Immunology Past Paper Questions

Q1.

(a)

Describe how each of the following parts of the body is protected to prevent
microorganisms entering living cells.
(i)
Skin
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(1)

(ii)

Lungs
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(iii)

Eyes
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(1)

(1)

(b)

Describe how macrophages help to prevent the spread of microorganisms that enter the
blood and other tissues.
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(2)
(Total 5 marks)

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Q2. A representative of a Department of Public Health presented a lecture to make people more
aware of the problems involved in transmission of diseases. This is a copy of the first slide that
was shown.

(a)

Exposure of host to pathogens

Pathogens gain entry to the body
High enough dose of pathogen to cause symptoms
Host susceptible to pathogen
Explain how the respiratory system may prevent pathogens gaining entry to the body.
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(3)

(b)

Explain how the digestive system reduces the number of pathogens.

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(3)

(c)

Explain how a host is made less susceptible by the use of vaccination.

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(6)
(Total 12 marks)

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Q3. (a)

Antibodies are protein molecules. Explain why protein molecules are particularly well
suited to carry out the role of antibodies.
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(2)

(b)

Give two factors which affect the ability of bacteria to cause a disease.
1. .................................................................................................................................
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2. .................................................................................................................................
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(2)

(c)

Diarrhoeal diseases cause the death of over three million people annually. These diseases
may be caused by certain types of bacteria in contaminated drinking water. More than
3
1000 bacteria per 100 cm water are needed to produce symptoms. The incidence of
diarrhoeal diseases can be reduced by using solar water disinfection which uses solar
radiation to kill pathogenic microorganisms. The treatment consists of filling transparent
containers with water and exposing them to full sunlight. In cloudy weather the exposure
time needs to be up to 2 days longer to be effective.
The graph shows the effect that exposure time has on the number of bacteriapresent in a
sample.
100 000

10 000
F aecal
b a c te ria
per
100 cm 3
flu id

1 000

100

10

0
0

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8
4
E x p o s u re tim e in fu ll s u n lig h t/h o u r s

10

12

(i)

Use the graph to estimate how long the sample of water must be exposed to full
sunlight to make sure that it will not cause diarrhoea.
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(1)

(ii)

Suggest one disadvantage of solar water disinfection.

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(1)

(d)

Salmonella infections are more likely to be contracted from contaminated food than from
contaminated water. Suggest a reason for this.
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(1)
(Total 7 marks)

Q4.

Read the following excerpt from a newspaper article.

In the 1950s and 1960s, children all over Britain used to be dragged to each others houses to
catch diseases such as mumps and rubella. Mumps can cause infertility in men after puberty;
rubella during pregnancy may cause a range of birth defects. Then the immunisation programme
came along and promised to be easier and safer. But for one group of parents there is a
dilemma. They do not believe vaccination is safe and are actively encouraging their children to
catch the very childhood diseases the medical profession wants to protect them from. They
believe that children should be allowed to catch childhood diseases naturally and build up their
own immunity. The idea is simple. When a child catches mumps, measles or chickenpox parents
inform others who then meet up. Just like the measles parties of the Fifties and Sixties, the
children play together and, hopefully, catch the disease. In recent years the number of children
being vaccinated against childhood diseases has dropped significantly. The numbers having the
three-in-one MMR jabs have fallen from 93 per cent in 1995 to 87 per cent in 1999.
(a)

Explain why children were taken to each others houses to catch diseases such as
mumps and rubella.
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(b)

Suggest two reasons why parents may decide against vaccination for their children.
1..................................................................................................................................
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2..................................................................................................................................
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(c)

Explain how vaccination protects against developing a disease.

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(2)

(2)

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(5)

(d)

Many elderly people are vaccinated against influenza.

Explain why it is necessary to vaccinate these people every year.
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(3)
(Total 12 marks)

Q5.

The diagram shows an antibody.

L ig h t c h a in

H in g e re g io n
H e a v y c h a in

(a)

Each heavy and light chain is made up from one type of monomer. Name the type of
monomer in each chain.
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(b)

Write X on the diagram to show where an antigen may form a complex with this
antibody.

