Oral medicine and oral cancer: glossitis: practice question

A Dentistry question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Dentistry · Oral medicine and oral cancer: glossitis

Sample item

A 55-year-old vegetarian has a smooth, beefy-red, painful tongue, paraesthesia of the feet and a macrocytic anaemia. Which investigation is most useful next?

ASerum vitamin B12 levelBBiopsy of the tongue for amyloidCSalivary flow rateDSerum ferritin only

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Serum vitamin B12 level

Atrophic glossitis with macrocytosis and neuropathy suggests vitamin B12 deficiency, for example from pernicious anaemia or a vegetarian diet. Serum B12 confirms the cause.

Option by option

A. Serum vitamin B12 level (correct)
Correct. B12 deficiency explains glossitis, neuropathy and macrocytosis.
B. Biopsy of the tongue for amyloid
Amyloid causes macroglossia, not smooth atrophic glossitis with macrocytosis.
C. Salivary flow rate
Salivary flow tests dry mouth, which does not explain the neuropathy.
D. Serum ferritin only
Ferritin tests iron stores, and iron deficiency gives a microcytic picture.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Dentistry question

What is the answer to this Dentistry question?

The best answer is A, Serum vitamin B12 level. Atrophic glossitis with macrocytosis and neuropathy suggests vitamin B12 deficiency, for example from pernicious anaemia or a vegetarian diet.

Why is "Biopsy of the tongue for amyloid" not the answer?

Amyloid causes macroglossia, not smooth atrophic glossitis with macrocytosis.

Why is "Salivary flow rate" not the answer?

Salivary flow tests dry mouth, which does not explain the neuropathy.

Why is "Serum ferritin only" not the answer?

Ferritin tests iron stores, and iron deficiency gives a microcytic picture.

What concept does this question test?

It tests Oral medicine and oral cancer: glossitis in Dentistry. Serum B12 confirms the cause.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Oral medicine and oral cancer: glossitis?

Learn the dental formula, eruption ages and tooth structure once, as tables. Then use the flashcards and the other Dentistry questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.