Sample Paper 1

Question 1

Starting from the nose, describe the route that air will take into the body before undergoing gaseous exchange

Answer 1

• Nose
• Paranasal sinuses
• Pharynx
• Larynx
• Trachea
• Bronchi
• Bronchioles
• Alveoli

Question 2

Name TWO signs and/or symptoms of chronic pulmonary obstructive disease (COPD)

Answer 2

• Chronic cough with sputum
• Dyspnoea.
• Prolonged expiration
• Wheeze.
• Frequent infections
• Tachypnoea
• Breathlessness on exertion Pursed lips breathing Patients may lean forward and rest arms on the table Flapping tremor Cyanosis Hyperinflation of chest OR barrel chest Clubbed nails

Question 3

Compare the actions of mast cells and neutrophils

Answer 3

’- Neutrophils: Phagocytosis: lysosomes digest microbes. First to migrate to site of infection (<1 hr).
- Mast cells: Release histamine from granules. Histamine dilates blood vessels.

Question 4

Complete the following in relation to blood cells

Answer 4

• Yellow pigment formed from the breakdown of haem = bilirubin
• Location of erythropoietin production = Kidney

Question 5

Name TWO signs that you might observe in a client who has leukaemia

Answer 5

• Malaise
• Anaemia e.g. pallor
• Easy bleeding
• Easy bruising
• Fever
• Weight loss
• Splenomegaly OR abdominal swelling
• Lymph node enlargement

Question 6

Describe TWO features of a vein

Answer 6

• Thin walls
• The tunica externa is their thickest layer
• Carry blood towards the heart
• Carry blood at low-pressure
• Carries deoxygenated blood
• Contain valves

Question 7

Define the term tachycardia

Answer 7

Resting heart rate over 100 bpm

Question 8

State ONE function of cholesterol

Answer 8

• Cell membrane integrity
• Vitamin D metabolism
• Calcium metabolism
• Sex hormones OR formation of oestrogen OR testosterone
• Formation of bile Formation of myelin sheath

Question 9

Describe the main difference between stable and unstable angina

Answer 9

• Stable: Pain is precipitated by physical exercise.
• Unstable: Occurs randomly.

Question 10

State ONE way in which proteins can be denatured in the body

Answer 10

• pH
• Temperature

Question 11

Explain what is meant by gut-associated lymphoid tissue (GALT)

Answer 11

• It is part of the first line of defense against ingested pathogens OR
• Composes around 25% of the intestine mucosal mass OR
• It contains 70% of the body’s immune cells

Question 12

Describe and compare the roles of goblet cells and enteroendocrine cells in the digestive system

Answer 12

• Goblet cells: secrete mucus to lubricate food and protect against digestive juice erosion.
• Enteroendocrine cells: specialised endocrine cells that secrete hormones into blood

Question 13

Name the type of unsaturated fatty acid found below

Answer 13

Transfat

Question 14

Name TWO red flags associated with digestive signs and/or symptoms (

Answer 14

• Dysphagia
• Black blood in the stools
• Alternating diarrhoea/constipation

Question 15

Name ONE digestive pathology which may cause mouth ulcers

Answer 15

’- Crohn’s disease
- Irritable bowel disease (0.5 marks for IBD)
- B12 deficiency

Question 16

List ONE nutrient required for the conversion of T4 to T3

Answer 16

Selenium Zinc

Question 17

Explain what is meant by down-regulation and give ONE example

Answer 17

If a hormone is present in excess, the number of target cell receptors may decrease
Example: Increase in hormones during puberty.

Question 18

Explain what is meant by homeostasis and list ONE physiological variable that must remain within narrow parameters in the body (2 marks)

Answer 18

• Examples could include:
• Core temperature
• Water concentration
• Electrolyte concentration
• pH of body fluids Blood glucose levels
• Blood pressure Flow of Life Force
• Blood and tissue O 2 / CO 2 levels

Question 19

Define the term diffusion

Answer 19

The movement of small substances from a high to low concentration.

Question 20

Explain what is meant by a free radical

Answer 20

• Unstable and highly reactive molecule
• Lacks an electron in its atomic structure, which can be donated by antioxidants.

Question 21

Explain how tight junctions are formed between cells

Answer 21

Transmembrane proteins fuse cells together to reinforce the junctions and seal off passageways.

