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: aspirin attending: chief complaint: off balance since one day; tx for ich major surgical or invasive procedure: none history of present illness: the patient is a 73 yo r-handed woman with mild dementia, htn and emphesema (on o2 at home), who is transferred from osh for ich. history from her sister and her husband, as well as patient (but she cannot remember all details). the patient has been feeling "dizzy" for the last week, which she decribed as "lightheaded", no spinning sensation, on and off, no factors that bring it on. she saw pcp last week for this, and her bp appeared not well controled (cannot tell how high). she was told to increase cartia xt from 120mg daily to 360mg daily. she has not yet done that. this morning (), after she woke up, her husband noticed that her gait was off (he cannot tell if she was veiring to the right or left). he hasn't wittnessed any falls and the pt also denies any falls. she developed a brifrontal headache, , pounding. when asked when it started she says: 10 minutes ago. however, per her husband she had the headache earlier during the day. unable to tell how it started. these problems them to go to the . she had no slurred speech, no wordfinding problems, no focal weakness or numbness. no nausea, no vomiting. she has been having pain in her eyes for about a month, on and off, not specifically when moving her eyes. blurry vision since a month, also on and off. problems with writing since a month according to her husband: she writes her words, and then halfway through a word she continues with a scribbled line. she had ringing in her ears a couple of times this month. tingling in her r-hand, at times (during the day; cannot give specifics) during the last month. the ct at osh showed a l-temporal sah (per report of neurosurgery here and radiol. resident; the disc could not be found later), unclear whether acute or subacute. at osh, it was read as intraparenchymal hemorrhage. after transfer, upon arrival in the ed here, her sbp ran in the 250's. an a-line was put in and nypride gtt was started. her sbp then dropped to 60's during which episode the pt was diaphoretic. currently her bp in well controled in 140's. she still has her headache. according to her family she is at baseline (not oriented for time; forgetful). ros: denies any fever, chills, weight loss, neckpain, nausea, vomiting, dysphagia, weakness, numbness, bowel-bladder dysfunction, chest pain, shortness of breath, abdominal pain, dysuria, hematuria, or bright red blood per rectum. past medical history: - htn, not well controled - copd, emphesema: home o2 - mild dementia since 2 yrs social history: smoking: stopped 6yrs ago; smoked 1.5 ppd since her teens; occasional ethoh; no drug abuse. level of activity: independent in adls; drives; no walker or cane; home o2 day and night. married and has 2 adopted children. family history: - sah mother, died at age 58 - prostate ca dad physical exam: vitals: tafebrile hr84 bp221/114 --> 143/90 rr20 so296% 4l gen: nad, in bed heent: mmm, no icterus neck: no lad; no carotid bruits; neck supple lungs: distant bs bilaterally, clear heart: regular rate and rhythm, normal s1 and s2, no murmurs abdomen: normal bowel sounds, soft, nontender, nondistended extremities: no clubbing, cyanosis, ecchymosis, or edema skull and spine: no bruits. mental status: awake and alert, cooperative with exam, normal affect. oriented to place, month , date then 206; knows her name. attention: moybw. memory: registration: items; recall at 5 min with prompting. language: fluent; repetition: intact; naming intact; comprehension decreased (but able to follow commands); no dysarthria, no paraphasic errors. writing: intact. : intact; prosody: normal 3d-construction: clock was intact; no apraxia. no neglect. is at times disinhibited during the exam, giggling like a school girl. cranial nerves: ii: visual acquity intact. visual fields are full to confrontation, pupils equally round and reactive to light both directly and consensually, 3-->2 mm bilaterally. disc margins sharp, no pappilledema. iii, iv, vi: extraocular movements intact without nystagmus. fixation and saccades are normal. no ptosis. v: facial sensation intact to light touch and pinprick. vii: facial movement somewhat slower on the l lower face viii: hearing intact to finger rub bilaterally. ix: palate elevates in midline. xii: tongue protrudes in midline, no fasciculations. : sternocleidomastoid and trapezius normal bilaterally. motor system: normal bulk bilaterally. tone increased in both le. action tremor bilaterally in ue and le. strenght full (although exam somewhat limited by splint in r-arm for a-line; deltoid, bic, tric and fe full) pronator drift: unable to assess due to lines in her arms. sensory system: sensation intact to light touch, pin prick, temperature (cold). vibration sense decreased in feet bilaterally. no extinction to dss. reflexes: b t br pa pl right 2 2 2 3 1 left 2 2 2 3 1 toes: upgoing bilaterally. coordination: normal , , hts. no dysmetria or pastpointing. gait: not able to test due to lines pertinent results: 10:31pm urine color-yellow