Q1.
Bacteria can cause a variety of diseases in humans.
(a)  What are two similarities between a bacterial cell and an animal cell?
Tick (✓) two boxes.
 
Both have a cell membrane.		
Both have a cell wall.		
Both have a nucleus.		
Both have cytoplasm.		
Both have plasmids.		
(2)
(b)  Salmonella food poisoning is caused by bacteria in food.
Give one symptom of salmonella food poisoning.
Do not refer to vomiting or diarrhoea in your answer.
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(1)
(c)  What is the name of the first antibiotic developed?
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(1)
A child with a severe bacterial infection was given a course of antibiotics.
Figure 1 shows how the concentration of live bacteria in the child’s body changed when taking the course of antibiotics.
Figure 1
 
(d)  The concentration of live bacteria in the body continued to increase after starting the course of antibiotics.
Suggest one reason why.
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(1)
(e)  After 3 days of taking the antibiotic:
•   the child felt better
•   there were still bacteria in the child’s body.
Why did the child feel better?
Tick (✓) one box.
 
Bacteria had become immune to the antibiotic.		
The child had become resistant to the bacteria.		
There were fewer toxins in the body than at day 0		
(1)
(f)  Suggest why doctors do not give antibiotics to patients with minor infections.
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(1)
Figure 2 shows blood viewed using a microscope.
Figure 2
 
Blood viewed using a microscope © jarun011 / iStock
(g)  A vaccine will stimulate the production of antibodies.
Which part of the blood in Figure 2 produces antibodies?
Tick (✓) one box.
 
A		B		C		D		
(1)
(h)  Which part of the blood in Figure 2 starts the clotting process?
Tick (✓) one box.
 
A		B		C		D		
(1)
(Total 9 marks)
Q2.
The body’s immune system protects us from diseases.
Describe the different ways in which white blood cells protect us from infectious diseases.
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(Total 4 marks)
Q3.
Communicable and non-communicable diseases are major causes of ill health.
(a)  Which disease is a non-communicable disease?
Tick (✓) one box.
 
AIDS		
Cancer		
Gonorrhoea		
Malaria		
(1)
Obesity is a risk factor for many non-communicable diseases.
(b)  Give one non-communicable disease that obesity is a risk factor for.
Do not refer to the diseases given in part (a) in your answer.
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(1)
(c)  National policies are used to help people who are obese to lose weight.
One national policy is to reduce the amount of sugar added to food and drinks.
Suggest one other national policy that could help people to lose weight.
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(1)
(d)  Body mass index (BMI) is one measure of obesity.
BMI is calculated using the equation:
 
The table below shows how BMI is used to describe an adult’s BMI category.
 
BMI	BMI category	
<18.5	Underweight	
18.5 to 24.9	Healthy weight	
25.0 to 29.9	Overweight	
>29.9	Obese	
A person is 1.64 m tall and has a mass of 69 kg.
Determine the BMI category for this person.
Use the BMI equation and the table above.
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The person’s BMI category is  ____________________
(3)
Scientists investigated the effect of smoking and of BMI on the birth mass of babies.
Women’s BMI categories were determined before the women became pregnant.
(e)  Suggest why BMI categories were determined before the women became pregnant.
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(1)
The figure below shows the results.

(f)   Give two conclusions that can be made from the figure above.
1  _________________________________________________________________
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2  _________________________________________________________________
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(2)
(g)  Measles is a communicable disease.
A virus causes measles.
Describe how the measles virus is transferred from person to person.
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(2)
Athlete’s foot is a communicable disease.
A fungus causes athlete’s foot.
The athlete’s foot fungus infects the skin on feet.
(h)  Scientists estimate that 17% of the UK population have athlete’s foot.
The estimated UK population is 67 961 900
Calculate how many people are estimated to have athlete’s foot.
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Estimated number of people with athlete’s foot =  ___________________________
(2)
(i)   Athlete’s foot fungus grows in moist conditions.
Suggest one way a person could reduce their chance of catching athlete’s foot.
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(1)
(Total 14 marks)
Q4.
New drugs have to be thoroughly tested before they are sold.
The diagram shows a time line for the testing of a new drug.
 
