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: ampicillin attending: chief complaint: syncope/st elevations major surgical or invasive procedure: intubation history of present illness: this patient is a 69 y/o f with remote history of mitral prolapse and regurgitation, gastric ulcer (no recent bleeding), anxiety disorder, smoking history s/p orif of wrist yesterday who presents with lethargy and syncope found to have 1mm st elevations of v2v3 and trop i of 1.99. the patient has had poor balance recently per family, and tripped, fell and broke her wrist ~10 days ago. she went for orif at yesterday . in the interim, she had not been taking much po, taking sips only. also, since the operation, she has been persistently lethargic with nausea/vomiting, and difficulty standing. she has been taking po narcotics for pain control. the patient had an episode of syncope today. patient's family reports that she had about 30 seconds of loss of conciousness. per report by ed attending, intraop yesterday she recieved a little fentanyl, propranolol, isoflourine, no, cevoflourine, and midazolam. got 1.5 l ns. at ed, the patient denied chest pain, shortness of breath, palpatations. she was not mentating that well and persistently lethargic. her ekg was notable for v2v3 1mm st elevations that looked different than on the preop ekg. her labs were notable for ckmb 20.7, ck 826, trop i 1.99, creatinine 3.7. she recieved asa 325mg, plavix, levoflox 500mg iv, lasix 40mg iv, 2l ns, heparin 5000u iv, then 800u an hour, 6mg morphine iv, narcan 0.4. renal and ruq u/s were normal. hr 70s, 104/70, sytolics 120-130 with fluids. she was transferred here for treatment of acs. an abg was obtained 7.2/63/62/24, given the hypercarbia, hypoxia and altered mental status, she was intubated prior to transfer. on arrival to the floor, the patient was intubated and sedated. ros unable to be obtained. per family, the patient denied any chest pain or pressure, new exertional dyspnea, orthopnea, pnd or leg edema, palpitations or syncope, claudication-type symptoms, melena, rectal bleeding, or transient neurologic deficits. no change in weight, bowel habit or urinary symptoms. no cough, fever, night sweats, arthralgias, myalgias, headache or rash. all other review of systems negative. past medical history: anxiety gastric ulcer mitral prolapse social history: smokes tob ppd, retired, no etoh use. family history: father with dm, brother with mi/cva, other brother with heart disease, mother died of lung ca. physical exam: general: thin female, intubated and sedated, does not respond to commands. heent: ncat. sclera anicteric. perrl. ett in place. neck: supple with no discernible jvd. cardiac: rrr, normal s1, s2. no m/r/g. lungs: no chest wall deformities, scoliosis or kyphosis. ctab, no crackles, wheezes or rhonchi. abdomen: nabs. scaphoid. soft, ntnd. no hsm or tenderness. extremities: no edema. wwp. 2+ pt and dp pulses. rue with forearm cast. 4 sec cap refill bilat hands. r hand with dusky discoloration skin: no stasis dermatitis, ulcers, scars, or xanthomas. pertinent results: admission labs 08:35pm blood wbc-6.7 rbc-2.91* hgb-10.2* hct-29.9* mcv-102* mch-34.9* mchc-34.1 rdw-13.0 plt ct-253 08:35pm blood pt-21.0* ptt-150* inr(pt)-2.0* 08:35pm blood glucose-98 urean-33* creat-2.9* na-134 k-5.4* cl-101 hco3-23 angap-15 08:35pm blood alt-762* ast-1127* ld(ldh)-1812* alkphos-102 totbili-0.5 08:35pm blood ck-mb-21* ctropnt-0.49* 08:35pm blood albumin-3.4 calcium-7.3* phos-5.6* mg-1.8 iron-77 cholest-108 08:35pm blood caltibc-299 vitb12-1688* folate-greater th ferritn-1359* trf-230 08:35pm blood triglyc-53 hdl-51 chol/hd-2.1 ldlcalc-46 09:15pm blood type-art temp-37.7 rates-14/ tidal v-480 peep-5 fio2-50 po2-134* pco2-60* ph-7.25* caltco2-28 base xs--1 -assist/con intubat-intubated 09:15pm blood lactate-1.0 other lab data 09:24am blood type-art temp-37.2 rates-/27 tidal v-300 peep-0 fio2-30 