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: aspirin / nsaids attending: chief complaint: hypoxia s/p elective ercp major surgical or invasive procedure: ercp history of present illness: this is a 75 yo f with a past medical history significant for copd, chf, cad s/p cabg, cva, who became increasingly hypoxic and tachypneic following an elective ercp today. the patient was recently admitted to an osh with cholangitis, treated and sent to in with this ercp scheduled electively. . on the last admission in , the patient reportedly had cholangitis induced sepsis. she underwent an ercp at that time and had a stent placed in the cbd. she was treated with antibiotics and volume resuscitation and discharged to with a scheduled follow up ercp when the patient had stabilized. . from the ercp periprocedure notes, the patient arrived today satting 88% on 4l by nc. she was intubated for the procedure and received a total of 400cc lr during the procedure and 500cc of fluid in the pacu. she then gradually became more tachypneic to 20-25 and desatted to 88% on 4l, which increased to the low 90's on 6l. she was given a nebulizer and a micu eval was requested. . on initial evaluation, the patient was slightly tachypneic, satting 89-91% on 6l by facemask. an abg and cxr were requested and given the patient's history of chf and the fact that she takes daily lasix and received almost 1l of fluid in several hours, a dose of 40mg iv lasix was suggested as well. . a foley was placed and lasix administered, which the patient responded to promptly, with improvement of her symptoms. cxr was confirmatory for diffuse perihilar infiltrates characteristic of pulmonary edema. anesthesia placed an a-line and then obtained an abg which was 7.30/66/93 and after several hundred cc's of diuresis, it improved to 7.34/63/98 (on 6l facemask). she was then transferred to the for further management. past medical history: copd cad s/p cabg, s/p mi chf (reported ef=50%) htn s/p cva, on coumadin - residual l hemiparesis recent history of cholangitis s/p ercp in with gallstones identified; reportedly was septic at this time. hyperlipidemia hx of psychosis gerd, pud hypothyroidism 5cm aaa s/p r hip replacement paget's ds depression, anxiety constipation diverticulosis dementia family history: nc physical exam: vitals: t 96.2 hr 101 bp 157/67 r 18 sat 88-96% on facemask with nasal airway in place general: elderly female, asleep, drowsy, nad heent: at/nc, perrl, op clear. mmm neck: jvp elevated to earlobes chest: rrr lungs: decreased lung volumes with dependent rales abd: obese, soft nt/nd +bs ext: no e/c/c neuro: unable to do full neuro exam as patient is extremely sleepy. dtr's in tact bilaterally. skin: wwp. pertinent results: 09:30am wbc-5.3 rbc-3.67* hgb-11.3* hct-32.6* mcv-89 mch-30.7 mchc-34.6 rdw-18.2* 09:30am plt count-306 09:30am pt-13.2* ptt-27.3 inr(pt)-1.2* 06:38pm glucose-126* urea n-35* creat-1.5* sodium-146* potassium-4.3 chloride-103 total co2-34* anion gap-13 06:38pm alt(sgpt)-12 ast(sgot)-20 ld(ldh)-342* ck(cpk)-88 alk phos-88 tot bili-0.4 06:38pm ck-mb-6 ctropnt-0.08* 06:43pm lactate-0.8 11:15pm ck-mb-6 ctropnt-0.08* . : cxr: impression: 1. left lower lobe opacity, suspicious for pneumonic consolidation. 2. congestive heart failure. . ercp report : 1. stent in the major papilla which was removed. 2. stones in the biliary tree 3. cholagiogram showed the presence of 2 stones in the distal cbd. 4. balloon sweeps were done to remove the stones. 5. a sphincterotomy was performed in the 12 o'clock position using a sphincterotome over an existing guidewire. . brief hospital course: 75 yo f with acute hypoxia and tachypnea following elective ercp, due to volume overload, exacerbated by sleep apnea. . 1. respiratory distress: given her improved cxr and clinical picture post-diuresis, it appeared that the primary cause of respiratory distress was likely fluid overload, and most likely, given that her sats were already decreased pre-procedure, that she was already volume overloaded before even receiving the additional liter of fluid pre-procedure. she was successfully diuresed about 3l with noticeable improvement in pulmonary status. cardiac enzymes were negative x 3. of note, the patient has multiple apneic episodes with significant desaturations while sleeping highly suggestive of osa / central sleep apnea. blood gas analysis suggests improvement of respiratory acidosis with bipap 10/5/5l, likely chronic compensatory metabolic alkalosis. by the time she was transferred out to the floor, she was on her baseline o2 requirement of 2l by nc, and tolerating bipap at night well. on the floor the patient had one episode of oxygen desaturation to the 70s which resolved with increasing oxygen via nasal canula to 5l. a cxr was obtained at that time which showed prominent pulmonary edema. the patient's diuretic regimen was increased to 40mg po bid however her serum creatinine continued to rise and her lasix was held. her oxygen saturation however has remained stable at her baseline requiring 2liters nasal canula to maintain oxygen saturation at 92-94%. we have restarted her lasix at a lower dose of 20mg daily. she has continued on her prior copd regimen of spiriva, low dose prednisone and nebs prn. 2. s/p ercp - patient is stable from an ercp perspective with successful removal of stone from cbd and subsequent sphincterotomy. lfts trended down and normalized by . she will only need outpatient gi follow up with dr. if she develops new abdominal symptoms or has recurrent evidence of obstruction. 