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: demerol / unasyn / cephalosporins / levaquin / moexipril / heparin agents attending: chief complaint: bilateral renal masses major surgical or invasive procedure: bilateral laparoscopic radical nephrectomies, ex-lap and evacuation of hematoma history of present illness: 29yf with esrd secondary to sle s/p failed renal transplant in now with bilateral renal masses noted on mri. consultations with radiology, transplant nephrology, and urology felt that the primary concern was need for tissue diagnosis and removal to facilitate relisting as transplant candidate. the least morbid and most efficient approach was considered laparoscopic bilateral nephrectomies. past medical history: 1. sle diagnosed complicated by lupus/nephritis, anemia, serositis and ascites 2. end stage renal disease secondary to lupus, hd t/th/sat 3. history of vsd s/p corrective surgery, age 13 4. hypertension 5. itp 6. mssa endocarditis 7. sickle cell trait 8. s/p left oophorectomy related to iud associated infection 9. restrictve lung disease noted on pfts . in , chest ct with diffuse ground glass opacities. 10. gerd 11. s/p cadaveric renal transplant on complicated by rejection and capsule rupture 11/. 12. right pelvic abscess s/p tah/rso 13. b/l renal solid masses social history: no smoking, occasional alcohol, no drug use. lives at home with husband and son. not currently employed. family history: nc physical exam: 98.6 84 130/72 18 94%ra gen: aaox3, nad chest: ctab cardiovascular: rrr, 2-3/6 systolic murmur. abd: soft, nd, min ttp incision: c/d/i with steri strips ext: no c/c/e pertinent results: 03:36pm glucose-83 urea n-46* creat-11.2*# sodium-137 potassium-5.2* chloride-97 total co2-29 anion gap-16 03:36pm calcium-8.5 magnesium-2.6 03:36pm wbc-10.6# rbc-2.99* hgb-9.0* hct-28.3* mcv-95 mch-30.0 mchc-31.7 rdw-21.3* 03:36pm plt count-105* 01:59pm type- po2-54* pco2-45 ph-7.43 total co2-31* base xs-4 intubated-intubated 01:59pm glucose-248* lactate-3.3* na+-136 k+-5.3 cl--98* 01:59pm hgb-9.2* calchct-28 01:59pm freeca-1.19 01:09pm type- po2-48* pco2-45 ph-7.44 total co2-32* base xs-5 01:09pm glucose-131* lactate-2.4* na+-138 k+-5.4* cl--99* 01:09pm hgb-10.1* calchct-30 01:09pm freeca-1.04* 11:10am type- po2-57* pco2-53* ph-7.38 total co2-33* base xs-4 intubated-intubated 11:10am type- po2-57* pco2-53* ph-7.38 total co2-33* base xs-4 intubated-intubated 11:10am glucose-147* lactate-1.9 na+-139 k+-5.1 cl--98* 11:10am hgb-10.3* calchct-31 11:10am freeca-1.06* 09:16am type- po2-60* pco2-45 ph-7.44 total co2-32* base xs-5 09:16am glucose-100 lactate-2.0 na+-140 k+-4.9 cl--97* 09:16am hgb-10.9* calchct-33 09:16am freeca-1.09* 04:33am blood wbc-13.2* rbc-3.60* hgb-11.2* hct-32.6* mcv-91 mch-31.1 mchc-34.3 rdw-18.7* plt ct-143* 09:57am blood wbc-12.9* rbc-3.99* hgb-11.9* hct-37.0 mcv-93 mch-29.7 mchc-32.1 rdw-18.2* plt ct-104* 07:28pm blood wbc-13.0* rbc-3.82* hgb-11.6* hct-34.9* mcv-91 mch-30.4 mchc-33.2 rdw-17.8* plt ct-72* 11:28am blood wbc-12.0* rbc-3.60* hgb-11.3* hct-32.5* mcv-90 mch-31.2 mchc-34.6 rdw-17.7* plt ct-74* 05:15am blood wbc-11.1* rbc-3.32* hgb-10.2* hct-30.5* mcv-92 mch-30.7 mchc-33.4 rdw-17.7* plt ct-64* 03:15am blood wbc-8.6 rbc-2.83* hgb-8.8* hct-24.9* mcv-88 mch-31.2 mchc-35.5* rdw-17.5* plt ct-63* 04:13pm blood hct-24.7* 03:04am blood wbc-7.9 rbc-2.94* hgb-9.2* hct-25.5* mcv-87 