Exam questions · Biology
Non-communicable Diseases
- 30 exam questions
- 89 marks
- 45 quick checks
Non-communicable Diseases and their Causes
Just this lesson-
1 State [1 mark]
State what is meant by a non-communicable disease.
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Model answer
A disease that is not caused by a pathogen, and cannot be passed from one person to another.
Mark scheme
- No pathogen, so it cannot be passed on — 1 mark
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2 State [2 marks]
State two non-communicable diseases that are caused by an interaction of factors.
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Model answer
Any two from: coronary heart disease, cancer, type 2 diabetes, emphysema, cirrhosis of the liver, obesity.
Mark scheme
- First — 1 mark
- Second — 1 mark
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3 Explain [3 marks]
A man has a family history of heart disease, eats a diet that is high in fat, and smokes. Explain why it is not possible to say that any one of these causes his heart disease.
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Model answer
Heart disease is caused by many factors that interact, including genes, diet and smoking. Each of the factors raises the risk, but none of them on its own makes the disease certain, and together they may increase the risk even more.
Mark scheme
- Many factors are involved — 1 mark
- Each raises the risk but is not certain on its own — 1 mark
- Factors may combine to increase the risk further — 1 mark
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4 Calculate [3 marks]
In a study, 80 out of 400 people who ate a high fat diet developed heart disease, and 30 out of 600 who ate a low fat diet did. Calculate the percentage in each group who developed heart disease.
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Model answer
High fat: 80 ÷ 400 × 100 = 20%. Low fat: 30 ÷ 600 × 100 = 5%. People on the high fat diet were 4 times more likely.
Mark scheme
- 20% — 1 mark
- 5% — 1 mark
- 4 times, or a correct comparison — 1 mark
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5 Explain [3 marks]
A scatter diagram shows that countries with more cars per person have more cases of heart disease. Explain why this does not show that cars cause heart disease.
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Model answer
A correlation does not prove a cause. Another factor, such as a richer country with less exercise and more fatty food, could cause both. More evidence is needed, such as a mechanism.
Mark scheme
- Correlation is not cause — 1 mark
- Another factor may cause both — 1 mark
- More evidence needed, such as a mechanism — 1 mark
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6 Evaluate [6 marks]
A government wants to reduce the number of people with non-communicable diseases. Evaluate the actions that it could take at a national level.
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Model answer
A government could pass laws, such as banning smoking in public places, which protects other people and reduces smoking, and has been shown to work. It could tax unhealthy foods and drinks, which raises money and may reduce how much people buy. It could run education campaigns on diet, exercise and alcohol, which are cheap but may not change behaviour in people who choose not to listen. It could offer screening and health checks, to find disease early, although this costs money. Laws can reduce freedom of choice, and some people oppose this. The most effective approach is likely to be to use a combination of laws, taxes and education, because the diseases have many causes, and the cost is much less than that of treating a large number of people with long-term illnesses.
Mark scheme
- A law, such as a smoking ban — 1 mark
- A tax on unhealthy food — 1 mark
- Education campaigns — 1 mark
- A limit or disadvantage, such as cost, or freedom of choice — 1 mark
- Screening or health checks — 1 mark
- A reasoned judgement — 1 mark
Quick check
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1
Which is a non-communicable disease?
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C: Coronary heart disease
Coronary heart disease is not caused by a pathogen, and cannot be passed on.
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2
What is a risk factor?
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A: Something that increases the chance of getting a disease
It is something that increases the chance of a disease.
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3
Which disease is caused by a lack of vitamin C?
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D: Scurvy
Scurvy is a deficiency disease caused by too little vitamin C.
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4
Which of these is a lifestyle factor?
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B: Smoking
Smoking is a choice that affects health, and is part of a person's lifestyle.
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5
What does a correlation show?
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C: That two variables are linked
It shows a link between two variables, which is not always a cause.
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6
In a study, 20 of 200 people got a disease. What percentage is this?
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A: 10%
\(20 \div 200 \times 100 = 10\%\).
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7
Why are large samples better than small samples in health studies?
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D: They give more reliable results
They give more reliable results, and are less affected by chance.
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8
Why are non-communicable diseases becoming more common worldwide?
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B: People live longer, and lifestyles are changing
People are living longer, and lifestyles and diets are changing.
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9
Which statement is correct?
