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GI

Total questions: 118

Worksheet time: 3570secs

Name
Class
Date
1.

What is the minimum therapeutic dose of a probiotic strain?

a)

It differs per strain, but it is a prudent to prescribe a minimum of 1 billion (10^9) colony forming units (CFU) of each strain

b)

It differs per strain, but it is a prudent to prescribe a minimum of 100 million CFU (10^8) of each strain

c)

10 billion (10^10) CFU

d)

100,000 (10^6) CFU

2.

Which of the following is not a common side effect from prebiotic administration?

a)

Flatulence

b)

Abdominal distension

c)

Sore joints

d)

Abdominal bloating

e)

Abdominal pain

3.

Probiotic characteristics are strain dependent. This means:

a)

Desirable characteristics cannot be extrapolated across the species level

b)

Strains within the same species may have differing therapeutic qualities

c)

One cannot generalize research results conducted on one probiotic strain to another one, even if it is within the same species

d)

All of the above

4.

What differentiates prebiotics from colonic foods?

a)

Only colonic foods are fermented to produce short-chain fatty acids

b)

Prebiotics are only utilized by a limited number of beneficial bacteria in the human GIT

c)

Prebiotics have to be naturally-occurring, whereas colonic foods do not

d)

Nothing differentiates them – they are different terms for the same thing

e)

Only prebiotics are fermented to produce short-chain fatty acids

5.

Which of the following disease states has been associated with gastrointestinal dysbiosis?

a)

Obesity and Type 2 Diabetes

b)

Chronic Fatigue Syndrome and Autism

c)

Depression and Anxiety

d)

All of the above

e)

None of the above

6.

All of the following are prebiotics except one. Choose the exception:

a)

fructooligosaccharides

b)

lactulose

c)

larch arabinogalactans

d)

lactitol

e)

galactooligosaccharides

7.

Synbiotics are a combination of prebiotic and probiotic agents. This combination is supposed to:

a)

enhance the survival of the probiotic bacteria through the upper GIT

b)

improve implantation of the probiotic strain in the colon

c)

have a stimulating effect on the growth and/or activities of both the exogenously provided probiotic strain(s) and the endogenous inhabitants of the bowel

d)

Do all of the above

e)

Do none of the above

8.

What is the general rule of dosing with prebiotic compounds?

a)

Start low and slowly work your way up to the ideal therapeutic dose

b)

Start with the ideal therapeutic dose and if this causes symptoms, slowly reduce the dose until it appears well-tolerated

c)

They work synergistically, so it is best to give a number of them concurrently to maximize effectiveness

d)

None of the above

9.

The probiotic strain Lactobacillus reuteri BioGaia is found in which commercially-available probiotic preparation in the USA?

a)

Bioceuticals UltraBiotic 45

b)

Natren Healthy Trinity

c)

Gerber Soother Colic Drops

d)

Standard Process ProSynbiotic

10.

A probiotic strain that has demonstrated efficacy in the prevention of atopic eczema is

a)

Lactobacillus rhamnosus VRI-003

b)

Lactobacillus rhamnosus HN001

c)

Bifidobacterium lactis HN01

d)

Lactobacillus acidophilus LAVRI-A1

11.

Based on the most recent research, probiotics can be used to treat:

a)

Endometriosis

b)

Post-partum obesity

c)

Mastitis

d)

All of the above

12.

Which of the following is not a probiotic myth?

a)

Never take probiotics alongside antibiotics as it is a waste of money

b)

Probiotics are best taken on an empty stomach

c)

Probiotics are best taken with larger, more dense meals to enhance survival through the upper GIT

d)

A good probiotic strain will permanently colonize the human GIT after consumption

e)

Probiotic supplements are superior to probiotic foods as therapeutic tools

13.

A species commonly used in probiotic supplements is

a)

Klebsiella pneumoniae

b)

Klebsiella pneumoniae

c)

Bacillus anthracis

d)

Saccharomyces cerevisiae

14.

