HKALE BIOLOGY | 23-26 Defence against diseases | P.

1. 1991/IA/5
Briefly describe the blood clotting process at the site of a wound.
(5 marks)
2. 1992/IA/5
List the differences between cell-mediated and antibody-mediated immunity.
(4 marks)
3. 1993/IIB/9
What is AIDS and why is it a cause of concern for modem society?
(20 marks)
4. 1994/IA/5
Give a brief account of the immunological basis of the ABO blood groups and its significance to blood
transfusion.
(6 marks)
5. 1994/IIB/7
Comment on the statement “Prevention of diseases is better than cure”.
(20 marks)
6. 1996/IA/2
(a) List four symptoms of the inflammatory response. For each or these symptoms, outline the
contributory process(es).
(5 marks)
(b) State three immunological differences between humoral immune response and inflammatory response.
(3 marks)
7. 1997/IA/6
Some types of vaccinations require a booster (second) dose. Briefly account for this requirement.
(3 marks)
8. 1998/IIB/4
While playing, a boy fell and scratched his leg. His leg bled, the wound became infected and swollen. Give
a full account of the various physiological responses of the boy’s body to his injury.
(20 marks)
9. 1999/IIA/3
(a) Distinguish infectious diseases from inheritable diseases with respect to their causes and modes of
transmission.
(6 marks)
(b) State and explain three features of the human body which are in the first line of defence in preventing
the entry of infectious agents.
(6 marks)
10. 2000/IIB/9
The bird's flu, AIDS (acquired immune deficiency syndrome) and the mad cow disease are threatening
diseases which involve different routes of transmission. As an individual, what can you do to avoid
contracting these diseases? What can the government do to prevent and control the spread of these
diseases? Discuss the feasibility of developing vaccines for combating these diseases.
(20 marks)
11. 2001/IIA/3c
In a traffic accident, the victim suffered from severe blood loss and needed blood transfusion.
(i) It was known that the victim was of blood group B. Explain whether Tom would be a possible
blood donor for the victim.
(2 marks)
(ii) Give an account of the humoral immune response of the victim in combating pathogens that had
entered his body through the wounds.
(6 marks)
12. 2002/IIA/1c
If this bacterium is pathogenic to human beings, describe how we can make use of molecules extracted
from structure B to protect us from the infection of this bacterium. (5 marks)
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13. 2003/IIA/1e

On the surface of cells, molecules like X are found. They are unique to each individual organism and can
act as antigens to other individuals, to humans, why is the ability to recognize, and respond to foreign
antigens.
(i) a merit to survival? Briefly describe we such response.
(3 marks)
(ii) an evil to organ transplant?
(1 mark)
14. 2003/IC/13
Read the following passage and then answer the questions that follow.

(a) Other than size and size-related features, give two biological features that are possessed by both the
smallpox virus and the anthrax bacterium which enable them to be used as biological weapons.
(2 marks)
(b) Suggest a measure to control the spread of smallpox virus from infected patients. (lines 2-3, 13-15)
(1 mark)
(c) As a broad spectrum antibiotic, what undesirable effect will ciprofloxacin have on the microbial
community in the body? (2 marks)
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(e) Why do the initial symptoms of anthrax make the anthrax bacterium a dangerous biological weapon?
(lines 11-15) (1 mark)
(f) Why is vaccination against smallpox and anthrax only recommended to high-risk populations?
(lines 15-17) (1 mark)

15. 2004/IC/13
(b) Explain why radioactive iodides that had been taken into the body would lead to an increased
incidence of thyroid cancer in children who lived around Chernobyl. (3 marks)
(d)(i)Which type of mutation can best be determined by (2 marks)
DNA sequencing analysis?
chromosomal analysis using the light microscope? _____________
(ii) With reference to one type of mutation that you state in (d)(i), suggest one mechanism for such a
mutation that would lead to the development of cancer.
(2 marks)
16. 2004/IIC/7
Discuss how human defence mechanisms can protect us against diseases transmitted by vectors and the
limitations of these mechanisms. What personal responsibilities should be taken to reduce the incidence of
infection due to transmission by vectors? Explain the biological basis for such responsibilities.
(20 marks)
17. 2005/IA/3
Complete the following paragraph with suitable word(s):
Cholera is caused by a bacterium, Vibrio cholerae, which is transmitted directly through (a)
. In sub-tropical areas, there is a distinct seasonal pattern of this
disease, with the highest incidence in the (b) season. The incidence of
cholera can be reduced by taking proper precautionary measures such as (c)
and (d) .
(4 marks)
18. 2005/IC/12
Read the following passage and then answer the questions that follow.

