Oxford Cambridge and RSA Examinations

GCE

Human Biology Advanced Subsidiary GCE

Unit F222: Growth, Development and Disease

Mark Scheme for January 2013

OCR (Oxford Cambridge and RSA) is a leading UK awarding body, providing a wide range of qualifications to meet the needs of candidates of all ages and abilities. OCR qualifications include AS/A Levels, Diplomas, GCSEs, Cambridge Nationals, Cambridge Technicals, Functional Skills, Key Skills, Entry Level qualifications, NVQs and vocational qualifications in areas such as IT, business, languages, teaching/training, administration and secretarial skills. It is also responsible for developing new specifications to meet national requirements and the needs of students and teachers. OCR is a not-for-profit organisation; any surplus made is invested back into the establishment to help towards the development of qualifications and support, which keep pace with the changing needs of today’s society. This mark scheme is published as an aid to teachers and students, to indicate the requirements of the examination. It shows the basis on which marks were awarded by examiners. It does not indicate the details of the discussions which took place at an examiners’ meeting before marking commenced. All examiners are instructed that alternative correct answers and unexpected approaches in candidates’ scripts must be given marks that fairly reflect the relevant knowledge and skills demonstrated. Mark schemes should be read in conjunction with the published question papers and the report on the examination. OCR will not enter into any discussion or correspondence in connection with this mark scheme. © OCR 2013

F22

2 M

ark

Sch

em

e Ja

nu

ary

2013

1

Qu

esti

on

A

nsw

er

Mar

ks

Gu

idan

ce

1 (a

)

idea

that

gro

win

g ta

ller

/ inc

reas

e in

hei

ght /

legs

l

engt

heni

ng /

prop

ortio

ns o

f bod

y ch

ange

;

1 C

RE

DIT

Gro

wth

rat

e va

ries

(with

in o

r be

twee

n ch

ildre

n)

AC

CE

PT

Ref

gro

wth

spu

rts

IGN

OR

E G

ene

ral c

omm

ents

abo

ut ‘g

row

ing’

or

varia

tions

in

heig

ht u

nqua

lifie

d

(b

) (i

) id

ea th

at s

ampl

e m

ay

not

be

repr

esen

tativ

e ;

1

IGN

OR

E r

efer

ence

to

bein

g ha

rd t

o ge

nera

lise

from

a s

mal

l sa

mpl

e w

ithou

t fur

ther

qua

lific

atio

n

IGN

OR

E r

ef to

rel

iabi

lity

/ acc

urac

y

AC

CE

PT

idea

it is

not

a t

ypic

al s

ampl

e (o

f th

at p

opul

atio

n)

eg p

aren

ts o

f obe

se c

hild

ren

may

ch

oose

not

to ta

ke p

art

(and

so

not r

epre

sent

ativ

e)

(i

i)

idea

that

fam

ilies

with

obe

se c

hild

ren

may

be

mor

e lik

ely

to

refu

se p

erm

issi

on fo

r ch

ildre

n to

be

mea

sure

d ;

idea

that

ther

e is

a s

tigm

a at

tach

ed to

obe

sity

;

1 IG

NO

RE

ref

to fe

wer

obe

se c

hild

ren

in th

e sa

mpl

e / m

ore

obes

e ch

ildre

n in

the

othe

r 9%

with

out a

rea

son

give

n

(c

)

(cor

onar

y) h

eart

dis

ease

/ C

HD

/ an

gin

a ;

ca

rdio

vasc

ular

dis

ease

/ at

hero

ma

/ ath

eros

cler

osis

;

hype

rten

sion

;

(ost

eo)a

rthr

itis

; br

east

can

cer

; bo

wel

can

cer

; ga

ll st

ones

;

slee

p ap

noea

;

2 M

ark

the

firs

t an

swer

on

eac

h p

rom

pt

line.