Which of the following is not a mechanism by which probiotics work:

a)

Conversion of excess intestinal gases to water

b)

Competition for space and nutrients with potential pathogens

c)

Production of selectively-acting anti-microbial substances

d)

Via interaction with immune cells along the GIT

e)

Via production of beneficial compounds in the GIT (e.g., polyamines)

15.

Which of the following probiotic products has clinical trial evidence of efficacy for the treatment of infantile colic?

a)

Culturelle Kids Probiotic

b)

Natural Factors Children’s Multi Probiotic

c)

Bio-Kult Infanti

d)

Klaire Labs Ther-Biotic Children’s Chewable

16.

Which prebiotic has been shown to increase microbial β-glucosidase activity in the colon?

a)

Larch arabinogalactans

b)

Galactooligosaccharides

c)

Fructooligosaccharides

d)

Lactulose

e)

Apple pectin

17.

The prebiotics with the current best research profile for improving skin health (levels of wrinkles and hydration) are?

a)

. Lactulose and Arabinogalactans

b)

Lactulose and GOS

c)

GOS and FOS

d)

Lactulose and FOS

18.

Foods rich in fructooligosaccharides include all of the following except one. Choose the exception.

a)

Onions

b)

Garlic

c)

Yacon tubers

d)

Black beans

19.

A prebiotic must have all the following characteristics except one. The exception is:

a)

ingestion of the substance alters the colonic microflora ecosystem towards a healthier composition

b)

the substance must be neither catabolised nor absorbed in the stomach or small intestine

c)

ingestion results in changes that improve the health of the host

d)

the substance must be naturally occurring

e)

the substance must be a selective substrate only utilised by a limited number of beneficial bacteria

20.

All of the following are desirable probiotic characteristics except one; choose the exception:

a)

Human origin

b)

Documented clinical safety

c)

Adherence to the intestinal mucosa

d)

Ability to colonize the human gastrointestinal tract (albeit only temporarily)

e)

Antagonism against lactobacilli and bifidobacteria

21.

Which of the following disease states has been associated with gastrointestinal dysbiosis?

a)

. Obesity and Type 2 Diabetes

b)

Chronic Fatigue Syndrome and Autism

c)

Depression and Anxiety

d)

All of the above

e)

None of he above

22.

Bifidobacterium longum BB536 can be found in which supplement?

a)

Pure Encapsulations Probiotic IMM

b)

Culturelle

c)

Natural Factors Acidophilus & Bifidus

d)

Yakult drink

23.

The potential for an antimicrobial agent to influence the gut microflora is related to its:

a)

Pharmacokinetics

b)

Spectrum of activity

c)

Length of administration

d)

All of the above

e)

None of the above

24.

A pathobiont is defined as:

a)

. A unit of biological organization composed to a host and its microbiota

b)

. A relationship benefitting both parties

c)

A healthy balanced ecosystem

d)

A commensal microorganism that is able to promote pathology only when specific genetic or environmental conditions are altered in the host

25.

Which if the following bacterial genera are capable of producing butyrate? Choose the most correct answer.

a)

Escherichia, Bacteroides, Peptococcus

b)

Anaerotruncus, Faecalibacterium, Roseburia

c)

Atopobium, Faecalibacterium, Enterococcus

d)

Anaerostipes, Bifidobacterium, and Lactobacillus

26.

Which of the following conditions is not associated with intestinal dysbiosis?

a)

Atopic eczema

b)

Obesity

c)

Rheumatoid arthritis

d)

Functional dyspepsia

e)

Irritable bowel syndrome

27.

Which of the following probiotic strains increase your endogenous populations of bifidobacteria when consumed:

a)

Lactobacillus casei Shirota

b)

Lactobacillus acidophilus NCFM

c)

Lactobacillus rhamnosus GG

d)

All of the above

e)

None of the above

28.

The three main short chain fatty acids produced in the colon are:

a)

Isovalerate, acetate and butyrate

b)

Propionate, butyrate and acetate

c)

Lactate, propionate and isovalerate

d)

Hydrochloric, acetate, and butyrate

e)

Acetate, butyrate and lactate

29.