po2-68* pco2-63* ph-7.23* caltco2-28 base xs--2 intubat-intubated vent-spontaneou 09:16pm blood type-art po2-53* pco2-48* ph-7.34* caltco2-27 base xs-0 08:35pm blood hcv ab-negative 08:35pm blood acetmnp-8.1 08:35pm blood hbsag-negative hbsab-negative hbcab-negative hav ab-negative 08:35pm blood triglyc-53 hdl-51 chol/hd-2.1 ldlcalc-46 04:37am blood albumin-3.1* calcium-8.1* phos-2.7 mg-1.7 03:18am blood ck-mb-17* mb indx-1.7 ctropnt-0.52* 05:33pm blood ck-mb-13* mb indx-1.5 04:37am blood ck-mb-8 03:18am blood alt-800* ast-1164* ck(cpk)-1013* 05:33pm blood alt-747* ast-815* ck(cpk)-891* alkphos-128* totbili-0.5 04:37am blood alt-591* ast-564* ld(ldh)-401* ck(cpk)-532* alkphos-116 totbili-0.5 04:37am blood pt-17.1* ptt-60.0* inr(pt)-1.5* 05:12am blood wbc-7.1 rbc-3.17* hgb-11.1* hct-31.3* mcv-99* mch-35.1* mchc-35.5* rdw-13.5 plt ct-274 05:33pm urine hours-random urean-702 creat-121 na-17 05:55am blood glucose-91 urean-22* creat-0.8 na-138 k-3.6 cl-100 hco3-30 angap-12 05:12am blood alt-456* ast-155* ld(ldh)-286* alkphos-110 totbili-0.7 micro: none reports/imaging tte the left atrium is normal in size. no atrial septal defect is seen by 2d or color doppler. the estimated right atrial pressure is 10-15mmhg. left ventricular wall thickness, cavity size and regional/global systolic function are normal (lvef >55%). there is no ventricular septal defect. right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. no aortic regurgitation is seen. the mitral valve appears structurally normal with trivial mitral regurgitation. there is no mitral valve prolapse. the left ventricular inflow pattern suggests impaired relaxation. there is mild pulmonary artery systolic hypertension. there is no pericardial effusion. cxr : et tube is 1.4 cm above the carina. it can be withdrawn 2 cm for standard position. ng tube tip is in the stomach but the sideport is at the level of the eg junction and should be advance for standard position. biapical pleural parenchymal scarring is greater on the right side and associated with upper deviation of the right hilum. the lower lungs are hyperinflated. there is no evidence of chf. there is no pleural effusion or pneumothorax. impression: lines and tubes are as described. evidence of old granulomatous infection. ecg sinus rhythm. non-specific st-t wave changes. no previous tracing available for comparison. renal us impression: 1. normal right renal waveforms. 2. patient could no longer tolerate exam; no dopplers on the left obtained. brief hospital course: 1. syncope/demand ischemia: patient denied cp at osh, ekg had mild st elevations in v2 and v3, but not enough to qualify as a stemi. she was initially started on asa, clopidogrel, statin, metoprolol, heparin iv. however, her presentation with lethargy and syncope was not suggestive of acs, and she has little known cardiac history and normal lipids. therefore, these symptoms may have been multifactorial from recent sedatives and hypovolemia. the above meds were stopped, except for asa and metoprolol. she was volume resuscitated with ivf and remained asymptomatic. her trop and ck-mb were mildly elevated, suggesting demand ischemia. her ck-mb has since trended down. tte showed preserve pump function. 2. respiratory failure: patient has long smoking history, abgs, physical exam, and cxr consistent with copd although no previous diagnosis or pfts available to confirm. given her shortness of breath, occasional wheezing, and dry cough, she was treated for a copd exacerbation with prednisone (complete), azithromycin (last day ), and nebs. symptoms have all improved. 3. acute renal failure - renal us at osh showed no obstruction. urine lytes were consistent with prerenal etiology from poor oral intake, and renal function normalized rapidly with iv fluids. patient was encouraged to continue po intake, although speech and swallow expressed concern regarding her lack of desire to eat or drink. a nutritional evaluation would likely be useful, and could also consider social work or psyhciatric evaluation for patient's apparent lack of concern regarding nutrition. 