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: tetanus / tetanus antitoxin / percocet / darvocet-n 50 attending: chief complaint: 59m s/p aortobiiliac bypass for bilateral cia aneurysms presents to with sudden onset of acute severe chest pain and was sob. thought he was having a heart attack, and transported to ed where cxr was negative but cta showed massive bilateral pe. major surgical or invasive procedure: ivc filter placement history of present illness: mr. is a 59m who underwent aortobiiliac bypass for bilateral cia aneurysms presented to with acute sharp chest pain and sob on . cxr was negative, cta showed large saddle embolus. past medical history: cad chf (ef unknown) s/p mi s/p cath htn dm2 sarcoid s/p lung biopsy copd asthma obesity chronic back pain social history: retired rn. spends summers in and in small rural community. family history: mother- pna, aortic anuerysm (2)- aaa physical exam: on admission: 95.3 110 126/73 20 91%nrb pleasant, well appearing, sob at end of sentences a+ox3, cn ii-xii intact perrl, eomi, mmm ctab tachycardic, nl s1s2, no m/r/g +bs, s, nt/nd ext wwp, no c/c/e pertinent results: 04:00pm plt count-300 04:00pm neuts-72.6* lymphs-21.0 monos-3.6 eos-2.4 basos-0.4 04:00pm wbc-11.6*# rbc-4.78# hgb-13.9*# hct-41.4# mcv-87 mch-29.2 mchc-33.7 rdw-13.7 04:00pm ck-mb-notdone 04:00pm ctropnt-<0.01 04:00pm ck(cpk)-46 04:00pm estgfr-using this 04:00pm glucose-337* urea n-22* creat-1.0 sodium-133 potassium-5.0 chloride-100 total co2-19* anion gap-19 04:19pm lactate-3.3* 06:46pm pt-12.4 ptt-28.8 inr(pt)-1.0 09:20pm ctropnt-0.06* cta chest w&w/o c&recons, non-coronary 5:07 pm impression: acute, extensive pulmonary embolus, including saddle embolus and thombus within all of the lobar arteries and extending into the segmental branches. there is ct evidece of right heart strain. correlation with echocardiography is recommended. chest (portable ap) 4:17 pm impression: stable radiograph with no superimposed acute process. in comparison with earlier study of this date, there is little change except for placement of a right ij catheter that extends to the mid portion of the svc. cardiology report ecg study date of 4:01:34 pm sinus tachycardia. modest right ventricular conduction delay. consider prior inferior myocardial infarction. low precordial qrs voltage is non-specific. clinical correlation is suggested. compared to the previous tracing of sinus tachycardia is now present. tracing #1 read by: , w. intervals axes rate pr qrs qt/qtc p qrs t 121 144 110 306/412 39 -40 -4 cardiology report ecg study date of 4:14:22 pm findings are as outlined on previous tracing earlier on and are without significant change. tracing #2 read by: , w. intervals axes rate pr qrs qt/qtc p qrs t 122 138 112 312/420 26 -38 -9 bilat lower ext veins 9:58 am impression: deep venous thrombosis of the right popliteal vein extending to the right superficial femoral vein. echocardiography report done at 3:31:13 pm final the left atrium is normal in size. there is mild symmetric left ventricular hypertrophy. due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. overall left ventricular systolic function is normal (lvef>55%). the right ventricular cavity is dilated with depressed free wall contractility with apical sparing ( sign). there is abnormal systolic septal motion/position consistent with right ventricular pressure overload. the aortic root is moderately dilated at the sinus level. the ascending aorta is mildly dilated. the aortic valve leaflets are mildly thickened. there is no aortic valve stenosis. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. the pulmonary artery systolic pressure could not be determined. there is no pericardial effusion. cardiology report ecg study date of 4:14:20 pm baseline artifact sinus tachycardia consider prior inferior myocardial infarction precordial low qrs voltage nonspecific t wave abnormalities modest nonspecific intraventricular conduction delay since previous tracing of , sinus tachycardia rate slower and further t waves changes seen read by: , w. intervals axes rate pr qrs qt/qtc p qrs t 108 188 110 374/458 38 -49 39 chest (portable ap) 12:13 pm findings: in comparison with the study of , there is little change in the appearance of the heart and lungs. again there is elevation of the right hemidiaphragmatic contour with meniscus formation consistent with pleural fluid. the right ij catheter again extends to the mid portion of the svc. no evidence of acute pneumonia. brief hospital course: briefly, mr. was admitted to on with acute cp and sob, found to have massive bilateral pes on cta. the remainder of his hospital course is broken down by system as follows: neuro pain reasonably well controlled on oxycodone and tylenol. card chest pain resolving after pe treated. pt placed on simvastatin. cxr negative on admission as detailed in results section. pulm pt was sob from bilateral pes. his sob decreased during hospital course as his pes were treated, and he was able to ambulate to kitchen without becoming sob on date of discharge. gi min clear dm fluids, lytes repleted prn gu no major issues, continued to void spontaneously heme a hep gtt started on arrival, cardiac enzymes were cycled, lenis performed which showed dvt as detailed in results section. an ivc filter was placed on which he tolerated well. pt is being discharged on coumadin 5 with lovenox bridge, to f/u coumadin clinic mon to maintain