RATIO - CEE 4 – WRITTEN MODULAR EXAM – MODULE 6

MODULE 6: QUALITY ASSURANCE AND QUALITY CONTROL

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Prepared by: Joyce Gem Canete, RPh | Celine Angelica Garcia, MD | Danielle Matuguinas, RPh
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PART 1 – QA-QC (45 ITEMS)

1. Which of the following statement(s) is/are TRUE about Determinate Errors?

(I) Error is caused by uncontrolled variables.
(II) Error can be detected.
(III) Error can be eliminated.
(IV) Also known as random error.

a. II and III only

b. I and IV only
c. I and III only
d. II and IV only

Determine errors are also called systematic errors. They are reproducible and can be discovered or corrected.

Determinate errors include instrument errors, method errors, and personal errors. The cause for this error can
be determined from any of the abovementioned, hence the name.

2. Which of the following statement(s) is/are TRUE about Acid Value?

I. A substance's AV increases upon aging

II. Also known as Acetyl Value
III. Determined by titrating the substance against standard alkali solution
IV. Equal to the mg of KOH needed to neutralized free acids and saponify esters

a. II and IV only
b. I and III only
c. I and IV only
d. II and III only

Upon aging, the acid value increases slowly at first and more rapidly later, especially if the substance is not well
protected from light & air. High acid value does not necessarily indicate rancidity.

Acid value is defined as the number of mg of KOH (an alkali) necessary to neutralize the free acids in 1 g of oil,
fat, wax, resin, balsam, or similar organic substance of complex composition.

If amount of KOH needed to neutralize AND saponify, you now call this saponification value.

3. A lubricant's Saponification Value and Ester Value are 205 and 140, respectively. What is its Acid Value if
15 grams of the lubricant was titrated against a standard alkali solution?

a. 65
b. 975
c. 4.33
d. 345

SV = AV + EV

AV = SV – EV
AV = 205 – 140 = 65

4. Semi-drying oils like olive oil and almond oil have Iodine Values ranging from 100 - 120.
Oils used for IM injection (e.g. Cottonseed oil) are non-drying type.
a. Only Statement 1 is correct
b. Only Statement 2 is correct
c. Both statements are correct
d. Both statements are incorrect

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 TYPES OF EXAMPLES IV
OILS
Drying Linseed oil, Cod > 120
liver oil
Semi-drying Corn oil, 100 -
Cottonseed oil, 120
Peanut oil,
Sesame oil
Non-drying Olive oil, Almond < 100
oil

CoCoPeSe are considered non-aqueous vehicles used in IM parenteral preparation.

5. Karl Fischer Reagent usually contains:

I. Iodine
II. Sodium chloride
III. Pyridine
IV. Methanol, anhydrous

a. I and III only

b. II and IV only
c. I, III and IV only
d. All of the above

KFR contains PIMS

Pyridine – is a base that helps stabilize the reaction (prevents its reversal) and maintain the pH at a suitable level
for the reaction to proceed. (Note: Imidazole can also be used)
Iodine - Iodine reacts with water to form hydrogen iodide/hydroiodic acid
Methanol, anhydrous - Prevents formation of pyridine-sulfur complex
Sulfur dioxide – Reacts with water to form sulfur trioxide, which will then react with the hydrogen iodide →
iodide ions. SO2 also acts as a reducing agent, preventing the oxidation of iodide ions to iodine and ensuring that
the reaction proceeds to completion.

6. The following are methods to determine moisture content EXCEPT:

a. Coulometric Method using KFR

b. Gravimetric Method
c. Azeotropic Distillation
d. None of the above.

These are methods of determining moisture content:

METHOD 1: TITRIMETRIC METHOD/KARL FISCHER METHOD
Method 1a - Direct Titration
Method 1b - Residual Titration
Method 1c - Coulometric Titration
METHOD 2: AZEOTROPIC DISTILLATION
METHOD 3: GRAVIMETRIC METHOD

7. A 980-milligram residue was retrieved after subjecting a 55-gram sample of acacia to incineration under
dull red heat. The retrieved residue was further treated using 3N HCl, leaving and an acid-insoluble
residue weighing 0.45 grams. SOLVE FOR THE % TOTAL ASH.

a. 17.82 %
b. 0.82 %
c. 5.61 %
d. 1.78 %

TOTAL ASH represents the inorganic salts/substances present (residue remaining after incineration)

%TA = (wt. total ash/ initial wt. of sample) * 100

= (980mg/55,000mg) * 100
= 1.78%

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 8. Endpoint for the standardization of 0.1 N Ce(SO4)2

a. Faint Pink Color

b. Formation of red ppt
c. First Appearance of red color
d. Blue color

Endpoint for different pharmaceutical assays:

Permangonometry – faint pink
Cerimetry – red to blue
Volhard method – reddish-brown ppt
Mohr method – appearance of first permanent white ppt

9. In the Assay of Hydrogen Peroxide, every molecule of H2O2 loses ____ electron(s).

a. 5
b. 10
c. 2
d. 4

H2O2 is usually an oxidizing agent (OA) but in this case it acts as a reducing agent (RA).

