Lactic acidosis, weakness, fatigue, and sleepiness are observed in patients with genetic defects of one if the enzymes of pyruvate dehydrogenase complex. Explain The causes of the elevation of lactate in the blood of such patients and the emergence of hypoenergetic state. For this purpose write the following:   a) scheme of the metabolic pathway of glucose metabolism, that includes this reaction and calculates the energetic effect of the process, outlining the reactions coupled with the use and formation of ATP.   b) reaction of the reduction of pyruvate and explain the reason for its acceleration inpatients that have such genetic defects.

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