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: patient recorded as having no known allergies to drugs attending: chief complaint: shortness of breath major surgical or invasive procedure: none history of present illness: the patient is a 73 year old woman with history of esrd on hd, hypertension, severe pvd s/p bilateral bka, and lvh with lvot who is presenting with acute shortness of breath. she was in her usual state of health until earlier this evening when she noticed that she "just didn't feel right." when she went to lay down, she noted the onset of shortness of breath. she denied chest pain or palpitations. she had her last hd session on friday. she denies eating salty food or missing medications . in the ed her initial vital signs were 220/110 120 rr 40 and 100% on bipap. she continued on bipap with improvement in her oxygenation. an ekg was interpreted as unchanged from prior. nitro-paste was administered for blood pressure control. a left femoral central line was placed for iv access. both cardiology and nephrology were consulted who recommended urgent dialysis for volume control. . on review of symptoms, she denies any prior history of stroke, tia, deep venous thrombosis, pulmonary embolism, bleeding at the time of surgery, myalgias, joint pains, cough, hemoptysis, black stools or red stools. she denies recent fevers, chills or rigors. she denies exertional buttock or calf pain. all of the other review of systems were negative. . *** cardiac review of systems is notable for absence of chest pain, palpitations, syncope or presyncope. past medical history: - diastolic chf with lvot obstruction at rest - chronic 2l nc at night - hypertension - diabetes - peripheral vascular disease status post bilateral knee amputations in (l) and (r) - gerd - hypercholesterolemia - esrd on hemodialysis m,w,f. receives dialysis at hemodialysis center in . - paroxysmal atrial flutter, s/p failed ablation with subsequent a. fib - peptic ulcer disease - hypertrophic obstructive cardiomyopathy - mild mitral stenosis (mva 1.5-2.0 cm2) - secondary hyperparathyroidism - diastolic congestive heart failure social history: social history is significant for the presence of current tobacco use (1 pack per week), and ppd x 50 years. there is no history of alcohol abuse. lives in facility and uses a mobile wheelchair or a walker. family history: her father died in his 90s and mother at the age of 102. patient unable to specify cause of death. she has one living sister and 6 sisters and one brother who passed away. her family history is significant for coronary artery disease, cancer, and diabetes. physical exam: vs: t 97.3, bp 121/69, hr 78, rr 18, o2 99% on 4l gen: thin elderly, african american female. oriented x3. mood, affect appropriate. pleasant. heent: ncat. sclera anicteric. right pupil 2mm->1, left surgical pupil, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. neck: supple with jvp to angle of jaw. gauze in place from lij line placement w/o hematoma cv: pmi located in 5th intercostal space, midclavicular line. rr, normal s1, s2. no s4, no s3. ii/vi holosystolic murmur at llsb/apex chest: no chest wall deformities, scoliosis or kyphosis. resp were unlabored, no accessory muscle use. crackles and rhonchi to way up back. abd: flat, soft, ntnd, no hsm or tenderness. no abdominal bruits. ext: no c/c/e. no femoral bruits. b/l bka. left femoral tlc skin: no stasis dermatitis, ulcers, scars, or xanthomas. pulses: right: carotid 2+ without bruit; femoral 2+ without bruit left: carotid 2+ without bruit; femoral 2+ without bruit pertinent results: 12:00am blood wbc-16.1*# rbc-4.34 hgb-12.5 hct-41.2 mcv-95 mch-28.9 mchc-30.4* rdw-18.8* plt ct-350 04:54am blood wbc-7.8 rbc-4.16* hgb-12.0 hct-38.9 mcv-93 mch-29.0 mchc-31.0 rdw-17.8* plt ct-324 12:00am blood pt-17.6* ptt-94.2* inr(pt)-1.6* 04:54am blood pt-27.2* ptt-38.1* inr(pt)-2.7* 12:00am blood glucose-182* urean-74* creat-8.1*# na-140 k-5.6* cl-100 hco3-26 angap-20 11:30am blood k-6.4* 04:54am blood glucose-100 urean-65* creat-6.9*# na-135 k-5.0 cl-98 hco3-27 angap-15 12:00am blood ck(cpk)-49 06:24am blood ck(cpk)-53 12:00am blood ck-mb-notdone ctropnt-0.05* 06:24am blood ck-mb-notdone ctropnt-0.05* 06:24am blood calcium-8.7 phos-6.4* mg-2.7* 08:00pm blood calcium-8.6 phos-2.8# mg-2.0 04:54am blood calcium-8.7 phos-5.6*# mg-2.5 brief hospital course: the patient is a 73 year old woman with history of esrd on hd, severe pvd, lvh with lvot obstruction presenting with shortness of breath and pulmonary edema. . # cad: although patient has with multiple cad risk factors, prior non-invasive and invasive testing showed no significant obstructive coronary disease. a troponin of 0.04 in the context of normal ck and ekg with no st-t changes was likely demand ischemia secondary to hypertensive heart disease. admission ekg did not show signs of active ischemia and the patient was monitored on telemetry and continued on aspirin and statin. . # chf: the pt's hypoxia was attributed to chf and not pneumonia as she denied any cough, and was afebrile and lacking a consolidate on chest xray. pulmonary embolism was also unlikely as the patient is on chronic anticoagulation. due to chronic diastolic congestive heart failure and a physiologic hocm that leads to hypotension during dialysis sessions, it is