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: abd pain major surgical or invasive procedure: - ercp history of present illness: hd 11 unasyn (11) 80m acute cholecystitis/cholangitis pmh: cri (2.5), fev1 70% (), niddm, mi , s/p lad and lcx. , 30-35%, hx a-flutter, syncope, cva x9 w/ cortical blindness psh: partial l. nephrectomy, b/l le bypass() : lopressor 25", amiodarone 200", asa 81', lipitor 80', isosorbide mn 30', flogard 2.2", plavix 75", coumadin 4 t/th/sat/saun, 3 m/w/f, hydralazine 25"', plavix 75' plan: - ercp chemical pancreatitis improving, clinically stable ->no plan to re-ercp at this point - cardiology informed of demand ischemia v nstemi, tele, bb, nitro - npo for now - gi rec. f/u in weeks when is performed - f/u w/ re: carot. endart needs to be done past medical history: cri s/p cva x 9 w/ prior left pca infarct with cortical blindness and right parietal occipital cerebrovascular accident. mi x 2 peripheral bypass bilaterally diabetes hypertension hyperlipidemia cyst removed from kidney aflutter, s/p ablation on amio/warfarin syncope renal arteries no stenosis by cath s/p eps s/p tte w/ ef to be newly depressed at 30-35% with left ventricular hypertrophy and +mr. w/ reversible defect -> cath w/ 60-70% lad stenosis and an 80% lcx stenosis. the rca was occluded with left to right collaterals. s/p to lad and lcx. social history: patient is married and lives at home with his wife; retired metal worker. he has had a prior tobacco history, but no alcohol use. family history: non-contrib physical exam: vitals: wd, wn, nad supple, no lad ctab, no w/c/r rrr, no m/r/g soft, non-distended, non-ttp, nabs no c/c/e pertinent results: 06:35am blood wbc-9.2 rbc-3.94* hgb-12.8* hct-36.1* mcv-92 mch-32.6* mchc-35.5* rdw-14.8 plt ct-285 07:40am blood wbc-10.4 rbc-3.91* hgb-12.6* hct-35.6* mcv-91 mch-32.3* mchc-35.5* rdw-14.7 plt ct-309 03:36am blood wbc-10.8 rbc-3.74* hgb-12.0* hct-33.7* mcv-90 mch-32.0 mchc-35.5* rdw-14.7 plt ct-258 09:56am blood wbc-14.7* rbc-3.96* hgb-12.8* hct-35.8* mcv-90 mch-32.4* mchc-35.8* rdw-14.7 plt ct-290 06:25am blood wbc-14.0* rbc-4.26* hgb-13.4* hct-38.5* mcv-91 mch-31.5 mchc-34.8 rdw-14.8 plt ct-319 06:50am blood wbc-12.6* rbc-4.12* hgb-12.7* hct-35.9* mcv-87 mch-30.9 mchc-35.5* rdw-14.6 plt ct-268 10:30pm blood wbc-14.8* rbc-4.36* hgb-13.4* hct-37.9* mcv-87 mch-30.7 mchc-35.3* rdw-14.7 plt ct-306 03:36am blood neuts-80.3* lymphs-11.3* monos-3.5 eos-4.2* baso-0.6 09:56am blood neuts-90* bands-3 lymphs-2* monos-3 eos-2 baso-0 atyps-0 metas-0 myelos-0 10:30pm blood neuts-62 bands-5 lymphs-16* monos-6 eos-11* baso-0 atyps-0 metas-0 myelos-0 09:56am blood hypochr-normal anisocy-normal poiklo-1+ macrocy-normal microcy-normal polychr-occasional ovalocy-occasional 06:35am blood plt ct-285 06:35am blood