2025 RAC Practice Exam: Questions and Answers, Exams of Medicine

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A physician reports to a manufacturer that a patient was hospitalized with acute sepsis after treatment with an approved device. This side effect is not listed in the package insert. This event must be reported by the manufacturer to FDA no later than: A. 5 calendar days. B. 15 calendar days. C. 30 calendar days. D. The next quarterly or annual report. - ✔✔C. 30 calendar days. Serious injury must be reported within 30 days. 21 CFR 803.50(a). Under the IDE regulation, all of the following must be reported to the sponsor within five working days EXCEPT:

A. A deviation from the investigational plan. B. Withdrawal of IRB approval. C. An unanticipated adverse device effect. D. Use of a device without informed consent. - ✔✔C. An unanticipated adverse device effect. The investigator notifies the sponsor and IRB within 10 days of notification of any unanticipated adverse effect. 21 CFR 812.150. When design verification testing is being performed by a manufacturer, which element is NOT included as a potential requirement under device design verification section of the QSR? A. Identification of the design. B. Software validation.

C. Identification of test methods used. D. Name of individuals performing the testing. - ✔✔C. Identification of test methods used. Refer to 820.30(f) Under the statutory violations, lack of an approved PMA for a PMA device that is not exempt and is in commercial distribution is considered to be: A. Adulteration B. Improper use C. Misbranded D. Fraudulent - ✔✔A. Adulteration PMA products introduced into commercial distribution without an approval PMA are considered to be adulterated. FD&C Act 501(f).

A manufacturer of the following must file an IDE before conducting a human clinical study? A. A device in commercial distribution before 28 May 1976 when used or investigated in accordance with its indications in labeling in effect at that time. B. A device intended solely for veterinary use. C. A custom device being studied for safety and effectiveness. D. A device in commercial distribution before 28 May 1976 when used or investigated in accordance with its indications in labeling in effect at that time. And a device intended solely for veterinary use. - ✔✔C. A custom device being studied for safety and effectiveness. While a custom device may be studied in humans without an IDE, if its safety and efficacy are being studied in support of commercial marketing, an IDE must be filed (21 CFR 812.2(c)(7)

The regulatory affairs professional performs all of the following prior to submitting a PMA to FDA EXCEPT: A. Preparing criteria for the MDR report. B. Preparing a brief statement of reasons for noncompliance with regulation. C. Identifying all omissions in PMA content. D. Reviewing, organizing and checking adequacy of data pertaining to safety and efficacy evaluation. - ✔✔A. Preparing criteria for the MDR report. MDR reporting is a post PMA approval requirement. Which of the following sections is required in a PMA? A. Patent certification information. B. A copy of quality manual. C. An economic cost/benefit assessment.

D. A discussion of benefit and risk considerations. - ✔✔D. A discussion of benefit and risk considerations. See 21 CFR 814.20(b)(3)(vi). Subacute toxicity testing should be performed: A. In two rodent species. B. In one rodent and one non-rodent species. C. For a minimum of two weeks. D. For a minimum of six months. - ✔✔B. In one rodent and one non-rodent species. See ICH guideline M3 Maintenance of The ICH Guideline on Non-Clinical Safety Studies for The Conduct of Human Clinical Trials for Pharmaceuticals.

What FDA clearances are required to export a drug approved by FDA? A. Certificate of Free Sale. B. Customs Tax Stamps. C. No clearance required. D. FDA receipt for sample Form-484. - ✔✔C. No clearance required. There are no FDA export requirements for approved products. Fully quality-assured individual toxicology reports are not required for submission of an initial IND application. However, finalized and fully quality assured reports should be available to FDA upon request within what period of the start of the human study? A. 90 days. B. 120 days.

C. One year. D. The final report is only required in the submission for the NDA. - ✔✔B. 120 days. See FDA "Guidance for Industry Q & A: Content and Format of INDs for Phase 1 Studies of Drugs, Including Well-Characterized, Therapeutic, Biotechnology- Derived Products." October 2000. With respect to drug product distribution procedures, a distributor is required to do all of the following EXCEPT: A. Establish a system whereby the oldest approved stock of a drug is distributed last. B. Establish written procedures describing the distribution of drug products. C. Establish a system whereby the oldest approved stock of a drug is distributed first.

D. Establish a system by which the distribution of each lot of drug product can be readily determined to facilitate its recall if necessary. - ✔✔A. Establish a system whereby the oldest approved stock of a drug is distributed last. According to §211.150, this is not required of a distributor since this way of rotating stock would potentially allow a drug product to expire in storage while awaiting distribution. Because of reported dispensing errors due to the similarity of proprietary drug names, one of the companies involved has decided to quickly and voluntarily notify physicians and others responsible for providing patient care about the issue via a "Dispensing Error Alert". In this approach, the company is NOT required to: A. Use first class mail and number 10 white envelopes. B. Use appropriate language on the outside of the mailing envelope that indicates the nature of the alert. C. Notify FDA of its action prior to disseminating the dispensing alert notification.

