Intracellular accumulation MCQs With Answer are essential for B.Pharm students preparing for pharmacology, toxicology, and pathophysiology exams. This focused set explores cellular mechanisms of intracellular accumulation, including lysosomal storage, protein aggregation, lipid deposition, and drug sequestration. These multiple-choice questions emphasize causes, biochemical pathways, diagnostic markers, and therapeutic implications of intracellular deposits and their pharmacological relevance. Practicing these targeted MCQs improves understanding of cellular transport, organelle dysfunction, xenobiotic handling, and drug-induced accumulation — key concepts in the pharmacy curriculum and clinical practice. Each question includes a clear answer to reinforce learning and exam readiness. Now let’s test your knowledge with 50 MCQs on this topic.
Q1. Which organelle is primarily responsible for degradation of intracellular macromolecules and is central to many intracellular accumulation disorders?
- Lysosome
- Mitochondrion
Correct Answer: Lysosome
Q2. Intracellular accumulation of triglycerides in hepatocytes is termed:
- Glycogenosis
- Steatosis
- Fibrosis
- Cholestasis
Correct Answer: Steatosis
Q3. Which mechanism commonly leads to intracellular accumulation of misfolded proteins?
- Enhanced autophagy
- Ubiquitin-proteasome system dysfunction
- Increased lysosomal enzyme activity
- Enhanced protein chaperone function
Correct Answer: Ubiquitin-proteasome system dysfunction
Q4. Gaucher disease results from deficiency of which lysosomal enzyme causing intracellular accumulation of glucocerebroside?
- Hexosaminidase A
- Glucocerebrosidase (β-glucosidase)
- Sphingomyelinase
- Alpha-galactosidase A
Correct Answer: Glucocerebrosidase (β-glucosidase)
Q5. Which cellular process clears damaged organelles and aggregated proteins and its impairment contributes to intracellular accumulation?
- Endocytosis
- Autophagy
- Exocytosis
Correct Answer: Autophagy
Q6. Accumulation of lipofuscin in aging cells is primarily due to:
- Excessive protein synthesis
- Lysosomal digestion of oxidized organelles
- Active DNA replication
- Increased glycolysis
Correct Answer: Lysosomal digestion of oxidized organelles
Q7. In drug-induced intracellular accumulation, drug sequestration often occurs in which intracellular compartment because of pH trapping?
- Cytosol
- Lysosomes
Correct Answer: Lysosomes
Q8. Which staining method is commonly used to detect neutral lipids in steatotic cells?
- Periodic acid–Schiff (PAS)
- Oil Red O
- Prussian blue
- Masson’s trichrome
Correct Answer: Oil Red O
Q9. Alpha-1 antitrypsin deficiency causes intracellular accumulation of misfolded protein primarily in which organ?
- Kidney
- Liver
- Lung
- Heart
Correct Answer: Liver
Q10. Which molecular tag directs proteins for degradation by the proteasome?
- SUMOylation
- Phosphorylation
- Ubiquitination
- Glycosylation
Correct Answer: Ubiquitination
Q11. Accumulation of hemosiderin intracellularly indicates excess accumulation of which element?
- Calcium
- Iron
- Copper
- Sodium
Correct Answer: Iron
Q12. Which inherited disorder leads to accumulation of sphingomyelin due to sphingomyelinase deficiency?
- Tay–Sachs disease
- Gaucher disease
- Niemann–Pick disease
- Fabry disease
Correct Answer: Niemann–Pick disease
Q13. Which imaging or lab marker is most useful to detect hepatic steatosis noninvasively?
- Serum amylase
- Abdominal ultrasound
- ECG
- Complete blood count
Correct Answer: Abdominal ultrasound
Q14. Proteinacous intracellular inclusions in neurodegenerative disease such as Lewy bodies are primarily composed of which protein?
- Tau
- Alpha-synuclein
- Amyloid-beta
- Huntingtin
Correct Answer: Alpha-synuclein
Q15. Which cellular transport defect can lead to intracellular accumulation of cholesterol and lipids in Niemann–Pick type C?
- Impaired LDL receptor endocytosis
- Failure of late endosome–lysosome cholesterol trafficking
- Excessive cholesterol efflux
- Increased mitochondrial uptake of cholesterol
Correct Answer: Failure of late endosome–lysosome cholesterol trafficking
Q16. Which biochemical change is typical in cells with phospholipidosis due to cationic amphiphilic drugs?
- Decreased lysosomal phospholipids
- Accumulation of phospholipid–drug complexes in lysosomes
- Enhanced mitochondrial fatty acid oxidation
- Increased Golgi-mediated secretion
Correct Answer: Accumulation of phospholipid–drug complexes in lysosomes
Q17. In Fabry disease, which substrate accumulates intracellularly?
