Haematinics: Ferrous sulphate* MCQs With Answer

Haematinics: Ferrous sulphate MCQs With Answer

This concise, SEO-friendly introduction is tailored for B.Pharm students studying haematinics and ferrous sulphate. It covers essential keywords like ferrous sulphate, elemental iron, iron absorption, iron deficiency anaemia, oral iron therapy, pharmacology, formulation, bioavailability and drug interactions. The content highlights mechanism of action, dosing principles, adverse effects, monitoring parameters and formulation differences (heptahydrate vs anhydrous) to deepen your practical understanding. These focused concepts will help you in pharmacology, pharmaceutics and therapeutics examinations as well as clinical pharmacy practice. Now let’s test your knowledge with 50 MCQs on this topic.

Q1. Which of the following best describes the primary mechanism of action of ferrous sulphate in treating iron deficiency anaemia?

• Acts as an erythropoietin analogue to stimulate RBC production
• Provides Fe2+ for incorporation into haemoglobin and replenishes ferritin stores
• Inhibits hepcidin to increase transferrin synthesis
• Chelates excess iron for renal excretion

Correct Answer: Provides Fe2+ for incorporation into haemoglobin and replenishes ferritin stores

Q2. Ferrous sulphate is mainly absorbed in which part of the gastrointestinal tract?

• Stomach
• Distal ileum
• Duodenum and upper jejunum
• Colon

Correct Answer: Duodenum and upper jejunum

Q3. Which transporter primarily mediates uptake of non‑heme Fe2+ into enterocytes?

• PEPT1
• DMT1 (divalent metal transporter 1)
• OATP2B1
• GLUT2

Correct Answer: DMT1 (divalent metal transporter 1)

Q4. Which of the following enhances absorption of oral ferrous sulphate?

• Proton pump inhibitors
• Calcium supplements
• Vitamin C (ascorbic acid)
• Tea (tannins)

Correct Answer: Vitamin C (ascorbic acid)

Q5. A standard 325 mg tablet of ferrous sulphate USP typically provides approximately how much elemental iron?

• 15 mg
• 65 mg
• 150 mg
• 325 mg

Correct Answer: 65 mg

Q6. Which adverse effect is most commonly associated with oral ferrous sulphate therapy?

• Nephrotoxicity
• Severe hepatotoxicity
• Gastrointestinal irritation with constipation and black stools
• QT prolongation

Correct Answer: Gastrointestinal irritation with constipation and black stools

Q7. Which laboratory parameter is the most sensitive early indicator of response to iron therapy?

• Hemoglobin concentration
• Serum ferritin
• Reticulocyte count
• Serum creatinine

Correct Answer: Reticulocyte count

Q8. Which test is most useful to assess body iron stores prior to initiating ferrous sulphate therapy?

• Serum ferritin
• Serum creatine kinase
• Serum sodium
• Liver function tests

Correct Answer: Serum ferritin

Q9. Ferrous sulphate is contraindicated or should be avoided in which of the following conditions?

• Iron deficiency anaemia due to blood loss
• Hemochromatosis or hemosiderosis
• Pernicious anaemia
• Pregnancy-related iron deficiency

Correct Answer: Hemochromatosis or hemosiderosis

Q10. Which of the following drugs decreases absorption of oral ferrous sulphate when co-administered?

• Ascorbic acid
• Proton pump inhibitors (e.g., omeprazole)
• Vitamin B12
• Folic acid

Correct Answer: Proton pump inhibitors (e.g., omeprazole)

Q11. Enteric-coated ferrous sulphate tablets are used primarily to:

• Increase bioavailability dramatically
• Reduce gastric irritation but may reduce absorption
• Provide immediate high peak plasma iron levels
• Deliver iron intravenously

Correct Answer: Reduce gastric irritation but may reduce absorption

Q12. Which of the following is the recommended antidote for acute severe iron overdose?