(a)    What is the main purpose of pre-clinical testing?
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(1)
(b)     In Phase 1 of the clinical testing, very low doses of the new drug are used on a small number of volunteers.
(i)     What is the main purpose of Phase 1 testing?
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(1)
(ii)     In Phase 1 testing, healthy volunteers are used rather than patients.
Suggest one reason for this.
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(1)
(c)    What is the main purpose of the Phase 2 and Phase 3 testing?
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(1)
(d)    During Phase 3 testing, many of the patients are given a placebo.
(i)     What is meant by a placebo?
______________________________________________________________
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(1)
(ii)     During the testing, who knows which patients are receiving the placebo?
Tick () one box.
 
Only the patients		
Only the doctors		
Both patients and doctors		
Neither patients nor doctors		
(1)
(Total 6 marks)
Q5.
Pseudomonas bacteria cause infections in hospital patients.
A new strain of Pseudomonas bacteria has evolved. This new strain can only be killed by one antibiotic called fluroquinolone.
Scientists want to prevent the new strain of Pseudomonas from spreading in the human population.
Explain the advice doctors should be given to prevent the spread of the new strain.
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(Total 6 marks)
Q6.
In 2014 there was an outbreak of Ebola virus disease (EVD) in Africa.
At the time of the outbreak there were:
•        no drugs to treat the disease
•        no vaccines to prevent infection.
(a)     By March 2015 there were an estimated 9850 deaths worldwide from EVD.
The number of deaths is an estimate.
Suggest why it is an estimate rather than an exact number.
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(1)
(b)     Why were no antibiotics used to treat EVD?
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(1)
(c)     After the outbreak began, drug companies started to develop drugs and vaccines for EVD.
A drug has to be thoroughly tested and trialled before it is licensed for use.
Testing, trialling and licensing new drugs usually takes several years.
Draw one line from each word about drug testing to the definition of the word.
 
Word about drug testing	 	Definition	
 	 	 	 	 	
 	Dose	 	 	Side effects making the person ill	
 	 	 	 	 	
 	Efficacy	 	 	The concentration of the drug to be used and how often the drug should be given	
 	 	 	 	 	
 	Toxicity	 	 	Whether the drug works to treat the illness	
(2)
(d)     The results of drug testing and drug trials are studied in detail by other scientists.
Only then can the results be published by the drug company.
Suggest one reason why the results are studied by other scientists.
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(1)
(Total 5 marks)
Q7.
Some infections are caused by bacteria.
(a)     The genetic material is arranged differently in the cells of bacteria compared with animal and plant cells.
Describe two differences.
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(2)
(b)     Tuberculosis (TB) is an infection caused by bacteria.
The table below shows the number of cases of TB in different regions of southern England from 2000–2011.
        Number of cases of TB per 100 000 people
 
Year	London	South East	South West	
2000	37	5	3	
2001	36	6	4	
2002	42	6	6	
2003	42	7	4	
2004	42	7	5	
2005	49	8	5	
2006	44	8	3	
2007	43	8	5	
2008	44	8	5	
2009	44	9	6	
2010	42	9	5	
2011	45	10	5	
(i)      How does the number of cases of TB for London compare with the rest of southern England?
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(1)
(ii)     Describe the pattern in the data for cases of TB in the South East.
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(1)
(iii)    Describe the pattern in the data for cases of TB in the South West.
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(2)
(c)     (i)      On the graph paper below:
•        plot the number of cases of TB in London
•        label both the axes on the graph
•        draw a line of best fit.
   
