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: hemoptysis major surgical or invasive procedure: 1. mechanical ventilation 2. arterial line placement history of present illness: this is a 58 year-old male with a history of hodgkin's disease, s/p surgery, radiation, splenectomy in , cad s/p pci , htn, hl, hypothyroidism, babesiosis w/ severe parasitemia presents with hemoptysis. the has been having sob over the last week. he went to see his pcp on and was started on flovent. last night the patient had worsening sob and a "small amount" of blood while coughing. today the sob worsened and had several more episodes of hemoptysis with a "cup full" this afternoon that prompted him to go to the ed. . in the ed at 99.0 118 158/127 32 83% ra. he was noted to have blood in his op and worsenign hemoptysis. labs were significant for leukocytosis of 20.8, hct 45.4, plts 457, inr: 1.1, ce negative x1. he was given cefepime/vancomycin. he was intubated for airway protect and respiratory distress. he was given succinylcholine/etomidate and started on a propofol gtt. post-intubation cxr showed lul consolidation and ett tube in proper position. he had a cta chest that showed l-sided consolidation vs blood. no evidence of pe. he was was paralyzed for transport with vecuronium and 2mg of versed. . on arrive the patient was on vt 450, fio2: 100%, rr: 14, peep: 5. he was noted to have blood in his et tube and ng lavage was performed that showed brb that continued to be pink colored after 1l. his vent setting were changed to vt 580, rr:18, fio2: 100%, peep: 8 on arrival and abg was 7.24/55/78/25 and rate was increased to 20. his foley catheter also showed blood. the prelim ct read showed lul consolidation that is likely blood. there was also an area of constriction in the lll that was concerning for mass. he also had a left pleural lesion and small left effusion. . ros: unable to obtain past medical history: - babesia requiring hospitalization from with severe parasitemia due requiring exchange transfusion. recently stopped azithro/atovaquone on . -hodgkin's disease, s/p surgery, radiation, splenectomy in -hypothyroidism -essential hypertension -hyperlipidemia -esophageal stricture: s/p dilatation in -basal cell carcinoma -cad s/p pci : 90% prox to mid lad lesion with cypher sent, nl left main and lcx social history: resides in ma with wife, three children, dog and 2 cats. owns his own consulting company. patient reports 14 pack year history (quit ), consumes ~6 drinks per week. reports occasional marijuana use in college and denies elicit drug use. family history: father deceased (48 ) from emphysema and mother deceased from 'old age.' no family history of malignancy physical exam: admission physical: gen: intubated and sedated, blood in his et tube, no acute distress heent:pupils reactive to light, sclera anicteric, blood in his et and dried blood in his mouth neck: no jvd, carotid pulses brisk, no lad cor: rrr, no m/g/r, normal s1 s2 pulm: diminished bs on the left side, coarse rhonchi, also rhonchi in the right upper lobe abd: soft, nt, nd, +bs, no hsm, no masses ext: no c/c/e, no palpable cords neuro: sedated, cn ii ?????? xii grossly intact. moves all 4 extremities. strength 5/5 in upper and lower extremities. patellar dtr +1. plantar reflex downgoing. skin: no jaundice, cyanosis, or gross dermatitis. no ecchymoses. . discharge physical: gen: alert, oriented, nad heent: eomi, sclera anicteric, mmm cor: rrr, normal s1 s2, soft systolic murmur, ne edema pulm: diminished bs in lul, bronchial breath sounds, good aeration b/l abd: soft, nt, nd, +bs, no hsm, no masses ext: no c/c/e, no palpable cords neuro: intact, no focal deficits skin: trunk and extremity red, pruritic urtical rash improving; persistent rash on back: pertinent results: micro: **final report ** urine culture (final ): <10,000 organisms/ml . source: stool. **final report ** ova + parasites (final ): no ova and parasites seen. this test does not reliably detect cryptosporidium, cyclospora or microsporidium. while most cases of giardia are detected by routine o+p, the giardia antigen test may enhance detection when organisms are rare. . cmv igg antibody (final ): positive for cmv igg antibody by eia. 127 au/ml. reference range: negative < 4 au/ml, positive >= 6 au/ml. cmv igm antibody (final ): negative for cmv igm antibody by eia. interpretation: infection at undetermined time. a positive igg result generally indicates past exposure. infection with cmv once