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: history of present illness: the patient is a 58-year-old female with a past history of depression on monoamine oxidase inhibitors recently increased in dose. the patient was found by her husband at 3 a.m. on the morning of with altered mental status, shrieking, stiff, shaking, wedged between the bed and the wall. she was taken to hospital by emergency medical services. on route, she was noted to have a tonic-clonic seizure for approximately two minutes. her blood sugar at that time was measured to be 127 mg/dl. on arrival to the emergency room at the outside hospital, the patient had coma scale score of 5, muscular rigidity, a temperature of 100, pulse of 93 and respirations of 28 per minute. her pupils were equal at 3 mm. the patient was sedated, paralyzed and intubated. her blood pressure was 142/92 and oxygen saturation was 100%. she was transferred to the emergency room by to evaluate the possibility of an intracranial hemorrhage. the patient's husband, a psychiatrist, reported recent insomnia and hypersomnia and mild agitation. he reported that the patient had not had any suicidal ideation, any change in her diet recently, but noted that she had been feeling more depressed recently and her psychiatrist had increased her dose of nardil to 60 mg a day from 30-45 mg per day. there were no known co-ingestants and a pill count verified no missing nardil. in the emergency room, there was no seizure activity noted. the patient was given activated charcoal for gastrointestinal contamination, cyproheptadine for the possibility of serotonin syndrome. a head ct was performed and a lumbar puncture was performed. the patient was given 2 grams of ceftriaxone for the possibility of bacterial meningitis and the patient was given benzodiazepines for sedation. past medical history: 1. depression. the patient has been treated by psychiatrists for depression for approximately 14 years. has failed many antidepressant medications and electroconvulsant therapy and has been on nardil since . patient has had several admissions to hospital for depression, most recently, approximately three years ago. the patient has no history of suicide attempts. 2. orthostatic hypotension. 3. transaminitis. the patient has had abnormal mildly elevated liver function tests on two occasions, thought to be secondary to alcohol use or maoi use. 4. heme positive stools. medications: 1. nardil 15 mg po q.i.d. 2. xanax 0.25 mg po q.i.d. 3. florinef prn. allergies: the patient has no known drug allergies. social history: the patient is a graduate of divinity school and has worked both in divinity and teaching art, most recently, she has worked at a friends gallery. she is married to a psychiatrist and lives at home with her husband. she is g3, p3 with three daughters. she has smoked one pack a day of cigarettes for at least 15 years. she drinks approximately two drinks of alcohol per night. she denies drug use. reports that she feels safe at home and she denies being hit, hurt or threatened at home. family history: the patient's mother was diagnosed with a mitochondrial encephalomyopathy late in life by muscle biopsy. this presented as a gait disturbance and depression was noted at the time. patient has a family history of coronary artery disease and myocardial infarction. there is no known history of seizure. review of systems: initially, the review of systems was unable to be performed secondary to the patient's mental status. later detailed review of systems revealed increased depression over the past two months with passive suicidal ideation, fatigue, insomnia, restlessness, poor concentration, decreased appetite. review of systems was otherwise except as noted in the history of present illness. physical examination: in the emergency room, the patient's temperature was 102.5. pulse was 80. blood pressure was 155/70. respiratory rate was in the 20s and oxygen saturation was 100%. in general, the patient was intubated, agitated at times. head exam revealed the pupils equal, round and reactive to light at 3 mm. there were no roving eye movements. neck exam revealed increased muscle tone, no lymphadenopathy. the lungs were clear to auscultation with no rales or wheezes. heart exam revealed a regular rate and rhythm with no murmurs, rubs or gallops. abdomen was soft and nontender with normal active bowel sounds and no hepatosplenomegaly. extremity exam revealed increased muscle tone in all four extremities with muscular rigidity greater in the lower extremities than the upper extremities. neurological exam revealed toes to be upgoing bilaterally. deep tendon reflexes were 3+ in all extremities. there was no ankle clonus. there was no cyanosis, clubbing or edema. the patient withdrew to pain in