Consider the following medical report that includes the patient's historical health records. Use it to predict the disease that the patient is high likely exposed to. 

 Medical Report: allergies: patient recorded as having no known allergies to drugs attending: chief complaint: dysphagia and weight loss major surgical or invasive procedure: pericardiocentesis gastric feeding tube placement by interventional radiology history of present illness: 60 yo f with newly diagnosed metastatic nsclc was admiteed from clinic for worsening dyphagia, dehydration, neutropenia, and arf. mrs. presented to clinic today for an unscheduled urgent visit due to an inability to swallow and extreme fatigue. she has chronic low-back pain and was also unable to take her percocet today. her nutrition has been worse over the last couple of days and her husband fears she has lost even more weight (98 lbs 10 days ago). otherwise, she has had no fevers at home, no chills or night sweats. constipation remains an issue as she has not had a bowel movement in about 3 days. past medical history: 1. smoked until 2 weeks ago, on nicotine patch until . 2. rheumatoid arthritis 3. pci to lad in (95% lad, 40%rca, 50% pda) 4. hypercholesterolemia 5. htn social history: lives w/ her husband of 38 . has daughter and son. smoked 1ppd for 40 , quit 3 weeks ago. drinks about 10 drinks per week. works for her sons asphalt company doing office work. family history: cad in brother/sister brother w/ prostate cancer physical exam: vital signs: temperature 96.6, blood pressure 142/86, pulse 102, oxygen saturation 96% on room air, weight is 90 pounds, height is 61 inches. ecog performance status is 2. in general, ms. is a thin, pleasant 60- year-old woman in no acute distress. heent: pupils are equal, round, and reactive to light. sclerae are anicteric. neck is supple with approximate 1-cm bilateral cervical lymph nodes. heart: tachycardic rate, regular rhythm with no appreciable murmurs, rubs, or gallops. lungs are clear to auscultation bilaterally with no wheezes or crackles. abdomen is soft, nontender, nondistended with normoactive bowel sounds. extremities: there is no edema, clubbing, or cyanosis. pertinent results: 11:53am urea n-77* creat-2.8*# sodium-131* potassium-3.8 chloride-91* total co2-30* anion gap-14 11:53am alt(sgpt)-32 ast(sgot)-31 ld(ldh)-300* alk phos-77 tot bili-0.5 dir bili-0.1 indir bil-0.4 11:53am albumin-4.1 calcium-9.6 11:53am cea-5107* 11:53am wbc-1.4*# rbc-3.96* hgb-13.1 hct-36.8 mcv-93 mch-33.0* mchc-35.5* rdw-12.2 11:53am neuts-8* bands-1 lymphs-52* monos-31* eos-3 basos-0 atyps-5* metas-0 myelos-0 11:53am plt smr-low plt count-85*# echo conclusions: the left atrium is normal in size. left ventricular wall thickness, cavity size, and systolic function are normal (lvef>55%). right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. the mitral valve appears structurally normal with trivial mitral regurgitation. there is a large, circumfirential pericardial effusion with pericardial thickening (2.0-3.0 cm anteriorly from subcostal view). there is respiratory variation in the mitral and tricuspid inflow that is non-diagnostic. there is right atrial and right ventricular early diastolic invagination without definite collapse. there appears to be occasional, prolonged rv free wall diastolic invagination (respiratory change?) that likely represents early tamponade. impression: large circumfirential pericardial effusion with probable early tamponade. echo conclusions: left ventricular wall thickness, cavity size, and systolic function are normal (lvef>55%). right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. the mitral valve leaflets are mildly thickened. there is a small pericardial effusion subtending primarily the right atrial and right ventricular free wall. there are no echocardiographic signs of tamponade. no right atrial diastolic collapse is seen. no right ventricular diastolic collapse is seen. compared with the findings of the prior report (tape unavailable for review) of , the pericardial effusion is smaller. brief hospital course: # dysphagia: pt with known significant lad compressing the esophagus. this has caused substantial weight loss and is likely contributing significantly to her weakness as she was unable to take po's. gi was consulted for placement of peg tube for initiation of tube feeds. they performed egd however were unable to pass the scope past the upper esophagus due to stricture likely from external source. ir was then called and they placed peg tube under flouroscopy. attempted to start using the peg tube 24 hours after placement with 4 boluses per day of nutritional supplement. with this method pt had residuals of 100 and was requesting use of pump. she was then started on cycling which was adjusted until she was able to tolerate with minimal residuals. she was also started on reglan and erythromycin for enhamced gi motility. pt continued to have problems with nausea and phlegm production. gi was reconsulted in reagrds to possible esophageal stent for comfort measures. pt decided against esophageal stent and patient was discharged home on cycling tube feeds, tolerating it well with reglan. . # pericardial effusion: pt had a small pericardial effusion seen on recent ct scan. she developed progressive sob in the setting of aggressive hydration for her arf due to dehydration. cxr showed small bilateral effusion