4. transaminitis: likely ischemic given profound elevation. hepatitis serologies and tylenol level negative. lfts trended down since admission. 5. anemia: uncertain baseline, currently with hct of ~30. macryocytic, with normal rdw. b12 and folate normal, and iron studies nonspecific, but may suggest anemia of chronic disease. remained stable during admission. 6. hypertension: initially hypertensive, but achieved good bp control on metoprolol, lisinopril, amlodipine. can uptitrate further if needed. 7. s/p orif: rue casted, neurovascular status intact. no pain complaints. medications on admission: alprazolam citalopram tagemet discharge medications: 1. aspirin 81 mg tablet sig: one (1) tablet po once a day. 2. citalopram 20 mg tablet sig: one (1) tablet po daily (daily). 3. alprazolam 0.25 mg tablet sig: 1-2 tablets po tid (3 times a day) as needed for anxiety. 4. ranitidine hcl 150 mg tablet sig: one (1) tablet po twice a day. 5. metoprolol tartrate 25 mg tablet sig: one (1) tablet po tid (3 times a day). 6. azithromycin 250 mg tablet sig: one (1) tablet po once a day for 1 days: last day . 7. amlodipine 5 mg tablet sig: two (2) tablet po daily (daily). 8. lisinopril 20 mg tablet sig: one (1) tablet po daily (daily). 9. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) inhalation every four (4) hours as needed for shortness of breath or wheezing. 10. ipratropium bromide 0.02 % solution sig: one (1) inhalation every six (6) hours as needed for shortness of breath or wheezing. discharge disposition: extended care facility: health care center discharge diagnosis: primary diagnosis: 1. dehydration 2. acute renal failure 3. hypertension 4. chronic obstructive pulmonary disease (presumptive diagnosis) exacerbation discharge condition: stable discharge instructions: you were admitted to the hospital with loss of consciousness. this was likely due to dehydration and fatigue from medications you received during your wrist procedure and poor fluid intake. we checked your heart pump function, which did not seem to be affected by this episode. you had some high blood pressure, which was well controlled with medication. we also treated a flare of worsening lung function with steroids and antibiotics. please take all of your medications as prescribed. we have made the following changes to your medications: - started a baby (81mg) aspirin for heart protection. - started metoprolol, lisinopril, and amlodipine for your blood pressure. - you have one more day of azithromycin, an antibiotic to treat a lung infection. - changed cimetidine to ranitidine, a different acid blocking medication that is less likely to interact with other medications. as we discussed, quitting smoking is the most important thing you can do for your health. please discuss this with your primary care physician at follow up. please seek immediate medical care if you develop fevers, shaking chills, night sweats, chest pain, shortness of breath, lower extremity swelling, light-headedness, dizziness, or lose consciousness. followup instructions: please follow up with the physician at your rehab facility. we were unable to make an appointment before discharge, but you should also follow up with your primary doctor, : (. procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours insertion of endotracheal tube diagnoses: subendocardial infarction, initial episode of care anemia, unspecified mitral valve disorders acute kidney failure, unspecified obstructive chronic bronchitis with (acute) exacerbation acute respiratory failure dehydration aftercare for healing traumatic fracture of other bone chronic gastric ulcer without mention of hemorrhage or perforation, without mention of obstruction 

Answer: The patient is high likely exposed to