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: hypotension, groin/abd/chest pain major surgical or invasive procedure: none history of present illness: 57 yo f h/o dvt/pe s/p ivc filter off coumadin, transfusion-dependent mds, recent admission (discharged ) for mechanical fall and uti who presented on with 10/10 sharp groin pain radiating upwards into abdomen at rehab lasting several hours. no dysuria, hematuria, diarrhea, constipation. she was transferred to . in the ed, vs notable for bp 86/45 (baseline 90-100). pt complaining of new chest pressure in absence of dyspnea, resolved with morphine. ekg baseline and ruled out for mi but chest cta significant for new segmental pes and started on heparin gtt. lactate elevate at 2.9 but abd xray with ileus or obstruction. received ns x 4l with improvement in sbp to low 90s and given ceftriaxone for pyuria on u/a although asymptomatic. admitted to micu for further management. past medical history: 1. chronic macrocytic anemia 2. bone marrow biopsy -mds v etoh toxicity pancytopenia > resolved and most likely attributed to etoh toxicity 3. hypothyroidism 4. h/o questionable seizures, but negative 48h eeg and nl mri in past. 5. migraine headaches 6. questionable history of cardiac arrhythmias. of hearts in past showed some tachys to 180s. patient denies. 7. peptic ulcer disease status post nissen fundoplication. 8. status-post hemorrhoidectomy. 9. asthma s/p intubation x 1 in past 10. osteoarthritis 11. b/l cataracts 12. r knee surgery . bilateral pulmonary embolic with dvt s/p ivc filter 14. weight loss of unknown etiology (now 88 pounds, was 150 pounds 1 year ago). 15. hemorroids. . social history: lives with her boyfriend of 14 years. she has three daughters. she is a retired photographer. +occasional etoh, no tobacco or illicit drug use. family history: no family h/o mds or leukemia. father dies of cad. maternal grandmother with breast ca. mother with breast ca. sister with breast ca. physical exam: vs: t 98, sbp 80-100 general: alert, oriented x 3, no acute distress, pleasantly talkative heent: sclera anicteric, mmm, oropharynx clear neck: supple, jvp not elevated, no lad lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema pertinent results: 03:30pm blood wbc-8.5# rbc-2.69*# hgb-9.5*# hct-29.7*# mcv-110* mch-35.1* mchc-31.9 rdw-15.9* plt ct-372# 03:30pm blood pt-13.3 ptt-21.7* inr(pt)-1.1 03:30pm blood glucose-115* urean-12 creat-0.7 na-138 k-4.3 cl-106 hco3-23 angap-13 03:30pm blood calcium-7.7* phos-3.1 mg-1.3* 03:30pm blood alt-12 ast-36 alkphos-146* . 03:30pm blood ck(cpk)-27 ck-mb-notdone ctropnt-0.06* 12:10am blood ck(cpk)-27 ck-mb-notdone ctropnt-0.03* . 09:10pm blood lactate-2.9* 12:29am blood lactate-1.6 . 05:35pm urine color-yellow appear-clear sp -1.021 05:35pm urine blood-neg nitrite-neg protein-neg glucose-neg ketone-neg bilirub-neg urobiln-neg ph-7.0 leuks-sm 05:35pm urine rbc-0 wbc-* bacteri-rare yeast-none epi-0 . 07:43pm urine color-yellow appear-clear sp -1.022 07:43pm urine blood-neg nitrite-neg protein-neg glucose-neg ketone-neg bilirub-neg urobiln-neg ph-6.5 leuks-neg . blood cultures: pending x 2 urine cultures: no growth . kub: supine and left lateral decubitus views of the abdomen are obtained. the bowel gas pattern demonstrates no evidence of ileus or obstruction. left lateral decubitus view is limited to detect free air given that the right lateral abdominal wall is excluded, thus limiting the evaluation for air layering along the edge of the liver. an ivc filter is noted in the mid abdomen. bony structures appear normal. multiple phleboliths are identified in the pelvis. included lung bases appear clear. . cxr: ap upright and lateral views of the chest are obtained. the lungs appear clear bilaterally, demonstrating no evidence of pneumonia or chf. no pneumothorax or pleural effusion is seen. cardiomediastinal silhouette is stable. bony structures appear intact. an ivc filter is partially visualized in the upper abdomen. no free air was seen below the right hemidiaphragm . chest cta: segmental pulmonary emboli in the rml, rll and lll. additional subsegmental emboli are seen in the lll. no acute aortic syndrome. ascites noted in the upper abdomen, new since prior study and of unclear etiology. 