3. cardiac ischemia - known cad s/p mi, cabg. no evidence of ischemia on ekg, enzymes negative. her bp meds were initially held after she was transferred to the icu however the isosorbide was added back upon transfer to the floor. the patient remained chest pain free during the entire hospitalization. given her history of cad, a lipid panel was obtained showing evidence of hypercholesterolemia with a cholesterol total of 259, ldl 158, and triglycerides 250. she was started on lipitor 20mg po daily and will need to have her lfts monitored in the future. we have added back her lopressor at a lower dose of 12.5mg po twice daily which can be titrated as needed. 5. arf - unclear baseline creatinine, prior cr of 1.5 suggesting likely ckd at baseline. as discussed above, her creatinine rose to a maximum of 2.6 and we felt this was likely attributed to lower bp (systolics in the 110s) in combination with diuresis. on the day of discharge her serum creatinine is 1.7. there were no electrolyte abnormalities during this hospitalization. she will need future monitoring of her renal function while at rehab. we suggest checking a complete metabolic panel on . 6. s/p cva - coumadin held for ercp -resuming coumadin at prior dose of 5mg po daily. she will need follow up with her pcp and neurologist regarding goals of care. she is currently subtherapeutic and will need continued coagulation panels. she is not a candidate for lovenox given her renal function and it was felt that the risks outweighed the benefits for starting her on iv heparin at this time. this was discussed with the patient's daughter who serves as the health-proxy. . 7. depression, anxiety, ?psychosis - continue ritalin, lexapro - continue to hold all sedating meds . 7. fen: low sodium diet, heart healthy, puree diet. continue to monitor electrolytes. . 8. ppx: heparin subcut, bowel reg, ppi was administered while she was an inpatient. medications on admission: tylenol prn bisacodyl mom nitroglycerin prn compazine colace k-dur isosorbide dinitrate advair albuterol spiriva reglan ativan prn vicodin prn amlodipine zyprexa mvi prednisone 2.5mg qdaily coumadin 5mg qhs (on hold for procedure) ritalin 10mg lasix 20mg metoprolol 25mg lexapro 20mg discharge medications: 1. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed. 2. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed. 3. nitroglycerin 0.3 mg tablet, sublingual sig: one (1) tablet, sublingual sublingual prn (as needed). 4. docusate sodium 100 mg capsule sig: two (2) capsule po daily (daily). 5. prednisone 2.5 mg tablet sig: one (1) tablet po daily (daily). 6. methylphenidate 10 mg tablet sig: one (1) tablet po bid (2 times a day). 7. escitalopram 10 mg tablet sig: two (2) tablet po daily (daily). 8. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day). 9. albuterol sulfate 0.083 % (0.83 mg/ml) solution sig: one (1) inhalation q6h (every 6 hours) as needed for wheezing. 10. ipratropium bromide 0.02 % solution sig: one (1) inhalation q6h (every 6 hours) as needed for wheezing. 11. albuterol 90 mcg/actuation aerosol sig: 1-2 puffs inhalation q4h (every 4 hours). 12. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 13. tiotropium bromide 18 mcg capsule, w/inhalation device sig: one (1) cap inhalation daily (daily). 14. isosorbide dinitrate 20 mg tablet sig: one (1) tablet po tid (3 times a day). 15. miconazole nitrate 2 % powder sig: one (1) appl topical tid (3 times a day). 16. ciprofloxacin 500 mg tablet sig: one (1) tablet po q24h (every 24 hours) for 3 days. 17. thiamine hcl 100 mg tablet sig: one (1) tablet po daily (daily). 18. atorvastatin 20 mg tablet sig: one (1) tablet po daily (daily). discharge disposition: extended care facility: care center - discharge diagnosis: respiratory failure acute renal failure altered mental status secondary diagnoisis: chronic obstructive pulmonary disease coronary artery disease dyslipidemia stroke discharge condition: stable discharge instructions: patient should continue on 2l nasal canula titrated to keep oxygen saturation between 90-92% given her co2 retention. she will require daily monitoring of her serum creatinine while her lasix dose is titrated back to her baseline. followup instructions: she should follow up with her pcp , , in weeks. she should also follow up with her neurologist in 6 weeks time. procedure: endoscopic removal of stone(s) from biliary tract endoscopic sphincterotomy and papillotomy non-invasive mechanical ventilation removal of t-tube, other bile duct tube, or liver tube diagnoses: obstructive sleep apnea (adult)(pediatric) urinary tract infection, site not specified congestive heart failure, unspecified long-term (current) use of steroids acute kidney failure, unspecified unspecified acquired hypothyroidism chronic airway obstruction, not elsewhere classified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified coronary atherosclerosis of unspecified type of vessel, native or graft aortocoronary bypass status depressive disorder, not elsewhere classified other persistent mental disorders due to conditions classified elsewhere chronic kidney disease, unspecified systolic heart failure, unspecified other and unspecified hyperlipidemia hypotension, unspecified long-term (current) use of anticoagulants abdominal aneurysm without mention of rupture urinary complications, not elsewhere classified osteitis deformans without mention of bone tumor late effects of cerebrovascular disease, aphasia hip joint replacement calculus of bile duct without mention of cholecystitis, without mention of obstruction mixed acid-base balance disorder 

Answer: The patient is high likely exposed to