contracted remains latent and may reactivate when immunity is compromised. if current infection is suspected, submit follow-up serum in weeks. greatly elevated serum protein with igg levels > mg/dl may cause interference with cmv igm results. . fecal culture (final ): no salmonella or shigella found. no enteric gram negative rods found. campylobacter culture (final ): no campylobacter found. ova + parasites (final ): no ova and parasites seen. this test does not reliably detect cryptosporidium, cyclospora or microsporidium. while most cases of giardia are detected by routine o+p, the giardia antigen test may enhance detection when organisms are rare. clostridium difficile toxin a & b test (final ): feces negative for c.difficile toxin a & b by eia. (reference range-negative). . 2:15 pm tissue ebus tbna level 7 lymph node. gram stain (final ): 1+ (<1 per 1000x field): polymorphonuclear leukocytes. no microorganisms seen. tissue (final ): no growth. anaerobic culture (final ): no growth. acid fast smear (final ): no acid fast bacilli seen on direct smear. acid fast culture (preliminary): no mycobacteria isolated. fungal culture (final ): no fungus isolated. potassium hydroxide preparation (final ): no fungal elements seen. . 2:24 pm bronchoalveolar lavage left upper lobe. gram stain (final ): 1+ (<1 per 1000x field): polymorphonuclear leukocytes. no microorganisms seen. respiratory culture (final ): ~/ml commensal respiratory flora. acid fast smear (final ): no acid fast bacilli seen on concentrated smear. acid fast culture (preliminary): no mycobacteria isolated. fungal culture (final ): no fungus isolated . 8:08 am sputum source: endotracheal. **final report ** gram stain (final ): >25 pmns and <10 epithelial cells/100x field. no microorganisms seen. respiratory culture (final ): no growth. . imaging: patient provided with cd, hard copies to be faxed tte : conclusions the left atrium and right atrium are normal in cavity size. left ventricular wall thickness, cavity size, and global systolic function are normal (lvef>55%). due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (?#) appear structurally normal with good leaflet excursion. there is no aortic valve stenosis. no aortic regurgitation is seen. the mitral valve appears grossly normal with trivial mitral regurgitation. the pulmonary artery systolic pressure could not be determined. there is no pericardial effusion. there is no evidence of pericardial constriction. impression: suboptimal image quality. normal biventricular cavity sizes with preserved global biventricular systolic function. no valvular pathology identified. no evidence for pericardial disease. . cxr : impression: 1. improved left and upper lobe consolidation, likely reflective of aspiration and atelectasis. 2. mild pulmonary edema. . cxr : over the past 24 hours, consolidation in the left upper lobe and previous moderate left pleural effusion have improved substantially. region of right lower lobe consolidation has worsened slightly since . heart size is normal. mediastinal widening in the region of the aortic arch is attributable to adenopathy. et tube at the upper margin of the clavicles is at least 5 cm from the carina. right internal jugular line is just above the estimated location of the superior cavoatrial junction. nasogastric tube passes below the diaphragm and out of view. small right pleural effusion remains. . cxr : impression: slightly increased moderate left pleural effusion. . cxr : the patient was extubated in the meantime interval. the ng tube was removed as well. there is currently unchanged appearance of the widened left mediastinum. left retrocardiac consolidation and left pleural effusion are unchanged. the perihilar opacity has slightly increased in the interim and might potentially represent area of atelectasis, although hemorrhage as well as aspiration cannot be entirely excluded. correlation with multiple prior radiographs demonstrates slight improvement of the right basal aeration. . fna flow cytometry : interpretation non-specific t cell dominant lymphoid profile; diagnostic immunophenotypic features of involvement by non-hodgkin lymphoma are not seen in specimen. however, there are clusters of highly atypical cells on the cytospin preparation, which are highly suspicious for involvement by a non-hematologic malignant neoplasm. refer to concurrent surgical pathology report (s10-) for final diagnosis. correlation with clinical findings is recommended. flow