2 mm rul nodule. 3 mm nodule lul. . ekg: ecg: sinus, rate 85 bpm, no st/t changes. brief hospital course: 57 yo f h/o dvt s/p ivc filter, h/o pe, transfusion-dependent mds, recent admission (discharged ) for mechanical fall and uti, presents from rehab with groin pain radiating to abd and chest, found to have new pe. # pe: for pe, patient transitioned from heparin to lovenox for new segmental emboli on cta chest. no indication for thrombolysis. she was discharged on lovenox due to benefit of easier reversibility compared to coumadin given history of difficult to control inrs and setting of fall risk. pt to schedule follow-up with pcp . # hypotension: in micu, patient given additional 2l fluids. sbp stable at 80-100, and pt remained asymptomatic. she was not felt to be infected given absence of fever, leukopenia, or positive micro data - *will need to follow up pending cultures.* also unlikely to be due to pe. pt reports that this is consistent with her baseline low-running blood pressures which has been noted multiple times in the past. encouraged po fluid intake. # chest pain: transient episode of atypical pain. most likely pe. ruled out for mi and remaining chest pain free since admission. # pyuria: pyuria on admission without any urinary sx; no urine cx sent but did receive one dose of ceftriaxone in ed. antibiotics not continued in micu as pt asymptomatic. foley removed and repeat u/a and ucx clean. pt remained asymptomatic. # mds: patient transfusion dependent, was scheduled to get blood transfusion as outpatient on . given hct 21 on , transfused 1 unit prbc overnight with appropriate response and subjective improvement in clinical status per pt. outpatient f/u with heme-onc per routine. # migraines: continued precocet and zofran as patient refusing outpatient imitrex citing decreased efficacy. # weight loss: 60-80 lbs over months of unknown etiology. suspicion for malignancy. however, last mammogram was in and colonoscopy in . extensive w/u at last admission including ct chest, ct abd w/o masses and nl spep. pt should continue outpatient work-up, including mammogram. # hypothyroidism: continued levothyroxine. # h/o questionable seizures: continued anti-seizure meds. # peptic ulcer disease status post nissen fundoplication: continued omeprazole. # asthma: continued nebs prn. # code: full # dispo: pt evaluated by pt and recommended for rehab. however, pt refused this and instead chose to go home with services including physical therapy. medications on admission: 1. albuterol 90 mcg/actuation aerosol : two (2) puffs inhalation every six (6) hours as needed for shortness of breath or wheezing. 2. folic acid 1 mg tablet : one (1) tablet po daily (daily). 3. levothyroxine 88 mcg tablet : one (1) tablet po daily (daily). 4. mirtazapine 15 mg tablet : one (1) tablet po hs (at bedtime). 5. cholecalciferol (vitamin d3) 400 unit tablet : two (2) tablet po daily (daily). 6. acetaminophen 325 mg tablet : 1-2 tablets po q6h (every 6 hours) as needed for pain. 7. senna 8.6 mg tablet : one (1) tablet po bid (2 times a day) as needed for constipation. 8. levetiracetam 250 mg tablet : three (3) tablet po bid (2 times a day). 9. omeprazole 20 mg capsule, delayed release(e.c.) : one (1) capsule, delayed release(e.c.) po bid (2 times a day). 10. thiamine hcl 100 mg tablet : one (1) tablet po daily (daily). 11. sumatriptan succinate 50 mg tablet : one (1) tablet po daily (daily) as needed for migraine. 12. oxycodone-acetaminophen 5-325 mg tablet : one (1) tablet po q6h (every 6 hours) as needed for migraine,pain: do not drive on this medication. 13. zolpidem 5 mg tablet : one (1) tablet po hs (at bedtime) as needed for insomnia. 14. prochlorperazine maleate 5 mg tablet : one (1) tablet po q6h (every 6 hours) as needed for nausea. 