Composition and functions of lymph MCQs With Answer is a focused study guide tailored for B. Pharm students exploring the lymphatic system’s biochemical makeup and physiological roles. This introduction covers lymph composition—cells (lymphocytes, macrophages), proteins, lipids (chyle), electrolytes—and core functions such as immune surveillance, transport of dietary lipids, fluid homeostasis, and drug/antigen trafficking. Emphasis is placed on clinical and pharmaceutical relevance: lymph formation, thoracic duct anatomy, lymph node filtering, and implications for lymphatic drug delivery and vaccines. Clear, concise terminology and targeted keywords help reinforce learning and exam preparation. Now let’s test your knowledge with 50 MCQs on this topic.
Q1. Which of the following best describes the main cellular components of lymph?
- Red blood cells and platelets
- Lymphocytes and macrophages
- Epithelial cells and fibroblasts
- Osteoclasts and chondrocytes
Correct Answer: Lymphocytes and macrophages
Q2. The fluid that enters lymphatic capillaries primarily originates from:
- Plasma filtered at glomeruli
- Lacteals in the small intestine only
- Interstitial fluid collected from tissues
- Synovial fluid drainage
Correct Answer: Interstitial fluid collected from tissues
Q3. Which lipid-rich fluid transported by lymphatics from the intestine is called?
- Serum
- Chyle
- Plasma ultrafiltrate
- Transudate
Correct Answer: Chyle
Q4. Compared with plasma, lymph typically has:
- Higher red blood cell count
- Lower protein concentration
- Higher concentration of albumin than plasma
- More platelets
Correct Answer: Lower protein concentration
Q5. Which structure drains lymph from the majority of the body into the venous system?
- Right lymphatic duct
- Thoracic duct
- Hepatic portal vein
- Superior vena cava directly
Correct Answer: Thoracic duct
Q6. Which lymphatic vessels collect dietary lipids absorbed across intestinal villi?
- Lacteals
- Valveless sinuses
- Terminal arterioles
- Collecting ducts of kidneys
Correct Answer: Lacteals
Q7. Lymph nodes primarily function to:
- Produce bile
- Filter lymph and mount immune responses
- Absorb glucose from lymph
- Generate cerebrospinal fluid
Correct Answer: Filter lymph and mount immune responses
Q8. Which cell type in lymph nodes is essential for antigen presentation to T cells?
- Adipocytes
- Dendritic cells
- Enterocytes
- Osteoblasts
Correct Answer: Dendritic cells
Q9. The cisterna chyli is:
- A lymph node in the axilla
- A dilated sac collecting lymph from lower limbs and abdomen
- A cardiac valve in the right atrium
- A synovial structure in the knee
Correct Answer: A dilated sac collecting lymph from lower limbs and abdomen
Q10. Lymphatic capillaries differ from blood capillaries because they:
- Have continuous tight junctions preventing fluid entry
- Are fenestrated like glomerular capillaries
- Have overlapping endothelial cells that allow one-way entry of fluid
- Contain smooth muscle in their walls
Correct Answer: Have overlapping endothelial cells that allow one-way entry of fluid
Q11. Which protein class found in lymph plays a key role in immune defense and is transported from plasma?
- Keratin
- Globulins, including immunoglobulins
- Collagen
- Elastin
Correct Answer: Globulins, including immunoglobulins
Q12. A primary function of lymph in fluid balance is to:
- Increase hydrostatic pressure in capillaries
- Return excess interstitial fluid and proteins to the circulation
- Absorb cerebrospinal fluid only
- Convert interstitial fluid into urine
Correct Answer: Return excess interstitial fluid and proteins to the circulation
Q13. Which anatomical region is drained by the right lymphatic duct?
- Lower limbs and abdomen
- Right upper limb, right side of head and thorax
- Entire left side of the body
- Both lower limbs only
Correct Answer: Right upper limb, right side of head and thorax
Q14. Lymph flow toward the heart is facilitated by all EXCEPT:
- Skeletal muscle contraction
- Presence of one-way valves in lymphatics
- Respiratory movements creating pressure gradients
- High intrinsic pressure comparable to arterial pressure
Correct Answer: High intrinsic pressure comparable to arterial pressure
Q15. In B. Pharm context, why is lymphatic transport important for drug delivery?
- It prevents any systemic absorption
- It bypasses first-pass hepatic metabolism for certain lipophilic drugs
- It reduces lymphocyte activation against drugs
- It removes drugs too quickly for therapeutic effect
Correct Answer: It bypasses first-pass hepatic metabolism for certain lipophilic drugs
Q16. Chylomicrons enter the lymphatic system because they are:
- Water-soluble small molecules
- Too large to enter blood capillaries directly
- Actively transported by RBCs
- Degraded in the stomach before absorption
Correct Answer: Too large to enter blood capillaries directly
Q17. Which immune cell type matures in lymph nodes and is central to humoral immunity?
