 54. A salivary gland biopsy shows a malignant neoplasm composed of mucous cells, epidermoid cells, and intermediate cells arranged in variable proportions. Which tumor classically contains intermediate cells as a characteristic component? Adenoid cystic carcinoma Mucoepidermoid carcinoma Pleomorphic adenoma Warthin tumor Myoepithelioma None Hint 55. A pathology review compares the risk of malignant transformation in different salivary gland sites. Which site is classically associated with the highest proportion of malignant tumors among primary salivary gland neoplasms? Parotid gland Submandibular gland Sublingual gland Minor salivary glands All sites have identical risk None Hint 56. A salivary gland pathology conference reviews tumors considered high-grade malignancies. Which of the following is generally classified as a low-grade or lower-grade salivary malignancy rather than a classic high-grade carcinoma? Basal cell adenocarcinoma High-grade mucoepidermoid carcinoma Adenoid cystic carcinoma Salivary duct carcinoma Carcinoma ex pleomorphic adenoma None Hint 57. A 19-year-old patient has a recurrent plunging ranula after previous simple drainage. The lesion repeatedly refills because the source of mucin leakage persists. Which treatment is most appropriate for recurrent ranula? Repeated incision alone Excision of the cyst only in every case Excision of the ranula with removal of the involved adjacent sublingual gland Marsupialization alone Observation without treatment None Hint 58. A patient undergoes conventional sialography of a normal major salivary gland. Contrast outlines the main duct and progressively smaller branches, producing a pattern resembling a tree bearing fruit. Which description best matches this normal appearance? Sausage-string appearance Fruit-laden tree appearance Leafless tree appearance Ball-in-hand appearance Snowstorm appearance None Hint 59. A 60-year-old patient presents with a slowly enlarging parotid mass. Histology shows small inner ductal cells surrounded by larger outer cells with clear cytoplasm, producing distinct two-layered epithelial islands. Which tumor is characterized by these epimyoepithelial islands? Sjögren syndrome Mucoepidermoid carcinoma Epithelial-myoepithelial carcinoma Myoepithelioma Warthin tumor None Hint 1 out of 30 Time's up
