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0eb3f572-c952-5f63-bca4-c6d2574f8a36
Describe how MAC changes with age
It increase 6% for every decade of life
It increase 10% for every decade of life
It decrease 6% for every decade of life
It decrease 10% for every decade of life
4
C
1
null
null
null
null
null
b24bac8c-13f3-5b11-a22d-15ea4231a4a4
At what age is a patients highest MAC levels?
1 year
21 years
6 months
1 month
4
C
1
null
null
null
null
null
4b010377-c785-5d9b-9e5b-e8725d4cc137
What is the only inorganic agent used
N2O
Sevoflurane
Isoflurane
Desflurane
4
A
1
null
null
null
null
null
59ccdc80-8a05-5f6f-9010-0e117d229cb0
What are the cardiac effects of N20?
Prolonger PR interval
Peaked T waves
Torsades de pointe
Can cause myocardial ischemia in hypovolemic patients and in patients with CAD.
4
D
1
null
null
null
null
null
5f101bb6-5cc3-5615-823c-0bf2e13dabdd
Which of the following is NOT a respiratory effect of N2O?
Tachypnea
Reddish skin discoloration
Response to CO2 is depressed
Increases the apneic threshold
4
B
1
null
null
null
null
null
89a0627b-0b67-5e99-a92d-1cd8548350ed
All of these factors affect pharmacokinetics of a drug except?
Extremes of age
Hydration
Renal or hepatic disease
Skeletal muscle mass
5
E
1
Skin pigmentation
null
null
null
null
46287bf2-4840-5ef3-bd31-99d707856e3d
The Pka of the drug delineates what % of a drug is in an ionized form?
25%
35%
50%
75%
4
C
1
null
null
null
null
null
78efb2de-2a21-5e03-a952-b48242f1e71f
Does a weak acid inserted into an alkaline medium manifest its desired effects faster?
True
False
null
null
2
B
2
null
null
null
null
null
63f7a794-c949-53a8-9617-2cbe94f719a6
A weak acid inserted into an acidic environment will be absorbed how?
Faster
Slower
The same
None of the above
4
A
2
null
null
null
null
null
61bb1057-69c7-502b-b55c-1d69c640d3cb
A weak acid inserted into an alkaline medium will manifest its desired effect how?
Faster
Slower
No change
null
3
A
2
null
null
null
null
null
06b21fe8-f3db-5db4-ba05-f3f1fa932b5e
An ionized medication will be metabolized by the liver.
True
False
null
null
2
B
1
null
null
null
null
null
ae2958c6-3ba2-5841-bd40-d40bd559efa6
What happens to a drug when the Pka and the pH are the same?
30% inoized & 70% unionized
60% inoized & 40% unionized
50% inoized & 50% unionized
75% inoized & 25% unionized
4
C
1
null
null
null
null
null
25c5514f-e46e-5ba1-90e9-7d51d7c8a1c4
When the pH and the Pka are equal how does a small change in pH effect the ionization
Little difference
Small changes in degree of ionization
No notable therapeutic effect
Large changes is degree of ionization
4
D
1
null
null
null
null
null
7ed612a8-ebce-5655-b436-4c7e9a0f5f80
Propofol, a weak acid, has a Pka of 11, how will propofol behave in a body with a pH of 7.4
More ionized
Less Ionized
No Change
Less ionized
4
B
2
null
null
null
null
null
147adc8e-c5e0-5f6e-a000-a10147bc950c
Isoflurane is a methyl esther what is halothane.
Alkyne derivative
Alkene derivative
Alkane derivative
Ethyl methyl terrible
4
C
1
null
null
null
null
null
63e3c68c-801b-59d7-861a-74022a3e5d28
What is the MAC of sevoflurane?
1.7
1.15
6
104
5
A
1
0.77
null
null
null
null
f408d804-445e-57ac-965c-0ee6442e97e0
What is the MAC of Isoflurane
1.7
1.15
6
105
5
B
1
0.77
null
null
null
null
aa0edf36-7e19-5587-9695-bb7c7845be14
What is the MAC of Halothane
1.7
1.15
6
104
5
E
1
0.77
null
null
null
null
a214c296-4485-5bfc-abd6-d6bb04d6f206
What is the MAC of desflurane
1.7
1.15
6
105
5
C
1
0.77
null
null
null
null
a6688358-94ee-5b05-95be-4f921127f8fe
How does age effect MAC?