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A: A person with a risk factor may not get the disease
A risk factor only raises the chance of a disease. Many smokers never get lung cancer, and some non-smokers do.
Cancer
Just this lesson-
1 State [1 mark]
State what is meant by cancer.
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Model answer
A disease caused by changes in cells which lead to uncontrolled cell division.
Mark scheme
- Uncontrolled cell division — 1 mark
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2 State [2 marks]
State two risk factors for cancer.
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Model answer
Any two from: smoking, ultraviolet radiation, ionising radiation, some viruses such as HPV, inherited genes, obesity, alcohol, age.
Mark scheme
- First — 1 mark
- Second — 1 mark
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3 Describe [3 marks]
Describe the differences between a benign tumour and a malignant tumour.
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Model answer
A benign tumour grows in one place, and does not invade the neighbouring tissues, but a malignant tumour invades neighbouring tissues. Cells of a malignant tumour can spread in the blood to other parts of the body and form secondary tumours.
Mark scheme
- Benign stays in one place — 1 mark
- Malignant invades neighbouring tissue — 1 mark
- Malignant cells spread, forming secondary tumours — 1 mark
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4 Explain [3 marks]
Explain why smoking increases the risk of lung cancer.
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Model answer
Tobacco smoke contains carcinogens, which can cause mutations in the DNA of lung cells. A mutation in a gene that controls cell division can cause a cell to divide in an uncontrolled way, which forms a tumour.
Mark scheme
- Smoke contains carcinogens — 1 mark
- Cause mutations in DNA — 1 mark
- Uncontrolled cell division forms a tumour — 1 mark
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5 Calculate [3 marks]
A cancer cell divides once every 2 days. Assuming that no cells die, calculate how many cells there will be after 20 days, starting with one cell.
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Model answer
20 days at one division per 2 days gives 10 divisions. 2 to the power 10 is 1024 cells.
Mark scheme
- 10 divisions — 1 mark
- 2 to the power 10 — 1 mark
- 1024 cells — 1 mark
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6 Evaluate [6 marks]
Evaluate the use of surgery, radiotherapy and chemotherapy in the treatment of cancer.
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Model answer
Surgery can remove a whole tumour, and is effective if the cancer has not spread, but it is not possible if the tumour is in a place that cannot be reached, or if it has already spread, and it carries the risks of any operation. Radiotherapy can be aimed at a particular tumour, and can kill cells that cannot be removed, but it also damages healthy tissue around it. Chemotherapy travels in the blood and can reach cancer cells all over the body, including those that have spread, but it also kills healthy cells that divide quickly, so it has side effects such as hair loss and sickness. The treatment chosen depends on the type of the cancer and on how far it has spread, and a combination is often used to give the best chance.
Mark scheme
- Surgery removes the tumour — 1 mark
- Limits of surgery — 1 mark
- Radiotherapy targets the tumour — 1 mark
- Radiotherapy damages healthy tissue — 1 mark
- Chemotherapy reaches the whole body but has side effects — 1 mark
- Treatment depends on the cancer, and may be combined — 1 mark
Quick check
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1
What is a tumour?
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B: A mass of abnormal cells
A tumour is a lump of abnormal cells that divide in an uncontrolled way.
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2
Which statement describes a malignant tumour?
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C: It invades other tissues and spreads
Malignant tumours invade other tissues and spread.
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3
What causes cells to become cancerous?
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A: Mutations in genes that control cell division
Mutations in the genes that control cell division.
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4
Which causes skin cancer?
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D: Ultraviolet radiation
Ultraviolet radiation damages the DNA of skin cells.
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5
What is a secondary tumour?
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B: A tumour formed by spread from another place
A tumour that forms where cancer cells have spread to.
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6
Why does chemotherapy cause hair loss?
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C: It harms healthy cells that divide quickly
It kills healthy cells that divide quickly, such as hair root cells.
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7
Which is a way of reducing the risk of cancer?
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A: Not smoking
Not smoking reduces the exposure to carcinogens.
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8
A cancer cell divides once a day. How many cells after 5 days?
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D: 32
\(2^5 = 32\).
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9
Why is cancer more common in older people?
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B: Mutations accumulate over time
Several mutations are usually needed, and they build up over time.
Diet, Obesity and BMI
Just this lesson-
1 State [1 mark]
State the equation used to calculate body mass index.
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Model answer
BMI = mass (kg) ÷ height (m) squared.
