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: penicillins / darvocet-n 100 / aspirin / amitriptyline / wellbutrin attending: chief complaint: doe/fatigue major surgical or invasive procedure: avr(#21 mosaic) history of present illness: 49 yo f with a history of a bicsupid aortic valve followed by serial echocardiograms. recent echo revealed rv dysfunction with increased mr, ai and as. she was referred for surgery. past medical history: pmh: - crohn's disease since age 19, no surgeries, treated with prednisone off and on - prednisone induced hyperglycemia - copd - pfts in showed fev1/fev 87% predicted - aortic stenosis (moderate,per echo ) - hypertension - high cholesterol - gastritis/gerd, h/o gi bleed - one seizures in the setting of emesis in , no aeds - skin cancer on nose - inflammatory problem periodically - pyoderma gangrenosum-on l calf and r ankle, tx with prednisone - osteopenia - all teeth extracted secondary to prednisone - right arm arterial bypass when she presented with right arm pain and pulselessness social history: completed 12th grade, currently on disability but formerly worked in an airplane factory, divorced, lives with son, active - 1-1.5 ppd x 32 years. no drinking or drug use (ivda). family history: mother deceased age 62 of stroke, htn, high chol, father deceased age 56 of mi and also had low back pain, sisters x 4 one with diabetes and neuropathy, one brother deceased (in army), and another alive with htn, high chol, and prostate cancer, one son healthy. physical exam: admission: hr 80 nsr rr 20 bp 140/80 nad lungs mild rhonchi heart rrr 3/6 sem abdomen obese, benign extrem warm, 1+ edema no varicosities discharge: vs t 97 bp 105/56 hr 65 sr rr 18 o2sat 94%/3lnp gen nad neuro alert, non focal exam pulm cta bilat cv rrr, no murmur. sternum stable, incision cdi abdm soft, nt/+bs ext warm, +edema bilat pertinent results: 12:23pm glucose-127* na+-136 k+-3.0* 12:12pm urea n-9 creat-0.7 chloride-114* total co2-24 12:12pm wbc-18.4* rbc-3.49*# hgb-9.7*# hct-29.2*# mcv-84 mch-27.8 mchc-33.1 rdw-15.1 12:12pm plt count-187 12:12pm pt-13.8* ptt-38.8* inr(pt)-1.2* 05:20am blood wbc-9.6 rbc-3.33* hgb-9.4* hct-28.8* mcv-87 mch-28.3 mchc-32.7 rdw-15.4 plt ct-233 05:20am blood plt ct-233 05:20am blood pt-11.8 ptt-20.9* inr(pt)-1.0 06:20am blood glucose-76 urean-11 creat-1.0 na-141 k-3.7 cl-99 hco3-40* angap-6* radiology final report chest (pa & lat) 10:47 am chest (pa & lat) reason: pna /plueral medical condition: 49 year old woman with cosistanlt requiring o2, low bp post cabg reason for this examination: pna /plueral effussion chest radiograph indication: oxygen requirement, rule out of pneumonia and pleural effusion. comparison: . as compared to the previous radiograph, the lung volumes have increased. due to the increased lung volumes, band-like opacities in both lung bases are better seen than on the previous radiograph. these opacities could correspond to plate-like atelectasis, old post- infectious scars or cryptogenic organizing pneumonia. the remaining differential diagnosis could be further worked up by ct. there is unchanged subtle blunting of the right costophrenic angle, suggestive of either a small pleural scar or a small pleural effusion. no newly occurred opacities. no evidence of hyperhydration or cardiac failure. the size of the cardiac silhouette is slightly above the normal range. dr. echocardiography report , (complete) done at 8:34:23 am final referring physician information , w. , status: inpatient dob: age (years): 49 f hgt (in): bp (mm hg): / wgt (lb): hr (bpm): bsa (m2): indication: aortic valve disease. left ventricular function. preoperative assessment. icd-9 codes: 440.0, 424.1 test information date/time: at 08:34 interpret md: , md test type: tee (complete) son: , md doppler: full doppler and color doppler test location: anesthesia west or cardiac contrast: none tech quality: adequate tape #: 2008aw4-: machine: echocardiographic measurements results measurements normal range left ventricle - septal wall thickness: *1.3 cm 0.6 - 1.1 cm left ventricle - ejection fraction: >= 55% >= 55% aorta - annulus: 2.1 cm <= 3.0 cm aorta - sinus level: 3.1 cm <= 3.6 cm aorta - sinotubular ridge: 2.4 cm <= 3.0 cm aorta - ascending: *3.5 cm <= 3.4 cm aortic valve - peak gradient: *40 mm hg < 20 mm hg aortic valve - mean gradient: 16 mm hg aortic valve - lvot diam: 2.1 cm aortic valve - valve area: *1.0 cm2 >= 3.0 cm2 findings right atrium/interatrial septum: no asd by 2d or color doppler. left ventricle: mild symmetric lvh. overall normal lvef (>55%). right ventricle: normal rv chamber size and free wall motion. aorta: complex (>4mm) atheroma in the descending thoracic aorta. aortic valve: bicuspid aortic valve. moderately thickened aortic valve leaflets. systolic doming of aortic valve leaflets. moderate as (aova 1.0-1.2cm2) mild (1+) ar. mitral valve: mildly thickened mitral valve leaflets. mild (1+) mr. tricuspid valve: normal tricuspid valve leaflets with trivial tr. pulmonic valve/pulmonary artery: normal pulmonic valve leaflets. physiologic (normal) pr. general comments: a tee was performed in the location listed above. i certify i was present in compliance with hcfa regulations. the patient was under general anesthesia throughout the procedure. no tee related complications. regional left ventricular wall motion: n = normal, h = hypokinetic, a = akinetic, d = dyskinetic conclusions prebypass no atrial septal defect is seen by 2d or color doppler. there is mild symmetric