(4)
(ii)     Suggest why a student thought the value for 2005 in London was anomalous.
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(1)
(d)     People can be vaccinated against TB.
Suggest how a vaccination programme would reduce the number of people with TB.
Details of how a vaccine works are not required.
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(2)
(Total 13 marks)
Q8.
Scientists at a drug company developed a new pain-killing drug, drug X.
(a)     Painkillers do not cure infectious diseases.
Why?
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(1)
(b)     The scientists compared drug X with two other pain-killing drugs, drug A and drug B.
In their investigation the scientists:
    •  chose 600 volunteers. The volunteers were all in pain
    •  gave 200 of the volunteers a standard dose of drug A
    •  gave 200 of the volunteers a standard dose of drug B
    •  gave 200 of the volunteers a standard dose of drug X.
Over the next seven hours the volunteers recorded how much pain they felt.
To get valid results the three groups of volunteers should be matched for as many factors as possible.
Suggest two of the factors that should be matched.
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(2)
(c)     The graph shows the results of the investigation.
 
(i)      How much pain did the volunteers still feel, four hours after taking drug A?
______________________________ percent
(1)
(ii)     Give one advantage of taking drug A and not drug B.
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(1)
(iii)    Give two advantages of taking drug B and not drug A.
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(2)
(d)     Drug X is much more expensive than both drug A and drug B.
A pharmacist advised a customer that it would be just as good to take drug A and drug B together instead of drug X.
Do you agree with the pharmacist’s advice?
Give reasons for your answer.
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(3)
(Total 10 marks)
Q9.
Read the article.
 
Parents all over the world advise children to ‘wrap up warm or you’ll catch a cold’.
Scientists at Cardiff University recruited 180 volunteers to take part in an investigation to find out if the advice was true. The investigation took place during the city’s common cold season.
Half of the volunteers put their feet in bowls of ice cold water for 20 minutes. The other volunteers sat with their feet in empty bowls.
Over the next few days, almost a third of the volunteers who put their feet into cold water developed colds. Fewer than one in ten of the other volunteers developed colds.	
(a)     Draw a ring around the correct answer to complete the sentence.
 
 	hearsay.	
The advice ‘wrap up warm or you’ll catch a cold’ is an example of	a hypothesis.	
 	a prediction.	
(1)
(b)     What was the experimental control in the investigation?
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(1)
(c)     The scientists did not prove that the advice ‘wrap up warm or you’ll catch a cold’ is true.
Explain why.
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(3)
(Total 5 marks)

Mark schemes
Q1.
(a)  both have a cell membrane
1
both have cytoplasm
1
(b)  any one from:
•   fever
allow high temperature
allow sweating / chills
•   abdominal / stomach cramps
ignore vomiting / sickness / diarrhoea
ignore feel unwell unqualified
ignore rashes
1
(c)  penicillin
allow phonetic spelling
1
(d)  any one from:
•   only a few bacteria killed so live bacteria continued to reproduce
allow bacteria reproducing when course started
•   time delay before antibiotic reached bacteria
allow takes time (for antibiotic) to travel through the body
•   time delay before antibiotic could kill bacteria
allow takes time (for antibiotic) to work
1
(e)  there were fewer toxins in the body than at day 0
1
(f)  to reduce / prevent resistant strains / bacteria developing
ignore references to bacteria becoming immune
or
to reduce / prevent antibiotic resistance (in bacteria)
allow because they will get better without taking any antibiotics
ignore body will fight the infection unqualified
allow some infections are caused by viruses
allow because they have been told not to by NHS / NICE
1
(g)  B
1
(h)  D
1
[9]
Q2.
(wbc) ingest / digest pathogens / bacteria / viruses
allow eat germs
ignore swallow germs
ignore ingest the disease
ignore attack / kill the disease
1
(wbc) produce antibodies
1
(wbc) produce antitoxins
1
any one from:
•        (antibodies) destroy or kill pathogens / bacteria / viruses / germs
ignore destroy / kill disease
ignore attack / fight pathogens
•        (antitoxins) counteract / destroy / neutralise toxins / poisons
ignore attack / killing toxins
•        reasonable reference to memory cells or rapid
production of antibodies upon re-infection
1
[4]
Q3.
(a)  cancer
1
(b)  any one from:
ignore cancer
•   (coronary) heart disease / CHD / cardiovascular disease
allow atherosclerosis
ignore heart attack
•   diabetes
allow high blood pressure
allow stroke / asthma / depression / gallstones / (osteo)arthritis
allow sleep apnoea
1
(c)  any one from:
•   taxes on high energy / fat / sugar foods
allow increase the price on high energy / fat / sugar foods
•   education (about diet and health)
•   (government) advertising
•   restrict media advertising of high energy / fat / sugar foods
•   information on food labels
•   help / advice / groups for obese people via the NHS
•   calorie information on restaurant / takeaway menus
•   regulation of supermarket offers on high sugar / fat / energy foods
•   regulation of type of foods for sale near checkouts
•   exercise campaigns
1
(d)  

