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 / cephalosporins / erythromycin base / codeine / nsaids / aspirin / sulfa (sulfonamides) / vancomycin / levaquin / clindamycin / sensipar attending: chief complaint: s/p vt/vf arrest major surgical or invasive procedure: parathyroidectomy et during surgery right a line right femoral line history of present illness: 57 yo female with pmh esrd, afib (on sotalol), baseline qtc prolongation, lupus, diverticulitis (s/p resection and ileostomy) had elective parathyroidectomy today c/b vt arrest. pt has a baseline pth of 2500 with bony pain and difficulty walking which prompted this surgery. she took sotolol this am. during the procedure, pt developed ventricular bigeminy. she then developed a prolonged episode of vt/vf which lasted for minutes. she became pulseless and cpr was initiated. the vt spontaneously terminated. pt was given amio 150mg bolus. she had recurrent episode of sustained vt which terminated and was given another amio 150mg and started on amio gtt at 1mg/min. also started on proporol gtt. of note, the parathyroidectomy was completed with removal of left upper/lower gland, right upper/lower gland (total 3.5 glands) and thyroid. pth was ; no repeat performed in setting of acute event outlined above. . on arrival to , pt was hemodynamically stable. started on magnesium. past medical history: hyperparathyroidism (baseline pth >2500; severe bone pain and inability to walk) lupus (diagnosed ) esrd ( lupus; hd mwf) afib (on sotalol and coumadin) diverticulitis (s/p resection-ileostomy) l knee surgery ( septic knee in c/b mult re-do surgeries. unable to bend knee at baseline) benign cyst removal from right knee () benign tongue growth removal () burst left arm aneurysm htn multiple avf surgeries hx of multiple cdiff infections mr social history: functional capacity limited pain, wheelchair-bound. family history: nc physical exam: vs: 98.2, p55, 107/49, rr18, 99% on ac 400 (spont 424)/16/5/.60 gen: intubated and sedated heent: perrl, clear op, et tube in place cvs: rrr, nl s1 s2, holosystolic murmur at base lungs: coarse bs bilaterally anteriorly abd: soft, nd, decr bs ext: no edema msk: deformed right elbow with effusion and no warmth or redness, bilateral ankle joint swelling w/o evidence of infection pertinent results: ekg: nsr@59, leftward axis, qtc prolongation of 497, slight std lead 2 (new), lvh by voltage criteria. . rhythm strips: unable to obtain strip of sustained vt. strip of episode of nsvt reveals short runs of polymorphic vt preceded by long pauses with significantly increased rr intervals. . echo: () normal lv size and function. ef 65%. mild concentric lvh. no regional wall motion abnl. 2+ mr. tr. biatrial enlargement. . echo: the left atrium is mildly dilated. the estimated right atrial pressure is 11-15mmhg.. left ventricular wall thickness, cavity size, and systolic function are normal (lvef>55%). regional left ventricular wall motion is normal. right ventricular chamber size and free wall motion are normal. the aortic valve leaflets are moderately thickened. there is a minimally increased gradient consistent with minimal aortic valve stenosis. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. moderate (2+) mitral regurgitation is seen. there is moderate pulmonary artery systolic hypertension. there is no pericardial effusion. impression: mild aortic valve stenosis. moderate mitral regurgitation. mild symmetric left ventricular hypertrophy with preserved global and regional biventricular systolic function. pulmonary artery systolic hypertension. clinical implications: based on aha endocarditis prophylaxis recommendations, the echo findings indicate prophylaxis is not recommended. clinical decisions regarding the need for prophylaxis should be based on clinical and echocardiographic data. . cxr: change in lung opacities. there has been interval extubation and removal of a nasogastric tube. cardiac silhouette remains enlarged with vascular engorgement and perihilar haziness, which may be due to chf or volume overload. homogeneous opacity in left retrocardiac region and adjacent left pleural effusion are again demonstrated with interval increase in size of left effusion. air space opacity in right lower lobe is difficult to compare due to positional differences but may be slightly worse, and there is also apparent slight increase in adjacent right pleural effusion. bones are heterogeneous in appearance with a lucent lesion of the left humeral head as described on the recent study. . ecg: technically difficult study sinus rhythm with pvcs with pacs qt interval prolonged for rate extensive st-t changes are nonspecific since previous tracing of the same date, premature beats are new, precordial voltage lower . ecg: sinus rhythm long qtc interval inferior/lateral st-t changes are nonspecific low limb lead voltage since previous tracing of , premature beats not seen, precordial voltage higher . cxr: probably no change in the left pleural effusion and underlying opacity in the left retrocardiac region. slight decrease in the right pleural effusion, as well as airspace opacity in the right lower lobe. slightly improved degree of vascular engorgement and perihilar haziness. . ecg: sinus rhythm, rate 70. since the previous tracing of minimal shortening of the q-t interval is present, though it remains prolonged. technical artifacts are noted over the lateral precordium. . ecg: sinus rhythm. left atrial abnormality. prolonged qtc interval. clinical correlation is suggested. compared to the previous tracing of no significant change. . cxr: worsening fluid status with features of chf and larger effusions. new right airspace disease which is nonspecific in nature requiring clinical correlation and additional imaging followup. . ecg: atrial flutter with rapid ventricular response. since the previous tracing of atrial flutter is now present. . ecg: sinus rhythm left atrial abnormality possible left ventricular hypertrophy since previous tracing of , sinus rhythm restored . ecg: atrial fibrillation with a rapid ventricular response. low limb lead voltage. compared to the previous tracing of atrial fibrillation with a rapid ventricular response has appeared. . ecg: sinus rhythm. non-specific t wave inversion in lead iii. baseline artifact in leads v5-v6 makes interpretation difficult. compared to the previous tracing of sinus rhythm is now present. . brief hospital course: 57 yo female with pmh af (on sotalol), baseline prolonged qtc, esrd on hd, lupus (on chronic steroids), now s/p parathyroidectomy c/b vt/vf arrest. . 