mch-31.2 mchc-36.0* rdw-17.4* plt ct-50* 09:48pm blood hct-24.8* 10:30am blood hct-24.5* 08:45pm blood wbc-10.2 rbc-3.22*# hgb-9.9*# hct-27.2*# mcv-85 mch-30.7 mchc-36.3* rdw-16.9* plt ct-64* 05:29pm blood wbc-9.9 rbc-2.34* hgb-7.2* hct-20.0* mcv-86 mch-30.9 mchc-36.0* rdw-18.3* plt ct-74* 02:35pm blood wbc-10.8 rbc-2.23* hgb-6.7* hct-19.2* mcv-86 mch-30.2 mchc-35.1* rdw-19.3* plt ct-94* 08:53am blood hct-18.0* 05:38am blood hct-21.0* plt ct-113* 02:01am blood wbc-15.2*# rbc-2.55* hgb-7.9* hct-23.3* mcv-91 mch-30.8 mchc-33.8 rdw-20.9* plt ct-109* 05:44am blood wbc-7.6 rbc-3.32* hgb-10.1* hct-29.3* mcv-88 mch-30.5 mchc-34.5 rdw-19.6* plt ct-85* 09:05pm blood hct-33.0* plt ct-85* 04:38am blood wbc-6.4 rbc-3.63* hgb-11.1* hct-32.7* mcv-90 mch-30.7 mchc-34.0 rdw-19.2* plt ct-90* 01:27am blood wbc-6.6 rbc-3.64* hgb-10.7* hct-32.6* mcv-90 mch-29.4 mchc-32.8 rdw-19.2* plt ct-100* 08:42pm blood wbc-6.7 rbc-3.91* hgb-11.6* hct-33.8* mcv-86 mch-29.7 mchc-34.4 rdw-19.2* plt ct-75* 03:46pm blood wbc-6.9 rbc-3.55* hgb-10.5* hct-32.0* mcv-90 mch-29.7 mchc-32.9 rdw-19.3* plt ct-76* 11:45am blood wbc-6.0 rbc-3.63* hgb-11.1* hct-31.9* mcv-88 mch-30.5 mchc-34.7 rdw-19.3* plt ct-104* 08:49am blood hct-34.1* 04:05am blood wbc-8.2 rbc-3.65* hgb-10.9* hct-33.7* mcv-92 mch-30.0 mchc-32.4 rdw-19.2* plt ct-86* 08:08pm blood wbc-7.8 rbc-3.63* hgb-11.1* hct-32.3* mcv-89 mch-30.7 mchc-34.5 rdw-19.4* plt ct-68* 01:26pm blood wbc-7.2 rbc-3.78* hgb-11.3* hct-34.0* mcv-90 mch-29.8 mchc-33.2 rdw-19.0* plt ct-75* 03:10am blood wbc-7.9 rbc-3.89* hgb-11.5* hct-34.9* mcv-90 mch-29.6 mchc-33.0 rdw-19.0* plt ct-68* 07:45pm blood hct-35.3* plt ct-73* 09:32am blood hct-36.6 plt ct-73* 05:48am blood wbc-8.5 rbc-3.97* hgb-11.8* hct-35.2* mcv-89 mch-29.9 mchc-33.6 rdw-19.3* plt ct-82* 12:55am blood wbc-9.0 rbc-3.88* hgb-11.7* hct-34.2* mcv-88 mch-30.1 mchc-34.1 rdw-19.1* plt ct-78* 08:40pm blood wbc-10.2 rbc-4.07* hgb-12.3 hct-35.5* mcv-87 mch-30.2 mchc-34.7 rdw-19.1* plt ct-76* 04:52pm blood wbc-9.3 rbc-4.02* hgb-12.1 hct-34.9* mcv-87 mch-30.0 mchc-34.6 rdw-19.0* plt ct-85* 12:41pm blood wbc-10.8 rbc-4.28 hgb-12.8 hct-37.0 mcv-87 mch-29.8 mchc-34.4 rdw-19.0* plt ct-80* 08:49am blood wbc-8.7 rbc-3.66* hgb-10.8* hct-32.0* mcv-87 mch-29.5 mchc-33.8 rdw-19.5* plt ct-95* 03:18am blood wbc-7.7 rbc-3.06* hgb-9.0* hct-26.1* mcv-85 mch-29.3 mchc-34.4 rdw-20.2* plt ct-84* 11:55pm blood wbc-7.4 rbc-2.85* hgb-8.3* hct-24.5* mcv-86 mch-29.0 mchc-33.8 rdw-19.9* plt ct-75* 08:28pm blood wbc-7.1 rbc-2.62* hgb-8.0* hct-22.5* mcv-86 mch-30.3 mchc-35.3* rdw-20.3* plt ct-76* 02:01pm blood hct-23.2* 10:25am blood hct-25.5*# 09:50am blood wbc-7.3 rbc-2.38* hgb-7.1* hct-22.9* mcv-96 mch-29.9 mchc-31.1 rdw-21.7* plt ct-105* 10:03pm blood wbc-7.9 rbc-2.61* hgb-8.0* hct-24.5* mcv-94 mch-30.6 mchc-32.7 rdw-21.6* plt ct-79* 01:54pm blood hct-27.4* 05:26am blood wbc-9.0 rbc-2.67* hgb-8.2* hct-24.8* mcv-93 mch-30.5 mchc-32.9 rdw-21.7* plt ct-85* 03:36pm blood wbc-10.6# rbc-2.99* hgb-9.0* hct-28.3* mcv-95 mch-30.0 mchc-31.7 rdw-21.3* plt ct-105* 12:51am blood neuts-81.1* lymphs-17.4* monos-1.4* eos-0 baso-0.1 02:01am blood neuts-81.7* lymphs-15.2* monos-2.8 eos-0.1 baso-0.2 12:41pm blood neuts-70.2* lymphs-24.3 monos-3.9 eos-1.2 baso-0.3 12:51am blood anisocy-1+ poiklo-1+ microcy-1+ 05:29pm blood hypochr-normal anisocy-2+ poiklo-occasional macrocy-normal microcy-1+ polychr-1+ ovalocy-occasional