1
BMI = 25.6(5437....)
allow 26 or 25.7
1
(the person's BMI category is) overweight
must be consistent with their calculated BMI value
1
(e)  any one from:
•   women will gain mass / weight (during pregnancy)
allow BMI (of woman) will increase (during pregnancy)
•   (developing) baby will increase mass / weight of woman
1
(f)   any two from:
•   smokers had babies with lower birth mass
•   women / smokers / non-smokers with higher BMI had heavier babies
allow obese women have the heaviest / heavier babies
allow underweight women have the lightest / lighter babies
•   smoking had the greatest effect on birth mass in underweight women
•   smoking had the least effect on birth mass in overweight women
•   smoking had less effect on birth mass in overweight and obese women (than in underweight and healthy weight women)
allow there is only a 365 g difference between the smallest and largest babies
2
statements must be comparative
allow converse statements
allow weight for mass
(g)  coughs / sneezes (spread virus in droplets)
allow breathing out (spreads virus in droplets)
1
droplets / virus are inhaled
allow droplets / virus are breathed in
ignore contact with infected person unqualified
1
assume 'it' refers to the virus
allow touch a contaminated surface and then touch your mouth / nose / eyes for 1 mark
if no other marks awarded allow kissing for 1 mark only
(h)  
allow 0.17 x 67 961 900
1
= 11 553 523
allow 11 553 500
1
(i)   any one from:
•   dry feet thoroughly (after washing)
allow use foot powder
ignore keep feet dry
ignore wash feet regularly
•   do not share socks / tights / shoes / towels
•   use a fungicide
allow named fungicide
allow wear silver(-impregnated) socks
•   do not walk around barefoot in public / contaminated areas
allow wear flip flops in public / contaminated areas
ignore avoid moist conditions
1
[14]
Q4.
(a)     testing for toxicity / see if it is safe /see if it is dangerous / to see if it works
ignore side effects unqualified
1
(b)     (i)     testing for side effects / testing for reactions (to drug)
ignore to see if it works
do not accept dosage
1
(ii)    any one from
ignore immune system
•        dose too low to help patient
•        higher risk for patient
•        might conflict with patient’s treatment / patient on other drug
•        effect might be masked by patient’s symptoms / side effects clearer
1
(c)     to find optimum dose
allow testing on larger sample or it makes results more reliable
allow to find out if drug is effective /find out if drug works on ill people (not just if drug works)
1
(d)     (i)     (tablet / drug / injection) that does not contain drug
allow control / fake / false
allow tablet / injection that does not affect body
do not accept drug that does not affect body
1
(ii)     neither patients nor doctors
1
[6]
Q5.
Level 3: Relevant points (advice / reasons) are identified, given in detail and logically linked to form a clear account.
5−6
Level 2: Relevant points (advice / reasons) are identified, and there are attempts at logical linking. The resulting account is not fully clear.
3−4
Level 1: Points are identified and stated simply, but their relevance is not clear and there is no attempt at logical linking.
1−2
No relevant content
0
Indicative content
precautions with reasons
•   do not prescribe fluroquinolone / antibiotics for mild infections
•   because they will get better due to the body’s normal immune system
•   do not prescribe fluroquinolone / antibiotics for viral infections / colds / flu
•   because antibiotics do not kill viruses
•   if you do prescribe fluroquinolone / antibiotics make sure the patient finishes the course
•   because any bacteria left may develop resistance, survive and reproduce rapidly (due to lack of competition)
•   only prescribe fluroquinolone if the patient has the new strain
•   because routine use would lead to an increase in resistant bacteria
other relevant content
•   doctors and nurses in the practice / hospital should be using antibacterial / alcohol hand wash between each patient and / or disinfectant to clean wards
•   to kill (resistant) bacteria
•   doctors should isolate patients with this strain of bacteria
•   to prevent other patients getting the resistant infection
[6]
Q6.
(a)     any one from:
•        not all deaths recorded
•        not all causes of deaths recorded
allow cause may not be known
1
(b)     antibiotics do not kill viruses
allow antibiotics only kill bacteria
1
(c)     
 
