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: keflex attending: chief complaint: tracheobronchomalacia with severe copd admit for increasing shortness of breath, possible y-stent placement. major surgical or invasive procedure: bronchoscopy, with therapeutic aspiration. rigid bronchoscopy, y stent placement. flexible bronchoscopy history of present illness: the patient is a 65-year-old woman with multiple medical problems including copd on home o2 and tracheobronchomalacia who presents today for progressive dyspnea over the last year. the patient was evaluated in by dr. and had bronchoscopy, which demonstrated significant tracheobronchomalacia. she underwent y-stent placement in . the stent was in place for approximately two weeks before it was removed due to increased coughing and mucous production. the patient could not tolerate the stent. the patient followed up on for reevaluation given that her shortness of breath has increased from baseline, her mobility is fairly significantly limited now. her previous use of home o2 has now increased to 24 hours a day, 3 liters nasal cannula. she uses cpap at night. she is referred by dr. for evaluation for possible re-stenting versus other surgical procedures. past medical history: cad, s/p cabg, with lad and lcx stenting chf, diastolic dysfunction chronic reactive airway disease, no prior h/o emergent intubation chronic renal insufficiency (baseline cr low-1s): erythropoietin deficiency afib gerd gout obstructive sleep apnea htn hyperlipidemia hypothyroidism depression obesity discoid lupus (inactive) s/p mvr with st. jude valve (), on coumadin s/p l parietal cva (), no residual neurologic deficits h/o bladder ca h/o colonic polyps h/o diverticulosis s/p cholecystectomy, t&a, tubal ligation, c-section, vocal cord polyp excision social history: 15 yr hx tobacco, 1pk every 3d, quit occasional etoh disability lives alone, just moved to new home without stairs divorced, one daughter ivdu family history: cardiomyopathy afib valvular heart disease older sister - ra sister - copd (), gerd physical exam: general: obese white female in nad wearing 4 liters of oxygen continuously heent: unremarkable cor: rrr s1, s2 w/ mech mitral valve chest: course breath sounds that clear w/ coughing. occas wheezes. abd: large, round, soft, nt, +bs extrem: no edema neuro: intact pertinent results: video swallow : pt appears safe from oropharyngeal standpoint for return to a po diet of regular solids and thin liquids. she does not require chin tuck maneuver at this time. she tolerates whole pills with thin liquids. pt may wish to have assistance with set up for meals/cutting meats, etc, but does not require 1:1 supervision with meals for swallow safety. maintain standard aspiration precautions. please reconsult if there are further concerns for aspiration or other oropharyngeal dysphagia. this swallowing pattern correlates to a dysphagia outcome severity scale (doss) rating of 6, wfl. recommendations: 1. po diet: regular solids, thin liquids 2. po meds whole with thin liquids 3. assist with meal set up as needed. pt may require assistance with cutting foods, etc. does not require 1:1 supervision with meals. 4. maintain standard aspiration precautions. 5. consider further w/u of coughing during meals not associated with aspiration and/or c/o gerd to level of pharynx during today's evaluation. in addition, pt has c/o food getting "stuck" at the level of the sternum, even prior to admit. 6. reconsult if there are further concerns for aspiration or other oropharyngeal dysphagia. cxr : reason for examination: followup of a patient with known tracheobronchomalacia and right lower lung pneumonia. portable ap chest radiograph was compared to . the cardiomegaly with bulging of the pulmonary trunk is stable. there is no change in the position of the mitral valve. there is no appreciable change in the right lower lobe and left perihilar opacities as well. there is no increase in pleural effusion. there is no pneumothorax. echo: conclusions there is mild symmetric left ventricular hypertrophy with normal cavity size and global systolic function (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 number of aortic valve leaflets cannot be determined. the aortic valve leaflets are mildly thickened. there is no aortic valve stenosis. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. a bileaflet mitral valve prosthesis is present. the mitral prosthesis appears well seated, with normal leaflet/disc motion and transvalvular gradients. the transmitral gradient is normal for this prosthesis. mild (1+) mitral regurgitation is seen. there is moderate pulmonary artery systolic hypertension. there is no pericardial effusion. impression: symmetric lvh with normal global systolic function. a focal wall motion abnormality cannot be excluded. mitral valve prosthesis with at least mild mitral regurgitation and normal gradients. compared with the prior study (images reviewed) of , the findings are similar. the pulmonary artery systolic pressures were not estimated on the prior study. brief hospital course: the patient was admitted on to the interventional pulmonology service for treatment of her increasing shortness of breath due to copd and evaluation for possible placement of a y-stent for tracheobroncialmalacia. on , she had a y-stent placed by dr. and therapeutic aspiration. she experienced acute exacerbation of her copd after placement of her y-stent and was admitted to the icu. steroids started, on a 14 day taper down to baseline of 5mg po daily. admitted to floor from icu for ongoing pulmonary care. pt w/ repeated episode of diarrhea- c-diff toxin neg. bowel regimen tapered. bal grew out mrsa that was sensitive to bactrim. vancomycin d/c'd. will complete a 2 week course of bacrtim on . pt's coumadin was resumed at lower dose than