target-occasional 02:01am blood anisocy-2+ macrocy-1+ microcy-1+ 12:41pm blood anisocy-2+ poiklo-1+ macrocy-1+ microcy-1+ 04:33am blood plt ct-143* 04:33am blood pt-12.3 ptt-27.0 inr(pt)-1.1 09:57am blood plt ct-104* 07:28pm blood plt ct-72* 11:28am blood plt ct-74* 05:15am blood plt ct-64* 05:15am blood pt-12.0 ptt-26.5 inr(pt)-1.0 03:15am blood plt ct-63* 03:15am blood pt-12.5 ptt-25.2 inr(pt)-1.1 11:42am blood pt-13.1 ptt-25.8 inr(pt)-1.1 03:04am blood plt ct-50* 04:14am blood plt ct-60* 04:14am blood pt-11.5 ptt-24.9 inr(pt)-1.0 08:45pm blood plt ct-64* 08:45pm blood pt-9.3* ptt-24.5 inr(pt)-0.8* 05:29pm blood plt ct-74* 05:29pm blood pt-15.1* ptt-26.6 inr(pt)-1.4* 02:35pm blood plt ct-94* 02:35pm blood pt-14.9* ptt-27.2 inr(pt)-1.3* 08:53am blood pt-15.0* ptt-26.8 inr(pt)-1.3* 05:38am blood plt ct-113* 05:38am blood pt-15.2* ptt-26.6 inr(pt)-1.4* 02:01am blood plt ct-109* 02:01am blood pt-15.7* ptt-26.3 inr(pt)-1.4* 05:27pm blood plt ct-95* 03:25pm blood pt-14.1* ptt-25.1 inr(pt)-1.2* 02:12pm blood plt ct-84* 05:44am blood plt ct-85* 05:44am blood pt-14.2* ptt-27.0 inr(pt)-1.3* 05:08pm blood plt ct-76* 04:38am blood plt smr-low plt ct-90* 04:38am blood pt-13.1 ptt-23.8 inr(pt)-1.1 01:27am blood plt ct-100* 01:27am blood pt-13.8* ptt-25.3 inr(pt)-1.2* 08:42pm blood plt ct-75* 03:46pm blood plt smr-very low plt ct-76* 03:46pm blood pt-13.0 ptt-24.2 inr(pt)-1.1 04:05am blood pt-13.7* ptt-25.4 inr(pt)-1.2* 08:08pm blood plt ct-68* 08:08pm blood pt-13.4* ptt-25.6 inr(pt)-1.2* 01:26pm blood plt ct-75* 01:26pm blood pt-13.5* ptt-24.0 inr(pt)-1.2* 03:10am blood pt-14.4* ptt-25.4 inr(pt)-1.3* 07:45pm blood plt ct-73* 07:45pm blood pt-13.8* ptt-24.7 inr(pt)-1.2* 01:41pm blood plt ct-71* 09:32am blood plt ct-73* 05:48am blood plt ct-82* 05:48am blood pt-13.3* ptt-24.3 inr(pt)-1.2* 05:48am blood pt-13.3* ptt-24.3 inr(pt)-1.2* 12:55am blood plt ct-78* 12:55am blood pt-13.1 ptt-24.1 inr(pt)-1.1 08:40pm blood plt ct-76* 08:40pm blood plt ct-76* 04:52pm blood pt-11.9 ptt-22.7 inr(pt)-1.0 12:41pm blood plt ct-80* 12:41pm blood pt-12.3 ptt-25.5 inr(pt)-1.1 08:49am blood plt ct-95* 08:49am blood pt-12.6 ptt-23.4 inr(pt)-1.1 03:18am blood plt ct-84* 11:55pm blood pt-12.9 ptt-25.0 inr(pt)-1.1 08:28pm blood plt ct-76* 04:33am blood fibrino-376 11:42am blood fibrino-389 12:51am blood fibrino-385 05:29pm blood fibrino-287 03:25pm blood fibrino-436* 09:05pm blood fibrino-323 04:38am blood fibrino-335 08:42pm blood fibrino-304 04:05am blood fibrino-289 03:10am blood fibrino-287 12:55am blood fibrino-404* 08:49am blood fibrino-341 d-dimer-7832* 03:18am blood fibrino-276 d-dimer-7656* 11:55pm blood fibrino-285 d-dimer-8650* 04:33am blood glucose-103 urean-63* creat-8.8* na-137 k-4.3 cl-100 hco3-24 angap-17 05:15am blood glucose-118* urean-89* creat-8.9*# na-138 k-4.7 cl-99 hco3-23 angap-21* 03:04am blood glucose-131* urean-38* creat-5.0*# na-143 k-4.0 cl-103 hco3-27 angap-17 05:29pm blood glucose-125* urean-51* creat-6.7* na-139 k-5.1 cl-102 hco3-25 angap-17 02:01am blood glucose-108* urean-44* creat-6.2*# na-141 k-4.7 cl-98 hco3-29 angap-19 04:38am blood glucose-79 urean-52* creat-6.1*# na-141 k-3.5 cl-99 hco3-31 angap-15 05:48am blood glucose-90 urean-31* creat-5.3* na-138 k-4.3 cl-95* hco3-30 angap-17 03:18am blood glucose-108* urean-33* creat-6.8*# na-141 k-4.4 cl-97 hco3-31 angap-17 01:03am blood glucose-101 urean-24* creat-5.0*# na-142 