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: amoxicillin / detrol attending: chief complaint: ams, code stroke major surgical or invasive procedure: ia tpa and merci clot retrieval. history of present illness: 72 yo woman with metastatic pancreatic ca (to liver, off chemo) s/p palliative roux en y and chemotherapy, dm, htn, multiple tias in past - l sided weakness, h/o breast ca s/p lumpectomy and xrt, recent pulmonary embolus in and nstemi 1.5 weeks ago on lovenox and asa who presented on with r sided back and chest pain and found to have troponin bump. she was otherwise well this am - last seen well at 7:30 am. when nurse evaluated her at 8:30, she was noted to have unresponsive pupil on r with l sided weakness. as a result, code stroke was called at just before 9am. upon initial evaluation, pt was arousable to sternal rub and able to maintain arousal initially only with tactile stimulation but after several minutes able to maintain arousal. pt states correct name and age, but thinks it's in , follows commands briskly. she is noted to have dilated, nonreactive pupil on r, oculomotor paresis except for ? of r eye abduction, no eyelid opening bilaterally, l sided weakness - antigravity strength but drift to bed in ue and le. reflexes brisker on r. stroke scale 8 (loc2, loc questions 1, commands 1, best gaze 2, facial palsy 2, motor l 1 for both arm and leg. she was taken emergently for ct/cta where cta demonstrated top of basilar thrombosis with loss of flow in rpca. pt also with loss of flow in l vertebral. ? hypodensity noted in midline pons. as a result, pt emergently taken to neurointerventional angiography suite for vascular intervention. past medical history: pancreatic ca. mets to liver and lung. palliative chemo and roux en y. has declined chemo since pe in - on lovenox nstemi: presently and 1.5 weeks ago. on asa. stroke/tias: followed previously by neurologist in . pt with l frontal infarcts in (although presented to l sided weakness). h/o previous tias with r facial droop/twitching. r frontal meningioma dm2 l total hip replacement gerd migraine - scotoma with throbbing unilateral ha htn social history: lives with her husband in . does not smoke or drink alcohol. pt. and her husband have 3 sons, one of whom lives in an apt beneath her. indepedent of adls. walks with cane and walker family history: sister with lung cancer- heavy smoker. stroke and heart attacks run in the family (mother, father, brother). physical exam: vs: t 97.1 hr 81-89 bp 156/82 rr18 95-96% ra general: nad, pleasant, appropriate and cooperative heent: ncat. sclera anicteric. cardiac: rrr lungs: clear bilaterally abdomen: soft, non-tender, non-distended. normal bowel sounds. extremities: no c/c/e. neuro: ms: no spont eye opening, arousable initially only with continued sternal rub, but after several minutes able to maintain arousal with continued exam. pt with fluent speech, although trouble with repetition, and following commands without l/r confusion briskly. oriented to name, but thinks she's at home and thinks it's . cn: able to visualize fingers but without btt. r pupil 7-8mm, nonreactive. l pupil 1.5 with minimal reactivity. minimal abduction of r eye, but otherwise with oculomotor plegia. l nlf flattening. tongue ml. palate ml. shoulder shrug, head turn full. motor: nl tone, with full strength on r. on l, delt 3+, bic 5-, tric 5-, we 1, fe 1, ff 5-. ip 5-, h 4+, df 3, te 3 reflexes: 2+ on r, 1+ on l. toes down coord. does not cooperate. : withdraws to tickle r>l. pertinent results: 06:22am blood wbc-22.7* rbc-2.87* hgb-8.3* hct-24.4* mcv-85 mch-28.8 mchc-33.8 rdw-18.2* plt ct-146* 03:20am blood wbc-20.1* rbc-2.93* hgb-8.3* hct-24.9* mcv-85 mch-28.3 mchc-33.4 