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: penicillins / protonix / codeine / venomil honey bee venom / vicodin attending: chief complaint: hypotension major surgical or invasive procedure: none history of present illness: the patient is a 62y.o m with a pmh of htn, hyperlipidemia, aaa (4.4cm ), ras s/p l renal stent , pvd, ckd (baseline cr 2.0) admitted with hypotension. the patient presented with complaints of back pain starting 4 days ago while lifting something heavy. states that it radiated up his back and down his legs and was increased in severity as compared to his baseline. . on arrival to the ed vitals: t 98.3, hr 60, bp 76/48, rr 20 o2 97% on ra. he underwent fast which was negative for free fluid. cta demonstrated aaa and aortic ulcer in the ascending aorta. he was evaluated urgently by surgery and ct surgery who felt that no acute surgical intervention was needed. following cta iv bicarb was started for cr of 5.2. he was given 1.5l ns with continued hypotension to 70s. mentating well. now being admitted to micu for evaluation and management of hypotension past medical history: -htn -hyperlipidemia -aaa 4.7 cm (followed by dr. -renal artery stenosis s/p l stent in -pvd s/p pta to left leg -ckd (baseline creatinine 2.0) with 1 functioning kidney (right) followed by dr. /anxiety/ptsd -restless leg syndrome -tobacco use -back fusion surgery -osteoporosis social history: smokes ppd, 70 pack-year history. former heavy alcohol use ( whiskeys per day), reports quitting 2 yrs ago; **per wife, patient still drinks at least 2 martinis every evening**. denies any drug use. retired police officer. veteran. family history: no history of cardiac disease physical exam: vitals: t 98.7, bp 114/83, hr 91, rr 15, o2 90% 6l nc gen: alert, oriented x3, in apparent pain, uncomfortable in bed heent: dry mm cv: rrr, nl s1/s2, soft systolic murmur rusb resp: +bibasilar crackles abd: soft, nt/nd, nabs ext: no le edema skin: dry, warm well perfused pertinent results: 11:53pm glucose-77 urea n-58* creat-5.0* sodium-135 potassium-5.3* chloride-105 total co2-18* anion gap-17 11:53pm ck(cpk)-119 11:53pm ck-mb-5 ctropnt-0.02* 11:53pm calcium-7.4* phosphate-5.8* magnesium-2.3 11:53pm wbc-6.5 rbc-2.93* hgb-8.8* hct-27.6* mcv-94 mch-30.1 mchc-32.0 rdw-14.9 11:53pm neuts-82.5* lymphs-10.8* monos-3.5 eos-2.9 basos-0.3 11:53pm plt count-184 09:24pm urine hours-random urea n-324 creat-239 sodium-10 09:24pm urine osmolal-359 07:30pm urine blood-neg nitrite-neg protein-neg glucose-neg ketone-tr bilirubin-sm urobilngn-neg ph-6.5 leuk-neg 04:40pm lipase-15 04:40pm ctropnt-0.02* 03:01am blood wbc-4.4 rbc-2.78* hgb-8.2* hct-26.4* mcv-95 mch-29.5 mchc-31.1 rdw-15.6* plt ct-149* 03:03am blood neuts-70.7* lymphs-19.2 monos-4.5 eos-5.4* baso-0.2 03:01am blood plt ct-149* 03:01am blood glucose-80 urean-37* creat-2.9* na-141 k-4.6 cl-110* hco3-23 angap-13 03:03am blood alt-12 ast-14 ld(ldh)-151 alkphos-103 totbili-0.4 03:03am blood ctropnt-0.03* 03:01am blood totprot-5.5* albumin-3.3* globuln-2.2 phos-3.6 mg-1.9 04:51am blood lactate-0.7 renal ultrasound 1. small atrophic right kidney, which is unchanged. 2. the left kidney is of good size, and while the resistive indices are high, the upstroke of the systolic waveform for the left renal artery appears good, indicating that the stent is patent. 3. the abdominal aorta cannot be assessed due to patient's raised body mass index. 06:55am blood wbc-5.2 rbc-2.94* hgb-8.4* hct-27.6* mcv-94 mch-28.7 mchc-30.5* rdw-14.9 plt ct-193 06:55am blood glucose-84 urean-17 creat-2.2* na-145 k-4.8 cl-113* hco3-21* angap-16 brief hospital course: # hypotension-the patient had no evidence of aortic dissection on cta. initial exam demonstrated a cvp of 20, warm extremities with good capillary refill. ce and ekg without evidence of acute ischemia.no evidence of fever or leukocytosis with sbps to 110's. patient had recent change in medications with increase in home labetalol a few days before presentation thought to be etiology hypotension. required levophed given maps to high 40s. despite hypotension patient has maintained good urine output, mental status and warm extremities. hypotension resolved off home antihypertensives. after normalization of his blood pressures in the micu, he was transferred to a general medical floor, shortly after transfer patient again became hypertensive, his blood pressure medications were slowly restarted. initially started on labetalol 100mg , and after his renal function returned to his baseline, his valsartan was also restarted, initially at 40mg, with the goal of uptitration as an outpatient. with restarting his prior anti-hypertensives at lower doses, patient's blood pressure was not at goal, as a result he was also started on amlodipine 10mg daily. . # acute renal failure - cr up to 5.2 on admission, 2.9 on transfer out of micu. etiology: prerenal vs poor perfusion leading to atn. pt got cta with contrast (and bicarb), but too early post contrast load to account for arf. renal consulted and raised question of cholesterol emboli from severely atherosclerotic aorta to kidneys, thus c3/c4 ordered. c3 wnl, c4 wnl. nephrotoxic home medications held. after discharge from the micu his renal function continued to improve, with it down to 2.2 at the time of discharge, with the etiology of his renal function contributed to hypoperfusion due to hypotension leading to atn. . # aaa/aortic ulceration - stable per cta. surgery following. ct