If th

e an

swer

is

corr

ect a

nd a

n ad

ditio

nal a

nsw

er is

giv

en th

at is

inco

rrec

t or

cont

radi

cts

the

corr

ect

answ

er t

hen

= 0

mar

ks

AC

CE

PT

hig

h bl

ood

pres

sure

D

O N

OT

CR

ED

IT lu

ng c

ance

r /

canc

er u

nqua

lifie

d

F22

2 M

ark

Sch

em

e Ja

nu

ary

2013

2

Qu

esti

on

A

nsw

er

Mar

ks

Gu

idan

ce

(d

) (i

) 52

397

; ;

2

Co

rrec

t an

sw

er =

2 m

arks

eve

n if

no w

orki

ng s

how

n If

answ

er in

corr

ect

CR

ED

IT 1

mar

k fo

r co

rrec

t wor

king

25

6 84

8 x

20.4

or

256 84

8 x

0.20

4

10

0 If

answ

er n

ot g

iven

to n

eare

st w

hole

num

ber

C

RE

DIT

1 m

ark

for

an u

nrou

nded

ans

wer

eg

5239

6.9

or

5239

6.99

(ii)

ag

ree

/ yes

AN

D

both

incr

ease

slig

htly

O

R

disa

gree

/ n

o A

ND

diff

eren

ce in

incr

ease

bet

wee

n bo

ys

and

girl

s no

t sig

nific

ant ;

1 A

CC

EP

T a

gre

e be

caus

e gi

rls b

y 0.

5% a

nd b

oys

by 0

.4%

A

CC

EP

T ‘t

here

is a

big

ger

incr

ease

’ for

agr

ee

AC

CE

PT

idea

that

girl

s at

0.5

% a

nd b

oys

at 0

.4%

are

ver

y si

mila

r

(iii)

mor

e bo

ys a

re o

bese

tha

n gi

rls ;

pa

ir of

figu

res

to s

uppo

rt ;

2 C

RE

DIT

nu

mbe

rs o

f obe

se in

divi

dual

s or

pre

vale

nce

for

boys

an

d gi

rls ta

ken

from

the

sam

e ye

ar

eg (

in 2

010)

20.

4% o

f boy

s w

ere

obes

e an

d 17

.0%

of g

irls

AC

CE

PT

‘(In

201

0) 2

0.4%

of b

oys

wer

e ob

ese

bu

t o

nly

17

.0%

of g

irls’

= 2

mar

ks (

as th

is im

plie

s m

ore

obes

ity in

bo

ys t

han

girls

)

F22

2 M

ark

Sch

em

e Ja

nu

ary

2013

3

Qu

esti

on

A

nsw

er

Mar

k G

uid

ance

(e)

bl

ood

gluc

ose

leve

l, be

low

nor

mal

ran

ge /

bel

ow 4

(m

mol

dm-3

) ;

1 A

CC

EP

T ‘b

lood

sug

ar’ i

nste

ad o

f ‘b

lood

glu

cose

’ IG

NO

RE

‘blo

od g

luco

se le

vel i

s lo

w’ u

nqua

lifie

d A

CC

EP

T ‘v

ery

/ dan

gero

usly

/ to

o lo

w’ a

s qu

alifi

catio

n

(f

)

up to

4 m

arks

max

imum

bl

ood

adde

d to

tes

t st

rip ;

te

st s

trip

con

tain

s, im

mob

ilise

d en

zym

e ;

(enz

yme

is)

glu

cose

oxi

dase

;

gluc

ose

oxid

ase

/ enz

yme

spe

cific

to

gluc

ose

; gl

ucos

e bi

nds

to (

activ

e si

te o

f), g

luco

se o

xida

se /e

nzym

e ;

gluc

ose

conv

erte

d to

glu

cona

lact

one

;

4 m

ax

elec

trod

e de

tect

s th

e, c

hem

ical

cha

nge

/ re

actio

n ;

id

ea th

at e

lect

rical

cur

rent

gen

erat

ed ;

id

ea th

at c

once

ntra

tion

prop

ortio

nal t

o cu

rren

t si

ze ;