D. Include its name and address in the upper left hand corner of the envelope. - ✔✔C. Notify FDA of its action prior to disseminating the dispensing alert notification. Because of the potential safety issue, the company may elect to act quickly and disseminate the "alert" without prior submission to FDA. A regulatory affairs professional wants to schedule a pre-NDA meeting with the FDA. He or she should: A. Write a letter to the FDA. B. Request a Type B meeting as an amendment to the IND. C. Call the project manager and set up a date over the phone. D. Email the division director with a list of three dates, 30 days into the future. - ✔✔B. Request a Type B meeting as an amendment to the IND.

See the CDER/CBER guidance published in February 2000 entitled "Formal Meetings With Sponsors and Applicants for PDUFA Products". Which one of the following statements is NOT true with respect to both Investigational New Drug Applications (INDs) and Investigational Device Exemptions (IDEs) for significant-risk products? A. The investigational product must be manufactured in full compliance with cGMP. B. Clinical studies must be approved by an Institutional Review Board. C. The IND or IDE goes into effect 30 days after FDA receives the application, unless FDA notifies the sponsor otherwise. D. The application must include an environmental impact statement that contains a claim for categorical exclusion or an environmental assessment. - ✔✔A. The investigational product must be manufactured in full compliance with cGMP.

Devices under approved IDEs are exempt from cGMP regulations except for design control requirements; investigational new drugs must be compliant with cGMP for finished pharmaceuticals (21 CFR 211). When the proprietary name or designation is used in promotion, the following is TRUE: A. The proprietary name or designation can, in certain instances, be used without the accompaniment of the established name. B. The established name shall be printed in letters that are at least half as large as the letters comprising the proprietary name or designation with which it is joined. C. The established name shall be printed in letters that are at least 1⁄4 as large as the letters compromising the proprietary name or designation. D. The proprietary name or designation must be printed in letters at least twice as large as the established name. - ✔✔B. The established name shall be printed in letters that are at least half as large as the letters comprising the proprietary name or designation with which it is joined.

This is true under 21 CFR 202.1(b)(2) A regulatory affairs professional is developing SOPs for a firm to cover compliance with drug GMPs. The firm's SOPs should require out-of-specification (OOS) test results to be completed within: A. A timely manner. B. 20 days. C. 30 days. D. 45 days. - ✔✔A. A timely manner. 21CFR 211.192 require an investigation, but do not specify a time frame. October 2006 GMP guidance states that investigation of out-of-specification test results should be timely.

Which information MUST be included in an IND? A. A list of all components used in the manufacture of the investigational drug product. B. A statement of compliance with applicable GMPs. C. Statistical methods to be used in the analysis of phase II and III clinical trials. D. Results of accelerated stability studies on three lots of the investigational drug product. - ✔✔A. A list of all components used in the manufacture of the investigational drug product. See 21 CFR 312.23(a)(7)(iv)(b). Which of the following documentation is NOT included in a Biologics License Application? A. Stability data.

B. Product labeling. C. GLP compliance statement(s). D. Overall quality summary. - ✔✔D. Overall quality summary. An overall quality summary is a CTD requirement, not a BLA requirement. Under IND/IDE regulations, obligations of a clinical study investigator do NOT include: A. Providing a final study report to the IRB. B. Protecting the rights, safety and welfare of study subjects. C. Controlling the drug under investigation. D. Returning unused supplies of the drug to the sponsor. - ✔✔A. Providing a final study report to the IRB.

21 CFR 312.64 - The investigator is not obligated to submit reports to the IRB. Investigators are responsible for submitting reports to the sponsor (i.e. - progress reports, safety reports, a final report). To be legally effective, a witness must observe the informed consent process at which of the following times? A. When the study subject is a minor. B. When the elements of informed consent are presented orally. C. When the consent is obtained from the subject's legal representative. D. When the elements of informed consent are written in a foreign language. - ✔✔B. When the elements of informed consent are presented orally. FDA regulations require a witness to an oral presentation of elements of informed consent to the subject or the subject's legally authorized representation. 21 CFR 50.27(b)(2).

FDA will do a for-cause inspection of an investigator if the investigator: A. Conducts a number of pivotal NDA studies. B. Is only participating in a small number of studies. C. Appears to have an excessive number of study projects. D. Consistently reports results different from other investigators. - ✔✔D. Consistently reports results different from other investigators. An inspection will be conducted if an investigator's results are inconsistent with those of other investigators and fraud is suspected. Which of the following federal laws includes information about ANDA submissions? A. Antibiotic Amendments of 1945. B. Durham-Humphrey Amendment of 1951.

