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: codeine attending: chief complaint: cardiac arrest major surgical or invasive procedure: intubation hemodialysis central line placement history of present illness: this is a 49 year-old male with history of diabetes, hypertension, and end stage renal disease who was transfered from an outside hospital after a pea arrest. for the past week, he has been feeling unwell. one week ago, he underwent placement of a perotoneal dialysis catheter. at that time, he required hospital admission for 2 days due to hyperkalemia and hyperglycemia. he was not dialysed at that time. he had persistent nausea. the day prior to admission, he was back to his baseline health, which is severe fatigue with ambulation of a few yards. the morning of presentation, he began to feel nauseated. per report, he fell from his chair and was unresponsive. he had some jerking movements of his arms that were similar to his hypoglycemic episodes. shortly thereafter, he was responsive but then became unresponsive again. when ems arrived, he was found to be bradycardic in pea arrest. he received epi and atropine. he subsequently became hypotensive to the 60s systolic and was asystolic. he was transcutaneously paced. he was taken to an outside hospital where he continued to be hypotensive. he received 4 l of iv fluid resuscitation. a temporary pacer was placed, and he was paced at 80 beats per minute. without pacing, he had only rare junctional escape beats. his labs were notable for hyperkalemia to 6.2, hyperglycemia to the 700s, and acidemia with a ph of 7.03. cardiac enzymes were negative and his bnp was elevated to . an echocardiogram revealed an ef of 15-20% with global hypokinesis and decreased right ventricular function. he was transfered to the for further management. on transfer, his vent settings were noted to be incorrect and he was found to be hypoxic to the 50s on 2 separate gases about 1.5 hours apart. on arrival he was oxygenating well. he was on 5 mcg of levophed to maintain his blood pressure. he was intially unresponsive, with fixed dilated pupils, with an absent corneal and gag reflex. an initial potassium was 6.4. he received calcium, bicarb, insulin, and kayexelate. he was admitted to the ccu. past medical history: 1. insulin dependant diabetes diagnosed 20 years ago. 2. end stage renal disease for about 1.5 years with plans to start perironeal dialysis next month. a pd catheter was placed last week. 3. hypertension 4. hyperlipidemia 5. history of lens removal in left eye. 6. history of tia social history: he is currently not working. he is married and has 2 children. he smokes 1 pack per day. he doesn't drink alcohol. family history: his mother has a triple bypass in her 60s. she also has diabetes and hypertension. physical exam: vitals: temperature:34 rectal blood pressure:121/72 on levophed pulse:80 v-paced respiratory:16 rate: oxygen saturation:99% on vent. general: intubated in no acute distress. heent: left pupil surgical fixed at 8mm, right pupil surgical at 6mm, moist mucous membranes. cardiac: regular rhythm, paced, s1, s1, no murmurs, rubs, gallops. pulmonary: clear to auscultation bilaterally. abdomen: normoactive bowel sounds, soft, nontender, nondistended, healing surgical incision. extremities: cool to touch, 2+ radilal and dorsalis pedis pulses. left cortis dressing intact. neuro: spontaneous eye opening, tracking to voice, moving all 4 extremities. pertinent results: outside hospital: 1. chest x-ray: cardiomegally, pacer wires coiled in the right ventricle, pulmonary edema, widened mediastinum. 2. head ct: negative for acute bleed or mass effect. 3. echocardiogram: ef 15-20% with global hypokinesis. decreased right ventricular systolic function. . : 1. chest x-ray: cardiomegally, pacer wires coiled in right ventricle, widened mediastinum, pulmonary edema. 2. chest cta: no pulmonary emboli, no aortic dissection, pulmonary edema with bilateral pleural effusions, coronary arteries grossly clean. . ekg: ventricular paced at 80 bpm with left bundle morphology. ekg with underlying rhythm: narrow complex escape beats at 50-60. . tte : conclusions: 1. the left atrium is mildly dilated. 2. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. overall left ventricular systolic function is moderately depressed. lvef 40% distal anterior, apical, and distal inferior hypokinesis is present. 3. the aortic root is mildly dilated. 4. the mitral valve leaflets are mildly thickened. 5. there is mild pulmonary artery systolic hypertension. 6. there is a small pericardial effusion. . . exercise stress test: the baseline ekg showed prominant voltage, diffuse stt wave abnormalities and lae. no additional, significant st segment changes over baseline were observed during the infusion or in recovery. the rhythm was sinus with no ectopy. appropriate blood pressure response to the infusion; blunted heart rate response. the dipyridamole was reversed with 125 mg of aminophylline iv. impression: no anginal type symptoms or significant ekg changes over baseline. nuclear report sent separately. . persantine mibi radiopharmeceutical data: 3.1 mci tl-201 thallous chloride; 21.0 mci tc-m sestamibi; history: diabetes, esrd, and hypertension, status post hyperkalemia-related cardiac arrest. cad evaluation. summary of the preliminary report from the exercise lab: dipyridamole was infused intravenously for 4 minutes at a dose of 0.142 milligram/kilogram/min. two minutes after the cessation of infusion, tc-99m sestamibi was administered iv. interpretation: image protocol: gated spect resting perfusion images were obtained with thallium. tracer was injected 15 minutes prior to obtaining the resting images. this study was interpreted using the 17-segment myocardial perfusion model. the image quality is adequate. left ventricular cavity size is dilated, and more dilated at stress than at rest. resting and stress perfusion images reveal uniform tracer uptake throughout the myocardium. gated images reveal diffuse hypokinesis without focal wall motion abnormalities.the calculated left ventricular ejection fraction is 48% impression: 1. normal myocardial perfusion. 2. transient dilitation of the left ventricle during dipyridamole (stress) images compared to rest, with a baseline dilated left ventricle. brief hospital course: 49 year-old male with diabetes, end-stage renal disease, hypertension, hyperlipidemia admitted with cardiac arrest likely secondary to hyperkalemia and acidemia. . 1. cardiac arrest: patient had an asystolic arrest in the setting of hyperkalemia to 6.4 and acidemia to 7.0. on arrival, he was 100% paced with an underlying rhythm of 50-60s junctional escapes. he was also hypotensive requiring levophed. he was treated for hyperkalemia in the emergency department with calcium gluconate, bicarb, insulin, and kayexalate. his mental status improved with treatment of hyperkalemia. his ekg with back-up pacing at a rate of 40 showed heart block with occasional conducted beats with av delay. there was also some inappropriate pacing spikes. the sensing was decreased with good effect. he subsequently converted to normal sinus rhythm without av delay as his potassium was corrected. his blood pressure also improved with treatment of his hyperkalemia. he is currently off of levophed. patient had a repeat tte which demonstrated an improvement in his ef to 40%. temporary pacer was discontinued on . patient did not have further evidence of arrythmia. he will have close follow-up locally and he will have his pcp refer him to a local cardiologist. . 2. chronic renal failure: secondary to diabetes and hypertension. at the osh the patient had a catheter placed with the goal of starting peritoneal dialysis in 1 month. however, during that hospitalization, he then developed hyperkalemia and subsequent pea arrest, which required transfer to .he was dialyzed on the night of admission and had two additional sessions of hemodialysis while in-house. tunneled dialysis line placed and out-pt hemodialysis was coordinated; he has follow-up with dr. his nephrologist on . . 3. diabetes: he was hyperglycemic to 700s initially without any evidence of ketosis. he received insulin and was started on an insulin drip. he was requiring 1 unit per hour. on hospital day 2, he was transitioned to nph and the insulin drip was weaned off. he was discharged on a regimen of glargine and lispro. . 