Older patient less MAC, younger patient more MAC
Older patients More MAC, younger patients less MAC
Older women less MAC older men more MAC
Teenagers usually need th most MAC
4
A
1
null
null
null
null
null
af14ec82-6ccc-51ce-825e-a4cdb3338b48
Which gas causes the most coronary steal?
Desflurane
Isoflurane
Sevoflurane
N2O
4
B
1
null
null
null
null
null
ba4b4ad1-dfef-561e-9021-03f56290fb71
What is coronary steal.
When the heart become less compliant and there is an inotropic decrease
When the heart slows down decreasing CO
When O2 is stolen from ischemic areas of the heart and brought to non ischemic areas.
Occurs in lateral decubiti position and placement of the kidney rest.
4
C
1
null
null
null
null
null
5b535ca8-7ad7-55be-bff7-eb45528d6286
What is Compound A?
A medicine that allows all CRNA student to get A's
CO2 absorbents containing Na/K OH react with Sevo and form a by-product that may cause Nephrotoxicity
A compound associated with increased MAC levels
Only found with the use of epinepherine
4
B
1
null
null
null
null
null
f97ffe0c-df40-5526-adf2-205c668a99be
What happens when you give an anesthetic agent and BP decreases what are your compensatory mechanisms?
Bradycardia and chemoreceptors
Bradycardia and baroreceptors
Tachycardia and chemoreceptors
Tachycardia and baroreceptors
4
D
1
null
null
null
null
null
3c6ba08c-3280-5496-8269-e1ee8029e73e
What is a potential side effect of Halothane
Halothane induced neuropathy
Halothane induced hepatitis
Halothane induced ESRD
Halothane induced myopathy
4
B
1
null
null
null
null
null
f2325c77-8d2b-5e8c-ab95-d9c5a3ad75e2
Where do inhaled anesthetics go first?
Adipose tissue
Bone
The blood vessel rich group such as the lungs heart liver brain
Scavenger system
4
C
1
null
null
null
null
null
404ac037-5430-5e73-8b76-ae8c89b0ec06
What is First Order Kinetics?
Drug is eliminated at a constant rate regardless of amount
The amount of time to eliminate half the drug concentration
When the first reaction with the body/drug takes place
A constant fraction is eliminated per unit time
4
D
1
null
null
null
null
null
18026cfb-0c66-515c-8368-93a584f3e0c6
How is emergence determined?
Brain elimination of the agent
Cardiac elimination of the agent
Pulmonary elimination of the agent
Kidney elimination of the agent
4
C
1
null
null
null
null
null
39a49a68-fefd-5325-9991-75eef66ec21d
Which inhalation agent is good for pediatric induction?
Isoflurane
Sevoflurane
Desflurane
Halothane
4
B
1
null
null
null
null
null
e2beb05f-93d9-5ee6-8831-53f77c796d94
How is elimination of an agent accomplished
Exhalation
Bio-transformation
Transcutaneous loss
All of the above
4
D
1
null
null
null
null
null
6f9d4cf7-0ded-5577-a0eb-b33ddba687bc
What is the most important route of elimination for an anesthetic agent?
Urine
Insensible loss through the skin
Bronchi
Alveoli
4
D
1
null
null
null
null
null
1c4ba5c2-8a46-50fc-9423-5437d4dafd98
True or false hyperventilation will decrease the rate of alveolar concentration?
True
False
null
null
2
B
2
null
null
null
null
null
626b0c65-fcb1-52aa-a8a0-5eff35e86954
True or false hypoventilation will decrease the rate of alveolar concentration?
True
False
null
null
2
A
1
null
null
null
null
null
b60c3673-586d-5321-9701-7740b44ba974
Complete the following: "The higher the flow delivered....."
The higher the inspiratory concentration
The lower the inspiratory concentration
The higher the solubility
The lower the solubility
4
A
1
null
null
null
null
null
6c4bd9ca-07db-57ed-96e9-8b91450623e9
What is the first thing a CRNA can do with a patient who has mild inspiratory wheezes?