all four extremities but did not respond to vocal commands. pulses were 2+ in all four extremities. there was no costovertebral angle tenderness. the skin was pale. initial laboratories: revealed a white blood cell count of 9.4, hematocrit of 34.5, hemoglobin of 11.6 and platelets of 245,000. serum chemistries revealed a sodium of 140, potassium of 3.2, chloride of 98, bicarbonate of 28, bun of 22, creatinine of 0.7 and glucose of 141. liver function tests revealed elevated alt of 83 and ast of 975, alkaline phosphatase of 511, total bilirubin of 9.7. there was slight coagulopathy with pt of 14.6 and inr of 1.5. a ptt of 23.5. amylase was 199, lipase 31, albumin was 3.9. tsh was 1.5, esr was 5, fibrinogen was 225. the ck was 110 with a ck-mb fraction of 4 and cardiac troponin was less than 0.3. lumbar puncture performed in the emergency room revealed a protein of 44, a glucose of 95, 1 white blood cell, 5 red blood cells and only 15 cells total. a gram stain of the cerebrospinal fluid revealed no polys and no microorganisms. culture of the cerebrospinal fluid was negative. a urinalysis revealed trace blood, trace protein, no nitrates, no glucose, trace ketones, no bilirubin, no leukocytes, red blood cells and 0 white blood cells and rare bacteria, only 1 epithelial cell per high powered field. urine culture was negative. blood culture that was drawn in the emergency room were negative. tox screen was negative for aspirin, alcohol, acetaminophen, barbiturates and tricyclics. serum and urine were sent out for screens for venlafaxine, sertraline, fluoxetine, and paroxetine. an electrocardiogram showed sinus rhythm with a rate of 84 with no remarkable findings. imaging: a chest x-ray revealed satisfactory placement of endotracheal and nasogastric tubes. there were low lung volumes with bibasilar atelectasis and a small left pleural effusion. an old seventh rib fracture was noted. a ct of the head and c spine without contrast revealed no evidence of acute intracranial hemorrhage or mass effect and a fracture of c6 of unknown chronicity with no cord compression or canal impingement. hospital course: the patient was admitted to the intensive care unit for airway protection and careful monitoring with a diagnosis most consistent with maoi overdose. it was unclear whether the overdose was intentional, or an unintentional possible drug or diet interaction of the life threatening variety such as serotonin syndrome. in the intensive care unit, the patient required sedation with propofol and benzodiazepines. a central line was placed. the patient's arterial blood gases showed a mixed acid based disorder initially and minute ventilation was decreased to maintain a normal ph. there was no evidence of rhabdomyolysis and no coagulopathy. there was no acute renal failure and the liver function tests started to trend down. their elevation was thought to be secondary to toxic hepatitis from maois coupled with alcohol. the patient's symptoms of drug toxicity resolved. the propofol was discontinued and the patient was extubated. the patient then self discontinued her nasogastric tube. the patient's hematocrit on hospital day two in the intensive care unit was measured to be 25. she was evaluated for sources of possible bleeding. none were found and the patient was clinically stable, so it was decided to monitor her hematocrit at that point. with the patient's acute syndrome resolved, the patient was transferred to the floor on the night of hospital day two. the patient at that time could give a more detailed history, but she denied all recollection of the events leading to her admission reporting that only she had gone to bed at 8 p.m. that night feeling fine and woke up on the floor at around 3 a.m. she reported a vague recollection of her ambulance trip and emergency room visit at the outside hospital. she denied feeling any pain or fever throughout the experience and had no recollection of the time spent in the intensive care unit. physical exam on admission to the floor on hospital day two revealed the patient had a temperature of 98.4. heart rate of 81. blood pressure of 162/90. respiratory rate of 16. oxygen saturation of 88% on room air and 94% on two liters. in general, she was lethargic and slow to respond but in no acute distress. physical exam was otherwise notable only for periorbital swelling and bruise over the right eye and a right scleral conjunctival hemorrhage. because of the uncertain etiology of the patients apparent drug toxicity, the patient was assigned a around the clock sitter on the floor. on hospital day three, the patient remained afebrile, somewhat hypertensive with a blood pressure of approximately 150/100. she was protecting her airway and tolerating an oral diet. her hematocrit had trended back