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: lobster / penicillins / sulfa(sulfonamide antibiotics) attending: chief complaint: pancreatic mass major surgical or invasive procedure: modified classical whipple with portal vein reconstruction and placement of jejunostomy tube. history of present illness: 76f presenting with recurrent pancreatitis. she had 3 episodes of pancreatitis in the last year. this time she presented with elevated lfts (alt 500, ast 300, t bil 7 and a lipase of a 1000) consistent with obstructive pattern. she failed ercp at osh and then had repeat here ercp at that showed a stricture with proximal dilation; she subsequently underwent a sphincterotomy and stent placement and at present denied abdominal pain. past medical history: pmh: recurrent pancreatitis, afib (not on coumadin), hypertension, hyperlipidemia, anxiety, r pulmonary nodule, rheumatic fever in childhood psh: appendectomy, lap ccy, cataracts, tonsillectomy, left salpingooophorectomy, b tka, rectal prolapse x3 surgeries social history: retired and lives alone. independent for all adls and iadls. she does not use alcohol or drugs. previous smoker but stopped >20 years ago. she seems to have minimal contact with her children and initially could not provide contact numbers for them. one daughter apparently cannot be reached due to drug use and "no one being able to find her". patient with recent significant stressors due to conflict with a friend. daughter was contact during her hospitalization . family history: patient was raised in the care system so does not know her parents medical history. does not know of any particular medical problems in her children but is not close to them. physical exam: on discharge: vs: t 100.5 hr 80 bp 122/54 rr 20 o2sat 95%ra general: in no acute distress heent: mucus membranes moist, nares clear, trachea @ midline cv: regular rate, rhythm pulm: ctab abd: appropriately tender, incision clean, dry, intact. former jp drain site clean, dry, intact. + bowel sounds msk: warm, well perfused. r picc in place without erythema or induration. neuro: appropriate, but often has depressed affect. can be engaged in conversation, at other times withdrawn. pertinent results: 05:00am blood wbc-6.1 rbc-3.02* hgb-9.4* hct-29.2* mcv-97 mch-31.1 mchc-32.2 rdw-13.2 plt ct-204 05:25am blood wbc-4.6# rbc-2.87* hgb-8.6* hct-27.2* mcv-95 mch-30.1 mchc-31.8 rdw-12.8 plt ct-162 04:09am blood wbc-10.2 rbc-3.76* hgb-11.3* hct-35.8* mcv-95 mch-30.0 mchc-31.5 rdw-13.8 plt ct-204 11:24pm blood wbc-8.0 rbc-3.74* hgb-11.4* hct-35.7* mcv-96 mch-30.5 mchc-31.9 rdw-13.7 plt ct-196 04:09am blood pt-12.6* inr(pt)-1.2* 11:24pm blood pt-13.3* inr(pt)-1.2* 05:00am blood glucose-134* urean-17 creat-0.4 na-137 k-4.4 cl-101 hco3-29 angap-11 05:25am blood glucose-127* urean-15 creat-0.3* na-139 k-3.6 cl-104 hco3-30 angap-9 04:00pm blood glucose-125* urean-17 creat-0.4 na-138 k-3.7 cl-103 hco3-29 angap-10 04:09am blood glucose-162* urean-17 creat-0.5 na-140 k-4.2 cl-106 hco3-25 angap-13 05:00pm blood glucose-126* na-141 k-5.7* cl-105 hco3-27 angap-15 04:09am blood alt-278* ast-437* alkphos-119* 05:00am blood alt-36 ast-27 alkphos-93 totbili-0.4 04:09am blood albumin-3.0* calcium-8.1* phos-3.2 mg-2.7* 05:00am blood calcium-8.0* phos-4.1 mg-1.9 05:25am blood calcium-8.0* phos-3.2 mg-1.7 09:46pm blood glucose-146* lactate-3.3* na-136 k-3.9 cl-104 calhco3-26 08:11pm blood glucose-152* lactate-3.1* na-135 k-3.7 cl-102 04:25pm blood glucose-129* lactate-1.1 na-137 k-3.1* cl-102 02:51pm blood glucose-119* lactate-1.5 na-139 k-3.0* cl-102 12:39pm blood glucose-113* lactate-0.8 na-137 k-3.5 cl-100 pathology specimen submitted: whipple specimen, fs whipple specimen, pancreatic neck. procedure date tissue received report date diagnosed by dr. /dsj?????? diagnosis: i. pancreas and duodenum, whipple resection (a-ag): adenocarcinoma of the distal common bile duct, invasive into the pancreas and focally the duodenal wall; see synoptic report. ii. small bowel segments, whipple resection (ah-aq): 1. duodenal segments with focal chronic, inactive duodenitis. 