157) A 25 year old woman presents to your office with complaints of muscle cramps and weakness. She smokes 1 pack cigarettes per day and chews tobacco and flavored gum. She also has history of alcoholism and ingests about one pint of vodka every day for the past 2 years. She also uses “Ecstasy” during weekend parties. She has a history of snoring in the night. On examination, afebrile, heart rate is 88/min and blood pressure is 150/98. Laboratory investigations reveal a Sodium of 144 meq/L, potassium of 3.0meq/L, Chloride 98meq/L , Bicarbonate of 34meq/L and Creatinine of 0.8mg%. Urinary chloride is 45meq/L. Which of the following points in the patient’s history is most helpful in diagnosing her condition?
A) Alcohol use
B) Chewing tobacco and flavored gum
C) Snoring in the night
D) Smoking
E) Use of Ecstasy


e?
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