Give subcutaneous epi
Give Brethine SQ
Increase rate of agent
Hang 1-2 gram Magnesium IV
4
C
2
null
null
null
null
null
60df7196-9dd2-54b6-bb66-23638b18ac81
Both hypothermia and hyperthermia require decreases in MAC True or False
True
False
True unless the Patient temperature is greater than 42 degrees celcius then more MAC is required
null
3
C
1
null
null
null
null
null
8bc0a12d-bfc1-588d-b12a-e732856ca10e
What decrease in Hct would constitute less MAC?
A 5% decrease
A 10% decrease
A 15% decrease
A 20% decrease
4
B
1
null
null
null
null
null
e5d75da0-17a3-5307-8532-234c18e30d67
At what PaO2 level is a decrease in MAC required?
80
60
40
30
4
C
1
null
null
null
null
null
a739305c-78f8-5a38-a387-77dd4739b29c
If a patient has hypocalcemia what change is MAC would be required
A decrease in MAC
An increase in MAC
No change in MAC
null
3
A
1
null
null
null
null
null
602faec1-807a-5935-8352-37f1fb3d3a1c
How many days postpartum must a patient be prior to returning to normal MAC level needs?
1 day
2 days
3 days
1 week
4
C
1
null
null
null
null
null
3fa570cd-9ae8-52f9-b580-2def9daaed9d
What is the CRNA's concerns with a patient who takes St. John's Wart
Increased cytochrome p-450 activity
Digoxin interference
Fatigue
Dizziness
5
E
1
All of the above
null
null
null
null
fbe7eff9-2ca5-5e99-9849-8adcbe375ed4
What is the usual effects of sevoflurane on BP
Increase
Decrease
No change
null
3
B
1
null
null
null
null
null
cb25b986-dd87-5786-9e5a-bf5cda5fa424
Isoflurane and Sevoflurane will have what type of effect on respiratory rate?
Increase
Decrease
No change
null
3
A
1
null
null
null
null
null
628183d6-9020-5cbd-81df-6e8371a9165f
Isoflurane and Sevoflurane will have what type of effect on tidal volume?
Increase
Decrease
No change
null
3
B
1
null
null
null
null
null
93c801d4-2de1-50c3-9424-cc75f6cf9793
Which agent is best for a patient with cerebral ischemia?
Desflurane
Sevoflurane
Isoflurane
N2O
4
C
2
null
null
null
null
null
da491b6c-7d84-5884-934a-ca4fb2bc9283
FOr cerebral blood flow what range are you trying to keep
20-120
60-160
90-140
75-135
4
B
1
null
null
null
null
null
c26437db-3310-5de1-aea0-61bf9c3d6eac
What are the factors that influence the magnitude of carbon monoxide production from volatile anesthetics?
Dryness of the carbon dioxide absorbent with hydration preventing formation
High temperatures of carbon dioxide absorbent as during fresh gas flow and/or increased metabolic production of carbon dioxide
Prolonged high fresh gas flow that causes dryness
Type of carbon dioxide absorbent
5
E
1
All of the above
null
null
null
null
cb8dcf8c-0564-5e27-b2f9-330fa91dbf9c
What does clinical pharmacokinetics describe?
Absorption
Distribution
Metabolism
Elimination
5
E
1
All of the above
null
null
null
null
10168666-784f-5020-b0a9-5dfb831e7d33
What does information about pharmacokinetis help us as CRNA's with
It describes ADME of a drug within the body
Describes the effects of the drug upon the body
It allows the prediction of plasma concentration following different dosing regimens
All of the above
4
C
1
null
null
null
null
null
04e1ab44-b34d-5fd0-ab7b-819b7d9092b7
What is ultimately responsible for undesired effects of a drug
Pharmacokinetics
Pharmacodynamics
Plasma levels
Metabolism
4
B
1
null
null
null
null
null
22f43679-a60a-5e39-8112-f2542ad933f2
What factors are responsible for variability in both PK&PD of drugs among patients?
Age
Concurrent illnesses
Concomitant medications
All of the above
4
D
1
null
null
null
null
null
295625dd-a514-5801-9295-c69aa9a891fa
Transfer of drugs across membranes are dependent upon what?
