Tutorial 3: Unit 1
Cardio vascular diseases
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1. The Portfolio diet is a diet that has been shown to lower low-density lipoproteins
(LDLs) and other risk factors of cardiovascular disease (CVD).
(a) (i) Which row in the table describes the cholesterol content and antioxidant content of this diet?
(1)
(ii) Name two other dietary risk factors that could be changed in this diet. (1)
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(b) The effect of this diet on the development of CVD in women was investigated.
The diagram shows how 123 330 women were selected from an initial group of 161 808 women.
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(i) Some of the women were removed from the initial group because there was information missing
about their lifestyles.
Suggest why women with missing lifestyle information were removed from the initial group. (1)
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(ii) Some of the women were removed from the initial group because they gave unrealistic estimates
of their daily energy intake.
Give two reasons why some women may have given unrealistic estimates of their daily energy
intake. (2)
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(iii) The women removed from the intermediary group had signs of CVD.
Explain why these women were removed from this investigation. (2)
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(iv) Calculate the percentage of all the women removed from this investigation.
(1)
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(c) Explain why a diet that is low in saturated fat is likely to reduce the risk of CVD. (3)
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(Total for Question 5 = 11 marks) /Jan 23
2. Stents are used in the treatment of atherosclerosis.
Stents widen the diseased coronary artery so that blood can flow through to the heart muscle.
The diagram shows a stent.
Stents can damage the endothelial cells lining the artery and trigger the formation of a blood clot.
Patients who have a stent fitted are given anticoagulants.
(a) Explain how damage to the endothelial cells results in the formation of thrombin. (2)
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(b) Give one risk of treating patients with anticoagulants.
(1)
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(c) The photograph shows a tropical bont tick.
This bont tick produces a peptide called variegin.
Variegin binds to the active site of thrombin and prevents blood clotting.
(i) Variegin is a peptide consisting of 32 amino acids.
Which is the minimum number of bases in the gene that codes for this peptide?
(1)
(ii) Explain how variegin prevents blood clotting.
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(iii) Thrombin slowly splits variegin into two molecules.
Explain how thrombin splits variegin. (2)
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(iv) The effect of variegin on the mass of blood clots forming inside a stent was investigated.
The masses were compared with another anticoagulant, drug H.
The graph shows the results of this investigation.
Each plotted point represents the mass of blood clot in one stent.
Comment on the results of this investigation. (2)
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(Total for Question 5 = 10 marks) /June 23
3. The development of cardiovascular disease (CVD) is often linked to high blood pressure.
(a) Explain what is meant by the term cardiovascular disease. (2)
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(b) Put a cross (X ) in the box to complete the following statement.
Drugs used to treat high blood pressure are called (1)
(c) State two risk factors, other than high blood pressure, that contributes to the development of
CVD. (2)
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(d) The table below shows the death rate from CVD in various European countries in 2011.
Males and females under the age of 65 are included in the data.
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(i) Suggest why the data are presented as deaths per 100 000. (1)
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(ii) In Poland, the death rate from CVD in 2011 was 115 per 100 000 of population. In 2001,
the death rate from CVD was 141 per 100 000.
Calculate the percentage decrease in the death rate.
Show your working. (2)
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(iii) Suggest an explanation for the difference in the death rates from CVD in Poland between
2001 and 2011. (3)
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Total for Question 2 = 11 marks)
4. About 22% of the current UK population are classified as being obese. Obesity is linked to the
development of CVD and type 2 diabetes.
Obesity can be estimated using the body mass index (BMI). BMI is calculated using the formula
below.
Mass in kilograms
BMI =
(height in metres)2
(a) Calculate the mass of a person with a BMI of 30 and a height of 1.95 metres. (2)
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(b) Type 2 diabetes can be caused by the pancreas not producing enough of the hormone
insulin. As a result, blood glucose levels remain high.
Studies show that about 90% of people with type 2 diabetes in the UK have a BMI over 30.
The graph below shows the results of a recent study to investigate the link between type 2
diabetes and BMI in both men and women.
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(i) Using the information in the graph, describe the relationship between BMI and the
incidence of type 2 diabetes in men.
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(ii) Compare the incidence of type 2 diabetes in men and in women. (3)
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(c) Suggest how an obese man should change his lifestyle. (2)
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(d) Food diaries are a way of allowing people with type 2 diabetes to monitor their diet at home
by recording their daily diet.