cytometry immunophenotyping may not detect all lymphomas as due to topography, sampling or artifacts of sample preparation. . level 7 lymph node, ebus-tbna, cell block metastatic non-small cell lung carcinoma. immunohistochemical stains show that tumor cells stain positive for cytokeratin cocktail (ae1/3 and cam 5.2), cytokeratin 7 and ttf-1. cells are negative for cytokeratin 20, chromogranin, synaptophysin, neuron-specific enolase, cd56 (ncam) and hmb45. lca (cd45) highlights background inflammatory cells. the cytomorphologic and immunophenotypic findings are consistent with metastatic non-small cell lung carcinoma; the tumor cannot be further classified in this sample. admission labs: 10:17pm type-art temp-37.3 rates-22/0 peep-8 po2-269* pco2-36 ph-7.40 total co2-23 base xs--1 -assist/con intubated-intubated 10:10pm ck(cpk)-158 10:10pm ck-mb-5 ctropnt-0.26* 10:10pm haptoglob-120 10:10pm haptoglob-120 10:10pm anca-negative b 10:10pm wbc-18.0* rbc-4.37* hgb-12.7* hct-37.0* mcv-85 mch-29.1 mchc-34.3 rdw-16.3* 10:10pm plt count-419 10:10pm pt-13.8* ptt-21.1* inr(pt)-1.2* 10:10pm fibrinoge-211 10:10pm parst smr-negative 05:02pm type-art po2-78* pco2-55* ph-7.24* total co2-25 base xs--4 05:02pm lactate-1.1 04:40pm urine color-straw appear-cloudy sp -1.032 04:40pm urine blood-lg nitrite-neg protein-25 glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-6.5 leuk-tr 04:40pm urine rbc->50 wbc-* bacteria-few yeast-none epi-0 04:35pm glucose-167* urea n-13 creat-1.0 sodium-139 potassium-4.4 chloride-102 total co2-27 anion gap-14 04:35pm estgfr-using this 04:35pm alt(sgpt)-23 ast(sgot)-27 ld(ldh)-318* ck(cpk)-187 alk phos-71 tot bili-0.4 dir bili-0.2 indir bil-0.2 04:35pm ck-mb-3 ctropnt-0.06* 04:35pm albumin-4.6 calcium-8.6 phosphate-5.5*# magnesium-1.9 04:35pm haptoglob-189 04:35pm wbc-26.4*# rbc-5.05 hgb-15.1 hct-44.3 mcv-88 mch-29.9 mchc-34.1 rdw-16.1* 04:35pm neuts-71.8* lymphs-22.2 monos-3.6 eos-1.6 basos-0.8 04:35pm hypochrom-normal anisocyt-occasional poikilocy-3+ macrocyt-normal microcyt-occasional polychrom-normal spherocyt-occasional target-occasional schistocy-occasional burr-2+ teardrop-occasional elliptocy-occasional 04:35pm plt count-470* 04:35pm pt-13.6* ptt-20.2* inr(pt)-1.2* 04:35pm fibrinoge-250# admission labs: discharge labs: wbc rbc hgb hct mcv mch mchc rdw plt ct 13.8* 3.45* 9.9* 30.5* 89 28.7 32.4 16.2* 1034*1 glucose urean creat na k cl hco3 angap 101 10 0.8 135 4.1 101 24 14 pleural pleural analysis wbc rbc polys lymphs monos eos meso macro 14:48 9000* * 0 67* 0 1* 10* 22* brief hospital course: this is a 58 year-old male with a history of hodgkin's disease, s/p surgery, radiation, splenectomy in , cad s/p pci , htn, hl, hypothyroidism, babesiosis w/ severe parasitemia , who presented with hemoptysis found to have non-small cell lung cancer. . #. hemoptysis/metastatic non-small cell lung carcinoma. regarding cancer risk patient with 14 pack year history of tobacco as well as h/o of hodgkins disease s/p mantle radiation in the . the patient was diagnosed with hodgkin's lymphoma in and treated with splenectomy and thoracic mantle radiotherapy by dr. at . he has since had no evidence of disease, and flow cytometry on revealed no evidence of lymphoma. repeat chest x-rays have shown stable bilateral paramediastinal fibrosis. regarding immediate history prior to this presentation patient developed shortness of breath in mid-, was started on flovent by his primary care physician. , he coughed up sputum with streaks of blood, and the following day had an episode of hemoptysis measuring one cup. he presented to , where oxygen saturation was 83%, and he was intubated. cta of the chest showed no pulmonary embolism, but revealed a large density involving the majority of the left upper lobe, likely representing pulmonary hemorrhage. it also showed a left lower lobe consolidation and an adjacent paramediastinal area of heterogeneous attenuation with adjacent focal narrowing of the left pulmonary artery apical segmental branch to the lower lobe. there was also a 2-cm subcarinal node and a 0.9-cm node adjacent to the left mainstem bronchus. hematocrit at that time was 45.5, with a wbc count of 20.8, and the patient was started on cefepime and vancomycin. he was transferred to for further evaluation and management, where his hemoptysis continued. initial bronchoscopy reportedly revealed a protruding lesion with intraluminal and extraluminal component in the left lower lobe, but there is no offical report