5 m

ax

AC

CE

PT

idea

that

enz

yme

is a

ttach

ed to

the

strip

C

RE

DIT

‘glu

cose

deh

ydro

gena

se’ i

nste

ad o

f ‘g

luco

se

oxid

ase’

N

OT

E ‘o

nly

glu

cose

, bin

ds to

/ fo

rms

an E

SC

with

. the

e

nzym

e’ =

2

AC

CE

PT

ph

onet

ic s

pelli

ng

(g

)

idea

that

they

can

do

mor

e / r

egul

ar, e

xerc

ise

/ AW

;

eat m

ore,

frui

t / v

eget

able

s / h

igh

fibre

food

s ;

ea

t le

ss,

fatty

/ fa

st /

junk

, fo

od /

AW

;

redu

ce c

alor

ie in

take

/ sm

alle

r po

rtio

ns ;

ea

t le

ss, s

ugar

/ A

W ;

ra

ise

awar

enes

s of

con

sequ

ence

s of

obe

sity

;

3 M

ark

the

firs

t 3

sug

ges

tio

ns

For

eac

h m

ark

poin

t, C

RE

DIT

sui

tabl

e sp

ecifi

c ex

ampl

es

eg g

o fo

r w

alks

, go

swim

min

g, g

o fo

r bi

ke r

ides

IG

NO

RE

ref

to

‘bal

ance

d’ o

r ‘h

ealth

y’ d

iet

unqu

alifi

ed

T

ota

l19

F22

2 M

ark

Sch

em

e Ja

nu

ary

2013

4

Qu

esti

on

A

nsw

er

Mar

ks

Gu

idan

ce

2 (a

)

trea

tmen

t, s

ucce

ssfu

l / m

ore

effe

ctiv

e / A

W ;

id

ea th

at m

oney

not

was

ted

on d

rugs

that

are

,

in

effe

ctiv

e /

unne

cess

ary

;

idea

that

few

er s

ide

effe

cts

beca

use

, few

er d

rugs

take

n ;

id

ea th

at t

reat

men

t le

ss g

ener

ally

toxi

c / h

arm

s fe

wer

h

ealth

y ce

lls ;

2 IG

NO

RE

‘Tre

atm

ent i

s m

ore

spec

ific’

or

‘Onl

y ta

rget

s sp

ecifi

c ce

lls’ a

s th

is is

in th

e qu

estio

n IG

NO

RE

ref

eren

ce to

not

nee

ding

a ‘c

ockt

ail o

f dr

ugs’

with

out q

ualif

icat

ion

as th

is is

giv

en in

the

case

stu

dy

(b

) (i

) (t

umou

r sp

ecifi

c) p

rote

ins,

act

as

antig

ens

; re

cogn

ised

by,

mac

roph

ages

/ d

endr

itic

cell

; fo

rmat

ion

of a

n an

tigen

pre

sent

ing

cell

/ A

PC

;

(whi

ch h

ave)

com

plem

ent

ary

rece

ptor

s ;

antig

en, b

inds

to /

fits

, the

rec

epto

r ;

idea

that

B/T

, lym

phoc

ytes

/ ce

lls, a

ctiv

ated

;

corr

ect r

ef to

, cyt

okin

es /

T-h

elpe

r, ly

mph

ocyt

e /

cell

;

3 A

CC

EP

T p

rote

ins

have

(ar

eas

whi

ch a

re)

antig

ens

IGN

OR

E r

ef to

lym

phoc

ytes

or

phag

ocyt

es fo

r m

p 2.