Molecular size
Degree of ionization
Lipid solubility
Protein binding
5
E
1
All of the above
null
null
null
null
2dc04f4e-8f9d-59b0-b968-87e42b88f8d8
True or false most electrolyte actions do not require energy
True
False
null
null
2
B
1
null
null
null
null
null
ea1801b1-e9ab-5565-820a-2028bfd7b3e9
Where is a drug concentration greater?
On the side of the membrane where the drug is more ionized
On the side of the membrane where the drug is less ionized
null
null
2
B
2
null
null
null
null
null
33fd240c-e832-5efd-b862-ce809767d81c
True or false.  For a drug to be transported it must be ionized?
True
False
null
null
2
B
1
null
null
null
null
null
619785a1-37bb-551f-af08-6b6a2810aecc
If a drug binds to a nonspecific sight what occurs?
Pharmacologic response
Toxic Response
No response
All of the above
4
C
1
null
null
null
null
null
38a8d2d9-cc08-5a01-aa2c-d2bb9c7b4fbe
Which organs have enzymes that can metabolize drugs resulting in metabolites that may be active or inactive?
Liver
GI tract
Lungs
All of the above
4
D
1
null
null
null
null
null
b4b58c95-7912-56a5-abfa-cb84537f8d8c
What part of the body has esterases (esterases are enzymes that cleave ester bonds and make the drug inactive)
Neuro tissue
Integumentary tissue
Blood
Catabolized muscle cells
4
C
1
null
null
null
null
null
f80bf2b6-2240-5ee4-8828-d9018a8f8912
What are pro-drugs?
Drugs with a very short half life for example adenosine
Drugs that are not active until the body itself activates them
Drugs that can only be given by MD anesthesiologist because of their toxic effect
I have no idea, but if I ask Barry Bonds, Roger Clemens, Sammy Sosa, A-Rod, or Manny Ramirez they would know.
4
B
1
null
null
null
null
null
51896065-7470-57d8-897e-c3f885da6284
What is a phase I reaction?
The initial reaction to a drug prior to anaphylaxis
When the drug is made more polar and water soluble
Inactivation of the pharmacologic activity of the drug
All of the above
4
B
1
null
null
null
null
null
3cf81a92-de98-566b-b5c5-2a4e2847085f
What is a phase II reaction
The initial reaction to a drug prior to anaphylaxis
When the drug is made more polar and water soluble
Inactivation of the pharmacologic activity of the drug
All of the above
4
C
1
null
null
null
null
null
8a34e0c5-f338-5cd1-b118-4cc62eaeec29
Which of the following statements best describes linear PK
It is the pharmacokinetics in which most drugs follow
Serum drug concentrations change proportionally to dosing
It is a steady state, when given IV, between dosage rate and elimination
All of the above
4
D
1
null
null
null
null
null
976c3f3e-4275-5e7e-bcf0-3f1178374fdd
What is compartmental PK?
Inactivation of the pharmacologic activity of the drug
When the drug is made more polar and water soluble
Describes the body as hypothetical compartments linked by transfer rate processes
All of the above
4
C
1
null
null
null
null
null
42b1033a-bb89-5de6-8258-3e8805b0475a
Which compartment can a drug sample not be taken from
Central Compartment
Peripheral compartment
One-compartment
All of the above
4
B
1
null
null
null
null
null
5e259bef-6962-5b43-a529-2f51ae18966d
What makes up the hypothetical central compartment
Brain
Lungs
Liver
Heart
5
E
1
All of the above
null
null
null
null
240ab438-da34-54d1-bc66-1e2ae016f4f5
What makes up the peripheral compartment
Muscle
Skin
Fat
Bone
5
E
1
All of the above
null
null
null
null
dcaade16-629f-5d7e-80d1-0dd446eff187
How is the volume of distribution of a drug calculated?
Total dose of the drug divided by the plasma concentrationat time=0
Theoretical volume of plasma that is completely cleared of a drug at a given tim
TIme it takes the drug concentration to fall 1/2
The time it takes for the total amount of drug to decrease by 1/2
4
A
1
null
null
null
null
null
72e3b631-3c83-5f17-bfcc-5fb5884f7398
What is clearance
Total dose of the drug divided by the plasma concentrationat time=0
Theoretical volume of plasma that is completely cleared of a drug at a given time
TIme it takes the drug concentration to fall 1/2
The time it takes for the total amount of drug to decrease by 1/2
4
B
1
null
null
null
null
null
24ba83c7-0d3f-5a0d-922d-b76902904052
What is elimination half time?
