Calcitonin MCQs With Answer

Calcitonin MCQs With Answer offer B. Pharm students a focused, clinical and pharmacological review of calcitonin, a peptide hormone released from thyroid C‑cells with key roles in bone metabolism and calcium homeostasis. These MCQs cover mechanism of action, receptor signaling (cAMP), therapeutic uses (hypercalcemia, Paget’s disease, osteoporosis adjunct), formulations (injectable, nasal), pharmacokinetics, adverse effects, diagnostic relevance in medullary thyroid carcinoma, and differences between human and salmon calcitonin. Questions also explore interactions, monitoring parameters, dosing, and stability. This set is designed to deepen understanding and prepare you for exams and clinical practice. Now let’s test your knowledge with 30 MCQs on this topic.

Q1. What is the primary source of endogenous calcitonin?

• Parafollicular C-cells of thyroid
• Parathyroid chief cells
• Osteoblasts
• Renal tubular cells

Correct Answer: Parafollicular C-cells of thyroid

Q2. Which of the following best describes calcitonin’s main effect on bone?

• Inhibits osteoclast activity, reducing bone resorption
• Stimulates osteoclast differentiation to increase resorption
• Directly increases osteoblast proliferation and bone formation
• Enhances PTH secretion to regulate bone turnover

Correct Answer: Inhibits osteoclast activity, reducing bone resorption

Q3. Calcitonin exerts its effects primarily through which intracellular second messenger?

• Cyclic AMP (cAMP)
• Inositol triphosphate (IP3)
• Tyrosine kinase phosphorylation
• Nitric oxide (NO)

Correct Answer: Cyclic AMP (cAMP)

Q4. Which formulation of calcitonin is commonly used for osteoporosis treatment?

• Nasal spray (salmon calcitonin)
• Oral tablet (human calcitonin)
• Transdermal patch (recombinant)
• Intravenous infusion (daily)

Correct Answer: Nasal spray (salmon calcitonin)

Q5. Salmon calcitonin is often preferred over human calcitonin because:

• It has greater potency and longer duration of action
• It is less antigenic and causes no antibody formation
• It is orally bioavailable
• It directly increases renal calcium reabsorption

Correct Answer: It has greater potency and longer duration of action

Q6. Which clinical condition is calcitonin most appropriately used to treat acutely?

• Severe hypercalcemia
• Chronic hypocalcemia
• Vitamin D deficiency
• Primary hypoparathyroidism

Correct Answer: Severe hypercalcemia

Q7. How is calcitonin helpful as a diagnostic marker?

• Elevated levels indicate medullary thyroid carcinoma
• Low levels confirm primary hyperparathyroidism
• High levels diagnose osteoporosis severity
• Undetectable levels indicate Paget’s disease

Correct Answer: Elevated levels indicate medullary thyroid carcinoma

Q8. What is a common adverse effect of calcitonin therapy, especially with nasal spray?

• Rhinitis and nasal irritation
• Severe hyperkalemia
• Neutropenia
• Hepatotoxicity

Correct Answer: Rhinitis and nasal irritation

Q9. Which statement best describes calcitonin’s interaction with parathyroid hormone (PTH)?

• Calcitonin lowers serum calcium, opposing PTH action
• Calcitonin stimulates PTH secretion to maintain calcium
• Calcitonin and PTH have identical effects on bone
• Calcitonin increases renal conversion of vitamin D like PTH

Correct Answer: Calcitonin lowers serum calcium, opposing PTH action

Q10. The therapeutic effect of calcitonin on bone is primarily due to:

• Direct inhibition of osteoclasts leading to reduced resorption
• Activation of osteoclasts to remodel bone
• Increased intestinal calcium absorption
• Enhanced vitamin D synthesis in the kidney

Correct Answer: Direct inhibition of osteoclasts leading to reduced resorption

Q11. Which route of administration provides rapid effect in hypercalcemic emergencies?

• Subcutaneous or intramuscular injection
• Oral tablet
• Nasal spray
• Transdermal patch

Correct Answer: Subcutaneous or intramuscular injection

Q12. Calcitonin decreases serum calcium primarily by:

• Inhibiting osteoclastic bone resorption
• Increasing renal tubular reabsorption of calcium
• Stimulating intestinal calcium absorption
• Promoting PTH secretion

Correct Answer: Inhibiting osteoclastic bone resorption

Q13. Which is true regarding development of antibodies to calcitonin therapy?

• Antibody formation can reduce clinical efficacy over time
• Antibodies enhance calcitonin’s potency
• Antibody formation is not possible due to identical human sequence
• Antibodies cause severe allergic reactions in most patients

Correct Answer: Antibody formation can reduce clinical efficacy over time

Q14. Which lab finding would you expect after calcitonin administration in hypercalcemia?

• Rapid fall in serum calcium within hours
• Marked increase in serum phosphate within minutes
• Immediate large increase in urinary calcium excretion only
• Sustained increase in PTH secretion

Correct Answer: Rapid fall in serum calcium within hours

Q15. Which statement about calcitonin pharmacokinetics is correct?

