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Murder or Medical Mishap?

Death on the Metabolic Ward


Nancy M. Boury
Department of Animal Science
Iowa State University


In this "clicker case," students assume the role of pre-med students participating in a summer internship. As interns, they diagnose several different genetic deficiencies of glycolytic pathway enzymes based on the biochemical activity of blood samples. In order to accurately interpret the blood test data, the students first complete a brief homework assignment before the case is presented. This assignment requires students to describe the reactants, products, and enzymes of the glycolytic pathway. The case reviews the process of glycolysis and its importance in the human body.  As the students work through the case, they are introduced to the physiological significance of isoenzymes and the regulation of glycolysis. The last part of the case is a mystery that reviews enzymatic defects and shows how misregulation of glycolysis can have lethal consequences. The case is designed as a "clicker case" using personal response systems (clickers) to engage students in a large classroom setting.  It is suitable for a second-semester general biology or anatomy and physiology course. A second, shorter version of the case without the "murder-mystery" element is also available in our collection under the title: "Monday on the Metabolic Ward: Adventures in Glycolysis."


  • Outline the process of the Embden-Myerhof pathway from glucose to pyruvate.
  • Predict the products and substrates present when a single enzyme of glycolysis is dysfunctional.
  • Analyze a set of data to determine which enzyme in the Embden-Myerhof pathway is dysfunctional.
  • Describe the insulin and glucagon feedback regulation required to maintain blood glucose homeostasis.
  • Use specific examples to demonstrate the value of isoenzymes in glycolysis.


Glycolysis; glucose; blood sugar; glucagon, insulin; energy; homeostasis; enzymes; isoenzymes; metabolism; metabolic disorders; Embden-Myerhof; anemia; hereditary fructose intolerance

Topical Areas


Educational Level

Undergraduate lower division


PDF, PowerPoint

Type / Methods

Clicker, Interrupted, Role-Play



Subject Headings

Biology (General)  |   Physiology  |   Biochemistry  |  

Date Posted


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Answer Key

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Roya Nabi
Eastern Regional High School
Voorhees, NJ
I used this activity in AP Biology as an extra credit challenge prior to our test on cell respiration. I had the students work in teams. They had to write their answers to the multiple choice questions and provide a one/two sentence rationale. I made copies of the PPT slides and removed some of the comments that say to "refer to homework." I must say they were very engaged and liked the scenario. They all said it "made them think," which really made me happy. This activity took exactly 45 minutes, and I gave them the longer version (with Leo dying at the end). Thank you! thank you! for posting something that piqued their interest on such a difficult topic.