rdw-17.3* plt ct-185 11:44am blood wbc-15.8* rbc-2.87* hgb-8.0* hct-24.5* mcv-85 mch-28.0 mchc-32.8 rdw-16.8* plt ct-221 03:44am blood wbc-17.6* rbc-2.90* hgb-8.4* hct-24.7* mcv-85 mch-29.0 mchc-34.0 rdw-17.1* plt ct-231 02:45am blood wbc-16.9* rbc-2.75* hgb-7.4* hct-23.5* mcv-86 mch-27.0 mchc-31.5 rdw-16.7* plt ct-235 03:12am blood wbc-26.6*# rbc-3.13* hgb-8.6* hct-26.4* mcv-85 mch-27.4 mchc-32.4 rdw-16.7* plt ct-286 02:17am blood wbc-16.3* rbc-3.62* hgb-10.0* hct-30.0* mcv-83 mch-27.7 mchc-33.4 rdw-16.5* plt ct-285 05:07am blood wbc-11.5* rbc-3.67*# hgb-10.2*# hct-30.2* mcv-82 mch-27.8 mchc-33.7 rdw-16.5* plt ct-283 06:52am blood wbc-8.7 rbc-2.85* hgb-7.5* hct-23.6* mcv-83 mch-26.3* mchc-31.7 rdw-16.4* plt ct-302 06:50am blood wbc-8.7 rbc-3.02* hgb-7.9* hct-25.2* mcv-84 mch-26.2* mchc-31.3 rdw-15.6* plt ct-376 02:17am blood neuts-90.4* lymphs-5.0* monos-3.8 eos-0.6 baso-0.3 06:50am blood neuts-87.2* lymphs-7.9* monos-3.5 eos-1.0 baso-0.3 03:20am blood ptt-26.0 11:44am blood ptt-59.9* 03:44am blood pt-13.1 ptt-54.3* inr(pt)-1.1 09:22pm blood ptt-54.4* 02:09pm blood ptt-70.5* 02:45am blood pt-14.5* ptt-85.1* inr(pt)-1.3* 04:25pm blood ptt-61.2* 08:59am blood ptt-48.5* 01:20am blood ptt-39.8* 04:50pm blood pt-14.8* ptt-31.5 inr(pt)-1.3* 05:07am blood pt-14.3* ptt-26.3 inr(pt)-1.2* 06:52am blood pt-13.8* ptt-75.5* inr(pt)-1.2* 06:50am blood pt-13.9* ptt-29.5 inr(pt)-1.2* 06:52am blood ret aut-2.3 06:22am blood glucose-184* urean-15 creat-0.4 na-142 k-3.4 cl-105 hco3-28 angap-12 03:20am blood glucose-182* urean-18 creat-0.4 na-143 k-3.7 cl-108 hco3-27 angap-12 03:44am blood glucose-163* urean-19 creat-0.5 na-141 k-5.2* cl-109* hco3-23 angap-14 02:45am blood glucose-122* urean-22* creat-0.5 na-143 k-3.6 cl-111* hco3-20* angap-16 03:12am blood glucose-144* urean-19 creat-0.6 na-144 k-3.8 cl-109* hco3-22 angap-17 02:17am blood glucose-89 urean-9 creat-0.4 na-144 k-3.0* cl-109* hco3-27 angap-11 05:07am blood glucose-81 urean-9 creat-0.4 na-142 k-3.4 cl-109* hco3-27 angap-9 06:52am blood glucose-118* urean-13 creat-0.5 na-143 k-3.8 cl-109* hco3-26 angap-12 06:50am blood glucose-117* urean-13 creat-0.4 na-142 k-3.6 cl-108 hco3-23 angap-15 03:12am blood ck(cpk)-82 04:50pm blood ck(cpk)-181* 11:26am blood ck(cpk)-216* 02:17am blood ck(cpk)-84 07:23pm blood ck(cpk)-56 05:07am blood alt-32 ast-30 ld(ldh)-248 ck(cpk)-36 alkphos-195* totbili-0.7 06:52am blood alt-28 ast-29 ld(ldh)-200 ck(cpk)-47 alkphos-198* totbili-0.2 05:00pm blood ck(cpk)-52 06:50am blood ck(cpk)-30 03:12am blood ck-mb-14* mb indx-17.1* ctropnt-0.45* 04:50pm blood ck-mb-31* mb indx-17.1* ctropnt-0.83* 11:26am blood ck-mb-35* mb indx-16.2* ctropnt-0.68* 02:17am blood ck-mb-notdone ctropnt-0.28* 07:23pm blood ck-mb-notdone ctropnt-0.22* 05:07am blood ck-mb-notdone ctropnt-0.14* 06:52am blood ck-mb-5 ctropnt-0.17* 05:00pm blood ck-mb-6 ctropnt-0.13* 06:50am blood ctropnt-0.08* 06:22am blood calcium-7.8* phos-2.4* mg-2.0 03:20am blood calcium-8.0* phos-1.7* mg-1.9 03:44am blood calcium-8.1* phos-2.5* mg-1.8 02:45am blood calcium-8.3* phos-2.9# mg-2.0 03:12am blood calcium-8.5 phos-4.5 mg-1.8 02:17am blood calcium-8.2* phos-4.1 mg-1.7 cholest-125 05:07am blood albumin-2.8* calcium-8.1* phos-3.3 mg-2.0 06:52am blood albumin-2.8* calcium-8.2* phos-3.5 mg-2.0 iron-16* 06:50am blood calcium-8.4 phos-2.8 mg-1.9 06:52am blood caltibc-220* ferritn-151* trf-169* 02:17am blood %hba1c-6.2* 02:17am blood triglyc-88 hdl-27 chol/hd-4.6 ldlcalc-80 cxr : impression: no acute cardiopulmonary process identified cta chest impression: 1. interval decrease in the burden of the pulmonary embolus within the right lower lobe pulmonary artery. no other focus of pulmonary embolism is identified. 