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 attending: chief complaint: altered ms x 24hr major surgical or invasive procedure: none history of present illness: 83 yo female w/ pmhx sig for htn, chf w/ diastolic dysfunction, right renal artery stenosis p/w increased lethargy and unresponsiveness for 1 day. her son states that she has not had any consitutional symptoms in the last several weeks. she denies fevers/chills/myalgias/n/v/cp/sob/abd pain. the son indicates that his mother recently started a oxaprazin (nsaid) in the last week for lower back pain. she has been taking the medication twice a day. she was in her ususal states of health prior to the last 24 hours. currently she is in bed and has decreased response to verbal commands. upon arrival to the ed the patient initially had a hr in the 40's with a bp of 120/58 and an ekg showing atrial fibrillation and a creatinine of 4.4 w/ a last measured creatinine of 1.7 in . her sbp subsequently dropped to the 80's but responded to glucagon, atropine, and calcium gluconate. however, the response was transient and she again began to drop her pressure requiring additional 2 additional doses of medications. she was transferred to the micu for monitoring of her hemodynamic instability. past medical history: 1. hypertension with a negative cardiac catheterization in and a negative stress test in , echocardiogram in showing an ef of greater then 55% and mild left ventricular hypertrophy, stress mibi negative. 2. questionable congestive heart failure secondary to diastolic dysfunction. 3. chronic dyspnea on exertion with a baseline o2 sat of the low 90s. 4. nephrolithiasis. 5.dyskinesias. 6. atrial septal defect with a left to rightshunt. 7. low back pain - spinmal disk disease 8. macular degeneration 9. pulmonary htn moderate by echo 10. r short segment renal artery stenosis 11. left kidney cyst 12. diverticulosis social history: she lives at home with her husband. she quit smoking 30 years earlier. rare etoh use family history: non-contributory physical exam: vitals - temp 97.9 bp 150/80 p 57 rr 18 97% 1.5l . gen - lying in bed, nad. heent - mildly dry mm, eomi cv: rrr s1/s2, no m/r/g lungs: bibasilar crackles abd: soft nt, nd, + bs ext: no c/c/e neuro: a&o x3 pertinent results: ct head - study limited by motion, but no intracranial hemorrhage or mass effect is seen. if clinically indicated and patient can tolerate, an mr is more sensitive to detect acute ischemia. . cxr - the cardiac and mediastinal contours are stable. there is respiratory motion. no definite infiltrates, but there are low lung volumes. no pulmonary edema. . ecg - atrial fibrillation with a rapid ventricular response. right bundle-branch block and left axis deviation. poissible prior inferior myocardial infarction. non-specific st-t wave changes. compared to the previous tracing of the ventricular response to atrial fibrillation is faster. clinical correlation is suggested. . 11:29pm wbc-15.1* rbc-3.33* hgb-10.1* hct-29.5* mcv-88 mch-30.2 mchc-34.2 rdw-13.4 11:29pm plt count-360 04:43pm urine hours-random urea n-421 creat-41 sodium-93 04:43pm urine osmolal-374 04:43pm urine color-straw appear-clear sp -1.009 04:43pm urine blood-lg nitrite-neg protein-neg glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-5.0 leuk-neg 04:43pm urine rbc-* wbc-0-2 bacteria-occ yeast-none epi-<1 04:43pm urine hyaline-0-2 04:43pm urine eos-negative 08:00am glucose-180* urea n-134* creat-4.4* sodium-141 potassium-3.8 chloride-98 total co2-20* anion gap-27* 08:00am calcium-9.9 phosphate-7.5* magnesium-2.0 08:00am c3-117 c4-37 08:00am wbc-25.4*# rbc-3.59* hgb-10.8* hct-33.0* mcv-92 mch-30.1 mchc-32.7 rdw-13.9 08:00am plt count-402 03:20am glucose-108* urea n-126* creat-4.1* sodium-137 potassium-4.4 chloride-96 total co2-21* anion gap-24* 03:20am phosphate-7.5*# magnesium-2.2 03:18am type-art po2-119* pco2-28* ph-7.46* total co2-21 base xs--1 12:20am urine hours-random 12:20am urine gr hold-hold 12:20am urine color-straw appear-clear sp -1.014 12:20am urine blood-neg nitrite-neg protein-neg glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-6.5 leuk-neg 11:00pm glucose-110* urea n-128* creat-4.4*# sodium-138 potassium-4.7 chloride-95* total co2-23 anion gap-25* 11:00pm ck(cpk)-53 11:00pm ctropnt-0.02* 11:00pm ck-mb-notdone 11:00pm calcium-9.2 11:00pm osmolal-325* 11:00pm wbc-15.6*# rbc-3.92* hgb-12.0 hct-35.6* mcv-91 mch-30.7 mchc-33.8 rdw-13.9 11:00pm neuts-72.0* lymphs-21.0 monos-3.8 eos-2.7 basos-0.5 11:00pm plt count-418# 11:00pm pt-13.4 ptt-23.6 inr(pt)-1.1 brief hospital course: 83 yo female w/ hx cad, diastolic chf, pulm htn, ra stenosis, dyskinesia p/w new arf, bradycardia, hypotension and ms changes secondary to beta-blocker/calcium channel blocker toxicity. . hypotension - this was most likely bb/ccb toxicity in the setting of recently starting nsaids, renal artery stenosis, and decreased po intake contributing to arf. toxicology was initially consulted in the ed. per their recommendations patient was given atropine, glucagon, and calcium salt infusions for her blood pressures. the patient was transferred to the micu on a glucagon and