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1. Probiotics

A. Are harmful bacteria B. Are normally measured in grams/mL C. Always require refrigeration D. May be present in foods as well as dietary supplements

2. Prescribers' opinion of probiotic use for their patients is

A. Concern about safety issues B. Generally negative C. Generally positive for gastrointestinal (GI) indications, such as irritable bowel syndrome (IBS) D. Positive regarding the level of evidence of effectiveness available

3. Which of the following is a mechanism by which probiotics are thought to counteract pathogenic organisms:

A. Decreasing immunomodulation and phagocytosis B. Decreasing inflammatory cytokine production C. Raising the pH in the GI tract D. Strengthening the epithelial lining

4. Which of the following is most important in choosing an appropriate probiotic product:

A. Cost B. Dosage form C. Probiotic strain D. Product name

5. Manufacturers of probiotic dietary supplements

A. Are required by law to report a “use by” date on the label B. Can make claims related to treatment or cure if evidence exists C. Can only make structure function claims for their products D. Should only use a powder dosage form because of viability issues

6. The most common probiotic organisms are:

A. Lactobacilli strains B. Streptococcus thermophilus C. Saccharomyces boulardii D. Streptococcus faecalis

7. A prebiotic is a

A. Developing probiotic organism B. Metabolic product of a probiotic organism C. Source of nutrition for a probiotic D. Toxic metabolite of a probiotic

8. Uses of probiotics for which quality evidence is available includes all of the following EXCEPT:

A. Antibiotic-associated diarrhea (AAD) B. Rotavirus diarrhea in infants and young children C. Crohn's Disease D. IBS

9. All of the following probiotic products require refrigeration EXCEPT:

A. Align Probiotic Supplement B. Florajen Probiotic Dietary Supplements C. Lactinex D. VSL#3

10. Which of the following are the most commonly reported side effect(s) of probiotic administration:

A. Bacteremia B. Bloating, gas, and abdominal discomfort C. Endocarditis D. Liver abscess

11. For which of the following patients would you be most concerned about the use of a probiotic product:

A. Has a milk allergy B. Diagnosed with Clostridum difficile diarrhea C. Receiving immunosuppressive chemotherapy D. Taking an antibiotic

12. Which of the following is an evidence-based database that rates the use of probiotics for the treatment of GI diseases, using an A - F scale:

A. American Academy of Pediatrics (AAP) B. Natural Medicines Comprehensive Database C. Natural Standard D. World Gastroenterology Organisation (WGO)

13. Which of the following is appropriate dosing information for taking a probiotic to treat antibiotic-associated diarrhea (AAD):

A. Space the antibiotic and probiotic doses 2 hours apart B. Start the probiotic when the course of antibiotic therapy is finished C. Start the probiotic dose 3 days prior to initiating antibiotic therapy D. Take the probiotic dose and antibiotic dose together

14. It is estimated that _____ patients need to be treated with probiotics to prevent 1 case of antibiotic-associated diarrhea (AAD).

A. 5 B. 8 C. 13 D. 20

15. The use of which one of the following probiotic strains is recommended for the treatment of rotaviral diarrhea in young children?

A. Align Probiotic Supplement B. Culturelle C. Florajen Probiotic Dietary Supplements D. VSL#3

16. VSL#3 has the best evidence basis to support its use for the treatment of which of the following conditions:

A. Acute infectious diarrhea B. IBS C. Inflammatory bowel disease (IBD) D. Lactose intolerance

17. Align Probiotic Supplement is rated as effective for improving the symptoms associated with which of the following:

A. C difficile-associated diarrhea (CDAD) B. H pylori associated diarrhea C. IBS D. Pouchitis

18. Yogurt containing Lactobacillus bulgaricus and Streptococcus thermophilus is recommended for the treatment of symptoms associated with which of the following:

A. Acute infectious diarrhea B. Antibiotic-associated diarrhea C. Lactose intolerance D. Traveler's diarrhea

19. Does the AAP recommend the supplementation of infant formula with probiotics?

A. Yes, the AAP recommends supplementation with LGG B. Yes, the AAP recommends supplementation with B infantis C. Yes, the AAP recommends supplementation with S thermophilus D. No, the AAP does not recommend the addition of probiotic supplementation at this time