- T cells
- B cells differentiating into plasma cells
- Neutrophils undergoing apoptosis
- Macrophages turning into osteoclasts
Correct Answer: B cells differentiating into plasma cells
Q18. Lymph composition can change during inflammation by increasing:
- Glucose concentration only
- Protein and immune cell content
- Bone mineral content
- Urea concentration exclusively
Correct Answer: Protein and immune cell content
Q19. Lymphoscintigraphy is a diagnostic test used to:
- Measure arterial blood gases
- Visualize lymphatic drainage and detect obstruction or lymphedema
- Assess cholinergic activity in nerves
- Quantify intracranial pressure
Correct Answer: Visualize lymphatic drainage and detect obstruction or lymphedema
Q20. Which statement about lymph vs plasma oncotic pressure is true?
- Lymph always has higher oncotic pressure than plasma
- Lymph oncotic pressure approximates plasma but is slightly lower due to lower protein
- Oncotic pressure is irrelevant for lymph formation
- Plasma has no oncotic pressure
Correct Answer: Lymph oncotic pressure approximates plasma but is slightly lower due to lower protein
Q21. Peyer’s patches are lymphoid aggregates located in:
- Bronchial mucosa
- Small intestine, especially ileum
- Dental pulp
- Skin epidermis
Correct Answer: Small intestine, especially ileum
Q22. Which molecule produced in plasma is transported in lymph and contributes to antigen opsonization?
- Hemoglobin
- Complement proteins and immunoglobulins
- Myosin
- Actin
Correct Answer: Complement proteins and immunoglobulins
Q23. Lymphatic obstruction leading to protein-rich swelling of tissues is called:
- Edema from heart failure
- Lymphedema
- Angioedema from allergy
- Hydronephrosis
Correct Answer: Lymphedema
Q24. Which anatomical feature prevents backflow of lymph within collecting vessels?
- Valves within lymphatic vessels
- Lack of endothelial lining
- High arterial pressure adjacent
- Capillary sphincters
Correct Answer: Valves within lymphatic vessels
Q25. The primary site for filtration of lymph and adaptive immune activation is the:
- Spleen only
- Lymph node cortex and paracortex
- Adrenal medulla
- Pineal gland
Correct Answer: Lymph node cortex and paracortex
Q26. Which substance increases in lymph after a high-fat meal?
- Glucose only
- Chylomicrons and triglyceride-rich lipoproteins
- Uric acid exclusively
- Creatinine primarily
Correct Answer: Chylomicrons and triglyceride-rich lipoproteins
Q27. In vaccine delivery, targeting lymph nodes enhances immune response mainly because:
- Nodes are sterile and prevent antigen degradation
- Lymph nodes concentrate antigen-presenting cells and lymphocytes for activation
- Lymph prevents antibody formation
- Nodes convert antigen into nutrients
Correct Answer: Lymph nodes concentrate antigen-presenting cells and lymphocytes for activation
Q28. Which cell type in lymph primarily executes cytotoxic responses against infected cells?
- B lymphocytes
- Cytotoxic T lymphocytes (CD8+ T cells)
- Platelets
- Endothelial progenitor cells
Correct Answer: Cytotoxic T lymphocytes (CD8+ T cells)
Q29. The endothelial junctions in lymphatic capillaries allow entry of:
- Only gases, not macromolecules
- Cells, proteins, and large particulate matter
- Only water molecules
- Only ions
Correct Answer: Cells, proteins, and large particulate matter
Q30. Lymphatic vessels are important in metastasis because they:
- Kill all migrating cancer cells
- Can transport tumor cells to regional lymph nodes and beyond
- Prevent tumor cells from leaving primary site
- Convert tumor cells to immune cells
Correct Answer: Can transport tumor cells to regional lymph nodes and beyond
Q31. Which statement is true about the protein content of lymph collected from inflamed tissue?
- Protein content decreases during inflammation
- Protein content increases due to enhanced vascular permeability
- Protein composition becomes identical to urine
- Only albumin disappears from lymph
Correct Answer: Protein content increases due to enhanced vascular permeability
Q32. In the context of drug absorption, which property favors lymphatic uptake from the gut?
- Highly hydrophilic, low molecular weight
- Lipophilic, association with chylomicrons
- Strongly basic and ionized at physiological pH
- Extensive first-pass hepatic extraction only
Correct Answer: Lipophilic, association with chylomicrons
Q33. Which structure in a lymph node is the main site for B cell proliferation and antibody production?
- Medullary sinus
- Germinal center of follicles
- Capsule
- Afferent lymphatic vessel
Correct Answer: Germinal center of follicles
Q34. Which of the following is NOT a function of the lymphatic system?
- Drain excess interstitial fluid
- Transport dietary lipids
- Return plasma proteins to the blood
- Oxygenate arterial blood
Correct Answer: Oxygenate arterial blood
Q35. Lymph from the spleen drains mainly into:
- Directly into the thoracic duct via splenic lymphatics
- Renal pelvis
- Hepatic portal vein
- Bone marrow venous sinuses
Correct Answer: Directly into the thoracic duct via splenic lymphatics
Q36. Which immunoglobulin is predominantly transported in lymph to mucosal sites?
