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: weakness major surgical or invasive procedure: lumbar puncture history of present illness: hpi: ms. is a 56-year-old woman with a history of hyperthyroidism who presents with progressive weakness. she reports that she was in her usoh until 2 days ago (thursday afternoon), when she noticed that her feet were heavy. by thursday evening, this had progressed to include her hands. on friday morning, she was having difficulty walking, so she went to an urgent care clinic, where blood was drawn but she is unsure of the results. by friday night she was unable to walk at all, but was using her arms. by this morning, she was having great difficulty pushing herself up with her arms. this prompted her to go to . at , they found her to be hyporeflexic. head ct was normal. she reports that she did have a feeling that she was "coming down with the flu" earlier in the week - myalgias, fatigue, "heavy eyes." this resolved within a day or two without any significant symptoms: no fever/chills, no night sweats, no diarrhea, no nausea/vomiting, no coughing, no dysuria. she denies having any new back pain, although she has had mild lbp for the last year; as well as no palpitations, lightheadedness, orthostasis, or other symptoms of dysautonomia. she feels the symptoms have been symmetric. she denies any sensory symptoms. she has had no sick contacts, no recent travel, no change in diet. she does note that 2 years ago she had a target lesion on her right forearm but tested negative for lyme on serology. additionally on ros, she noted that she thought her left eye, which has been ptotic for some years, was "droopier" than normal. she denied headache, loss of vision, blurred vision, diplopia, dysarthria, dysphagia, vertigo, tinnitus or hearing difficulty. denied difficulties producing or comprehending speech. denied focal weakness, numbness, parasthesiae. no bowel or bladder incontinence or retention. denied difficulty with gait. on general review of systems, she notes an unintentional 30-pound weight loss. as noted above she denied recent fever or chills. no night sweats. denied cough, shortness of breath. denied chest pain or tightness, palpitations. denied nausea, vomiting, diarrhea, constipation or abdominal pain. no recent change in bowel or bladder habits. no dysuria. denied arthralgias or myalgias. denied rash. past medical history: hyperthyroidism svt social history: she drinks 2 glasses of wine per day. no smoking or illicits. she works with a placement agency and lives with her husband in . family history: mother died at age 61 with metastatic breast cancer. father is alive at age 82 with cad s/p cabg and dm2. physical exam: vitals: t: 98.8 p: 94 r: 16 bp: 120/75 sao2: 98%ra general: awake, cooperative, nad. heent: nc/at, no scleral icterus noted, mmm, no lesions noted in oropharynx neck: supple, no carotid bruits appreciated. no nuchal rigidity pulmonary: lungs cta bilaterally without r/r/w cardiac: rrr, nl. s1s2, no m/r/g noted abdomen: soft, nt/nd, normoactive bowel sounds, no masses or organomegaly noted. extremities: no c/c/e bilaterally, 2+ radial, dp pulses bilaterally. skin: no rashes or lesions noted. neurologic: -mental status: alert, oriented x 3. able to relate history without difficulty. attentive. language is fluent with intact repetition and comprehension. normal prosody. there were no paraphasic errors. speech was not dysarthric. able to follow both midline and appendicular commands. -cranial nerves: i: olfaction not tested. ii: pupils 4 to 2mm on right and 5 to 3mm on left and brisk. vff to confrontation. funduscopic exam revealed no papilledema, exudates, or hemorrhages. iii, iv, vi: impaired upgaze bilaterally, otherwise eomi without nystagmus. normal saccades. v: facial sensation intact to pinprick. vii: no facial droop, but ptosis on left. viii: hearing intact to finger-rub bilaterally. ix, x: palate elevates symmetrically. : 5/5 strength in trapezii and scm bilaterally. xii: tongue protrudes in midline. -motor: normal bulk, tone throughout. no pronator drift bilaterally. no adventitious movements noted. no asterixis noted. delt bic tri wre ffl fe io ip hab had quad ham ta edb r 4+ 4- 3 4+ 4- 4- 4 3 5 5 4- 3+ 1 4- 2 1 l 4+ 4 3 4+ 4- 4- 4 3 5 5 4- 4 1 4 2 1 -sensory: some diminishment of cold sensation distal to ankles. no deficits to light touch, pinprick, vibratory sense, proprioception throughout. no extinction to dss. -dtrs: tri pat ach r 1 0 2 1 0 l 1 0 2 1 0 plantar response was mute bilaterally. -coordination: no intention tremor, no dysdiadochokinesia noted. no dysmetria on fnf or hks bilaterally. -gait: unable. pertinent results: 06:13pm