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: history of present illness: the patient is a 61 year-old female with multiple medical problems including end stage renal disease on hemodialysis, congestive heart failure with an ef of 45 to 50%, coronary artery disease, hypertension and repeat admissions for congestive heart failure secondary to hypovolemia who presents with shortness of breath on the morning of admission. the patient reports a hard time sleeping on the night prior to admission and then at 5:00 a.m. developed dyspnea without chest pain, nausea, vomiting or diaphoresis or other symptoms. she denies fevers or chills, night sweats, dietary indiscretions, and noncompliance that would explain failure. she is typically dialyzed monday, wednesday and friday. her blood pressure in the emergency department was 210/100 and given intravenous hydralazine before being seen by the medicine team. past medical history: 1. end stage renal disease on hemodialysis. 2. type 2 diabetes. 3. congestive heart failure with an ef of 45 to 50% with mild regional left ventricular systolic dysfunction. 4. coronary artery disease with a stress mibi in , measured moderate distal anterior apical fixed perfusion deficits. 5. hypertension. 6. anemia. 7. gastroparesis. 8. right thalamic infarct in . allergies: reglan. medications on admission: 1. clonidine q sunday. 2. aspirin 81 q.d. 3. norvasc 10 q.d. 4. metoprolol 50 on monday, wednesday and friday. 5. lisinopril 40 q day. 6. atorvastatin 20 q.d. 7. protonix 40 q.d. 8. nitro patch .4 q 24. 9. insulin nph and sliding scale. social history: the patient lives in originally from . she denies tobacco and alcohol use. she has six children. family history: notable for diabetes. physical examination: on examination the patient's temperature was 99.5, pulse 85, blood pressure 198/72. respiratory rate 15. 98% on 4 liters. general, this is a somnolent woman in no acute distress. neck examination she had jvd to the angle of the jaw. lungs had decreased breath sounds bilaterally. there is bibasilar crackles. she was dull to percussion at the bases. heart examination regular rate and rhythm with occasional premature beats. no murmurs, rubs or gallops. abdomen was soft, nontender, nondistended. positive bowel sounds. extremities no clubbing, cyanosis or edema. laboratory: white blood cell count was 18.9 with 89% polys, hematocrit 29.1, platelets 265. her chem 7 she had a sodium of 138, potassium 4.3, chloride 90, bicarb 32, bun 42, creatinine 7.2, glucose 211. she had a ck of 99, troponin of .09. chest film she had bilateral pulmonary infiltrates, cardiomegaly consistent with congestive heart failure. hospital course: 1. later on the day of admission while being previously stable she developed significant hypoxia consistent with flash pulmonary edema. her blood pressure escalated to approximately 260/110 with crackles throughout her lung examination. she developed pink frothy sputum and sating at the mid 80s on 6 liters ultimately requiring a face mask and sating better. at this time there are several therapies undergone. she was given 80 mg of lasix with poor diuretic response. because the patient makes very little urine as well as started on a nitroglycerin drip to lower blood pressure. she was also given a total of 8 mg of morphine with significant improvement. after these symptoms began the intensive care unit team was called and the decision was made to put the patient on bipap and transferred to the intensive care unit. during this time she was still hypertensive and the patient was given intravenous metoprolol. ............ service who had earlier consulted on the patient was consulted again and they deferred emergent dialysis pending more medical management. after increase in the nitroglycerin drip the patient's blood pressure finally responded going under 180 to 190 with significant improvement in her symptoms and oxygen saturation at this point. she was transferred to the intensive care unit and given bipap overnight. over the next several days the patient underwent several rounds of hemodialysis with ultra filtration prior to that to take off more volume. the plan was to over the next week and in coming times to take off more fluid with dialysis likely having an ultra filtration prior to actually initiating hemodialysis. by discharge the patient was in much better respiratory shape with sating in the mid to high 90s on room air without any dyspnea. 2. hypertension: the patient presented with hypertensive emergency. she was started on metoprolol q.d. instead of three times a week and was discharged with toprol xl 50 due to heart failure. further cardiac workup was postponed for several reasons. for one she had a cardiac consult in , which suggested that her previous mibi scan was interpretable and further study would require an mri, which we did not have at this institution. in addition, the patient deferred cardiac catheterization and so further ischemic workup was not indicated. the clonidine patch, which she had been on admission was discontinued and was replaced with metoprolol. this was in the renal service who would like more room with her blood pressure to take off fluid during dialysis and ultra filtration. condition on discharge: stable. discharge status: to home. discharge medications: 1. aspirin 81 q.d. 2. lipitor 20 q.d. 3. amlodipine 10 q.d. 4. lisinopril 40 q.d. 5. protonix 40 q.d. 6. nitroglycerin tab prn. 7. toprol 50 q.d. discharge diagnoses: 1. hypertensive emergency. 2. congestive heart failure. 3. end stage renal disease. follow up plans: the patient will follow up with her outpatient nephrologist and her primary care physician within one week. she will have outpatient vna for physical therapy and other services. , m.d. dictated by: medquist36 procedure: hemodialysis diagnoses: pneumonia, organism unspecified nephritis and nephropathy, not specified as acute or chronic, in diseases classified elsewhere congestive heart failure, unspecified diabetes with neurological manifestations, type ii or unspecified type, not stated as uncontrolled polyneuropathy in diabetes hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease diastolic heart failure, unspecified diabetes with renal manifestations, type ii or unspecified type, not stated as uncontrolled diabetes with ophthalmic manifestations, type ii or unspecified type, not stated as uncontrolled 

Answer: The patient is high likely exposed to