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: elective admission for atrial fibrillation ablation. major surgical or invasive procedure: atrial fibrillation ablation and placement of a pacemaker. history of present illness: the pt is a 58 year-old woman with hypothyroidism and atrial fibrillation discovered in during screening colonoscopy. she was initially electively admitted for an atrial fibrillation ablation procedure and pacemaker placement on . the ablation procedure was apparently unsuccessful, but pacemaker was placed. the following history is that obtained on transfer to the neurology service on . on hospital day two, the pt developed acute onset of diplopia while she was on the floor, the morning after the procedure. a code stroke was called and the stroke fellow saw her immediately. she noted an aphasia and brought the pt immediately to the ct scanner. en route and at the scanner, the patient became noticeably worse, with the development of right arm plegia and a question of sensory deficits over her hand as well. she also had a left gaze deviation, a right facial droop, mild dysarthria, and some disorientation. her nihss was 11 her ct showed no hemorrhage/bleed. she then had a cta which showed no major vessel cut-off, but did have decreased apparent branch perfusion of the left posterior frontal lobe. her inr was 1.1. she was taken to the icu and tpa was administered. her deficits improved afterwards, with improvement in her gaze deviation, speech, and arm strength. past medical history: hypothyroidism atrial fibrillation syncope s/p caesarian section social history: pt lives with her husband. she also has 3 children. history of tobacco use but not recently. social alcohol use. no illicit drug use. family history: no neurological disease. physical exam: exam: vitals: hr=70, bp=140s/60-70s, rr=16, o2 sat=96-99% on 2lnc gen: sleepy, but answers questionas and follows some commands. heent: mmm. sclera clear. op clear cv: rrr, nl s1 and s2, no murmurs/gallops/rubs lung: clear to auscultation bilaterally ext: no cyanosis/edema neurologic examination: mental status: awake, but sleepy. difficulty with commands, but does follow all commands. does need mimicry for some of these. orientation: unable to test initially. now knows attention: fairly inattentive. registration: not tested language: initially fluent but mostly non-sensical. she could repeat. able to read, but again, it was non-sensical. could name thumb, but not knuckles. when asked a question, she did say she had a "hard time expressing" herself. cranial nerves: i: not tested ii: pupils unequal, with left 2-3 mm larger than right. they both react to light. vf difficult to test. iii, iv, vi: left gaze deviation, but she was able to cross midline to right with effort. later, she continues to have gaze palsy and has more trouble crossing midline. v, vii: initially with right umn facial. resolved after tpa. viii: hearing intact grossly xii: tongue midline without fasciculations, intact movements motor: no tremor grossly, lue was strong to exam. rue was essentially plegic. rle was weak and she could hold off of bed for ~3 secs. lle normal. after tpa, right leg 5/5 strength and rue fluctauates, but much improved. sensation: intact to light touch in all extremities after tpa. before, reported no lt sensation in right hand. coordination: unable gait: unable pertinent results: 10:31pm blood wbc-9.4 rbc-3.39* hgb-10.1* hct-29.0* mcv-86 mch-29.6 mchc-34.6 rdw-15.7* plt ct-267 10:31pm blood pt-13.8* ptt-29.1 inr(pt)-1.2* 10:31pm blood glucose-118* urean-10 creat-0.7 na-134 k-3.7 cl-102 hco3-24 angap-12 10:31pm blood calcium-8.4 phos-3.2 mg-1.6 cta head w&w/o c & recons; ct 100cc non ionic contrast (): noncontrast head ct: there is no evidence for hemorrhage. there is no mass effect or shift of normally midline structures. the -white matter differentiation is preserved. the osseous structures are unremarkable. there is a small presumed mucus retention cyst within the right maxillary sinus, otherwise, the paranasal sinuses are clear. the mastoid air cells are clear. ct angiography of the circle of : the distal carotid arteries and circle of opacify without evidence for stenosis or aneurysm. the vertebral arteries and basilar arteries opacify without abnormality. cta neck: the internal, common carotid, and internal carotid opacify without evidence for hemodynamically significant stenosis, dissection, or aneurysmal dilation. the vertebral arteries opacify without evidence for stenosis, dissection, or aneurysm. there