Lesson 52 - Final Course Completion Quiz - Kresser Institute Membership Site

Question 1 of 40

The exposome is:

a. All of the mutations an individual’s genome undergoes in his or her lifetime.
b. The sum of all non-genetic exposure in an individual’s lifetime.
c. The environment an individual deliberately exposes him or herself to over the course of a day.
d. All of the healthcare system-related inputs in an individual’s lifetime.

Question 2 of 40

The gut microbiota’s primary function(s) are:

a. Metabolic
b. Protective
c. Structural
d. All of the above

Question 3 of 40

The focus of the reset diet is to:

a. Eliminate foods that contribute to disease.
b. Focus on safe, nourishing foods.
c. Eliminate foods that people are most often intolerant or sensitive to.
d. All of the above.

Question 4 of 40

If a patient is resisting making many dietary changes, you can have them focus on:

a. Creating a list of all their obstacles to address at a follow-up visit.
b. Adding one or two key supplements to their daily routine.
c. Starting an exercise regimen.
d. Eliminating refined flour, refined sugar, and industrial seed and plant oils.

Question 5 of 40

What is the difference between Crohn’s disease and ulcerative colitis?

a. UC is restricted to the colon and rectum while Crohn’s can occur anywhere in the GI tract.
b. UC can affect all layers of the mucosa while Crohn’s is in the smooth muscle.
c. UC requires a biopsy for diagnosis while Crohn’s does not.
d. None of the above.

Question 6 of 40

Who should get tested with Cyrex Array 3?

a. Anyone who tests positive for a lactose intolerance.
b. Anyone who presents with fatigue or difficulty sleeping.
c. Anyone who is currently eating wheat/gluten or wants to be able to.
d. A & C

Question 7 of 40

How do we define and treat insufficiency dysbiosis on a stool analysis?

a. It is an overgrowth of yeast that does not allow for healthy amounts of bacteria. Treated with antifungal botanicals.
b. It is a deficiency of micronutrients in the diet that doesn’t allow for a fully populated microbiome. Treated with diet and micronutrient supplementation.
c. It is the lack of beneficial bacteria. Treated by rebuilding beneficial bacteria with pre- and probiotics.
d. It is an overgrowth of dysbiotic bacteria leading to malabsorption issues. Treated with botanicals or antibiotics, if serious.

Question 8 of 40

What beneficial functions does H. pylori have if acquired in infancy?

a. Protects against development of allergies and asthma.
b. Decreases ghrelin and increases leptin, which helps regulate appetite.
c. A & B
d. None of the above.

Question 9 of 40

What factors influence the pathogenicity of H. pylori?

a. Host environment
b. Timing of acquisition
c. Strain
d. All of the above

Question 10 of 40

Why can patients with SIBO have such a wide range of symptoms?

a. Symptoms tend to change as SIBO flare-ups occur in each patient.
b. Different types of flora can produce many different metabolites and toxins.
c. Side effects of botanical treatment protocols are often mistaken for symptoms.
d. All of the above

Question 11 of 40

Is there greater risk in over- or under-treating SIBO, and why?

a. Undertreating. SIBO that is untreated can become drug resistant after too long.
b. Undertreating. Both botanical and pharmaceutical treatments are quite safe.
c. Overtreating. Treatment protocol side effects are frequent and too severe to risk in misdiagnosed patients.
d. Overtreating. The cost of treatment protocols is very high and misuse can mean they aren’t able to afford care for their true issues.

Question 12 of 40

What are the components of the female athlete triad?

a. Calorie deficiency, insomnia, and irregular menstrual cycles.
b. Insomnia, weight gain, and irregular periods.
c. Skin problems, menstrual changes, and fatigue.
d. Calorie deficiency, menstrual changes, and osteopenia/osteoporosis.

Question 13 of 40

Why is re-testing so important during treatment of SIBO?

a. It’s necessary to know whether treatment was successful.
b. Symptom improvement occurs before breath test normalization, so early treatment discontinuation usually leads to recurrence.
c. If symptoms don’t improve in accordance to improved test results, it suggests that there is another underlying condition.
d. All of the above

Question 14 of 40

Why is a low-FODMAP diet not advised during SIBO treatment?

a. It leads to dormant non-dividing bacteria, which makes antimicrobials less effective.
b. It was found in studies to lead to deficiency of several micronutrients crucial for repopulating healthy bacteria in the gut.
c. Several foods not allowed on a low-FODMAP diet increase the absorption of antimicrobials used to treat SIBO.
d. B & C

Question 15 of 40

What are the three main considerations for treating SIBO?

a. Duration of treatment, retesting, and whether hydrogen, methane, or both are elevated.
b. Past SIBO episodes, duration of treatment, and whether hydrogen, methane, or both are elevated.
c. Whether hydrogen, methane, or both are elevated, concurrent treatment protocols of the patient, and results of stool cultures.
d. Duration of treatment, drug allergies, and the ability of the patient to do monthly breath tests.

Question 16 of 40

What is the treatment length for H. pylori?

a. Three months, followed by a retest
b. Until gut symptoms resolve
c. 30 days of pharmaceuticals, followed by two months of botanical treatment
d. 30 days followed by a retest

Question 17 of 40

What is a major differentiating factor for how irritable bowel syndrome (IBS) is diagnosed versus other gut pathologies?

a. It requires referral to a specialist for testing before being diagnosed.
b. It is a diagnosis of exclusion, when other gut pathologies are not the correct diagnosis.
c. It can be diagnosed just from symptoms, which are different enough to be defining.
d. None of the above.