k-2.8* cl-100 hco3-33* angap-12 10:03pm blood glucose-101 urean-25* creat-6.6*# na-146* k-3.6 cl-102 hco3-29 angap-19 05:26am blood glucose-100 urean-53* creat-12.1* na-135 k-6.9* cl-97 hco3-28 angap-17 05:29pm blood ld(ldh)-269* 02:01am blood alt-38 ast-22 ld(ldh)-311* alkphos-149* amylase-65 totbili-0.9 dirbili-0.4* indbili-0.5 05:44am blood alt-43* ast-30 ld(ldh)-282* alkphos-141* amylase-67 totbili-0.6 dirbili-0.4* indbili-0.2 10:25am blood ld(ldh)-70* 04:33am blood calcium-8.8 phos-5.1* mg-2.3 05:15am blood albumin-2.9* calcium-6.6* phos-6.5* mg-2.4 03:04am blood calcium-8.0* phos-7.0* mg-1.9 05:29pm blood calcium-7.9* phos-6.6* mg-1.8 02:01am blood albumin-3.6 calcium-9.7 phos-6.0* mg-1.9 04:38am blood calcium-8.9 phos-3.9# mg-2.0 03:10am blood calcium-8.2* phos-7.6* mg-2.2 06:02am blood calcium-8.5 phos-4.5 mg-1.9 09:50am blood calcium-8.0* phos-5.5* mg-2.1 05:26am blood calcium-8.9 phos-7.4*# mg-2.8* 06:00am blood vanco-25.7* 06:10pm blood vanco-21.9* 05:16am blood vanco-81.8* 04:53pm blood type-mix ph-7.35 01:27am blood type-art po2-153* pco2-29* ph-7.55* caltco2-26 base xs-4 05:45pm blood type-art temp-37.2 po2-141* pco2-43 ph-7.46* caltco2-32* base xs-6 12:25pm blood type-art po2-174* pco2-49* ph-7.41 caltco2-32* base xs-5 intubat-intubated vent-controlled 10:53am blood type- ph-7.48* 01:09pm blood type- po2-48* pco2-45 ph-7.44 caltco2-32* base xs-5 04:42am blood glucose-126* lactate-0.8 k-5.2 08:54pm blood glucose-114* lactate-1.7 k-5.1 03:00pm blood lactate-1.7 03:43pm blood lactate-1.2 01:09pm blood glucose-131* lactate-2.4* na-138 k-5.4* cl-99* 09:16am blood glucose-100 lactate-2.0 na-140 k-4.9 cl-97* 04:42am blood o2 sat-98 12:25pm blood hgb-9.1* calchct-27 11:10am blood hgb-10.3* calchct-31 04:53pm blood freeca-1.15 01:27am blood freeca-1.15 05:45pm blood freeca-0.98* 12:25pm blood freeca-1.01* 10:53am blood freeca-1.03* 01:09pm blood freeca-1.04* 09:16am blood freeca-1.09* ***recent results: complete blood count wbc rbc hgb hct mcv mch mchc rdw plt ct 07:30am 8.1 3.56* 10.6* 33.2* 93 29.9 32.0 18.2* 134* 12:20pm 9.8 3.48* 10.3* 32.1* 93 29.7 32.1 18.2* 146* 05:45am 6.9 3.19* 9.7* 29.2* 92 30.3 33.0 18.3* 157 07:40am 8.2 3.16* 9.6* 28.3* 90 30.5 34.0 18.1* 180 basic coagulation pt ptt inr(pt) plt 07:40am 12.5 28.3 1.1 180 06:50am 11.6 27.4 1.0 210 05:20pm 11.8 27.7 1.0 renal & glucose glucose urean creat na k cl hco3 angap 07:30am 113* 32* 9.4* 139 4.9 99 25 20 12:20pm 27* 8.7* 138 5.3* 97 07:40am 75 34* 8.9*# 136 5.0 99 25 17 pth 05:40am 361* hepatitis hbsag hbsab 05:40am pnd pnd brief hospital course: - the patient was admitted on and underwent left laparoscopic radical nephrectomy and right laparoscopic radical nephrectomy the same day. ebl 100cc. there were no intraoperative complications. the patient was stable and was transferred to the floor. the patient's post-operative course was complicated by post-op bleeding noted as increased abdominal pain and falling hematocrit on pod 2. the patient was transferred to the intensive care unit and hematology was consulted. she was started on vancomycin for elevated temps. the patient was found to have a coagulopathy and aggressive resuscitation was started. she was also found to have a decreasing plt count, thought to be from her uremia. she was transfused with prbc's, platelets, ffp and cryo prn to maintain her levels. a hit ab panel was sent which came