appropriate inr. id no major issues. endo patient was placed on an insulin sliding scale during this hospitalization. he should resume his home medications including glyburide and metformin on discharge. mr. is being discharged home today in stable condition. he is being discharged on lovenox and coumadin, so he should be closely followed in coumadin clinic/dr. . he knows to call dr. office at to confirm his follow-up appointments scheduled for . his pcp . is aware that he is being discharged on coumadin with a lovenox bridge. medications on admission: asa 325, glyburide 5", lisinopril 45', metformin 1000", oxycodone 10, zocor, ultram 50"", testosterone inj discharge medications: 1. aspirin 325 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po once a day. disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* 2. simvastatin 40 mg tablet sig: two (2) tablet po qhs (once a day (at bedtime)). disp:*60 tablet(s)* refills:*2* 3. lisinopril 10 mg tablet sig: one (1) tablet po daily (daily). 4. tramadol 50 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed. 5. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po q6h (every 6 hours) as needed. disp:*150 ml(s)* refills:*0* 6. metoprolol tartrate 25 mg tablet sig: 1.5 tablets po tid (3 times a day). disp:*135 tablet(s)* refills:*2* 7. hexavitamin tablet sig: one (1) cap po daily (daily). disp:*30 cap(s)* refills:*2* 8. b-complex with vitamin c tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 9. nortriptyline 25 mg capsule sig: two (2) capsule po hs (at bedtime). 10. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*2* 11. coumadin 5 mg tablet sig: one (1) tablet po at bedtime for 2 weeks: have your inr carefully followed in coumadin clinic. disp:*14 tablet(s)* refills:*0* 12. polyvinyl alcohol-povidone 1.4-0.6 % dropperette sig: drops ophthalmic prn (as needed). 13. bisacodyl 10 mg suppository sig: one (1) suppository rectal daily (daily) as needed. 14. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed. 15. famotidine 20 mg tablet sig: one (1) tablet po q12h (every 12 hours). disp:*60 tablet(s)* refills:*2* 16. topiramate 100 mg tablet sig: one (1) tablet po qhs (once a day (at bedtime)). 17. oxycodone 10 mg tablet sustained release 12 hr sig: one (1) tablet sustained release 12 hr po q8h (every 8 hours). disp:*30 tablet sustained release 12 hr(s)* refills:*0* 18. enoxaparin 120 mg/0.8 ml syringe sig: one (1) subcutaneous (2 times a day): 110 mg sc bid. disp:*30 inj* refills:*0* 19. glyburide 5 mg tablet sig: one (1) tablet po twice a day. 20. metformin 1,000 mg tablet sig: one (1) tablet po twice a day. discharge disposition: home discharge diagnosis: large saddle embolus, s/p ivc filter discharge condition: stable discharge instructions: division of and endovascular surgery discharge instructions medications: ?????? take aspirin 325mg (enteric coated) once daily ?????? continue all other medications you were taking before surgery, unless otherwise directed ?????? you make take tylenol or prescribed pain medications for any post procedure pain or discomfort what activities you can and cannot do: ?????? when you go home, you may walk and go up and down stairs ?????? you may shower (let the soapy water run over groin incision, rinse and pat dry) ?????? your incision may be left uncovered, unless you have small amounts of drainage from the wound, then place a dry dressing or band aid over the area that is draining, as needed ?????? no heavy lifting, pushing or pulling (greater than 5 lbs) for 1 week (to allow groin puncture to heal) ?????? after 1 week, you may resume sexual activity ?????? after 1 week, gradually increase your activities and distance walked as you can tolerate ?????? no driving until you are no longer taking pain medications ?????? follow-up with dr. on at 9am. you will report to the lab at 8:30am prior to your follow-up appointment. call to confirm your appointments. what to report to office: ?????? changes in vision (loss of vision, blurring, double vision, half vision) ?????? slurring of speech or difficulty finding correct words to use ?????? severe headache or worsening headache not controlled by pain medication ?????? a sudden change in the ability to move or use your arm or leg or the ability to feel your arm or leg ?????? trouble swallowing, breathing, or talking ?????? numbness, coldness or pain in lower extremities ?????? temperature greater than 101.5f for 24 hours ?????? new or increased drainage from incision or white, yellow or green drainage from incisions ?????? bleeding from groin puncture site sudden, severe bleeding or swelling (groin puncture site) ?????? lie down, keep leg straight and have someone apply firm pressure to area for 10 minutes. if bleeding stops, call office. if bleeding does not stop, call 911 for transfer to closest emergency room. followup instructions: provider: , md phone: date/time: 10:20 provider: lab phone: date/time: 8:30 provider: , md phone: date/time: 9:00 procedure: interruption of the vena cava diagnoses: obstructive sleep apnea (adult)(pediatric) coronary atherosclerosis of native coronary artery congestive heart failure, unspecified unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled sarcoidosis old myocardial infarction chronic obstructive asthma, unspecified other pulmonary embolism and infarction lung involvement in other diseases classified elsewhere 

Answer: The patient is high likely exposed to