This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Anaesthesia
Which of the following does not represent a significant anaesthetic problem in the morbidly obese patient? 
Select and explain. 
A. Difficulties in endotracheal intubation, B. Suboptimal aerial oxygen tension, C. Increased metabolism of volatile agents, D. Decreased cardiac output relative to total body mass
D: Decreased cardiac output relative to total body mass
Answer: D: Decreased cardiac output relative to total body mass 
Explanation: D i.e. Decreased cardiac out put relative to total body mass Obesity related changes Cardiovascular Respiratory Gastrointestinal Problems during anesthesia - T Blood volume - ,I. Compliance - Hiatus hernia - Difficult intubation Q - I Cardiac outputc2 - i Respiratory drive - Gastroesophageal - Increased risk of aspiration - I B.P. - 1 Vital capacity & FRC reflux poor gastric pneumonia - I Stroke volume - 1, Blood 02 (Hypoxemia) Q emptying Hyper - Volatile agents are metabolized - I Cardiac workload - These patients require high acidic gastric rapidly while the action of - I Cardiomegaly Fi02 to achieve adequate oxygenation, the ratio of fluid. nonvolatile agents are prolonged. Q - Difficulties in regional anesthesia N2O/O2 is kept 2/3 - Respiratory failure is the major post operative problemQ