back negative on the final tests. see table below for details. -preop --- hct 33.4 bp 90/57 (pod#1) stable on 12r, sips --- hct 27.4 bp 90/52 (#2) taking clears, pain in pm --- hct 25.9 bp 85/55 (am) low bp ?????? transfer unit --- hct 20.2 bp 85/50 initial hematology consult ?????? possible dic. given baseline uremia manage with ddavp, ffp, cryo for fibrinogen > 100 and platelets for > 100. initial coagulation and dic screen pt 13.8, ptt 66, inr 1.2 fibrinogen 405, fdp 10-40, d-dimer 8500, thrombin 150 -on pod #3 a ct of abd/pelvis was obtained which revealed 1. bilateral retroperitoneal hematomas with some active extravasation on the left and the patient is status post bilateral nephrectomy. 2. free intraperitoneal air status postop. 3. coronary artery calcifications. 4. several cystic areas in the pancreas which measure 1-2 mm which may represent ipmt. she contineud to have a significant requirement for prbc's (9 units total at this point), platelets, and cryo. she was continued on ddavp and was continued on hemodialysis. due to difficulties in peripheral access a right femoral line was placed. an echo was obtained on pod #5 which revelaed a linear mitral annular echodensity and mitral regure, which was seen on a previos echo. blood and sputum cultures were sent which were both negative. the renal team followed the patient regarding her dialysis and electrolyte control. on pod # the patient's platelt counts and coags stabilized and the ddavp was held. she was kept on vitamin k and estrogens. -on pod #9 the patient had a large requirement in her pain medications and developed severe increasing abdominal pain. she also had increased bleeding around her incision. a ct scan was obtained which showed 1. marked interval increase in size of right retroperitoneal hematoma in the nephrectomy bed. given the relative high attenuation of this collection, the degree of short-term increase in size, and the presence of a small hyperenhancing focus, active extravasation cannot be excluded. 2. relatively stable left retroperitoneal hematoma. 3. stable bilateral lower lobe airspace disease. . stable cardiomegaly. due to this finding the transplant general surgery team was consulted and it was felt that would need to return to the or for a washout and to stop the bleeding. her hct reached a nadir of 18.0 for which she was transfused 5 units. -the patient was transferred to the sicu on the and taken to the or on pod #10 with dr. and dr. . in the or the right colon was mobilized and the large clot evacuated from the right retroperitoneum. hemostasis was secured with argonbeam coagulation, application of topical hemostatic sheets and fibrin glue. there was a small hematoma on the left retroperitoneum, which was also controlled in a similar fashion. there were several mesenteric hematomas both in the small and large bowel, but all of the colon and small bowel itself was viable. please see dr. operative note for further details. the patient tolerated the procedure well and was sent back to the sicu postoperatively. she was given activated factor viia in the post operative period, which greatly improved her coagulopathies. at this point in her stay she had required 17u prbc, 11u platelets, and 4u of cryo. after being given the factor vii, the patient did not require any further transfusions of blood products for the remainder of her hospital