• It has a short plasma half‑life, cleared by kidney and liver
• It is long‑acting with half‑life measured in days
• It is extensively absorbed orally with high bioavailability
• It accumulates significantly with repeated dosing

Correct Answer: It has a short plasma half‑life, cleared by kidney and liver

Q16. In Paget’s disease of bone, calcitonin is used because it:

• Reduces abnormal osteoclastic activity and bone pain
• Stimulates rapid bone formation to replace lytic lesions
• Is the first-line lifelong therapy preferred over bisphosphonates
• Increases PTH to normalize bone turnover

Correct Answer: Reduces abnormal osteoclastic activity and bone pain

Q17. Which is a contraindication or precaution for calcitonin use?

• Known hypersensitivity to calcitonin (e.g., salmon protein)
• Asymptomatic mild hypocalcemia
• Concurrent use of bisphosphonates (always contraindicated)
• Use in all pregnant women due to teratogenicity

Correct Answer: Known hypersensitivity to calcitonin (e.g., salmon protein)

Q18. Which diagnostic test is most specific for medullary thyroid carcinoma monitoring?

• Serum calcitonin level
• Serum alkaline phosphatase
• Serum osteocalcin
• Thyroid peroxidase antibody

Correct Answer: Serum calcitonin level

Q19. Calcitonin gene-related peptide (CGRP) differs from calcitonin because:

• CGRP is a distinct neuropeptide involved in vasodilation and pain
• CGRP has identical effects on bone resorption as calcitonin
• CGRP is secreted by thyroid C-cells to regulate calcium
• CGRP is used therapeutically for hypercalcemia

Correct Answer: CGRP is a distinct neuropeptide involved in vasodilation and pain

Q20. Monitoring response to calcitonin therapy in Paget’s disease is best done by serial measurement of:

• Serum alkaline phosphatase
• Serum calcitonin only
• Serum calcium alone
• Urinary sodium excretion

Correct Answer: Serum alkaline phosphatase

Q21. Which mechanism explains calcitonin’s renal effects?

• Minor inhibition of renal tubular reabsorption of calcium and phosphate
• Large increase in renal calcium reabsorption causing hypercalcemia
• Activation of 1-alpha-hydroxylase increasing vitamin D
• Stimulation of renin release to alter electrolyte balance

Correct Answer: Minor inhibition of renal tubular reabsorption of calcium and phosphate

Q22. A pharmacologic limitation of calcitonin therapy for osteoporosis is:

• Development of tachyphylaxis and reduced long‑term efficacy
• Extremely long duration of action leading to accumulation
• Excessive stimulation of bone formation causing osteosclerosis
• Complete lack of effect on bone pain

Correct Answer: Development of tachyphylaxis and reduced long‑term efficacy

Q23. Which is true regarding the use of calcitonin in pregnancy?

• Use only if potential benefit justifies the potential risk to fetus
• It is absolutely contraindicated in all pregnant patients
• It is the preferred therapy for hypercalcemia in pregnancy
• It crosses the placenta and is teratogenic in first trimester

Correct Answer: Use only if potential benefit justifies the potential risk to fetus

Q24. What is the molecular nature of calcitonin?

• Peptide hormone composed of about 32 amino acids
• Steroid hormone synthesized from cholesterol
• Small molecule catecholamine
• Thyroid iodine-containing amino acid derivative

Correct Answer: Peptide hormone composed of about 32 amino acids

Q25. Which best describes the clinical role of calcitonin compared with bisphosphonates in osteoporosis?

• Calcitonin is less potent and often adjunctive; bisphosphonates are first line
• Calcitonin is more effective and replaces bisphosphonates as first line
• Both are identical in efficacy and side effect profile
• Calcitonin cures osteoporosis permanently after short course

Correct Answer: Calcitonin is less potent and often adjunctive; bisphosphonates are first line

Q26. Which adverse effect is most associated with injectable calcitonin therapy?

• Nausea and flushing
• Severe neutropenia
• Hepatic necrosis
• Renal tubular acidosis

Correct Answer: Nausea and flushing

Q27. In pharmacology, tachyphylaxis to calcitonin refers to:

• Rapid decrease in response after repeated administration
• Delayed onset of action after first dose
• Enhanced response with chronic dosing
• Autoimmune destruction of thyroid C-cells

Correct Answer: Rapid decrease in response after repeated administration

Q28. During a provocative test for medullary thyroid carcinoma, calcitonin levels that rise after stimulation indicate:

• Presence of C-cell hyperplasia or medullary carcinoma
• Deficiency of vitamin D
• Primary hypoparathyroidism
• Normal thyroid function with no pathology

Correct Answer: Presence of C-cell hyperplasia or medullary carcinoma

Q29. Which storage requirement is important for calcitonin formulations?

• Protect from light and store refrigerated as directed
• Store at room temperature indefinitely without protection
• Must be frozen and thawed before each use
• Keep in direct sunlight for activation

Correct Answer: Protect from light and store refrigerated as directed

Q30. For long-term management of bone pain in Paget’s disease, calcitonin is effective because it:

• Reduces osteoclastic overactivity and alleviates bone pain
• Increases serum calcium to relieve pain receptors
• Directly anesthetizes bone tissue
• Causes rapid bone formation that increases pain

Correct Answer: Reduces osteoclastic overactivity and alleviates bone pain

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