Hydrogen sulfide gas is produced by which colonic bacterial species:

a)

Bifidobacterium spp. and Lactobacillus spp.

b)

Desulfovibrio spp. and Desulfomaculum spp.

c)

Desulfovibrio spp. and Bacteroides spp.

d)

Bifidobacterium spp. and Desulfomaculum spp.

30.

Which of the following is not a physiological activity of short chain fatty acids:

a)

Trophic effects on the small intestine

b)

Improved colonic epithelial barrier function

c)

Improved laxation

d)

Improved mineral absorption

e)

Improved serum vitamin B12 levels

31.

Which short chain fatty acid directly suppresses the growth of the main methane-producing bacterial species in the gastrointestinal tract (Methanobrevibacter smithii)?

a)

Butyrate

b)

Acetate

c)

Propionate

d)

Lactate

32.

A high milk-fat diet encouraged the growth of what microorganism?

a)

Bilophila wadsworthia

b)

Bacteroides fragilis

c)

Bifidobacterium lactis

d)

Lactobacillus acidophilus

e)

Clostridiodes difficile

33.

Two probiotic strains with evidence of efficacy in the treatment of intestinal dysbiosis are:

a)

Lactobacillus acidophilus La5 and Lactobacillus casei Shirota

b)

Bifidobacterium lactis Bb12 and Lactobacillus acidophilus La5

c)

Lactobacillus rhamnosus GG and Bifidobacterium lactis HN019

d)

Lactobacillus acidophilus La5 and Bifidobacterium lactis HN019

34.

Causes of dysbiosis include:

a)

Antibiotics

b)

Stress

c)

Birth via Caesarean section

d)

All of the above

35.

Which of the following is not a byproduct of intestinal putrefaction?

a)

hydrogen peroxide

b)

Indoles

c)

Phenols

d)

Short chain fatty acids

e)

Ammonia

36.

The disappearing microbiota hypothesis states

a)

That alterations in human macroecology have progressively affected the composition of our indigenous microbiota, which in turn has affected human physiology and, ultimately, increased the risk of allergic and metabolic diseases

b)

That the increased rates of modern allergic and metabolic diseases has arisen due to changes in our genetics

c)

That the increased rates of modern allergic and metabolic diseases has arisen due to global warming.

d)

All of the above

e)

None of aove

37.

Putrefaction is the process by which:

a)

Resistant starch is fermented

b)

Protein is fermented

c)

Non-starch polysaccharides are fermented

d)

Oligosaccharides are fermented

38.

The main cause of gastrooesophageal reflux is

a)

a. Lower esophageal sphincter incompetence

b)

b. Cigarette smoking

c)

c. Low gastric acid output

d)

d. High gastric acid output

39.

Melatonin helps in GERD by:

a)

a. Inhibiting gastric acid output

b)

b. Inhibiting nitric oxide biosynthesis; thereby reducing the rate of transient relaxations in the LES

c)

c. Strengthening the LES

d)

d. All of the above

e)

e. None of the above

40.

In human clinical trials, which agent(s) appears to be the most effective in eradicating H. pylori when used without antibiotics?

a)

a. Mastic gum (Pistacia lentiscus var Chia)

b)

b. Rhubarb root (Rheum emodi)

c)

c. Black seed (Nigella sativa)

d)

d. Vitamin C

e)

e. Vitamin E and C

41.

All of the following agents can be used to improve the efficacy of antibiotics in eradicating H. pylori except:

a)

a. Zinc carnosine

b)

b. Lactose

c)

c. Lactobacillus acidophilus La5 and Bifidobacterium lactis Bb12

d)

d. Vitamin C and vitamin E

e)

e. Vitamin C

42.

According to human clinical trials, which agent appears to have the greatest effect in speeding the healing of peptic ulcers?

a)

a. Zinc carnosine

b)

b. Cabbage juice

c)

c. Melatonin

d)

d. Mastic gum

43.

Causes of peptic ulcer disease include all of the following except one. Choose the exception:

a)

a. Helicobacter pylori

b)

A predominantly wholefoods, plant-based diet

c)

c. Use of oral corticosteroids

d)

d. Use of NSAIDs

e)

e. Use of aspirin

44.