(c)

Each antibody can form a complex with only one type of antigen. Explain why.
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(d)

The hinge region of the antibody allows both ends to pivot and rotate in relation to one
another. Suggest how this action assists the role of antibodies in agglutination.
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(1)

(1)

(1)

(1)
(Total 4 marks)

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Q6. A vaccine has recently been developed against malaria. A trial of this vaccine was carried out in
South America. The graph shows some of the results of this trial.
C o n tro l g ro u p

N um b er o f cases
o f m a la ria

V a c c in a te d g ro u p

J
(a)

O
N
M o n th

(i)

Suggest how the control group should have been treated.

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(ii)

Explain why it was necessary to have a control group.

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(1)

(1)

The table shows some more data collected during this trial. It shows the total number and
percentage of people in different age groups who caught malaria during the first year of the trial.
Age group/
Vaccinated group
Control group
years
Total number
Percentage
Total number
Percentage
14
3
0.07
13
0.32
59
32
0.44
43
0.58
10 14
36
0.57
58
0.75
15 44
68
0.62
83
0.57
(b)

Explain the advantage of giving the percentage of people who caught malaria as well as
the total number.
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(c)

From the data concerning the percentage of people catching malaria, the researchers
concluded that the vaccine was most effective with people 1-4 years old.
(i)
Explain the evidence from the table that supports this conclusion.
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(2)

(1)

(ii)

Suggest why the vaccine was most effective with people in this age group.
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(2)

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(d)

Explain how B-lymphocytes, plasma cells and memory cells help to protect the body
from disease.
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(5)
(Total 12 marks)

Q7. Read the following passage.

Cystic fibrosis affects epithelial cells lining organs such as the lungs and intestines. In 1989,
the mutated gene responsible for cystic fibrosis was identified. This has opened the way for
the development of gene therapy to reduce the symptoms of the disease. The idea has been to
introduce a normal copy of the gene into the cells of patients who only have the mutant gene.
5
Clinical trials have used viruses, called adenoviruses. In an aerosol spray, these viruses can
introduce normal genes into epithelial cells of the lungs of cystic fibrosis sufferers.
Adenoviruses are thought to be safe since they are not associated with human malignancies.
Adenoviruses normally cause throat infections, so they must be modified before use in gene
therapy. Despite this precaution, some patients have produced an immune response to the
10
modified adenoviruses.
Use the information from the passage and your own knowledge to answer the following
questions.
(a) Suggest how the adenoviruses must be modified before use in gene therapy (lines 8 9).
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(2)

(b)

Explain what is meant by malignancies (line 7).

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(c)

Describe how the presence of adenoviruses will produce a primary immune response.
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(d)

The adenovirus is used as a vector to introduce the normal gene into the human cell.
Explain why it is described as a vector.
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(1)

(6)

(2)

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(e)

The normal gene allows the epithelial cells to produce a protein known as CFTR. The
CFTR protein enables these cells to secrete chloride ions through the plasma membrane.
What does each of the following observations suggest about the effectiveness of the gene
therapy treatment?
(i)
Messenger RNA, coding for the CFTR protein, is found inside the epithelial cells.
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(2)

(ii)

An increased amount of chloride ions is detected outside the epithelial cells.

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(2)
(Total 15 marks)

Q8.
Measles is an infectious disease that can cause serious complications in children. In
countries where measles is uncommon a combined measles, mumps and rubella vaccine (MMR)
is given at 15 months. In a country where measles is common a single measles vaccine (MV)
may be given at 9 months, followed by MMR at 15 months. In an investigation, the efficiency
of the two vaccination programmes was compared in a country where measles is common. The
amount of measles antibody in the blood of children before vaccination and after completing
vaccination were measured. The graph shows the results. All difference are statistically
significant.
0 .8
0 .7
0 .6
M e a n a m o u n t 0 .5
o f m e a s le s
a n tib o d y in
0 .4
a rb itra ry u n its

B e fo re v a c c in a tio n
A fte r v a c c in a tio n

0 .3
0 .2
0 .1
0

(i)

M V + M M R
g ro u p

M M R o n ly
g ro u p

What was the effect of vaccination in the MMR only group? Express your answer as the
percentage increase in the amount of measles antibody in the MMR group after
vaccination. Show your working.
Percentage increase ...................................... %
(2)

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(ii)

The MV + MMR group had more measles antibodies in their blood before vaccination
than the MMR only group. Suggest an explanation for this.
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(1)
(Total 3 marks)

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Q9.

