14-With respect to the clinical significance of ketogenesis, which of the statem

Question

14-With respect to the clinical significance of ketogenesis, which of the statements below are FALSE?

a) The Ketone bodies are relatively strong acids

b) The increase of ketone bodies in the blood lowers the pH of the blood.

c) The acidification of the blood by an increase of ketone bodies in the blood is dangerous because it impairs the ability of hemoglobin to bind oxygen

d) A severe increase of ketone bodies in the blood occurs in untreated insulin-dependent diabetes mellitus.

e) none of the above

Explanation / Answer

Ans. Option A. Correct: Ketone bodies are relatively (with respect to water) strong acid. For a comparative account, they have pKa value of around 3.5; so are stronger acids than lactic acid (pKa 3.8).

Option B. Correct. Being strong acid, ketone bodies reduce (lower) the pH of blood below 7.3. The result physiological condition, lowering of blood pH due to ketone bodies is called ketoacidosis.

Option C. Correct. Lowering of blood pH favors the T-state of hemoglobin. T- state of Hb has low affinity for O2 compared to the affinity of R-state. Thus, lowering of blood pH also lowers the affinity of Hb for O2, the phenomenon being known as Bohr’s effect.

Option. D. Correct. Ketogenesis is the formation of ketone bodies (acetone, acetoacetate, b-hydroxybutyrate) from catabolism of fats and ketogenic amino acids. The process takes place when there is scarcity of glucose (the most readily available energy source carbohydrate) in the body. To compensate energy demand under scarcity (low level) of glucose, the cells breakdown fats and ketogenic amino acids (Tyrosine, leucine, lysine, etc.) simultaneously with the product of ketone bodies.

Untreated insulin-dependent diabetes mellitus (as well as insulin- independent, but less severe ketoacidosis compared to previous one) causes low availability of glucose to cells in spite of high blood glucose level. Since, the disease leaves the cell with glucose scarcity, the body cells catabolize fats and ketogenic amino acids to compensate their energy demands leading to the formation of ketone bodies and subsequently ketoacidosis.

Option E. Correct. None of the options (A, B, C, D) is false about ketogenesis.          

Thus,

The correct option is. Option E

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