left ventricular hypertrophy. overall left ventricular systolic function is normal (lvef>55%). right ventricular chamber size and free wall motion are normal. the aortic valve is bicuspid. the aortic valve leaflets are moderately thickened. there is systolic doming of the aortic valve leaflets. there is moderate aortic valve stenosis (area 1.0-1.2cm2). mild (1+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. mild (1+) mitral regurgitation is seen. postbypass biventricular systolic function is preserved. there is a well seated, well functioning bioprosthesis in the aortic position. there is trace perivalvular ai. mr remains mild. the study is otherwise unchanged from prebypass. i certify that i was present for this procedure in compliance with hcfa regulations. electronically signed by , md, interpreting physician 15:54 brief hospital course: she was a direct admission to the operating room on where she underwent an avr, please see or report for details. in summary she had avr with 21mm mosaic valve, her bypass time was 102 min with cross clamp of 75 minutes. she tolerated the operation well and was transferred to the icu in critical but stable condition. she was extubated on the morning of pod #1 and later in the day was transferred to the floor. once on the floors she had an uneventful post-operative course. her chest tubes were removed late on pod1 and epicardial wires were removed on pod3. her activity was advanced by nursing and pt. on pod4 she was transfused with prbc's for a hct of 22. her hct stayed stable over the next 2 days and on pod6 she was transferred to rehabilitation at lifecare of . medications on admission: prednisone 10', albuterol, lipitor 20', budesonide 6', pletal 100", duloxetine 30", chantix, lasix 40", folate 1', boniva 150'qmo, lisinopril 20', ativan 0.5", methadone 5 q6/prn, percocet 5/325-prn, donnatal 16.2'/prn, lyrica 150", protonix 40", carafate 1", sulfasalazine 1000", spiriva 18', trazadone 300/hs, asa 81', calcium 500", vit b12 100', mvi discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 2. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 3. prednisone 5 mg tablet sig: two (2) tablet po daily (daily). 4. atorvastatin 20 mg tablet sig: one (1) tablet po daily (daily). 5. methadone 5 mg tablet sig: one (1) tablet po q6h (every 6 hours). 6. duloxetine 30 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po bid (2 times a day). 7. pregabalin 75 mg capsule sig: two (2) capsule po bid (). 8. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q12h (every 12 hours). 9. sucralfate 1 gram tablet sig: one (1) tablet po bid (2 times a day). 10. trazodone 100 mg tablet sig: three (3) tablet po hs (at bedtime). 11. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 12. sulfasalazine 500 mg tablet sig: 1-2 tablets po tid (3 times a day). 13. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). 14. furosemide 40 mg tablet sig: one (1) tablet po once a day. 15. potassium chloride 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po once a day. 16. albuterol 90 mcg/actuation aerosol sig: 2-4 puffs inhalation q4h (every 4 hours) as needed. 17. lorazepam 0.5 mg tablet sig: one (1) tablet po bid (2 times a day) as needed. 18. tiotropium bromide 18 mcg capsule, w/inhalation device sig: one (1) cap inhalation daily (daily). 19. calcium carbonate 500 mg tablet, chewable sig: one (1) tablet, chewable po bid (2 times a day). 20. nicotine 14 mg/24 hr patch 24 hr sig: one (1) patch 24 hr transdermal daily (daily): 14mg/day x 1 week then 7mg/day patch. 21. tramadol 50 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed. 22. hydromorphone 2 mg tablet sig: 1-3 tablets po q4h (every 4 hours) as needed for pain. 23. boniva 150 mg tablet sig: one (1) tablet po once a month. 24. donnatal 16.2 mg tablet sig: one (1) tablet po once a day as needed for diarrhea. discharge disposition: extended care facility: life care center of discharge diagnosis: as/ai now s/p avr pmh: htn,^chol,copd,phtn,pvd,crohn's, s/p gib,gastritis,gerd, depression,chf,skin ca s/p excision(nose),l ear chrondrodermatitis,osteopenia,restless leg,c-sectionx2,r arm bypass/embolectomy,l caf debridement discharge condition: good. discharge instructions: call with fever, redness or drainage from incision or weight gain more than 2 pounds in one day or five in one week. shower, no baths, no lotions, creams or powders to incisions. no lifting more than 10 pounds for 10 weeks. no driving until follow up with surgeon. followup instructions: dr. 4 weeks already scheduled appointments: provider: , md phone: date/time: 1:30 provider: , md phone: date/time: 3:20 provider: , md phone: date/time: 10:20 procedure: extracorporeal circulation auxiliary to open heart surgery diagnostic ultrasound of heart cardioplegia open and other replacement of aortic valve with tissue graft transfusion of packed cells diagnoses: esophageal reflux pure hypercholesterolemia congestive heart failure, unspecified unspecified essential hypertension chronic airway obstruction, not elsewhere classified other chronic pulmonary heart diseases peripheral vascular disease, unspecified depressive disorder, not elsewhere classified personal history of other malignant neoplasm of skin mitral valve insufficiency and aortic valve stenosis acute combined systolic and diastolic heart failure congenital insufficiency of aortic valve precipitous drop in hematocrit disorder of bone and cartilage, unspecified 

Answer: The patient is high likely exposed to