insulin drip. nephrology consultation recommended volume replacement for treatment of pre-renal azotemia. the patient was also written for phosphate binders in the setting of acute renal failure. the patient was maintained on d5w @ 70cc/hr. an arterial line was placed for tight bp monitoring. her bp stabilized in the micu and she was transferred to the floor on . . arf - likely secondary to her nsaids along w/ her ace-i and renal artery stenosis. she also likely had a prerenal component, though her fena was ~ 7% suggesting intrarenal disease -- she may have progressed to atn (though muddy brown casts absent in sediment). her blood pressure medications and diuretics were held. after fluid hydration her creatinine trended down and on the floor returned to 1.7. . ms changes - pt likely had poor cerebral perfusion secondary to hypotension and bradycardia, she may have had an additional component of uremia. she was given ativan in the ed and had a prolonged period of sedation but eventually became more lucid when her metabolic abnormalities were corrected. . afib - the patient was continuously in and out of atrial fibrillation during the hospitalization. she had a documented episode of atrial fibrillation from a previous hospitalization. she also had a tte from one year prior that showed a dilated left atrium. the patient had a tsh level that was normal. it was thought that she likely had paf that was long standing. she had two episodes of rapid atrial fibrillation resulting in flash pulmonary edema that responded to lasix and po lopressor. once her creatinine stabilized, the patient was given her outpatient dose of metoprolol and half her diltiazem dose with good rate control. per the attending, anticoagulation was held as the patient was deemed to be a large fall risk. her anticoagulation would be redressed when her functional status was better elucidated. . cad - the patient was continued on her aspirin and lipitor . htn - the patient documented sbp in the 200's as an outpatient. upon transfer to the floor her bp slowly began to trend up. her bp medications were added slowly in light of her presenting episode. her last measured bp was 150/84. upon d/c she was taking metoprolol 25 mg po bid and diltiazem 120 mg po bid. she started on lasix 20 mg po qd. her outpatient hydrochlorothiazide and lisinopril were held for the interim. . dyskinesia - pt w/ oro-lingual-buccal dyskinesia x many years on 0.25mg po q24h haloperidol (0.5mg prescribed) w/ good response. an ekg on showed qtc prolongation, as a result her haloperidol was held. another ekg on the day of d/c still showed qtc prolongation so the medication was held on d/c as well. . disp - the patient was transferred to for acute rehabilitation. medications on admission: diltiazem 120 mg fluoxetine 20 mg daily hctz 50 mg po daily lasix 20 mg qd metoprolol 25 mg lisinopril 40 mg po qd oxaprazin lipitor 10 haloperidol .25 mg po q 24 fosamax 70 mg po once/week nitroglycerin .4 mg sl prn:chest pain anusol - hc 2.5% :prn to hemorrhoid anusol - 25 mg rectally discharge medications: 1. heparin sodium (porcine) 5,000 unit/ml solution sig: one (1) injection tid (3 times a day). 2. colace 100 mg capsule sig: one (1) capsule po twice a day. 3. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). 4. ipratropium bromide 0.02 % solution sig: one (1) neb inhalation q 6h:prn as needed. 5. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 6. atorvastatin calcium 10 mg tablet sig: one (1) tablet po daily (daily). 7. albuterol sulfate 0.083 % solution sig: one (1) inhalation q 6h:prn as needed for wheezing. 8. diltiazem hcl 120 mg tablet sig: one (1) tablet po twice a day. 9. lasix 20 mg tablet sig: one (1) tablet po once a day. 10. fosamax 70 mg tablet sig: one (1) tablet po once a week. 11. anusol-hc 2.5 % cream sig: one (1) application rectal :prn as needed for hemorrhoids. 12. anusol-hc 25 mg suppository sig: one (1) rectal twice a day. 13. nitroglycerin 0.4 mg tablet, sublingual sig: one (1) sublingual prn as needed for chest pain. discharge disposition: extended care facility: - discharge diagnosis: beta blocker/calcium channel blocker toxicity atrial fibrillation htn chf arf discharge condition: stable discharge instructions: please call you primary care physician if you experience fatigue, confusion, lethargy, shortness of breath, chest pain, heart palpiations, fever, diarrhea. followup instructions: dr. office will arrange an appointment for you to see , rn, cs where: in weeks. please call phone: in the next 1-2 days to confirm the date. . provider: , .d. where: phone: date/time: 11:20 md, procedure: arterial catheterization diagnoses: congestive heart failure, unspecified unspecified essential hypertension acute kidney failure, unspecified atrial fibrillation coronary atherosclerosis of unspecified type of vessel, native or graft other specified cardiac dysrhythmias hypotension, unspecified other antihypertensive agents causing adverse effects in therapeutic use drug-induced delirium cardiac rhythm regulators causing adverse effects in therapeutic use orofacial dyskinesia 

Answer: The patient is high likely exposed to