is a very slight asymmetry of the vertebral arteries (right greater than left, but no evidence for origin stenosis). multiple small normal-appearing lymph nodes are identified within the soft tissues of the neck. the mastoid air cells are clear, and the osseous structures are unremarkable. ct perfusion: ct perfusion studies including calculation of blood volume, mean transit time, and blood flow demonstrate no perfusion abnormality. selected slice imaging was performed through the middle cerebral artery territory, and perfusion defects outside the area of interest may not be detected. impression: 1. normal noncontrast head ct. 2. normal cta of the circle of and neck without evidence for stenosis, embolus, or aneurysm. 3. normal ct perfusion head. non-contrast head ct. (): findings: there is no intra- or extra-axial hemorrhage, shift of normally midline structures or hydrocephalus. new areas of hypodensity within the left thalamus, left frontal and left cerebral peduncle likely reflecting evolving infarct. the ventricles and cisterns demonstrate normal size and symmetry. the basal cisterns are not effaced. a rounded soft tissue density in the right maxillary sinus likely reflects a small mucous retention cyst. the paranasal sinuses are otherwise clear. the mastoid air cells are well- aerated. impression: 1. no intracranial hemorrhage or mass effect. 2. focal areas of hypodensity involving the left thalamus, cerebral peduncle and temporal region suggestive of evolving infarct. mr would help for further evaluation. ct of the abdomen: there are dependent atelectatic changes in the lung bases bilaterally. a large hiatal hernia is identified. pacemaker wires are seen within the heart. the visualized pericardium appears unremarkable. assessment of the abdominal organs is limited by lack of intravenous contrast. there is a hypodensity within the left lobe of the liver measuring 9 mm in diameter, best seen on series 2, image 27. the gallbladder is collapsed. the adrenal glands, spleen, and pancreas appear unremarkable. the kidneys are prominent bilaterally with multiple large simple fluid attenuating cysts, the largest in the right kidney measures 6.6 cm. the largest in the left kidney measures 5.4 cm. the loops of small and large bowel appear normal in caliber and contour. no free air or free fluid is seen within the abdomen. ct of the pelvis: a foley catheter as well as nondependent air is seen within the bladder lumen. the uterus and rectum appear unremarkable. there is stranding in the right groin, with a small hematoma at the puncture site, tracking inferiorly. no retroperitoneal hematoma is identified. no free fluid is seen in the pelvis. the osseous structures demonstrate no concerning lytic or sclerotic lesions. impression: 1. no evidence of retroperitoneal hematoma. small right groin hematoma, tracking inferiorly, with associated stranding. 2. bilateral simple fluid attenuating kidney cysts. 3. large hiatal hernia. tte: no atrial septal defect is seen by 2d or color doppler. overall left ventricular systolic function is normal (lvef>55%). right ventricular chamber size and free wall motion are normal. there is no pericardial effusion. compared with the prior study (images reviewed) of , a pacemaker is now present. femoral artery ultrasound: a hematoma is present anterior to the right common femoral artery and vein. there is no evidence of a pseudoaneurysm or arteriovenous fistula in the right inguinal region. the right common femoral, profunda femoral and superficial femoral arteries in the inguinal region are patent. the right profunda femoral vein is patent. the right superficial femoral vein in this region is patent. the right common femoral vein is partly compressed by the adjacent hematoma. the vein itself does contain flow, however, there is some loss of respiratory variation. brief hospital course: 1. stroke: as detailed in the hpi, the pt was transferred from the cardiology service to the neuro icu where iv tpa was administered. her deficits greatly improved, the only persistent symptom being diplopia. this continued throughout the hospital stay and was felt to be the manifestation from a supranuclear midbrain lesion. otherwise, her neurologic examination remained normal. she was in the icu for five days over concern of low blood pressure (treated intermittently with a neosynephrine gtt) and anemia (work-up as detailed below). given likely cardioembolic source of the stroke, she was started on a heparin gtt and warfarin. she was called out the floor on hospital day seven and there remained stable. on hospital day ten, she was transitioned to sc lovenox and warfarin and discharged. she will have her inr checked by her pcp after discharge, at which time lovenox may be discontinued once inr is in the therapeutic range (). she will follow-up in stroke clinic and in clinic. 