appear-hazy sp -1.026 10:31pm urine blood-lg nitrite-neg protein-30 glucose-neg ketone-150 bilirubin-neg urobilngn-neg ph-5.0 leuk-tr 10:31pm urine rbc->50 wbc-21-50* bacteria-few yeast-none epi-0-2 renal epi-0-2 10:31pm urine hyaline-0-2 10:30am type-art po2-128* pco2-38 ph-7.36 total co2-22 base xs--3 10:30am glucose-82 10:30am freeca-1.18 05:00am glucose-88 urea n-19 creat-1.0 sodium-141 potassium-3.6 chloride-103 total co2-22 anion gap-20 05:00am alt(sgpt)-11 ast(sgot)-16 ld(ldh)-154 alk phos-44 tot bili-0.6 05:00am ck-mb-3 ctropnt-<0.01 05:00am calcium-8.8 phosphate-4.1 magnesium-1.8 cholest-126 05:00am %hba1c-5.7 -done -done 05:00am triglycer-50 hdl chol-77 chol/hdl-1.6 ldl(calc)-39 05:00am tsh-0.86 05:00am wbc-8.0 rbc-4.46 hgb-13.5 hct-38.8 mcv-87 mch-30.4 mchc-34.9 rdw-13.9 05:00am neuts-76.6* lymphs-15.2* monos-5.1 eos-0.6 basos-2.4* 05:00am plt count-212 05:00am pt-13.2* ptt-21.7* inr(pt)-1.2* 02:13am wbc-7.4 rbc-4.32 hgb-13.0 hct-37.7 mcv-88 mch-30.0 mchc-34.3 rdw-13.7 02:13am neuts-83.1* lymphs-11.6* monos-4.3 eos-0.5 basos-0.4 02:13am plt count-198 02:13am pt-12.2 ptt-22.1 inr(pt)-1.0 11:12pm urine blood-neg nitrite-neg protein-100 glucose-neg ketone->80 bilirubin-sm urobilngn-neg ph-5.5 leuk-tr 11:12pm urine rbc-0 wbc-0-2 bacteria-none yeast-none epi-0 09:43pm glucose-80 urea n-20 creat-1.0 sodium-142 potassium-3.5 chloride-104 total co2-24 anion gap-18 mri brain: increased signal on flair images and susceptibility artifact in the left parietal lobe sulci are consistent with the patient's known subarachnoid hemorrhage. multiple periventricular and subcortical areas of increased flair intensity likely represent chronic small vessel infarction. in the right parietotemporal lobe, two areas of increased flair intensity spare the cortex and likely represents vasogenic edema. there are no areas of restricted diffusion to indicate acute infarct. impression: 1. left parietal subarachnoid hemorrhage. 2. chronic microvascular infarction in the subcortical and periventricular white matter. 3. increased flair signal in the right parietal and temporal lobes may represent vasogenic edema. no definitive mass effect is seen. this would be better evaluated with gadolinium-enhanced mr images mra circle of : the major vessels of the circle of are patent with no evidence of aneurysmal dilatation. the right internal carotid artery is almost completely occluded. small central focus of signal is seen throughout the expected course of the internal carotid artery and likely represents recanalization of this vessel. the vertebral basilar arteries are unremarkable. impression: 1. near complete occlusion of right internal carotid artery with some degree of vessel recanalization. these findings were communicated to the house staff officer at 5:45 p.m. cta brain: non-contrast head ct. findings: high-density material is seen layering within the left postcentral gyrus consistent with subarachnoid hemorrhage. no other focal areas of hemorrhage are identified within the brain parenchyma. there is no evidence of hydrocephalus, mass effect or shift of normally midline structures. there is prominence of the ventricles and sulci consistent with age-related involutional change. periventricular white matter hypodensities are suggestive of chronic small vessel ischemic change. the basal cisterns are patent. there is minimal mucosal thickening within the ethmoid sinuses. the mastoid air cells are well aerated. cta of the head: technique: following administration of 90 cc of optiray contrast, contiguous axial images through the head were obtained during opacification of internal carotid, vertebral arteries and circle of . multiplanar reconstructed images remain pending at the time of this report. findings: preliminary images of the head demonstrate extensive plaque within the right carotid artery and complete occlusion of the right common carotid at the level of the c4 vertebral body. vertebral and basilar arteries are patent. there is no evidence of aneurysm. the major arteries of the circle of are patent and received contributions from the left internal carotid and posterior circulation. impression: 1. left-sided subarachnoid hemorrhage of unknown etiology. no evidence of mass effect or hydrocephalus. 2. complete occlusion of the right internal carotid artery at the level of the fourth cervical vertebra. no evidence of aneurysm. the posterior circulation and vessels of the circle of are patent. these findings were discussed with dr. at 4 a.m. on the date of dictation. brief hospital course: 73 yo right-handed woman with htn (not well controled), emphysema (o2 dependent at home) and mild dementia who presented to the ed at osh after one week of feeling dizzy and a day of gait problems, followed by bifrontal headache. head ct at osh showed a sah in the l-temporal region, and her systolic blood pressure was elevated to the 250 range, after which she was transferred to for further workup. at , she was evaluated and admitted to the neurology icu for management of hypertensive encephalopathy as well as subarachnoid hemorrhage. on initial exam, her blood pressure had been controlled with a nipride drip, and was in