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: patient recorded as having no known allergies to drugs attending: chief complaint: ? vt arrest major surgical or invasive procedure: intubation history of present illness: mrs. is a very nice 76 year-old woman with history of cad s/p cabg x 4, recent in , schf (ef 25-30%), cafib, and htn who was found down at rehab with vt. per report, she was doing well at rehab until yesterday 8:15 pm when she was found minimally responsive in the toilet without signs of trauma. to minutes afterwards became unresponsive, without pulse and without breathing in front of nursing staff. they started cpr immediately and placed aed that shocked her twice (120 j and 150 j respectively). ems arrived and per their report she was in sinus rhythm with ventricular ectopy. she had a pulse and was breathing. she received 100 mg lidocaine iv bolus. she was transfered to . her initial bp was ~70/40 mmhg and no neurologic exam or is documented. she was intubated for "airway protection" with propofol, etomidate and succynilcoline and bp dropped afterwards and dopamine was started. . initial labs showed: k of 7.5, creatinine of 3.38, na 132, wbc of 15.9 with left shift, plt 246, ck 38, mb 2.3, tnt 0.05. other labs included: pt 14, inr 1.4, bun 66, ca 8.3, ast 52, alt 39, tp 5.3, albumin 2.9, globulin 2.4, ap 162. her ecg showed sinus rhythm with lbbb unchanged from prior here on . she received kayexalate, insulin, calcium gluconate and was transfered to the for further care. . in the bidmcs er vs were t 97.7, hr 81, bp 104/46, rr 19, spo2 100% on ac 450/5/50/rr?. per report she was moving l . in discussion with rn at rehab, she denies that patient has h/o of stroke, tia, deep venous thrombosis, pulmonary embolism, bleeding at the time of surgery, myalgias, joint pains, cough, hemoptysis, black stools or red stools. she further denies patient with complaints of recent fevers, chills or rigors, exertional buttock or calf pain. . cardiac review of systems rn is notable for absence of chest pain, dyspnea on exertion, paroxysmal nocturnal dyspnea, orthopnea, ankle edema, palpitations, syncope or presyncope. past medical history: past cardiovascular history: 1. cardiac risk factors: - diabetes, -dyslipidemia, +hypertension 2. cardiac history: -cabg: x4 with anatomy: lima-d, svg-lad, svg-pda, svg-om -percutaneous coronary interventions: none -pacing/icd: ppm 3. other past medical history: lmca had a 90% stenosis filling lad 100% at the origin lcx 100% at the origin rca 100% at the mid-vessel. svg-pda 100% occluded svg-lad patent filling anterograde and retrograde collaterals to pda and faintly to the omb lvg-omb was occluded proximaly lima-diagonal patent 60% stenosis of the left subclavian artery with a 10-15 mmhg gradient past medical history: cad s/p cabg x 4 in : marekdly positive stress c/w 3vd in and refused cath at that time. ef last year was >40%. chronic systolic heart failure ef 25-30% () /09 ppm: sensia sedr01. tachy-brady/complete heart block likely in the setting of . lead information chamber date implanted manufacturer model # fixation serial # (+) mitral regurgitation pulmonary hypertension chronic afib: not anticoagulated due to h/o gib that required multiple transfusions . chronic kidney disease: stage iii with egfr of 46 ml/min and baseline creatinine 1.2. pth target 35/70. htn asthma gout hypothyroidism social history: lives in with husband (step-father to daughters in ). no tobacco, etoh or illicit drug use. family history: brother with stroke, sister with cad s/p cabg, sister with angina physical exam: vital signs - temp 97.8 f, bp 140/90 mmhg, hr 85 bpm, rr 20 x', o2-sat 100% 50% general - -appearing woman, responsive to pain stimuli. heent - nc/at, perrla, pupils 3 mm, symetric and responsive to light, eomi, sclerae anicteric, mmm, op clear, conjunctiva were pink, no pallor or cyanosis of the oral mucosa. no xanthalesma. neck - supple, no thyromegaly, no jvd, no carotid bruits, rij in place lungs - cta bilat, no r/rh/wh, good air movement, resp unlabored, no accessory muscle use heart - pmi located in 5th intercostal space, midclavicular line. rrr, normal