2. eight lymph nodes with no carcinoma seen (0/8). iii. pancreatic neck, true margin, resection (ar): no carcinoma seen. kub no definite free intra-abdominal air is seen. there is a surgical clip seen within the mid abdomen. multiple surgical tacks are seen in a circular pattern in the mid abdomen suggestive of hernia mesh. there is a nonspecific bowel gas pattern with air and stool seen throughout the colon. no definite dilated loops of small bowel are seen. there is also no free intra-abdominal gas identified. cxr mild cardiomegaly is stable. bibasilar opacities, larger on the right side, are unchanged, consistent with atelectasis. the upper lungs are grossly clear. there is no pneumothorax. if any, there is a small left pleural effusion. right picc tip is in the lower svc. brief hospital course: the patient was admitted to the general surgical service on for treatment of a duodenal stricture causing pancreatitis. on the patient underwent a modified classical whipple with portal vein reconstruction and placement of jejunostomy tube, which went well without complication (reader referred to the operative note for details). the patient stayed in the pacu until pod 2 for decreased urine output. it was around 10 cc's per hour the first day post op. after four 500 cc boluses and albumin x2, the urine output picked up to over 30 cc's per hour and the pt was then transferred to the floor. she remained hemodynamically stable throughout. she arrived on the floor npo with an ng tube, on iv fluids, with a foley catheter and a jp drain in place, and epidural for pain control. the patient was hemodynamically stable. the hospital course was mostly uneventful and followed the whipple clinical pathway without deviation. post-operative pain was initially well controlled with the epidural which was converted to oral pain medication when tolerating clear liquids. the ng tube was discontinued on pod#3, and the foley catheter discontinued on pod#4. the patient subsequently voided without problem. the patient was started on sips of clears on pod#4. however, shortly after starting clears, the patient developed nausea and several episodes of emesis. she was made npo, tube feeds were stopped and kub was not revealing. she was slowly advanced to a regular diet, but with limited oral intake; tpn was continued, cycling at night, to supplement her nutrition. she did not have emesis or inability to tolerate food. she was discharged to rehab on tpn. her j tube unfortunately became clogged and could not be opened up despite several interventions; thus tube feeds were temporarily held until reassessment at her follow-up appointment. jp amylase was sent in the evening of pod#6; the jp was discontinued on pod#7 as the output and amylase level were low at 2-3. during this hospitalization, the patient ambulated early and frequently, was adherent with respiratory toilet and incentive spirrometry, and actively participated in the plan of care. the patient received subcutaneous heparin and venodyne boots were used during this stay. the patient's blood sugar was monitored regularly throughout the stay; sliding scale insulin was administered when indicated. at the time of discharge on , the patient was doing well, afebrile with stable vital signs. the patient was tolerating a regular diet, ambulating, voiding without assistance, and pain was well controlled. staples were removed, and steri-strips placed. the patient was discharged to a rehabilitation facility. the patient received discharge teaching and follow-up instructions with understanding verbalized and agreement with the discharge plan. medications on admission: amlodipine 5', atenolol 25', asa 81, protonix 40' discharge medications: 1. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 2. hydromorphone 2 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for pain for 10 days. disp:*45 tablet(s)* refills:*0* 3. amlodipine 5 mg tablet sig: one (1) tablet po daily (daily). 4. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 5. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for fever/pain. 6. metoclopramide 10 mg tablet sig: 0.5 tablet po qidachs (4 times a day (before meals and at bedtime)). 