Insulin and its preparations MCQs With Answer

Insulin and its preparations MCQs With Answer

Insulin therapy is central to diabetes care, and mastery of insulin preparations is crucial for B. Pharm students. This concise guide covers insulin classification, insulin analogs (lispro, aspart, glulisine, glargine, detemir, degludec), pharmacokinetics and pharmacodynamics (onset, peak, duration), formulations (regular, NPH, U-100, U-500), routes and devices (subcutaneous, IV, pumps), storage and stability, mixing rules, dosing strategies such as basal-bolus, and adverse effects including hypoglycemia and lipodystrophy. Topics also include immunogenicity, biosimilars, insulin assays, patient counseling, and emergency management to build practical pharmacy competence.

‘Now let’s test your knowledge with 30 MCQs on this topic.’

Q1. Which parameters form the basis for classifying insulin preparations?

• Manufacturer and brand name
• Onset, peak and duration of action
• Route of administration only
• Concentration (units/mL) only

Correct Answer: Onset, peak and duration of action

Q2. Which of the following is a rapid-acting insulin analog?

• Insulin lispro
• Regular (soluble) insulin
• NPH (isophane) insulin
• Insulin glargine

Correct Answer: Insulin lispro

Q3. Typical onset of action for insulin lispro is approximately:

• 5 minutes
• 15 minutes
• 60 minutes
• 3 hours

Correct Answer: 15 minutes

Q4. The peak action time of NPH (intermediate-acting) insulin is usually around:

• 30–60 minutes
• 1–2 hours
• 4–10 hours
• 24 hours

Correct Answer: 4–10 hours

Q5. Which insulin provides a relatively flat, long-acting basal profile and should not be mixed with other insulins?

• Insulin aspart
• Regular insulin
• Insulin glargine
• NPH insulin

Correct Answer: Insulin glargine

Q6. Which insulin analog is classified as ultra-long acting with very prolonged duration (>42 hours) suitable for once-daily dosing?

• Insulin detemir
• Insulin degludec
• Insulin lispro
• Regular insulin

Correct Answer: Insulin degludec

Q7. Which insulin formulation is suitable for intravenous infusion in emergencies like DKA?

• Insulin NPH suspension
• Insulin glargine solution
• Regular (soluble) human insulin
• Insulin detemir suspension

Correct Answer: Regular (soluble) human insulin

Q8. What does a U-500 insulin formulation indicate?

• 500 units per vial (no volume specified)
• 500 units per mL (concentrated insulin)
• 500 international units per injection recommended
• Use only for pediatric patients

Correct Answer: 500 units per mL (concentrated insulin)

Q9. Unopened insulin vials should be stored at which temperature range to maintain stability?

• Room temperature (20–25°C)
• Freezer (<0°C)
• Refrigerator (2–8°C)
• Any temperature is acceptable

Correct Answer: Refrigerator (2–8°C)

Q10. After opening, many insulin vials/cartridges can be used at room temperature for approximately:

• 7 days
• 14 days
• 28 days
• 6 months

Correct Answer: 28 days

Q11. Which insulin preparation should not be mixed in the same syringe with other insulins due to pH incompatibility?

• Regular insulin
• Insulin NPH
• Insulin glargine
• Insulin lispro

Correct Answer: Insulin glargine

Q12. When mixing short-acting insulin with NPH in one syringe, which technique is recommended?

• Draw cloudy (NPH) then clear (regular) — cloudy before clear
• Draw clear (regular) then cloudy (NPH) — clear before cloudy
• Mix vials vigorously before drawing
• Always mix glargine first

Correct Answer: Draw clear (regular) then cloudy (NPH) — clear before cloudy

Q13. First-line immediate treatment for a conscious patient experiencing symptomatic hypoglycemia is:

• Intravenous 50% dextrose (IV bolus)
• Intramuscular glucagon only
• Oral administration of 15–20 g fast-acting carbohydrate (glucose)
• Wait and observe for spontaneous recovery

Correct Answer: Oral administration of 15–20 g fast-acting carbohydrate (glucose)

Q14. The most frequent adverse effect associated with insulin therapy is:

• Hepatotoxicity
• Hypoglycemia
• Severe hypertension
• Renal failure

Correct Answer: Hypoglycemia

Q15. Best practice to prevent lipodystrophy at injection sites is:

• Use the same injection spot every time
• Rotate injection sites systematically
• Always inject into scar tissue
• Change insulin brand weekly

Correct Answer: Rotate injection sites systematically

Q16. Rapid-acting analogs achieve faster absorption than regular insulin mainly because:

• They contain added enzymes to digest insulin
• Amino acid substitutions reduce hexamer formation
• They are given intramuscularly only
• They are more concentrated (U-500)

Correct Answer: Amino acid substitutions reduce hexamer formation

Q17. Most clinical insulin preparations today are produced by which method?

