A 17-Year-Old Boy Who Was Recently Diagnosed with Type 1

question 44

Multiple Choice

A 17-year-old boy who was recently diagnosed with type 1 diabetes mellitus is found unresponsive at home.  His family reports that the patient did not feel good last night and skipped dinner, but he still took his usual dose of insulin.  Paramedics find that his fingerstick blood glucose is 32 mg/dL and immediately administer intramuscular glucagon.  Glucagon binds to a transmembrane receptor in hepatocytes, which promotes binding of intracellular GTP to a specific receptor-associated protein.  This leads to further downstream signaling and rapid metabolic changes within hepatocytes, including a rapid decrease in intracellular glycogen stores and release of glucose into the blood.  Which of the following is the most likely mediator responsible for these effects?

• A)cGMP-dependent protein kinase
• B)Janus tyrosine kinase
• C)Phosphodiesterase
• D)Protein kinase A
• E)Tyrosine-specific protein kinase

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