Mark scheme
- Mass in kg divided by height in m squared — 1 mark
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2 Calculate [3 marks]
A boy has a mass of 60 kg and a height of 1.75 m. Calculate his BMI, to 1 decimal place.
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Model answer
Height squared = 1.75 × 1.75 = 3.0625. BMI = 60 ÷ 3.0625 = 19.6.
Mark scheme
- Height squared — 1 mark
- Division — 1 mark
- 19.6 — 1 mark
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3 Calculate [2 marks]
A woman has a waist measurement of 85 cm and a hip measurement of 95 cm. Calculate her waist to hip ratio, to 2 decimal places, and state whether it shows a higher risk of disease.
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Model answer
85 ÷ 95 = 0.89. This is above 0.85, so it shows a higher risk.
Mark scheme
- 0.89 — 1 mark
- Above 0.85, higher risk — 1 mark
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4 Explain [2 marks]
Explain why a rugby player may have a BMI in the overweight range, but be healthy.
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Model answer
Muscle has more mass than fat, so a person with a lot of muscle has a high mass for their height, and so a high BMI, even though they have little body fat.
Mark scheme
- Muscle has a greater mass than fat — 1 mark
- High BMI without much body fat — 1 mark
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5 Explain [3 marks]
Explain how a poor diet and a lack of exercise can lead to type 2 diabetes and cardiovascular disease.
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Model answer
A diet that has more energy than the body uses, with little exercise, results in the extra energy being stored as fat, so the person becomes obese. Obesity raises the risk of type 2 diabetes and of cardiovascular disease, as the fat can raise blood pressure and cholesterol, and affects how the body responds to insulin.
Mark scheme
- Excess energy stored as fat, so obese — 1 mark
- Obesity raises the risk of diabetes — 1 mark
- And of cardiovascular disease — 1 mark
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6 Evaluate [6 marks]
Obesity is increasing in many countries. Evaluate the actions that a government and individuals could take to reduce obesity.
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Model answer
A government could tax sugary drinks, which may reduce how much of them are bought, and use the money to improve health. It could improve school meals and put clear labels on food, so that people can make better choices, and provide sports facilities, though these have a cost. Education campaigns are cheap but may not change what people do. Individuals could eat less saturated fat and sugar, eat more fruit and vegetables, and exercise regularly, which costs little, and has other benefits such as a lower risk of heart disease. However, people on low incomes may find healthy food more expensive, and so find it difficult to make changes. The most effective approach is likely to be a combination of actions by both a government and individuals.
Mark scheme
- Tax or labelling by government — 1 mark
- Education, school meals or facilities — 1 mark
- Individual changes in diet — 1 mark
- Individual exercise — 1 mark
- A limit, such as cost or access to healthy food — 1 mark
- A reasoned conclusion — 1 mark
Quick check
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1
A person has a BMI of 27. Which category is this?
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C: Overweight
25 to 29.9 is overweight.
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2
Which gives the BMI equation correctly?
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A: Mass ÷ height squared
BMI is mass in kg divided by height in metres squared.
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3
A person has a mass of 50 kg and a height of 1.60 m. What is the BMI?
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D: 19.5
\(1.60^2 = 2.56\), and \(50 \div 2.56 = 19.5\).
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4
Why can BMI be misleading for a very muscular person?
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B: Muscle has a larger mass than fat
Muscle has a greater mass than fat, so BMI may be high without too much fat.
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5
Which disease is caused by a lack of vitamin D?
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A: Rickets
Rickets, in which the bones are soft and bend.
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6
What happens to energy in food that is not used?
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C: It is stored as fat
It is stored as fat.
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7
Which waist to hip ratio shows a higher risk in a man?
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D: 0.95
A ratio above 0.90 shows a higher risk for a man.
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8
What does waist to hip ratio show that BMI does not?
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B: Where fat is stored
It shows where fat is stored, as fat around the waist is more harmful.
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9
A man is 1.75 m tall. Which mass would give a BMI of 25?
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A: 76.6 kg
Mass = BMI × height squared = \(25 \times 3.0625 = 76.6\) kg.
Alcohol and Smoking
Just this lesson-
1 State [1 mark]
State the name of the organ that is damaged by heavy drinking of alcohol.
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Model answer
The liver.
