This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Oxidation of Fatty acids: Ketogenesis, Subject name: Biochemistry
Ketosis is caused by - 
Select and explain. 
A. Excessine utilization of glucose, B. Over production of acetyl-CoA, C. Excessine secretion of insulin, D. Excessine intake of carbohydrates
B: Over production of acetyl-CoA
Answer: B: Over production of acetyl-CoA 
Explanation: Ans. is 'b' i.e., Over production of acetyl-CoA o Ketogenesis occurs when there is high rate of fatty acid oxidation in liver which provides excessine acetyl-CoA.o Normally, rates of ketone body synthesis and their utilization (oxidation) are balanced so that their serum concentration is maintained to very low level (normal is < 0.2 mmol/L or< 1 mg/d1) and urinary excretion is negligible (< 1 mg/ 24 hours).o However, when rate of ketogenesis exceeds their utilization, their concentration in blood rises, and the condition is known as ketonemia (hyperketonemia).o Excess ketone bodies are eliminated in urine, this is known as kenonuria.o The overall condition is called Ketosis.o Ketogenesis is usually associated with excessive fatty acid oxidation^ which occurs most notably in starvation and diabetes (type 1 DM).