(a)

Changes to the protein coat of the influenza virus cause antigenic variability.
Explain how antigenic variability has caused some people to become infected more than
once with influenza viruses.
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(b)

The drawings show the changes in a B lymphocyte after stimulation by specific antigens.

(2)

B lymphocyte before stimulation

B lymphocyte after stimulation

(i)

Describe the role of macrophages in stimulating B lymphocytes.

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(ii)

Explain how the changes shown in the drawings are related to the function of B
lymphocytes.
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(1)

(4)
(Total 7 marks)

Q10. A child was given two vaccinations consisting of antigens from the virus which causes
poliomyelitis. The graph shows the concentration of antibodies resulting from these
vaccinations.
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A n tib o d y
c o n c e n tra tio n
in b lo o d

T im e
F irs t v a c c in a tio n
u s in g p o lio m y e litis
a n tig e n s

S e c o n d v a c c in a tio n
u s in g p o lio m y e litis
a n tig e n s

(a)

What is a poliomyelitis antigen?

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(b)

Describe and explain the difference in the childs response to the two vaccinations shown
in the graph.
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(2)

(3)
(Total 5 marks)

Q11. (a)

(i)

What is a pathogen?
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(ii)

What is an attenuated microorganism?

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(1)

(1)

(b)

Research by the World Health Organisation (WHO) has shown that a population is
protected from a pathogenic disease when 95% of children are vaccinated against that
disease. Explain why there is a low risk of a disease spreading when vaccination levels
reach 95%.
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(c)

The table shows information about vaccination levels against measles in 1997 and 2000.
Year
1997
2000
Percentage of children vaccinated
92
88.4
against measles

(2)

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(i)

Explain one advantage of recording the percentage of children vaccinated rather

than the number of children vaccinated.
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(ii)

For every 100 000 children born, calculate how many fewer children were
vaccinated in the year 2000. Show your working.

(1)

Answer.....................................
(1)

(d)

Give two ways in which passive immunity differs from active immunity.
1 ..................................................................................................................................
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2 ..................................................................................................................................
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(2)
(Total 8 marks)

Q12. (a)

An antigen in a vaccine leads to the production of antibodies. Describe the part played by
B lymphocytes in this process.
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(4)

(b)

Hepatitis B vaccine contains a viral antigen produced by genetically modified bacteria.

Describe how the isolated gene that codes for a protein in the viruss coat could be
transferred to the bacterial cells.
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(3)
(Total 7 marks)

Q13. A test has been developed to determine if a person is infected with variant CJD (vCJD), the
human form of BSE (mad cow disease). The test detects the protein which causes vCJD in a
urine sample.
The test kit contains the following components.

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A n tib o d y

W e ll

Test
p la te

E nzym e
A te s t p la te w ith w e lls
c o n ta in g a n tib o d ie s
to th e p ro te in w h ic h
causes vC JD

(a)

A n tib o d ie s to th e p ro te in
w h ic h c a u s e s v C J D . T h e s e
a n tib o d ie s h a v e a n e n z y m e
a tta c h e d to th e m

C o lo u rle s s s o lu tio n
w h ic h tu rn s b lu e
if th e e n z y m e is
p re se n t

Complete the flow chart to describe how this test would be used.
U rin e s a m p le is a d d e d to w e ll in te s t p la te

P la te is w a s h e d to re m o v e u n b o u n d v C J D p ro te in

(3)

(b)

Explain why this test would detect vCJD, but not other antigens in the urine.
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(2)
(Total 5 marks)

Q14. (a)

(i)

What is an antigen?
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(ii)

Myeloid leukaemia is a type of cancer. Monoclonal antibodies are used in treating

(2)

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it. A monoclonal antibody will bind to an antigen on a myeloid leukaemia cell. It

will not bind to other types of cell. Explain why this antibody binds only to an
antigen on a myeloid leukaemia cell.
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(2)

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(b)

Calichaemicin is a substance which is very toxic and kills cells. Scientists have made a
drug by joining calichaemicin to the monoclonal antibody that attaches to myeloid
leukaemia cells. Explain why this drug is effective in treating myeloid leukaemia.
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(2)
(Total 6 marks)

Q15. Read the following passage.