3. congestive heart failure: at the outside hospital, he had an echocardiogram that showed diffused hypokinesis with an ejection fraction of 15-20%. it also showed decreased right ventricular function. according to his wife, he had a normal echocardiogram on month prior. repeat echo at showed at ef of 40%. his ef may continue to improve following this event. he should have a repeat echo in the next several months. . 4. elevation in cardiac enzymes: on admit, he had a troponin leak that was likely secondary to hypotension in the setting of his arrest. also, noted to have elevated ck-mb. enzymes trended down during his admission. he did not have a cath while he was here. he will discuss elective cardiac catheterization at follow-up with his pcp and primary cardiologist. . 6. hypertension: was briefly on pressors, then as pressure came up required nitro for blood pressure control (initially avoiding nodal blocking agents). additional agents were slowly added back and he was discharged on a regimen of procardia, labetalol and lisinopril. blood pressure will be followed by pcp and regimen will be titrated up as necessary. . 7. intubation: he was intubated for airway protection at the osh. as his electrolyte disturbances resolved, ventilation and sedation were weaned. he was extubated on hospital day 2. he did not have any additional respiratory issues. medications on admission: 1. lantus 2. novalog 3. lipitor 4. labetalol 5. norvasc 6. lasix 7. metolazone 8. neurontin 9. thiamine 10. folate 11. b12 12. procrit 13. calcium carbonate discharge medications: 1. atorvastatin 80 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 2. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 3. calcium acetate 667 mg capsule sig: two (2) capsule po tid w/meals (3 times a day with meals). disp:*180 capsule(s)* refills:*2* 4. lisinopril 20 mg tablet sig: two (2) tablet po daily (daily). disp:*60 tablet(s)* refills:*2* 5. labetalol 200 mg tablet sig: three (3) tablet po tid (3 times a day). disp:*270 tablet(s)* refills:*2* 6. insulin glargine 100 unit/ml solution sig: thirty (30) units subcutaneous q am. 7. insulin lispro (human) 100 unit/ml solution sig: as dir units subcutaneous four times a day: as per sliding scale. 8. gabapentin 100 mg capsule sig: one (1) capsule po tid prn (). 9. thiamine hcl 100 mg tablet sig: one (1) tablet po daily (daily). 10. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 11. cyanocobalamin 100 mcg tablet sig: one (1) tablet po daily (daily). 12. terazosin 1 mg capsule sig: one (1) capsule po hs (at bedtime). 13. doxercalciferol 2.5 mcg capsule sig: one (1) capsule po daily (daily). 14. epoetin alfa 10,000 unit/ml solution sig: as directed units injection asdir (as directed): at hd. 15. procardia 10 mg capsule sig: one (1) capsule po three times a day. disp:*90 capsule(s)* refills:*2* discharge disposition: home discharge diagnosis: primary: - pea arrest - hyperkalemia - esrd with hemodialysis initiation - chf secondary: - insulin dependant diabetes - end stage renal disease - hypertension - hyperlipidemia - history of lens removal in left eye. - history of tia discharge condition: - stable to home, with outpatient hemodialysis discharge instructions: - take medications as directed. - follow up as scheduled. - follow up with dr. . you have been started on dialysis - follow up for dialysis as scheduled. followup instructions: follow up with your kidney doctor (dr. as scheduled. follow up for hemodialysis on saturday, at the kidney center. dr. office should call you on friday (tomorrow). call him if you do not hear from him tomorrow. his number is . youi can speak with im or his assistant . follow up with your pcp 1 week. your pcp should follow your blood pressure as changes have been made to your blood pressure regimen and further changes may be needed as you continue with dialysis. you should discuss finding a local cardiologist with your pcp. may need to have a cardiac catheterization at some point in the future. md, procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours hemodialysis venous catheterization for renal dialysis arterial catheterization diagnoses: hyperpotassemia end stage renal disease congestive heart failure, unspecified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease cardiac arrest diabetes with renal manifestations, type i [juvenile type], not stated as uncontrolled 

Answer: The patient is high likely exposed to