Question 22

Describe the difference between supine and prone body positions

Answer 22

• Supine describes the body lying face up.
• Prone describes the body lying face down

Question 23

Complete the following paragraph

Answer 23

The skeletal system stores minerals such as calcium phosphate and magnesium or potassium, whilst functioning to provide a support framework for the body. Some bones in the body are known as long bones. These contain a shaft known as the diaphysis, and 2 heads known as the epiphyses. An example of a long bone is the femur or tibia or humerus.

Question 24

Explain why a post-menopausal woman could be susceptible to the development of
osteoporosis

Answer 24

Oestrogen would normally suppress osteoclast activity

Question 25

List ONE characteristic of slow oxidative skeletal muscle

Answer 25

• Any two of the following
• Colour: dark red
• Respiration: aerobic
• Myoglobin and mitochondria: highest
• Duration: longest
• Good for: endurance
• Diameter: small

Question 26

What does the term excitability mean in relation to the properties of muscle?

Answer 26

• Ability to conduct an electrical current. OR
• Nerve impulses cause muscles to contract.

Question 27

Describe specifically how the muscular system maintains body posture

Answer 27

Stabilising joints, posture, and balance through continued partial muscle contraction.

Question 28

List ONE cause/risk factor for the development of fibromyalgia

Answer 28

• Poor mitochondrial functioning
• Altered stress response
• Post-viral
• Chronic toxic load
• Poor gut health
• Serotonin deficiencies
• Noradrenaline deficiencies
• Sleep dysregulation

Question 29

Describe the role of the eustachian tube

Answer 29

Equalises pressure in the middle ear

Question 30

Describe ONE function (NOT airway passage) of the larynx

Answer 30

• Production of sound OR speech
• Protection — the epiglottis closes off the trachea during swallowing and prevents food entering the lungs.
• Warming OR humidifying.

Question 31

Explain in detail why you might observe hyperpigmentation in Addison’s disease

Answer 31

The hypothalamus produces an excess of corticotrophin releasing hormone (0.5 marks for CRH), which causes the pituitary to produce melanocyte stimulating hormone. This causes the skin colour to darken OR hyperpigmentation

Question 32

List ONE factor that increases the production of adrenocorticotrophic hormone
(ACTH)

Answer 32

• Hypoglycaemia
• Exercise
• Stressors such as emotions
• Fever
• Interleukin-1 OR inflammatory response to infection

Question 33

Explain what is meant by homeostasis and list ONE physiological variable that must remain within narrow parameters in the body

Answer 33

The condition of equilibrium or balance in the body’s internal environment is maintained by the body’s own regulatory processes (1 mark).
- Examples could include:
- Core temperature
- Water concentration
- Electrolyte concentration
- pH of body fluids
- Blood glucose levels
- Blood pressure
- Flow of Life Force
- Blood and tissue O 2 / CO 2 levels

Question 34

Define the term diffusion

Answer 34

The movement of small substances from a high to low concentration.

Question 35

Describe THREE functions of the lymphatic system. Identify TWO substances found in lymph and discuss TWO ways in which lymph is drained (6 marks)

Answer 35

Functions: Tissue drainage: returns proteins, lipids, and water from the interstitial fluid to the blood.
Immunity against harmful organisms.
Absorption: Lacteals absorb fat-soluble substances/nutrients from the small intestines into the body (0.5 marks each for function and 0.5 marks for description. Max. 3 marks)
Lymph constituents:
Water
Leukocytes OR white blood cells (WBCs - 0.25 marks)
Plasma proteins
Fats
Bacteria
Cell debris (0.5 marks each. Max. 1 mark)

Lymphatic pump: Mild, rhythmical contractions of lymphatic vessels
Skeletal muscle pump: Movement OR exercise drains fluid.
Respiratory pump: During inhalation air pressure drops in the thoracic region and lymph moves from high to low pressure (0.5 marks for name and 0.5 marks for description. Max. 2 marks)

Dry brushing (0.25 marks) Manual lymphatic drainage (0.25 marks)

Question 36

Describe TWO key differences between Crohn’s disease and ulcerative colitis. You should give details about each condition when showing how they differ (2 marks)

Answer 36

Crohn’s disease Ulcerative colitis

Region affected Any part of the GIT but mostly the terminal ileum. Colon and rectum.

Distribution Skip lesions. Proximally continuous.

Layers affected All layers (transmural). Mucosa only (‘ulcers’).

Key symptoms:
Crohns:
Crampy abdominal pain (right).
Loose semi-solid stools
Ulcerative Colitis:
Abdominal pain (left)
Bloody diarrhoea.

