Monoclonal antibodies (mAbs) are at the forefront of biopharmaceutical innovation, offering highly specific and targeted treatments for a range of complex diseases, from cancer to autoimmune disorders. As a PharmD student, understanding the nomenclature, mechanisms of action, production methods, and unique clinical considerations of mAbs is essential. This knowledge is critical for safely managing patients on these powerful therapies. This quiz will test your foundational knowledge of this vital class of drugs.
1. A therapeutic monoclonal antibody with the suffix “-ximab” in its nonproprietary name is classified as what type of antibody?
- Murine
- Chimeric
- Humanized
- Fully human
Answer: Chimeric
2. The part of the antibody that binds to the specific antigen is known as the:
- Fc region
- Hinge region
- Fab region
- J chain
Answer: Fab region
3. What is the primary reason that monoclonal antibodies are typically administered via intravenous or subcutaneous injection?
- They have an unpleasant taste
- They are proteins that would be degraded by proteases in the gastrointestinal tract
- They require activation by sunlight on the skin
- They are not soluble in water
Answer: They are proteins that would be degraded by proteases in the gastrointestinal tract
4. Hybridoma technology, a classic method for producing mAbs, involves the fusion of what two cell types?
- A T-cell and a cancer cell
- A B-cell and a myeloma (cancerous plasma) cell
- A red blood cell and a stem cell
- A CHO cell and a yeast cell
Answer: A B-cell and a myeloma (cancerous plasma) cell
5. A major advantage of fully human monoclonal antibodies (-umab) over murine (-omab) or chimeric (-ximab) antibodies is:
- They have a much shorter half-life
- They are significantly less likely to cause an immunogenic response in the patient
- They are much cheaper to manufacture
- They can be administered orally
Answer: They are significantly less likely to cause an immunogenic response in the patient
6. Adalimumab (Humira) and infliximab (Remicade) are widely used monoclonal antibodies that primarily target which cytokine?
- Interleukin-6 (IL-6)
- Tumor Necrosis Factor-alpha (TNF-α)
- Interleukin-2 (IL-2)
- Interferon-gamma (IFN-γ)
Answer: Tumor Necrosis Factor-alpha (TNF-α)
7. An “antibody-drug conjugate” (ADC) like inotuzumab ozogamicin works by:
- Using the antibody to deliver a potent cytotoxic drug directly to a target cell
- Blocking a receptor to prevent a ligand from binding
- Stimulating a widespread immune response
- Neutralizing a circulating cytokine
Answer: Using the antibody to deliver a potent cytotoxic drug directly to a target cell
8. The Fc region of an antibody is responsible for which of the following functions?
- Binding to the specific antigen
- Interacting with immune effector cells and the complement system
- Forming the light chain of the antibody
- Providing flexibility to the antibody structure
Answer: Interacting with immune effector cells and the complement system
9. What is the primary purpose of “humanizing” a monoclonal antibody?
- To make it effective in human patients by reducing its murine (mouse) protein content
- To enable its production in human cell lines exclusively
- To allow it to be taken orally
- To shorten its half-life for rapid elimination
Answer: To make it effective in human patients by reducing its murine (mouse) protein content
10. A potential serious adverse effect of monoclonal antibodies that suppress the immune system (e.g., TNF-α inhibitors) is:
- Increased appetite
- Increased risk of serious infections
- Hair growth
- Lowered blood pressure
Answer: Increased risk of serious infections
11. Rituximab is a monoclonal antibody used in oncology and rheumatology that targets which protein on the surface of B-cells?
- HER2
- CD20
- VEGF
- EGFR
Answer: CD20
12. The term “epitope” refers to the:
- Entire antibody molecule
- Specific part of an antigen that is recognized and bound by an antibody
- The cell that produces the antibody
- The patient receiving the antibody therapy
Answer: Specific part of an antigen that is recognized and bound by an antibody
13. Most modern therapeutic monoclonal antibodies are produced in which type of expression system to ensure proper protein folding and glycosylation?