s1, s2. no m/r/g. no thrills, lifts. no s3 or s4. abdomen - nabs, soft/nt/nd, no masses or hsm, no rebound/guarding. abd aorta not enlarged by palpation. no abdominial bruits. extremities - wwp, no c/c/e, 2+ peripheral pulses (radials, dps), no c/c/e. no femoral bruits. skin - no rashes or lesions. no stasis dermatitis, ulcers, scars, or xanthomas. lymph - no cervical, axillary, or inguinal lad neurologic: mental status: awake and alert, cooperative with exam, normal affect. cranial nerves: pupils equally round and reactive to light, 4 to 2 mm bilaterally. non papilledema on fundoscopic exam. extraocular movements unable to assess. tone in muscles of neck normal. . cerebellum: unable to assess. . motor: normal bulk bilaterally. tone normal to increased symetric bilateraly. no observed myoclonus or tremor. no pronator drift. . sensation: unable to assess . reflexes: hyper-reflectic in right leg; otherwise symetric. toes downgoing bilaterally. . coordination: unable to assess. . gait: unable to assess.. pulses: right: carotid 2+ femoral 2+ popliteal 2+ dp 2+ pt 2+ left: carotid 2+ femoral 2+ popliteal 2+ dp 2+ pt 2+ pertinent results: cxr-ap (portable) : 1. mild volume overload without overt pulmonary edema. 2. et tube positioned 3.6 cm from the carina. . ct head w/out contrast : no acute intracranial hemorrhage. two small regions of hypodensity in the right frontal lobe, age indeterminate w/o prior study for comparison, but likely chronic infarct. . urine: blood-mod nitrite-pos protein-75 glucose-neg ketone-tr bilirub-neg urobiln-neg ph-5.0 leuks-tr rbc-* wbc-* bacteri-many yeast-none epi-0-2 hours-random urean-321 creat-155 na-25 cl-20 osmolal-334 . blood: wbc-18.0*# rbc-3.27* hgb-9.8* hct-31.4* mcv-96 mch-30.1 mchc-31.3 rdw-17.3* plt ct-289# neuts-82* bands-3 lymphs-3* monos-7 eos-2 baso-1 atyps-1* metas-1* myelos-0 pt-14.8* ptt-82.4* inr(pt)-1.3* glucose-131* urean-66* creat-3.3*# na-137 k-6.4* cl-109* hco3-18* angap-16 type-art po2-306* pco2-36 ph-7.29* caltco2-18* base xs--8 glucose-121* lactate-1.5 na-136 k-6.1* cl-108 calhco3-18* . ct head there is interval development of hypodense appearance of the cerebral parenchyma on the right side diffusely, in the right frontal, parietal and temporal lobes predominantly, with sulcal effacement and loss of -white matter differentiation. findings can relate to acute infarction or hypoxic/anoxic/ischemic injury evaluation of basal ganglia, brain stem and posterior fossa structures is limited, as also evidence for herniation. no acute gross hemorrhage is noted. study significantly limited due to artifacts from the electrodes. consider repeating after removal of electrodes, if appropriate and correlate clinically. evaluation for associated infection is limited kub an ng tube has been advanced, and is likely within distal stomach. there has been a decrease in distension of a loop of bowel within the mid abdomen, now measuring approximately 4.5 cm (previously 5.5 cm). this likely reflects a small bowel loop rather than colon. there is no free air or pneumatosis. impression: 1. interval improvement in a dilated loop of bowel in the mid abdomen, likely reflecting small bowel. 2. ng tube tip in distal stomach. brief hospital course: mrs. is a very nice 76 year-old woman with history of cad s/p cabg x 4, recent in , htn, schf (ef 25-30%) who had vt arrest in rehab. she was transferred to ccu, received arctic sun protocol but never regained cortical function. she passed on . # anoxic brain injury, r mca cva - patient never regained cortical function after neurologic insult prior to admission. eeg showed diffuse brain dysfunction. repeat cts showed massive cva. serial neuro exams were concerning for brain death. given prognosis, family communicated that patient would rather pass than "live as a vegetable". a decision was made to slowly withdraw care. roughly 20 family members were at the bedside in her final days. . #. vf/vt arrest - no strips, but aed fired twice, so most likely vf/vt arrest secondarely to ischemia after his . never clear how long she was pulseless. there was suggestion of focal neurologic deficits in ed, ct negative. artic sun