All of the following foods or drinks inhibit the growth of Helicobacter pylori except:

a)

a. Alfalfa sprouts

b)

b. Green tea

c)

c. Grapes

d)

d. Bilberries

45.

To facilitate contact between Helicobacter pylori and anti-microbial agents (natural or pharmaceutical), which agent(s) should be co-administered?

a)

a. N-acetyl cysteine

b)

b. Lactobacillus reuteri MM53

c)

c. Lactobacillus acidophilus La5 and Bifidobacterium lactis Bb12

d)

d. Zinc carnosine

e)

e. B and C

46.

Which dietary agent causes impaired esophageal motility, increased gastric acid secretion, transient lower esophageal relaxations and slows gastric emptying?

a)

a. Chocolate

b)

b. Coffee

c)

c. Alcohol

d)

d. Fatty foods

47.

Other contributing factors in GERD include:

a)

a. Delayed gastric emptying

b)

b. Impaired esophageal acid clearance

c)

c. Decreased salivation

d)

d. All of the above

e)

e. None of the above

48.

Slow gastric emptying contributes to GERD by:

a)

a. increasing the amount of time for Helicobacter pylori to eat the food. Which results in increased gas production; causing belching and reflux

b)

b. increasing the length of time refluxate is available in the stomach

c)

c. increasing gastric distension, which has been found to increase the rate of transient LES relaxations

d)

d. A and B

e)

e. B and C

49.

Which probiotic strain has demonstrated the greatest efficacy in eradicating H. pylori?

a)

a. Saccharomyces cerevisiae var boulardii Biocodex

b)

b. Lactobacillus reuteri MM53

c)

c. Lactobacillus acidophilus NAS

d)

d. Lactobacillus rhamnosus GG

e)

e. Bifidobacterium lactis Bb12

50.

Which of the following agents improves functioning of the LES?

a)

a. D-limonene

b)

b. Melatonin

c)

c. Lactobacillus rhamnosus GG

d)

d. Lactobacillus reuteri MM53

e)

e. All of the above

51.

Key risk factors for GERD development include all the following except one. Choose the exception.

a)

a. Smoking

b)

b. Physical inactivity

c)

c. Pregnancy

d)

d. High BMI

52.

Which of the following nutrients has been shown to be capable of reversing Barrett’s esophagus in humans?

a)

a. Vitamin C

b)

b. Beta-carotene

c)

c. Vitamin E

d)

d. Lycopene

53.

Wheat allergy can be differentiated from celiac disease and gluten sensitivity by:

a)

a. The presence of a positive IgE test result

b)

b. The presence of a positive AGA IgA test result

c)

c. The presence of a positive tTg IgG test result

d)

d. The presence of a positive tTg IgA test result

54.

Which of the following signs and symptoms occur in celiac disease?

a)

a. Diarrhea

b)

b. Constipation

c)

c. Vomiting

d)

d. All of the above

55.

Fructose malabsorption is more common in which gastrointestinal conditions?

a)

a. GERD and Peptic Ulcer disease

b)

b. Functional dyspepsia and Crohn’s disease

c)

c. IBS and GERD

d)

d. Gastritis and IBS

e)

e. Crohn’s disease and diverticular disease

56.

Which of the following substances interferes with fructose absorption?

a)

a. Sorbitol

b)

b. Galactose

c)

c. Dextrose

d)

d. Glucose

57.

Which of the following is a reason for the rising prevalence of celiac disease?

a)

a. Increased frequency of C-section births

b)

b. Increase in the gluten content of currently grown wheat varieties

c)

c. Shortened duration of breastfeeding

d)

d. All of the above

e)

e. None of the above

58.

Ideally, an adequate dose of gluten needs to be consumed for how long prior to celiac disease testing to ensure the accuracy of the result?

a)

a. 6 weeks

b)

b. 5 weeks

c)

c. 4 weeks

d)

d. 3 weeks

e)

e. 2 weeks

59.