the 140s systolic; she had evidence of a mild dementia, as well as increased tone in the lower extremities and decreased vibration in the feet; exam was otherwise unremarkable (facial movement later confirmed to be at baseline). the etiology of the non-traumatic sah was thought potentially related to her hypertension, versus an underlying problem (aneurysm or malformation; family history is positive). ct of the brain confirmed the findings from the outside hospital and revealed no underlying lesion; mri of the brain revealed an area of ncreased flair signal in the right parietal and temporal lobes that was read on radiology reports as vasogenic edema, but when reviewed in neuroradiology conference appeared to be a likely old infarct. on mra, consistent with cta findings, there appeared to be near complete occlusion of right internal carotid artery with some degree of vessel recanalization. there was no aneurysm or underlying vascualr malformation present on either cta or mra. she underwent conventional angiogram to better diagnose this occlusion, and to consider a potential intervention. no intervention was taken, but there did appear to be complete or near-complete occlusion of this vessel - likely responsible for the old stroke. official report was still pending at the time of discharge. both the night before and the night following the procedure, she was markedly agitated, thinking she was moving to a new apartment; she was paranoid and felt that the icu staff were treating her poorly. she was transferred to 5 later in the night and although she remained agitated for hours, she fell asleep later on. the following night, she responded well to a dose of seroquel 25 mg at bedtime and had no agitation or hallucinations/delusions. her mental status returned to baseline and on the day of discharge, she was "90%" herself according to the family, who felt comfortable taking her home. regarding her blood pressure, she was transitioned from nipride to a labetalol drip and managed on the drip as longer acting blood pressure medications took effect. as she had not yet taken the dose of diltiazem (long-acting) prescribed to her, this was initiated (300 mg/day) in the icu. for futher blood pressure control, captopril was started and increased to 12.5 mg tid. this could be switched as an outpatient to lisinopril or comparable once-a-day ace inhibitor. blood pressure normalized (120s systolic) and she was transferred to the floor for further management. she was monitored on telemetry and ruled out for mi during the hospitalization. her breathing status remained stable during the admission and she was continued on her home o2 as well as her inhalers. insulin sliding scale was initiated for tight glycemic control while in the icu; she no longer required this when on the floor. initial creatinine was 1.2, slightly elevated. following the cta, she was gently hydrated. creatinine remained 1.2 at discharge, suggesting perhaps some underlying renal insufficiency. she was seen by pt, who recommended home physical therapy. she was very close to baseline regarding her mental status, with no headache, and no focal findings on exam. she was discharged home. medications on admission: - cartia xt 120mg (should have been 360mg) - advair 100/50 - combivent tid discharge medications: 1. fluticasone-salmeterol 100-50 mcg/dose disk with device sig: one (1) disk with device inhalation (2 times a day). 2. albuterol-ipratropium 103-18 mcg/actuation aerosol sig: puffs inhalation every 6-8 hours. 3. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*2* 4. diltiazem hcl 300 mg capsule, sustained release sig: one (1) capsule, sustained release po daily (daily). disp:*30 capsule, sustained release(s)* refills:*2* 5. captopril 12.5 mg tablet sig: one (1) tablet po tid (3 times a day). disp:*90 tablet(s)* refills:*2* 6. quetiapine 25 mg tablet sig: one (1) tablet po hs (at bedtime) as needed: can take for sleep or anxiety or confusion at bedtime as needed; discontinue this medication when it is no longer needed. disp:*15 tablet(s)* refills:*0* discharge disposition: home with service facility: discharge diagnosis: hypertensive encephalopathy subarachnoid hemorrhage discharge condition: stable - occasional mild confusion now, but greatly improved over admission. discharge instructions: please md or return to ed if you experience new symptoms that could relate to an elevated blood pressure (confusion, speech or language problems, for example) or a stroke (ie, weakness, numbness, visual changes, speech/language problems, or trouble walking). take all prescribed medications; it is very important to take all blood pressure medications. followup instructions: f/u with drs. and (neurology) in weeks - please call for appointment. please f/u with primary care doctor. md, procedure: arteriography of cerebral arteries diagnoses: chronic airway obstruction, not elsewhere classified subarachnoid hemorrhage other persistent mental disorders due to conditions classified elsewhere occlusion and stenosis of carotid artery without mention of cerebral infarction hypertensive encephalopathy 

Answer: The patient is high likely exposed to