7. atenolol 25 mg tablet sig: one (1) tablet po daily (daily). 8. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection tid (3 times a day). 9. zofran odt 4 mg tablet, rapid dissolve sig: one (1) tablet, rapid dissolve po every eight (8) hours as needed for nausea for 2 weeks. 10. insulin regular human 100 unit/ml solution sig: one (1) injection asdir (as directed). 11. glucagon (human recombinant) 1 mg recon soln sig: one (1) recon soln injection q15min () as needed for hypoglycemia protocol. discharge disposition: extended care facility: discharge diagnosis: pancreatic mass discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you were admitted to the surgery service for surgical management of your pancreatic mass. you have done well in the hospital and are now safe to go home to complete your recovery there with the following instructions: please call your doctor or nurse practitioner if you experience the following: *you experience new chest pain, pressure, squeezing or tightness. *new or worsening cough, shortness of breath, or wheeze. *if you are vomiting and cannot keep down fluids or your medications. *you are getting dehydrated due to continued vomiting, diarrhea, or other reasons. signs of dehydration include dry mouth, rapid heartbeat, or feeling dizzy or faint when standing. *you see blood or dark/black material when you vomit or have a bowel movement. *you experience burning when you urinate, have blood in your urine, or experience a discharge. *your pain is not improving within 8-12 hours or is not gone within 24 hours. call or return immediately if your pain is getting worse or changes location or moving to your chest or back. *you have shaking chills, or fever greater than 101.5 degrees fahrenheit or 38 degrees celsius. *any change in your symptoms, or any new symptoms that concern you. . general discharge instructions: please resume all regular home medications , unless specifically advised not to take a particular medication. also, please take any new medications as prescribed. please get plenty of rest, continue to ambulate several times per day, and drink adequate amounts of fluids. avoid lifting weights greater than lbs until you follow-up with your surgeon, who will instruct you further regarding activity restrictions. avoid driving or operating heavy machinery while taking pain medications. please follow-up with your surgeon and primary care provider (pcp) as advised. incision care: *please call your doctor or nurse practitioner if you have increased pain, swelling, redness, or drainage from the incision site. *avoid swimming and baths until your follow-up appointment. *you may shower, and wash surgical incisions with a mild soap and warm water. gently pat the area dry. *if you have staples, they will be removed at your follow-up appointment. *if you have steri-strips, they will fall off on their own. please remove any remaining strips 7-10 days after surgery. you have a j tube in place which is currently clogged. your tube feeds have been suspended for now. you will be continued on tpn until you are able to tolerate more po intake. this tube will be re-evaluated in clinic on when you see dr. . followup instructions: provider: , md phone: date/time: 2:45 procedure: other enterostomy enteral infusion of concentrated nutritional substances radical pancreaticoduodenectomy suture of vein insertion of catheter into spinal canal for infusion of therapeutic or palliative substances systemic to pulmonary artery shunt diagnoses: unspecified essential hypertension personal history of tobacco use accidental puncture or laceration during a procedure, not elsewhere classified nausea with vomiting other and unspecified hyperlipidemia anxiety state, unspecified accidents occurring in residential institution obstruction of bile duct mechanical complication of colostomy and enterostomy acute pancreatitis oliguria and anuria malignant neoplasm of extrahepatic bile ducts secondary malignant neoplasm of other digestive organs and spleen accidental cut, puncture, perforation or hemorrhage during surgical operation solitary pulmonary nodule 

Answer: The patient is high likely exposed to