The time it takes for the total amount of drug to decrease by 1/2
Total dose of the drug divided by the plasma concentrationat time=0
TIme it takes the drug concentration to fall 1/2
Theoretical volume of plasma that is completely cleared of a drug at a given time
4
C
1
null
null
null
null
null
2d10cc26-465e-5c49-b4f1-2dccbeb0e46b
What is elimination half life?
The time it takes for the total amount of drug to decrease by 1/2
Total dose of the drug divided by the plasma concentrationat time=0
TIme it takes the drug concentration to fall 1/2
Theoretical volume of plasma that is completely cleared of a drug at a given time
4
A
1
null
null
null
null
null
6743a746-0753-50ff-8827-3ae32b6bcfaf
What is context sensitive half time?
Theoretical volume of plasma that is completely cleared of a drug at a given time
The time necessary for plasma drug concentration to fall by 50% or other % after continuous infusion of specific duration
TIme it takes the drug concentration to fall 1/2
All of the above
4
B
1
null
null
null
null
null
5ac3537d-4f3e-5703-ac94-6bd8ae5f586b
Why are diuretic usually held prior to surgery?
Volume depletion
Rebound hypertension
Intraoperative hypertension
Intraoperative hyperglycemia
4
A
1
null
null
null
null
null
9f78fe29-aff0-53d5-a9ec-ceecc106827c
At what diastolic BP will surgery usually be held?
80
90
100
110
4
D
1
null
null
null
null
null
7102a8ff-ba56-53d2-bae8-c0653bdb9779
What is the ASA recommendation in regards to herbal supplements?
Stop taking 3 days prior to surgery
Stop taking 1 week prior to surgery
Stop 2 weeks prior to surgery
Stop taking 3 weeks prior to surgery
4
C
1
null
null
null
null
null
1c98eb16-075f-5424-b8cf-f53b8d0252b5
What is the CRNA's concerns with a patient who takes echinacea (used to treat viral bacterial and fungal infections)
Tachyphylaxis
Barbituate toxicity
Hepatotoxicity
Activation of macrophages and killer T-Cells
5
E
1
All of the above
null
null
null
null
83f4f220-60e9-5e28-a4f2-9738bbc9618c
What is the CRNA's concerns with a patient who takes Ephedra or Ma Huang (used for increased energy and appetite supression
Acts on Alpha and Beta cells like ephedrine
Increased HR
Increased BP
Relaxation of smooth muscles
5
E
1
All of the above
null
null
null
null
665dbeae-0078-591d-8f8c-47cde773a31d
What drug should be used for a patient who is currently taking ephedra and become hypotensive during surgery
Dopamine
Neosynephrine
Dobutamine
Calcium
4
B
2
null
null
null
null
null
df71562b-df62-585e-a23d-3b239a338965
What is the CRNA's concerns with a patient who takes Garlic
Hypotension
Increased bleeding times
Increased risk for hypotension
Impaired platelet aggregation
5
E
1
All of the above
null
null
null
null
757eb328-06e4-599e-a6e6-bd4e051813c4
What is the CRNA's concerns with a patient who takes Ginseng
Hypertension
Insomnia
Hemodynamic instability
Prolonged bleeding time
5
E
1
All of the above
null
null
null
null
6f2d511c-ca3a-54f5-bb89-d5e0c2f496c6
What is the CRNA's concerns with a patient who takes Kava-Kava
Interaction with levodopa
Potentiation of barbituates
Potentiation of benzodiazepines
Decrease in MAC
5
E
1
All of the above
null
null
null
null
3780afbf-9f27-50cf-b625-7a3d6b004bde
What is the CRNA's concerns with a patient who takes Valerian
Tremors
Headache
Dysrythmias
Liver dysfunction
5
E
1
All of the above
null
null
null
null
f4e0b2a3-9743-50ec-9b1a-021ea13ff44a
Higher Vd relates to elimination how?