2. multiple pulmonary nodules and multiple hypodense liver lesions which appear relatively unchanged compared to the prior study. findings are compatible with the reported pancreatic metastatic disease ct/ct perf/cta head : impression: 1. small area of reversible ischemia in the left cerebellar hemisphere in the medial portion. 2. please note that the accuracy of ctp in the detection of small acute infarcts in the posterior fossa. in addition, acute infarcts in this location are elsewhere in the brain, not imaged, cannot be excluded. mr of the head can be considered, if this information is necessary. 3. lack of enhancement in the tip of the basilar artery, as well as the posterior cerebral arteries on both sides, p1 and p2 segments on the right side and p1 segment on the left side, consistent with thrombosis. this appearance is new compared to the mr angiogram done on . 4. the patient is apparently undergoing conventional angiogram for better assessment and possible intervention; please see the detailed report on the conventional angiogram study. 5. degenerative changes noted in the cervical spine at c4-5 level, not completely assessed on the present study. mri/mra brain : impression: 1. multiple acute infarcts, in the bilateral mca, pca territories, likely related to embolic etiology. 2. recanalization of the previously thrombosed tip of the basilar artery and the posterior cerebral arteries on both sides. evaluation for any acute hemorrhage may be limited. correlate with follow up ct study. ct head : conclusion: no new intracranial hemorrhage. beginning visibility of multiple infarcts noted on a prior mr study of , as described in detail above. cxr : impression: no acute cardiopulmonary process is identified\ echo : the left atrium is normal in size. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. overall left ventricular systolic function is normal (lvef 70%). there is no ventricular septal defect. right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. no masses or vegetations are seen on the aortic valve. trace aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is mild mitral valve prolapse. no mass or vegetation is seen on the mitral valve. trivial mitral regurgitation is seen. there is borderline pulmonary artery systolic hypertension. no vegetation/mass is seen on the pulmonic valve. there is no pericardial effusion. compared with the findings of the prior study (images reviewed) of , no major change is evident. impression: no mass or vegetations seen cxr : findings: as compared to the previous radiograph, a dobbhoff catheter has been placed. the course of the catheter is unremarkable, the tip of the catheter is not included on the radiograph. unchanged position of left-sided port-a-cath. mild pre-existing right suprabasilar atelectasis. no new lung opacities. ct abd/pelvis : impression: 1. right inguinal hematoma, cannot exclude active extravasation. 2. innumerable liver and pulmonary metastases. pancreatic head mass. 3. bilateral small pleural effusions. femoral u/s : impression: large inguinal hematoma, no evidence of pseudoaneurysm ct head : impression: 1. evolving left mca infarct involving the left frontal and parietal lobes with obliteration of the adjacent sulci and no hemorrhage. this appears larger than on the previous mr examination. 2. unchanged right thalamic infarction. 