1. (a) Explain what is meant by the term infection.

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(b) Tuberculosis is a disease caused by the bacterium Mycobacterium tuberculosis. The

disease is caught when secretions from the lungs and airways of an infected person are
inhaled and the bacteria pass down to the lungs. Tuberculosis is characterised by
persistent coughing with blood-stained mucus.

Tuberculosis can be treated with antibiotics. Patients need to be given three or four
different antibiotics (combination therapy) for several months. It is important that the
drugs are taken every single day and that the medication continues to be taken even after
the patient feels better, to prevent the development of antibiotic resistance.

(i) With reference to the effect of M. tuberculosis on lung tissue, suggest how the
bacteria cause the coughing of blood-stained mucus.

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(ii) Explain how antibiotic resistance develops.

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(Total 6 marks)

Bishop Thomas Grant School 1

2. The diagram below shows the possibility of developing tuberculosis (TB) when people are
exposed to the bacterium Mycobacterium tuberculosis.

(a) Name the organ which is the most commonly infected by M. tuberculosis.

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(b) Suggest why 90% of people who are infected by M. tuberculosis never develop TB.

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Bishop Thomas Grant School 2

 (c) Outline the treatment for those people with active TB.

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(Total 6 marks)

3. Mycobacterium bovis is a bacterium which can be injected into the body to stimulate active
immunity against tuberculosis (TB). This is known as the BCG vaccine. TB is caused by
Mycobacterium tuberculosis, a bacterium that is closely related to M. bovis.

(a) Explain what is meant by active immunity.

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Bishop Thomas Grant School 3

 (b) Describe the role of B cells in active immunity.

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Another common bacterium, Mycobacterium fortuitum is harmless and often found in soil. In a
study to compare the effects of different Mycobacterium species, mice were infected with
Mycobacterium as shown in the diagram opposite. Enough time was allowed between injections
for an immune response to develop.

B a c te riu m s p e c ie s T re a tm e n t A T re a tm e n t B T re a tm e n t C
in je c te d

M . fo r tu itu m

M . b o v is

M . tu b e rc u lo s is

M o u s e d ie s o f T B M o u s e s u rv iv e s M o u s e d ie s o f T B

Bishop Thomas Grant School 4

 (c) Explain why the mouse died of TB after treatment A, but the mouse used for treatment B
did not die of TB.

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(d) The BCG vaccine needs the M. bovis cells to grow and divide in order to provide
protection. Suggest reasons why the BCG vaccine in treatment C failed to protect the
mouse against TB.

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(e) M. fortuitum often infects wounds in young children. Suggest one possible consequence
of this in later life.

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(Total 12 marks)

Bishop Thomas Grant School 5

4. Describe how the disease tuberculosis (TB) is caused.

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(Total 3 marks)

5. Many people infected with the bacterium that causes tuberculosis (TB) do not develop the
disease for a number of years.

(a) Suggest how some TB bacteria avoid being destroyed by the immune system for a
number of years.

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(b) Describe the role of B-cells and T-cells in preventing the development of the symptoms of
TB in an infected person.

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Bishop Thomas Grant School 6

 (c) (i) Suggest why a patient infected with TB is more likely to develop symptoms of the
disease if they are also infected by HIV.

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(ii) Give two symptoms which are likely to occur in a person with TB.

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(Total 8 marks)

6. Tuberculosis (TB) is caused by the bacterium, Mycobacterium tuberculosis.

(a) The table below lists five structural features that may be found in bacteria and viruses.
Put a cross in the box if the structural feature is present.

Structural feature Bacteria Viruses

Mesosome

Capsid

Nucleic acid

Cytoplasm

Ribosome
(5)

(b) The table below shows the number of new TB cases recorded in 1994 and in 2004 from
four different geographical regions. These data exclude people who are HIV positive.

Year Number of new TB cases per 100 000 of the population

Africa Asia South America Europe
1994 148 629 98 48
2004 281 535 59 104

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 (i) Describe the trends shown by the data.

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(ii) HIV positive people were excluded from the data. If they had been included
suggest how the data would differ. Give an explanation for your answer.

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Bishop Thomas Grant School 8

 (c) TB is increasing in some countries which have well-funded health services. Suggest two
reasons for this.

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(2)
(Total 12 marks)

Bishop Thomas Grant School 9