Multiple choice questions: ANSWERS

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1 Multiple choice questions: ANSWERS Chapter 2. Modification of the gut microbiota to promote human health 1. Bacteriocins are: b. Bacterially produced heat-stable antimicrobial peptides 2. Prebiotics, probiotics, synbiotics and antibiotics are associated with modulation of the intestinal microbiota and improvement of health. An example of a symbiotic formulation is: c. A nutritional supplement containing Lactobacillus and inulin 3. Which of these statements is false? a. Lactobacillus increases the incidence of diarrhea 4. Which in vivo model is most advantageous when studying the human intestinal microbiota? c. Human microbiota associated 5. Rodents born and raised in controlled/sterile environment and colonized with known microorganisms are: b. Gnotobiotic animals but not germ-free animals 6. Which of the following is not an important limitation of in vitro models to study the human intestinal microbiota? c. The use of different anatomical compartments of the human gastrointestinal tract 7. What is the basis of the most frequently used technique to characterize the human intestinal microbiota? a. Sequencing and targeting of the 16S rrna 8. Antibiotic-associated diarrhea can be reduced the most with: b. Probiotic consumption during antibiotic administration For reprint orders, please contact: reprints@futuremedicine.com Future Medicine Ltd

2 Multiple choice questions: answers Chapter 3. Antimicrobial and immune modulation properties of probiotics 1. Probiotics can kill pathogens by: b. Disrupting the pathogen s cell wall 2. Probiotics inhibit growth of pathogens by: 3. Antimicrobial peptides released by intestinal epithelial cells are: a. Effective against only pathogens 4. Probiotics modulate dendritic cells by: a. Increasing both anti- and pro-inflammatory cytokine production 5. Probiotic DNA has similar properties as whole probiotics, in that it can modulate intestinal mucosa by: c. Decreasing inflammatory effects Chapter 4. Prebiotics and synbiotics: how do they affect health? 1. Prebiotic fermentation results in a selective stimulation of: b. Lactic acid bacteria 2. Dietary fiber is generally not considered as a prebiotic because: c. It is not selectively fermented 3. Benefits of prebiotic fermentation include: c. An anti-inflammatory effect due to butyrate production 4. Beneficial effects of prebiotics outside the gut are mediated through: d. Signaling of short-chain fatty acids to free fatty acid receptor 2 and free fatty acid receptor 3 receptors 5. Synbiotic combinations of a pre- and pro-biotic: a. Aim to improve the survival of the probiotic during passage in the GI tract Chapter 5. Probiotic use in the critically ill 1. Which of the following is/are required to meet the WHO major criteria of a probiotic agent? 141

3 2. What is a prebiotic agent? b. An indigestible food ingredient that selectively promotes the growth or activity of beneficial bacteria, thereby benefiting the host 3. Which of the following statements best describe(s) existing clinical trials regarding probiotics in the intensive care unit? a. These studies have had limited regulatory oversight to date given that probiotics are considered dietary supplements and not pharmaceutical agents 4. Which of the following statements best describes the collective data regarding the use of probiotics to prevent ventilator-associated pneumonia? 5. How is the PROPATRIA study singularly unique compared with all other large-scale, randomized, controlled clinical trials studying probiotic use in critically ill patients? c. PROPATRIA showed increased mortality with probiotic administration Chapter 6. Use of probiotics and prebiotics in inflammatory bowel disease 1. Inflammatory bowel disease is: c. A group of chronic, relapsing disorders of the intestine with complex etiology, and primarily comprises ulcerative colitis and Crohn s disease 2. Inflammatory bowel disease is: 3. Probiotics alter the mucosal immune response by 4. Which statement is not correct? a. Both Crohn s disease and ulcerative colitis can be maintained in remission by probiotics 5. Prebiotics in inflammatory bowel disease: b. Are currently not accepted as therapeutics, mainly due to insufficient number of well-powered clinical studies 142

4 Multiple choice questions: answers Chapter 7. Use of probiotics in irritable bowel syndrome 1. Irritable bowel syndrome (IBS): b. May occur de novo following an acute bacterial gastroenteritis 2. Evidence to support a role for the gut microbiota in IBS includes all of the following, except: d. The much higher prevalence of IBS in developing nations 3. Regarding the use of probiotics in IBS: d. Probiotic products are well tolerated 4. With regard to the safety of probiotics in IBS: d. Probiotics are well tolerated and generally safe in IBS 5. Which of the following IBS-associated symptoms has been most consistently improved in response to a probiotic, in general, in IBS? a. Bloating Chapter 8. Diarrheal disease 1. There are adequate data to suggest that probiotics should be used in all patients receiving antibiotics to prevent the occurrence of Clostridium difficile-associated diarrhea. 2. In studies on the use of probiotics in the prevention of travelers diarrhea, which of the following statements is correct? d. Studies on the utility of probiotics in the prevention of travelers diarrhea are conflicting and it cannot be said definitely if they prevent travelers diarrhea. 3. There is no evidence to suggest that probiotics can alleviate the symptoms of lactose intolerance. 4. In the prevention and treatment of acute diarrhea, which of the following is correct? a. Are beneficial for shortening the duration of diarrhea in children with acute diarrhea 143

5 5. Antibiotic-associated diarrhea is uncommon, and should not be the focus of further research on the use of probiotics to prevent it. 144