Streptokinase – chemistry, sources, preparation, evaluation, preservation, storage, therapeutic uses and commercial utility MCQs With Answer

Streptokinase is a bacterial plasminogen activator widely studied for its thrombolytic properties. This concise primer for B.Pharm students covers streptokinase chemistry, microbial sources, fermentation and recombinant preparation, purification and potency evaluation, formulation, preservation and storage strategies (including lyophilization and stabilizers), therapeutic uses (acute myocardial infarction, pulmonary embolism, DVT), safety, antigenicity and comparative commercial utility versus other thrombolytics. Emphasis is placed on quality-control assays, stability testing, cold-chain requirements and practical pharmacy considerations for manufacturing and clinical use. Now let’s test your knowledge with 30 MCQs on this topic.

Q1. Which best describes streptokinase’s primary mechanism of action?

  • Direct enzymatic cleavage of fibrin
  • Formation of a complex with plasminogen to generate plasmin
  • Inhibition of plasmin to stabilize clots
  • Activation of antithrombin III

Correct Answer: Formation of a complex with plasminogen to generate plasmin

Q2. Streptokinase is produced naturally by which organisms?

  • Beta-hemolytic streptococci (groups A, C and G)
  • Escherichia coli strains only
  • Bacillus subtilis strains
  • Fungal species such as Aspergillus

Correct Answer: Beta-hemolytic streptococci (groups A, C and G)

Q3. Approximate molecular weight of streptokinase is:

  • 10 kDa
  • 25 kDa
  • 47 kDa
  • 100 kDa

Correct Answer: 47 kDa

Q4. Which feature distinguishes streptokinase from tissue plasminogen activator (tPA)?

  • Streptokinase is fibrin-specific while tPA is non-specific
  • Streptokinase is a non-enzymatic activator of plasminogen and not fibrin-specific
  • Both are identical in mechanism and specificity
  • Streptokinase directly degrades fibrin without plasminogen

Correct Answer: Streptokinase is a non-enzymatic activator of plasminogen and not fibrin-specific

Q5. Common industrial production of native streptokinase involves which culture process?

  • Solid-state fermentation on agar plates
  • Submerged fermentation in peptone-rich broth
  • Plant tissue culture expression
  • Direct chemical synthesis

Correct Answer: Submerged fermentation in peptone-rich broth

Q6. Which purification technique is routinely used in streptokinase downstream processing?

  • Affinity chromatography against human antibodies only
  • Ion-exchange chromatography followed by gel filtration
  • Simple dialysis without chromatography
  • Precipitation with organic solvents exclusively

Correct Answer: Ion-exchange chromatography followed by gel filtration

Q7. Which assay is standard for measuring streptokinase potency in pharmacopeias?

  • UV absorbance at 280 nm only
  • Fibrin clot lysis (fibrin plate) assay expressed in IU
  • Gram staining
  • pH titration

Correct Answer: Fibrin clot lysis (fibrin plate) assay expressed in IU

Q8. Preferred storage condition for lyophilized streptokinase vials is:

  • Room temperature (20–25°C)
  • Freezer at −20°C
  • Refrigerated at 2–8°C
  • Exposed to light at ambient humidity

Correct Answer: Refrigerated at 2–8°C

Q9. Which excipient is commonly used as a stabilizer in streptokinase formulations?

  • Human serum albumin
  • Benzalkonium chloride
  • Sodium lauryl sulfate
  • Polymethyl methacrylate

Correct Answer: Human serum albumin

Q10. Typical plasma half-life of streptokinase after IV administration is closest to:

  • 1 minute
  • 5 hours
  • 23 minutes
  • 48 hours

Correct Answer: 23 minutes

Q11. Primary clinical indication for streptokinase therapy is:

  • Chronic hypertension management
  • Acute myocardial infarction within recommended window
  • Long-term anticoagulation for atrial fibrillation
  • Hyperlipidemia treatment

Correct Answer: Acute myocardial infarction within recommended window

Q12. Which is an absolute contraindication to streptokinase use?

  • Uncontrolled hypertension
  • Active internal bleeding
  • Stable angina
  • Recent uncomplicated dental extraction

Correct Answer: Active internal bleeding

Q13. Most common adverse reactions associated with streptokinase include:

  • Hypersensitivity and hypotension
  • Severe hyperglycemia only
  • Ototoxicity and vision loss
  • Renal stones

Correct Answer: Hypersensitivity and hypotension

Q14. Why is repeated administration of streptokinase often less effective?

