<prompt> Hyperammonemia impairs Citric acid cycle by depletingPyruvatea-ketoglutarateOxaloacetateSuccinate  <response>: Hyperammonemia, as occurs in advanced liver disease, leads to loss of consciousness, coma, and convulsions as a result of the impaired activity of the citric acid cycle, leading to reduced formation of ATP. Ammonia both depletes citric acid cycle intermediates by withdrawing a-ketoglutarate for the formation of glutamate and glutamine and also inhibits the oxidative decarboxylation of a-ketoglutarate. Reference: Harper; 30th edition; Page no: 161 