• Purified bovine pancreas extracts
• Chemical synthesis from amino acids
• Recombinant DNA technology (human insulin produced in microbes)
• Extraction from porcine pancreas only

Correct Answer: Recombinant DNA technology (human insulin produced in microbes)

Q18. Basal-bolus insulin therapy typically combines which types of insulin?

• Two intermediate-acting insulins only
• Long-acting basal insulin plus rapid-acting bolus insulin
• Only ultra-long acting insulins
• Only pre-mixed insulin twice daily

Correct Answer: Long-acting basal insulin plus rapid-acting bolus insulin

Q19. Insulin pumps (continuous subcutaneous insulin infusion) most commonly use which insulin type?

• NPH suspension
• Regular human insulin
• Rapid-acting insulin analogs
• Insulin glargine solution

Correct Answer: Rapid-acting insulin analogs

Q20. Which insulin has an onset of ~30 minutes and a peak at about 2–4 hours, often used before meals?

• Insulin lispro
• Regular (soluble) insulin
• Insulin glargine
• Insulin detemir

Correct Answer: Regular (soluble) insulin

Q21. NPH insulin is an intermediate-acting preparation formed by complexing insulin with:

• Protamine
• Albumin
• Fatty acids
• Zinc-free buffer

Correct Answer: Protamine

Q22. Historically, which insulin source was associated with higher immunogenicity compared to recombinant human insulin?

• Recombinant human insulin
• Pork (porcine) and bovine animal-derived insulin
• Synthetic peptide insulin
• Plant-derived insulin analogs

Correct Answer: Pork (porcine) and bovine animal-derived insulin

Q23. Insulin exerts its cellular effects primarily by binding to which receptor type?

• G-protein coupled receptor
• Tyrosine kinase receptor
• Nuclear steroid receptor
• Ion channel receptor

Correct Answer: Tyrosine kinase receptor

Q24. A common metabolic consequence of insulin therapy that pharmacists should counsel about is:

• Weight loss
• Weight gain
• Hyperthyroidism
• Ototoxicity

Correct Answer: Weight gain

Q25. Which injection site generally provides the fastest absorption of subcutaneous insulin?

• Thigh
• Upper arm
• Abdomen
• Buttock

Correct Answer: Abdomen

Q26. In diabetic ketoacidosis (DKA), initial insulin management typically involves:

• Subcutaneous NPH every 12 hours
• Continuous IV infusion of regular insulin
• Single IM injection of glargine
• No insulin until potassium is normalized

Correct Answer: Continuous IV infusion of regular insulin

Q27. Insulin glargine is formulated at acidic pH to improve solubility; as a result, when injected it forms microprecipitates that slowly release insulin. This formulation property explains why it:

• Can be mixed safely with NPH
• Should not be mixed with other insulins in the same syringe
• Is ideal for IV use
• Has a very rapid onset

Correct Answer: Should not be mixed with other insulins in the same syringe

Q28. Which long-acting insulin analog uses fatty-acid acylation to bind albumin and prolong duration?

• Insulin aspart
• Insulin detemir
• Insulin lispro
• Regular insulin

Correct Answer: Insulin detemir

Q29. A concentration labeled U-100 on an insulin vial means:

• 100 international units per vial
• 100 units per mL
• 100 mg per mL
• Use by 100 days from opening

Correct Answer: 100 units per mL

Q30. Which laboratory test best reflects average glycemic control over the preceding 2–3 months and is used to monitor insulin therapy effectiveness?

• Fasting plasma insulin level
• Plasma C-peptide
• HbA1c (glycated hemoglobin)
• Random glucose at one visit

Correct Answer: HbA1c (glycated hemoglobin)

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