of this, and no biopsies were taken. rigid bronchoscopy on showed slow oozing of bright red blood from the apical posterior segment of the left upper lobe and an enlarged subcarinal lymph node. biopsy of the left upper lobe revealed scant strips of benign respiratory epithelium and fibrinous exudate and clot with acute and chronic inflammation. flow cytometry revealed no lymphoma, but showed clusters of highly atypical cells on the cytospin, suspicious for a non-hematologic malignancy. biopsy results of the enlarged subcarinal lymph node + non-small cell lung cancer (immunohistochemical stains show that tumor cells stain positive for cytokeratin cocktail (ae1/3 and cam 5.2), cytokeratin 7 and ttf-1. cells are negative for cytokeratin 20, chromogranin, synaptophysin, neuron-specific enolase, cd56 (ncam) and hmb45. lca (cd45) highlights background inflammatory cells. the cytomorphologic and immunophenotypic findings are consistent with metastatic non-small cell lung carcinoma; the tumor cannot be further classified in this sample). the patient underwent ir embolization of right bronchial artery branches on , and ir embolization of left bronchial, intercostal, and internal mammary branches on . he was seen by the thoracic surgery team on for consideration of lobectomy which due to involvement/encasement of pulmonary arteries did not appear to be an option. rad onc and med onc . further staging was performed including ct chest, abd, pelvis, mri head and brain - which were negative for metastasis. us guided thoracentisis performed on day prior to discharge to determine presence of malignany effusion as well as further delinate adenocarcinoma vs squamous cell carcinoma. cell block obtained; results pending at time of discharge - initial results below: pleural analysis wbc rbc polys lymphs monos eos meso macro 14:48 9000* * 0 67 0 1* 10* 22* home regimen of asa/plavix discontinued. hematocrit monitored closely and stable at 30 at time of discharge. . # pulmonary embolism, dvt s/p ivc filterplacement. on patient with complaint of area of induration on posterior right leg on . leni's + popliteal dvt. ct with non-occlusive thrombis within the right pulmonary artery. decision made to place permanent filter due to inability to anti-coagulate. patient did demonstrate intermittent sinus tachycardia to 130s with exertion though likely manifestation of pulmonary embolism. no document hypoxia on the floor. ambulatory sat 93-94% on ra. . # gi bleed. gi due to several episodes of dark tarry stool as well as bright red blood per rectum. during hospitalization, shortly after extubation, patient with several episodes of small volume loose black, sticky foul smelling stool. additionally, on , he began having loose stools with bright red blood surrounding his stool, last brb bowel movement this am. he has some anal discomfort but no abdominal pain. denies nausea, vomitting, or persistent reflux. last episode of hemoptysis was and patient remembers swallowing a large amount of blood at that point. he denies a history of hematochezia, melena, hemaetemesis prior to admission. he has been on plavix and aspirin for his cad up until admission on . he has never had a colonscopy due to the fact that he has been on plavix. prior to admission bowel movements were regular (occuring once daily), no change in caliber, brown and formed, no abdominal pain with bowel movements. patient underwent egd which was negative - dark stools thought secondary to aspirated blood, colonscopy demonstrated 2 small poylps in the rectum s/p polypectomy. circumferential area in rectum of ulceration, erythema and friability of unknown significance. biopsies demonstrated colonic mucosal samples: sigmoid polyp (polypectomy): fragments of adenoma. rectum (biopsy): fragments of colonic/rectal mucosa with focal, sharply demarcated ulceration, fibrinopurulent exudate and adjacent crypt regeneration; no diagnostic features of chronic colitis, granulomata or viral inclusions are identified. the differential includes infection, a drug effect (e.g. nsaid's) or, less likely, ischemic injury, among other etiologies. patient started on canasa suppositories with improvement in rectal irritation. will follow-up with gi as outpatient if needed. . #. babesiosis: pt with severe prior infection and pcr from was negative. his azithro and atovoquone were stopped per id roughly one month prior. no evidence that babesiosis is related to his hemoptysis. admission thick and thin smears