7.5.3 Medical technology and performance-enhancing substances Quiz: Pearson Edexcel Biology A (Salters-Nuffield), Unit 7

The 20 questions

1. What is the main advantage of keyhole surgery over open surgery for an athlete recovering from a joint injury?

   • It uses smaller incisions, which usually means less tissue damage and a faster recovery
   • It stops all bleeding during the operation without clamps, so the surgeon does not need to close any wounds
   • It removes the need for any anaesthetic, so the athlete is awake throughout the whole procedure and recovers at once
   • It permanently replaces the joint with a metal structure, so the athlete never needs further repair

2. What is a prosthesis in the context of sport?

   • An artificial body part that replaces a missing or damaged limb or joint, allowing movement and participation
   • A drug that increases muscle mass, which athletes take to improve their strength and power during training
   • A training schedule used by athletes to plan their sessions across a season of competition
   • A type of protective helmet for cyclists, which is designed to reduce head injuries in a fall

3. Which of the following is an example of medical technology that allows people with disabilities to take part in sport?

   • Anabolic steroids, which increase muscle size and are sometimes misused by athletes seeking an advantage
   • Caffeine supplements, which stimulate the nervous system and are sometimes taken before competitive events
   • Erythropoietin injections, which increase red blood cell count and are banned in most competitive sport
   • Carbon-fibre running blades, which are prosthetic devices that allow amputee athletes to run and compete

4. Which performance-enhancing substance stimulates the bone marrow to produce more red blood cells?

   • Adrenaline, a hormone released during stress that increases heart rate and redirects blood to the muscles
   • Erythropoietin (EPO), a hormone that stimulates the bone marrow to make more red blood cells
   • Insulin, a hormone released by the pancreas that lowers blood glucose by promoting uptake into cells
   • Anabolic steroids, which are synthetic versions of testosterone that promote muscle growth and protein synthesis

5. Which property of erythropoietin (EPO) would most directly improve an endurance athlete's performance?

   • It increases the rate of glycolysis inside red blood cells, which speeds up the release of energy from glucose
   • It increases the number of red blood cells and so the oxygen-carrying capacity of the blood
   • It breaks down glycogen in the liver, which releases glucose into the blood during prolonged exercise
   • It reduces the heart's ability to pump blood, which lowers the work the athlete's heart must do during exercise

6. Which statement best describes an anabolic steroid?

   • A synthetic substance related to testosterone that promotes muscle growth and protein synthesis in the body
   • A drug that blocks the action of the sodium-potassium pump, which stops the body from maintaining its resting potential
   • A hormone that lowers blood glucose by stimulating the uptake of glucose into the liver and muscle cells
   • A substance that removes lactate from muscles, which reduces the burning sensation felt during intense exercise

7. A student argues that all performance-enhancing substances should be banned because they are unnatural. Which is the strongest ethical counter-argument?

   • All substances are equally natural in the body, so no bans can ever be justified on any grounds whatsoever
   • Athletes always need steroids to recover from injury, so banning them would harm every athlete who is injured
   • Many accepted medical treatments are also synthetic, so being unnatural alone does not settle whether a substance is acceptable
   • Natural and unnatural are the same thing, so the distinction the student draws has no meaning for any ethical question

8. Which ethical position argues that performance-enhancing substances should be allowed because they give athletes freedom and reduce harmful secret use?

   • Libertarian ethics, which emphasises individual choice and regulated access so that use can be monitored and made safer
   • Religious ethics that apply only to clergy and have no bearing on the decisions that athletes make in sport
   • Deontological ethics that bans all drugs, since the rules of duty forbid any substance which alters the natural body
   • Utilitarian ethics that ignore consequences, since the morality of an act depends only on the intention behind it

9. Which ethical position argues that performance-enhancing drugs should be banned because they harm athletes' health and undermine fair competition?