15. heparin (porcine) 5,000 unit/ml solution : one (1) ml (5000 units) injection tid (3 times a day). 16. docusate sodium 100 mg capsule : one (1) capsule po bid (2 times a day) as needed for constipation. capsule(s) 17. loperamide 2 mg capsule : one (1) capsule po qid (4 times a day) as needed for diarrhea. discharge medications: 1. albuterol sulfate 90 mcg/actuation hfa aerosol inhaler : two (2) inhalation q6h (every 6 hours) as needed for sob/wheezing. 2. folic acid 1 mg tablet : one (1) tablet po daily (daily). 3. levothyroxine 88 mcg tablet : one (1) tablet po daily (daily). 4. mirtazapine 15 mg tablet : one (1) tablet po hs (at bedtime). 5. cholecalciferol (vitamin d3) 400 unit tablet : two (2) tablet po daily (daily). 6. senna 8.6 mg tablet : 1-2 tablets po bid (2 times a day) as needed for constipation. 7. levetiracetam 750 mg tablet : one (1) tablet po twice a day. 8. omeprazole 20 mg capsule, delayed release(e.c.) : one (1) capsule, delayed release(e.c.) po twice a day. 9. thiamine hcl 100 mg tablet : one (1) tablet po daily (daily). 10. sumatriptan succinate 50 mg tablet : one (1) tablet po daily (daily) as needed for migraine. 11. oxycodone-acetaminophen 5-325 mg tablet : one (1) tablet po q6h (every 6 hours) as needed for migraine, pain: do not take this medication if driving or operating machinery; may cause drowsiness. disp:*28 tablet(s)* refills:*0* 12. zolpidem 10 mg tablet : one (1) tablet po at bedtime as needed for insomnia. disp:*10 tablet(s)* refills:*0* 13. prochlorperazine maleate 5 mg tablet : one (1) tablet po every six (6) hours as needed for nausea. 14. docusate sodium 100 mg capsule : one (1) capsule po bid (2 times a day): hold for diarrhea. 15. enoxaparin 40 mg/0.4 ml syringe : forty (40) mg subcutaneous (2 times a day). disp:*30 syringes* refills:*0* 16. tucks pads, medicated : one (1) topical once a day as needed for hemorrhoids. disp:*7 * refills:*0* 17. outpatient physical therapy home physical therapy discharge disposition: home with service facility: vna of discharge diagnosis: primary - pulmonary emboli secondary - h/o pe and dvt s/p ivc filter - myelodysplastic syndrome - weight loss of unclear etiology - hypothyroidism - migraines - h/o seizures discharge condition: hemodynamically stable. baseline bp 80-100. discharge instructions: you were admitted for abdominal pain. your abdominal imaging did not show any acute findings. however, your chest ct scan was notable for new pulmonary emboli. you were started on a blood thinner for this. your blood pressures are known to be low at baseline; please continue to try to stay well hydrated. you should continue your nutritional supplements. please note that you were scheduled for an outpatient blood transfusion but were already given one unit of blood while you were hospitalized. the following changes were made to your medications: - lovenox injections started. please be aware that blood thinners put you at a higher risk of bleeding especially with any trauma or fall. please continue all other medications as prescribed by your doctor. please seek immediate medical attention if you develop chest pain, difficulty breathing, dizziness, bleeding, inability to keep food down, inability to pass gas/stool, inability to urinate, or any other concerning symptoms. followup instructions: you will need to follow up with your pcp, . . please call his office at to schedule an appointment on tuesday, . md procedure: transfusion of packed cells diagnoses: unspecified acquired hypothyroidism asthma, unspecified type, unspecified myelodysplastic syndrome, unspecified loss of weight other chest pain personal history of venous thrombosis and embolism other pulmonary embolism and infarction migraine, unspecified, without mention of intractable migraine without mention of status migrainosus unspecified deficiency anemia peptic ulcer of unspecified site, unspecified as acute or chronic, without mention of hemorrhage or perforation, without mention of obstruction other nonspecific findings on examination of urine 

Answer: The patient is high likely exposed to