Suggest two reasons why this might not be a reliable method for monitoring diet. (2)
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(Total for Question 5 = 11 marks)
5. Blood clots in veins and arteries may lead to heart attacks.
(a) (i) Put a cross (X) in the box that completes the following statement. (1)
The role of thrombin in the blood clotting process is to
A activate the enzyme thromboplastin
B catalyse the conversion of fibrinogen to fibrin
C stimulate the release of fibrinogen
D stimulate the release of prothrombin
(ii) Explain how a blood clot can cause a heart attack. (3)
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(b) The photograph below shows a cross section of a large vein, as seen using a light
microscope.
Magnification ×12
Calculate the actual thickness of the wall of this vein between X and Y. Show your working. (2)
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*( c) Explain how the structure of an artery is related to its function. (5)
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(Total for Question 6 = 11 marks)
June 2018 Oct/WBI01/01
6. The risk of developing cardiovascular disease (CVD) can be increased by a number of factors
including diet and a history of thrombosis.
Thrombosis is the development of a blood clot in a blood vessel. Blood clots can develop in
veins and then move through the circulatory system into the coronary artery.
(a) A diet high in saturated triglycerides raises the levels of cholesterol in the blood.
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(i) What is the ratio of glycerol to fatty acid in a triglyceride molecule? (1)
(iii) The table gives some information about four fatty acids.
Explain which of these fatty acids would have the lowest risk of causing CVD, if included in a
diet in equal masses. (2)
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(b) Anticoagulants, antiplatelets and thrombolytics are drugs used to treat blood clots.
(i) One anticoagulant binds to the active site of thrombin. Explain how this drug reduces blood
clotting. (2)
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(ii) Molecules on the surface of platelets enable them to bind to other molecules. One of the
antiplatelet drugs affects molecules on the surface of platelets.
Explain how this drug reduces blood clotting. (2)
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(iii) One thrombolytic drug converts plasminogen into the active enzyme, plasmin.
Plasmin breaks down fibrin.
Explain how this drug reduces the formation of blood clots. (2)
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(Total for Question 2 = 10 marks)
7. Dietary antioxidants may reduce the risk of cardiovascular disease (CVD).
(a) Explain how dietary antioxidants reduce the risk of CVD. (3)
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(b) Chocolate contains high concentrations of a group of antioxidants called flavonoids. It has
been suggested that eating chocolate could reduce the risk of CVD.
The table shows some information about two types of chocolate.
(i) Explain whether eating dark chocolate is likely to reduce the risk of CVD more than eating
milk chocolate. Use the information in the table to support your answer. (4)
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(ii) The table gives some information about ingredients in three different brands of milk
chocolate and dark chocolate.
Use the information in both tables to identify which ingredient contains the most flavonoids. (1)
(Total for Question 6 = 11 marks)
May 2019
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8. The graph shows the relative risk of developing cardiovascular disease (CVD) for non-smokers
and for smokers.
(a) (i) Describe the conclusions that can be made about the risk factors for CVD.
Use the information in the graph to support your answer. (2)
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(ii) The information shown in this graph was collected more than 25 years ago.
Explain how this graph might appear if it showed data collected last year. (2)
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b) The number of people in the world who die from CVD each year is 17.7 million.
This is 31% of all total deaths.
How many deaths are there in the world each year? (1)
(Total for Question 1 = 5 marks)
9. Haemophilia A is an inherited genetic disorder. Haemophilia A results in the blood not being able
to clot.
(a) The table gives some information about blood clotting components. Complete the table by
filling in the empty boxes with either the name of the component, the role of the component
or the solubility of the component.
(6)
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(Total for Question 3 = 6 marks)
2019 Oct
10. A diet high in salt has been shown to increase the risk of some diseases.
The graph shows the results of one study into the increased risk of death related to a diet high in
salt. An increased risk of death is associated with a high hazard ratio.
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(a) State two conclusions that can be drawn from these results. (2)
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(b) The values for the hazard ratio were adjusted for a number of factors, including age and
smoking.
(i) Explain why age and smoking were taken into account when determining the hazard ratio. (3)
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(ii) State two factors, other than age and smoking that may have been considered when
adjusting the values for the hazard ratio. (2)
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(c) Suggest why the hazard ratio for low salt intake was 1.00 for each cause of death. (2)
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(d) (i) The results of this study suggest that there is a correlation between salt intake and cause
of death.
State the meaning of the term correlation. (1)
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(ii) Suggest why studies of this type are unreliable. (2)
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(Total for Question 6 = 12 marks)
Jan 2020
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