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: codeine / aspirin / ibuprofen / lipitor / crestor attending: chief complaint: fall down stairs, syncope major surgical or invasive procedure: paravertebral block by acute pain service history of present illness: this is a y/o f, with h/o previous c7 vertebral body compression fx last year after a syncopal event while defecating, who presents to ed after falling down flight of stairs today. pt was carrying laundry up a flight of stairs and fell when she had a syncopal event. pt aroused at bottom of stairs and called for help. at presentation she complained of right sided back pain. she had head, c-spine, and torso ct scan which showed multiple right sided rib fractures. pt does have chronic neck pain after compression fx last year. she wears a neck brace as needed at night for comfort. she currently denies neck pain, headache, abdominal pain or distension, and additionally denies any chest pain or sob or palpitations prior to the fall. past medical history: pmh: 1. a-fib 2. type ii dm 3. hx of pe 20 yrs ago 4. hyperlipidemia 5. osteoporosis 6. osteoarthritis 7. anxiety 8. c7 compression fracture s/p fall psh: none social history: patient lives at home, engages in water aerobics everyday, denies use of tobacco, alcohol, or iv drug use family history: father died from mi at age 50 brother died from mi at age 37 physical exam: at discharge vs: afebrile, vss 96.2 87 158/82 16 98%2l constitutional: well appearing, no acute distress neck: no masses cv: rrr, no murmurs. resp: ctab, no wheezes or crackles, is 300. + ttp r ant/post chest. no crepitus. abd: soft, no ttp, nondistended, +bs ext: warm, distal pulses palpable bilaterally skin: face, neck and chest is normal musculoskeletal: normal to gait and station spine, pelvis and extremities: stable psychiatric: normal to judgment, insight, memory, mood and affect pertinent results: lactate:3.8 ua negative 132 95 22 agap=19 -------------328 4.8 23 0.8 ck: 270 mb: 5 trop-t: <0.01 alt: 70 ap: 55 tbili: 0.7 alb: ast: 102 ldh: dbili: tprot: : lip: dig: 0.7 13.0 15.4 ----- 165 39.1 n:91 band:5 l:2 m:2 e:0 bas:0 poiklo: occasional ovalocy: occasional pt: 24.8 ptt: 24.5 inr: 2.4 . carotid duplex: 60-69% stenosis of l ica, 40-59% stenosis of r ica . ct head: no acute intracranial process . ct c-spine: interval c7 vertebral body height loss new since prior but could represent . ct abd/pelvis: 1. multiple acute right rib fractures without evidence of flail chest or segmental fractures. 2. asymmetric pulmonary edema, right greater than left, with trace right pleural effusion and bibasilar atelectasis. 3. 1.5 cm left lower lobe pulmonary nodule, not included in the field of view of the prior study. if clinically indicated, a three-month followup is recommended. 4. unchanged left adnexal cyst. brief hospital course: the patient was admitted to the trauma surgery service on after a syncopal episode causing a fall down stairs resulting in multiple broken ribs, but no other injuries. neuro: pain control was problem for this patient during her hospitalization and the acute pain service was consulted to provide recommendations to better manage the patient's rib pain. she initially received iv pain medicaions, including a pca, and also had a paravertebral block performed by aps. when tolerating oral intake, the patient was transitioned to oral pain medications, on a regimen including neurontin, lidoderm patch, standing tylenol, tramadol and dilaudid for break-through pain, with fair pain control. the pt also underwent carotid duplex ultrasound in the evaluation for syncope, which showed 60-69% stenosis of l ica, 40-59% stenosis of r ica. she will follow up with vascular surgery in 6 months for this, but this is not likely the cause of her syncope. cv: the patient was stable from a cardiovascular standpoint; vital signs were routinely monitored. she was kept on telemetry which was reassuring. ecg on admission was not thought to be consistent with stemi. additionally, cardiac enzymes were negative x 1. vital signs were routinely monitored and were stable. she needs follow up with her regular doctor, as she may need an echo or holter monitoring as an out-patient. pulmonary: the patient was stable from a pulmonary standpoint; vital signs were routinely monitored. she did require 2l of o2 nasal cannula at discharge, this was thought to be due to poor deep breathing mild persistent rib pain. chest xrays did not reveal any pneumonia or fluid overload. the pt did have a 1.5 cm left lower lobe pulmonary nodule noted on ct chest. she will need follow up by her regular doctor, likely with repeat ct chest to eval for interval change. gi/gu: at admission, the patient was resuscitated with iv fluids until tolerating oral intake. her diet was advanced when appropriate, which was tolerated well. she was also started on a bowel regimen to encourage bowel movement. foley was removed on hd#2. intake and output were closely monitored and were normal. she did have some episodes of incontinence. prophylaxis: the patient received subcutaneous heparin during this stay, and was encouraged to get up and ambulate as early as possible with pt. at the time of discharge on hd#7, the patient was doing well, afebrile with stable vital signs, tolerating a regular diet, working with pt, voiding without assistance, and pain was fairly well controlled. medications on admission: digoxin 250 mcg 6 out of 7 days of the week, zetia 10', lisinopril 5', toprol xl 25', coumadin, vitamin c, vitamin d, mvi discharge medications: 1. ezetimibe 10 mg tablet sig: one (1) tablet po daily (daily). 2. digoxin 250 mcg tablet sig: one (1) tablet po 6x/week (,mo,tu,we,th,fr). 