As an OA, hydrogen peroxide readily accepts electrons from other species and is reduced itself. This reaction
can be represented as follows:

H2O2 + 2e- → 2H+ + O2

Here, hydrogen peroxide gains two electrons (2e-) and is reduced to water while the other species (oxidizable
species) loses electrons and is oxidized.

As an RA, hydrogen peroxide donates electrons to oxidizing species and is itself oxidized. This reaction can be
represented as follows:

H2O2 → O2 + 2H+ + 2e-

Here, hydrogen peroxide loses two electrons (2e-) and is oxidized to oxygen while the other species (reducible
species) gains electrons and is reduced.

Overall, the redox reaction of hydrogen peroxide can be represented as follows:

2 H2O2 + 2 e- → 2 H2O + O2

This reaction shows that for every two molecules of hydrogen peroxide reduced, four electrons are
transferred, and one molecule of oxygen gas (O2) is produced. (In other words, 1 molecule = 2 electrons)

10. A 0.2500g sample of Na2C2O4 (98%) required 36 mL of KMnO4 solution in a titration. Solve for the
Normality of the KMnO4.

MW of Na2C2O4 is 134 g/mol.

a. 0.1016 N
b. 1.1000 N
c. 0.1190 N
d. 1.0109 N

To solve for the normality of KMnO4.

𝑤𝑡 𝑜𝑓 𝑠𝑎𝑚𝑝𝑙𝑒 𝑥 𝑃𝑢𝑟𝑖𝑡𝑦
𝑁=
𝑉 𝑥 𝑚𝐸𝑞

0.2500 𝑔 𝑥 0.98
𝑁=
134
36𝑚𝐿 𝑥 ( )
2 𝑥 1000

= 0.1016 N

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 11. A 50-ml 1N Sulfuric Acid was placed into the burette in preparation for the Assay of Sodium Hydroxide.
Into the Erlenmeyer flask, both phenolphthalein and methyl orange were placed, together with the
analyte.

Identify the TITRANT used in the assay.

a. NaOH
b. H2SO4
c. Phenolphthalein
d. Methyl Orange

TitranT (top) – placed inside the burette (this is the volumetric solution of known concentration)
TitranD (down) – placed inside the Erlenmeyer flask (this is the analyte or sample assayed whose concentration
is unknown)
Indicator – usually phenolphthalein, or any dyes (added inside the flask too, it will make the end point visible)

12. Iodometry: ____ :: Iodimetry: ____

a. Reducing agents - Oxidizing agents

b. Oxidizing agents - Reducing agents
c. Oxidizing agents - Oxidizing agents
d. Reducing agents - Reducing agents

In iodimetry, the concentration of the reducing agent in a given sample solution is determined by titrating it
against a standard iodine solution using direct method.
In iodometry, we determine the concentration of the oxidizing agent in a given sample solution using an
indirect method.

13. If a 2-gram sample of cod liver oil required 4.5 ml of 0.02 N NaOH in the titration of the free fatty acids,
what would be the acid number of the oil?

a. 2.616
b. 0.806
c. 5.611
d. 2.525

Solving for Acid number uses the ff. equation:

V x N x 56.11
Acid no =
𝑤𝑡 𝑜𝑓 𝑠𝑎𝑚𝑝𝑙𝑒
4.5 mL x 0.02 N x 56.11
Acid no =
2𝑔
= 2.525

14. The water layer measured in a graduated tube of the toluene apparatus was 2.5 ml. It was distilled from
65 g of powdered granules. What is the % moisture content of the powdered granules?

a. 3.533 %
b. 3.846 %
c. 4.759 %
d. 1.879 %

% MC = (Water layer / wt of sample) * 100

= (2.5 ml / 65 g) * 100
= 3.846 %

15. A technique where the substance being analyzed can be determined through the measurement of mass.

a. Qualitative Analysis
b. Gravimetric Analysis
c. Volumetric Analysis
d. Titrimetric Analysis

Qualitative analysis is concerned with the identification of the substance. Quantitative analysis is for the
determination of the amount of sample

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Gravimetric - It is the separation by extraction, precipitation, or other means, of the sample and weighing of the
resulting product.

