The structure and functions of pancreas MCQs with answer is a focused study resource for B. Pharm students exploring pancreatic anatomy, histology, endocrine and exocrine roles, islets of Langerhans, insulin and glucagon physiology, digestive enzymes, and regulatory mechanisms. This concise, exam-oriented guide emphasizes clinical correlations—pancreatitis, diabetes mellitus, cystic fibrosis, enzyme replacement therapy—and pharmacological targets including insulin preparations, sulfonylureas, GLP-1 agonists, and DPP-4 inhibitors. Clear, keyword-rich explanations strengthen understanding of pancreatic cell types, zymogen activation, secretion control, and diagnostic markers such as amylase and lipase. Ideal for revision and pharmacology exam prep, each question aligns with B. Pharm syllabus. Now let’s test your knowledge with 50 MCQs on this topic.
Q1. Which embryological buds form the adult pancreas?
- Dorsal and ventral pancreatic buds
- Lateral and medial pancreatic plates
- Ventral and caudal digestive buds
- Anterior and posterior pancreatic lobes
Correct Answer: Dorsal and ventral pancreatic buds
Q2. Which cells in the islets of Langerhans primarily secrete insulin?
- Alpha cells
- Beta cells
- Delta cells
- PP (F) cells
Correct Answer: Beta cells
Q3. Which enzyme converts trypsinogen to active trypsin in the small intestine?
- Enterokinase (enteropeptidase)
- Pepsin
- Carboxypeptidase
- Chymotrypsin
Correct Answer: Enterokinase (enteropeptidase)
Q4. What is the primary role of pancreatic ductal bicarbonate secretion?
- Activate pancreatic zymogens
- Neutralize gastric acid in duodenum
- Stimulate insulin release
- Increase bile secretion
Correct Answer: Neutralize gastric acid in duodenum
Q5. Which hormone stimulates pancreatic enzyme secretion during the cephalic phase?
- Cholecystokinin (CCK)
- Secretin
- Gastrin
- Somatostatin
Correct Answer: Cholecystokinin (CCK)
Q6. Which pancreatic hormone raises blood glucose by activating hepatic glycogenolysis?
- Insulin
- Glucagon
- Pancreatic polypeptide
- Somatostatin
Correct Answer: Glucagon
Q7. Which diagnostic marker is most specific for acute pancreatitis?
- Serum amylase
- Serum lipase
- Serum ALT
- Serum CK-MB
Correct Answer: Serum lipase
Q8. Which drug class acts by closing pancreatic beta-cell KATP channels to stimulate insulin release?
- Sulfonylureas
- Biguanides
- Alpha-glucosidase inhibitors
- Thiazolidinediones
Correct Answer: Sulfonylureas
Q9. Proinsulin is cleaved to insulin and which peptide during biosynthesis?
- C-peptide
- Preproinsulin fragment
- Proglucagon
- Amylin
Correct Answer: C-peptide
Q10. Which pancreatic cell type secretes somatostatin?
- Alpha cells
- Beta cells
- Delta cells
- Stellate cells
Correct Answer: Delta cells
Q11. Which pancreatic enzyme hydrolyzes triglycerides to monoglycerides and free fatty acids?
- Amylase
- Lipase
- Trypsin
- Elastase
Correct Answer: Lipase
Q12. What is the primary vascular supply to the body and tail of the pancreas?
- Superior mesenteric artery
- Gastroduodenal artery
- Splenic artery
- Common hepatic artery
Correct Answer: Splenic artery
Q13. Which zymogen is activated directly by trypsin to cascade activation?
- Chymotrypsinogen
- Pepsinogen
- Prolactin
- Insulinogen
Correct Answer: Chymotrypsinogen
Q14. Pancreatic exocrine insufficiency leading to steatorrhea is commonly treated with:
- Pancrelipase (pancreatic enzyme replacement)
- Insulin therapy
- Proton pump inhibitors
- Somatostatin analogs
Correct Answer: Pancrelipase (pancreatic enzyme replacement)
Q15. Which mutation is primarily responsible for cystic fibrosis affecting the pancreas?
- BRCA1 mutation
- CFTR gene mutation
- KRAS mutation
- HBB gene mutation
Correct Answer: CFTR gene mutation
Q16. Which islet cell type is typically located centrally in human islets?
- Alpha cells
- Beta cells
- Delta cells
- Fibroblasts
Correct Answer: Beta cells
Q17. Which peptide hormone from the pancreas inhibits both insulin and glucagon secretion?
- Pancreatic polypeptide
- Somatostatin
- Secretin
- Cholecystokinin
Correct Answer: Somatostatin
Q18. What is the mechanism of action of metformin in glucose control?