all correct for 2 marks
1 or 2 correct for 1 mark
2
(d)     any one from:
•        to prevent false claims
•        to make sure the conclusions are correct / valid
•        to avoid bias
1
[5]
Q7.
(a)     any two from:
•        only one ‘chromosome’
allow one strand of DNA
•        circular
allow loop
•        may have plasmids
•        not in a nucleus / no nucleus
2
(b)     (i)      any one from:
•        London is much higher
or converse
•        more variable / wider range
allow ‘on average it is 5 / 6 times greater’
1
(ii)     increases
Included figures must be correct
1
(iii)    overall slight increase
accept ‘doesn’t change much’
1
variable / goes up and down
1
(c)     (i)      both axes correctly labelled
x = Year
y = Number of cases
1
correct points
all correct = 2 marks
1-2 errors = 1 mark
> 2 errors = 0 marks
2
suitable line of best fit
accept straight line or smooth curve
1
(ii)     doesn’t fit the pattern / line of best fit
1
(d)     provides immunity / protection (to TB)
ignore ‘stops people catching it’
ignore ‘resistance’
1
prevents TB spreading
accept ref to herd immunity
1
[13]
Q8.
(a)     don’t kill pathogens / bacteria / viruses / microbes / microorganisms
allow don’t contain antibiotics
ignore antibodies / attack / fight
allow only treat symptoms / pain
ignore kill disease / germs
1
(b)     any two from:
•        age
•        gender
•        extent / severity of pain
or how long had pain before trial
•        type of pain / illness / site of pain
accept ‘the pain’ for 1 mark, if neither extent or type given
ignore pain threshold
•        (body) mass / weight / height
allow body size / physique
•        other medical issues / drugs taken / health / fitness
•        ethnicity
2
(c)     (i)        75
ignore calculations / %
1
(ii)     faster pain relief / decrease
allow pain relief sooner 
or it works quicker
or more pain relief at start / in first 1 / 1 hours
1
(iii)    decrease of pain higher / more
ignore more effective unless qualified by time > 1 
hours allow effect lasts longer
1
decrease of pain is longer lasting
1
(d)     any three from:
ignore yes or no
(Yes because)
•        rapid pain relief (from A)
•        long lasting pain relief (from B)
•        and it costs less
•        the sum of the pain relief (from A + B) is greater (than X)
(No because)
•        drug X gives more pain relief
•        (A + B / they ) might interact with each other
•        could result in overdose
•        could be more / new side effects
if neither points gained
allow (more) dangerous
3
[10]
Q9.
(a)    hearsay
1
(b)     (volunteers with feet in) empty bowls
accept bowl with no (iced) water
do not accept mention of bowl with iced water
1
(c)     any three from:
ignore control variables, eg age, gender
•       only some of those whose feet were in cold water caught colds
•       some controls caught colds 
•        only feet were cold in experimental group 
allow (control) not wrapped up warm
•        only kept feet in cold water for 20 minutes 
•        insufficient evidence for ‘proof’ / only showed increased risk 
allow small sample size
•        don’t know activities of individuals before / after the investigation
(eg exposure to cold virus) / reference to immune system
allow investigation done in ‘cold season’
3
[5]