1.

(a)

Tuberculosis is caused by the bacterium, Mycobacterium tuberculosis.

Describe how Mycobacterium tuberculosis enters the human body.
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(2)

The graph shows the death rate from tuberculosis in England and Wales.
4000
3500
3000
D e a th s p e r 2 5 0 0
m illio n o f
p o p u la tio n 2 0 0 0
1500
1000
500
0
1840 1860 1880 1900 1920 1940 1960 1980 2000
Year

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(b)

The population of England and Wales in 1860 was 20 066 000. Calculate the
number of people who died of tuberculosis that year. Show your working.

Answer ..................................
(2)
(Total 4 marks)

2.

(a)

The graph shows the number of new cases of two diseases which occurred in
two different human populations.

S a lm o n e lla fo o d p o is o n in g

N um ber of
new cases
re p o rte d
each day

In flu e n z a

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6
T im e / d a y s

10

11

Explain the shape of the curve for

(i)

Salmonella food poisoning;

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(ii)

influenza.
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(2)

(b)

Individuals with food poisoning often suffer from diarrhoea. Explain how the
effects of diarrhoea on the body can be treated.
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(2)
(Total 4 marks)

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3.

(a)

Whooping cough is a childhood respiratory disease caused by a bacterium.

The graph shows the incidence of whooping cough in Central Europe from 1969
to 1999.
7
6
5
R e p o rte d
cases per 4
100 000
p o p u la tio n 3
2
1
0
1969 1974 1979 1984 1989 1994 1999
Year

(i)

Calculate the percentage change in the incidence of whooping cough from

1982 to 1999. Show your working.

Answer ............................................
(2)

(ii)

Suggest one reason for the trend in the number of cases of whooping
cough since 1982.
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(1)

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(b)

Whooping cough bacteria prevent the normal functioning of cilia in the respiratory
tract. Explain how this effect is linked to the persistent coughing associated with
the disease.
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(2)
(Total 5 marks)

4.

The table shows the results of some blood tests carried out on a patient admitted to
hospital suffering from a suspected myocardial infarction (heart attack).
Substance

Concentration in
patients
blood/arbitra
ry units

Range of
concentratio
n in blood of
healthy
individuals/a
rbitrary units

Urea

5.7

2.56.7

Cholesterol

8.2

3.66.7

2263

300 600

4.3

3.4 5.2

Lactate dehydrogenase enzyme

Potassium

(a)

A myocardial infarction results in damage to the muscle of the heart.

(i)

Explain how a blood clot may cause damage to the muscle of the heart.
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(2)

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(ii)

Lactate dehydrogenase is an enzyme found inside healthy heart muscle

cells. Suggest why the concentration of this enzyme in the blood can be
used to confirm that this patient had suffered a myocardial infarction.
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(2)

(b)

Use the table to explain what is meant by a risk factor.

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(2)
(Total 6 marks)

5.

(a)

The graph shows the number of deaths from influenza per year in a developed
country.

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6
N um ber of
d e a th s p e r
year /
th o u s a n d s

5
4
3
2
1
0

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5
7
6
T im e / y e a rs

10

11

(i)

Suggest an explanation for the change in the number of deaths from

influenza during the first 10 years.
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(1)

(ii)

Suggest an explanation for the large increase in the number of deaths from
influenza in year 11.
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(2)

(b)

The diagram shows some of the structures on the outside of an influenza virus.
N e u ra m in id a s e

H a e m a g g lu tin in

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Haemagglutinin and neuraminidase are protein molecules. Haemagglutinin binds

to receptor molecules on the surface of epithelial cells in the breathing system.
Neuraminidase is an enzyme which breaks down molecules in the surface
membrane of epithelial cells and allows the viruses to be released from the cells.
(i)

Describe how T lymphocytes recognise and respond to the influenza virus.

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(2)

(ii)

Describe how B lymphocytes respond to the influenza virus.

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(2)

(c)

New drugs have recently become available for treating influenza. One type is a
neuraminidase inhibitor. Explain how this type of drug would act as a treatment
for influenza.
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(2)
(Total 9 marks)

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6.

People considered at risk are offered a vaccination against influenza each year. The bar chart
shows the number of people in the UK population aged 65 and over and the percentage of those
who were vaccinated against influenza each winter.
100

10

80

P e rc e n ta g e o f
p e o p le a g e d
65 and over 60
v a c c in a te d
th a t w in te r

40

P o p u la tio n
aged 65 and
o v e r / m illio n s

P e rc e n ta g e
20

(a)

1990
1991

1995
1996

1998
1999
Y ear

2000
2001

2002
2003

P o p u la tio n

Suggest one reason to explain the change in the percentage of people aged 65
and over being vaccinated.
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(1)

(b)

(i)

Calculate the change in the total number of people aged 65 and over being
vaccinated between 1990/91 and 2000/01. Show your working.

Answer .................................
(2)

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(ii)

A student suggested that some people aged 65 and over were being
vaccinated every year. Explain how the information in the bar chart
supports this suggestion.
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(2)

(iii)

Suggest why it is advisable for people to be vaccinated against influenza

every year.
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(2)

(c)

An influenza virus consists of a protein coat surrounding nucleic acid. The

influenza vaccine consists only of the protein coat of the virus. Explain how the
influenza vaccine produces immunity in the body.
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(2)
(Total 9 marks)

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