Volumetric - It is the determination of the volume of a solution of known concentration required to react with a
given amount of substance to be analyzed.

16. Boric acid is

a. monobasic
b. tribasic
c. diprotic
d. monoprotic

Although H3BO3 contains 3 H groups, it acts as a monobasic acid rather than a tribasic acid. H 3BO3 does not act
as a proton donor rather it accepts a pair of electrons from OH- ions.
A change in color happens after the 1st addition of phenolphthalein.

17. Which of the following statements are true?

I - Total ash content represents the carbon content of the sample which are the product of incineration.
II - Sulfated ash represents the silica content of a sample
III - Ash content can help you confirm the presence of adulterants in the samples
IV - Both Loss on Ignition and Loss on Drying determine the volatile matter present in the sample

a. I, II, III, IV
b. II, III, IV
c. III, IV
d. III only

Total ash content represents the inorganic salts/substances present (residue remaining after incineration).

Acid insoluble ash represents the silica content of a sample.

18. Which of the following pairs is/are INCORRECT?

I. Method I - Hanus method - uses iodobromide TS

II. Method II - Wijs Method - uses Iodochloride TS
III. Method III - Hubl method

a. I only
b. I and II
c. II and III
d. None of the above

All of the are correctly paired. These are methods to determine iodine value of fats and oils.

Acid value is the number of grams of iodine absorbed under specified conditions by 100 gram of oil, fat, wax, or
other substance.

This value is a quantitative measure of the proportion of unsaturated fatty acids present (both free and
combined as esters) that have the property of absorbing iodine.

19. Philippines climatic zone for stability testing

a. 1
b. 2
c. 3
d. 4

1. Climatic Zone I: mild climate, typically 21°C to 25°C and a relative humidity of 45% to 75%. Includes US,
Canada, and most of Europe.
2. Climatic Zone II: subtropical or Mediterranean climate, typically 25°C to 30°C and a relative humidity of
45% to 75%. Includes Japan, Taiwan, and parts of southern Europe.

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 3. Climatic Zone III: hot and dry climate, typically 30°C to 40°C and a relative humidity of 20% to 30%.
Includes Saudi Arabia, Egypt, and parts of Australia.
4. Climatic Zone IV: hot and humid climate, typically 30°C to 40°C and a relative humidity of 75% to 85%.
Includes India, Southeast Asia, and parts of South America.

20. A document that gives detailed information about the nature of a chemical, such as physical and
chemical properties, health, safety, fire, and environmental hazards of a chemical product.
a. USP-NF
b. MSDS
c. SOP
d. PNDF

Material Safety Data Sheet (MSDS) - a document that provides information about the hazards and safe handling
of a chemical substance. Example: Flammability and organ toxicity of the substance

United States Pharmacopeia–National Formulary (USP–NF) is a compendium of quality standards for drug
substances, dosage forms, excipients, dietary supplements, and other related products.

SOP, or standard operating procedures, include information such as the purpose of the procedure, the materials
and equipment required, the steps to be followed, any safety precautions that need to be taken, and the
expected outcome of the procedure.

PNDF, or Philippine National Drug Formulary, a comprehensive list of essential drugs that are approved and
recommended for use in the Philippines.

21. This instrument is used in the analysis of raw materials in which it measures how much speed of light is
reduced when it travels within specific solvents.
a. Refractometer
b. Friabilator
c. Polarimeter
d. Disintegrator

Friabilator – used to measure friability or ability to withstand normal handling of the preparation
Polarimeter – used to measure optical activity or angle of rotation
Disintegrator – not a common term; we usually use basket rack assembly as the name for the equipment for
disintegration test

22. The USP acceptable criteria for hardness of sublingual tablets.

a. 4-10kg
b. 7-10kg
c. 2-3kg
d. 2-5kg

Conventional tablets are usually ~ 4 kg

Sublingual tablets are generally softer as they are expected to dissolve rapidly under the tongue = ~2-3kg
Buccal tablets are harder since they are expected to dissolve slower in the buccal cavity ~ 7kg

23. The USP-NF criteria for Moisture Content of granules prior to compression.
a. 0.2-1%
b. 0.8-2%
c. 0.4-0.9%
d. 0.5-1%

24. A parenteral is declared to be pyrogenic if the total rise in temperature of the rabbits is:
a. ess than 3.3 deg C in the 8 rabbits
b. Less than 0.5 deg C in the 8 rabbits
c. More than 3.3 deg C in the 8 rabbits
d. More than 0.5 deg C in the 8 rabbits

This is an example of pyrogen testing (in vivo).

