Biochemistry · USMLE Step 1

USMLE Biochemistry: Lipid Metabolism

Fatty acid synthesis, beta-oxidation, and lipoprotein metabolism tested on USMLE Step 1.

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What is the rate-limiting enzyme of fatty acid synthesis?
Acetyl-CoA carboxylase
What vitamin-derived cofactor does acetyl-CoA carboxylase require?
Biotin
What is the direct product of the acetyl-CoA carboxylase reaction?
Malonyl-CoA
Which metabolite allosterically activates acetyl-CoA carboxylase?
Citrate
Which metabolite provides feedback inhibition of acetyl-CoA carboxylase?
Palmitoyl-CoA (long-chain fatty acyl-CoA)
Which enzyme phosphorylates and inactivates acetyl-CoA carboxylase during fasting or exercise?
AMP-activated protein kinase (AMPK)
What multi-enzyme complex assembles palmitate from acetyl-CoA and malonyl-CoA units?
Fatty acid synthase
In which cellular compartment does fatty acid synthesis take place?
The cytoplasm
In which cellular compartment does fatty acid beta-oxidation take place?
The mitochondrial matrix
What pathway is the main source of NADPH used in fatty acid synthesis?
The pentose phosphate pathway (HMP shunt)
What shuttle moves acetyl-CoA from the mitochondria to the cytoplasm for fatty acid synthesis?
The citrate shuttle
Which enzyme cleaves cytoplasmic citrate into acetyl-CoA and oxaloacetate?
ATP-citrate lyase
What molecule is required to shuttle long-chain fatty acids into the mitochondria for oxidation?
Carnitine
What is the rate-limiting enzyme of fatty acid beta-oxidation?
Carnitine palmitoyltransferase I (CPT-I)
Which metabolite inhibits CPT-I, preventing fatty acid oxidation when synthesis is active?
Malonyl-CoA

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