Complications:
Crohns:
Fistulas, abscess, obstruction, malabsorption, B12 + B9 def.
Ulcerative Colitis:
Haemorrhage.

Bowel wall: Cobblestone appearance. Thin wall.

Question 37

In relation to the layers of tissue affected, explain the main difference between a superficial skin wound and a deep skin wound (1 mark)

Answer 37

Superficial: epidermis affected Deep: dermis and subcutaneous layer affected

Question 38

Name and describe the function of ONE cell found in the epidermis (1 mark)

Answer 38

Keratinocytes: Protects from heat OR microbes OR chemicals. OR Melanocytes: Contributes to skin colour OR absorbs UV light. OR Langerhans cells: Immune cells that are in involved in skin surveillance

Question 39

Describe ONE key difference in the signs and/or symptoms of acne vulgaris and acne rosacea (1 mark)

Answer 39

Acne rosacea does not have comedones
Acne rosacea has a butterfly rash
Acne rosacea has facial flushing

Question 40

Describe ONE approach to optimising lymphatic health (1 mark)

Answer 40

• Exercise High
• anti-inflammatory diet
• Antioxidant diet OR any of the following: green leafy vegetables, berries, omega-3 foods, nuts and seeds, turmeric, ginger.
• Reducing oxidative stress
• Good quality sleep
• Reducing stress
• Healthy diet
• Remove common allergens
• Dry brushing
• Lymphatic drainage
• Hydration

Question 41

Define the pathology lymphadenitis (1 mark)

Answer 41

Inflammation of lymph nodes.

Question 42

Explain what the neuromuscular junction is and name the neurotransmitter that is released at the junction. Describe the physiology of how a muscle relaxes (6 marks)

Answer 42

The neuromuscular junction is the meeting point OR synapse where motor neurons meet a muscle fibre (1 mark)
Neurotransmitter = acetylcholine (1 mark)
(ACh - 0.5 marks) Sliding Filament - Relaxation
 Nerve stimulation stops OR no nerve impulse (0.5 marks)
 Using magnesium (0.25 marks) and ATP (0.25 marks) calcium is actively transported OR pumped back into storage (0.5 marks) breaking the actin (0.25 marks) and myosin bond (0.25 marks)
 Actin and myosin slide back into starting positions, lengthening the fibre again (relaxation) (1 mark)
 Magnesium makes muscle fibres less excitable and prevents myosin binding with actin (1 mark)

Question 43

Name THREE organelles found in a human cell. For each organelle state TWO features / functions (6 marks)

Answer 43

The nucleus is a spherical structure that contains the body’s genetic information, in the form of DNA.
All body cells have a nucleus, except for red blood cells.
The nucleus controls all cell functions, hence is the brain of the cell.
It contains a nucleolus which produces RNA.
The nucleus is surrounded by a double-layered nuclear membrane which separates the nucleus from the cytoplasm.
 The membrane is continuous with the rough endoplasmic reticulum.
 The nuclear membrane contains nuclear pores for substance movement in and out of the nucleus.

Question 44

Name THREE organelles found in a human cell. For each organelle state TWO features / functions (6 marks)

Answer 44

The cytoskeleton is a network of protein filaments (microtubules and microfilaments) that extends through the cytosol.
These protein filaments assist in the following:
1. Generate cell movement
2. Physical support and shape
3. Cell division

Question 45

Name THREE organelles found in a human cell. For each organelle state TWO features / functions (6 marks)

Answer 45

The Mitochondria
Second largest organelle
They are bean shaped.
Cells powerhouses OR generate ATP
They are located near where oxygen enters cells (e.g., towards periphery / outside) or where ATP is used in the cell.
They contain a double-layered membrane with fluid in between.
The inner membrane has a series of folds called cristae which produce a vast surface area for reactions.
Cells can contain one hundred to several thousand mitochondria, depending on the cell.
Muscle cells (including those in the heart) are thought to contain the most mitochondria.

Question 46

Name THREE organelles found in a human cell. For each organelle state TWO features / functions (6 marks)

Answer 46

Ribosomes
Ribosomes act as the sites of protein synthesis.
Their name reflects the high content of ribonucleic acid (RNA).
Ribosomes are either free or mobile in cytoplasm or bound to rough endoplasmic reticulum or stationery.
Free ribosomes make protein for inside the cell, whilst those on the rough endoplasmic reticulum make protein for outside the cell.