- IgM exclusively
- IgA (especially secretory IgA)
- IgE predominantly
- IgD mainly
Correct Answer: IgA (especially secretory IgA)
Q37. Lymph formation at capillary-interstitium interface is influenced by Starling forces; an increase in capillary hydrostatic pressure leads to:
- Reduced interstitial fluid formation
- Increased filtration into interstitium and more lymph formation
- Immediate reabsorption into arterial lumen
- Decreased lymph flow due to vasoconstriction
Correct Answer: Increased filtration into interstitium and more lymph formation
Q38. Which diagnostic sign indicates disruption of lymphatic drainage in the limb?
- Decreased skin temperature only
- Non-pitting, protein-rich edema and limb swelling
- Sharp localized pain without swelling
- Increased arterial pulses in the limb
Correct Answer: Non-pitting, protein-rich edema and limb swelling
Q39. Which is a pharmacological strategy to enhance drug delivery through the lymphatics?
- Formulating highly water-soluble ionic salts
- Designing lipophilic prodrugs or lipid-based nanoparticles to associate with chylomicrons
- Using molecules that are exclusively renally excreted
- Delivering drugs only via inhalation to avoid lymphatics
Correct Answer: Designing lipophilic prodrugs or lipid-based nanoparticles to associate with chylomicrons
Q40. Which structure serves as the entry point for afferent lymph into a lymph node?
- Efferent lymphatic vessel
- Afferent lymphatic vessels entering the convex surface
- Hilum only
- Thoracic duct directly
Correct Answer: Afferent lymphatic vessels entering the convex surface
Q41. The medullary cords of a lymph node mainly contain:
- Red blood cells and platelets
- Plasma cells and macrophages
- Cartilage and bone
- Hepatocytes
Correct Answer: Plasma cells and macrophages
Q42. Which clinical condition can result from surgical removal of lymph nodes?
- Hyperthyroidism
- Secondary lymphedema due to impaired lymph drainage
- Immediate improvement in lipid absorption
- Increased vaccine efficacy systemically
Correct Answer: Secondary lymphedema due to impaired lymph drainage
Q43. Lymph transported in the thoracic duct empties into which venous junction?
- Left internal jugular and left subclavian vein junction
- Right atrium directly
- Portal vein confluence
- Superior mesenteric vein
Correct Answer: Left internal jugular and left subclavian vein junction
Q44. Which factor most increases the passage of macromolecules into lymphatics rather than blood capillaries?
- Small molecular size and hydrophilicity
- Larger particle size and association with lipids/chylomicrons
- Rapid renal clearance
- Strong binding to hemoglobin
Correct Answer: Larger particle size and association with lipids/chylomicrons
Q45. The presence of Reed-Sternberg cells in lymph nodes is characteristic of:
- Acute bacterial lymphadenitis
- Hodgkin lymphoma
- Reactive hyperplasia only
- Autoimmune thyroiditis
Correct Answer: Hodgkin lymphoma
Q46. Which of the following best describes chylomicron fate after entering lymphatics?
- They are degraded immediately in lymphatics
- Carried via thoracic duct into bloodstream for systemic lipid distribution
- Converted into glucose in lymph nodes
- Sequestered permanently in spleen
Correct Answer: Carried via thoracic duct into bloodstream for systemic lipid distribution
Q47. Which laboratory test specifically assesses immune cells or proteins in lymph fluid clinically?
- Complete urine analysis
- Lymph fluid cytology and flow cytometry for cell immunophenotyping
- Blood glucose only
Correct Answer: Lymph fluid cytology and flow cytometry for cell immunophenotyping
Q48. Which statement about mucosa-associated lymphoid tissue (MALT) is correct?
- MALT is absent in the gastrointestinal tract
- MALT provides localized immune defense at mucosal surfaces
- MALT produces digestive enzymes
- MALT only stores fat
Correct Answer: MALT provides localized immune defense at mucosal surfaces
Q49. Lymphatic endothelial cells express specific markers; which marker is commonly used to identify them?
- CD31/PECAM-1 only found on neurons
- VEGFR-3 and podoplanin (D2-40)
- Albumin as a surface antigen
- Insulin receptor exclusive to lymphatics
Correct Answer: VEGFR-3 and podoplanin (D2-40)
Q50. For B. Pharm students, which concept links lymphatic physiology to drug safety and efficacy?
- Lymphatics have no impact on drug distribution
- Lymphatic transport can alter bioavailability, reduce first-pass metabolism, and influence immune responses to biologics and vaccines
- All drugs are equally taken up by lymphatics
- Lymphatics always inactivate drugs before systemic exposure
Correct Answer: Lymphatic transport can alter bioavailability, reduce first-pass metabolism, and influence immune responses to biologics and vaccines

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