Which of these fruits should be acceptable for a patient with fructose malabsorption to consume?

a)

a. Apricots, persimmons, grapes

b)

b. Apples, cherries and pears

c)

c. Plums, bananas and pears

d)

d. Bananas, blueberries and fresh figs

e)

e. Watermelon, mango and lychees

60.

Which of these vegetables should be acceptable for a patient with fructose malabsorption to consume?

a)

a. Alfalfa sprouts and green beans

b)

b. Potatoes and celery

c)

c. Beetroot (beets) and zucchini

d)

d. A and B

e)

e. A and C

61.

Fructose malabsorption causes depression as a result of:

a)

a. Fermentation of fructose creates toxins that when absorbed reduce the production of melatonin

b)

b. Fermentation of fructose creates short chain fatty acids that when absorbed decrease the livers capacity to detoxify endotoxins and ammonia

c)

c. Decreased tryptophan and folic acid absorption

d)

d. All of the above

e)

e. None of the above

62.

Indicators of “hidden” celiac disease include:

a)

a. Iron deficiency anemia

b)

b. Delayed puberty

c)

c. Raised liver enzymes (AST and/or ALT)

d)

d. All of the above

e)

e. None of the above

63.

Which of the following substances does not improve absorption of fructose?

a)

a. Glucose

b)

b. L-alanine

c)

c. L-glutamine

d)

d. Erythritol

e)

e. L-phenylalanine

64.

Nutritional deficiencies of all of the following nutrients except one are common in celiac disease. Choose the one nutrient that is not commonly impacted in celiac disease.

a)

a. Calcium

b)

b. Ascorbic acid

c)

c. Magnesium

d)

d. selenium

e)

e. Zinc

65.

Treatment of celiac disease differs from that of gluten sensitivity in that:

a)

a. It requires a strict gluten-free diet

b)

b. Additional small intestinal healing measures may be required

c)

c. It doesn’t require a strict gluten-free diet

d)

d. Nutritional supplementation with a high-potency multivitamin/mineral preparation is needed

66.

Synbiotics are a combination of prebiotic and probiotic agents. This combination is supposed to:

a)

a. enhance the survival of the probiotic bacteria through the upper GIT

b)

b. improve implantation of the probiotic strain in the colon

c)

c. have a stimulating effect on the growth and/or activities of both the exogenously provided probiotic strain(s) and the endogenous inhabitants of the bowel

d)

d. Do all of the above

e)

e. Do none of the above

67.

Which prebiotic has been shown to increase microbial β-glucosidase activity in the colon?

a)

a. Lactulose

b)

b. Fructooligosaccharides

c)

c. Apple pectin

d)

d. Larch arabinogalactans

e)

e. Galactooligosaccharides

68.

Lactase persistence is more common in:

a)

a. People of African descent

b)

b. People of Asian descent

c)

c. People of northern European descent

d)

d. People of Mexican descent

69.

A lectin in which foodstuff can help treat giardiasis:

a)

a. Chick peas

b)

b. Oat bran

c)

c. Mung beans

d)

d. Wheat germ

70.

Lactase nonpersistence is:

a)

a. A condition in which too much cow’s milk is drunk

b)

A condition in which malabsorbed lactose produces symptoms

c)

A condition in which a sizable fraction of a dosage of lactose is not absorbed in the small bowel and thus is delivered to the colon

d)

d. A condition in which the brush border lactase activity is only a small fraction of the infantile level

71.

Causes of secondary lactose intolerance include:

a)

a. Chemotherapy

b)

b. Viral gastroenteritis

c)

c. Celiac disease

d)

d. All of the above

72.

Which of the following probiotic strains is the most appropriate to utilize in the treatment of giardiasis?

a)

Saccharomyces cerevisiae var boulardii Biocodex

b)

b. Bifidobacterium lactis Bb12

c)

c. Lactobacillus plantarum La5

d)

d. Escherichia coli Nissle 1917

e)

e. Lactobacillus reuteri MM53

73.

When taken on an empty stomach, the maximum dose of lactose that is generally well-tolerated in patients with lactose intolerance is:

a)

a. 12g

b)

b. 14g

c)

c. 18g

d)

d. 24g

e)

e. 36g

74.