Longer elimination
Shorter elimination
No change in elimination time
null
3
A
1
null
null
null
null
null
18b55fa9-223b-5745-8433-47bde3ba0217
Define zero order kinetics
A constant fraction is eliminated per unit time
A constant amount of drug is eliminated per unit time
The time necessary for plasma drug concentration to fall by 50% or other % after a continuous infusion or specific duration.
All of the above
4
B
1
null
null
null
null
null
dd893617-3648-5fa9-ac42-6074886988ef
Where can elimination of a drug from the body occur
Central compartment
Peripheral compartment
All of the above
null
3
A
1
null
null
null
null
null
38245fcf-dc44-5e94-ba05-a61a32996cf5
Emergence is mainly dependent on what?
Fresh gas flow
Pulmonary elimination
Kidney elimination
Nephrotoxicity
4
B
1
null
null
null
null
null
8b7d1035-ca3c-53e3-a62c-60dc24f34c5f
Which type of agent is taken up by the blood more readily soluble or insoluble?
Soluble
Insoluble
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null
2
B
1
null
null
null
null
null
70a837f2-e9ee-53b6-ad9b-28d606f2170c
How is the blood gas coefficient related to solubilty?
The lower the coefficient the more soluble the agent
The lower the coefficient the less soluble the agent
The higher the concentration the less soluble the agent
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3
B
1
null
null
null
null
null
236e363d-bea8-59c8-b60f-0953b866efaa
What is dead space?
Perfusion no ventilation
Perfusion with ventilation
Ventilation with perfusion
Ventilation but no perfusion
4
D
1
null
null
null
null
null
474a3094-ec0b-5777-a19d-d392a49a4dda
What is shunting
Perfusion no ventilation
Perfusion with ventilation
Ventilation with perfusion
Ventilation but no perfusion
4
A
1
null
null
null
null
null
a67f0c92-2f0c-5e97-9d49-ea9ff16928cd
How is elimination accomplishes?
Exhalation
Biotransformation
Transcutaneous loss
All of the above
4
D
1
null
null
null
null
null
a1c1ead2-6ced-5b1e-8fc0-9c8fa3ba82e3
What is MAC-BAR
When there is a bromide attachment to the agent
When there is a barium attachment to the agent
Block adrenergic response
Where all Irish guys go after class
4
C
1
null
null
null
null
null
be24961b-d395-5b56-9af9-75f20b53b170
What is MAC- awake?
This is the MAC at time=0
50% of patients will be able to follow a a simple command at this level
This is MAC when patient arrises from anesthesia
All of the above
4
B
1
null
null
null
null
null
8f08cfe1-c738-549d-84f6-dbf46a32491b
What do you have to be concerned with when a patient is hypovolemic and receive N20
Pulmonary vascular resistance
Myocardium depression
Myocardium ischemia
Catecholamine release
5
E
1
All of the above
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null
null
null
efe52753-5842-54e7-9373-b6e3d432169f
When giving N2O what respiratory concerns will you have as a CRNA?
Increased Apneic threshold
Tachypnea
Increased respiratory rate
Decreased tidal volume
5
E
1
All of the above
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null
null
null
ff486530-b895-5b7c-9c4d-56a2b2afed67
In which of the following surgeries will N2O be contraindicated?
Craniotomy
Eye globe
Pneumothorax
All of the above
4
D
1
null
null
null
null
null
5f8e0bce-df39-5905-b52b-4792315b4f46
What is the MAC of desflurane?
1
2
4
6
5
D
1
7
null
null
null
null
748b7d13-d207-5816-bbca-f1f7db1e2793
Which of the following vaporizers is heated?
Isoflurane
Halothane
Sevoflurane
Desflurane
4
D
1
null
null
null
null
null
8213067a-01f2-5d9d-b9d6-90ca169e6bfb
True or false minute volume is (RR*V)/minutes
True
False
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null
2
A
1
null
null
null
null
null
b15e994c-fe6c-5970-a1c6-f501af900006
Which gas is the most irritating to the airway?
Sevoflurane
Isoflurane
Desflurane
Halothane
4
C
1
null
null
null
null
null
532d2b64-4836-53d3-a5be-73bdb8e9b8f7
Which gas is the Least irritating to the airway
Sevoflurane
Desflurane
Isoflurane
Halothane
4
A
1
null
null
null
null
null