Q1. (a) (i) Some diseases can be tackled by using antibiotics and vaccination. Explain fully why antibiotics cannot be used to cure viral diseases.

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Q. (a) (i) Some diseases can be tackled by using antibiotics and vaccination. Explain fully why antibiotics cannot be used to cure viral diseases......... (ii) A recent study found that babies in 90 % of hospitals are infected with the MRSA bacterium. Explain how the MRSA bacterium has developed resistance to antibiotics......... (b) A person can be immunised against a disease by injecting them with an inactive form of a pathogen. Explain how this makes the person immune to the disease................... (3) (Total 7 marks) Page of 4

Q2. Students investigated how well antibacterial mouthwashes worked. They tested four different mouthwashes, P, Q, R and S. They spread bacteria on nutrient jelly in a Petri dish. They soaked identical discs of filter paper in mouthwashes P, Q, R or S. They placed the discs on the growing bacteria as shown in Diagram. They covered the Petri dish. They incubated the Petri dish for two days. (a) The nutrient jelly was heated to 20 C before being poured into the Petri dish. Why is this necessary? Tick ( ) one box. Statement Tick ( ) To make bacteria grow more quickly. To kill microorganisms. To make the nutrients dissolve. () Page 2 of 4

(b) What is the maximum temperature at which bacteria should be incubated in a school laboratory? Tick ( ) one box. Temperature Tick ( ) 5 C 25 C 37 C () (c) Diagram 2 shows the appearance of the Petri dish after two days. Which mouthwash, P, Q, R or S kills most bacteria? Give one reason for your answer. (Total 4 marks) Q3. Dr Semmelweiss collected data about the number of deaths in the two maternity wards in the hospital where he worked. From 833 to 838 there were the same number of doctors and midwives delivering babies in both Ward and Ward 2. From 839 to 847 medical students and doctors delivered babies in Ward ; midwives delivered babies in Ward 2. Dr Semmelweiss also noticed that doctors often came straight from examining dead bodies to the delivery ward. Page 3 of 4

The table shows the number of patients and the number of deaths in the two wards. Years Ward Number of patients Number of deaths Death rate as deaths per 000 patients 833 838 839 847 Ward 23 509 505 64.0 Ward 2 3 097 73 55.8 Ward 20 204 989 98.4 Ward 2 7 79 69 (a) (i) Use the formula death rate = to calculate the death rate for Ward 2 in the years 839-847....... Death rate =... deaths per thousand (ii) Suggest a hypothesis for the difference in the death rates on Ward and Ward 2 in the years 839-847............. (b) Antibiotics are now used in hospitals. What is an antibiotic, and what does it do? Page 4 of 4

(c) MRSA is causing problems in hospitals. Give one reason why. () (d) How can the work of Semmelweiss help to reduce the problems caused by MRSA? () (Total 8 marks) Q4. Many diseases are caused by viruses. Children are given vaccines to protect them against viral disease. (a) Complete the following sentences. It is difficult to kill viruses inside the body because viruses.... A vaccine contains an... form of the virus. The vaccine stimulates the white blood cells to produce.... (3) Page 5 of 4

(b) In the 990s many people thought that the MMR vaccine caused autism in some children. This is why the Japanese government stopped using the MMR vaccine. The graph gives information about the percentage of Japanese children who developed autism during the 990s. Page 6 of 4

The data in the graph support the view that there is no link between MMR vaccination and autism. Explain why. (4) (Total 7 marks) Q5. Influenza is a disease caused by a virus. (a) Explain why it is difficult to treat diseases caused by viruses............. Page 7 of 4

(b) In some years there are influenza epidemics. The graph shows the death rate in Liverpool during three influenza epidemics. (i) The population of Liverpool in 95 was approximately 700 000. Calculate the approximate number of deaths from influenza in week 4 of the 95 epidemic. Show clearly how you work out your answer....... Number of deaths... (ii) In most years, the number of deaths from influenza in Liverpool is very low. Explain, in terms of the influenza virus and the body s immune system, why there were large numbers of deaths in years such as 98 and 95................... (3) (Total 7 marks) Page 8 of 4

Q6. Read the passage about the use of antibiotics in food production. People do not always agree about the use of antibiotics in food production. Some farmers put low doses of antibiotics in feed for animals such as cattle and sheep. Antibiotics help to keep animals disease-free. Antibiotics also help animals to grow. The use of antibiotics in livestock feed means that there is a higher risk of antibioticresistant bacteria developing. These could be dangerous to human health. (a) Explain how a population of antibiotic-resistant bacteria might develop from non-resistant bacteria. (3) (b) Suggest two reasons why it is an advantage to keep farm animals disease free.... 2... (Total 5 marks) Page 9 of 4

M. (a) (i) viruses live inside cells viruses inaccessible to antibiotic allow drug / antibiotic (if used) would (have to) kill cell (ii) mutation ignore mutation caused by antibiotic natural selection or no longer recognised by antibiotics accept description of natural selection (b) (stimulate) antibody production ignore antitoxin (by) white cells rapidly produce antibody on re-infection ignore antibodies remain in blood [7] M2. (a) to kill microorganisms extra boxes ticked cancels the mark (b) 25 C extra boxes ticked cancels the mark (c) S widest clear area [4] M3. (a) (i) 38.84 correct answer with or without working gains 2 marks (69 000) / 7 79 gains mark 2 Page 0 of 4

(ii) women in Ward infected by pathogens / bacteria / viruses passed on by doctors (who have been in contact with dead bodies) (b) medicine / drug that kills bacteria (c) resistant to / not killed by antibiotics (d) Semmelweiss showed that infection could be passed on via touch and so hand washing by doctors / nurses / patients / visitors reduces the risk of infection [8] M4. (a) live inside cells inactive antibodies (b) the percentage of children vaccinated fell to zero in 995 but the number of children developing autism rose and fell during the period when % vaccinations was falling number of children developing autism peaked after MMR vaccination had ceased which suggests that something other than MMR vaccination was causing autism [7] Page of 4

M5. (a) any two from live inside / infect body cells difficult for drugs to enter (body) cells / drug would kill (body) cell antibiotics ineffective against viruses viruses mutate frequently 2 (b) (i) 420 correct answer with or without working if answer incorrect evidence of number of deaths 7 or 60 seen gains mark ignore 6 000 000 2 (ii) any three from: virus / flu mutates people no longer / not immune ignore resistance white blood cells / memory cells / immune system do not recognise virus relevant reference to antibodies / antigens current vaccine ineffective or no vaccine available then or takes time to develop new vaccine allow no tamiflu / anti-viral drugs conditions less hygienic / lack of hygiene people in poor health (following world wars) allow people had weak immune system 3 [7] M6. (a) idea that bacteria mutate or that there is variation in bacteria leading to bacteria /resistant cells that survive antibiotic these bacteria (resistant cells) go on to breed do not allow bacteria get used to antibiotics or idea that antibiotics change the bacteria or bacteria become immune or references to adaptation or evolution Page 2 of 4

(b) the treated animals do not use energy overcoming illness an economic reason, eg treated animals do not infect other animals / farm workers [5] Page 3 of 4

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