most likely that the patient developed pulmonary edema in the setting of volume status change while receiving dialysis. her oxygenation status improved significantly following blood pressure and rate control and a dialysis session. there are no pft's to support the diagnosis of copd, but marked hyperinflation on cxr and notable smoking history indicated strong possibility of copd contributing to patient's symptoms so patient was treated with home dose of spiriva and albuterol as needed. the patient was weaned on bipap and began to breathe comfortably on room air following dialysis. . # atrial fibrillation: the pt was anticoagulated with coumadin and rate controlled with metoprolol and diltiazem for her history of atrial fibrillation. . # hypertension: the patient's hypertension was also controlled with diltiazem and metoprolol and following a successful dialysis session her lisinopril and irbesartan were restarted. . # diabetes: for her diabetes the patient was continued on her home dose of nph with an insulin sliding scale. . # hyperkalemia: the patient has end stage renal disease and receiving hd. the patient was orginally volume overloaded and on day two of admission developed hyperkalemia to a k of 6.7. she had no peaked t waves or qt prolongation on ekg and received calcium carbonate and d5/insulin as well as dialysis. her electrolytes were monitored closely with subsequent k between 4.1 and 5.0. # heme: on admission labs the patient was erythrocytotic. prior evaluations had not shown renal mass that could contribute to over production of erythropoietin and on the epo level was low normal which would suggest a mpd such as . patient would benefit from heme follow up as an outpatient. medications on admission: nephro-cap 1 capsule daily warfarin 2 mg daily brimonidine 0.15 % drops daily latanoprost 0.005 % drops hs tiotropium 18 mcg daily ranitidine hcl 150 mg daily lisinopril 30 mg daily insulin nph 4 albuterol 90 mcg 1 puff:q6hours aspirin 325 mg daily simvastatin 80 mg daily diltiazem hcl sr 120 mg daily irbesartan 150 mg daily metoprolol tartrate 100 mg sevelamer hcl 800 mg tid discharge medications: 1. warfarin 2 mg tablet sig: 1.5 tablets po once daily at 4 pm. 2. tiotropium bromide 18 mcg capsule, w/inhalation device sig: one (1) cap inhalation daily (daily). 3. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 4. brimonidine 0.15 % drops sig: one (1) drop ophthalmic daily (daily). 5. latanoprost 0.005 % drops sig: one (1) drop ophthalmic hs (at bedtime). 6. b complex-vitamin c-folic acid 1 mg capsule sig: one (1) cap po daily (daily). 7. ranitidine hcl 150 mg tablet sig: one (1) tablet po daily (daily). 8. simvastatin 40 mg tablet sig: two (2) tablet po daily (daily). 9. sevelamer hcl 800 mg tablet sig: one (1) tablet po tid w/meals (3 times a day with meals). 10. metoprolol tartrate 50 mg tablet sig: two (2) tablet po bid (2 times a day). 11. lisinopril 10 mg tablet sig: three (3) tablet po daily (daily). 12. irbesartan 150 mg tablet sig: one (1) tablet po daily (). 13. diltiazem hcl 120 mg capsule, sust. release 24 hr sig: one (1) capsule, sust. release 24 hr po once a day. 14. insulin nph human recomb 100 unit/ml suspension sig: four (4) units subcutaneous twice a day. 15. albuterol 90 mcg/actuation aerosol sig: 1-2 puffs inhalation every 4-6 hours as needed for shortness of breath or wheezing. discharge disposition: home with service facility: discharge diagnosis: primary: acute diastolic heart failure end stage renal disease on hemodialysis . secondary: peripheral vascular disease atrial fibrillation on coumadin hypertension discharge condition: stable discharge instructions: you were admitted with shortness of breath and acute diastolic heart failure. this has been treated with dialysis & aggressive blood pressure control. . we have not made any changes to your medications, please make sure to adhere to a low salt diet and keep all your follow up appointments as shown below. . if you develop any worsening shortness of breath, chest pain, weakness or any other general worsening of condition, please call your pcp or come directly to the ed. . it is very important that you adhere to a low sodium diet. followup instructions: 1. provider: , md phone: date/time: 12:40 . 2. provider: , md phone: date/time: 11:40am . 3. provider: , md phone: date/time: 1:40pm procedure: hemodialysis venous catheterization for renal dialysis diagnoses: end stage renal disease nephritis and nephropathy, not specified as acute or chronic, in diseases classified elsewhere esophageal reflux pure hypercholesterolemia congestive heart failure, unspecified other pulmonary insufficiency, not elsewhere classified atrial fibrillation acute on chronic diastolic heart failure personal history of tobacco use hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease long-term (current) use of insulin long-term (current) use of anticoagulants secondary hyperparathyroidism (of renal origin) atherosclerosis of native arteries of the extremities, unspecified diabetes with renal manifestations, type ii or unspecified type, not stated as uncontrolled below knee amputation status polycythemia, secondary diabetes with peripheral circulatory disorders, type ii or unspecified type, not stated as uncontrolled 

Answer: The patient is high likely exposed to