- E. coli bacteria
- Transgenic plants
- Mammalian cell lines, such as CHO cells
- Chemical synthesis
Answer: Mammalian cell lines, such as CHO cells
14. A “naked” monoclonal antibody is one that:
- Is not linked to any other molecule like a toxin or radioisotope
- Lacks an Fc region
- Is produced without a host cell
- Has a very short half-life
Answer: Is not linked to any other molecule like a toxin or radioisotope
15. What does the development of Human Anti-Chimeric Antibodies (HACA) in a patient indicate?
- The patient is having an excellent therapeutic response
- The drug is working as intended
- The patient’s immune system is recognizing the chimeric antibody as foreign
- The antibody has been fully humanized
Answer: The patient’s immune system is recognizing the chimeric antibody as foreign
16. Trastuzumab (Herceptin) is a cornerstone of therapy for which type of cancer?
- Cancers that are HER2-positive, such as certain breast and gastric cancers
- Cancers that are CD20-positive
- All types of lung cancer
- Cancers related to the human papillomavirus (HPV)
Answer: Cancers that are HER2-positive, such as certain breast and gastric cancers
17. Blinatumomab is a Bi-specific T-cell Engager (BiTE) antibody, which means it is engineered to:
- Bind to two different antigens or epitopes simultaneously
- Bind only to T-cells
- Be resistant to degradation
- Deliver a chemotherapy agent
Answer: Bind to two different antigens or epitopes simultaneously
18. Why do monoclonal antibodies generally have a long half-life in the body?
- They are very small molecules that are not easily filtered by the kidneys
- They undergo recycling via the neonatal Fc receptor (FcRn)
- They are not metabolized by the liver
- They are resistant to all forms of protein degradation
Answer: They undergo recycling via the neonatal Fc receptor (FcRn)
19. A potential risk during the intravenous infusion of a monoclonal antibody is:
- An immediate drop in blood sugar
- A severe infusion-related reaction, which can include fever, chills, and rigors
- The patient developing a sudden fear of needles
- The antibody turning the patient’s skin blue
Answer: A severe infusion-related reaction, which can include fever, chills, and rigors
20. Omalizumab works by binding to IgE, making it an effective therapy for which condition?
- Osteoporosis
- Severe allergic asthma
- Rheumatoid arthritis
- Anemia
Answer: Severe allergic asthma
21. The “complement-dependent cytotoxicity” (CDC) mechanism of some mAbs involves:
- The antibody delivering a toxic drug to the cell
- The Fc portion of the antibody activating the complement cascade to lyse the target cell
- The antibody blocking a growth factor receptor
- The antibody neutralizing a cytokine
Answer: The Fc portion of the antibody activating the complement cascade to lyse the target cell
22. A pharmacist’s role in mAb therapy includes educating the patient about:
- How to self-administer the medication if it is a subcutaneous formulation
- The need to avoid all other medications
- The certainty that the therapy will cure their disease
- The unimportance of reporting side effects
Answer: How to self-administer the medication if it is a subcutaneous formulation
23. What does “phage display” technology offer for antibody development?
- A method for producing antibodies in transgenic plants
- A way to screen vast libraries of antibody fragments to find one with high affinity for a target
- A technique for purifying antibodies using chromatography
- A computer program for designing new antibodies from scratch
Answer: A way to screen vast libraries of antibody fragments to find one with high affinity for a target