3. right cerebellar and right occipital infarctions, barely detectable on this ct. cxr : findings: as compared to the previous radiograph, there is no relevant change. right port-a-cath and dobbhoff catheter in place. unchanged size of the cardiac silhouette, unchanged tortuosity of the thoracic aorta. no signs of overhydration, no pleural effusions, no focal parenchymal opacities suggestive of pneumonia. brief hospital course: this 72 f was admitted for chest pain and was being managed for nstemi. she experienced a tip of the basilar stroke as outlined in the hpi. she was taken to the angio suite and received ia tpa and merci clot retrieval with subsequent recanalization of her pca's bilaterally. although post-catheterization she was noted to be speaking, her neuro exam deteriorated overnight and the next morning she was somnolent, nonverbal, but able to move all extermities against gravity. her brain mri overnight showed scattered infarcts in the cerebellum, midbrain, right thalamus, and cortex. a repeat head ct showed no evidence of bleeding post-tpa, and she was started on a heparin gtt. post-catheterization, her troponins began increasing again and peaked at about 0.8. she was started on a beta-blocker and aspirin. her wbc count increased over days, however an infectious workup returned negative. over days, her hemoglobin was noted to be trending down, a ct abd/pelivs was done and confirmed the presence of a femoral hematoma. the heparin gtt was dc'd. subsequently, her neuro exam deteriorated more to the point where she was not moving her extremities as well as previously. a repeat nchct showed evolution of her prior left mca territory infarct. she was otherwise stable from a caridopulmonary perspective and was transferred out of the icu to the floor. given her hx of metastatic pancreatic ca, trousseau syndrome, and now scattered strokes, her family decided that hospice care would be most appropriate for her. medications on admission: -amylase-lipase-protease 30,000-8,000- 30,000 unit tablet sig: two (2) tablet po qid. -atenolol 50 mg tablet: one (1) tablet po daily. -spironolactone 12.5 mg po daily. -enoxaparin fifty (50) mg subcutaneous . -glipizide 2.5 mg tab,sust rel osmotic push 24hr, 1 tab po daily. -oxycodone 5 mg tablet sig: one (1) tablet po q6h prn. -docusate sodium 100 mg capsule sig: two (2) po bid. -aspirin 325 mg tablet sig: one (1) tablet po daily. -senna 8.6 mg tablet sig: two (2) tablet po bid prn. discharge medications: 1. morphine concentrate 20 mg/ml solution sig: one (1) po q1h (every hour) as needed for pain. 2. lorazepam 1 mg tablet sig: 1-2 tablets po q2h (every 2 hours) as needed for resp distress, restlessness. 3. scopolamine base 1.5 mg patch 72 hr sig: one (1) patch 72 hr transdermal q72hr (). 4. hyoscyamine sulfate 0.125 mg tablet, sublingual sig: one (1) tablet, sublingual sublingual qid (4 times a day). 5. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for fever. discharge disposition: extended care facility: - discharge diagnosis: end-stage pancreatic ca trouso syndrome myocardial infarction cerebral embolism with multiple infarctions bacteremia discharge condition: comfort care discharge instructions: you had multiple strokes due to increased clotting caused by pancreatic cancer followup instructions: hospice care md, procedure: injection or infusion of thrombolytic agent arteriography of cerebral arteries procedure on two vessels endovascular removal of obstruction from head and neck vessel(s) diagnoses: subendocardial infarction, initial episode of care anemia, unspecified malignant neoplasm of liver, secondary unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled hematoma complicating a procedure personal history of malignant neoplasm of breast other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure bacteremia malignant neoplasm of head of pancreas personal history of venous thrombosis and embolism secondary malignant neoplasm of lung hemiplegia, unspecified, affecting unspecified side cerebral thrombosis with cerebral infarction thrombophlebitis migrans 

Answer: The patient is high likely exposed to