• Uses rabbits
• Checks the individual rise in temperature
• Pass: NMT 3 out of 8 showed + 0.5 °C or more OR sum of temperature rise is NMT 3.3 °C

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 25. Brookefield apparatus measures

a. Viscosity
b. Melting point
c. Particle size
d. Sedimentation rate

Melting point determination – using capillary tube

Freezing point determination – Cryoscopic osmometer
Particle size – microscope, coulter counter, sieve setup (particle size distribution), etc.
Sedimentation rate – Andreasen apparatus

26. Stationary phase for Ion-exchange

a. Solid
b. Water
c. Silica gel G
d. Resin

In ion-exchange chromatography, the stationary phase is an ion exchange resin while the mobile phase is a
liquid.

It follows the rule: “Like charges repel, opposites attract”

If the resin beads is negatively charged, the positively charged protein can bind to it.

27. Stationary Phase is also known as Fixed phase.

The mobile phase is responsible for the sorption in the sorption-desorption process.

a. Only statement 1 is correct

b. Only statement 2 is correct
c. Both statements are incorrect
d. Both statements are correct

The stationary phase is typically a solid or liquid that is immobilized within a column or on a surface, while the
mobile phase is a liquid or gas that flows through the stationary phase and carries the sample components along
with it.

During sorption, the sample components are adsorbed onto the surface of the stationary phase due to attractive
forces between the component molecules and the surface of the stationary phase. This results in a temporary
retention of the sample components on the stationary phase.

During desorption, the sample components are released from the stationary phase and are carried along by the
mobile phase. This occurs when the mobile phase contains a solvent that is less attractive to the sample
components than the stationary phase, allowing the components to be eluted or released from the stationary
phase and carried along by the mobile phase.

28. Reagent specific for TLC chromatogram visualization of corticosteroids

a. Ethanol Sulfuric Acid 20%

b. Alkaline tetrazolium blue
c. Potassium permanganate
d. Dragendorff reagent

Ethanol Sulfuric Acid 20% also known as the Lucas reagent, is commonly used as a reagent to detect the
presence of primary, secondary, and tertiary alcohols.

Potassium permanganate – detection of sugars or sugar-like molecules and drugs with aliphatic double binds
(e.g. antibiotics)

Dragendorff reagent – tertiary amines

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 29. Shortest wave form

a. Radio waves
b. Gamma rays
c. Ultraviolet rays
d. X- rays

The shorter the wavelength, the higher is its frequency (higher energy).

Gamma rays is considered the strongest (here on Earth! In outer space, cosmic waves should be stronger)

Radio waves is considered the weakest electromagnetic radiation.

30. Blue shift is?

a. Hyperchromic
b. Barochromic
c. Hypochromic
d. NOTA

Hyperchromic - increase in intensity of an absorption band

Hypochromic - decrease in intensity
Barochromic - a shift to lower energy (“red shift”); sometimes it is spelled as Bathochromic
Hypsochromic – a shift in the spectral band towards shorter wavelengths or higher energies (“blue shift”)

31. If 125 parts of the solvent dissolved 3 part of caramel, how would you describe the solute?

a. very soluble
b. sparingly soluble
c. soluble
d. freely soluble

3 𝑝𝑎𝑟𝑡𝑠 1 𝑝𝑎𝑟𝑡𝑠
=
125 𝑝𝑎𝑟𝑡𝑠 𝑥 𝑝𝑎𝑟𝑡

X = 41.67
sparingly soluble

< 1: Very soluble

1-10: Freely soluble
10-30: Soluble
30-100: Sparingly soluble
100-1000: Slightly soluble
1000-10000: Very slightly soluble >10000: Practically insoluble

32. A test used to perform for tablets containing 25 mg of API or more.

a. Weight uniformity
b. Dissolution
c. Content Uniformity
d. Weight Variation

Uniformity of dosage forms based on amount of API:

Weight variation Test ≥ 25mg API

Content Uniformity < 25mg API

Allowable limits
Weight variation – 85 to 115 % of the ave weight of all unit doses
Content uniformity – 85 to 115% of label claim

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 33. Test for W/O emulsions will have the ff results

I. Conductivity test – no bulb glow

II. Dilution test – phase change with water added
III. Cobaltous chloride paper test – blue to pink

a. I and II
b. II and III
c. I and III
d. I, II, III

The external phase of the emulsion will determine its characteristics.