Herpes viruses cause cold sores and, in some cases, genital warts. Scientists are well on the way
to producing an antibody which will counteract herpes infection. This antibody works by
sticking to the virus and blocking its entry into cells. It has proved very effective in animal
tests.
5
One drawback with this approach, however, is that antibodies are at present produced using
hamster ovary cells. This method is expensive and only produces limited amounts. A new
technique is being developed to produce antibodies from plants. It involves introducing the
DNA which codes for the required antibody into crop plants such as maize.
Use information from the passage and your own knowledge to answer the questions.
(a) (i)
What is an antibody?
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(2)

(ii)

Describe how antibodies are produced in the body following a viral infection.
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(6)

(b)

Describe how the antibody gene could be isolated from an animal cell and introduced into
a crop plant such as maize (lines 7-8).
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(c)

Taking a course of these antibodies from plants to treat a herpes infection would not
produce long-term protection against disease. Explain why.
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(4)

(2)
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(d)

Explain one advantage of using antibodies from plants to treat a disease, rather than
antibodies produced in an experimental animal (lines 5-6).
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(1)
(Total 15 marks)

Q16. (a)

Whooping cough is a childhood respiratory disease caused by a bacterium.

The graph shows the incidence of whooping cough in Central Europe from 1969 to 1999.
7
6
5
R e p o rte d
cases p er 4
100 000
p o p u la tio n 3
2
1

(i)

0
1969 1974 1979 1984 1989 1994 1999
Year
Calculate the percentage change in the incidence of whooping cough from 1982 to
1999. Show your working.

Answer ............................................
(2)

(ii)

Suggest one reason for the trend in the number of cases of whooping cough since
1982.
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(1)

(b)

Whooping cough bacteria prevent the normal functioning of cilia in the respiratory tract.
Explain how this effect is linked to the persistent coughing associated with the disease.
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(2)
(Total 5 marks)

Q17. One blood group system is Rhesus. Rhesus positive people have rhesus antigens on their red
blood cells. Rhesus negative people have no rhesus antigens. To find out whether a person is
rhesus positive or negative, a sample of blood is mixed with rhesus antibodies.
(a) Explain why rhesus positive blood agglutinates when it is mixed with rhesus antibodies.
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(1)

(b)

A person who is rhesus negative will produce rhesus antibodies if rhesus antigens get into

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the blood.
(i)
Describe how these antibodies are produced.
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(5)

(ii)

Explain how antibodies are produced more quickly if the same type of antigen gets
into the blood on a second occasion.
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(2)
(Total 8 marks)

Q18. S A medical officer investigated the effectiveness of five different types of influenza vaccine. A
total of 1350 people agreed to be vaccinated. The medical officer divided these into five groups.
The number who suffered from influenza in the following year was recorded. The results are
shown in the table.
Number of people vaccinated
Type of influenza
Suffered from
Did not suffer
Total
Proportion
vaccine
influenza
from influenza
suffering from
influenza
I
43
237
280
0.15
II
52
198
250
0.21
III
25
245
270
0.09
IV
260
0.18
V
57
233
290
0.20
(a)

Complete the spaces in the table for the people vaccinated with type IV vaccine.

(b)

The medical officer used a statistical test to assess the effectiveness of the five different
vaccines.
(i)
What would be the null hypothesis?
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(1)

(1)

(ii)

The statistical test gave a probability of less than 0.05. What conclusion can be
drawn from this?
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(1)

(c)

It was suggested that the raw data showed that the type III vaccine was the most effective.
Give two reasons why this conclusion may not be reliable.
1 ..............................................................................................................................
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2 ..............................................................................................................................
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(2)

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(Total 5 marks)

Q19. The table shows the concentration of a disinfectant and the contact time needed to kill all the
bacteria in a sample.
Species of bacteria
Concentration of
Concentration of
Contact time/
disinfectant/
hypochlorite in
minutes
3
disinfectant/
g dm
parts per million
Escherichia coli
1.0
125
5
Escherichia coli

0.2

25

30

Mycobacterium
tuberculosis
Mycobacterium
tuberculosis
Mycobacterium
tuberculosis
Clostridium tetani

1.0

125

10

Clostridium tetani

2.0

0.4
0.2

30
25

240

500

250

30

(a)

Complete the data in the table.

(b)

Give two conclusions which may be drawn from the data.