3. lisinopril 5 mg tablet sig: one (1) tablet po daily (daily). 4. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 5. lidocaine 5 %(700 mg/patch) adhesive patch, medicated sig: one (1) adhesive patch, medicated topical q12 (): 12 hours with patch on, 12 hours with patch off. 6. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 7. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed for constipation. 8. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection tid (3 times a day). 9. ipratropium bromide 0.02 % solution sig: one (1) inhalation q6h (every 6 hours). 10. hydromorphone 2 mg tablet sig: 0.5-1 tablet po every hours as needed for pain for 30 days: hold for sedation, rr < 12. 11. acetaminophen 500 mg tablet sig: two (2) tablet po q 8h (every 8 hours) as needed for pain for 30 days: do not exceed more than 4g tylenol daily. 12. gabapentin 300 mg capsule sig: one (1) capsule po tid (3 times a day) for 30 days: hold for sedation. 13. metoprolol succinate 25 mg tablet sustained release 24 hr sig: 2.5 tablet sustained release 24 hrs po daily (daily): hold for sbp < 100 and hr < 60 . 14. tramadol 50 mg tablet sig: 0.5 tablet po qid (4 times a day) for 30 days. 15. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) neb inhalation q6h (every 6 hours). disp:*120 neb* refills:*0* 16. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po q6h (every 6 hours) as needed for constipation for 10 days. discharge disposition: extended care facility: newbridge on the discharge diagnosis: primary: 1) fall (trauma), 2) syncope, 3) right posterior rib fractures, 4) right anterior 6th rib fx secondary: 1) atrial fibrillation, 2) osteoporosis, 3) diabetes mellitus ii, 4) pe 20 years ago, 5) previous c7 fx discharge condition: mental status:clear and coherent level of consciousness:alert and interactive activity status:out of bed with assistance to chair or wheelchair discharge instructions: *you were admitted to to the trauma service after a fall due to losing consciousness. *you were found to have 5 rib fractures on ct scan. the most important treatment for this kind of fracture is pain control to optimize deep breathing. there is no surgery or brace for support that is recommended. optimization of pain control is imperative because splinting (weak breathing due to pain) can result in pneumonia. * you should expect to have rib pain for 4-6 weeks from your injury until your ribs have begun to heal. please continue to take the pain medication prescribed until then. please also continue to use the incentive spirometer (breathing machine) 10 times per hour in order to keep your lungs adequately inflated (like a balloon). * you had ct scan of your head, neck, abdomen and pelvis which revealed no other injuries. ct scan of the chest did show a small nodule in your left lung. you should follow up with your regular doctor to discuss imaging the lung in several months evaluate for growth. * in evaluation for your loss of consciousness, we did blood tests that look at heart strain or decreased blood flow (troponins) which were normal. additionally you were kept on telemetry (continuous heart monitoring) which was reassuring. finally, you underwent an ultrasound study of your carotids, which showed some degree of narrowing but not narrowing significant enough to have caused your syncopal episodes. you need to follow up with vascular surgery dr. in 6 months for this. you may also need additional evaluation for heart monitoring, and should follow up with your regular doctor to discuss this. please call your doctor, talk to your doctor at rehab or return to the er if: * if you are vomiting and cannot keep in fluids or your medications. * if you have shaking chills, fever greater than 101.5 (f) degrees or 38 (c) degrees, chest pain, cough, shortness of breath, or anything else that is troubling you. * any serious change in your symptoms, or any new symptoms that concern you. * please resume all regular home medications and take any new meds as ordered. * do not drive or operate heavy machinery while taking any narcotic pain medication. you may have constipation when taking narcotic pain medications (oxycodone, percocet, vicodin, hydrocodone, dilaudid, etc.); you should continue drinking fluids, you may take stool softeners, and should eat foods that are high in fiber. followup instructions: call dr. office for a follow up appointment in 6 months, tell them that you will need carotid ultrasound prior to appointment. phone: . please also follow up with dr. in weeks. call ( for an appointment. please let your regular doctor know about this hospitalization and follow up with him or her in weeks. you may need additional monitoring of your heart rhythm. procedure: insertion of catheter into spinal canal for infusion of therapeutic or palliative substances systemic to pulmonary artery shunt injection of anesthetic into peripheral nerve for analgesia proctostomy diagnoses: diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled atrial fibrillation occlusion and stenosis of carotid artery without mention of cerebral infarction other and unspecified hyperlipidemia anxiety state, unspecified accidental fall on or from other stairs or steps osteoporosis, unspecified long-term (current) use of anticoagulants osteoarthrosis, unspecified whether generalized or localized, site unspecified other diseases of lung, not elsewhere classified personal history of venous thrombosis and embolism occlusion and stenosis of multiple and bilateral precerebral arteries without mention of cerebral infarction syncope and collapse acute pain due to trauma closed fracture of five ribs personal history of traumatic fracture 

Answer: The patient is high likely exposed to