An O/W emulsion has an AQUEOUS external therefore it will:

- Conduct electricity
- Dissolve amaranth / methylene blue dye
- May dilute with water (no phase change)
- Turn cobaltous chloride paper from blue to pink
No continuous fluorescence

34. An apparatus that measures tablet thickness.

a. Caliper
b. Friabilator
c. Pycnometer
d. Basket Rack

Caliper – tablet thickness or dimensions of any object (drug and container)

Friabilator – friability
Pycnometer – density
Basket RAck – disintegRAtion
Backet assembly - dissolution

35. Light source specific for the UV Region.

a. Quartz lamp
b. Tungsten lamp
c. Halogen lamp
d. Deuterium lamp

UV-Vis spectrometer uses different light sources depending on the region:

Deuterium lamp – UV region

Quartz – Visible region
Tungsten / Halogen lamps – near-infrared or mid-infrared region

36. States that the power of a transmitted radiant beam decreases exponentially as the thickness of the
solution containing the absorbing chemical species increases.

a. Beer’s Law
b. Beer-Lambert’s Law
c. Le Chatelier’s Principle
d. Bouguer’s Law

Beer’s Law (concerned with concentration) - It states that the power of transmitted radiant beam decreases
exponentially as the concentration of the solution containing the absorbing chemical species increases.

Bouguer’s Law (concerned with thickness) – also known as Lambert’s Law. It states that the power of a
transmitted radiant beam decreases exponentially as the thickness of the solution containing the absorbing
chemical species increases.

Beer-Lambert’s Law simply combines these two laws. It will contain the two key words “concentration” and
“thickness”.

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Le Chatelier’s Principle states that when a system is subjected to a stress or change, it will adjust its equilibrium
position in such a way as to counteract the stress or change and re-establish equilibrium.

37. In Ion-exchange Chromatography, one of the rules is that like charges attract.
Quaternary amines bonded onto the stationary resin will make the resin good for retaining anionic
compounds.

a. Only first statement is correct.

b. Only second statement is correct.
c. Both Statements are True
d. Both Statements are False

In ion exchange chromatography, like charges repel. When an analyte is attracted to the resin beads, it will be
retained in the column longer.

The repelled analyte leaves the column first.

Resins may be rendered negatively-charged by binding carboxylate or sulfonate groups on its surface, which will
attract and retain (+) ions.

It may be rendered positively charged using amine or quaternary ammonium groups, which will retain (-) ions.

38. In this separation mode, the sample molecules diffuse into the pores of a porous medium and
depending on their size relative to the pore size, the molecules are separated.

a. Ion-exchange
b. Normal phase
c. Size exclusion
d. Reversed phase

Ion-exchange - a type of liquid chromatography in which ions of opposite charge are attracted to a resin with an
opposite charge.

Size exclusion - a type of liquid chromatography in which the stationary phase is a porous resin that allows
molecules to pass through based on their size.

Normal phase - a type of liquid chromatography in which the stationary phase is polar, and the mobile phase is
non-polar.

Reversed phase - a type of liquid chromatography in which the stationary phase is non-polar, and the mobile
phase is polar.

39. Absorption of radiant energy is associated with vibrational transitions of atoms within molecules.

A. UV-Vis spectrophotometry
B. IR spectroscopy
C. Mass Spectrometry
D. X-ray spectroscopy

UV-Vis spectrophotometry is associated with the absorption of radiant energy due to electronic transitions of
molecules.

Mass spectrometry is associated with the ionization of molecules which causes them to turn into fragments with
different masses.

X-ray spectroscopy is concerned with the electronic structure of molecules.

40. Sample compartment used in UV-Vis spectrometer is made of what material?

a. Alkali metal halides

b. Quartz
c. Metal oxides
d. NaCl

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The sample compartment used in UV-Vis spectrometer is typically made of quartz, a material that is transparent
in the UV and visible region of the electromagnetic spectrum.

Quartz is preferred over other materials such as alkali metal halides or metal oxides because it has a high
chemical resistance and is less prone to scratching, which could affect the accuracy of the measurements.

NaCl, which is also an alkali metal halide, may be used in some UV-Vis spectrometers as an alternative to quartz,
but it has a lower resistance to moisture and can dissolve in water, which limits its use in some applications.

41. The minimum acceptable potency of our medicines is usually at _____ %.

a. 90
b. 80
c. 85
d. 95

While 90% is the common minimum potency of a stable medicine, this is highly variable depending on the
monograph. It will still depend on the manufacturer what is deemed to be “good quality” in terms of potency.

Commonly, we consider the potency of a product to be 90 % or more before its expiration date.

Although there are exceptions, 90% of the labeled potency is generally recognized as the minimum acceptable
potency level.” [Old reference: Remington’s Pharmaceutical Sciences, Sixteenth Edition, Pg. 284 (1985).]

