ANUG Infection
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Questions and Answers

What is the type of infection that ANUG is considered?

  • Endogenous infection (correct)
  • Fungal infection
  • Exogenous infection
  • Mixed infection
  • Which of the following is NOT a local predisposing factor for ANUG?

  • Poor oral hygiene
  • Alcohol
  • Tobacco
  • HIV infection (correct)
  • What is the characteristic appearance of the ulcers in ANUG?

  • Flat and non-bleeding ulcerations
  • Raised and bleeding ulcerations
  • Punched out or crater like ulcerations (correct)
  • Linear and painful ulcerations
  • What is the main goal of treatment for ANUG?

    <p>Removal of local irritating factors</p> Signup and view all the answers

    Which of the following is a systemic manifestation of ANUG?

    <p>Fever</p> Signup and view all the answers

    What is the type of granulomas found in Actinomycosis?

    <p>Tuberculoid granulomas</p> Signup and view all the answers

    Which of the following is NOT a causative organism of Actinomycosis?

    <p>Bacteroides</p> Signup and view all the answers

    What is the purpose of Ziehl-Neelsen stain in the diagnosis of Actinomycosis?

    <p>To demonstrate the presence of mycobacteria</p> Signup and view all the answers

    Which of the following is a characteristic of Actinomycosis?

    <p>It is a chronic suppurative granulomatous infection</p> Signup and view all the answers

    What is the typical location of Actinomycosis?

    <p>Soft tissue of the angle of the mandible</p> Signup and view all the answers

    What is the most common site of infection in Peripheral Actinomycosis?

    <p>Submandibular region</p> Signup and view all the answers

    What is the characteristic feature of the pus discharged in Actinomycosis?

    <p>Sulfur granules</p> Signup and view all the answers

    What is the primary cause of Noma (cancrum oris)?

    <p>ANUG</p> Signup and view all the answers

    What is the mode of transmission of Gonorrhea?

    <p>Sexual intercourse</p> Signup and view all the answers

    What is the characteristic feature of the mucous patches in Secondary stage of acquired Syphilis?

    <p>Irregular, painless ulcers covered by grayish-white pseudo membranes</p> Signup and view all the answers

    What is the term for the invasion of the body by harmful microorganisms?

    <p>Infection</p> Signup and view all the answers

    What are the five cardinal signs of inflammation?

    <p>Pain, heat, redness, swelling, and loss of function</p> Signup and view all the answers

    What is the main function of macrophages in the immune system?

    <p>To detect and destroy bacteria and other harmful organisms</p> Signup and view all the answers

    What is the term for the complex response to harmful stimuli?

    <p>Inflammation</p> Signup and view all the answers

    What is the primary site of infection in Central Actinomycosis?

    <p>Jaw bone</p> Signup and view all the answers

    What is the term for a focal aggregate of immune cells that forms in response to a persistent inflammatory stimulus?

    <p>Granuloma</p> Signup and view all the answers

    What is the treatment for Actinomycosis?

    <p>Incision and drainage with long-term penicillin-based antibiotics</p> Signup and view all the answers

    What is the causative organism of Acute Necrotizing Ulcerative Gingivitis (ANUG)?

    <p>Bacteroides and Fusobacterium species</p> Signup and view all the answers

    What is the oral manifestation of Gonorrhea?

    <p>Generalized erythematous stomatitis, ulceration, and difficulty swallowing</p> Signup and view all the answers

    What is the primary risk of untreated primary syphilis?

    <p>Progression to secondary syphilis</p> Signup and view all the answers

    What is the primary lesion of the oral mucosa in tuberculosis?

    <p>Rare and usually associated with coughing-up of infected sputum from pulmonary tuberculosis</p> Signup and view all the answers

    What is the characteristic feature of Hutchinson's teeth?

    <p>All of the above</p> Signup and view all the answers

    What is the characteristic feature of central caseous necrosis in tuberculosis?

    <p>Foci of structureless eosinophilic masses that have completely lost their cellular architecture</p> Signup and view all the answers

    What is the likely cause of deafness in congenital syphilis?

    <p>Damage to the eighth cranial nerve</p> Signup and view all the answers

    What is the mode of transmission of syphilis?

    <p>Through direct contact, such as vaginal, oral, and anal sex</p> Signup and view all the answers

    What is the characteristic feature of the primary stage of acquired syphilis?

    <p>Formation of a painless nodule that breaks down to form a round ulcer with raised, indurated, and rolled margins</p> Signup and view all the answers

    What is the purpose of the Silver impregnated method in diagnosing syphilis?

    <p>To detect Treponema pallidum</p> Signup and view all the answers

    What is the characteristic oral manifestation of tertiary syphilis?

    <p>All of the above</p> Signup and view all the answers

    What is the term for the lesions that appear in the oral cavity during the primary stage of acquired syphilis?

    <p>Chancre</p> Signup and view all the answers

    What is the term for the giant cells formed by the fusion of monocytes/macrophages?

    <p>Multinucleated giant cells</p> Signup and view all the answers

    What is the histopathological feature of tertiary stage of acquired syphilis?

    <p>Central coagulation necrosis surrounded by chronic inflammatory cells</p> Signup and view all the answers

    What is the causative organism of leprosy?

    <p>Mycobacterium leprae</p> Signup and view all the answers

    What is the characteristic feature of lepromatous leprosy?