- Ceramide trihexoside (globotriaosylceramide)
- Sulfatide
- Glycogen
- Glucocerebroside
Correct Answer: Ceramide trihexoside (globotriaosylceramide)
Q18. Which technique is best to visualize intracellular inclusions at the ultrastructural level?
- Light microscopy with H&E
- Transmission electron microscopy
- Flow cytometry
- NMR spectroscopy
Correct Answer: Transmission electron microscopy
Q19. Accumulation of abnormal proteins due to impaired chaperone-mediated folding primarily implicates which organelle?
- Mitochondrion
- Endoplasmic reticulum
- Lysosome
- Peroxisome
Correct Answer: Endoplasmic reticulum
Q20. Which marker elevates in serum when intracellular hepatic accumulation progresses to hepatocellular injury?
- Serum creatinine
- Alanine aminotransferase (ALT)
- Cardiac troponin
- Alkaline phosphatase only
Correct Answer: Alanine aminotransferase (ALT)
Q21. Which drug class is known to cause phospholipidosis by accumulating in lysosomes?
- Beta-blockers
- Aminoglycoside antibiotics
- Cationic amphiphilic drugs (e.g., amiodarone)
- Statins
Correct Answer: Cationic amphiphilic drugs (e.g., amiodarone)
Q22. Intracellular accumulation of glycogen in muscle due to enzyme deficiency is called:
- Wilson disease
- Pompe disease
- Fabry disease
- Huntington disease
Correct Answer: Pompe disease
Q23. Which pathway transports membrane proteins and lipids between Golgi and lysosomes and, when defective, may cause accumulation?
- Anterograde ER to Golgi only
- Endosome–lysosome trafficking pathway
- Secretory vesicle exocytosis
- Cytoskeletal microtubule polymerization
Correct Answer: Endosome–lysosome trafficking pathway
Q24. Which intracellular pigment accumulates in conditions of chronic hemorrhage or excess iron and is seen as brown granular deposits?
- Mucin
- Hemosiderin
- Melanin
- Biliverdin
Correct Answer: Hemosiderin
Q25. Accumulation of alpha-synuclein in dopaminergic neurons is associated with which disease?
- Alzheimer disease
- Parkinson disease
- Multiple sclerosis
- ALS
Correct Answer: Parkinson disease
Q26. Which therapeutic strategy aims to reduce intracellular substrate accumulation in lysosomal storage disorders?
- Substrate reduction therapy
- Radiation therapy
- Beta-blockade
- Antioxidant supplementation only
Correct Answer: Substrate reduction therapy
Q27. Which biomolecule accumulates in Tay–Sachs disease?
- GM2 ganglioside
- Sphingomyelin
- Glucocerebroside
- Glycogen
Correct Answer: GM2 ganglioside
Q28. Impaired efflux transporters in hepatocytes can cause intracellular drug accumulation; which ABC transporter is key in biliary drug excretion?
- P-glycoprotein (ABCB1)
- Bile salt export pump (BSEP/ABCB11)
- MDR-associated protein 2 (MRP2/ABCC2)
- Organic cation transporter 2 (OCT2)
Correct Answer: MDR-associated protein 2 (MRP2/ABCC2)
Q29. Intracellular accumulation of glycogen in the liver with impaired glucose-6-phosphatase is seen in which von Gierke disease type?
- Type I
- Type II
- Type III
- Type V
Correct Answer: Type I
Q30. Which cellular stress response is activated by accumulation of unfolded proteins in the endoplasmic reticulum?
- Heat shock response
- Unfolded protein response (UPR)
- Oxidative phosphorylation
- DNA damage response
Correct Answer: Unfolded protein response (UPR)
Q31. Lipid-laden macrophages (foam cells) in atherosclerotic plaques result from accumulation of which molecule?
- Triglycerides only
- Cholesteryl esters and oxidized LDL
- Glycogen
- Uric acid crystals
Correct Answer: Cholesteryl esters and oxidized LDL
Q32. Which lab methodQuantitatively estimates intracellular drug accumulation in cultured cells?
- Light microscopy
- Liquid chromatography–mass spectrometry (LC-MS/MS)
- ELISA for serum antibodies
- Western blot for histones
Correct Answer: Liquid chromatography–mass spectrometry (LC-MS/MS)
Q33. Which intracellular accumulation results from chronic ethanol intake leading to fatty liver?
