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: sulfa (sulfonamides) / codeine / ativan attending: chief complaint: respiratory distress major surgical or invasive procedure: none history of present illness: this is an 81 y/o female with history of obesity, htn, iddm, osa, chronic respiratory failure, with tracheotomy. patient was brought from her house by ems on after she was noticed to be cyanotic with agonal breathing. per ems, she was found to be cyanotic, spo2 near 50% . she was suctioned by paramedics who , per report ,removed a large mucous plug from her upper airway. her spo2 returned to high 90s on 14 lt o2 by tracheostomy mask. patient was transferred to icu to continue mechanical ventilation. of note , patient was admitted to bimdc in after cardiac arrest, presumed to be secondary respiratory failure. she had a tracheostomy at that time and has been in rehab for at least 3 months. she was discharged home from rehab 10 days ago. ros: no history of fever,chills, chest pain , cough, abdominal pain, diaphoresis, urinary symptoms. ros negative in detail. . ed course: vs t 97.6 , hr 104, bp 112/61, spo2 99% on 14 lt. cxr with decreased lung volumes, no clear consolidation. she was given asa, solumedrol 125 mg x 1 and combivent nebs. past medical history: 1. htn 2. dm - on insulin 3. lymphoma, s/p chemotherapy several years ago and s/p xrt (unclear where radiation was targeted to) - followed at 4. glaucoma 5. cataracts, baseline anisocoria (r pupil<l pupil) social history: lives at home with her daughter, at baseline very active. no tobacoo/etoh/illicits. receives medical care primarily from b&w and . family history: non-contributory physical exam: physical exam: admission vs: tc 99.7, bp 111/57, hr 87-104, rr 28, sao2 100% 14 lt tracheal mask abg 7.39/58/116. . general: obese woman , mildly diaphoretic ,in nad. heent: nc/at, non-reactive to light. tracheoostomu mask in place. neck: supple, unable to determine jvd given thickness of neck chest: decreased bs over bases b/l, coarse rhonchi b/l, wheezing b/l cv: rrr, s1 s2 normal, no m/g/r abd: obese, nt, nabs ext: edema +++ b/l, warm extremities neuro: ao x 3, moving all four extremities. pertinent results: 03:45pm wbc-10.4 rbc-4.25 hgb-12.5 hct-38.6 mcv-91 mch-29.6 mchc-32.5 rdw-14.4 03:45pm plt count-379 03:45pm neuts-55.3 lymphs-38.4 monos-4.3 eos-1.7 basos-0.3 03:45pm glucose-391* urea n-14 creat-0.8 sodium-139 potassium-4.0 chloride-98 total co2-31 anion gap-14 03:45pm ck(cpk)-57 03:45pm ck-mb-notdone ctropnt-<0.01 08:26pm lactate-1.3 08:26pm type-art temp-36.7 o2 flow-10 po2-119* pco2-56* ph-7.39 total co2-35* base xs-7 intubated-not intuba comments-tracheal m 06:00pm urine blood-sm nitrite-neg protein-tr glucose-1000 ketone-neg bilirubin-neg urobilngn-neg ph-5.0 leuk-neg . cxr: impression: low lung volumes with no focal consolidation or edema. . ekg: sinus tachycardia. left ventricular hypertrophy. compared to the previous tracing of the rate has slowed. the voltage is more prominent in the limb leads. otherwise, no diagnostic interim change. brief hospital course: 81 y/o female with history of obesity, htn, iddm, osa, chronic respiratory failure ,s/p tracheostomy presents with acute respiratory failure. . 1.respiratory failure: the respiratory failure was thought to be due to the mucous plug. it was unlikely to be aspiration, atelectasis or pulmonary embolism. there was no evidence of acs. additionally, diastolic dysfunciton could play a role in the respiratory symptoms as the patient is wheezing and echo from shows abnormal e/a ratio. however, bnp 250's. patient was continued on o2 via tm and weaned as symptoms improved. sp02 goal was around 95%. patient was given nebulized bronchodialators and suctioning prn. lasix was given to control the edema. patient was follow by physical therapy and respiratory therapy who worked with the patient on a daily basis to improve her conditioning. patient was downsized to a 6.0 portex. she was eventually moved to capping as much as possible. the goal is decannulation. throughout the admission, patient adamantly refused outpatient rehab. patient was decannulated and tolerated the procedure well. she remained stable and sating well for the rest of the admission. . 2.respiratory acidosis: patient has respiratory acidosis with compensatory metabolic alkalosis, pco2 near baseline. fio2 was kept at a level to improve respiratory drive. . 3. diabetes: blood sugar was found to be elevated at admission, 367. likely related to steroids. her hba1c was recorded, steriods stopped. patient was maintained on an iss and nph. she was given a diabetic diet. she was sent home on an insulin regiment. . 4.cad: patient was continued on aspirin, beta blocker and ccb. . 5.metabolic alkalosis: thought to be due to chronic co2 retention, could also be component of contraction alkalosis. respiratory status, bicarb levels, and fluid status were followed. . 6.anemia-patient's baseline is 35-36. hematocrit was followed. normocytic anemia. . 7.glaucoma-patient was continued on her outpatient eye drop regiment. . 