negative. resent babesia pcr per id's request. they will follow-up results . #. urinary retention. patient noted to have hematuria in micu which was deemed traumatic bleeding in the setting of foley placement. coags wnl. no further episodes of hematuria in house however initial concern for metastatic disease to spine in setting of new retention. mri spine without any spinal lesions. patient passed voiding trial on day prior to admission. did endorse some urinary discomfort, no overt dysuria. ua without sign of infection. benefit from urology follow-up as outpatient if symptoms do not improve. . #. ecg changes: on admission to micu ecg demonstrates less then 1mm st elevations diffusely. ce at were negative. troponins in house elevated likely (peak to .26, downtrended last check 0.09) illustrating a cardiac events however in setting of hemoptysis patient not candidate for heparin gtt. patient without anginal complaints in house. . # rash. patient started on levofloxacin due to concern for pneumonia in asplenic patient. on day 5 patient developed pruritic urtical rash on back. levofloxacin was transitioned to ceftriaxone with improvement of rash. patient completed course of antibiotics with 5 additional days ceftriaxone. on , final day of ceftrixone, patient developed pruritic, urticaral rash on trunk and upper and lower bilateral extremities. patient was treated with anti-histamines and short pulses of low dose prednisone, 20mg daily. rash improved and day of discharge. #. hl: continued home statin . #. htn: held all anti-hypertensives in house. at time of discharge medications were not restarted. . #. hypotension: patient presenting blood pressures labile and required periperal neo for the bronch. this was likely due to sedation, but concern for sepsis prompted icu team to empirically cover with vanco/cefepime to cover encapsulated organisms due to patient asplenic status. patient weaned off neo as sedatives wore off and hematocrit stabilized. home atenolol held in house and throughout remainder of stay on the floor patient normotensive without anti-hypertensives. pending studies: babesia pcr pleural fluid analysis and cytology medications on admission: azithro/atovaquone stopped on lorazepam 0.5mg :prn atenolol 25mg daily protonix 40mg plavix 75mg daily lipitor 10mg daily asa discharge medications: 1. atorvastatin 10 mg tablet sig: one (1) tablet po daily (daily). 2. prednisone 20 mg tablet sig: one (1) tablet po daily (daily) for 3 days. disp:*3 tablet(s)* refills:*0* 3. guaifenesin 100 mg/5 ml syrup sig: 5-10 mls po q4h (every 4 hours) as needed for cough. 4. lorazepam 0.5 mg tablet sig: one (1) tablet po twice a day as needed for esophageal stricture/spasm. 5. protonix 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po twice a day. 6. menthol-cetylpyridinium 3 mg lozenge sig: one (1) lozenge mucous membrane prn (as needed) as needed for cough/sore throat. 7. albuterol sulfate 90 mcg/actuation hfa aerosol inhaler sig: 1-2 puffs inhalation every 4-6 hours as needed for shortness of breath or wheezing. disp:*2 inhalers* refills:*2* 8. diphenhydramine hcl 25 mg capsule sig: one (1) capsule po q6h (every 6 hours) as needed for itching. 9. ranitidine hcl 150 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* discharge disposition: home discharge diagnosis: primary: metastatic non-small cell lung cancer pulmonary embolism s/p ivc filter placement . secondary: hypertension. coronary artery disease. hyperlipidemia discharge condition: mental status: clear and coherent ambulates without assistance. discharge instructions: mr it was a pleasure taking care of you. . you were admitted to after episode of coughing up blood. you were initially admitted to the intensive care unit for close monitoring and intubated for protection of your airway. our team of interventional pulmonologists examined your airways and identified the bleeding source. they cauterized the area and stopped the bleeding. unfortunately imaging demonstrated a large mass in the left upper lobe of your lung. biopsy of an adjacent lymph node was performed which was positive for non-small cell lung cancer. due to the fact that the lymph node is located outside of your lung your lung cancer is characterized as metastatic, which indicates spread (the pathology slide will be mailed to ). additional imaging of your belly, spine and brain where negative for metastasis. to complete staging, a sample of fluid was removed from your pleural space, the pleura