A

CC

EP

T a

des

crip

tion

of a

ntig

en p

rese

ntat

ion

f

or m

p 3

AC

CE

PT

an

tigen

/ pr

otei

n, b

inds

to, a

ntib

ody

(va

riabl

e re

gion

) IG

NO

RE

ref

eren

ce to

lym

phoc

ytes

det

ectin

g an

tigen

fo

r m

p 6

(i

i)

T k

iller

/ cy

toto

xic

T (

lym

phoc

yte)

;

1

Mar

k th

e fi

rst

answ

er. I

f th

e an

swer

is c

orre

ct a

nd

an a

dditi

onal

ans

wer

is g

iven

that

is in

corr

ect o

r co

ntra

dict

s th

e co

rrec

t an

swer

the

n =

0 m

arks

(c

) (i

) no

imm

une

resp

onse

(to

ow

n tis

sue)

/ tis

sue

will

not

be

reje

cted

;

1 A

CC

EP

T id

ea th

at ti

ssue

s or

org

ans

are

not

dest

roye

d by

the

imm

une

syst

em

IGN

OR

E n

ot d

estr

oyed

by

body

(i

i)

able

to g

ive

rise

to m

any

diffe

rent

cel

l typ

es ;

OR

A

1

CR

ED

IT to

tipot

ent /

plu

ripot

ent O

R a

dult

stem

cel

ls

are

mul

tipot

ent

F22

2 M

ark

Sch

em

e Ja

nu

ary

2013

5

Qu

esti

on

A

nsw

er

Mar

ks

Gu

idan

ce

(d

) (i

) 1

(D

NA

rep

licat

ion

occu

rs d

urin

g) in

terp

hase

/ S

pha

se ;

2

D

NA

, unw

inds

/unz

ips

; 3

(c

atal

ysed

by)

DN

A h

elic

ase

; 4

ca

uses

hyd

roge

n bo

nds

to b

reak

;

5

free

(D

NA

) nu

cleo

tides

pai

r up

with

exp

osed

bas

es ;

6

co

mpl

emen

tary

bas

e pa

iring

rul

e / A

-T a

nd C

-G ;

7

pu

rine(

s) p

air

with

pyr

imid

ine(

s) ;

8

ca

uses

form

atio

n ph

osph

odie

ster

bon

d ;

9

(c

atal

ysed

by)

DN

A p

olym

eras

e / l

igas

e ;

10

by a

con

dens

atio

n re

actio

n ;

11

new

str

ands

hav

e ex

actly

the

sam

e se

quen

ce o

f bas

es a

s

orig

inal

mol

ecul

e ;

12

(DN

A)

mol

ecul

e ha

s on

e ol

d an

d on

e ne

w s

tran

d ;

QW

C –

for

corr

ect o

rder

of e

vent

s ;

7 1

8 A

CC

EP

T ‘f

orm

atio

n of

bon

ds b

etw

een

suga

r an

d ph

osph

ate’

A

war

d if

m

p 1

is a

war

ded

and

1

mar

k fr

om m

ps

2 –

4

is fo

llow

ed b

y

1

mar

k fr

om m

ps

5 –

12

(ii)

th

ey d

ivid

e by

mito

sis

; th

ey, d

iffer

entia

te /

beco

me

spec

ialis

ed ;

to

pro

duce

live

r ce

lls /

to r

epla

ce d

amag

ed c

ells

;

2 IG

NO

RE

ref

to r

epai

ring

dam

aged

live

r as

this

is in

the

ques

tion

F22

2 M

ark

Sch

em

e Ja

nu

ary

2013

6

Qu

esti

on

A

nsw

er

Mar

k G

uid

ance

(e)

(i)

only

effe

ctiv

e in

one

in fo

ur p

atie

nts

; O

RA

(v

ery)

exp

ensi

ve /

was

te o

f mon

ey to

use

whe

n no

t effe

ctiv

e ;

not a

ll w

omen

hav

e be

en te

sted

(fo

r H

ER

2) ;

id

ea th

at d

iagn

osis

mig

ht h

ave

been

too

late

/ ca

ncer

too

far

ad

vanc

ed to

mak

e tr

eatm

ent,

appr

opria

te /

effe

ctiv

e ;

