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I think they are talking about the GHRH receptor on somatotrophs, which works through the cAMP pathway.
I don’t know how it relates to GH/IGF-1 in particular, but the question said there was a mutation in the alpha subunit of Gs, which activates adenylyl cyclase.
I agree the patient does have Acromegaly, but in the question it talked about how the patient had a mutation that prevented the GTPase activity of Gas. So Gs would be overactive --> excess adenylyl cyclase
ugh i was so excited too bc i thought i remembered jak stat epicfail