42. Preferred primary standard used in the standardization of 0.1N potassium permanganate

a. Sodium oxalate
b. Phenolphthalein
c. Hydrogen peroxide
d. Manganese dioxide

For permanganometry:

Standard solution: KMnO4

Primary standard: Oxalic acid/ Na Oxalate
Indicator: None (self-indicating)
Endpoint: Faint pink
Sample assay
• Direct: H2O2
• Indirect: Cherry juice for malic acid*, precipitated manganese oxide, titanium dioxide
• Residual: Sodium nitrite

43. Ferrous tablets are assayed by

a. Diazotization
b. Cerimetry
c. Iodometry
d. Iodimetry

Diazotization – sulfa drugs, benzocaine

Cerimetry - Ferrous tablets, hydroquinone, homatropine hydrobromide, menadione
Iodometry – Vitamin C, Sulfur dioxide (i.e., reducing agents)
Iodimetry – Hydrogen peroxide, hypochlorite (i.e. oxidizing agents)

44. Two (2) grams of NaOH was titrated against 1M HCl, using phenolphthalein and methyl orange as
indicators. What specific type of neutralization was involved?

a. Direct Acidimetric Titration

b. Residual Acidimetric Titration
c. Direct Alkalimetric Titration
d. Residual Alkalimetric Titration

The name of the assay is based on the TITRANT used. Here, 1M HCl is used as the titrant (an acid) and it was
directly added to the sample (a base) hence it is called a direct acidimetry. It follows a neutralization principle.

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Meanwhile, indirect acidimetry is carried out by first converting the basic sample to an acid by a suitable
chemical reaction. The resulting acidic sample (in solution) is then titrated with a standard solution of a base to
determine the concentration of the sample. This is also known as residual or back titration.

45. It is the point at which the color changes indicating a complete titration.

a. End Point
b. Stoichiometric Point
c. Equivalence Point
d. Indicator

End point is also known as visual or experimental end point. It relies on an indicator that will show a color
change when equivalent quantities of the titrant and titrand have reacted.

As the name implies, Equivalence point or Stoichiometric end point or Theoretical point is based on a well-
defined equation which calculates at which equal amounts of analyte and titrant have reacted.

PART II – MICROBIOLOGY (45 ITEMS)

46. Which of the following disease is caused by a non-enveloped, single stranded DNA virus?
a. Roseola Infantum
b. Chickenpox
c. Influenza
d. Erythema infectiosum
e. COVID-19

47. Mary was found out to have cervical cancer. Which of the following is the causative agent for this
pathology?
a. non-enveloped, single stranded DNA virus
b. non-enveloped, double stranded DNA virus
c. enveloped, single stranded RNA virus
d. enveloped, double stranded RNA virus

48. The following are true regarding the difference between gram positive and gram negative bacteria,
except?
a. All gram-positive bacteria do not contain lipopolysaccharide.
b. Endotoxins are produced only by gram negative bacteria
c. Exotoxins can be produced by both gram positive and gram negative bacteria
d. NOTA
e. AOTA

49. The person who discovered prontosil.

a. Emil von behring
b. Domagk
c. Ehrlich
d. Fleming

50. Rose has walking pneumonia. What is the best treatment for her condition?
a. Macrolide
b. Penicillin
c. Cephalosporin
d. Do not give antibiotic.

51. The only cephalosporin with activity against MRSA.

a. Ceftriaxone
b. Ceftaroline
c. Cefepime
d. Cefoperazone
e. Cefazolin

52. In relation to Question 51, what generation of cephalosporin does this drug belong to?
a. 1st
b. 2nd
c. 3rd

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 d. 4th
e. 5th

53. A patient took a specific antibacterial and this led to the development of pseudomembranous colitis on
the patient. What is the most common antibiotic causing this disease?
a. Metronidazole
b. Vancomycin
c. Clindamycin
d. Tetracycline

54. Taenia solium is classified as?

a. Nematode
b. Cestode
c. Trematode
d. Protozoa

55. Donna has leprosy and was given a specific medication which caused her skin to have red-orange
discoloration. Which of the following drug is responsible for this?
a. Dapsone
b. Rifampin
c. Clofazimine
d. Isoniazid

56. This antifungal punches holes in the ergosterol which increases membrane permeability resulting in cell
death.
a. Ketoconazole
b. Amphotericin
c. Terbinafine
d. Caspofungin
e. Griseofulvin

57. The infectious particle of Chlamydia

a. Elementary body
b. Initial body
c. Reticulate body
d. B and C
e. None of the choices