8.anxiety- patient was continued on her psych regiment of haldol, trazadone, and quetiapine. medications on admission: 1. lisinopril 40 2. glyburide 10 3. lasix 40 4. nifedipine xl 90 5. atenolol 50 6. humulin 60 units qam, 40 units qpm (uncertain of doses) 7. lipitor 10 8. multiple eye gtt 9. ambien 5 hs 10. remeron 15 daily discharge medications: 1. miconazole nitrate 2 % powder : one (1) appl topical qid (4 times a day) as needed. 2. ipratropium bromide 17 mcg/actuation aerosol : 4-6 puffs inhalation q6h (every 6 hours). 3. brimonidine 0.15 % drops : one (1) drop ophthalmic (2 times a day). 4. nystatin 100,000 unit/ml suspension : five (5) ml po qid (4 times a day) as needed. 5. olanzapine 2.5 mg tablet : two (2) tablet po bid (2 times a day) as needed for agitation. 6. trazodone 50 mg tablet : 0.5 tablet po hs (at bedtime) as needed. 7. heparin (porcine) 5,000 unit/ml solution : 5000 (5000) u injection tid (3 times a day). 8. dorzolamide-timolol 2-0.5 % drops : one (1) drop ophthalmic (2 times a day). 9. docusate sodium 50 mg/5 ml liquid : one hundred (100) mg po bid (2 times a day). 10. bisacodyl 5 mg tablet, delayed release (e.c.) : two (2) tablet, delayed release (e.c.) po daily (daily) as needed for constipation. 11. lansoprazole 30 mg tablet,rapid dissolve, dr : one (1) tablet,rapid dissolve, dr daily (daily). 12. diltiazem hcl 90 mg tablet : one (1) tablet po qid (4 times a day). 13. insulin nph human recomb 100 unit/ml cartridge : twenty two (22) units subcutaneous twice a day: please give qam and qhs. 14. insulin lispro (human) 100 unit/ml cartridge : as directed subcutaneous qachs: sliding scale, fingersticks: 0-60 1 amp d50 61-150 0 units 151-200 2 untis 201-250 4 units 251-300 6 units 301-350 8 units 351-400 10 units > 400 contact md. discharge medications: 1. fluticasone 110 mcg/actuation aerosol : two (2) puff inhalation (2 times a day). 2. trazodone 50 mg tablet : 0.5 tablet po hs (at bedtime) as needed for insomnia. disp:*15 tablet(s)* refills:*0* 3. albuterol 90 mcg/actuation aerosol : 1-2 puffs inhalation q6h (every 6 hours). 4. ipratropium bromide 17 mcg/actuation aerosol : two (2) puff inhalation qid (4 times a day). 5. albuterol 90 mcg/actuation aerosol : 1-2 puffs inhalation q2h (every 2 hours) as needed for wheezing. 6. timolol maleate 0.25 % drops : one (1) drop ophthalmic (2 times a day): 1 drop to the left eye . disp:*qs * refills:*0* 7. brimonidine 0.15 % drops : one (1) drop ophthalmic (2 times a day): one drop to left eye. disp:*qs * refills:*0* 8. metoprolol tartrate 25 mg tablet : 0.5 tablet po bid (2 times a day). disp:*30 tablet(s)* refills:*2* 9. diltiazem hcl 360 mg capsule, sustained release : one (1) capsule, sustained release po once a day. disp:*30 capsule, sustained release(s)* refills:*2* 10. quetiapine 50 mg tablet : one (1) tablet po twice a day. disp:*60 tablet(s)* refills:*2* 11. dorzolamide 2 % drops : one (1) drop ophthalmic (2 times a day). disp:*qs * refills:*0* 12. dorzolamide-timolol 2-0.5 % drops : one (1) drop ophthalmic (2 times a day). disp:*qs * refills:*0* 13. docusate sodium 100 mg capsule : one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*0* 14. bisacodyl 5 mg tablet, delayed release (e.c.) : two (2) tablet, delayed release (e.c.) po daily (daily) as needed. disp:*30 tablet, delayed release (e.c.)(s)* refills:*0* 15. furosemide 40 mg tablet : one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*1* 16. insulin nph human recomb 100 unit/ml suspension : twenty four (24) units subcutaneous with breakfast. disp:*qs * refills:*2* 17. insulin nph human recomb 100 unit/ml suspension : twenty four (24) units subcutaneous with dinner. disp:*qs * refills:*2* 18. humalog 100 unit/ml solution : as directed per sliding scale units subcutaneous per sliding scale. disp:*qs * refills:*2* 19. lancets & blood glucose strips combo pack : one month supply miscellaneous as directed. disp:*qs * refills:*2* discharge disposition: home with service facility: vna discharge diagnosis: respiratory failure secondary to mucus plugging of trach collar discharge condition: good discharge instructions: you were admitted because you developed a mucous plug that obstructed your airway. the mucous plug was removed and eventually your tracheostomy was removed. if you develop shortness of breath, difficulty breathing, chest pain, dizziness, abdominal pain, irritation or discharge from the tracheostomy site or any other concerning symptom please contact your doctor or go to the emergency room. please follow up with the appointments below. please continue to take your medications as prescribed. followup instructions: follow up with your primary care physician . at in days after you are discharged from the hospital. md, procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours removal of tracheostomy tube diagnoses: acidosis obstructive sleep apnea (adult)(pediatric) unspecified essential hypertension other malignant lymphomas, unspecified site, extranodal and solid organ sites acute and chronic respiratory failure alkalosis long-term (current) use of insulin diabetes mellitus without mention of complication, type ii or unspecified type, uncontrolled other tracheostomy complications obstructive chronic bronchitis with acute bronchitis 

Answer: The patient is high likely exposed to