PastPaper.question 1 · Structured Open
10 PastPaper.marksAtherosclerosis is a disease of the coronary arteries that can lead to coronary heart disease (CHD).
(a) Explain how atherosclerosis develops in an artery. (4)
(b) Describe the role of thrombin in the blood clotting process. (3)
(c) Discuss how a high-salt diet can increase the risk of cardiovascular disease (CVD). (3)
(a) Explain how atherosclerosis develops in an artery. (4)
(b) Describe the role of thrombin in the blood clotting process. (3)
(c) Discuss how a high-salt diet can increase the risk of cardiovascular disease (CVD). (3)
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PastPaper.workedSolution
(a) Damage to the endothelial lining of the artery occurs (e.g. due to high blood pressure or toxins from smoking). This triggers an inflammatory response, where white blood cells (macrophages) move into the artery wall and accumulate lipids/cholesterol (LDLs), forming an atheroma. Fibrous tissue and calcium salts deposit, hardening the plaque and narrowing the lumen, restricting blood flow.
(b) Thrombin is an active enzyme converted from its inactive precursor prothrombin. This conversion is catalysed by the enzyme thromboplastin (in the presence of calcium ions). Thrombin then catalyses the conversion of the soluble plasma protein fibrinogen into insoluble fibrin, which forms a mesh that traps platelets and red blood cells to form a blood clot.
(c) A high-salt diet increases water retention in the blood, which increases overall blood volume. This causes elevated blood pressure (hypertension). The high blood pressure increases the risk of damage to the endothelial lining of the arteries, initiating or accelerating the inflammatory response that leads to atherosclerosis.
(b) Thrombin is an active enzyme converted from its inactive precursor prothrombin. This conversion is catalysed by the enzyme thromboplastin (in the presence of calcium ions). Thrombin then catalyses the conversion of the soluble plasma protein fibrinogen into insoluble fibrin, which forms a mesh that traps platelets and red blood cells to form a blood clot.
(c) A high-salt diet increases water retention in the blood, which increases overall blood volume. This causes elevated blood pressure (hypertension). The high blood pressure increases the risk of damage to the endothelial lining of the arteries, initiating or accelerating the inflammatory response that leads to atherosclerosis.
PastPaper.markingScheme
(a)
1. Damage to endothelial lining of artery (due to high blood pressure / toxins) (1)
2. Inflammatory response occurs and white blood cells / macrophages move into the wall (1)
3. Cholesterol / lipids accumulate, forming an atheroma / plaque (1)
4. Deposition of calcium / fibrous tissue hardens plaque, narrowing the lumen (1)
[Max 4 marks]
(b)
1. Thrombin is formed from inactive prothrombin (1)
2. Conversion is catalysed by thromboplastin (and calcium ions) (1)
3. Thrombin catalyses conversion of soluble fibrinogen to insoluble fibrin (which traps blood cells) (1)
[Max 3 marks]
(c)
1. High salt intake increases water retention / increases blood volume (1)
2. This causes elevated blood pressure / hypertension (1)
3. High blood pressure increases endothelial damage, leading to higher risk of atheroma formation (1)
[Max 3 marks]
1. Damage to endothelial lining of artery (due to high blood pressure / toxins) (1)
2. Inflammatory response occurs and white blood cells / macrophages move into the wall (1)
3. Cholesterol / lipids accumulate, forming an atheroma / plaque (1)
4. Deposition of calcium / fibrous tissue hardens plaque, narrowing the lumen (1)
[Max 4 marks]
(b)
1. Thrombin is formed from inactive prothrombin (1)
2. Conversion is catalysed by thromboplastin (and calcium ions) (1)
3. Thrombin catalyses conversion of soluble fibrinogen to insoluble fibrin (which traps blood cells) (1)
[Max 3 marks]
(c)
1. High salt intake increases water retention / increases blood volume (1)
2. This causes elevated blood pressure / hypertension (1)
3. High blood pressure increases endothelial damage, leading to higher risk of atheroma formation (1)
[Max 3 marks]