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The exam instructions cover labeling answers per page, limits on how much to write, the need for explanations for open questions, legible ink-only writing (no correction fluid), permitted tools (Binas book, non-graphic calculator, drawing materials), and rules for answering on a separate sheet. The content includes biology questions on type 1 diabetes, insulin, ADH regulation, dawn phenomenon, insulin pumps, and bioengineered pancreatic islet capsules, plus further study content starting with X chromosome inactivation.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":20,"@type":76,"position":81},"https://docshare.wps.com/document/exam/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/practice-exam-1-vwo-biology-please-read-instructions-and-answer-questions/446754/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/practice-exam-1-vwo-biology-please-read-instructions-and-answer-questions/446754.png","ImageObject",300,407,{"name":92,"@type":93},"Eliana","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-19","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":29},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"How are the answers for open questions expected to be handled?","Question",{"text":112,"@type":113},"Open questions require the requested explanation or calculation; lacking the required explanation or calculation generally results in no points.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What writing and correction rules apply during the exam?",{"text":117,"@type":113},"Write legibly and in ink; correction fluid is not permitted. 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The use of correction fluid is not permitted. Pencils are allowed only for drawing images or graphs.  \n• You may use a Binas book, a non-graphic calculator, and drawing materials.  \n• All questions refer to normal situations and healthy organisms, unless stated otherwise.  \n• Write all of your answers on the separate paper provided, and not on the exam paper.  \n• Please hand in the exam paper along with your answers!  \nNew Pancreatic Islets  \nRuth is one of over 10,000 Dutch type 1 diabetes patients under the age of 25. Luckily for Ruth, this type of diabetes has not been life-threatening since the discovery of insulin. In the past, research was focussed on improving insulin quality and ways of administering it; nowadays the challenge is finding a cure for type 1 diabetes.  \nWhen Ruth was five years old, she exhibited the first symptoms of type 1 diabetes: excessive thirst and urination . Her primary care physician measured her blood glucose levels, which were elevated. Glucose was also found in her urine . Type 1 diabetes is an autoimmune disease: the immune system creates antibodies against the insulin-producing beta cells in the pancreatic islets of Langerhans.  \nDuring embryonic development the insulin gene is transcribed in the thymus. Thymus cells in children with type 1 diabetes express the insulin gene at lower levels than thymus cells in healthy children .  \n1(2p) Explain why a normal production of insulin in the thymus is necessary to prevent an autoimmune response of T cells against the pancreatic beta cells.  \nIn healthy individuals, a high blood glucose level causes a decrease in the amount of urine produced, regulated by the amount of ADH released.  \n2(2p) Is the release of ADH increased or decreased in response to high blood sugar levels? As a result, is the reabsorption of water in the kidneys increased or decreased?  \nA  \nB  \nC  \nD  \nADH release  \ndecreases  \ndecreases increases  \nincreases  \nwater reabsorption  \ndecreases increases decreases increases  \nIf Ruth’s diabetes is left untreated, she will lose weight despite the high glucose levels in her blood.  \n3(2p) Explain why Ruth will lose weight if she does not use insulin.  \n\n| High blood glucose levels (hyperglycemia) is unhealthy because small blood vessels get damaged. This is why Ruth learned at a young age how to inject herself with rapid-acting insulin prior to each meal. In addition, she had to also administer long-acting insulin twice a day (figure 1) . |  |\n| --- | --- |\n| | |\n| Even in patients such as Ruth who are careful about their use of insulin , blood glucose levels greatly fluctuate at times. At night, hypoglycemia (low blood glucose) may occur and in the early morning, before breakfast , blood glucose levels may increase a lot, also known as the ‘dawn phenomenon’. |  |\n\n4(2p) How can the ‘dawn phenomenon’ in diabetic patients be best explained?  \nA Due to lower blood insulin levels, aerobic respiration decreases.  \nB Due to lower blood insulin levels, the liver stores less glucose.  \nC Due to lower blood glucose levels, the liver produces glucagon .  \nD During sleep less glucose is used than during the day.  \nRuth has been using an insulin pump since the age of 14 (figure 2) . The pump is programmed to constantly release insulin via a small needle in her belly. When Ruth eats, the pump calculates how much extra insulin is necessary (the meal bolus), based on th","cbCainaBQQnDswNC","https://ap.wps.com/l/cbCainaBQQnDswNC","pdf",2774912,22,"English","# New Pancreatic Islets\n## Insulin and autoimmune response\n## ADH regulation and kidney water reabsorption\n## Weight loss without insulin\n## Dawn phenomenon explanation\n## Insulin pump statements based on a 24-hour diagram\n## Gel capsule requirements for beta cell survival\n## Glucose diffusion through the gel layer\n# X Chromosome Inactivation","[{\"question\":\"How are the answers for open questions expected to be handled?\",\"answer\":\"Open questions require the requested explanation or calculation; lacking the required explanation or calculation generally results in no points.\"},{\"question\":\"What writing and correction rules apply during the exam?\",\"answer\":\"Write legibly and in ink; correction fluid is not permitted. Pencils are allowed only for drawings of images or graphs.\"},{\"question\":\"Why does the dawn phenomenon occur in diabetic patients according to the exam question?\",\"answer\":\"The exam asks for the best explanation among options, focusing on differences in glucose use during sleep versus the day.\"}]","Practice Exam 1-VWO Biology - Please read instructions and answer questions | PDF",1790717068,55]