Mark scheme
- Liver — 1 mark
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2 Name [2 marks]
Name two chemicals in cigarette smoke that increase the risk of cardiovascular disease, and state one effect of each.
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Model answer
Nicotine raises the heart rate and blood pressure. Carbon monoxide reduces the amount of oxygen the blood can carry.
Mark scheme
- Nicotine and its effect — 1 mark
- Carbon monoxide and its effect — 1 mark
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3 Describe [3 marks]
Describe how heavy drinking over many years can damage the liver.
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Model answer
Fat builds up in the liver cells (fatty liver), then the liver becomes inflamed and cells die (hepatitis). Scar tissue then replaces liver cells, which is cirrhosis, and which is permanent and can lead to liver failure.
Mark scheme
- Fatty liver — 1 mark
- Hepatitis, cells die — 1 mark
- Cirrhosis, scarring, permanent — 1 mark
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4 Explain [3 marks]
Explain how smoking can lead to the narrowing of an artery.
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Model answer
Chemicals in tobacco smoke damage the lining of the artery. Fatty material from the blood builds up in the damaged wall, forming a deposit that narrows the artery, so the blood flow is reduced.
Mark scheme
- Chemicals damage the lining — 1 mark
- Fatty material builds up — 1 mark
- Artery narrows, so reduced blood flow — 1 mark
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5 Calculate [3 marks]
Calculate the number of units of alcohol in a 175 ml glass of wine that has an alcohol content of 12% by volume. Give your answer to 1 decimal place.
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Model answer
Units = 175 × 12 ÷ 1000 = 2100 ÷ 1000 = 2.1 units.
Mark scheme
- Substitution into the equation — 1 mark
- 2100 ÷ 1000 — 1 mark
- 2.1 units — 1 mark
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6 Evaluate [6 marks]
A government is deciding how to reduce the harm that is caused by alcohol and smoking. Evaluate the measures it could use.
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Model answer
Laws such as a ban on smoking in public places protect non-smokers and make smoking less common, and they have been shown to work. Higher taxes on cigarettes and alcohol raise the price, so some people buy less, and the money can be used to pay for health care, but people with an addiction may continue to pay, and some may buy illegally. Education and health warnings are cheap, and raise awareness, but may not change the behaviour of those who are addicted. Support to stop smoking, such as nicotine patches and advice, helps those who want to give up, and costs less than treating a lot of illnesses later. Some people feel that laws limit personal freedom. A combination of laws, taxes, education and support is probably the most effective, because the problem has many causes.
Mark scheme
- Law such as a smoking ban — 1 mark
- Tax or minimum price — 1 mark
- Education and warnings — 1 mark
- Support to give up — 1 mark
- A limit or disadvantage of a measure — 1 mark
- A reasoned conclusion — 1 mark
Quick check
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1
Which organ is damaged by drinking too much alcohol?
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C: Liver
Alcohol is broken down in the liver, which can be damaged.
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2
What is cirrhosis?
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B: Permanent scarring of the liver
Permanent scarring of the liver.
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3
Which chemical in cigarette smoke reduces the oxygen carried by the blood?
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A: Carbon monoxide
Carbon monoxide binds to haemoglobin.
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4
Which chemical in smoke makes the heart beat faster?
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D: Nicotine
Nicotine increases the heart rate and the blood pressure.
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5
What is the cause of a stroke?
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B: A blocked blood vessel to the brain
A blood vessel in the brain is blocked or bursts.
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6
How many units are in 500 ml of beer with 5% alcohol by volume?
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C: 2.5
\(500 \times 5 \div 1000 = 2.5\) units.
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7
Which is the first stage of alcohol-related liver damage?
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A: Fatty liver
Fat builds up in the liver cells, which is called a fatty liver.
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8
Which is a risk of passive smoking?
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D: A higher risk of lung disease
People who breathe in other people's smoke have a higher risk of lung disease and heart disease.
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9
The death rate from lung cancer is 40 in non-smokers and 400 in heavy smokers. What does this show?
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B: Heavy smokers are 10 times more likely to die of it, which suggests a link
Heavy smokers are 10 times as likely to die from it, which is a strong correlation, and with the known mechanism, suggests a cause.
Treating Cardiovascular Disease
Just this lesson-
1 State [1 mark]
State what is meant by a stent.
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Model answer
A mesh tube that is put into an artery to keep it open.