up to 29. her serum chemistries were notable for a hypokalemia of 2.5. a psychiatry consult was obtained and following their recommendations, the patient was placed on a low tyramine diet and a ciwa scale to monitor for signs of benzodiazepine and alcohol withdrawal to be treated with ativan as necessary and the patient was started on haldol 1-2 mg prn for agitation. on hospital day four, the patient continued to have some episodes of disorientation and confusion with slightly slurred speech and slight tremor, ciwa scores of . overall, the patient appeared to be improving. hematocrit remained stable. on hospital day five, the patient developed significant delirium manifested by severe agitation, confusion, disorientation to time and place, with no understanding of where she was or why she was in the hospital. she removed her central line. she remained very agitated throughout the day with word finding difficulties, tremor and slurred speech. her ciwa score was 20 and she was given ativan and haldol prn for treatment. on hospital day six, to evaluate the possible causes of the delirium, the patient had a urinalysis which was negative, a chest x-ray which showed interval resolution of the previously noted pleural effusion and was read as clear. an mri of the head was obtained which was read as unremarkable. the ativan was discontinued as it was felt that the patient's delirium may be in part due to the administration of benzodiazepines. the patient's b12 and folate were checked and were found to be in the normal range and the patient's rpr was found to be nonreactive. the etiology of the delirium was unclear, but the differential diagnosis included withdrawal from alcohol and benzodiazepines, resolving toxicity of maoi overdose and potential contribution from unmasked dementia and/or underlying psychiatric illness. on hospital day seven, in the early morning hours, the patient struck her sitter and lunged at a security guard posted outside her door during which time she slipped and bumped her head on the floor. a head ct was obtained which was read as negative with no evidence of acute intracranial hemorrhage. the patient had a waxing and course of delirium throughout the day with intermittent confusion, agitation, tearfulness and disorientation. an electroencephalogram was obtained that showed background slowing and bitemporal spikes. on hospital day eight, the patient's delirium had resolved. the patient was alert, awake and oriented to person, place and time with no recollection of her agitation the previous several days. a neurology consult was obtained. the neurology team felt that the patient's recent mental status changes as well as her initial presentation combined with the findings of the electroencephalogram were suggestive of possibly ongoing seizure activity. the possible etiologies for this seizure activity include the ingestion of nardil which has been to lower seizure threshold possibly complicated by withdrawal from benzodiazepines and/or alcohol. the haldol was discontinued, though, it had not been used for agitation since the early morning of hospital day seven. the patient's mental status continued to improve and she remained clear and oriented. on hospital day nine, the patient had been clear, oriented and with intact mental status for more than 48 hours. the patient continued to show signs of steady improvement. it was felt by both the medical and psychiatric teams that the patient would benefit from an inpatient admission to a psychiatric hospital where her antidepressant medication could be resumed in a controlled medical setting, however, both the patient and her husband felt that they would prefer not to resume any psychiatric medications at this time and instead follow-up with the patient's outpatient psychiatrist, dr. . the patient was thus discharged on hospital day nine with a clear sensorium and a negative medical work-up for delirium. condition of discharge: stable. discharge status: the patient was discharged on no medications. follow-up: the patient was to follow-up with her outpatient psychiatrist, dr. . phone number . she was also given an appointment with psychopharmacologist, dr. , on at 2 p.m. the patient was also instructed to follow-up with the clinic for an outpatient work-up to investigate the possibility of seizures and the possibility of a hereditary mitochondrial encephalomyopathy. discharge diagnoses: 1. drug toxicity, most likely due to nardil. 2. possible seizure activity. 3. delirium. 4. depression. , md dictated by: medquist36 procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours spinal tap incision of lung diagnoses: unspecified essential hypertension other convulsions hypopotassemia drug withdrawal 

Answer: The patient is high likely exposed to