1. vt/vf arrest: most likely secondary to torsade de pointes in setting of alkalemia and hypocalcemia in this patient with baseline prolonged qtc sotalol. pt had ventricular bigeminy preceding event, and pvc with post-pvc compensatory pause likely initiated torsades. we discontinued amio, sotalol(esp since it's renally cleared) and plaquenil, all of them prolonged qt; continued her tele and repeat ekg qam; monitored and repleted lytes aggressively. no further events in house. . 2. hyperparathyroidism (s/p parathyroidectomy): likely secondary hyperparathyroidism esrd vs. tertiary hyperpara. pth 58 post surgery. received hydrocortisone 100mg x 1 in or. developed subsequent hungry bone syndrome requiring a calcium drip, calcitriol, and po calcium supplement. she was weaned off the drip but is still requiring large amounts of po calcium to maintain her levels. renal and endocrine were consulted and assisted with her management. she will have calcium checked with hemodialysis to follow for weaning of her po supplement. . 3. abnl cxr: rll opacity, lll collapse vs. atelectasis. patient received 7 days of antibiotics for treatment. . 4. afib: patient was in sinus prior to surgery. her sotalol had to be discontinued. cardiology recommended starting lopressor for rate control. her rate has been well controlled on this medication. she is on coumadin for anticoagulation. she will have her inr checked with hemodialysis until it is stable. . 5 esrd: renal was consulted, she was to continue on hd on mwf. continue nephrocaps. . 6. lupus: no evidence of acute infection/inflammation. continued her prednisone 6mg daily (home dose), but stopped her plaquenil as plaquenil prolongs qt and discussed with her outpt rheumatologist (dr. , ) who agreed with stopping her plaquenil and continuing the prednisone. 7. hypertension: normotensive. hold captopril and stopped sotalol given prolongation of qt. currently on lopressor. . 8. drug rash: thought possible due to ceftriaxone for pneumonia so this was stopped after 6 days. she received a 7th day of antibiotics, with doxycycline. . 9. full code . 10. comm: medications on admission: hydroxychloroquine 200mg qhd prednisone 6mg qd nephrocaps qd captopril 12.5 mg qd sotolol ? dose ( tab qd) protonix 40mg qd coumadin 1 mg daily qd tylenol prn discharge medications: 1. prednisone 1 mg tablet sig: six (6) tablet po daily (daily). 2. b complex-vitamin c-folic acid 1 mg capsule sig: one (1) cap po daily (daily). 3. warfarin 1 mg tablet sig: one (1) tablet po daily (daily). 4. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 5. calcium citrate 950 mg tablet sig: six (6) tablet po qid (): you must have your calcium closely followed when taking this. disp:*336 tablet(s)* refills:*0* 6. calcitriol 0.5 mcg capsule sig: three (3) capsule po bid (2 times a day). disp:*84 capsule(s)* refills:*0* 7. ergocalciferol (vitamin d2) 50,000 unit capsule sig: one (1) capsule po q mon (). disp:*4 capsule(s)* refills:*0* 8. metoprolol tartrate 25 mg tablet sig: three (3) tablet po bid (2 times a day). disp:*180 tablet(s)* refills:*2* 9. outpatient lab work please draw calcium and inr with every hemodialysis, until stable. please contact dr. with the results, phone: discharge disposition: home with service facility: all care vna of greater discharge diagnosis: primary: cardiac arrest secondary to ventricular fibrillation ventricular tachycardia hypocalcemia atrial fibrillation hyperparathyroidism s/p parathyroidectomy community acquired pneumonia secondary: systemic lupus erythematous end stage renal disease discharge condition: good: calcium stable, no significant arrhythmias discharge instructions: please call your doctor or go to the emergency room if you experience chest pain, palpitations, shortness of breath, cramping in your muscles or abdominal area, or other concerning symptoms. please note that your sotalol and hydrochloroquine have been discontinued due to a life-threatening heart rhythm. please do not take this medication anymore. you have been started on 3 new medications, please take them as prescribed. you must have your calcium and coumadin level checked with every hemodialysis until it is stable. followup instructions: 1. you have an appointment scheduled with your primary care doctor, dr. , on friday at 12:30. 2. you have a follow-up appointment scheduled with dr. on thursday at 12:45. 3. you have a follow-up appointment scheduled in the endocrine clinic at with dr. on , at 8:20 am. 4. you have an appointment scheduled in the cardiology clinic at . provider: , m.d. phone:. date/time: 9:00. location: , building, . 5. please call to schedule a follow-up appointment with your ent doctor within 1-2 weeks. procedure: venous catheterization, not elsewhere classified hemodialysis arterial catheterization cardiopulmonary resuscitation, not otherwise specified other parathyroidectomy other and unspecified hysterectomy diagnoses: pneumonia, organism unspecified chronic glomerulonephritis in diseases classified elsewhere acidosis systemic lupus erythematosus other iatrogenic hypotension end stage renal disease hyposmolality and/or hyponatremia cardiac complications, not elsewhere classified atrial fibrillation atrial flutter paroxysmal ventricular tachycardia hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease cardiac arrest other specified surgical operations and procedures causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation ventricular fibrillation secondary hyperparathyroidism (of renal origin) accidents occurring in residential institution disorders of magnesium metabolism long qt syndrome 

Answer: The patient is high likely exposed to