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: hyperkalemia major surgical or invasive procedure: none history of present illness: history of present illness: pt is 34 yo m w/ pmh of esrd on hd, poorly controlled htn who presented to the ed w/ a complaint of chest pain. according to the pt, he awoke this afternoon with substernal chest pain, without radiation, consistent w/ previous episodes that he had in the past. the pt took 4 sublingal ng and presented to the ed where he was found to be hyperkalemic to 8.1, with ecg changes. in the ed the pt was chest pain free, and subsequently had an episode of monomorphic vtach, with pulse, confirmed by ecg. the patient maintained pulse through the entire episode and he was given 2 rounds of insulin 10u iv, 1 amp d50, along with 2 amps bicarbonate and 2 amps ca gluconate. . initial vitals in the ed were t 98, bp 127/72, hr 55, 100% ra. vitals after intervention were t 98.6 p 70 bp 136/83 r 14 o2 99% sat. at the time of interview pt was undergoing hemodialysis, somnolent and arousable but uncooperative with interview, so information has been obtained from prior notes. . upon arrival to the floor, pt's vitals were t 98.4 hr 79 bp 144/91 rr 13 o2 sat 100% ra. . review of systems: unable to be obtained, as pt somnolent and uncooperative with interview past medical history: - htn dx in at age 28 (in jail), urgency in , lost to follow up and then presented with n/v in renal failure in . - esrd secondary to htn - started on mwf dialysis in - left brachiocephalic avf placed in (after permacaths) - h/o medication non-compliance - h/o substance abuse - h/o right internal jugular vein thrombus associated with hd catheter - h/o pulmonary edema in the setting of hypertensive urgency - h/o intubation in the setting of hypertensive urgency/flash pulmonary edema - dyslipidemia on statin - s/p appendectomy with emergent ex-lap for post-op leak/abcess - multiple admissiona and ed visits for chest pain social history: he used to work as a plasterer, but is now on disability. mother died 4 months ago. tobacco: 1ppd x 20 years, currently 3 cigarettes a day. etoh/drugs: denies recent alcohol, cocaine and marijuana use. family history: there is no family history of premature coronary artery disease or sudden death. father - died at age 36 from unknown cancer mother - died at age 58 of mi, had htn maternal grandmother - on hemodialysis for end-stage renal disease. physical exam: admission vitals: t: 98.4 bp: 144/91 p: 79 r: 13 o2: 100 ra general: somnolent but arousable, oriented, no acute distress, currently receiving dialysis and uncooperative with interview and exam heent: sclera anicteric, mmm, oropharynx clear neck: supple, jvp not elevated, no lad lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema discharge vitals: 98.0, 140/88, 60, 11, 95%ra general: pleasant, nad, aao3 heent: sclera anicteric, mmm, oropharynx clear neck: supple, jvp not elevated, no lad lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops, enlarged/nondisplaced pmi abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly. fem line site ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema pertinent results: admission plt count-217 neuts-73.7* lymphs-17.5* monos-6.8 eos-1.2 basos-0.8 wbc-6.6 rbc-4.48*# hgb-12.6*# hct-39.9*# mcv-89 mch-28.1 mchc-31.5 rdw-17.3* calcium-8.6 phosphate-8.3*# magnesium-2.2 ck-mb-8 ctropnt-0.11* ck(cpk)-884* estgfr-using this glucose-55* urea n-46* creat-10.7*# sodium-139 potassium-8.1* chloride-91* total co2-22 anion gap-34* glucose-58* lactate-2.8* na+-138 k+-9.1* cl--86* tco2-30 top pt-12.9 ptt-28.8 inr(pt)-1.1 plt count-206 neuts-77.5* lymphs-17.1* monos-4.8 eos-0.2 basos-0.4 wbc-5.8 rbc-4.11* hgb-11.3* hct-35.3* mcv-86 mch-27.5 mchc-31.9 rdw-17.2* glucose-134* urea n-48* creat-10.6* sodium-143 potassium-4.4 chloride-91* total co2-30 anion gap-26* lactate-2.2* k+-4.2 glucose-172* k+-4.5 subsequent labs 06:28am blood wbc-6.1 rbc-4.04* hgb-10.9* hct-35.3* mcv-88 mch-27.0 mchc-30.9* rdw-17.2* plt ct-200 06:28am blood pt-12.7 ptt-29.7 inr(pt)-1.1 06:28am blood glucose-139* urean-17 creat-6.0*# na-141 k-4.3 cl-93* hco3-35* angap-17 09:05am blood k-4.3 04:25am blood k-3.9 08:00pm blood glucose-134* urean-48* creat-10.6* na-143 k-4.4 cl-91* hco3-30 angap-26* 07:00pm blood ctropnt-0.11* 09:05am blood ck-mb-pnd ctropnt-pnd 09:05am blood ck(cpk)-pnd 06:28am blood calcium-8.5 phos-5.7*# mg-1.6 cxr 9/3/9 the lungs are clear without consolidation or edema. the mediastinum is unremarkable. the cardiac silhouette is top normal for size with a left ventricular configuration. no effusion or pneumothorax is noted. a large rim calcified structure again projects within the right upper quadrant, stable across multiple prior studies. no effusion or pneumothorax is seen. a healed posterior left rib fracture is incidentally noted. brief hospital course: summary this is a 34 yo m w/ hx esrd on hd, htn, medication non-compliance, substance abuse, and multiple recent hospital admissions for cp who presented to the ed after an episode of cp and was found to be hyperkalemic to 8.1, and subsequently had an episode of monomorphic vtach, with sustained pressures. he was treated by resolving the underlying condition: fluids, ca-gluconate and insulin. he was dialyzed twice and responded wonderfully. he spent one night in the micu and was called out. on the floor, his ekg's showed persistent repolarization abnormalities that were sufficiently concerning that we kept him an extra night. we reviewed the ekg's and the consensus was that these abnormalities, which crossed territories and occurred in the absence of symptoms, were related to the resolving