Physiology

Endocrine regulation Practice Questions

23 free Endocrine regulation practice questions for the USMLE Step 1. Tap an option to answer — you get instant feedback, the correct answer, and a detailed explanation for every question.

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Question 1 of 23 Medium

Which of the following is the most common mechanism by which hormone secretion is regulated in the endocrine system?

  1. A Positive feedback from the target gland
  2. B Negative feedback from the target gland
  3. C Autocrine stimulation within the same gland
  4. D Neural conduction along endocrine tissues

Correct answer: Negative feedback from the target gland

Negative feedback from the target gland is the predominant mechanism by which hormone secretion is regulated: when target-gland hormone levels rise sufficiently, they inhibit further release from the hypothalamus and/or pituitary, maintaining homeostasis.

Question 2 of 23 Medium

In the HPA axis, what is the correct sequence of hormone release during a stress response?

  1. A ACTH → CRH → Cortisol
  2. B Cortisol → ACTH → CRH
  3. C CRH → ACTH → Cortisol
  4. D CRH → Cortisol → ACTH

Correct answer: CRH → ACTH → Cortisol

In the HPA axis, stress triggers hypothalamic release of CRH, which stimulates the anterior pituitary to release ACTH; ACTH then acts on the adrenal cortex to produce cortisol.

Question 3 of 23 Medium

Elevated circulating cortisol levels will most directly inhibit which of the following?

  1. A Renin-angiotensin-aldosterone system (RAAS) activation
  2. B Thyroid-stimulating hormone (TSH) secretion
  3. C Corticotropin-releasing hormone (CRH) and ACTH release
  4. D Insulin secretion from pancreatic beta cells

Correct answer: Corticotropin-releasing hormone (CRH) and ACTH release

Cortisol exerts negative feedback on both the hypothalamus and the anterior pituitary, reducing CRH and ACTH secretion to regulate HPA axis activity.

Question 4 of 23 Medium

Which type of stimulus refers to regulation of an endocrine gland by changes in blood ion concentration or other non-hormonal blood chemicals?

  1. A Neural stimulus
  2. B Hormonal stimulus
  3. C Humoral stimulus
  4. D Autocrine stimulus

Correct answer: Humoral stimulus

A humoral stimulus refers to the release of hormones in response to changing levels of ions or nutrients in the blood (e.g., calcium, glucose, osmolarity).

Question 5 of 23 Medium

Which anterior pituitary hormone is directly stimulated by (TRH)?

  1. A ACTH
  2. B TSH
  3. C GH
  4. D Prolactin

Correct answer: TSH

TRH from the hypothalamus stimulates the anterior pituitary to release thyroid-stimulating hormone (TSH), which in turn acts on the thyroid gland.

Question 6 of 23 Medium

If circulating free thyroid hormone (T3/T4) levels rise, what happens to TRH and TSH secretion under normal physiology?

  1. A Both TRH and TSH increase
  2. B TRH increases, TSH decreases
  3. C Both TRH and TSH decrease
  4. D TRH decreases, TSH increases

Correct answer: Both TRH and TSH decrease

Elevated levels of free T3/T4 exert negative feedback on both the hypothalamus (decreasing TRH) and the anterior pituitary (decreasing TSH), reducing further thyroid hormone secretion.

Question 7 of 23 Medium

Which of the following best describes a ‘tropic’ hormone?

  1. A A hormone that acts on the same gland that secreted it
  2. B A hormone that regulates metabolism directly in peripheral tissues
  3. C A hormone that stimulates another endocrine gland to release a hormone
  4. D A peptide hormone derived from cholesterol

Correct answer: A hormone that stimulates another endocrine gland to release a hormone

Tropic hormones are those secreted by one endocrine gland (e.g., pituitary) that stimulate another endocrine gland to release its hormone (e.g., TSH → thyroid gland).

Question 8 of 23 Medium

In the regulation of the (HPG axis), continuous (non-pulsatile) administration of (GnRH) leads to which of the following outcomes?

  1. A Increased LH and FSH release from pituitary
  2. B Decreased LH and FSH release from pituitary
  3. C Increased sex steroid production from gonads
  4. D No change in gonadal function

Correct answer: Decreased LH and FSH release from pituitary

Continuous (non-pulsatile) GnRH leads to downregulation of GnRH receptors in the pituitary and paradoxically reduces LH and FSH release, suppressing gonadal function — a principle used clinically for GnRH agonist therapy.