protocol completed and repeat ct showed r mca cva. while her cardiac status was stable in a lbbb pattern, she had permanent and terminal damage . #. hypotension/septic shock - most likely in the setting of starting mechanical ventilation and with sedation. patient also dehydrated given diarrhea at rehab. had + u/a on admission. on rewarming, she required more pressors. ultimately, she had c. diff colitis complicated by sepsis and renal failure. she was on po vanc and iv flagyl until care was withdrawn . #. acute renal failure (atn) # acute on chronic kidney disease - patient with diarrhea at home, poor po intake on lisinopril and spironolactone who comes with worsening of the creatinine. she ultimately had anuric renal failure likely to sepsis and c diff . # complicated c diff colitis, - had diarrhea at rehab and after cooling was stopped, became septic and kub showed dilated bowel (likely small). patient was on po vanc and iv flagyl until care withdrawn . # peripheral vascular disease: patient admitted with dopplerable dorsalis pedis pulses. during septic shock, those pulses became undetectable. by the time of death, her feet were cyanotic and black on the toes. . # tophaceous gout: patient had severe, voluminous tophaceous gout on the feet, r > l medications on admission: spironolactone 25 mg tablet sig: one (1) tablet po daily (daily). aspirin 325 mg tablet sig: one (1) tablet po daily (daily). clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). atorvastatin 80 mg tablet sig: one (1) tablet po daily (daily). furosemide 40 mg tablet sig: one (1) tablet po every twelve (12) hours. lisinopril 5 mg tablet sig: 0.5 tablet po daily (daily). digoxin 125 mcg tablet sig: .5 tablet po daily (daily). metoprolol tartrate 25 mg tablet sig: 1.5 tablets po tid (3 times a day). levothyroxine 137 mcg tablet sig: one (1) tablet po daily (daily). allopurinol 300 mg tablet sig: 0.5 tablet po daily (daily). . ranitidine hcl 150 mg tablet sig: one (1) tablet po daily (daily). miconazole nitrate 2 % cream sig: one (1) appl topical (2 times a day) as needed for rash. nystatin 100,000 unit/ml suspension sig: five (5) ml po qid (4 times a day). camphor-menthol 0.5-0.5 % lotion sig: one (1) appl topical qid (4 times a day) as needed for itching. maalox 200-200-20 mg/5 ml suspension sig: 15-30 mls po qid (4 times a day) as needed for tongue sores. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) inhalation q6h (every 6 hours) as needed for sob. ipratropium bromide 0.02 % solution sig: one (1) inhalation q6h (every 6 hours). guaifenesin 100 mg/5 ml syrup sig: 5-10 mls po q6h (every 6 hours) as needed for cough. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for pain. discharge medications: deceased discharge disposition: expired discharge diagnosis: deceased discharge condition: deceased discharge instructions: deceased followup instructions: deceased procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more arterial catheterization diagnoses: acidosis hyperpotassemia coronary atherosclerosis of native coronary artery acute kidney failure with lesion of tubular necrosis urinary tract infection, site not specified congestive heart failure, unspecified unspecified septicemia severe sepsis unspecified acquired hypothyroidism coronary atherosclerosis of autologous vein bypass graft hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified gout, unspecified atrial fibrillation asthma, unspecified type, unspecified other chronic pulmonary heart diseases peripheral vascular disease, unspecified other specified forms of chronic ischemic heart disease chronic kidney disease, stage iii (moderate) cardiac arrest anoxic brain damage compression of vein septic shock intestinal infection due to clostridium difficile other left bundle branch block chronic systolic heart failure cardiac pacemaker in situ dehydration other and unspecified coagulation defects cerebral artery occlusion, unspecified with cerebral infarction subendocardial infarction, subsequent episode of care examination of participant in clinical trial chronic gouty arthropathy with tophus (tophi) 

Answer: The patient is high likely exposed to