- Protein inclusion bodies
- Hepatic steatosis (fat accumulation)
- Glycogen depletion
- Excess iron deposition
Correct Answer: Hepatic steatosis (fat accumulation)
Q34. Which therapeutic approach supplies the missing lysosomal enzyme to reduce intracellular substrate accumulation?
- Enzyme replacement therapy
- Antibody therapy
- Beta-adrenergic agonists
- Calcium channel blockers
Correct Answer: Enzyme replacement therapy
Q35. Excessive intracellular calcium deposition causing cell injury is known as:
- Dystrophic calcification
- Metastatic calcification
- Steatosis
- Hemosiderosis
Correct Answer: Metastatic calcification
Q36. Which protein quality control pathway recognizes and delivers misfolded ER proteins for degradation via the proteasome?
- Endosomal sorting complex required for transport (ESCRT)
- ER-associated degradation (ERAD)
- Autolysosomal fusion
- Peroxisomal import
Correct Answer: ER-associated degradation (ERAD)
Q37. Which intracellular accumulation causes the “onion-skin” lamellated myelin figures seen with certain drugs?
- Phospholipidosis
- Glycogen storage
- Iron overload
- Uric acid deposition
Correct Answer: Phospholipidosis
Q38. Neuronal accumulation of hyperphosphorylated tau protein is a hallmark of which disorder?
- Parkinson disease
- Alzheimer disease
- Fabry disease
- Wilson disease
Correct Answer: Alzheimer disease
Q39. Which intracellular storage material is PAS-positive and diastase-sensitive?
- Neutral lipids
- Glycogen
- Hemosiderin
- Protein aggregates
Correct Answer: Glycogen
Q40. Defect in which peroxisomal function leads to accumulation of very long–chain fatty acids intracellularly?
- Beta-oxidation in mitochondria
- Peroxisomal beta-oxidation
- Glycolysis
- Cholesterol synthesis
Correct Answer: Peroxisomal beta-oxidation
Q41. Which intracellular accumulation can cause ER stress and activation of apoptotic pathways?
- Excess water only
- Misfolded proteins
- Excess ATP
- Increased ribosomes
Correct Answer: Misfolded proteins
Q42. Which drug-storage phenomenon explains why weakly basic drugs accumulate in acidic lysosomes?
- Passive diffusion only
- pH partitioning (ion trapping)
- Endocytosis of drug–protein complexes
- P-glycoprotein-mediated uptake
Correct Answer: pH partitioning (ion trapping)
Q43. Accumulation of abnormal proteins tagged with ubiquitin typically indicates failure of which system?
- Lysosomal hydrolases only
- Ubiquitin–proteasome system
- Mitochondrial electron transport chain
- Golgi glycosylation enzymes
Correct Answer: Ubiquitin–proteasome system
Q44. Which intracellular accumulation is characteristic of Wilson disease?
- Copper in hepatocytes
- Iron in cardiomyocytes
- Alpha-synuclein in neurons
- Glycogen in muscle
Correct Answer: Copper in hepatocytes
Q45. Which therapeutic modality can restore trafficking defects in some lysosomal storage disorders by correcting the underlying genetic defect?
- Gene therapy
- Systemic corticosteroids
- Antifungal therapy
- Statin therapy
Correct Answer: Gene therapy
Q46. Which component accumulates in Mallory–Denk bodies seen in alcoholic liver disease?
- Keratin intermediate filaments (cytokeratins)
- Collagen type I
- Vimentin only
- Myosin heavy chain
Correct Answer: Keratin intermediate filaments (cytokeratins)
Q47. Measuring intracellular accumulation of fluorescently labeled drugs in live cells is commonly done using:
- Confocal fluorescence microscopy
- Light microscopy without labels
- Naked eye inspection
- Electrocardiography
Correct Answer: Confocal fluorescence microscopy
Q48. Which intracellular accumulation in neurons forms plaques contributing to neurotoxicity in Alzheimer disease?
- Synaptic vesicles
- Amyloid-beta extracellular plaques with intracellular APP processing relevance
- Lysosomal storage bodies only
- Excess neurotransmitters in cytosol
Correct Answer: Amyloid-beta extracellular plaques with intracellular APP processing relevance
Q49. Which laboratory test helps assess systemic iron overload that can lead to intracellular hemosiderin accumulation?
- Serum amylase
- Serum ferritin and transferrin saturation
- Serum insulin
- Urine ketones
Correct Answer: Serum ferritin and transferrin saturation
Q50. Which pro-survival cellular mechanism can be therapeutically enhanced to promote clearance of intracellular aggregates?
- Inhibition of autophagy
- Activation of autophagy
- Suppression of proteasome activity
- Blockage of chaperone proteins
Correct Answer: Activation of autophagy
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