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MBBS QUESTION #10353
Question 1
Ketone bodies (acetoacetate, beta-hydroxybutyrate, and acetone) are synthesized primarily in the liver during prolonged fasting or uncontrolled diabetes, yet the liver itself cannot utilize the ketone bodies it produces for energy, because it lacks which enzyme?
  • HMG-CoA synthase
  • Succinyl-CoA:3-ketoacid CoA transferase (thiophorase)✔️
  • HMG-CoA reductase
  • Beta-hydroxybutyrate dehydrogenase
Correct Answer Explanation
The liver possesses the enzymes to synthesize ketone bodies but lacks thiophorase, required to reactivate acetoacetate back to acetoacetyl-CoA for further metabolism; this ensures ketone bodies are exported for use as fuel by extrahepatic tissues (brain, heart, skeletal muscle) rather than being consumed by the liver that produces them.