2. anemia: the pt developed progressively declining hematocrit after tpa administration and institution of anticoagulation. she had an extensive work up including ct of the abdomen and pelvis which ruled out retroperitoneal hematoma, tte which ruled out hemopericardium, serial guiaic negative stool, and normal hemolysis labs. she was transfused one unit of prbcs in the icu when her hematocrit dropped to 22.1 (to which she responded appropriately) a femoral ultrasound was performed on hospital day nine when the pt developed right groin and thigh pain which demonstrated hematoma is present anterior to the right common femoral artery and vein. the cardiology service felt that this was likely the area of blood loss to account for anemia. at the time of discharge, her hematocrit had been stable at 26 for three days. she was discharged on iron supplementation. 3. right leg pain: as above, the pt developed right groin and thigh pain on hospital day nine. a femoral ultrasound was performed and demonstrated hematoma is present anterior to the right common femoral artery and vein. she was treated symptomatically with prn oxycodone. physical therapy evaluated the pt and felt that she would need home pt and a walker to aid in ambulation at the time of discharge. 4. atrial fibrillation: the electrophysiology service followed the pt after transfer to the neurology service. they interrogated her pacemaker prior to discharge and it was noted to be working properly. she will follow-up in cardiology clinic after discharge. 5. hypothyroidism: the pt was maintained on her usual dose of synthroid. medications on admission: synthroid 100mg po daily effexor xr 150mg po daily atenolol, but stopped coumadin stopped lovenox and discharge medications: 1. venlafaxine 75 mg capsule, sust. release 24hr sig: two (2) capsule, sust. release 24hr po daily (daily). 2. atorvastatin 10 mg tablet sig: one (1) tablet po daily (daily). 3. levothyroxine 100 mcg tablet sig: one (1) tablet po daily (daily). 4. warfarin 5 mg tablet sig: one (1) tablet po hs (at bedtime). disp:*30 tablet(s)* refills:*2* 5. oxycodone 5 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for pain. disp:*50 tablet(s)* refills:*0* 6. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*2* 7. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed. disp:*30 tablet(s)* refills:*2* 8. ferrous sulfate 325 (65) mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 9. enoxaparin 80 mg/0.8 ml syringe sig: one (1) injection subcutaneous q12h (every 12 hours). disp:*30 injection* refills:*0* discharge disposition: home with service facility: discharge diagnosis: -left thalamic, cerebral peduncle and temporal lobe stroke -atrial fibrillation, s/p ablation procedure and placement of pacemaker -anemia of uncertain etiology, probably due to blood loss in the groin discharge condition: stable. neurologic examination notable for dysconjugate gaze and resultant diplopia. discharge instructions: please continue all medications as prescribed. please attend all follow up appointments. if you experience weakness, numbness, dizziness or other concerning symptoms, please call your primary care doctor or come to the emergency department for evaluation. followup instructions: please follow-up with your primary care doctor to have your inr checked on monday. please schedule a follow-up appointment for the next 7-10 days. provider: , spec surgery- spec (nhb) date/time: 10:30 provider: , md phone: date/time: 1:15 neurology: provider: , md phone: date/time: 9:30 please call dr. in neuro-ophthalmology at to arrange a follow-up appointment in the next month. cardiology: dr. at 1pm at . please also report to clinic at at 12:30pm on . md, procedure: injection or infusion of thrombolytic agent excision or destruction of other lesion or tissue of heart, endovascular approach initial insertion of dual-chamber device initial insertion of transvenous leads [electrodes] into atrium and ventricle arterial catheterization atrial cardioversion diagnoses: iron deficiency anemia secondary to blood loss (chronic) atrial fibrillation hematoma complicating a procedure iatrogenic cerebrovascular infarction or hemorrhage 

Answer: The patient is high likely exposed to