1..................................................................................................................................
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2..................................................................................................................................
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(c)

(i)

Give one factor, other than the ones given in the table, which needs to be kept
constant in order to obtain reliable data in this experiment.
...........................................................................................................................

(ii)

Describe and explain how variation in this factor might affect the results.
...........................................................................................................................

(1)

(2)

(2)

(d)

The action of the disinfectant depends on the formation of hypochlorous acid from the
hypochlorite. Hypochlorous acid is a powerful oxidising agent which oxidises proteins.
Explain how the action of antibiotics on bacteria is different from that of this disinfectant.
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(2)
(Total 7 marks)

Q20. Read the following passage.

The body is protected by a large number of cells and molecules working together. Specialised
cells, such as macrophages, travel round the body ingesting the antigens they find and
fragmenting them into peptides.
5

Pieces of these peptides are then joined to special molecules which display them on the
surface of the macrophage. Receptor molecules on the surface of T-lymphocytes enable each
T-lymphocyte to recognise a different peptide displayed on the surface of the macrophages.
T-lymphocytes, activated by this recognition, divide and then secrete substances called
lymphokines which boost the activity of B-lymphocytes.

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10

There are millions of types of B-lymphocytes, each with a different surface antibody. When
one type of B-lymphocyte recognises an antigen, it is stimulated by the lymphokines to clone.
Cloning produces many cells each with the same antibody-producing capability. Some of these
cells are stored as memory B cells.

(a)

Name the type of enzyme which would be responsible for fragmenting antigens into
peptides (line 3).
.....................................................................................................................................

(b)

Explain how the receptor molecules on the surface of the T-lymphocytes are able to
recognise different peptides on the surface of the macrophage (lines 5 6).
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(c)

(i)

Suggest how cloning results in the production of B-lymphocytes that all have the
same antibody-producing capability (lines 11-12).
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(ii)

Explain the advantage of storing memory B cells (line 12).

...........................................................................................................................
...........................................................................................................................

(1)

(2)

(4)

(1)

(d)

A newborn infant is not able to make the sort of immune response described in the
passage.
Describe how a newborn infant may be protected naturally against infection.
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(2)
(Total 10 marks)

Q21. Haemophilus influenza type b (Hib) is the bacterium which causes Hib meningitis.
A carbohydrate from the bacterial coat was used to prepare a vaccine against the disease.
However, this vaccine was not effective in children under two years of age because they
produced very few antibodies and were unable to produce the necessary memory cells. When
the carbohydrate was combined with a protein from the bacterial coat, a vaccine effective in
children less than a year old was produced. This vaccine was introduced into the UK in October
1992. In 1993 the number of cases of Hib meningitis occurring in children under one year old
was only 25% of that predicted. All of these occurred in unvaccinated children. The goal is now
the elimination of Hib meningitis from the UK by vaccinating at least 90% of the children under
2 years of age.
(a)

Explain the function of the protein from the bacterial coat when the vaccine is injected
into a child.
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(2)

(b)

Explain how Hib meningitis may be eliminated even though every child is not vaccinated.
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(c)

Give two other methods used to prepare vaccines.

1. ...............................................................................................................................
2. ...............................................................................................................................

(2)

(2)
(Total 6 marks)

Q22. (a)

Explain how the defence mechanisms of the body reduce the chance of entry by a
pathogen.
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(5)

(b)

Explain how the body responds both generally and specifically to pathogens that enter the
blood.
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(7)
(Total 12 marks)

Q23. In an investigation, the response to vaccination of people who were stressed was compared with
the response of people who were not stressed. Everyone in the study was given the same dose of
influenza vaccine. The graph shows the response to the vaccine.

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100
S tre s s e d
P e rc e n ta g e o f
s u b je c ts
re s p o n d in g
to v a c c in e

N o t s tre s se d

50

0
U n d e r 7 0 y e a rs
o ld

A b o v e 7 0 y e a rs
o ld

(i)

Suggest one other factor that would have to be similar for the stressed and not stressed
groups to make this comparison valid.
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(ii)

Blood samples were taken before vaccination and again after 35 days. Suggest how blood
samples would show that the vaccination had been effective.
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(iii)

Describe two conclusions that can be drawn from the graph.

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(1)

(1)

(2)
(Total 4 marks)

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