Question 47

Name THREE organelles found in a human cell. For each organelle state TWO features / functions (6 marks)

Answer 47

Endoplasmic Reticulum
The endoplasmic reticulum (ER) is a network of membranes in the form of flattened sacs.
The ER extends from the nuclear envelope throughout the cytoplasm, to the cell membrane. Rough ER: Continuous with nuclear membrane. o Synthesises and transports proteins.
Smooth ER: The smooth ER contains no ribosomes, hence the ‘smooth’ appearance. o It contains unique enzymes and synthesises lipids and steroid hormones and detoxifies alcohol and drugs. o In muscle, it releases calcium for muscle contraction.

Question 48

Name THREE organelles found in a human cell. For each organelle state TWO features / functions (6 marks)

Answer 48

Golgi Apparatus
The Golgi apparatus modifies, sorts, packages and transports proteins received from the rough ER.
It consists of flattened membranous sacs.
Most cells have several Golgi apparatuses.

Question 49

Name THREE organelles found in a human cell. For each organelle state TWO features / functions (6 marks)

Answer 49

Lysosomes
Lysosomes are vesicles that perform a key role in cell digestion.
Contain as many as 60 powerful enzymes, which can break down a variety of molecules once fused with them.
Lysosomes recycle worn-out organelles; they engulf and digest these and the components are returned to the cytosol for re-use.
They are also used to digest foreign cells.
Lysosomes also release enzymes externally, such as with sperm to assist egg entry.

Question 50

Describe in detail the flow of blood as it arrives at the heart as deoxygenated blood, through to leaving the heart via the aorta as oxygenated blood. Include all specific components of the heart and associated organs, vessels, and valves (6 marks)

Answer 50

Blood enters the right atrium from the superior and inferior vena cava as deoxygenated blood.  Blood goes through the tricuspid valve into the right ventricle.  Blood then passes from the right ventricle through the pulmonary valve into the pulmonary artery.  Blood flows through the pulmonary artery to the lungs to be oxygenated.  Blood (now oxygenated) returns to the heart to the left atrium via the pulmonary vein.  Blood passes from the left atrium through the mitral valve into the left ventricle.  Blood is then pumped through the aortic valve into the aorta.

Question 51

Define the pathologies hypothyroidism and hyperthyroidism. For each pathology state ONE cause and TWO signs and/or symptoms (6 marks)

Answer 51

Hypothyroidism Causes: Autoimmune, Iodine deficiency Thyroid destruction OR iodine deficiency OR surgery OR medications OR tumour Fluoride
Signs & symptoms: Tiredness Malaise Weight gain Cold intolerance Constipation Depression Slow cognition Poor memory Low libido Deep voice Menstrual changes Muscle aches Arthralgia Goitre Dry OR brittle skin Thin hair Loss of eyebrows. Myxoedema OR swelling often around the eyes Slow tendon reflexes Bradycardia
Hyperthyroidism Causes: Graves’ disease OR Autoimmune Excessive iodine supplementation. Tumour
Hyperthyroidism Causes: Graves’ disease OR Autoimmune Excessive iodine supplementation. Tumour Signs & symptoms: Nervousness Irritability Hyperactivity Unexplained weight loss. Insomnia Palpitations Muscle weakness Frequent bowel and bladder movements Diarrhoea Fatigue Heat sensitivity Increased sweating Goitre Biomedicine Semester 1 Exam - Sample Paper 1 Page 14 of 18 The College of Naturopathic Medicine Exophthalmos Tachycardia Tremor Brisk tendon reflexes Lid lag OR von Gräfe’s sign

Question 52

Describe THREE functions of the lymphatic system. Identify TWO substances found in lymph and discuss TWO ways in which lymph is drained (6 marks)

Answer 52

Functions: Tissue drainage: returns proteins, lipids, and water from the interstitial fluid to the blood. Immunity against harmful organisms. Absorption: Lacteals absorb fat-soluble substances / nutrients from the small intestines into the body (0.5 marks each for function and 0.5 marks for description. Max. 3 marks) Lymph constituents: Water Leukocytes OR white blood cells (WBCs - 0.25 marks) Plasma proteins Fats Bacteria Cell debris (0.5 marks each. Max. 1 mark) Lymphatic pump: Mild, rhythmical contractions of lymphatic vessels Skeletal muscle pump: Movement OR exercise drains fluid. Respiratory pump: During inhalation air pressure drops in the thoracic region and lymph moves from high to low pressure (0.5 marks for name and 0.5 marks for description. Max. 2 marks) Dry brushing (0.25 marks) Manual lymphatic drainage (0.25 marks)