AV

P ;

2 M

ark

the

firs

t 2

sug

ges

tio

ns

IGN

OR

E ‘o

nly

1 in

4 h

ave

the

prot

ein

/ HE

R2’

IG

NO

RE

‘tar

gets

onl

y 1

in 4

’ unq

ualif

ied

eg

pa

lliat

ive

care

may

be

mor

e ap

prop

riate

patie

nt m

ay h

ave

anot

her

cond

ition

mea

ning

th

at H

erce

ptin

® u

se is

inap

prop

riate

(ii)

ch

emot

hera

py ;

lu

mpe

ctom

y / m

aste

ctom

y / r

emov

al o

f lym

ph n

odes

;

radi

othe

rapy

;

tam

oxife

n ;

2 M

ark

firs

t tw

o s

ug

ges

tio

ns

AC

CE

PT

‘sur

gery

/ op

erat

ion’

T

ota

l22

F22

2 M

ark

Sch

em

e Ja

nu

ary

2013

7

Qu

esti

on

A

nsw

er

Mar

ks

Gu

idan

ce

3 (a

)

(by)

dro

plet

(in

fect

ion)

;

(infe

cted

per

son)

cou

ghs

/ sn

eeze

s / b

reat

hes

out

bac

teria

;

bact

eria

inha

led

;

2 IG

NO

RE

ref

to

airb

orne

unq

ualif

ied

(b

)

pers

iste

nt /

AW

, c

ough

;

bloo

d st

aine

d, m

ucus

/ sp

utum

;

feve

r / A

W ;

w

eigh

t lo

ss ;

ni

ght s

wea

ts ;

fa

tigue

/ A

W ;

2 M

ark

the

firs

t 2

sug

ges

tio

ns

IGN

OR

E ‘c

hest

y’ o

r ‘b

ad’ c

ough

– lo

okin

g fo

r id

ea o

f a

coug

h th

at d

oes

not

go a

way

(c

) (i

) to

o m

any

ne

w c

ases

to c

ount

, acc

urat

ely

/ eas

ily ;

id

ea th

at m

any

case

s no

t, r

epor

ted

/ dia

gnos

ed ;

1 eg

‘the

y do

not

kno

w th

ey h

ave

the

dise

ase’

(ii)

S

ub-S

ahar

an A

fric

a / l

ow in

com

e co

untr

y, s

how

s a

p

erce

ntag

e in

crea

se (

in in

cide

nce

of T

B)

; in

all

othe

r gr

oups

/ m

iddl

e an

d h

igh

inco

me

grou

ps,

th

ere

is a

per

cent

age

decr

ease

;

in m

iddl

e in

com

e gr

oups

, Sou

th E

ast A

sia

and

the

Wes

tern

P

acifi

c sh

ows

the

bigg

est

decr

ease

OR

A (

for

Ce

ntra

l and

E

aste

rn E

urop

e) ;

th

e hi

ghes

t inc

ome

grou

p / A

ustr

alia

and

N

orth

Am

eric

a an

d W

este

rn E

urop

e, s

how

(s)

the

bi

gges

t dec

reas

e (o

vera

ll) ;

(t

he tr

end

is)

the

high

er th

e co

untr

y’s

inco

me

the

gr

eate

r th

e pe

rcen

tage

dec

reas

e ;

3 A

CC

EP

T ‘+

’ or

‘– ‘

figur

es fo

r in

crea

se a

nd d

ecre

ase

th

roug

hout

F22

2 M

ark

Sch

em

e Ja

nu

ary

2013

8

Qu

esti

on

A

nsw

er

Mar

ks

Gu

idan

ce

(iii)

in

crea

se tr

ansm

issi

on li

nked

to a

ny

of fo

llow

ing

mps

;

soci

al

ov

ercr

owdi

ng /

poor

livi

ng c

ondi

tions

;

m

ore

hom

eles

s ;

m

ore

mig

ratio

n ;

m

ore

peop

le, w

ith H

IV /

AID

S ;

wea

kene

d im

mun

e sy

stem

;

do

n’t c

ompl

ete

cour

se o

f, dr

ugs

/ ant

ibio

tics

;

po

or e

duca

tion

abou

t, sy

mpt

oms

/ ho

w it

is s

prea

d ;

ec

onom

ic –

idea

that

can

not a

fford

:

drug

s /

antib

iotic

s (n

eede

d to

tre

at T

B)

