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1. Which of the following appropriately characterizes a probiotic:

A. Commensal native bacteria B. Live organism that provides host with a health benefit C. Metabolic byproduct of bacteria that affects host function D. Nondigestible substance that stimulates bacterial growth

2. A product that contains both a bacteria known to provide a health benefit and a carbohydrate that stimulates the activity of the bacteria in the intestinal tract is a

A. Prebiotic B. Probiotic C. Postbiotic D. Synbiotic

3. The word probiotic means

A. For life B. Good bacteria C. Healthy bacteria D. Healthy intestine

4. Microbes in the gastrointestinal tract are most plentiful in the

A. Mouth B. Ileum C. Jejunem D. Colon

5. The effects of probiotic organisms are _________ specific.

A. Bacteria B. Genus C. Species D. Strain

6. Probiotics work through a number of mechanisms. Which of the following is an immune mechanism:

A. Competition for essential nutrients B. Increasing the acidic environment of the intestine C. Modulation of cytokine production D. Strengthening the intestinal barrier

7. Which of the following is TRUE regarding the use of probiotics to treat diarrhea:

A. Antibiotic-associated diarrhea is not significantly reduced by use of lactic acid probiotics B. Probiotic use in the first day or two can decrease stool frequency and duration of diarrhea C. S boulardii has been shown to be effective in treating pediatric rotaviral infection D. Traveler's diarrhea has been significantly reduced (> 50%) by probiotic administration

8. The best evidence to date for effective treatment of Clostridium difficile infection with probiotics is a regimen of

A. L acidophilus and L bifidus B. S boulardii alone C. S boulardii with vancomycin, metronidazole or both D. No probiotic has been shown to have activity against C difficile infection

9. The best evidence to date for effective treatment of irritable bowel syndrome with probiotics using appropriately designed trials is with which of the following:

A. B infantis 35624 B. E coli Nissle 1917 C. S boulardii D. VSL#3

10. A probiotic product that has shown effectiveness in trials for treatment of pouchitis is

A. E. coli Nissle 1917 B. LGG C. S boulardii D. Combination of lactobacillus, bifodobacterium, and S thermophilus

11. A form of inflammatory bowel disease that has had disappointing study results with regard to effectiveness of probiotic therapy is

A. Crohn's disease B. Pouchitis C. Ulcerative colitis D. Results have been disappointing with all three of these diseases

12. The use of probiotics in infant formula is based primarily on

A. Clinical studies showing efficacy in preventing colic B. Comparison studies of probiotic formulas to breast-feeding C. Evidence that the early microbial environment affects overall health D. Needs of seriously ill patients for beneficial organisms

13. Healthy immunocompetent patients are most likely to experience the following risk when using lactobacillus or bifidobacteria-containing probiotics:

A. Acidosis B. Antibiotic resistance C. Sepsis D. None of the above are significant for healthy patients

14. All of the following factors can affect the viability of a probiotic ingredient in a proprietary product, EXCEPT:

A. Other ingredients in a food product B. Storage temperature C. Time since date of manufacture D. All of the above affect probiotic viability

15. In the United States, most probiotic products are marketed as

A. Dietary supplements B. Drugs C. Foods D. A and C are correct

16. Which of the following is an appropriately labeled probiotic product:

A. L bulgaricus B. L plantarum 299V C. B adolescentis D. Streptococcus thermophilus

17. Which of the following would be an improper disease-related claim by a probiotic dietary supplement:

A. Improves digestive health B. Regulates intestinal function C. Stimulates proper digestive function D. Treats irritable bowel syndrome and constipation

18. Recommendations for use of probiotic products should be based on all of the following, EXCEPT:

A. “Best by” date B. Dose of CFUs used in clinical trials C. Legal definition of probiotic D. Strain of bacteria used in clinical trials

19. When comparing doses of probiotic products

A. Activity at time of manufacture is the most important factor B. The appropriate dose is strain-specific and based on condition treated C. The number of CFUs per dose is the deciding factor on which product will be more effective D. All of the above are important factors in comparing doses

20. Patients who take a probiotic to prevent or treat antibiotic-associated diarrhea should

A. Pretreat with the probiotic for 24 hours B. Take the probiotic and antibiotic doses together C. Take the probiotic dose two hours after the antibiotic D. Take the probiotic dose four hours after the antibiotic