24. The high cost of monoclonal antibody therapies is primarily due to:
- The expensive raw materials, like gold and platinum
- The complex development, manufacturing, and purification processes
- The high salaries paid to the pharmacists who dispense them
- The cost of the glass vials they are packaged in
Answer: The complex development, manufacturing, and purification processes
25. Denosumab is a mAb that inhibits RANKL and is used to treat:
- High cholesterol
- Osteoporosis
- Influenza
- Diabetes
Answer: Osteoporosis
26. The “-zu-” infix in a mAb name like trastuzumab indicates that the antibody is:
- Murine
- Chimeric
- Humanized
- Fully human
Answer: Humanized
27. What is “antibody-dependent cell-mediated cytotoxicity” (ADCC)?
- A mechanism where the Fc region of an antibody binds to an immune cell (like an NK cell), which then kills the target cell
- The process of the antibody directly poisoning the target cell
- The degradation of the antibody by the target cell
- The antibody’s ability to prevent a virus from entering a cell
Answer: A mechanism where the Fc region of an antibody binds to an immune cell (like an NK cell), which then kills the target cell
28. Bevacizumab is a mAb that works by targeting and inhibiting:
- Tumor Necrosis Factor-alpha (TNF-α)
- The CD20 protein
- Vascular Endothelial Growth Factor (VEGF)
- The HER2 receptor
Answer: Vascular Endothelial Growth Factor (VEGF)
29. The specificity of a monoclonal antibody is its key therapeutic advantage, but it can also be a limitation if:
- The target antigen undergoes mutation
- The patient’s disease does not involve the target antigen
- The antibody binds too strongly to the target
- Both A and B
Answer: Both A and B
30. A “loading dose” is sometimes given at the beginning of mAb therapy to:
- Test if the patient is allergic to the drug
- Rapidly achieve a therapeutic concentration in the body
- Reduce the total cost of therapy
- Weaken the patient’s immune system
Answer: Rapidly achieve a therapeutic concentration in the body
31. The development of a biosimilar for a mAb requires extensive testing to prove that it is:
- Chemically identical and therefore a generic
- Highly similar in structure and function with no clinically meaningful differences
- More effective than the original product
- Produced by the exact same cell line as the original
Answer: Highly similar in structure and function with no clinically meaningful differences
32. The linker in an antibody-drug conjugate (ADC) must be stable in the bloodstream but cleavable:
- Inside the target cell to release the cytotoxic payload
- In the pharmacy before administration
- By the liver enzymes
- By sunlight
Answer: Inside the target cell to release the cytotoxic payload
33. What is a key counseling point for a patient starting a subcutaneously injected mAb at home?
- The importance of rotating injection sites
- That the injection should be given into a vein
- To store the medication at room temperature at all times
- To share needles with family members
Answer: The importance of rotating injection sites
34. The “-o-” infix in a mAb name like rituximab indicates the antibody is of what origin?
- Rat
- Primate
- Human
- Mouse (murine)
Answer: Mouse (murine)
35. A “chimeric” antibody is constructed from:
- The variable regions of a mouse antibody and the constant regions of a human antibody
- Only human antibody components
- Only mouse antibody components
- The constant regions of a mouse antibody and the variable regions of a human antibody
Answer: The variable regions of a mouse antibody and the constant regions of a human antibody
36. A common challenge for oral formulations of mAbs is their:
- High molecular weight and susceptibility to enzymatic degradation
- Poor solubility in water
- Inability to bind to any targets in the GI tract
- Simple chemical structure
Answer: High molecular weight and susceptibility to enzymatic degradation
37. Which part of an antibody provides the specificity for binding a particular antigen?
- The constant region of the heavy chain
- The hinge region
- The variable regions of the heavy and light chains
- The Fc portion
Answer: The variable regions of the heavy and light chains
38. Palivizumab is a mAb used for the prevention of:
- Respiratory Syncytial Virus (RSV) in high-risk infants
- Influenza in the elderly
- Shingles in adults
- COVID-19 in all populations
Answer: Respiratory Syncytial Virus (RSV) in high-risk infants
39. Checkpoint inhibitors, a class of cancer immunotherapy mAbs, work by:
- Directly killing cancer cells with a toxin
- Blocking proteins that prevent the immune system from attacking cancer cells
- Inhibiting the formation of new blood vessels
- Neutralizing growth factors
Answer: Blocking proteins that prevent the immune system from attacking cancer cells