;

vacc

ine

;

(acc

ess

to)

med

ical

cen

tres

/ h

ospi

tals

;

pr

ovis

ion

of, d

octo

rs /

nur

ses

;

mal

nutr

ition

;

ethi

cal i

ssue

s

stig

ma

of b

eing

dia

gnos

ed ;

fear

tha

t di

agno

sis

lead

s to

loss

of j

ob ;

refu

sal b

ecau

se o

f, r

elig

ious

/ c

ultu

ral /

po

litic

al b

elie

fs ;

pate

nts

/ ov

er-p

riced

dru

gs /

blac

k m

arke

t dru

gs ;

Q

WC

– b

alan

ced

acco

unt

(1)

;

8

1

AC

CE

PT

‘den

sely

pop

ulat

ed’

CR

ED

IT ‘b

eco

me

soci

ally

isol

ated

’ A

war

d if

1

mar

k fr

om m

ps

2 –

8 A

ND

1

mar

k fr

om m

ps

9 –

17

To

tal

17

F22

2 M

ark

Sch

em

e Ja

nu

ary

2013

9

Qu

esti

on

A

nsw

er

Mar

ks

Gu

idan

ce

4 (a

)

arte

riole

s ;

nico

tine

;

carb

on m

onox

ide

/ CO

;

haem

oglo

bin

;

oxyg

en /

O2

; w

eigh

t ;

6 C

RE

DIT

art

erie

s

(b

) (i

) sy

ndro

me

a gr

oup

of s

ympt

om

s / c

hara

cter

istic

s of

a c

ondi

tion

/ AW

;

in F

AS

an

y 2

mar

ks fr

om

smal

l hea

d / u

pper

jaw

;

eyes

, nar

row

/ sm

all /

AW

;

thin

/ sm

ooth

, upp

er li

p ;

hear

t de

fect

s ;

poor

mus

cle

tone

/ la

ck o

f coo

rdin

atio

n ;

m

enta

l ret

arda

tion

/ lea

rnin

g di

fficu

lties

;

beha

viou

ral p

robl

ems

; 2

max

3 A

CC

EP

T id

ea o

f st

ruct

ural

pro

blem

s w

ith f

ace

A

CC

EP

T a

des

crip

tion

of e

yes

eg ‘e

yes

do n

ot a

ppea

r to

be

fully

ope

n’

(ii)

al

coho

l ent

ers

mat

erna

l blo

od ;

al

coho

l cro

sses

the

pla

cent

a ;

trav

els

in, f

etal

blo

od /

circ

ulat

ion

;

2 IG

NO

RE

ref

to

umbi

lical

cor

d

(c

)

ultr

asou

nd s

can

; bi

-par

ieta

l / c

row

n ru

mp,

mea

sure

me

nts

; co

mpa

re to

sta

ndar

d m

easu

rem

ent /

AW

;

2 A

CC

EP

T d

esc

riptio

n of

bi-p

arie

tal a

nd /

or c

row

n ru

mp

mea

sure

me

nt

F22

2 M

ark

Sch

em

e Ja

nu

ary

2013

10

Qu

esti

on

A

nsw

er

Mar

ks

Gu

idan

ce

(d

) (i

) 25

; ;