    <p>Poorly formed granuloma with sheets of macrophages</p> Signup and view all the answers

    What is the purpose of the Fite-Faraco stain in diagnosing leprosy?

    <p>To detect Acid-fast bacilli</p> Signup and view all the answers

    What is the characteristic feature of oral lesions in leprosy?

    <p>All of the above</p> Signup and view all the answers

    Study Notes

    Acute Necrotizing Ulcerative Gingivitis (ANUG)

    • Caused by fusiform bacilli, Bacteroides, and spirochetes, known as Vincent's organisms
    • Normal oral flora, making ANUG an endogenous infection
    • Predisposing factors: local (alcohol, tobacco, poor oral hygiene, pre-existing gingivitis), systemic (psychological stress, poor diet, immunocompromised status)
    • Clinical features: necrotic punched-out or crater-like ulcerations on interdental papilla and marginal gingiva, grayish pseudo membrane, gingival bleeding, pain, foul odor, excessive salivation, bad metallic taste
    • Systemic manifestations: fever, malaise, cervical lymphadenopathy
    • Histopathological features: non-specific, necrosis of surface epithelium, acute inflammatory cells in connective tissue
    • Treatment: removal of local irritating factors, antibiotics (penicillin and metronidazole)

    Actinomycosis

    • Definition: chronic suppurative granulomatous bacterial infection, usually occurs in the soft tissue of the angle of the mandible
    • Causative organisms: endogenous bacteria, especially Actinomyces israeli and/or Actinomyces bovis
    • Predisposing factors: local (poor oral hygiene, periodontal pocket, or after tooth extraction or jaw surgery), systemic (immunocompromised patients with malignancies, HIV, diabetes, or steroid use)
    • Clinical features: two types of Actinomycosis can be distinguished
      • Peripheral Actinomycosis: lesion begins as asymptomatic firm (indurated) swelling, later breaks down forming sinuses and discharging pus with sulfur granules, characterized by formation of multiple abscesses and sinus tracts
      • Central Actinomycosis: occurs in the bones of the jaw, leading to chronic actinomycosis osteomyelitis
    • Histopathological features: central abscess consists of colonies of microorganisms with radiating filaments, forming a rosette pattern, with neutrophils, multinucleated giant cells, and macrophages
    • Treatment: incision and drainage, long-term penicillin-based antibiotics, antiseptic mouth rinse

    Noma (Cancrum Oris)

    • Definition: destructive, disfiguring, necrotizing disease affecting the orofacial tissues
    • Most frequently affects children in developing countries, especially Sub-Saharan Africa, who are malnourished or debilitated by systemic conditions
    • Histopathological and bacteriological features are similar to ANUG
    • Noma is preceded by ANUG, so early diagnosis prevents the development of noma and death

    Gonorrhea

    • Definition: venereal disease transmitted by sexual intercourse, caused by Neisseria gonorrhea
    • Oral manifestations: vary from asymptomatic to painful, including generalized erythematous stomatitis, ulceration, burning sensation, and difficulty swallowing
    • Secondary stage of acquired syphilis: highly contagious, characterized by the formation of mucous patches and condyloma latum, with a typical snail-track appearance

    Syphilis

    • Definition: chronic, specific granulomatous bacterial infection, transmitted by direct contact, caused by Treponema pallidum
    • Classification: acquired and congenital types
    • Acquired syphilis: 3 stages
      • Primary stage: characterized by the formation of Chancre, a painless nodule that breaks down to form a round ulcer with raised, indurated, and rolled margins, with regional lymphadenopathy
      • Secondary stage: highly contagious, characterized by the formation of mucous patches and condyloma latum, with a typical snail-track appearance
      • Tertiary stage: appears 2-3 years, characterized by gumma, diffuse syphilitic glossitis, and diffuse syphilitic osteitis
    • Histopathological features: central coagulation necrosis, surrounded by chronic inflammatory cells, with fibroblasts for the synthesis of fibrous tissue with endarteritis obliterans

    Tuberculosis of the Oral Cavity

    • Definition: chronic specific granulomatous bacterial infection, caused by Mycobacterium tuberculosis
    • Clinical features: primary lesion of the oral mucosa is rare, usually associated with coughing-up of infected sputum from pulmonary tuberculosis, with a chronic, irregular, indurated, painful ulcer that slowly increases in size, affecting the tongue, buccal mucosa, palate, and lips
    • Histopathological features: microscopic examination of T.B reveals granulomatous inflammation, with central caseous necrosis, collections of epithelioid histiocytes, lymphocytes, and multinucleated Langhans giant cells

    Leprosy

    • Definition: chronic infectious disease produced by Mycobacterium leprae, with two forms: tuberculoid leprosy (limited form with low-virulence bacilli) and lepromatous leprosy (generalized form with high-virulence bacilli)
    • Clinical features: oral lesions in the form of multiple necrotic and ulcerated nodules with slow healing and atrophic scarring, affecting the palate, tongue, and gingiva, with cutaneous lesions, severe maxillofacial deformities, and damage to peripheral nerves
    • Histopathological features: granulomatous inflammatory response with epithelioid histiocytes and multinucleated giant cells, with infiltration of nerves by mononuclear inflammatory cells, and acid-fast bacilli demonstrated with Fite-Faraco stain

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    This quiz covers the causative organisms, predisposing factors, and clinical features of Acute Necrotizing Ulcerative Gingivitis (ANUG).

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