40. Why would a patient receiving a murine-derived mAb be at high risk for an infusion reaction?
- The human immune system recognizes the mouse protein as foreign
- Murine antibodies are inherently toxic
- All intravenous drugs cause reactions
- The antibody is not a protein
Answer: The human immune system recognizes the mouse protein as foreign
41. The “-u-” infix in a mAb name like adalimumab indicates the antibody is:
- Humanized
- Chimeric
- Murine
- Fully human
Answer: Fully human
42. A major goal of molecular engineering for therapeutic antibodies is to:
- Increase their size to prevent renal clearance
- Decrease their affinity for the target
- Enhance their efficacy and reduce their immunogenicity
- Make them require more frequent dosing
Answer: Enhance their efficacy and reduce their immunogenicity
43. A patient’s insurance requires a “prior authorization” for a mAb. This means:
- The patient must pay for the drug entirely out-of-pocket
- The pharmacy must justify the medical necessity of the drug before it will be covered
- The drug is not approved by the FDA
- The drug can only be dispensed by a hospital pharmacy
Answer: The pharmacy must justify the medical necessity of the drug before it will be covered
44. What is the role of a myeloma cell in hybridoma technology?
- It provides the ability to produce the specific antibody
- It provides the property of immortality, allowing the hybrid cell to be cultured indefinitely
- It targets the B-cell for destruction
- It supplies the nutrients for cell growth
Answer: It provides the property of immortality, allowing the hybrid cell to be cultured indefinitely
45. Downstream purification of mAbs often involves:
- A single, simple filtration step
- A multi-step process including affinity and ion-exchange chromatography
- Heating the mixture to high temperatures to remove contaminants
- Adding large amounts of salt to precipitate all proteins
Answer: A multi-step process including affinity and ion-exchange chromatography
46. Which statement is true regarding the storage of most monoclonal antibodies?
- They should be frozen at -20°C
- They require refrigeration and should not be frozen or vigorously shaken
- They are stable at room temperature for years
- They should be exposed to direct sunlight to maintain potency
Answer: They require refrigeration and should not be frozen or vigorously shaken
47. The high specificity of mAbs contributes to:
- A higher incidence of off-target side effects compared to small molecules
- A lower incidence of off-target side effects compared to many small molecules
- The inability to treat any human diseases
- Their use as flavoring agents
Answer: A lower incidence of off-target side effects compared to many small molecules
48. Polyclonal antibodies differ from monoclonal antibodies in that they:
- Are a homogenous mixture of antibodies that all bind to the same epitope
- Are a heterogeneous mixture of antibodies that recognize multiple epitopes on an antigen
- Cannot be produced in animals
- Are not proteins
Answer: Are a heterogeneous mixture of antibodies that recognize multiple epitopes on an antigen
49. An important consideration before starting therapy with a mAb that targets B-cells, like rituximab, is:
- The patient’s cholesterol level
- Reactivation of latent viral infections, like Hepatitis B
- The patient’s blood type
- The patient’s ability to drive
Answer: Reactivation of latent viral infections, like Hepatitis B
50. The continued evolution of mAb technology aims to create therapies that are:
- More expensive and less effective
- More potent, safer, and able to address a wider range of diseases
- Less specific in their targeting
- Only available for a very small number of patients
Answer: More potent, safer, and able to address a wider range of diseases
I am a Registered Pharmacist under the Pharmacy Act, 1948, and the founder of PharmacyFreak.com. I hold a Bachelor of Pharmacy degree from Rungta College of Pharmaceutical Science and Research. With a strong academic foundation and practical knowledge, I am committed to providing accurate, easy-to-understand content to support pharmacy students and professionals. My aim is to make complex pharmaceutical concepts accessible and useful for real-world application.
Mail- Sachin@pharmacyfreak.com