Question 18 of 40

What is the core theory behind the low fermentation potential diet?

a. Fermented foods actually feed harmful bacteria in SIBO and thus should not be eaten by patients with gut dysbiosis.
b. Patients eliminate all high-fiber-content foods since those are more prone to feeding overgrown bacteria.
c. Carbohydrates with a low fermentation potential deprive overgrowing bacteria of food since they are rapidly absorbed high up in the gut.
d. B & C

Question 19 of 40

What approach should be taken in patients with genetic causes of elevated LDL-P?

a. Low-carb diet
b. Focusing their fat intake primarily on saturated fats
c. “Mediterranean” Paleo with lower fat and higher starch intake
d. Botanical cholesterol-lowering therapies

Question 20 of 40

How does the body protect itself from chronically elevated cortisol levels?

a. Downregulating the HPA axis.
b. Reducing cortisol production.
c. Downregulating expression of glucocorticoid receptors.
d. All of the above.

Question 21 of 40

Which test is one of the most reliable measures of HPA axis responsiveness or function?

a. Morning free cortisol test
b. TSH
c. Norepinephrine levels
d. Insulin tolerance test

Question 22 of 40

What blood sugar targets should patients look for at one and two hours after a meal, respectively?

a. Under 140mg/dL, and under 180mg/dL
b. Both should be under 120mg/dL
c. Under 140mg/dL, and under 120mg/dL
d. Under 100mg/dL, and under 140mg/dL

Question 23 of 40

What are the three basic categories of HPA axis function assessment?

a. Salivary cortisol levels, medication history, and sleep assessment
b. Signs, symptoms, and history; laboratory tests; and perceived stress questionnaires
c. Signs and symptoms, laboratory tests, and medication history
d. Salivary cortisol levels, sleep and stress questionnaires, and laboratory tests

Question 24 of 40

What method of cortisol testing captures information on over 50 percent of cortisol production in a 24-hour period?

a. Urine cortisol testing
b. Four-point saliva testing
c. Cortisol awakening response
d. A free cortisol test within 60 minutes of waking

Question 25 of 40

Iron overload is associated with what conditions?

a. Hyperthyroidism
b. Impaired insulin sensitivity and glucose tolerance
c. High blood pressure
d. All of the above

Question 26 of 40

What basic lipid test correlates well for LDL particle number?

a. LDL/HDL ratio
b. Total cholesterol/HDL ratio
c. VLDL cholesterol
d. LDL cholesterol minus triglycerides

Question 27 of 40

Which biomarker is the most sensitive marker for predicting future diabetes and heart disease?

a. Hemoglobin A1c
b. Post-meal blood sugar
c. Fasting glucose
d. Fructosamine

Question 28 of 40

What is the most sensitive marker for detecting iron deficiency?

a. Serum iron
b. Transferrin saturation percentage
c. Ferritin
d. Red cell distribution width

Question 29 of 40

What decreases intake or absorption of iron?

a. Plant-based diets without the heme form
b. High stomach acid
c. Proton pump inhibitors
d. A & C

Question 30 of 40

B12 deficiency symptoms can mimic what disease(s)?

a. Respiratory conditions like asthma and COPD
b. Those commonly associated with aging
c. Type 2 diabetes
d. All of the above

Question 31 of 40

What is the relationship between inflammation and serum zinc and copper, respectively?

a. Both direct
b. Both inverse
c. Inverse and direct
d. Direct and inverse

Question 32 of 40

Production of what biomarker precedes clinical hypothyroidism by years, or even decades?

a. Thyroid antibodies
b. Reverse T3
c. TPO
d. Cellular T4

Question 33 of 40

TSH levels above what threshold are shown to increase the chance of developing future clinical hypothyroidism?

a. 1.5
b. 2
c. 3
d. 4.5

Question 34 of 40

What nutritional consideration(s) need to be made in chronic kidney disease?

a. Ensuring adequate magnesium intake
b. Balancing fat-soluble vitamin intake
c. Reducing sodium intake in sensitive patients
d. All of the above

Question 35 of 40

Which biomarker is expected to be elevated in a textbook example of iron-deficiency anemia?

a. Hematocrit (Hct)
b. Red blood cell distribution width (RDW)
c. Mean corpuscular volume (MCV)
d. All of the above

Question 36 of 40

What is the greatest predictor of heart disease risk?

a. Total cholesterol
b. LDL cholesterol
c. Number of low-density lipoproteins in blood
d. Inflammation as measured by CRP

Question 37 of 40

The apoB mutation in familial hypercholesterolemia causes dyslipidemia by what mechanism?

a. Increasing triglyceride production
b. Decreasing LDL particle clearance from the bloodstream
c. Increasing LDL particle size
d. All of the above

Question 38 of 40

Impaired methylation leads to a buildup of what metabolite?

a. B12
b. Methionine
c. Homocysteine
d. C-reactive protein

Question 39 of 40

Which two nutrients are most important for methylation?

a. Vitamins D and B12
b. Vitamin B12 and folate
c. Omega-3s and magnesium
d. CoQ10 and folate

Question 40 of 40

Why does B12 deficiency get more common as patients age?

a. Functional ranges increase with age.
b. Dietary intake seems to decrease with age.
c. SIBO and H. pylori infection get more common with age.
d. All of the above.

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