with pulmonary edema. at this point she was diuresed with minimal effect. her sob and o2 requirement continued to worsen. repeat cxr now showed moderate szized effusion on the left with increase size of silhoutte of heart. pulsus was 15 at this time. she was then sent for echo which demonstrated large pericardial effusion with tamponade physiology. pt was tachycardic but bp stable at this time. cardiology was consulted and patient was sent to the west for urgernt pericardiocentesis. they drained the effusion and performed a balloon pericardiotomy. after the drainiage her heart rate decreased and patient clinicallyy improved however still required o2. after the procedure she was monitored in the ccu for 1 day then on the floors by cardiology for 2 more days. follow up echos showed no evidence of reacculmulation 5 days later. . # volume status: pt was very dry at admission & labs c/w prerenal. rec'd aggressive iv hydration. now with pleural effusion in the setting of pericardial effusion. pleural effusion was present on discharge. disucussed possibility of thoracentesis, pt refused and wanted to go home. . # arf: pt presented with creatinine of 2.8 and bun of 77. her baseline creatinine was 0.8. her fena at this time was <1% and renal failure felt to be secondary to dehydration. she was aggressively hydrated with gradual improvement in her renal function. after several days creatinine had returned to baseline. . # hypoxia: pt with bilateral effusion left greater then right. also likely has lymphangetic spread of the tumor. disucussed possibility of tapping the effusion but the pt refused. also not sure if tapping would help with hypoxia anyway given lymphangetic spread. pt sent home with o2 for comfort. . # cad: no chest pain during stay. was on bb for most part. had stop for for short period when pt was hypotensive. did not restart statin as would have no benefit to patient in short term. . # hyponatremia: was likely due to volume depletion, this resolved with ivf. . # non-small-cell lung ca: did not actively treat as inpatient. however started on tarceva prior to discharge. . # pt had isolated fever on after pericardiocentesis. she was emipirically started on levo/vanco. blood cultures and ua thus far negaitve. since pt had been afebrile otherwise we stopped the abx. . # dispo- discharged home with vna services and likely transition to hospice. medications on admission: inderal, benicar, lipitor, percocet one tablet q.6h. p.r.n. discharge medications: 1. fentanyl 25 mcg/hr patch 72hr sig: one (1) patch 72hr transdermal q72h (every 72 hours). disp:*10 patch 72hr(s)* refills:*2* 2. sodium chloride 0.65 % aerosol, spray sig: sprays nasal qid (4 times a day) as needed. disp:*qs * refills:*2* 3. lidocaine-diphenhyd--mag- 200-25-400-40 mg/30 ml mouthwash sig: 15-30 ml mucous membrane every four (4) hours as needed for mouth pain. disp:*qs * refills:*2* 4. lorazepam 0.5 mg tablet sig: 1-2 tablets po every six (6) hours as needed for nausea/anxiety: please take 0.5mg qhs and then use q6hr prn otherwise. disp:*120 tablet(s)* refills:*1* 5. acetaminophen 325 mg tablet sig: 1-2 tablets po q4-6h (every 4 to 6 hours) as needed. 6. metoclopramide hcl 10 mg tablet sig: one (1) tablet po qid (4 times a day). disp:*120 tablet(s)* refills:*2* 7. senna 8.6 mg tablet sig: 1-2 tablets po bid (2 times a day) as needed for constipation. disp:*60 tablet(s)* refills:*2* 8. oxycodone-acetaminophen 5-325 mg/5 ml solution sig: 5-20 mls po q6h (every 6 hours) as needed. disp:*qs ml(s)* refills:*2* 9. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po bid (2 times a day). disp:*30 tablet(s)* refills:*2* 10. docusate sodium 150 mg/15 ml liquid sig: fifteen (15) ml po bid (2 times a day). disp:*900 ml* refills:*2* 11. dextromethorphan-guaifenesin 10-100 mg/5 ml syrup sig: mls po q6h (every 6 hours) as needed. disp:*qs ml(s)* refills:*2* 12. oxygen pt requires 4l of continuous oxygen via nc 13. probalance liquid sig: four (4) cans po once a day. disp:*120 8 oz cans* refills:*2* 14. tube feed supplies pt will need a tube feed pump, pole, and g tube supplies(tubing, bag for tube feeds, etc.) discharge disposition: home with service facility: healthcare hospice discharge diagnosis: non-small cell lung cancer dehydration dysphagia due to lymphadenopathy pericardial effusion with tamponade discharge condition: stable, tolerating tubefeeds and small amounts of pos, breathing comfortably discharge instructions: take all medications as instructed. please contact dr. if you develop fever/chills, worsening shortness of breath, worsening pain, or other concerning symptoms. followup instructions: you will need to follow-up with dr. and dr. please call their office at to set up an appointment for next thursday. md procedure: enteral infusion of concentrated nutritional substances pericardiocentesis percutaneous [endoscopic] gastrostomy [peg] pericardiotomy transfusion of packed cells transfusion of platelets closed [endoscopic] biopsy of esophagus diagnoses: acute kidney failure, unspecified hyposmolality and/or hyponatremia secondary malignant neoplasm of other specified sites constipation, unspecified secondary malignant neoplasm of brain and spinal cord malignant neoplasm of bronchus and lung, unspecified secondary and unspecified malignant neoplasm of intrathoracic lymph nodes stricture and stenosis of esophagus 

Answer: The patient is high likely exposed to