- Stimulates insulin secretion via KATP channels
- Activates AMP-activated protein kinase (AMPK) to reduce hepatic gluconeogenesis
- Inhibits alpha-glucosidase in the gut
- Acts as a PPAR-gamma agonist to increase insulin sensitivity
Correct Answer: Activates AMP-activated protein kinase (AMPK) to reduce hepatic gluconeogenesis
Q19. Activation of trypsin within the pancreas can lead to which condition?
- Cholelithiasis
- Acute pancreatitis
- Type 2 diabetes
- Peptic ulcer disease
Correct Answer: Acute pancreatitis
Q20. Which tumor marker is most commonly elevated in pancreatic adenocarcinoma?
- CEA
- AFP
- CA 19-9
- PSA
Correct Answer: CA 19-9
Q21. Which drug class enhances incretin activity by inhibiting DPP-4 enzyme?
- GLP-1 receptor agonists
- DPP-4 inhibitors
- SGLT2 inhibitors
- Sulfonylureas
Correct Answer: DPP-4 inhibitors
Q22. Which statement about insulin storage in beta-cell granules is correct?
- Insulin is stored as monomers without ions
- Insulin stored as hexamers coordinated with zinc ions
- Insulin stored bound to glucagon
- Insulin stored in mitochondria
Correct Answer: Insulin stored as hexamers coordinated with zinc ions
Q23. Which nerve provides parasympathetic stimulation to the pancreas?
- Phrenic nerve
- Vagus nerve
- Glossopharyngeal nerve
- Sympathetic splanchnic nerves
Correct Answer: Vagus nerve
Q24. Which laboratory finding supports a diagnosis of chronic pancreatitis with exocrine deficiency?
- Elevated serum insulin
- Low fecal elastase
- High serum C-peptide
- High urinary glucose
Correct Answer: Low fecal elastase
Q25. Which drug is a GLP-1 receptor agonist used to enhance insulin secretion and slow gastric emptying?
- Sitagliptin
- Exenatide
- Metformin
- Glibenclamide
Correct Answer: Exenatide
Q26. Which is NOT a major exocrine secretion of the pancreas?
- Trypsin
- Chymotrypsin
- Insulin
- Pancreatic lipase
Correct Answer: Insulin
Q27. What effect does secretin have on pancreatic secretions?
- Stimulates enzyme-rich secretion
- Inhibits bicarbonate secretion
- Stimulates bicarbonate-rich ductal secretion
- Promotes insulin release
Correct Answer: Stimulates bicarbonate-rich ductal secretion
Q28. Which clinical feature is most characteristic of exocrine pancreatic insufficiency?
- Polyuria without weight loss
- Steatorrhea and weight loss
- Hypoglycemia episodes
- Hematemesis
Correct Answer: Steatorrhea and weight loss
Q29. Which pharmacological agent is contraindicated in type 1 diabetes as monotherapy?
- Insulin
- Metformin
- Sulfonylureas
- GLP-1 agonists
Correct Answer: Metformin
Q30. Which cell hormone pair is correctly matched?
- Alpha cells — Insulin
- Beta cells — Glucagon
- Delta cells — Somatostatin
- PP cells — Amylase
Correct Answer: Delta cells — Somatostatin
Q31. Which condition commonly causes obstructive pancreatitis by blocking the pancreatic duct?
- Alcohol abuse
- Gallstones in the ampulla
- Hyperthyroidism
- Viral hepatitis
Correct Answer: Gallstones in the ampulla
Q32. Which is the principal metabolic action of insulin on skeletal muscle?
- Decrease GLUT4 translocation to membrane
- Increase glucose uptake via GLUT4 translocation
- Stimulate hepatic gluconeogenesis
- Promote lipolysis
Correct Answer: Increase glucose uptake via GLUT4 translocation
Q33. Which protease inhibitor in the pancreas prevents premature trypsin activation?
- SPINK1 (serine protease inhibitor Kazal type 1)
- Alpha-1 antitrypsin
- Trypsin inhibitor A from stomach
- Pepsin inhibitor
Correct Answer: SPINK1 (serine protease inhibitor Kazal type 1)
Q34. Which histological feature distinguishes endocrine islets from exocrine pancreas?
- Presence of acinar cells
- Clusters of hormone-secreting cells with rich capillary network
- Striated ducts with tall columnar epithelium
- Fibrous capsule with bile ducts
Correct Answer: Clusters of hormone-secreting cells with rich capillary network
Q35. Which oral antidiabetic drug delays carbohydrate absorption by inhibiting intestinal alpha-glucosidases?