stay. -she was found to be hemodynamically stable and remained so, therefore she was transferred to the floor. post-operatively she did very well. her hct's remained stable and her adbominal exam was much improved. her vanco was d/c'd and her jp drains were d/c'd on . she was continued on dialysis and her pain was controlled with a pca. a chronic pain service consult was requested who started her on a po pain regimen on . her pain was controlled with po meds, she was tolerating a regular renal diet, and her cvl was d/c's on . the renal team continued to follow to assist with her electrolye imbalances and dialysis management. over the weekend on the patient did extremely well - she was able to ambulate, her pain was controlled on po meds, and she was tolerating a regular diet. on the patient developed increasing left abdominal pain and her hct dropped 4 points. the next day her hct was down another two points and a noncontrasted ct scan was obtained which revealed 1. post-surgical changes in both nephrectomy beds with fibrin net placement. 2. decreased size of right nephrectomy bed hematoma. 3. slight increase in size of fluid collection in left nephrectomy site. high-density internal areas likely represent residual clot. the collection is lower in hounsfield units than on the prior study and is likely due to combination of hematoma and fluid. the patient was felt to be stable and a post dialysis hct on was back up to 31 (stable from previous checks). blood cultures were sent on and her hct was stable. the patient continued to do well, tolerating her renal diet, ambulating, and her pain controlled on po medications. -due to some increase in abdominal pain on , a ct repeat ct was obtained which revelaed postsurgical changes in both nephrectomy beds with bilateral hematomas in evolution, which have not significantly changed in size compared to 4 days prior but are smaller and liquifying compared to . on a cxr was taken to evaluate some consolidation seen on the upper cuts of her abd ct. the cxr showed: slight improvement in fluid balance with persistent bilateral patchy opacities in lung bases, suspicious for pneumonia or aspiration. underlying pulmonary arterial hypertension as previously noted. the pulmonoly team was asked for advice on treatment of the consolidation and pa htn, and recommended no abx at this time due to the fact the the patient has no clinical symptoms of a pneumonia, she has been afebrile, and has a normal wbc. she will followup in pulmonology clinic for further eval of her pa htn. on she was much improved. her labs were stable and she had no further complaints. all of her cultures were negative to date, she has been afebrile, and has a normal wbc count. she is being discharged in stable condition, tolerating a regular renal diet, pain control on po meds, ambulating well, with stable hct's, wbc's, and a benign abdominal exam. she will start back on her home dialysis schedule at hospital and will f/u with her pcp, , and dr. . medications on admission: amoxil 500 mg--4 tablet(s) by mouth 4 tabs one hour prior to procedure then 1 tab every 8 hours 1 hour prior to procedure aztreonam 1 gram--1 gram iv q24 hours until amitriptyline 50 mg--1 tablet(s) by mouth at bedtime for neuropathy dilaudid 4 mg--1 tablet(s) by mouth twice a day as needed for pain ibuprofen 600mg--one pill by mouth every 6-8 hours as