Overall dietary recommendations to treat giardiasis include which of the following:

a)

a. Eat a wholefoods, high-fiber diet

b)

b. Avoid simple sugars (e.g., lactose and sucrose)

c)

c. Decrease fat intake

d)

d. All of the above

e)

e. None of the above

75.

A condition commonly associated with lactose intolerance is:

a)

a. Celiac disease

b)

b. Diverticulitis

c)

c. Irritable bowel syndrome

d)

d. A and B

e)

e. A and C

76.

Lactose is a sugar found in all mammalian milks

a)

True

b)

False

77.

Giardia infects what section of the gut?

a)

a. All of the above

b)

b. Stomach

c)

c. Large intestine

d)

d. Small intestine

78.

Probiotics can play a role in the management of SIBO by:

a)

a. selectively modifying the small intestinal ecosystem

b)

b. stimulating the migrating motor complex

c)

c. helping to heal the leaky gut

d)

d. all of the above

e)

e. none of the above

79.

Which of the following conditions is not commonly associated with SIBO?

a)

a. rheumatoid arthritis

b)

b. acne vulgaris

c)

c. Parkinson's disease

d)

d. fibromyalgia

e)

e. NAFLD

80.

The medicinal herb with activity against the widest range of SIBO-related microorganisms is:

a)

a. pomegranate rind

b)

b. green tea

c)

c. peppermint essential oil

d)

d. dried garlic extract

e)

e. none of the above

81.

Based on the following breath test result, what is the most likely diagnosis? Choose the best answer.

a)

a. Small intestinal bacterial overgrowth - methane and colonic methane overproduction

b)

b. Fructose intolerance

c)

c. Lactose intolerance

d)

d. Small intestinal bacterial overgrowth - hydrogen

82.

The microorganisms involved in SIBO can:

a)

a. ferment carbohydrates only

b)

b. ferment carbohydrates and putrefy proteins

c)

c. cause deficiency of vitamin B12

d)

d. a and c

e)

e. b and c

83.

Based on current best evidence, which breath test is considered the most accurate for the diagnosis of SIBO:

a)

a. glucose breath test

b)

b. fructose breath test

c)

c. lactose breath test

d)

d. lactulose breath test

84.

Gut healing agents that could be utilized in SIBO include:

a)

a. Saccharomyces cerevisiae var. boulardii Biocodex

b)

b. glutamine

c)

c. lactulose

d)

d. partially hydrolysed guar gum

e)

e. all of the above

85.

Risk factors for SIBO include all of the following except:

a)

a. moderate alcohol consumption

b)

b. use of opiates

c)

c. proton pump inhibitor use

d)

d. radiotherapy-induced enteritis

86.

Normal GI protective mechanisms against SIBO include:

a)

a. gastrointestinal secretory IgA secretion

b)

b. gastric acid

c)

c. normal intestinal motility

d)

d. all of the above

87.

In patients with SIBO, prebiotics are:

a)

a. potentially useful therapeutic tools

b)

b. contraindicated

88.

According to human research, the herbal medicines with the most supportive evidence in the treatment of Crohn's disease are:

a)

a. Aloe vera, slippery elm, and marshmallow root

b)

b. wormwood, boswellia, and turmeric

c)

c. turmeric, chamomile, and peppermint

d)

d. bilberries, turmeric, and barberry

89.

Supplementation of what vitamin that appears to be most efficacious in the treatment of Crohn's disease?

a)

a. Vitamin D

b)

b. Vitamin A

c)

c. Vitamin B12

d)

d. Vitamin B9

90.

The most important aspect of dealing with a child with viral gastroenteritis is:

a)

a. giving the right probiotic strain

b)

b. preventing dehydration

c)

c. shortening the duration of the vomiting

d)

d. shortening the duration of the diarrhea

91.

Which of the following agents can be used to treat viral gastroenteritis?

a)

a. carob powder

b)

b. cinnamon bark tea

c)

c. blackberry or raspberry leaf tea

d)

d. all of the above

e)

e. none of the above

92.

