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Review Question - QID 109407

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QID 109407 (Type "109407" in App Search)
A 5-year-old boy is brought to the emergency department by his parents for difficulty breathing. He was playing outside in the snow and had progressive onset of wheezing and gasping. His history is notable for eczema and nut allergies. The patient has respirations of 22/min and is leaning forward with his hands on his legs as he is seated on the table. Physical examination is notable for inspiratory and expiratory wheezes on exam. A nebulized medication is started and begins to relieve his breathing difficulties. Which of the following is increased in this patient as a result of this medication?

Diacylglycerol

4%

9/229

Cyclic GMP

14%

31/229

Cyclic AMP

74%

170/229

Protein kinase C

3%

8/229

ATP

2%

5/229

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The patient in the question is likely having an asthma attack, for which he is given albuterol. Albuterol is a beta-2 adrenergic receptor agonist and leads to an increase in cyclic AMP.

Molecular signaling is often conducted through G-protein coupled receptors (GPCRs). The Gs subtype’s alpha receptor activates the conversion of ATP to cAMP which leads to increased levels of protein kinase A. There are a number of receptors that use this GPCR subtype, including the beta-adrenergic receptors, dopamine 1 receptor, histamine 2 receptor, and the vasopressin 2 receptor. Albuterol is a beta-2 receptor agonist and would therefore lead to an increase in cyclic AMP levels.

Incorrect Answers:
Answer 1: Diacylglycerol would increase with the Gq subtype, which is activated by histamine 1, alpha 1, vasopressin 1, muscarinic 1, and muscarinic 3 receptors.

Answer 2: Cyclic GMP is increase by nitric oxide and nitrates.

Answer 4: Protein kinase C levels increase with the Gq subtype. Albuterol increases levels of cyclic AMP and protein kinase A.

Answer 5: ATP levels would decrease as ATP is converted to cyclic AMP.

Bullet Summary:
The Gs subtype of GPCRs activates adenylyl cyclase which increases cyclic AMP and ultimately protein kinase A activity.

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