• Deferoxamine
• Calcium gluconate
• N-acetylcysteine
• Activated charcoal

Correct Answer: Deferoxamine

Q13. The percentage of elemental iron in ferrous sulphate heptahydrate (FeSO4·7H2O) is approximately:

• 5%
• 20%
• 50%
• 75%

Correct Answer: 20%

Q14. Which of the following is a major clinical indication for oral ferrous sulphate?

• Iron overload disorders
• Iron deficiency anaemia
• Vitamin D deficiency
• Bacterial infections

Correct Answer: Iron deficiency anaemia

Q15. Compared to ferrous sulphate, ferrous fumarate contains a higher percentage of elemental iron. Which statement is correct?

• Ferrous fumarate has lower elemental iron than ferrous sulphate
• Ferrous fumarate contains approximately 33% elemental iron, higher than ferrous sulphate heptahydrate
• Both salts have identical elemental iron content
• Ferrous fumarate is not used clinically

Correct Answer: Ferrous fumarate contains approximately 33% elemental iron, higher than ferrous sulphate heptahydrate

Q16. Which protein exports iron from enterocytes into plasma where it binds transferrin?

• Ferritin
• Ferroportin
• DMT1
• Hepcidin

Correct Answer: Ferroportin

Q17. A patient taking ferrous sulphate also takes tetracycline antibiotics. What is the likely interaction?

• Tetracyclines increase iron absorption
• Ferrous sulphate chelates tetracyclines, reducing antibiotic absorption
• No interaction occurs
• Both drugs potentiate anticoagulant effect

Correct Answer: Ferrous sulphate chelates tetracyclines, reducing antibiotic absorption

Q18. What is the usual total daily therapeutic dose range of elemental iron recommended historically for adult treatment of iron deficiency anaemia?

• 10–20 mg/day
• 30–60 mg/day
• 150–200 mg/day (elemental iron)
• 500–1000 mg/day

Correct Answer: 150–200 mg/day (elemental iron)

Q19. Which formulation strategy is commonly used to minimize gastrointestinal irritation from ferrous sulphate while maintaining absorption?

• Intramuscular depot injections of ferrous sulphate
• Slow-release formulations or dosing lower frequency with vitamin C co‑administration
• Combined administration with antacids
• Administering with high‑fibre meals

Correct Answer: Slow-release formulations or dosing lower frequency with vitamin C co‑administration

Q20. Which of the following statements about iron absorption regulation is correct?

• Body loses iron actively via renal excretion under physiological conditions
• Hepcidin reduces iron absorption by promoting ferroportin degradation
• Transferrin delivers iron to enterocytes for storage
• Iron absorption is independent of iron stores

Correct Answer: Hepcidin reduces iron absorption by promoting ferroportin degradation

Q21. Ferrous sulphate tablets should ideally be administered with which instruction to maximize absorption?

• Take with milk to aid absorption
• Take with food rich in calcium
• Take on an empty stomach or with vitamin C–containing drink
• Crush and mix with antacid before ingestion

Correct Answer: Take on an empty stomach or with vitamin C–containing drink

Q22. In pharmacopoeial quality control of ferrous sulphate tablets, which test is essential to ensure consistent drug release?

• Melting point determination
• Dissolution testing
• pH of solution only
• Optical rotation

Correct Answer: Dissolution testing

Q23. Which of the following intravenous iron preparations is commonly used when oral iron is not tolerated?

• Ferrous sulphate IV
• Iron sucrose
• Oral ferrous fumarate solution
• Deferoxamine

Correct Answer: Iron sucrose

Q24. Which of the following is a common laboratory finding in iron deficiency anaemia?

• Increased MCV (macrocytosis)
• Low ferritin and low transferrin saturation
• High serum ferritin
• Elevated transferrin saturation

Correct Answer: Low ferritin and low transferrin saturation

Q25. What is the effect of co-administering dairy products with ferrous sulphate?

• Enhances iron absorption due to calcium content
• Decreases iron absorption due to calcium complexation
• No effect
• Converts Fe2+ to a more absorbable form

Correct Answer: Decreases iron absorption due to calcium complexation

Q26. Which clinical sign is most suggestive of long‑standing iron deficiency?