needed for joint pain nephrocaps 1mg--one by mouth every day prednisone 5mg--take as directed protonix 20mg--one by mouth every day for gerd sevelamer 800 mg--1 tablet(s) by mouth three times a day phosphate binder amitriptyline 75 mg--1 tablet(s) by mouth at bedtime for neuropathy discharge medications: 1. folic acid 1 mg tablet : one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 2. b-complex with vitamin c tablet : one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 3. sevelamer 800 mg tablet : two (2) tablet po tid (3 times a day). disp:*180 tablet(s)* refills:*2* 4. docusate sodium 100 mg capsule : one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*2* 5. senna 8.6 mg tablet : one (1) tablet po bid (2 times a day) for 2 weeks. disp:*28 tablet(s)* refills:*0* 6. prednisone 5 mg tablet : one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 7. lansoprazole 30 mg tablet,rapid dissolve, dr : one (1) tablet,rapid dissolve, dr daily (daily). disp:*30 tablet,rapid dissolve, dr(s)* refills:*2* 8. amitriptyline 50 mg tablet : two (2) tablet po hs (at bedtime). disp:*60 tablet(s)* refills:*2* 9. fentanyl 100 mcg/hr patch 72 hr : one (1) transdermal q72h (every 72 hours). disp:*10 patches* refills:*2* 10. calcium acetate 667 mg capsule : two (2) capsule po tid w/meals (3 times a day with meals). disp:*180 capsule(s)* refills:*2* 11. hydromorphone 2 mg tablet : 1-3 tablets po q3h (every 3 hours) as needed for pain. disp:*75 tablet(s)* refills:*0* discharge disposition: home with service facility: care group vna discharge diagnosis: bilateral renal masses discharge condition: stable discharge instructions: m.d. if fever > 101.5, nausea, vomiting, increasing abdominal pain, shortness of breath, chest pain, difficulty urinating, , noted bleeding, dizziness, or any other concerns. resume a regular renal diet as directed. activity as tolerated except no heavy lifting or strenuous activity. you may take a shower but no tub bathing or soaking until followup. a vna will visit you for the first week to assess your wound and make sure you are not having any problems. followup instructions: please follow-up with dr. in 2 weeks. please call ( to schedule your appointment. please call for an appointment to followup with pulmonology. call ( to schedule an appointment in weeks for followup of pulmonary hypertension. please followup with you pcp, . in 1 week for reassesment of your home medications, followup. call (. please resume your normal dialysis schedule at hospital. please call to set up your next appointment procedure: hemodialysis transfusion of packed cells other laparotomy transfusion of other serum transfusion of platelets transfusion of coagulation factors application or administration of an adhesion barrier substance perioperative autologous transfusion of whole blood or blood components bilateral nephrectomy diagnoses: systemic lupus erythematosus end stage renal disease hemangioma of intra-abdominal structures long-term (current) use of steroids acute posthemorrhagic anemia other chronic pulmonary heart diseases hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease hemorrhage complicating a procedure other and unspecified coagulation defects kidney replaced by transplant sickle-cell trait other specified cystic kidney disease other acute postoperative pain 

Answer: The patient is high likely exposed to