Etiological factors involved in the development of Crohn's disease include all of the following except one. Choose the exception.

a)

a. living at higher latitudes

b)

b. formula feeding in infancy and early childhood

c)

c. living in a rural environment

d)

d. recent antibiotic usage

93.

Dietary risk factors for Crohn's disease development include:

a)

a. a high refined sugar intake

b)

b. decreased consumption of vegetables and fruit

c)

c. consumption of a low fiber diet

d)

d. increased consumption of animal protein and a high total protein intake

e)

e. all of the above

94.

Conditions associated with Crohn's disease include all of the following except one. Choose the exception.

a)

a. Clostridium difficile infection

b)

b. peptic ulcer disease

c)

c. SIBO

d)

d. fructose intolerance

e)

e. lactose intolerance

95.

Dietary suggestions that may improve gastrointestinal signs and symptoms of Crohn's disease patients in remission or prevent relapse include:

a)

a. eating a predominantly plant-based diet rich in antioxidants

b)

b. low lactose or lactose free diet

c)

c. low fructose diet

d)

d. all of the above

e)

e. reducing intake of animal protein and processed foods

96.

The probiotic strains of choice in the treatment of Crohn's disease are:

a)

a. Lactobacillus rhamnosus GG and Lactobacillus johnsonii LA1

b)

b. Saccharomyces cerevisiae var. boulardii Biocodex and Bifidobacterium lactis Bb12

c)

c. Saccharomyces cerevisiae var. boulardii Biocodex and Echerichia coli Nissle 1917

d)

d. Lactobacillus johnsonii LA1 and Lactobacillus reuteri MM53

e)

e. none of the above

97.

The most appropriate probiotic strain for the treatment of viral gastroenteritis is:

a)

a. Saccharomyces cerevisiae var. boulardii Biocodex

b)

b. Lactobacillus rhamnosus GG

c)

c. Lactobacillus rhamnosus GR1

d)

d. Lactobacillus reuteri MM53

e)

e. none of the above

98.

The prebiotic of choice in IBS is:

a)

galactooligosaccharides

b)

fructooligosaccharides

c)

lactulose

d)

lactitol

e)

all of these

99.

Risk factors for the development of IBS include all of the following except:

a)

stressful life events

b)

familial disposition

c)

antibiotic use

d)

tinea versicolour

e)

acute GIT infection

100.

Other dietary considerations in IBS include:

a)

FODMAPs

b)

gluten

c)

IgG allergens

d)

all of the above

e)

none of the above

101.

What Western herbal medicine appears to have the greatest evidence in support for its use in the treatment of IBS?

a)

Turmeric

b)

Peppermint essential oil

c)

Fennel essential oil

d)

Asafoetida

102.

Choose the single answer that best answers the question. Agents that have demonstrated a capability to decrease one of the key underlying factors in IBS, visceral hypersensitivity, include:

a)

Iberogast herbal formula

b)

Melatonin

c)

Lactobacillus reuteri DSM 17938

d)

Both Iberogast and Lactobacillus reuteri DSM 17938

e)

Both Iberogast and Melatonin

103.

The main tools used to normalize bowel habits in C-IBS are:

a)

fiber

b)

exercise

c)

fluid

d)

all of the above

e)

none of the above

104.

Treatment aims in IBS include:

a)

optimizing the GIT microflora

b)

. minimize IBS symptoms

c)

diminish visceral hypersensitivity

d)

all of the above

e)

none of the above

105.

The three GIT symptoms that have the greatest negative impact upon the quality of life of IBS sufferers are:

a)

distension, diarrhea and flatulence

b)

bloating, abdominal pain and straining at stool

c)

frequent belching, bloating and straining at stool

d)

bloating, diarrhea and frequent belching

e)

none of the above

106.

Etiological factors involved in IBS include:

a)

dysbiosis

b)

altered GIT motility

c)

low-grade inflammation

d)

enhanced visceral perception

e)

all of the above

107.