(a) Suggest explanations for the reversed trend of coronary heart disease observed in different social
classes in Western countries and in Hong Kong. (lines 5-7)
(3 marks)
(b) In terms of disease control, why is it important to distinguish between lifestyle-related and lifestyle-
unrelated risk factors? (lines 7-9) (2 marks)
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(c) Give two reasons to explain why old age is the single most important risk factor for the development
of cancer. (line 13) (2 marks)

(d) Some viral infections are found to be related to the development of certain cancers. Give one example
of such cancers that is common in Hong Kong. Suggest two preventive measures that individuals can
take to protect themselves from such viral infection.
(3 marks)
(e) Some people believe that diabetes mellitus is caused by excessive intake of sugary food. Discuss
whether this idea is valid based on your knowledge of the two different types of diabetes mellitus.
(4 marks)
(f) Legislation and health education are two public health strategies adopted in Hong Kong to reduce the
incidence or the mortality rates of coronary heart disease, cancer and diabetes mellitus. With reference
to the measures taken in these strategies, state how they can deal with the above-mentioned diseases.
Present your answer in a short paragraph.
(6 marks)
19. 2006/IC/13
Read the following passage and then answer the questions that follow.

(b) Explain why the crowded conditions in the prison led to the quick and wide spread of tuberculosis
among the prisoners in the Soviet Union. (lines 11-12) (2 marks)

(d) The strain of Mycobacterium tuberculosis found in New York City was identical to that in the Soviet
Union. Suggest two explanations for this phenomenon. (lines 15-16) (2 marks)

(e) Suggest two ways in which individuals can contribute to slowing down the loss of effectiveness of
antibiotics in treating diseases in the community. Support your answer with biological rationales.
(lines 19-21) (4 marks)

(f) The use of antibiotics and vaccination are possible means of disease control. Give two differences in
the principles of these two means in dealing with infectious diseases. (4 marks)

(g) Suggest two reasons why the combination of the flu vaccines has to be reviewed and determined
regularly. (lines 27-28) (2 marks)
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(h) Argue for and against keeping stocks of the smallpox virus and the anthrax bacterium based on
scientific and ethical grounds. (lines 18-20) (5 marks)
Argue for keeping their stocks:
Argue for against keeping their stocks:
(i) What can nations do to prevent the use of pathogenic organisms as weapons? Propose two such
preventive measures. (2 marks)

20. 2006/IIA/1c

Cholesterol is important to our body, but if in excess, it can bring about adverse effects on health. It can be
absorbed into the body through diet and can also be synthesized within the body. Cholesterol in the blood
is then taken into body cells for various functions.
(c) The uptake of cholesterol into liver cells requires a membrane protein (receptor) and the abundance
of this receptor is determined by a gene.

(i) People homozygous for the dominant allele of this gene have few or no such receptors on the liver cell
membrane. Based on this information and the biosynthetic pathway above, explain why these people
have a very high level of cholesterol in the blood. (4 marks)
(ii) Many of the people mentioned in (i) suffer from coronary heart disease and die before 30 years of age.
Explain why a very high blood cholesterol level would result in severe coronary heart disease.
(4 marks)
(iii) People heterozygous for this gene have half the normal number of the receptors on the liver cell
membrane. Their blood cholesterol level tends to be higher than normal, but it can be reduced by a
combination of drug administration and lifestyle modification.
(2) Another group of drugs acts in the intestine. Propose one possible action of these drugs in
reducing the blood cholesterol level. (1 mark)
(3) Suggest two lifestyle modifications that these people should adopt to reduce the blood cholesterol
level. (2 marks)
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21. 2007/IIA/3
Up till the late 19th century, people knew little about the role of microorganisms in infectious diseases. In
1882, a German doctor, Robert Koch, formulated four criteria, now known as Koch’s postulates, for
determining whether a particular organism is the cause of a specific infectious disease. The four
postulates that have to be fulfilled are as follows:

I. The suspected organism should be found in all animals suffering from

the disease, but not in healthy animals.

II. The organism should be isolated from the diseased animal and can be
grown in pure culture.

III. The cultured organism should cause the disease when experimentally
introduced into a healthy animal.

IV. The organism re-isolated from the experimentally infected animal should be
the same as the suspected organism.

(a) The presence of a microorganism in the diseased animal alone is not sufficient to conclude that the
microorganism is the pathogen of the disease. Why? (2 marks)

(b) The second part of postulate I may not apply in some cases because some apparently healthy
individuals may harbour the pathogen. Give two reasons to account fro this phenomenon.
(2 marks)

(c) One of Koch's postulates should not be applied in the study of infectious diseases that occur in
humans only. Identify the postulate and suggest a reason why it should not be applied. (2 marks)

(f) Discuss how the application of Koch's postulates contributes to

(i) the treatment of infectious diseases; (2 marks)
(ii) the control of infectious diseases. (4 marks)
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22. 2008/IC/13
Read the following passage and then answer the questions that follow it.