Mark scheme
- A tube that holds an artery open — 1 mark
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2 Name [2 marks]
Name two types of drug that are taken for life by people with coronary heart disease, and state what each does.
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Model answer
Statins lower the level of cholesterol. Anticoagulants make the blood clot less easily. (Others: aspirin makes platelets less sticky, beta blockers lower blood pressure.)
Mark scheme
- First drug and its effect — 1 mark
- Second drug and its effect — 1 mark
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3 Describe [3 marks]
Describe how a stent is used to treat a narrowed coronary artery.
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Model answer
A thin tube with a balloon, which has a stent around it, is passed through the blood vessels to the narrowed place. The balloon is inflated, which presses the fatty deposit against the wall and widens the artery. The balloon is removed, and the stent is left in place to keep the artery open.
Mark scheme
- Balloon and stent threaded to the narrowing — 1 mark
- Balloon inflated to widen the artery — 1 mark
- Stent left in place to hold it open — 1 mark
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4 Explain [3 marks]
Explain why a patient who has had a heart transplant has to take drugs for the rest of their life.
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Model answer
The immune system recognises the donated heart as foreign, because it has different antigens, and could attack it, which is rejection. The drugs, called immunosuppressants, reduce the activity of the immune system, so that the heart is not rejected.
Mark scheme
- Donor heart has different antigens — 1 mark
- Immune system would attack it — 1 mark
- Drugs suppress the immune system — 1 mark
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5 Calculate [3 marks]
In a trial, 400 people took a drug and 28 had a heart attack. Of 400 people on a placebo, 52 had a heart attack. Calculate the percentage of each group that had a heart attack, and the difference between them.
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Model answer
Drug: 28 ÷ 400 × 100 = 7%. Placebo: 52 ÷ 400 × 100 = 13%. The difference is 6 percentage points.
Mark scheme
- 7% — 1 mark
- 13% — 1 mark
- 6 percentage points — 1 mark
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6 Evaluate [6 marks]
A 55-year-old man has a coronary artery that is 80% blocked. He smokes, and is overweight. Evaluate the treatments that could be offered to him.
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Model answer
An angioplasty with a stent would quickly open the artery, so it reduces the immediate risk of a heart attack, and the recovery is short, but it is costly and carries risks, and does not deal with the cause. Medication, such as a statin and aspirin, is cheap and lowers the risk of the artery narrowing further and of clots, but he must take it for life and may get side effects. Lifestyle changes, such as stopping smoking, a healthier diet and exercise to lose weight, have no side effects, cost little, and deal with the causes, but need a lot of motivation, and will not remove the blockage which is already there. The best approach for him is probably a stent to open the artery now, together with medication and lifestyle changes to stop it happening again.
Mark scheme
- Stent: quick, opens the artery — 1 mark
- Stent: cost or risk, does not treat the cause — 1 mark
- Medication: reduces risk, taken for life, side effects — 1 mark
- Lifestyle: no side effects, tackles the causes — 1 mark
- Lifestyle: needs motivation, does not remove the blockage — 1 mark
- A reasoned conclusion, such as a combination — 1 mark
Quick check
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1
What does a statin do?
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B: Lowers blood cholesterol
It lowers the level of cholesterol in the blood.
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2
What is the purpose of a stent?
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A: To hold an artery open
To hold an artery open.
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3
Which treatment involves taking a blood vessel from the leg?
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C: A coronary bypass
A bypass uses a vessel to carry blood around the blocked artery.
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4
Why must a transplant patient take drugs for life?
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D: To prevent rejection
To stop the immune system rejecting the donor organ.
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5
Which is an advantage of lifestyle changes over surgery?
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B: They have few side effects and cost little
They have no side effects, and little cost.
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6
Which is a disadvantage of anticoagulants?
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A: They can cause bleeding
They can cause serious bleeding.
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7
In a trial, 10 of 100 patients on a drug and 20 of 100 on a placebo had a heart attack. What is the reduction in risk, in percentage points?
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C: 10
\(20\% - 10\% = 10\) percentage points.
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8
What is angina?
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D: Chest pain due to a poor blood supply to the heart
Chest pain, caused by too little blood to the heart muscle.
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9
Why is a combination of treatments often used for coronary heart disease?
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B: Because each treatment deals with a different part of the problem
Surgery opens the artery quickly, but medication and lifestyle changes tackle the causes and prevent it narrowing again.