Here is Part2 for Questions 6-10 to follow the previous Part1 for Questions 1-5. To get the most out this exercise, you should look at the questions first—they are provided below
6. Your patient has a persistent inflammatory/metabolic disease. The microbial stool analysis did not show evidence of inflammation or dysbiotic colonization, and you suspect the presence of a nonculturable microbe. Segmented filamentous bacteria have been found in the gastrointestinal tract of humans and are specifically and most importantly noted to increase which of the following:
A. Superantigens
B. BactDNA
C. Butyrate
D. P-cresol
E. Treg cells
F. Th17 cells
G. B cells
7. Your patient wants to be informed of options to hypoglycemic drugs for the treatment of diabetes. The antidiabetic effect of metformin is most similar (clinical effectiveness, impact on microbiome) to which of the following treatments:
A. Artemesinin
B. Oregano
C. Berberine
D. Rifaxamin
E. Vitamin D
8. Microbe-induced disorders can be treated with a variety of strategies, including antimicrobial therapy. Eradication of Staphylococcus aureus in the nares is most affordably, safely, and effectively accomplished by which of the following:
A. Trimethoprim-cotrimoxazole
B. Cephalexin
C. Povidone iodine
D. Mupirocin
E. Vancomycin
F. Metronidazole
9. The ability to achieve sustained remission in rheumatoid arthritis is impressively low with the use of current immunosuppressive and antiinflammatory drugs (Prince et al. Sustained rheumatoid arthritis remission is uncommon in clinical practice. Arthritis Research & Therapy 201214:R68 doi:10.1186/ar3785). In the treatment of the orodental dysbiotic component of rheumatoid arthritis, the most important initial component of the treatment plan, for reducing pain and inflammation, is scaling and planing. Improving orodental health has been shown to reduce pain and inflammation in patients with rheumatoid arthritis. While some of the benefit is via nonspecific reductions in gingival permeability and bacterial inflammogen load/absorption, the specific goal is to reduce/eradicate Porphyromonas gingivalis because of its production of which of the following?
A. Peptydil-arginine deiminase
B. Transglutaminase
C. Acid phosphatase
D. Peptidase
E. Protease
F. Beta-glucuronidase
10. Microbial molecules are capable of inducing a wide range of human physiologic disruption. Which of the following microbial molecules is noteworthy for its abilities to 1) promote systemic inflammation, 2) increase intestinal permeability, 3) impair cytochrome p450 "detoxification" enzymes, 4) impair mitochondrial function and ATP production, and 5) promote pain sensitization via peripheral and central mechanisms:
A. Lipoteichoic acid
B. Lipopolysaccharide
C. Acetate
D. Peptidoglycan
E. Bacterial capsule
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