This directed case study focuses on exercise-induced rhabdomyolysis (exRML).  Students are guided though skeletal muscle cell membrane transport and calcium homeostasis.  They are then asked to predict how depletion of ATP at the skeletal muscle cell level could affect cellular membrane transport, skeletal muscle tissue integrity, blood composition, and kidney organ function. This cause-and-effect scenario, which incorporates human physiology at all levels from ion to organ, is presented in the context of the protagonist, "Rachel," who pushes her exercise regime too far and ends up in the hospital with exRML. Students are provided with a variety of clinical data (vital signs, blood values, and plotted data) and are then invited to apply what they have learned to determine how to tailor Rachel's treatment plan. This case was written for a general biology or human physiology course and is designed to be used within one 50-minute block.