surgery signed off. plan to keep bp goals normotensive but low. will follow up as outpatient in 3 months with mri. . # chronic low back pain secondary to compression fractures. back pain was inciting event bringing patient to hospital, concern on arrival for aortic dissection. no dissection by ct. close monitoring for changes in pain inhouse. good pain control currently with lidocaine patch, and outpatient oxycodone regimen at the time of discharge. . # anemia - hct down slightly to 30 from 27.6 on admission,36.7 on dc from micu. no evidence of bleeding. given hx aaa, hct checks have been q12 while in the micu, all stools guiaced with plan for transfusion for hct<21, and recommendation to contact stat for hct drop. patient's hct remained stable while in the hospital, with no signs of bleeding. . # anxiety/depression-remained stable on his outpatient regimen while in the hospital medications on admission: calcitriol 0.25 mcg capsule 6 times per week folic acid 1 mg tablet daily furosemide 20 mg tablet qam gabapentin 300 mg capsule qhs labetalol 400 mg tablet tid lorazepam 0.5 mg tablet qhs oxycodone 5 mg tablet tablet(s) by mouth q4 prn pramipexole 0.5 mg tablet qhs sertraline 100 mg tablet 2 tablet(s) by mouth every day simvastatin 40 mg tablet 2 tablet(s) by mouth daily valsartan 160 mg tablet daily zolpidem 10 mg tablet qhs aspirin 81 mg tablet daily docusate sodium ferrous sulfate 325 mg (65 mg iron) daily thiamine hcl 100 mg tablet daily discharge medications: 1. calcitriol 0.25 mcg capsule sig: one (1) capsule po 6x/week (mo,tu,we,th,fr,sa). 2. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 3. simvastatin 40 mg tablet sig: two (2) tablet po daily (daily). 4. ferrous sulfate 325 mg (65 mg iron) tablet sig: one (1) tablet po daily (daily). 5. thiamine hcl 100 mg tablet sig: one (1) tablet po daily (daily). 6. sertraline 100 mg tablet sig: two (2) tablet po daily (daily). 7. lidocaine 5 %(700 mg/patch) adhesive patch, medicated sig: one (1) adhesive patch, medicated topical q24h (every 24 hours). disp:*30 adhesive patch, medicated(s)* refills:*0* 8. zolpidem 5 mg tablet sig: two (2) tablet po hs (at bedtime). 9. lorazepam 0.5 mg tablet sig: one (1) tablet po hs (at bedtime). 10. gabapentin 300 mg capsule sig: one (1) capsule po hs (at bedtime). 11. pramipexole 0.25 mg tablet sig: two (2) tablet po qhs (once a day (at bedtime)) as needed for rls. 12. labetalol 100 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*1* 13. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 14. amlodipine 10 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*0* 15. diovan 40 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*1* discharge disposition: home discharge diagnosis: 1. hypotension 2. acute renal failure from hypoperfusion discharge condition: at the time of discharge patient was tolerating his current blood pressure regimen without difficulty but with blood pressures above goal at 135/98, was ambulating and tolerating oral intake without difficulty and considered medically stable for discharge. discharge instructions: you initially presented to for evaluation of lower back pain, and you were also found to be hypotensive (had low blood pressure) and acute renal failure with a creatinine of 5.2. there was initial concern about a possible enlargement of your abdominal aortic aneurysm, so at ct with contrast was done which showed that your abdominal aortic aneurysm was stable. you were admitted to the micu for management of your hypotension and kidney failure, it was thought that your low blood pressure was due to, too many anti-hypertensive medications and your kidney failure was the result of poor perfusion due to your low blood pressure. after your blood pressure stabilized you were sent out of the icu and to the general medical floor, at which time your blood pressure had risen and you were hypertensive. your labetalol was restarted but at a much lower dose, as was your diovan but at a lower dose and you were started on a new medication-amlodipine. changes made to your outpatient medication regimen: 1. labetalol 100mg twice a day 2. diovan 40mg daily 3. amlodipine 10mg daily please call your doctor or return to the hospital if you experience any chest pain, shortness of breath, headache, changes in your urine output or any other concerning symptoms. followup instructions: follow up with dr (ct surgery) in 3 months and mri in 3 months to evaluate aorta - please contact office after discharge - follow up with dr (ct surgery) in 3 months and mri in 3 months to evaluate aorta - please contact office after discharge - provider: , md phone: date/time: 2:10 provider: , m.d. phone: date/time: 11:30 provider: mri phone: date/time: 10:30 procedure: venous catheterization, not elsewhere classified diagnoses: acidosis hyperpotassemia other iatrogenic hypotension other chronic pain tobacco use disorder acute kidney failure with lesion of tubular necrosis chronic airway obstruction, not elsewhere classified chronic kidney disease, stage iv (severe) hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified aortocoronary bypass status peripheral vascular disease, unspecified dysthymic disorder atherosclerosis of renal artery osteoporosis, unspecified other antihypertensive agents causing adverse effects in therapeutic use hypoxemia lumbago restless legs syndrome (rls) thoracoabdominal aneurysm, without mention of rupture 

Answer: The patient is high likely exposed to