- Pioglitazone
- Acarbose
- Glibenclamide
- Canagliflozin
Correct Answer: Acarbose
Q36. Which is a common systemic complication of chronic pancreatitis?
- Hyperthyroidism
- Secondary diabetes mellitus (type 3c)
- Chronic kidney disease due to immune complexes
- Myasthenia gravis
Correct Answer: Secondary diabetes mellitus (type 3c)
Q37. Which molecule is a direct intracellular second messenger stimulating glycogenolysis after glucagon receptor activation?
- cAMP
- cGMP
- IP3
- Calcium-binding calmodulin only
Correct Answer: cAMP
Q38. Which imaging modality is most sensitive for detecting small pancreatic ductal lesions?
- Plain abdominal X-ray
- Endoscopic ultrasound (EUS)
- Ultrasound for liver
- Electrocardiography (ECG)
Correct Answer: Endoscopic ultrasound (EUS)
Q39. Which pancreatic product regulates exocrine secretion and gallbladder contraction?
- Insulin
- Cholecystokinin (CCK)
- Glucagon
- Pancreatic polypeptide
Correct Answer: Cholecystokinin (CCK)
Q40. Which of the following can be a drug-induced cause of acute pancreatitis?
- Azathioprine
- Metformin (when used alone without risk factors)
- Insulin glargine
- Atorvastatin
Correct Answer: Azathioprine
Q41. Which statement best describes the role of pancreatic polypeptide (PP)?
- Stimulates insulin release directly
- Regulates pancreatic secretion and gastrointestinal motility
- Converts proinsulin to insulin
- Activates zymogens in the intestine
Correct Answer: Regulates pancreatic secretion and gastrointestinal motility
Q42. Which is an endocrine complication resulting from total pancreatectomy?
- Hyperinsulinemia
- Loss of insulin and glucagon leading to brittle diabetes
- Excessive pancreatic enzyme secretion
- Improved glucose tolerance
Correct Answer: Loss of insulin and glucagon leading to brittle diabetes
Q43. Which histochemical stain is commonly used to visualize pancreatic islet cells?
- Periodic acid–Schiff (PAS) for glycogen only
- Immunohistochemistry for insulin and glucagon
- Methylene blue for elastic fibers
- Oil Red O for calcifications
Correct Answer: Immunohistochemistry for insulin and glucagon
Q44. Which transporter mediates insulin-independent glucose uptake in liver and pancreatic beta cells?
- GLUT4
- GLUT2
- SGLT1
- GLUT1 only
Correct Answer: GLUT2
Q45. Which class of drugs increases renal glucose excretion and may indirectly affect pancreatic workload?
- SGLT2 inhibitors
- DPP-4 inhibitors
- Sulfonylureas
- Alpha-glucosidase inhibitors
Correct Answer: SGLT2 inhibitors
Q46. Which pancreatic enzyme deficiency is most likely to cause fat malabsorption?
- Amylase deficiency
- Lipase deficiency
- Protease deficiency
- Ribonuclease deficiency
Correct Answer: Lipase deficiency
Q47. Which factor directly triggers insulin granule exocytosis in beta cells?
- Decrease in intracellular calcium
- Closure of KATP channels leading to membrane depolarization and calcium influx
- Activation of glucagon receptor
- Somatostatin binding to beta cells
Correct Answer: Closure of KATP channels leading to membrane depolarization and calcium influx
Q48. Which pancreatic neoplasm is most often functional and causes hypoglycemia due to insulin secretion?
- Gastrinoma
- Insulinoma
- Glucagonoma
- Acinar cell carcinoma
Correct Answer: Insulinoma
Q49. Which statement about CA 19-9 is true in pancreatic disease?
- CA 19-9 is always diagnostic for pancreatic cancer in early stages
- CA 19-9 may be elevated in pancreatic adenocarcinoma but is not specific for early diagnosis
- CA 19-9 levels are used to measure insulin production
- CA 19-9 is a functional pancreatic enzyme
Correct Answer: CA 19-9 may be elevated in pancreatic adenocarcinoma but is not specific for early diagnosis
Q50. Which therapeutic approach is appropriate for enzyme replacement in cystic fibrosis-related pancreatic insufficiency?
- Oral insulin to replace digestive enzymes
- High-dose pancreatic enzyme replacement with meals (pancrelipase)
- Intravenous lipase infusion daily
- Somatostatin analog therapy to stimulate exocrine secretion
Correct Answer: High-dose pancreatic enzyme replacement with meals (pancrelipase)
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