Question 9 of 23 Medium

Which of the following hormones is primarily regulated by a humoral stimulus related to blood osmolarity rather than hormonal feedback?

  1. A TSH
  2. B ACTH
  3. C ADH
  4. D FSH

Correct answer: ADH

ADH (vasopressin) release is regulated by osmoreceptors in the hypothalamus sensing changes in blood osmolarity (a humoral stimulus), prompting water reabsorption to correct osmolarity.

Question 10 of 23 Medium

Which of the following pairs appropriately illustrates a hormone and its primary peripheral effect?

  1. A TSH → increased insulin release
  2. B ACTH → increased cortisol secretion
  3. C GnRH → increased thyroid hormone production
  4. D ADH → increased glucagon secretion

Correct answer: ACTH → increased cortisol secretion

ACTH stimulates the adrenal cortex to secrete cortisol (a glucocorticoid), which is the primary peripheral effect in the HPA axis response.

Question 11 of 23 Medium

The secretion of hormones in many endocrine axes is pulsatile or circadian rather than constant. What is a key advantage of such rhythmic secretion?

  1. A It ensures constant maximal receptor activation
  2. B It prevents receptor down-regulation over time
  3. C It eliminates negative feedback suppression
  4. D It causes permanent elevation of hormone levels

Correct answer: It prevents receptor down-regulation over time

Pulsatile or circadian secretion avoids continuous receptor stimulation, thereby reducing receptor down-regulation and helping maintain sensitivity of target tissues.

Question 12 of 23 Medium

During a prolonged period of high stress, which endocrine axis is most directly responsible for maintaining elevated glucocorticoid levels?

  1. A HPG axis
  2. B Thyroid axis
  3. C HPA axis
  4. D Somatotropic axis

Correct answer: HPA axis

The HPA axis governs the stress response by increasing CRH, ACTH, and ultimately cortisol (a glucocorticoid), thus sustaining elevated levels during prolonged stress.

Question 13 of 23 Medium

Which of the following correctly describes the control of (TSH) secretion under normal physiology?

  1. A TSH release is stimulated by high circulating T3/T4
  2. B TSH release is independent of hypothalamic input
  3. C TSH release increases when circulating T3/T4 levels fall
  4. D TSH release occurs only in response to neural stimuli

Correct answer: TSH release increases when circulating T3/T4 levels fall

When circulating thyroid hormone (T3/T4) levels fall, reduced negative feedback prompts increased TRH and TSH secretion to stimulate the thyroid gland.

Question 14 of 23 Medium

Which regulatory mechanism is least likely to apply to the secretion of prolactin from the anterior pituitary under physiological conditions?

  1. A Inhibitory regulation by dopamine from the hypothalamus
  2. B Stimulation by thyrotropin-releasing hormone (TRH)
  3. C Positive feedback from elevated prolactin levels
  4. D Suppression by high estrogen levels

Correct answer: Positive feedback from elevated prolactin levels

Prolactin release is primarily under inhibitory control by hypothalamic dopamine, with additional modulation by TRH and estrogen; it is not classically regulated by positive feedback from its own levels.

Question 15 of 23 Medium

Which of the following endocrine regulation scenarios illustrates a ‘short-loop’ negative feedback mechanism?

  1. A Thyroid hormone inhibiting hypothalamic TRH release
  2. B Cortisol inhibiting both CRH and ACTH release
  3. C Pituitary hormone inhibiting hypothalamic releasing hormone secretion
  4. D Pancreatic insulin inhibiting glucagon secretion

Correct answer: Pituitary hormone inhibiting hypothalamic releasing hormone secretion

Short-loop negative feedback refers to a pituitary hormone acting back on the hypothalamus to inhibit secretion of its releasing hormone — matching 'pituitary hormone inhibiting hypothalamic releasing hormone secretion.' Thyroid hormone or cortisol inhibiting the hypothalamus/pituitary are long-loop feedback, and insulin inhibiting glucagon is local paracrine regulation within the pancreas, not a short-loop axis mechanism.

Question 16 of 23 Medium

Which of the following glands is considered a ‘secondary’ endocrine gland (i.e., not primarily endocrine) but still contributes to endocrine regulation?

