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    Subjects/Biochemistry/Glycolysis
    Glycolysis
    hard
    flask-conical Biochemistry

    A 28-year-old woman from Delhi presents with acute onset of severe muscle pain, dark urine, and myoglobinuria following intense exercise at a gym. Serum creatine kinase is 8,500 U/L (normal <200). Blood glucose is 78 mg/dL, lactate is 1.2 mmol/L (normal), and venous pH is 7.38. Muscle biopsy shows subsarcolemmal glycogen accumulation and absent acid maltase activity. Which glycolytic/glycogenolytic enzyme deficiency would explain the normal lactate despite severe muscle breakdown?

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