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Questions and Answers
What is a characteristic histopathological appearance of tuberculosis lesions?
What is a characteristic histopathological appearance of tuberculosis lesions?
What is an essential feature for a positive diagnosis of tuberculosis?
What is an essential feature for a positive diagnosis of tuberculosis?
How can tuberculosis lesions be differentiated from malignant lesions?
How can tuberculosis lesions be differentiated from malignant lesions?
Which of the following is NOT considered in the differential diagnosis of tuberculosis lesions?
Which of the following is NOT considered in the differential diagnosis of tuberculosis lesions?
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What type of lesions can be found in both pulmonary and oral tuberculosis?
What type of lesions can be found in both pulmonary and oral tuberculosis?
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What is the primary responsibility for treating granulomatous lesions similar to tuberculosis?
What is the primary responsibility for treating granulomatous lesions similar to tuberculosis?
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Which of the following is NOT a method mentioned for diagnosing granulomatous lesions similar to tuberculosis?
Which of the following is NOT a method mentioned for diagnosing granulomatous lesions similar to tuberculosis?
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Which type of medication is primarily used in the treatment of granulomatous lesions similar to tuberculosis?
Which type of medication is primarily used in the treatment of granulomatous lesions similar to tuberculosis?
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What is the expected outcome of oral medication for granulomatous lesions similar to tuberculosis?
What is the expected outcome of oral medication for granulomatous lesions similar to tuberculosis?
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What type of medication is explicitly categorized as a tuberculostatic?
What type of medication is explicitly categorized as a tuberculostatic?
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What is the primary cause of tuberculosis of the oral cavity?
What is the primary cause of tuberculosis of the oral cavity?
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Which form of tuberculosis is primarily responsible for infections in the oral cavity?
Which form of tuberculosis is primarily responsible for infections in the oral cavity?
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Which of the following locations is NOT commonly associated with oral tuberculosis infections?
Which of the following locations is NOT commonly associated with oral tuberculosis infections?
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What characterizes the lesions that may appear in the oral cavity due to tuberculosis?
What characterizes the lesions that may appear in the oral cavity due to tuberculosis?
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Why is primary oral infection of tuberculosis considered rare?
Why is primary oral infection of tuberculosis considered rare?
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What is a common consequence of persistent infection with Koch's bacillus in the submandibular nodes?
What is a common consequence of persistent infection with Koch's bacillus in the submandibular nodes?
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Which area of the oral cavity is least likely to be affected by secondary tuberculosis?
Which area of the oral cavity is least likely to be affected by secondary tuberculosis?
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How do oral tuberculosis lesions typically present?
How do oral tuberculosis lesions typically present?
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What characterizes gingival involvement in tuberculosis?
What characterizes gingival involvement in tuberculosis?
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What is a common route of infection for Koch's bacillus in maxillary bones?
What is a common route of infection for Koch's bacillus in maxillary bones?
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What characterizes periapical tuberculosis lesions?
What characterizes periapical tuberculosis lesions?
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Which of the following is a common consequence of tuberculous osteomyelitis?
Which of the following is a common consequence of tuberculous osteomyelitis?
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What is a defining histopathologic feature of tuberculosis lesions?
What is a defining histopathologic feature of tuberculosis lesions?
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Which type of oral tuberculosis is characterized by firm, small lesions that ulcerate and drain?
Which type of oral tuberculosis is characterized by firm, small lesions that ulcerate and drain?
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What type of cells is specific to oral tuberculosis lesions?
What type of cells is specific to oral tuberculosis lesions?
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Study Notes
Tuberculosis of the Oral Cavity
- Caused by Mycobacterium tuberculosis (Koch bacillus) and, less commonly, Mycobacterium bovis.
- Most commonly originates from pulmonary tuberculosis.
- Can be primary (rare, often in children) or secondary (more common in patients with pulmonary tuberculosis).
- Primary oral infection can occur at any age, but is rare.
- Secondary infection can spread via sputum or bloodstream.
Secondary Infection
- Affects maxillary mucosa, bones, and gums, especially in pulmonary tuberculosis patients.
- Can cause small, persistent lesions on the oral mucosa.
- Preferred sites include the tongue, palate, lips, and cheek mucosa.
Tuberculous Lesions
- Typically manifest as superficial or deep ulcers with limited expansion and no pain.
- Often mistaken for trauma or cancer-related ulcers.
- Gingival involvement is less common, presenting as diffuse, hyperemic, papillary or nodular proliferation.
- Tuberculosis of the maxillary bones can occur via periapical infection.
Periapical Tuberculosis
- Painless, rapidly expanding bone lesions, often affecting the jaws.
Tuberculous Osteomyelitis
- Chronic, typical osteomyelitis with microscopic evidence of mycobacteria.
- Often caused by hematogenous spread from other parts of the body.
- Can develop fistulas in the oral cavity leading to facial swelling and drainage.
Lupus Vulgaris
- Skin-based infection with tuberculous bacilli.
- Characterized by superficial, ulcerating papules often appearing on the face, but can be located elsewhere.
Gummas
- Firm, small lesions that can appear in the tongue or palate.
- Swell, soften, ulcerate, and drain a viscous, purulent material.
Histopathologic Features of Oral Tuberculosis
- Tubercles: Well-circumscribed areas of inflammation with a central area of caseous necrosis.
- Surrounding Inflammation: Consists of histiocytes and multinucleated giant cells (Langhans giant cells).
- Specific Cells: The presence of Langhans giant cells with a peripheral nucleus and transparent cytoplasm is a specific feature of oral tuberculosis.
Diagnosis of Oral Tuberculosis
- Positive Diagnosis: Based on characteristic clinical presentation (absence of pain), presence of bacteria in saliva (Ziehl-Nielsen staining), and animal inoculation (cultivation).
- Differential Diagnosis: Differentiated from malignant lesions based on clinical signs (tuberculosis lesions are softer).
- Biopsy: Crucial to differentiate from other conditions like syphilis, Sporotrichosis, and Blastomycosis.
Treatment of Granulomatous Lesions Similar to Tuberculosis
- Cultivation: Fungi, biopsy, skin tests, and animal inoculations
- Diagnosis: Experiments can lead to the diagnosis of granulomatous lesions similar to tuberculosis.
- Treatment: Managed by a pulmonologist due to the increasing incidence of pulmonary tuberculosis or other infections with M. tuberculosis.
- Medications Used: Tuberculostatics, antibiotics.
- Outcome: Oral medication leads to the healing of lesions.
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Description
This quiz explores tuberculosis affecting the oral cavity, including its origins, types, and specific lesions. Learn about primary and secondary infections, common symptoms, and how oral tuberculosis can be misdiagnosed. Test your understanding of this complex condition and its implications for dental health.
