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Drug of choice for focal seizure is:

 # Drug of choice for focal seizure is:
A. Phenytoin
B. Gabapentin
C. Lorazepam
D. Levetiracetam



The correct answer is D. Levetiracetam.

Levetiracetam is the drug of choice for focal (partial) onset seizures.

Current clinical practice and guidelines (including ILAE and NICE) prefer Levetiracetam (or Lamotrigine) as a first-line monotherapy due to its broad-spectrum efficacy, rapid onset, linear pharmacokinetics, minimal drug interactions, and superior safety profile compared to older agents.

Breakdown of the options:

  • Levetiracetam: First-line drug of choice for newly diagnosed focal seizures (both with and without focal-to-bilateral tonic-clonic evolution).

  • Phenytoin: Classic first-line agent for focal seizures, but largely replaced by newer anticonvulsants due to zero-order kinetics, severe drug-drug interactions, and adverse effects (e.g., gingival enlargement, nystagmus, ataxia).

  • Gabapentin: Used primarily as adjunctive (add-on) therapy for focal seizures, or for neuropathic pain.

  • Lorazepam: First-line drug of choice for acute emergency management of status epilepticus, not long-term monotherapy.


Which of the following is not an antigen-presenting cell?

 # Which of the following is not an antigen-presenting cell?
A. B cell
B. Dendritic cell
C. T cell
D. Macrophage


The correct answer is C. T cell.

Explanation:
Professional Antigen-Presenting Cells (APCs) are specialized immune cells that process and display foreign antigens complexed with Major Histocompatibility Complex (MHC) class II molecules on their surfaces. Their primary role is to present these antigens to T cells to trigger an immune response.

The classical professional APCs are:

Dendritic cells: The most potent APCs, crucial for initiating primary immune responses by activating naive T cells.

Macrophages: Phagocytes that engulf pathogens and present antigens to T cells to sustain ongoing immune responses.

B cells: Internalize antigens via their specific surface antibodies and present them to helper T cells to receive the signals necessary for antibody production.

T cells, conversely, are the "responders." They use their T cell receptors (TCRs) to recognize the antigens presented by the APCs. They do not serve the primary function of capturing and presenting antigens.

Ringer lactate does not contain:

 # Ringer's lactate does not contain:
A. Magnesium
B. Chloride
C. Potassium
D. Sodium



The correct answer is Magnesium.

Ringer's lactate (also known as Hartmann's solution or sodium lactate solution) is an isotonic crystalloid fluid used for intravenous resuscitation and fluid replacement. It is formulated to closely mimic the electrolyte concentration of human blood plasma, but it does not contain magnesium.




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