What is the best rationale to base your prescribing of a particular probiotic supplement on?

a)

Claims made in a manufacturers' brochure

b)

Your clinical experience

c)

Your colleagues' clinical experience

d)

Choose the supplement with the highest CFU

e)

Clinical trial level evidence of efficacy

108.

Based on clinical trial data, the probiotic strains of choice in bacterial vaginosis are...

a)

Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14

b)

Lactobacillus acidophilus LA5

c)

Lactobacillus acidophilus NCFM

d)

Lactobaciullus rhamnosus GG

109.

Which of the following is not a significant source of dietary sulfate?

a)

Baked potato

b)

Organic dried fruit

c)

Red wine

d)

Frozen shrimp

e)

White bread

110.

Which of the following is not a health benefit of the colonic microflora?

a)

Xenobiotic metabolism

b)

Colonization resistance

c)

Modulation of the immune system

d)

Enhanced laxation

e)

Vit C production

111.

Which gut bacteria produce lactate?

a)

bacteroides

b)

e coli

c)

klebsiella

d)

lactobacillus

e)

Streptococcus

112.

What is the prebiotic of choice to prevent Traveler's diarrhea?

a)

GOS

b)

FOS

c)

Lactulose

d)

Inulin

113.

An alarm sign to be aware of when treating someone diagnosed with GERD is:

a)

Black tarry stools

b)

Dysphagia (difficulty swallowing)

c)

Vomiting

d)

Diarrhea

114.

The best probiotic strains to use in the treatment of IBS are:

a)

Bifidobacterium lactis CUL-34,

b)

Bifidobacterium bifidum CUL-20

c)

Lactobacillus acidophilus CUL-60 and CUL-21

d)

Bifidobacterium infantis 35624

e)

all of the above

115.

Carminative herbs (gas reducing) include all of the following except:

a)

dragon bloos

b)

peppermint

c)

caraway

d)

dilseed

e)

fennel seeds

116.

1. Enhance immunity - reduce infections, diarrhea, fever in toddlers

2. Enhance Ca+ absorption - enhance calbindin-D9k (Ca transporter) and lower pH

3. Improve phytoestrogen bioavailability - genistein

4. Improved medicinal herb efficacy - Important post-antibiotic therapy

5. Improve serum lipids

6. Health damaged intestines/mucosa

7. Treat and prevent atopic eczema - improve dysbiosis

8. Promote satiety and lower BW

9. Dysbiosis - Enhances bifidobacteria and decreases pathogens (clostridia, E. coli)

* Dosage: 10 g/day but start 3 g/day

a)

FOS

b)

GOS

c)

Lactulose

d)

Colonic Foods

117.

- Semi-synthetic disaccharide (fructose + galactose) made from heating lactose

- Uses:

1. Dysbiosis - Enhances Lactobacilli and Bifidobacteria, treats SIBO and salmonella

2. Candida (GIT and vaginal) from AB

3. Constipation

4. Colon cancer

5. Damaged intestinal or colonic mucosa

6. Alcoholic liver disease

7. Lowered immunity

8. Endotoxemia - give before surgery to reduce sepsis/LPS

9. Prevents UTIs

10. Atopic eczema

11. Ulcerative colitis

* Dosage: 10 g 2x/day, more for constipation and liver disease. Syrup - 5 ml = 3.5 g so 3 tsp/day, start 1 tsp

a)

FOS

b)

GOS

c)

Lactulose

d)

Colonic Foods

118.

- Non-digestible CHO produced from lactose using B-galactosiades

- Uses:

1. Dysbiosis - Enhance lactobacilli and bifidobacteria, reduce Desulfovibrio

2. Constipation

3. Atopic diseases

4. Increased resistance to infections

5. IBS - 3.5 g/day (reduce symptoms, anxiety)

6. Improved Ca+ absorption

7. Metabolic syndrome - Lower CRP, insulin, TC, TG

8. Prevent GIT infections

9. Traveller's diarrhea

* Less likely to cause bloating, gas, pain

** Dosing: 2.5 - 15 g/day

a)

FOS

b)

GOS

c)

Lactulose

d)

Colonic Foods