58. A general test to differentiate Staphylococcus from Streptococcus

a. Coagulase test
b. Catalase test
c. Hemolysis test
d. Bacitracin sensitivity

59. How would you differentiate the spores of bacillus and clostridium?
a. Bacillus’ spores are located centrally
b. Clostridium’s spores are terminally located
c. Both are true
d. Neither

60. Specialized structure used for bacterial survival. Used to resist heat, chemicals and dehydration.
a. Flagella
b. Cilia
c. Capsule
d. Spore
e. None of the choices

61. The culture medium used to isolate Corynebacterium diphtheriae

a. Saboraud agar
b. Loeffler’s agar
c. Buffered Charcoal Yeast Agar
d. Lowenstein-Jensen
e. Thayer-Martin

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 62. Patient with vaginal tampon developed sudden onset fever with vomiting, rash with desquamation.
Most likely causative agent?
a. Psedomonas aeruginosa
b. Vibrio cholerae
c. Staphylococcus aureus
d. Staphylococcus epidermidis
e. Streptococcus pneumoniae

63. Identify:
Gram negative, curved rod, oxidase positive, loves hot temperatures (42 degrees Celsius)
Major cause of bacterial gastroenteritis

a. Vibrio cholerae
b. Campylobacter jejuni
c. Entamoeba histolytica
d. Shigella dysenteriae
e. E. coli

64. True about the lesion/s caused by Treponema pallidum

a. Hard painful chancre
b. Painless ulcer on genitals
c. Sexually transmitted
d. A and C
e. B and C

65. Cutaneous fungal infection presenting with hypopigmentation patches on skin with no inflammation. On
the microscope, it appears as “spaghetti with meatballs”. Causative agent?
a. Microsporum spp.
b. Malassezia spp.
c. Epidermophyton spp.
d. Sporothrix spp.
e. None of the choices

66. Major structural protein on fungal cell wall

a. Peptidoglycan
b. Chitin
c. Ergosterol
d. Cellulose
e. Phospholipid bilayer

67. Predisposing factor in acquiring Histoplasmosis

a. Owning a pigeon
b. Spelunking
c. Diving in deep waters
d. Wading in flood waters
e. Having a pet rabbit

68. Few campers developed diarrhea with fatty stools after drinking contaminated water. On microscopy,
“old man’s glasses”-looking organisms were visualized. What is the DOC for this?
a. Pyrantel pamoate
b. Itraconazole
c. Ivermectin
d. Metronidazole
e. Praziquantel

69. DOC of malaria caused by P.falciparum in the Philippines

a. Chloroquine
b. Mefloquine
c. Artemisinin compounds
d. Primaquine
e. None of the choices.

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 70. DOC for treatment of CNS phase of West African Sleeping Sickness
a. Pentamidine
b. Eflornithine
c. Melarsoprol
d. Suramin
e. Benznidazole

For numbers 71-75, Choose from the ff.:

a. Enterobius vermicularis
b. Stronglyloides stercoralis
c. Necator americanus
d. Ancylostoma duodenale
e. Trichuris trichuria

71. Old World Hookworm D

72. Threadworm B
73. Whipworm E
74. Pinworm A
75. New World Hookworm C

For numbers 76-79, Identify whether the ff. helminths/helminth infections are from:
a. Nematode
b. Cestode
c. Trematode

76. Filariasis A
77. Schistosoma C
78. Diphyllobotrium latum B
79. Strongyloides A

80. Causes Benign Tertian Malaria

a. P. vivax
b. P. malariae
c. P. falciparum
d. P.knowlesi
e. A and B

81. Causes cat scratch disease

a. Francisella tularensis
b. Pasteurella multocida
c. Borrelia burgdorferi
d. Bartonella species
e. None of the choices

82. Main cause of hot tub folliculitis

a. Staphyloccus epidermidis
b. Klebsiella pneumoniae
c. Mycobacterium tuberculosis
d. Mycobacterium leprae
e. Pseudomonas aeruginosa

83. Considered as the 2nd most common cause of uncomplicated UTI in young women
a. E. coli
b. S. aureus
c. S. saprophyticus
d. S. bovis
e. P.mirabilis

84. What test is used to best differentiate staphylococcus species?

a. Catalase test
b. Hemolytic test
c. Coagulase test
d. Bacitracin sensitivity
e. Oxygen requirement test

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 85. Function of iodine in gram staining
a. Primary stain
b. Counterstain
c. Intensify color of primary stain
d. Intensify color of counterstain
e. To remove the color of the primary stain