Genes and diseases

Certain human diseases are caused by gene mutation, which may occur 1
spontaneously in cells or may be induced by certain agents. Most mutations do
not result in any important changes in body traits. However, some mutations do
cause problems in our body, resulting in genetic disorders.

Some scientists believe that the ultimate solution to genetic disorders is to repair 5
the genetic defects by gene therapy. This can be achieved by transferring correct
copies of the gene into the problem cells. Severe Combined Immunodeficiency
Disease (SCID) is the first human genetic disorder to be treated by gene therapy.
SCID refers to a group of inherited disorders, in which
patients’ T cells and B cells fail to produce immune responses. The most common 10
type of SCID is called XSCID in which the mutated gene, being recessive, is
located on the X chromosome. Another form of SCID is called ADA SCID, which
is caused by a recessive mutation of the ADA gene on chromosome 20. Most
SCID patients do not live past their teens. In 1990, two SCID patients were
successfully treated by having the normal gene transferred into their 15
lymphocytes to compensate for the mutation. This is an example of ‘somatic
gene therapy’, which corrects the genetic defects in the body cells of the patients.
‘Germ-line gene therapy’, on the other hand, treats genetic disorders for the
offspring of the patients. The correct copy of the gene is first introduced into
germ cells, which
then differentiate into eggs or sperms. However, government in many countries 20
have banned ‘germ-line gene therapy’.

Gene mutation is also known to play a significant role in causing cancer, which is
one of the top killer diseases in developed countries. However, it has been
estimated that two-thirds of human cancers could be prevented through
appropriate lifestyle modifications. For example, a nationwide health promotion 25
campaign in the United Stated encourages people to eat at least five servings of
fruits and vegetables a day to reduce the risk of certain cancers and other
chronic diseases. Thus, other than one’s own genome, a healthy lifestyle can
contribute much to improving a person’s health.

(c) Low levels of antibodies and T cells after vaccination are characteristic features which can be used
for the diagnosis of SCID in newborns. Explain why SCID babies have such characteristics.
(lines 8 – 9) (2 marks)

(f) In developed countries, people become more aware of the effects of smoking and alcoholism on the
development of cancer. Discuss why cancer remains one of the top killer diseases in developed
countries. (lines 21 – 24) (5 marks)

(g) Besides cancer, state two other chronic diseases the risk of which can be reduced by sufficient daily
intake of vegetables and fruits. (lines 22 – 25) (2 marks)
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23. 2008/IIC/8
In the past century, there has been a decline in the number of deaths caused by infections diseases in well-
developed countries. From the perspectives of diseases prevention and treatment, discuss the reasons for
such a decline and the underlying biological principles. Explain the challenges faced by the medical and
health profession in the coming years regarding the control of infectious diseases.
(20 marks)
24. 2009/IA/4
Select the appropriate description listed in Column 2 that matches with the cell type given in Column 1.
Put the appropriate letter in the space provided. (4 marks)
Column 1 Column 2
B cell A. Contains a lot of lysosomes

T cell B. Kills own body cells that display foreign antigens on

their surface.
Phagocyte C. Is primarily responsible for the humoral immune
response
Memory cell _____ D. Can pass through the placenta and confer natural
immunity to the foetus
E. Proliferates rapidly upon second exposure to the
same antigen

25. 2010/IC/11
Read the following passage and then answer the questions that follow it.

Food Vaccines
Vaccine is a powerful weapon for humans to use in the fight against infectious 1
diseases. Traditional vaccines consist of weakened or dead pathogens. Nowadays,
pharmaceutical manufacturers favour the production of subunit vaccines. This
involves the transfer of genes that encode the antigenic protein(s) of a pathogen into
bacterial or animal cell cultures. The antigenic proteins produced from the cell 5
culture are harvested for vaccination. This is generally safer than the use of
traditional vaccines. However, subunit vaccines are usually much more expensive
than traditional ones. Like traditional vaccines, subunit vaccines are usually
delivered to people through injection.
In many developing countries, millions of infants die from infectious diseases, 10
partly because the vaccines are too costly. In response to the call from the World
Health Organization for inexpensive vaccines, plant biologists have advanced the
current subunit vaccine technology by transferring the antigenic genes from
infectious bacteria and viruses into food plants. The encoded antigenic proteins are
then produced in the edible parts of food plants so that upon consumption people 15
are vaccinated. Very often, the bacterium Agrobacterium tumefaciens is used as a
vector to deliver the antigenic genes into food plants. In practice, for example, a
potato leaf is infected by A. tumefaciens, which carries the antigenic genes. A.
tumefaciens can induce the infected leaf cells to develop a callus which contains the
antigenic genes. The callus is then cultured into a plantlet which finally develops 20
into a plant that can produce potatoes containing the antigenic proteins. When a
person eats the potatoes, the plant cells gradually release their antigenic proteins
upon digestion. Special cells in the intestinal lining will take up these proteins and
deliver them to the bloodstream. An immune response will then be triggered.
Each type of food plants poses its own challenges for food vaccine production. 25
Potatoes are ideal in many ways, but they usually have to be cooked before
consumption. Bananas and tomatoes have also been explored to produce food
vaccines. Although a number of trial studies on animals and humans have
supported the feasibility of food vaccines, many issues remain to be addressed.
 HKALE BIOLOGY | 23-26 Defence against diseases | P.9