C. Drug Amendments of 1962. D. Drug Price Competition and Patent Term Restoration Act of 1984. - ✔✔D. Drug Price Competition and Patent Term Restoration Act of 1984. This Act permitted manufacturers to use abbreviated NDAs to gain approval for generic versions of approved drugs whose patents had expired. A company's supplier of the active drug substance for the company's OTC drug product informs the company that the supplier will be moving their production of the drug substance from the current plant to a new manufacturing plant in another state in 6 months. The supplier states that all manufacturing processes will remain the same and the specifications will not change. The company intends to qualify the change suitably. How should the company report the change to FDA?

The change only needs to be reported in an annual report because the company will qualify the change and the supplier said the process and specifications won't change. B. The change should be reported in a pre-approval supplement (e.g., CBE, CBE- 30 or full pre-approval supplement) because it is a change to the drug substance manufacturing location. C. The change does not have to be reported because it is an OTC drug. D. Not enough information. - ✔✔D. Not enough information. It is unclear from this question if the OTC drug product is an OTC monograph product for which there would be no FDA administrative file to report the change to, or if this is an NDA-OTC drug product (versus an NDA-Rx drug product). For an NDA-OTC drug product, the company would have an approved NDA file where they could send a supplement for review. All of the following are additional IND submissions to FDA EXCEPT:

A. Information amendments. B. Protocol deviations. C. IND safety reports. D. Annual reports. - ✔✔B. Protocol deviations. Protocol deviations are departures from the specific procedure as described in the protocol or protocol amendment without prior IRB approval. They need to be reported to the sponsor and are reported to the IRB, per their individual guidelines. A minimum of 10 tablets is required to perform all tests for product release. To meet GMP requirements, reserve samples must be at least: A. 10 tablets. B. 20 tablets. C. 30 tablets.

D. 100 tablets. - ✔✔B. 20 tablets. The reserve sample consists of at least twice the quantity necessary for each required test. 21 CFR 211.170(a). When assembling an NDA, all of the following are required EXCEPT: A. Proposed labeling. B. Nonclinical toxicology studies. C. Bioequivalence studies. D. Manufacturing information. - ✔✔C. Bioequivalence studies. Bioequivalence data is required in an ANDA, not a NDA, see 21 CFR 314.94(7). A company has found a way to produce its drug product more economically; however, the current manufacturing process would have to be changed

substantially. What would be the most appropriate post-approval vehicle for this potential action? A. Post-Approval Supplement: Changes Being Effected - Immediate (CBE 0). B. Post-Approval Supplement: Changes Being Effected in 30 Days (CBE 30). C. Prior approval supplement. D. Annual report. - ✔✔C. Prior approval supplement. Changes made under this designation are considered to be major, representing a high potential to have an adverse effect on the identity, strength, quality, purity or potency of a drug product. Since the changes to the current manufacturing process are substantial, the potential of the proposed change(s) to adversely effect the identity, strength, quality, purity or potency of the drug product is high and, thus, represent(s) a major change. See FDA's "Guidance for Industry Changes to an Approved NDA or ANDA. See also 21CFR §314.70(b).

In preparing the list of components of a drug product to include in an NDA, the regulatory affairs practitioner should submit: A. The list of all active ingredients, antimicrobial preservatives and antioxidants, with their pharmaceutical grades and the names of the suppliers. B. Drug Master File referral letters from each supplier of active ingredients, antimicrobial preservatives and antioxidants. C. GMP Certifications from the suppliers of all active ingredients and excipients. D. The list of all components used in the manufacture of the drug product, regardless of whether they appear in the drug product. - ✔✔D. The list of all components used in the manufacture of the drug product, regardless of whether they appear in the drug product. All information required in the regulation is provided. 21 CFR 314.50(d)(1)(ii). Which of the following is NOT TRUE for a Memorandum of Understanding (MOU)?

A. MOUs clarify the regulatory responsibilities between the FDA and other federal agencies. B. MOUs delineate roles and authority of the FDA and state governments. C. New MOUs are announced in the Federal Register. D. MOUs are binding agreements that describe the inspection procedures used by agencies collaborating with the FDA. - ✔✔D. MOUs are binding agreements that describe the inspection procedures used by agencies collaborating with the FDA. MOUs are non-binding agreements. In order to ensure that a facility complies with GMP requirements, all of the following features should be evaluated EXCEPT: A. Air handling system.

B. Animal supply facilities. C. Lighting. D. Potable water. - ✔✔B. Animal supply facilities. Evaluation of animal supply facilities does not fall under GMP, but rather falls under GLP, 21 CFR 58.45. Under whose authority can an imported drug, device or biologic be detained or refused entry into the US? A. US Department of Agriculture. B. US Customs. C. FDA. D. FBI. - ✔✔B. US Customs.