home regimen as she is on bactrim which will elevate her inr. therapeutic bronchoscopy; mid-trachea proximal end of silicone y-stent minimal granulation tissue, extensive amount of mucus secretions in y-stent successfully suctioned through the bronchoscope, distal end of the stent bilaterally with minimal amount of granulation tissue. passed video swallow: reg diet w/ thin liquids and meds whole w/o difficulty. pt had loose stool x 3days and c-diff toxin a+b were negative x3. pt was placed on lactose free diet and imodium. the patient is on maximal medical therapy for copd with inhalers as well as prednisone. recommendation would be to continue her medications as prescribed at this time. she remians on cpap at night for sleep apnea medications on admission: aspirin 81', bumex 4qam, 3qpm, l-thyroxine 0.05', prilosec 20'', kcl 40'', lexapro 20', effexor 150', allopurinol 100'', lipitor 80', clonidine 0.1'', singulair 10', spiriva, verapamil sr 240', coumadin 5 mg/5 mg/7.5 mg alternating, colace''', prednisone 5 mg daily)albuterol nebulizer b.i.d., iron 325', advair 500/50'', colchicine 0.6'', klonopin 0.5'', fiber laxative, flexeril prn - bipap, she believes the settings are 17/10. discharge medications: 1. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 2. levothyroxine 50 mcg tablet sig: one (1) tablet po daily (daily). 3. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po bid (2 times a day). 4. benzonatate 100 mg capsule sig: two (2) capsule po tid (3 times a day). 5. escitalopram 10 mg tablet sig: two (2) tablet po 8pm (). 6. venlafaxine 75 mg capsule, sust. release 24 hr sig: two (2) capsule, sust. release 24 hr po qam (once a day (in the morning)). 7. allopurinol 100 mg tablet sig: one (1) tablet po bid (2 times a day). 8. atorvastatin 80 mg tablet sig: one (1) tablet po hs (at bedtime). 9. clonidine 0.1 mg tablet sig: one (1) tablet po bid (2 times a day). 10. montelukast 10 mg tablet sig: one (1) tablet po qpm (once a day (in the evening)). 11. tiotropium bromide 18 mcg capsule, w/inhalation device sig: one (1) cap inhalation daily (daily). 12. verapamil 120 mg tablet sig: two (2) tablet po qam (once a day (in the morning)). 13. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 14. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: 2.5/3 mg/ml inhalation q4h (every 4 hours) as needed for wheezes. 15. ferrous sulfate 325 mg (65 mg iron) tablet sig: one (1) tablet po daily (daily). 16. fluticasone-salmeterol 250-50 mcg/dose disk with device sig: one (1) disk with device inhalation (2 times a day). 17. clonazepam 0.5 mg tablet sig: one (1) tablet po bid (2 times a day). 18. cyclobenzaprine 10 mg tablet sig: one (1) tablet po bid (2 times a day). 19. gabapentin 100 mg capsule sig: two (2) capsule po bid (2 times a day). 20. bumetanide 2 mg tablet sig: two (2) tablet po bid (2 times a day). 21. acetaminophen 325 mg tablet sig: two (2) tablet po q6h (every 6 hours) as needed. 22. dextromethorphan-guaifenesin 10-100 mg/5 ml syrup sig: ten (10) ml po bid (2 times a day). 23. acetylcysteine 20 % (200 mg/ml) solution sig: five (5) ml miscellaneous tid (3 times a day). 24. codeine-guaifenesin 10-100 mg/5 ml syrup sig: ten (10) ml po qhs (once a day (at bedtime)). 25. ipratropium bromide 0.02 % solution sig: three (3) ml inhalation q6h (every 6 hours) as needed. 26. ipratropium-albuterol 18-103 mcg/actuation aerosol sig: puffs inhalation q6h (every 6 hours) as needed. 27. coumadin coumadin dose daily based on inr- last inr 3.4 on given 1 mg today goal 2.5-3.5 home coumadin dose 5mg alter w/ 7.5mg 28. prednisone prednisone 50mg starting then decrease by 10mg every 2 days until at maintenance dose of 5mg. 29. imodium a-d 2 mg tablet sig: one (1) tablet po qid prn. discharge disposition: extended care facility: hospital discharge diagnosis: tracheobronchomalacia with severe chronic obstructive pulmonary disease. atrial fibrillation, cad s/p cabg and stent chf (diastolic dysfunction), reactive airway disease cri (~1.2), pulm nodules, l parietal cva ', h/o bladder ca, diverticulosis, gerd, gout, osa, htn, hypercholesterol, hypothyroid, depression, obesity, ? discoid lupus psh: mvr (mechanical valve ), cabg, appendectomy, cholecystecomy, bl tubal ligation, c-sxn, vocal cord polyp excision discharge condition: decondition discharge instructions: call dr. office if experience: -fever, increased shortness of breath, cough, increased sputum production, difficulty swallowing, or nausea/vomiting. prednisone taper 50 mg x 3 days (day one ), 40 mg x 3 days, 30 mg x 3 days, 20 mg x 3 days, 10 mg x 3 days then 5 mg daily. check inr daily until stable therapeutic. follow inr daily until inr stabilized between 2.5-3.5 followup instructions: follow-up with dr. as directed follow-up with your pcp . md procedure: non-invasive mechanical ventilation other intubation of respiratory tract other intubation of respiratory tract closed [endoscopic] biopsy of bronchus diagnoses: obstructive sleep apnea (adult)(pediatric) congestive heart failure, unspecified unspecified acquired hypothyroidism hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified gout, unspecified atrial fibrillation infection with microorganisms resistant to penicillins obstructive chronic bronchitis with (acute) exacerbation depressive disorder, not elsewhere classified chronic kidney disease, unspecified heart valve replaced by other means other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure long-term (current) use of anticoagulants personal history of malignant neoplasm of bladder methicillin susceptible pneumonia due to staphylococcus aureus diarrhea other and unspecified complications of medical care, not elsewhere classified diastolic heart failure, unspecified chronic respiratory failure other diseases of trachea and bronchus 

Answer: The patient is high likely exposed to