(a) Why are subunit vaccines safer than traditional vaccines? (lines 2 – 6) (3 marks)

(b) Suggest two reasons to explain why the cost of producing subunit vaccines is usually much higher
than that of traditional vaccines (lines 3 – 7) (2 marks)

(c) Food vaccines in the form of edible parts of plants can be administered orally but subunit vaccines
cannot. Why? (lines19 – 21) (4 marks)

(d) After being taken up into the bloodstream, how can the content of the food vaccines confer
immunological protection to the individuals against a specific infectious disease? (lines 21 – 22)
(4 marks)

(e) Suggest one advantage and one disadvantage of using bananas, instead of potatoes, as a food vaccine.
(lines 23 – 25) (2 marks)

(f) Before the food vaccines can be produced and delivered to the public successfully, there are still
challenges and concerns to be addressed. Discuss these challenges and concerns. (5 marks)

26. 2010/IC/11
In recent years, cancer has emerged as a major life-threatening disease in Hong Kong. It begins with a
group of cells that display uncontrolled cell division. A lot of research and resources have been dedicated
to the development of various cancer treatments to save the lives of cancer patients.
(a) Some cancers are treated by administering ionising radiation to kill cancer cells in the affected area.
Suggest two harmful effects of this treatment on the cancer patients.
(2 marks)
(c) The incidence of cancer is higher in the older age group. Suggest two reasons for this.
(2 marks)
Essay
1. 1991/IIB/9
“Smoking is hazardous to health” is a well-known slogan. Discuss the significant physiological effects of
tobacco smoking and its economic cost to Hong Kong society.
(20 marks)
2. 1992/IIB/9
“Cancer-related deaths are seen as more prevalent nowadays simply because most other potentially fatal
diseases are treatable by modem medicine.” Discuss this statement and give arguments both for and
against it in relation to medical and environmental developments since 1950.
(20 marks)
3. 1992/IIB/13
Discuss recent medical advances in the treatment of human infertility.
(20 marks)
4. 1993/IIB/9
What is AIDS and why is it a cause of concern for modem society?
(20 marks)
5. 1994/IIB/7
Comment on the statement “Prevention of diseases is better than cure”.
(20 marks)
6. 1995/IIB/7
Write an essay on: ‘Certain diseases are transmitted through contact with the blood of infected persons
while some are diseases of the blood itself.’
(20 marks)
7. 1995/IIB/8
Scientists envisage a continuous search for and development of new drugs for the benefit of mankind.
Why?
(20 marks)
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8. 1998/IIB/8
What are antibiotics and how do they work? Describe and explain the consequences of the indiscriminate
long-term use of antibiotics and suggest two possible solutions to alleviate such consequences.
(20 marks)
9. 1998/IIB/10
‘Smoking harms yourself and others’ is a slogan used by anti-smoking advocates. Explain the health
problems associated with smoking. Describe two social and two economic impacts of smoking on the local
community.
(20 marks)
10. 1999/IIB/9
‘Long-term health problems can be brought about if a person takes in food that is contaminated, or
regularly consumes food that contains excessive fat, or sugar, or sodium.’ Give a full account of the
biological basis for this statement. (Do not include acute cases such as food poisoning in your answer.)
(20 marks)

11. 2000/IIB/10
Regular exercise (aerobic or endurance exercise) is a key component to good health. Describe the long-
term exercise-induced adjustments on the cardiovascular, respiratory and musculo-skeletal systems, and
the health-related benefits resulting from such adjustments. Explain under what environmental conditions
a person should avoid doing exercise to safeguard his/her health.
(20 marks)
12. 2001/II/7
Demands for transplants and prosthetic devices (i.e. artificial human body parts) to replace diseased or
damaged human body parts have driven research and development in various fields. These include
immunology, in vitro culture, genetic engineering and biomedical engineering. Discuss, with specific
examples, the contributions of advances in two of these fields to transplantation and / or prosthetics. What
are their limitations / drawbacks? Discuss the associated ethical concerns of transplantations
(20 marks)