2

Co

rrec

t an

sw

er =

2 m

arks

ev

en if

no

wor

king

sho

wn

If an

swer

inco

rrec

t C

RE

DIT

1 m

ark

for

corr

ect w

orki

ng

(25

– 20

) x

100

2

0 O

R 2

.5 –

2.0

x 1

00

2.0

(i

i)

incr

ease

in s

ize

due

to

incr

ease

in n

umbe

r of

/ m

ore,

cel

ls ;

(a

s a

resu

lt of

) m

itosi

s ;

sepa

ratio

n of

dig

its

cell,

dea

th /

dest

ruct

ion

; (a

s a

resu

lt of

) ap

opto

sis

;

4

T

ota

l19

F22

2 M

ark

Sch

em

e Ja

nu

ary

2013

11

Qu

esti

on

A

nsw

er

Mar

ks

Gu

idan

ce

5 (a

) (i

) by

obs

ervi

ng ti

ssue

und

er m

icro

scop

e ;

canc

er /

abno

rmal

, cel

ls s

een

/ A

W ;

(c

ells

) st

aine

d ;

AV

P ;

2 eg

re

fere

nce

to n

amed

test

or

PA

P te

st

us

ing

antib

odie

s to

tes

t for

ant

igen

s on

can

cer

cells

ref t

o ch

ecki

ng fo

r H

PV

DN

A in

can

cer

cells

(ii)

id

ea th

at s

igni

fican

tly,

mor

e H

PV

in th

e co

nfirm

ed

canc

er c

ases

;

alw

ays,

mor

e H

PV

in t

he c

onfir

med

can

cer

case

s ;

corr

ect

data

quo

te ;

2 D

O N

OT

CR

ED

IT ‘m

ore

case

s of

can

cer

show

HP

V’

with

out f

urth

er q

ualif

icat

ion

LO

OK

FO

R a

figu

re fo

r co

ntro

l and

con

firm

ed c

ases

from

at

leas

t on

e na

med

cou

ntry

(i

ii)D

NA

fro

m H

PV

ent

ers

cell

/ nuc

leus

;

caus

es a

, mut

atio

n /

chan

ge in

cel

l’s D

NA

;

that

aff

ects

, pro

to-o

ncog

enes

/

tum

our

supp

ress

or g

enes

/ A

W ;

le

ads

to /

AW

, los

s of

con

trol

of c

ell d

ivis

ion

;

2 A

CC

EP

T g

ene

tic m

ater

ial o

r ge

nes

for

‘DN

A’

IGN

OR

E ‘c

ells

div

ide

unco

ntro

llabl

y’ w

ithou

t the

link

to a

caus

e

(b

)

idea

of h

avin

g un

prot

ecte

d, s

ex ;

id

ea o

f hav

ing

man

y se

xual

par

tner

s ;

1 M

ark

the

firs

t an

swer

. If t

he a

nsw

er is

cor

rect

and

an

addi

tiona

l ans

wer

is g

iven

that

is in

corr

ect o

r co

ntra

dict

s th

e co

rrec

t ans

wer

then

= 0

mar

ks

IGN

OR

E r

ef to

not

hav

ing

been

vac

cina

ted

(a

s va

ccin

atio

n do

es n

ot p

reve

nt tr

ansm

issi

on)

(c

)

smok

ing

; ex

posu

re to

oth

er, (

nam

ed)

carc

inog

ens

/ mut

agen

s ;

gene

tical

ly s

usce

ptib

le /

fam

ily h

isto

ry ;

2 A

CC

EP

T t

ar /

ben

zpyr

ene

eg U

V,

X-

rays

, gam

ma

ray

s, io

nisi

ng r

adia

tion,

hig

h

a

lcoh

ol

AC

CE

PT

he

redi

ty

F22

2 M

ark

Sch

em

e Ja

nu

ary

2013

12

Qu

esti

on

A

nsw

er

Mar

ks

Gu

idan

ce

low

soc

io-e

cono

mic

gro

up /

AW

;

com

prom

ised

imm

une

syst

em ;