electrolyte disturbance of his presentation. he was discharged to follow up early the following week by problem #hyperkalemia: pt currently undergoes dialysis mwf and according to the pt he was dialyzed the day before admission. although the pt has a hx of non-compliance w/ medication and follow-up, if the pt was dialyzed yesterday this level of hyperkalemia 1 day after dialysis is surprising and likely comes in the setting of a significant potassium load by diet. at the time of arrival to the floor, pt's potassium had resolved to 4.4. a nutrition consult was ordered, but he was also educated on potassium containing foods by the team. serial labs and ekgs as above. # ventricular tachycardia: occured in the setting of hyperkalemia. followed on tele and serial ekgs. resolved with electrolyte normalization but left him with subtle repolarization abnormalities. . # hypertension held home anti-hypertensives this evening as pt is being dialyzed. restarted home antihypertensive regimen am w/ appropriate holding parameters. also level of pt compliance w/ medications is unclear. a great deal of time was spent in education . # substance abuse and social issues - pt unwilling to answer question of most recent use of etoh and cocaine. but endorses that he continues to abuse substances. talking with the patient, it is clear that he knows the consequences of his actions and acknowledges that he is not ready to mature. we talked about how with ckd, his ability to 'bounce back' is and his days of tolerating drugs/alcohol with such minimal consequences are limited. he agrees. he says that soon he will 'shape up' and pursue sobriety in effort to acquire a transplant. he also says that the primary reason for the delay in this process is that he has not been impressed by the results of kidney transplantation by the recipients he meets in the community and at dialysis. to be resolved outpatient 1) hyperkalemia - must be followed; reinforce dietary education 2) substance abuse - education, counselling, support medications on admission: 1. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 2. sevelamer carbonate 800 mg tablet sig: two (2) tablet po tid w/meals (3 times a day with meals). 3. isosorbide mononitrate 30 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po daily (daily). 4. simvastatin 40 mg tablet sig: two (2) tablet po daily (daily). 5. nifedipine 90 mg tablet sustained release sig: one (1) tablet sustained release po daily (daily). 6. terazosin 1 mg capsule sig: one (1) capsule po hs (at bedtime). 7. lisinopril 20 mg tablet sig: two (2) tablet po bid (2 times a day). 8. ferrous sulfate 325 mg (65 mg iron) tablet sig: one (1) tablet po daily (daily). 9. phoslo 667 mg capsule sig: two (2) capsule po three times a day. 10. multivitamin tablet sig: one (1) tablet po once a day. discharge medications: 1. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 2. aspirin 81 mg tablet, chewable sig: two (2) tablet, chewable po daily (daily). 3. sevelamer carbonate 800 mg tablet sig: one (1) tablet po tid w/meals (3 times a day with meals). 4. isosorbide mononitrate 30 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po daily (daily). 5. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily) for 1 doses. 6. nifedipine 90 mg tablet sustained release sig: one (1) tablet sustained release po daily (daily). 7. terazosin 1 mg capsule sig: one (1) capsule po hs (at bedtime). 8. lisinopril 20 mg tablet sig: two (2) tablet po bid (2 times a day). 9. ferrous sulfate 325 mg (65 mg iron) tablet sig: one (1) tablet po daily (daily). 10. calcium acetate 667 mg capsule sig: one (1) capsule po tid w/meals (3 times a day with meals). discharge disposition: home discharge diagnosis: primary hyperkalemia ventricular tachycardia secondary esrd on hd htn substance abuse discharge condition: afebrile, ambulating, tolerating regular diet discharge instructions: you were admitted for chest pain and abnormal heart rhythm. this was caused by high potassium. your potassium most likely came from something you ate or took in. we kept you to monitor your heart and check for damage. you must avoid eating too many foods that are high in potassium. you must also continue taking your high blood pressure medicines as well as making your dialysis sessions if you should experience severe chest pain, light headedness, severe nausea/vomitting, then return to the hospital. foods with high potassium dried fruits: raisins, prunes, apricots, dates fresh fruits: bananas, strawberries, watermelon, cantaloupe, oranges fresh vegetables: beets, greens, spinach, peas, tomatoes, mushrooms dried vegetables: beans, peas fresh meats: , fish, beef fresh juices: canned juices: grapefruit, prune, apricot follow up 1) primary care: , md phone: date/time: 3:25; call to reschedule if problems followup instructions: primary care: , md phone: date/time: 3:25; call to reschedule if problems. try to reach you for reschedule as well foods with high potassium dried fruits: raisins, prunes, apricots, dates fresh fruits: bananas, strawberries, watermelon, cantaloupe, oranges fresh vegetables: beets, greens, spinach, peas, tomatoes, mushrooms dried vegetables: beans, peas fresh meats: , fish, beef fresh juices: canned juices: grapefruit, prune, apricot procedure: venous catheterization, not elsewhere classified hemodialysis diagnoses: hyperpotassemia end stage renal disease alcohol abuse, unspecified cocaine abuse, unspecified paroxysmal ventricular tachycardia hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease old myocardial infarction noncompliance with renal dialysis 

Answer: The patient is high likely exposed to