   • A position that ignores the consequences of drug use, since only the intention of the athlete determines the moral value
   • A position that requires athletes to take as many drugs as possible, since the most successful athletes always use them
   • A position that focuses on fairness, safety and the integrity of sport, so that competition rewards training and natural ability
   • A position that argues all sport should be free of rules, so that athletes can use any means to achieve their goals

10. Which statement describes a long-term health risk linked to anabolic steroid misuse?

    • Improved liver function, since the steroid is processed by the liver and so the organ becomes stronger over time
    • Reduced risk of tendon injury in all cases, since the steroid strengthens every connective tissue in the body
    • Increased bone density only, which is the only lasting effect the drug has on the skeleton of the athlete
    • Liver damage and cardiovascular problems, including raised blood pressure and changes to cholesterol levels

11. Why might the use of EPO by an endurance athlete be considered unfair?

    • It causes all competitors to finish at the same time, which makes the race result impossible to determine
    • It increases the athlete's height permanently, which gives a physical advantage over opponents who are shorter
    • It gives an artificial advantage in oxygen delivery that other athletes cannot achieve by training alone
    • It reduces the athlete's need for oxygen during exercise, so the athlete uses less energy in competition

12. A clinical trial finds that a new prosthetic knee improves walking speed for amputees compared with an older design. Which measure would best show the improvement is statistically reliable?

    • A single participant's walking speed on one day, measured once with the new device and once with the old one
    • The number of times the device was photographed during the trial, which records how often it was used
    • Average speeds for many participants compared with a control, with a statistical test to check for chance
    • The colour of the prosthetic, which may influence how the wearer feels about the device during the walk

13. Which statement about keyhole surgery is most accurate?

    • It involves a large open cut through the whole limb, which allows the surgeon to see all the tissue directly
    • It is only used in the treatment of skin conditions, since it is designed for procedures on the surface of the body
    • It uses instruments and a camera inserted through small incisions, allowing the surgeon to view and repair tissue inside the body
    • It cannot be used on joints, because the instruments are too large to fit inside the small spaces of a joint

14. Which statement describes the difference between a performance-enhancing substance and a medical treatment?

    • Performance enhancement always cures disease, which is why athletes need it to recover from injury and illness quickly
    • Medical treatment is used to restore normal function, whereas performance enhancement aims to exceed normal capacity
    • There is no difference, since both are drugs that act on the body in the same way and produce the same results
    • Medical treatment always increases muscle size, while performance enhancement always cures a disease in the body

15. An athlete uses a drug that increases red blood cell count. Which physiological change would improve endurance most directly?

    • Increased production of lactate in red blood cells, which speeds up the release of energy in the working muscles
    • Lower stroke volume, which reduces the amount of blood the heart pumps in each beat during any level of activity
    • Increased oxygen delivery to working muscles during aerobic respiration, which supports greater energy release for longer
    • Reduced breathing rate at rest, which lowers the work done by the lungs when the athlete is not exercising at all

16. Which evaluation of the use of prosthetics in sport is most balanced?

    • They should be banned for all athletes without exception, since any device gives an unfair advantage over others
    • They have no effect on performance, since a prosthetic is only a replacement for a body part and nothing more
    • They are always unfair because they are artificial, so any athlete who uses one should be excluded from competition
    • They widen participation for disabled athletes, but a device may raise fairness questions against non-disabled athletes

17. Which technology could help a footballer recover more quickly from a torn ligament, and why?

    • Anabolic steroids, because they repair the ligament directly by building new collagen fibres in the damaged tissue
    • Blood transfusion, because it removes all damage to the ligament by replacing the blood with a fresh supply
    • Keyhole surgery, because it causes less damage to the tissue around the joint and so speeds up the recovery of the ligament
    • Caffeine, because it binds to collagen in the ligament and makes the fibres stronger during the healing period

18. A sports scientist wants to test whether a training aid improves speed. Which design best reduces bias?

    • Test the aid only on a day when the athletes are already very fast, so that any change in speed is easier to see
    • Randomly assign athletes to aid and no-aid groups, with speeds measured under the same conditions for every athlete
    • Ask athletes to report their own times from memory after the session, so that the results reflect their own experience
    • Test only the fastest athlete in the team, since the best performer shows the clearest effect of the training aid

19. Which statement best summarises the ethical debate about performance-enhancing substances?

    • Ethics has no role in the debate, since only the chemistry of the substance determines whether it is acceptable
    • Different ethical positions weigh fairness, athlete health, autonomy and the consequences of use differently
    • There is a single agreed answer that all scientists accept, so the debate is settled and no further discussion is needed
    • Only the rules of the sport decide the question, so the ethical arguments are irrelevant to the outcome of any debate

20. Which statement correctly describes why an athlete might choose a prosthetic limb?

    • It stops the athlete from feeling pressure through the foot, which is the main purpose of a prosthetic
    • It removes the need for any training at all, since the device does the work of the muscles
    • It may restore function after a limb loss, allowing the athlete to take part in sport
    • It always makes running faster than a natural limb, so it is preferred by every athlete

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