A

VP

;

eg e

arly

ons

et o

f pub

erty

(d

)

idea

that

mig

ht e

ncou

rage

und

erag

e se

x ;

idea

that

mig

ht e

ncou

rage

pro

mis

cuity

;

idea

that

som

e cu

lture

s / r

elig

ions

may

obj

ect t

o a

v

acci

ne a

gain

st a

sex

ually

tra

nsm

itted

dis

ease

;

mig

ht r

educ

e up

take

for

cerv

ical

can

cer

scre

enin

g / A

W ;

m

ay h

ave

unk

now

n, s

ide

/ lon

g te

rm, e

ffect

;

disc

rimin

ates

aga

inst

boy

s ;

(bec

ause

) H

PV

ma

y ca

use

canc

er in

boy

s ;

2 IG

NO

RE

ref

eren

ce t

o pa

rent

al c

onse

nt b

eing

req

uire

d si

nce

this

is tr

ue o

f all

child

hood

vac

cina

tion

prog

ram

mes

(e

)

viru

ses

mut

ate

freq

uent

ly

OR

vi

ral a

ntig

en(s

) ch

ange

id

ea th

at th

e ex

istin

g va

ccin

e w

ill n

ot p

rote

ct a

gain

st th

e ne

w

viru

s O

R

mos

t peo

ple

will

hav

e no

imm

unity

to a

new

viru

s ;

2 D

O N

OT

CR

ED

IT in

the

cont

ext o

f ant

ibio

tic o

r dr

ug

resi

stan

ce

CR

ED

IT ‘w

e d

o no

t hav

e a

vacc

ine

agai

nst t

he n

ew v

irus’

C

RE

DIT

de

scrip

tion

of im

mun

ity s

uch

as h

avin

g ‘c

orre

ct’

ant

ibod

ies

CR

ED

IT ‘l

ittle

imm

unity

in th

e po

pula

tion’

T

ota

l13

F22

2 M

ark

Sch

em

e Ja

nu

ary

2013

13

Qu

esti

on

A

nsw

er

Mar

ks

Gu

idan

ce

6 (a

) (i

) hi

ghes

t mor

talit

y in

Bla

ck (

Am

eric

ans)

; lo

wer

mor

talit

y in

, A

sian

/ P

acifi

c Is

land

ers

/ H

ispa

nic

; hi

gher

mor

talit

y in

men

/ lo

wer

mor

talit

y in

wom

en ;

pair

of c

ompa

rativ

e fig

s to

sup

port

;

3 A

war

d fo

r

sam

e ge

nder

in d

iffer

ent e

thni

c gr

oups

o

r

diff

eren

t ge

nder

s w

ithin

the

sam

e et

hnic

gro

up

wit

h

corr

ect u

nits

(pe

r 10

0 00

0) fo

r th

e m

orta

lity

(i

i)

smok

ing

;

gene

tic p

redi

spos

ition

to C

HD

;

obes

ity ;

hi

gh c

onsu

mpt

ion

of,

high

fat

/ f

ast

/ jun

k /

proc

esse

d, fo

od ;

hi

gh s

alt i

n th

e di

et ;

di

abet

es ;

hi

gh b

lood

pre

ssur

e /

hype

rten

sion

;

high

cho

lest

erol

;

lack

of

/ A

W,

exer

cise

;

stre

ss ;

lo

w u

ptak

e of

trea

tmen

t;

4 M

ark

the

firs

t 4

sug

ges

tio

ns

IG

NO

RE

ref

to a

ge

AC

CE

PT

idea

of f

amily

his

tory

or

here

dity

IG

NO

RE

ref

to

‘die

t’ un

qual

ified

A

CC

EP

T a

n e

xam

ple

e.g.

ref

usal

to ta

ke s

tatin

s

(b

)

fatty

dep

osits

– a

ther

oma

;

ches

t pai

n –

angi

na (

pect

oris

) ;

he

art a

ttack

– m

yoca

rdia

l inf

arct

ion

;

3

T

ota

l10

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