86. DOC for influenza infection

a. Amantadine
b. Oseltamivir
c. Aciclovir
d. Valaciclovir

87. White ulcerative lesions in the buccal mucosa seen in measles. Considered as pathognomonic for this
disease.
a. Koplik spots
b. Forchheimer spots
c. Peyer’s patches
d. Rose spots

88. An adolescent college student has a fever, sore throat, and lymphadenopathy accompanied by
lymphocytosis. The diagnosis is most likely infectious mononucleosis (IM). What is the causative agent of
this disease?
a. HSV 1
b. HSV 2
c. HSV 3
d. HSV 4
e. HSV 5

89. Which among of the viruses that causes viral hepatitis is also known as the “serum hepatitis”?
a. Hepatitis A
b. Hepatitis B
c. Hepatitis C
d. Hepatitis D
e. Hepatitis E

90. Vitamin deficiency associated with fish tapeworm infection

a. B1
b. C
c. B6
d. B12
e. K

PART 3 – PUBLIC HEALTH (10 ITEMS)

91. The sudden unexpected occurrence of a disease in a given population.

a. Endemic
b. Sporadic
c. Outbreak
d. Pandemic

Outbreak – [same definition with epidemic] an increase, often sudden, in the number of cases of a disease
above what is normally expected in that population in that area (used for a more limited geographic area).

Endemic - constant presence and/or usual prevalence of a disease or infectious agent in a population within a
geographic area
Sporadic - disease that occurs infrequently and irregularly
Pandemic - epidemic that has spread over several countries or continents, usually affecting many people

92. Administration of a toxoid confers:

a. Naturally acquired active immunity
b. Artificially acquired active immunity
c. Naturally acquired passive immunity
d. Artificially acquired passive immunity

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Artificially acquired active – antigens introduced through vaccination

Naturally acquired active – initial exposure to pathogen

Naturally acquired passive – mom to baby
Artificialy acquired passive – immunoglobulins/antibodies injection given
93. Nosocomial infections are:
a. Infections developed while the patient is in the hospital
b. Infections of the nasal area
c. Infections where pathogens enters the body through the nose
d. Infections among animals

94. Pfizer-Biotech’s Cominarty is a COVID19 vaccine using which novel vaccine technology?
a. Viral Vector
b. Live attenuated
c. Protein subunit
d. mRNA

mRNA – Pfizer and Moderna

Live attenuated – traditional weakend pathogen Ex: Sinovac
Protein subunit – nanoparticle technology exc: Novavax
Viral Vector – viral vector carries sarscov-2 dna ex: AstraZeneca

95. Timing for administration of two different live parenteral vaccines

a. Space 4 weeks apart
b. No timing necessary
c. Space 2 weeks apart
d. Upon doctor’s discretion

96. Added to vaccines to simulate the production of antibodies against the vaccine to make it more
effective.
a. Antigen
b. Preservative
c. Stabilizer
d. Adjuvant

These are a highly heterogeneous group of compounds with only one thing in common: their ability to enhance
the immune response

97. The number of cases of Filipinos with AIDS has increased tremendously over the past few years. This is
described as:
a. Endemic
b. Sporadic
c. Epidemic
d. Pandemic

98. The following statements about live attenuated vaccine is correct, except:

a. derived from disease-causing pathogens that have been weakened under laboratory conditions
b. attenuated pathogens can revert back to its original form thus can cause disease
c. have no live components
d. usually not given in pregnancy

Have live components, just weakened pathogen

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 99. Which of the following types of immune responses involves antigens binding directly to the B cells
causing the production of antibodies?
a. Humoral immunity
b. Cell-mediated immunity
c. Active immunity
d. Passive immunity

Humoral - With assistance from helper T cells, B cells will differentiate into plasma B cells that can produce
antibodies against a specific antigen.
Cell-mediated - involve the destruction of infected cells by cytotoxic T cells, or the destruction of intracellular
pathogens by macrophages (it triggers apoptosis)
Active - results when exposure to a disease organism triggers the immune system to produce antibodies to that
disease.
Passive - provided when a person is given antibodies to a disease rather than producing them through his or her
own immune system

100. In 1988, the Institute of Medicine defined three core functions of public health agencies that must be
carried out at all levels of government for the overall public health system to work effectively. This includes the
following, EXCEPT:
a. Mobilize Community Partnership
b. Knowing what needs to be done
c. Being part of the solution to get it done
d. Assurance

The three core functions are assessment, policy

development, and assurance.
Assessment is knowing what needs to be done; policy
development is being part of the solution to get it
done; and assurance is making sure it gets done.
Mobilize Community Partnership is an essential
service.

= END OF EXAM (100 POINTS) =

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