• Spur cell anaemia
• Koilonychia (spoon nails)
• Jaundice
• Blue sclera

Correct Answer: Koilonychia (spoon nails)

Q27. For pharmacy compounding, ferrous sulphate is photosensitive and hygroscopic. Best storage condition is:

• Open container at room humidity
• In a tightly closed container, protected from moisture and light
• Refrigerated at −20°C
• Stored in direct sunlight to prevent degradation

Correct Answer: In a tightly closed container, protected from moisture and light

Q28. Which of the following statements about ferrous sulphate pharmacokinetics is true?

• Oral ferrous sulphate is completely absorbed irrespective of iron status
• Absorption is inversely related to body iron stores
• Iron is eliminated rapidly via renal excretion
• Ferrous sulphate has 100% oral bioavailability

Correct Answer: Absorption is inversely related to body iron stores

Q29. Which measurement best indicates iron available for erythropoiesis (functional iron)?

• Serum ferritin alone
• Transferrin saturation (TSAT)
• Serum sodium
• Alkaline phosphatase

Correct Answer: Transferrin saturation (TSAT)

Q30. During pregnancy, recommended prophylactic elemental iron supplementation is typically:

• 0.5–1 mg/day
• 5–10 mg/day
• 30–60 mg/day
• 200–300 mg/day

Correct Answer: 30–60 mg/day

Q31. Which of the following adverse effects may indicate iron overload during long-term therapy?

• Hypotension and hypoglycaemia
• Skin hyperpigmentation, hepatic dysfunction and cardiomyopathy
• Persistent cough
• Renal colic

Correct Answer: Skin hyperpigmentation, hepatic dysfunction and cardiomyopathy

Q32. Which of the following is an appropriate monitoring parameter within 2–4 weeks after starting ferrous sulphate therapy?

• Blood pressure only
• Hemoglobin and reticulocyte count
• Bone mineral density
• ECG

Correct Answer: Hemoglobin and reticulocyte count

Q33. Which statement about ferrous sulphate and food interactions is correct?

• Tea and coffee enhance iron absorption
• Phytates in cereals and legumes inhibit iron absorption
• All foods uniformly enhance ferrous sulphate uptake
• Dairy improves absorption due to casein

Correct Answer: Phytates in cereals and legumes inhibit iron absorption

Q34. Which of the following is a typical pharmaceutics issue with tabletting ferrous sulphate?

• Excessive sweetness in tablets
• Correlation with strong metallic taste and oxidation leading to instability
• Complete insolubility in gastric fluid
• Spontaneous combustion risk

Correct Answer: Correlation with strong metallic taste and oxidation leading to instability

Q35. In pediatric iron therapy, a child prescribed ferrous sulphate at 3 mg/kg/day elemental iron means for a 10 kg child the elemental dose is:

• 0.3 mg/day
• 3 mg/day
• 30 mg/day
• 300 mg/day

Correct Answer: 30 mg/day

Q36. Which of the following best explains why oral iron therapy can cause dark stools?

• Iron reacts with gastric mucosa causing bleeding
• Non-absorbed iron oxidizes in the gut producing dark-coloured compounds
• Ferrous sulphate increases bilirubin production
• Formation of melanin-like pigment

Correct Answer: Non-absorbed iron oxidizes in the gut producing dark-coloured compounds

Q37. Which population is at highest risk of iron deficiency and commonly prescribed ferrous sulphate prophylaxis?

• Young adult males
• Postmenopausal women
• Pregnant women and young children
• Individuals on high‑iron diets

Correct Answer: Pregnant women and young children

Q38. Which form of iron salt contains the highest percentage of elemental iron by weight?

• Ferrous sulphate heptahydrate
• Ferrous sulfate anhydrous
• Ferric hydroxide
• Iron dextran

Correct Answer: Ferrous sulfate anhydrous

Q39. Which of the following laboratory changes suggests adequate response to iron therapy within 1 month?

