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Obesity hypoventilation syndrome — ABIM Board MCQ

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HardPulmonary/Critical CareObesity hypoventilation syndromeABIM Board

A 49-year-old who smokes daily wants a medication-assisted quit attempt. He has no seizure disorder, eating disorder, pregnancy, or recent cardiovascular instability. Which initial pharmacotherapy has the strongest ATS recommendation?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — Offer varenicline with counseling and behavioral support

The ATS recommends varenicline over nicotine patch and bupropion for adults initiating pharmacologic tobacco-dependence treatment when there is no contraindication. Behavioral support should accompany medication regardless of the option selected.

Reference: American Thoracic Society: Pharmacologic Treatment of Tobacco Dependence: https://www.atsjournals.org/doi/full/10.1164/rccm.202005-1982ST