cerebrospinal fluid (csf) protein-34 glucose-72 ld(ldh)-26 06:13pm cerebrospinal fluid (csf) csf-pep-no oligocl 06:13pm cerebrospinal fluid (csf) wbc-1 rbc-0 polys-0 lymphs-24 monos-76 04:40pm alt(sgpt)-18 ast(sgot)-34 amylase-98 tot bili-0.9 04:40pm lipase-35 04:40pm vit b12-1282* 04:40pm tsh-0.55 04:40pm t4-6.8 04:40pm hbc ab-negative 04:40pm crp-0.3 04:40pm hcv ab-negative 04:40pm wbc-8.1 rbc-4.31 hgb-14.1 hct-41.7 mcv-97 mch-32.8* mchc-33.8 rdw-13.1 04:40pm neuts-66.5 lymphs-25.9 monos-7.0 eos-0.5 basos-0.2 04:40pm sed rate-1 12:17pm urine blood-neg nitrite-neg protein-neg glucose-neg ketone-tr bilirubin-neg urobilngn-neg ph-8.0 leuk-tr 12:17pm urine rbc-0 wbc-<1 bacteria-none yeast-none epi-<1 brief hospital course: 56 year old woman presented with ascending weakness. a comprehensive workup for reversible etiologies was initiated - this included but was not limited to thyroid tests, hiv, cmv, ebv, b12, hepatitis b, hepatitis c, serum lead, rheumatoid factor, , crp, esr, hcg, lft, spep, upep, and csf-pep. all of these were negative. urine arsenic, mercury and lead were all within normal limits. pending at the time of discharge were b1, b6 levels and a csf lyme test. in the absence of any obvious reversible cause for the patient's symptoms it was felt likely that she had syndrome. as such she received iv-igg x 5 days with some improvement in strength. during this period the patient's respiratory status was monitored with q4h negative inspiratory force (nif)and vital capacities (vc). the patient never required intubation. she continued to improve her strength right through the day of discharge. of note there was some concern that the patient had lost considerable amount of weight prior to admission. an mri of the pelvis revealed an adnexal cyst and uterine masses that were likely fibroids. a prelminary read of this imaging study suggested that these abnormalities could be followed up on an outpatient basis. the patient has been made aware of these abnormalities and knows to follow up with her ob/gyn regarding these issues. the official read of this mri was pending at the time of discharge. medications on admission: none discharge medications: 1. heparin (porcine) 5,000 unit/ml solution sig: one (1) dose injection tid (3 times a day): this can be held if the patient is out of bed > 4x per day. . 2. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 3. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed. 4. gabapentin 300 mg capsule sig: one (1) capsule po q8h (every 8 hours). 5. diphenhydramine hcl 25 mg capsule sig: one (1) capsule po q6h (every 6 hours) as needed for pruritis. 6. camphor-menthol 0.5-0.5 % lotion sig: one (1) appl topical qid (4 times a day) as needed. 7. ibuprofen 600 mg tablet sig: one (1) tablet po q8h (every 8 hours). 8. diazepam 2 mg tablet sig: one (1) tablet po qhs (once a day (at bedtime)). 9. oxycodone 5 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for pain. 10. cyclobenzaprine 10 mg tablet sig: one (1) tablet po tid (3 times a day) as needed for muscle spasm. 11. acetaminophen 500 mg tablet sig: two (2) tablet po q6h (every 6 hours). discharge disposition: extended care facility: rehabilitation center (at ) - discharge diagnosis: gbs discharge condition: vital signs stable. the patient's strength has improved enormously from the nadir she reached in the icu. at that time she was a reflexic and unable to lift her arms at the biceps or her legs at the ips. she always retained some strength at the deltoids. at discharge she could lift her arms at the bicesp with 4/5 strength and at the ips with 4/5 strength. her reflexes were returning. discharge instructions: please take your medications as prescribed. please follow up with your appointments as documented below. please return to the hospital if you should have any worsening of your weakness or any other concerning symptoms. please follow up with your ob/gyn regarding your pelvic cyst and masses. you can call to obtain the official read of your mri prior to that appointment. it was not read on the day of your discharge, but should be read soon. followup instructions: provider: . & phone: date/time: 1:00 we would also suggest that you follow up with your primary care physician and your ob/gyn specialist as requested above. md procedure: spinal tap incision of lung injection or infusion of immunoglobulin diagnoses: thyrotoxicosis without mention of goiter or other cause, and without mention of thyrotoxic crisis or storm loss of weight tachycardia, unspecified acute infective polyneuritis leiomyoma of uterus, unspecified other specified disorders of uterus, not elsewhere classified 

Answer: The patient is high likely exposed to