• Decrease in hemoglobin by 2 g/dL
• Increase in reticulocyte count within 7–10 days
• Sharply decreased white cell count
• Marked rise in serum creatinine

Correct Answer: Increase in reticulocyte count within 7–10 days

Q40. Which statement regarding the use of ferrous sulphate in combination with oral levothyroxine is correct?

• Ferrous sulphate increases levothyroxine absorption
• Co-administration may reduce levothyroxine absorption; separate dosing by several hours
• Levothyroxine neutralizes iron side effects
• They should always be taken together for synergy

Correct Answer: Co-administration may reduce levothyroxine absorption; separate dosing by several hours

Q41. What is the likely impact of antacids taken simultaneously with ferrous sulphate?

• Increase iron absorption by providing alkaline medium
• Decrease iron absorption by raising gastric pH and forming insoluble complexes
• No impact
• Cause iron to be excreted rapidly in urine

Correct Answer: Decrease iron absorption by raising gastric pH and forming insoluble complexes

Q42. Which of the following is an advantage of ferrous sulphate over ferric iron salts when given orally?

• Ferrous form (Fe2+) is more readily absorbed than ferric (Fe3+)
• Ferrous sulphate is completely free of GI side effects
• Ferric salts have higher elemental iron content always absorbed better
• Ferrous sulphate cannot oxidize

Correct Answer: Ferrous form (Fe2+) is more readily absorbed than ferric (Fe3+)

Q43. In a quality control assay, ferrous sulphate tablets show lower than labelled iron content due to:

• Oxidation of ferrous to ferric iron and moisture‑induced degradation
• Contamination with inert cellulose
• Excessive tablet hardness only
• Deliberate under‑labelling

Correct Answer: Oxidation of ferrous to ferric iron and moisture‑induced degradation

Q44. Which vitamin deficiency can mimic or worsen iron deficiency anaemia and should be assessed concurrently?

• Vitamin C deficiency
• Vitamin B12 and folate deficiency
• Vitamin K deficiency
• Vitamin A excess

Correct Answer: Vitamin B12 and folate deficiency

Q45. Which of the following best describes the role of ferritin in iron metabolism?

• Plasma carrier protein transporting iron to tissues
• Primary intracellular iron storage protein reflecting body iron stores
• Transmembrane exporter of iron
• Enzyme that converts Fe2+ to Fe3+

Correct Answer: Primary intracellular iron storage protein reflecting body iron stores

Q46. A tablet containing 200 mg ferrous sulphate (heptahydrate) will approximately provide how many mg of elemental iron?

• 40 mg
• 200 mg
• 100 mg
• 10 mg

Correct Answer: 40 mg

Q47. Which of the following anemia types is least likely to respond to ferrous sulphate therapy?

• Iron deficiency anaemia
• Anemia of chronic disease with hepcidin‑mediated sequestration
• Iron‑deficiency due to dietary lack
• Pregnancy‑related iron deficiency

Correct Answer: Anemia of chronic disease with hepcidin‑mediated sequestration

Q48. Which manufacturing consideration is important when formulating ferrous sulphate tablets to minimize oxidation?

• Use of strong oxidizing excipients
• Adequate antioxidants and protective film coating to limit air/moisture exposure
• Keeping tablets uncoated and exposed to air during packaging
• Storing tablets in humid conditions

Correct Answer: Adequate antioxidants and protective film coating to limit air/moisture exposure

Q49. For a patient intolerant to oral ferrous sulphate due to severe GI side effects, the pharmacist may recommend:

• Increase dose and take with antacids
• Switch to an alternative oral iron such as ferrous fumarate or consider IV iron preparations
• Stop iron therapy entirely without alternative
• Double the dose at each intake

Correct Answer: Switch to an alternative oral iron such as ferrous fumarate or consider IV iron preparations

Q50. Which monitoring value suggests iron repletion and when deciding to stop iron therapy?

• Persistently low hemoglobin despite therapy
• Ferritin normalized (within lab reference) and transferrin saturation adequate; haemoglobin improved
• Markedly increased serum creatinine
• Elevated ESR only

Correct Answer: Ferritin normalized (within lab reference) and transferrin saturation adequate; haemoglobin improved

G S Sachin

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