  • Rapid renal clearance prevents activity
  • Formation of neutralizing anti-streptokinase antibodies
  • Streptokinase is converted to inactive peptides by stomach acid
  • Lack of oxygen reduces its action

Correct Answer: Formation of neutralizing anti-streptokinase antibodies

Q15. Compared to tPA, streptokinase is characterized by:

  • Higher fibrin specificity and shorter systemic effect
  • Lower cost and less fibrin specificity
  • Higher molecular weight and oral bioavailability
  • Immunity to antibodies in all patients

Correct Answer: Lower cost and less fibrin specificity

Q16. Major commercial advantage of streptokinase production is:

  • Extremely high price making it profitable
  • Complex manufacturing making regulation easier
  • Low production cost and established manufacturing processes
  • Complete absence of immunogenicity

Correct Answer: Low production cost and established manufacturing processes

Q17. Which diluent is recommended for reconstituting lyophilized streptokinase?

  • Sterile water for injection
  • Absolute ethanol
  • 10% acetic acid
  • Mercurochrome solution

Correct Answer: Sterile water for injection

Q18. Activity of streptokinase is usually expressed in which units?

  • Milligrams per milliliter (mg/mL)
  • International Units (IU)
  • Degrees Celsius
  • Moles per liter (M)

Correct Answer: International Units (IU)

Q19. A sensitive laboratory marker of systemic fibrinolysis after streptokinase is:

  • Serum creatinine
  • D-dimer
  • Fasting blood glucose
  • Total bilirubin

Correct Answer: D-dimer

Q20. Typical pharmaceutical dosage form of commercial streptokinase is:

  • Oral tablets
  • Topical cream
  • Lyophilized powder for injection
  • Transdermal patch

Correct Answer: Lyophilized powder for injection

Q21. Which processing approach best increases long-term stability of streptokinase?

  • Lyophilization with appropriate stabilizers
  • Storage in aqueous solution at 30°C
  • Exposure to UV light for sterilization
  • Addition of proteases to formulation

Correct Answer: Lyophilization with appropriate stabilizers

Q22. Which preservative practice is recommended for parenteral streptokinase products?

  • Add benzyl alcohol to multi-dose vials routinely
  • Avoid preservatives in single-dose lyophilized vials
  • Use parabens to extend in-use time indefinitely
  • Store reconstituted product at room temperature for weeks

Correct Answer: Avoid preservatives in single-dose lyophilized vials

Q23. Which chromogenic substrate is commonly used in chromogenic assays for plasmin activity related to streptokinase?

  • S-2251 (H-D-Val-Leu-Lys-pNA)
  • p-nitrophenyl phosphate for alkaline phosphatase
  • Methyl orange for titration
  • Bradford reagent for protein

Correct Answer: S-2251 (H-D-Val-Leu-Lys-pNA)

Q24. Which factor most increases immunogenicity of streptokinase preparations?

  • Use of human recombinant expression systems
  • Repeated dosing in the same patient
  • Lyophilization with stabilizers
  • Proper cold-chain storage

Correct Answer: Repeated dosing in the same patient

Q25. Recombinant production of streptokinase offers which key advantage?

  • Guaranteed absence of antigenicity in all patients
  • Consistent quality, higher yields and controlled impurities
  • Elimination of need for potency assays
  • Ability to be administered orally

Correct Answer: Consistent quality, higher yields and controlled impurities

Q26. Most critical quality-control parameter before release of streptokinase batch is:

  • Colour of the vial cap
  • Potency/activity (IU) per vial
  • Size of external packaging
  • Melting point of the freeze-dried cake

Correct Answer: Potency/activity (IU) per vial

Q27. If reconstituted streptokinase is not used immediately, recommended practice is:

  • Store at 2–8°C for the minimal validated in-use period
  • Leave at room temperature for 72 hours
  • Add preservative and reuse for multiple patients
  • Freeze at −20°C for later use

Correct Answer: Store at 2–8°C for the minimal validated in-use period

Q28. Hypotension during streptokinase infusion is primarily due to:

  • Excessive sodium load in formulation
  • Bradykinin and cytokine-mediated vasodilation
  • Direct myocardial depression
  • Blockade of beta-adrenergic receptors

Correct Answer: Bradykinin and cytokine-mediated vasodilation

Q29. Which statement about streptokinase is FALSE?

  • It forms a complex with plasminogen to activate plasmin
  • It is itself a serine protease enzyme
  • It can induce antibody formation on repeated exposure
  • It is less fibrin-specific than tPA

Correct Answer: It is itself a serine protease enzyme

Q30. Typical shelf-life of properly stored lyophilized streptokinase at 2–8°C is approximately:

  • 1 week
  • 6 months
  • 2 years
  • 10 years

Correct Answer: 2 years

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