Chapter 11: Vitamins Required for Oral Soft Tissues and Salivary Glands
Test Bank

MULTIPLE CHOICE

1. Deficiencies in which of the following nutrients is least associated with manifestations of systemic disease in the oral cavity?
a. Vitamin A
b. B-complex vitamins
c. Vitamin C
d. Protein

ANS: A
Although all nutrients, including vitamin A, have links to oral health, oral manifestations of systemic diseases caused by deficiencies of the remaining nutrients are seen with more frequency and intensity. Other such nutrients are vitamin K and iron.

REF: p. 190

2. The system most likely to be responsible for excessive salivation in a nervous dental patient is the:
a. Krebs cycle.
b. TCA cycle.
c. parasympathetic autonomic nervous system.
d. sympathetic autonomic nervous system.

ANS: C
Physiologically, the sympathetic autonomic nervous system stimulates the body in times of stress and crisis. In contrast, the parasympathetic autonomic nervous system balances or slows down impulses from sympathetic nerves. Whereas the sympathetic impulses influence salivary composition, the parasympathetic system increases the amount of saliva when stimulated. The Krebs cycle, also known as the citric acid or TCA (tricarboxylic) cycle is responsible for metabolic production of energy from carbohydrates, fats and proteins.

REF: p. 190

3. Each of the following oral structures is lined with keratinized mucosa except one. Which one is the exception?
a. Floor of the mouth
b. Gingiva surrounding the teeth
c. Dorsum of the tongue
d. Hard palate

ANS: A
The floor of the mouth is lined with nonkeratinized mucosa. The only oral tissues lined with keratinized mucosa are the gingival tissues surrounding the teeth, the dorsum (upper surface) of the tongue, and the hard palate. The remainder of the oral cavity is lined with nonkeratinized mucosa.

REF: p. 191

4. The loss of which papilla types is most likely to result in a loss of taste buds and changes in taste acuity?
a. Circumvallate and foliate
b. Foliate and fungiform
c. Circumvallate and fungiform
d. Fungiform and filiform
e. Filiform and foliate

ANS: B
Taste buds are located on the foliate and fungiform papillae. Foliate papillae appear as visible grooves located on the lateral borders of the tongue. Fungiform papillae are bright red, mushroom-shaped structures scattered throughout the filiform papillae. Of all papillae, taste buds are located only on the foliate, circumvallate lingual, and foliate.

REF: p. 191 | p. 192

5. Fungiform papillae are pale pink because they are covered in with keratinized mucosa and have a rich blood supply.
a. Both the statement and the reason are correct and related.
b. Both the statement and the reason are correct but are not related.
c. The statement is correct, but the reason is not correct.
d. The statement is not correct, but the reason is correct.
e. Neither the statement nor the reason is correct.

ANS: D
Fungiform papillae are covered with keratinized mucosa and have a rich blood supply. It is this highly vascular nature that imparts the bright red color to fungiform papilla. Note that chronic severe nutrient deficiencies result in loss of fungiform papillae and a smooth red tongue.

REF: p. 191

6. During early phases of nutritional deficiency, which epithelial tissue is the most likely to be evident?
a. Gingival
b. Lips
c. Glossal
d. Palatal

ANS: C
Manifestations of a nutritional deficiency are usually first evident in the glossal (tongue) epithelium.

REF: p. 192 | Dental Considerations

7. Patients taking medications for bradycardia (low heart rate) exhibit increased salivary flow because such medications affect salivary secretion control by cholinergic parasympathetic nerves.
a. Both the statement and the reason are correct and related.
b. Both the statement and the reason are correct but are not related.
c. The statement is correct, but the reason is not correct.
d. The statement is not correct, but the reason is correct.
e. Neither the statement nor the reason is correct.

ANS: D
Patients taking medication for bradycardia exhibit decreased salivary flow. The anticholinergic effects of such medications disrupt the cholinergic mechanisms of the parasympathetic nerves. Disruption of cholinergic nerves that control salivary secretions results in decreased salivary flow.

REF: p. 192 | Dental Considerations

8. Each of the following accurately describes physiological roles of thiamin except one. Which one is the exception?
a. Thiamin functions as a coenzyme in the Krebs cycle.
b. The main effects of thiamin deficiency are disturbances of protein and lipid metabolism.
c. Thiamin is an essential component in synthesis of niacin.
d. Also known as vitamin B1, thiamin helps regulate appetite.

ANS: B
Although thiamin is required for metabolism of carbohydrates, proteins, and fats, the main effects of thiamin deficiency are disturbances of carbohydrate metabolism. Its role as a coenzyme in the Krebs cycle, also called the citric acid cycle or the tricarboxylic cycle (TCA), is production of energy through metabolism of energy nutrients. The logical extension is that thiamin is essential for metabolism of carbohydrates.

REF: p. 192 | p. 193

9. Which of the following meats is an exceptionally good source of thiamin?
a. Chicken
b. Turkey
c. Pork
d. Beef

ANS: C
Although thiamin is widely distributed in foods and an intake of a variety of foods can ensure adequate amounts, pork is an exceptionally good source of thiamin (vitamin B1).

REF: p. 193

10. Beriberi manifests with impairment of the autonomic nervous system. Other symptoms include bradycardia and decreased size of the heart.
a. Both statements are true.
b. Both statements are false.
c. The first statement is true; the second is false.
d. The first statement is false; the second is true.

ANS: D
Beriberi, which means “I cannot,” manifests as impairment of the central nervous system. This results in impairment of sensory and motor functions including muscular wasting, tachycardia (increased heart rate) and an enlarged heart. Other manifestations include deep muscle pain in the calves and peripheral paralysis. There are two categories of beriberi. Dry beriberi causes muscular wasting, whereas wet beriberi causes edema.

REF: p. 193