is a sac that surrounds your lungs. this fluid will be analysized by the lab. the results will be used to help tailor your chemotherapeutic regimen. these were pending at the time of discharge and will be followed by your oncologist. . during your hospitalization you noted both dark stools as well as episodes of bright blood in the toilet. our team of gi doctors and underwent both an upper endoscopy which visualized the upper part of your gi tract as well as a colonoscopy which visualized your lower gi tract. the egd was negative and the colonoscopy illustrated rectal ulcerations. biopsies were obtained which were consistent with rectal irritation/inflammation. overall the team of gi doctors were not concerned. you can discontinue the enemas and follow-up with them if you have any additional questions or occurences of blood in stool. . you also broke out in a rash twice while hospitalized, both which were attributed to a drug rash (first levofloxacin, second: ceftriaxone) to treat your rash you were started on anti-histamines as well as oral steriods. at time of discharge your rash was overall improving but still present. . also the infectious disease doctors in on the monitoring of the babesia. a lab test was sent off to monitor for any signs of babesia in the blood. this result was pending at the time of discharge but will be followed up by your team of infectious disease doctors. . regarding ongoing transfer of care, you were discharged with media copy of all imaging studies. a hard copy of results including discharge summary will be faxed to . the pathology results/slide will be mailed from our pathology department to . . changes to your medications: to treat your rash: continue taking prednisone 20mg. take one 20mg tablet through - at that time you will have completed a 7 day course. for sympotamatic relief of your rash you make take/apply the following as needed: - rantidine 150mg tablets. take one pill twice daily as needed until rash resolves. - benadryl 25mg tablets. take one pill every six hours as needed for itch. . to help in your breathing you may use: - albuterol inhaler: 1-2 puffs every 4-6hrs as needed for sob. - guaifenesen: 5-10ml po every four hours for cough suppression. . stop taking plavix and aspirin to minimize your risk of bleeding. stop taking atenolol. . take all other prescription medications as prescribed. . again, it was a honor taking care of you. we wish you and your family as the best. take care. followup instructions: regarding your ongoing treatment at the - you will plan to follow-up with both dr. and this friday. below is the number for the clinic. please feel free to contact if you have further questions or concerns. clinic. procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more other endoscopy of small intestine insertion of endotracheal tube interruption of the vena cava fiber-optic bronchoscopy thoracentesis injection or infusion of other therapeutic or prophylactic substance injection or infusion of other therapeutic or prophylactic substance arterial catheterization other intubation of respiratory tract arteriography of other intrathoracic vessels arteriography of other intrathoracic vessels closed [endoscopic] biopsy of bronchus closed [endoscopic] biopsy of bronchus closed [endoscopic] biopsy of bronchus aortography endoscopic polypectomy of large intestine angiocardiography of venae cavae [endoscopic] polypectomy of rectum diagnoses: coronary atherosclerosis of native coronary artery pure hypercholesterolemia unspecified pleural effusion unspecified essential hypertension unspecified acquired hypothyroidism percutaneous transluminal coronary angioplasty status acute respiratory failure other specified cardiac dysrhythmias personal history of other malignant neoplasm of skin blood in stool retention of urine, unspecified diarrhea hypovolemia accidents occurring in residential institution drug-induced delirium benign neoplasm of colon hematuria, unspecified other pulmonary embolism and infarction secondary and unspecified malignant neoplasm of intrathoracic lymph nodes malignant neoplasm of lower lobe, bronchus or lung other chronic nonalcoholic liver disease benign neoplasm of rectum and anal canal benzodiazepine-based tranquilizers causing adverse effects in therapeutic use personal history of hodgkin's disease bacterial pneumonia, unspecified shock, unspecified ulcer of anus and rectum urticaria, unspecified 

Answer: The patient is high likely exposed to