  1. A Adrenal gland
  2. B Thyroid gland
  3. C Pancreas
  4. D Pituitary gland

Correct answer: Pancreas

The pancreas is often considered a secondary endocrine gland — its main function is digestive (exocrine), but its islets secrete hormones (insulin, glucagon) contributing to endocrine regulation.

Question 17 of 23 Medium

Which of the following best describes how sex steroids regulate the HPG axis in adults under normal conditions?

  1. A Positive feedback of testosterone on GnRH release in males
  2. B Negative feedback of sex steroids on hypothalamus and pituitary
  3. C Stimulation of GnRH release by estrogen in both sexes
  4. D Inhibition of GnRH by gonadal peptides exclusively

Correct answer: Negative feedback of sex steroids on hypothalamus and pituitary

Gonadal sex steroids (e.g., testosterone, estrogen) exert negative feedback on the hypothalamus and anterior pituitary to suppress GnRH and LH/FSH secretion, thereby regulating the HPG axis.

Question 18 of 23 Medium

Which physiologic effect is most directly mediated by glucocorticoids like cortisol during prolonged stress?

  1. A Increased insulin secretion causing hypoglycemia
  2. B Enhanced immune response
  3. C Increased gluconeogenesis and blood glucose
  4. D Increased immune cell proliferation

Correct answer: Increased gluconeogenesis and blood glucose

Glucocorticoids such as cortisol promote gluconeogenesis, raising blood glucose — a key component of the metabolic adaptation to prolonged stress.

Question 19 of 23 Medium

Which of the following best describes the role of the median eminence in endocrine regulation?

  1. A It stores and releases cortisol into the blood
  2. B Where hypothalamic releasing hormones enter the portal blood
  3. C It directly secretes thyroid hormone into circulation
  4. D It converts thyroxine (T4) to active T3

Correct answer: Where hypothalamic releasing hormones enter the portal blood

The median eminence is a hypothalamic region where releasing hormones are secreted into the hypophyseal-portal blood vessels and transported to the anterior pituitary to regulate pituitary hormone secretion.

Question 20 of 23 Medium

Which of the following describes an endocrine control mechanism where a hormone from a target gland rapidly suppresses its upstream regulators (within minutes)?

  1. A Slow (genomic) negative feedback
  2. B Fast (non-genomic) negative feedback
  3. C Positive feedback
  4. D Long-loop positive feedback

Correct answer: Fast (non-genomic) negative feedback

Fast (non-genomic) negative feedback — such as rapid feedback inhibition of the HPA axis by cortisol — can suppress upstream hormone release within minutes, independent of gene transcription.

Question 21 of 23 Medium

Which of the following is NOT a typical mode of stimulus for hormone secretion in endocrine glands?

  1. A Humoral (blood-borne) stimuli
  2. B Neural (nervous system) stimuli
  3. C Hormonal (tropic) stimuli
  4. D Mechanical stretch stimuli

Correct answer: Mechanical stretch stimuli

Typical modes of endocrine gland stimulation include humoral (blood-based), neural (nerve signals), or hormonal (from other glands). Mechanical stretch is not a standard mode of endocrine hormone release.

Question 22 of 23 Medium

Which gland pair is correctly matched with its primary endocrine output and a major physiological function?

  1. A Pancreas → cortisol → stress adaptation
  2. B Adrenal cortex → thyroid hormones → metabolic rate
  3. C Thyroid gland → T3/T4 → basal metabolic rate regulation
  4. D Pituitary posterior lobe → insulin → blood glucose control

Correct answer: Thyroid gland → T3/T4 → basal metabolic rate regulation

The thyroid gland secretes T3 and T4, which are key regulators of basal metabolic rate; this is a central endocrine function.

Question 23 of 23 Medium

Which situation would likely lead to increased (GH) secretion from the anterior pituitary?

  1. A High somatostatin release from hypothalamus
  2. B Sustained high blood glucose levels
  3. C Ghrelin release during fasting
  4. D High circulating IGF-1 concentrations

Correct answer: Ghrelin release during fasting

Ghrelin, released during fasting, stimulates growth hormone (GH) secretion. In contrast, high somatostatin, sustained high blood glucose, and high circulating IGF-1 all inhibit GH release through inhibitory hormones or negative feedback.

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