pt-12.7 inr(pt)-1.1 07:40am blood plt ct-309 07:40am blood pt-12.7 ptt-22.5 inr(pt)-1.1 03:36am blood plt ct-258 03:36am blood pt-15.4* ptt-24.5 inr(pt)-1.4* 09:56am blood plt smr-normal plt ct-290 09:56am blood pt-17.9* ptt-25.2 inr(pt)-1.7* 06:25am blood plt ct-319 06:25am blood pt-19.1* inr(pt)-1.8* 03:48pm blood pt-21.3* inr(pt)-2.1* 06:50am blood plt ct-268 06:50am blood pt-30.9* ptt-29.2 inr(pt)-3.3* 10:30pm blood plt ct-306 10:30pm blood pt-28.3* ptt-28.0 inr(pt)-2.9* 06:35am blood glucose-124* urean-36* creat-1.9* na-146* k-3.8 cl-110* hco3-24 angap-16 07:40am blood glucose-80 urean-48* creat-2.3* na-147* k-3.6 cl-107 hco3-26 angap-18 03:36am blood glucose-99 urean-42* creat-2.6* na-142 k-3.3 cl-104 hco3-30 angap-11 09:56am blood glucose-136* urean-35* creat-2.3* na-141 k-5.1 cl-103 hco3-27 angap-16 06:25am blood glucose-133* urean-34* creat-2.1* na-142 k-4.2 cl-103 hco3-24 angap-19 06:50am blood glucose-151* urean-43* creat-2.2* na-139 k-4.5 cl-106 hco3-22 angap-16 10:30pm blood glucose-192* urean-48* creat-2.4* na-137 k-4.4 cl-101 hco3-22 angap-18 09:45am blood ck(cpk)-86 06:35am blood alt-91* ast-113* ld(ldh)-217 alkphos-535* amylase-267* totbili-1.4 02:21am blood ck(cpk)-90 06:30pm blood ck(cpk)-83 06:25am blood ck(cpk)-84 amylase-263* 07:40am blood alt-95* ast-103* alkphos-408* amylase-721* totbili-2.0* 08:10pm blood amylase-1388* 11:39am blood ck(cpk)-96 03:36am blood alt-110* ast-116* ld(ldh)-177 ck(cpk)-120 alkphos-398* amylase-1643* totbili-3.3* 10:14pm blood ck(cpk)-175* 09:56am blood ck(cpk)-214* 06:25am blood alt-125* ast-150* ld(ldh)-223 alkphos-501* amylase-91 totbili-3.7* 06:50am blood alt-110* ast-180* alkphos-402* amylase-104* totbili-2.4* 10:30pm blood alt-70* ast-122* alkphos-328* amylase-141* totbili-1.4 06:35am blood lipase-684* 06:25am blood lipase-477* 07:40am blood lipase-741* 08:10pm blood lipase-1797* 03:36am blood lipase-3806* 06:25am blood lipase-43 06:50am blood lipase-54 10:30pm blood lipase-108* 09:45am blood ck-mb-notdone ctropnt-0.25* 02:21am blood ck-mb-notdone ctropnt-0.27* 06:30pm blood ck-mb-notdone ctropnt-0.24* 06:25am blood ck-mb-notdone ctropnt-0.23* 07:40am blood ck-mb-3 ctropnt-0.18* 08:10pm blood ck-mb-3 ctropnt-0.17* 11:39am blood ck-mb-notdone ctropnt-0.19* 03:36am blood ck-mb-5 ctropnt-0.24* 10:14pm blood ck-mb-7 ctropnt-0.25* 09:56am blood ck-mb-6 ctropnt-0.08* 06:35am blood albumin-3.2* calcium-8.8 phos-2.4* mg-2.0 07:40am blood calcium-8.9 phos-3.0 mg-2.1 03:36am blood albumin-3.2* calcium-8.6 phos-3.2 09:56am blood calcium-8.9 phos-3.7 mg-2.0 06:25am blood calcium-8.9 phos-2.9 mg-1.9 06:50am blood albumin-3.5 calcium-8.6 phos-3.1 mg-2.1 08:53am blood type-art rates-/24 po2-58* pco2-41 ph-7.43 calhco3-28 base xs-2 intubat-not intuba comment-non-rebrea radiology final report ct abdomen w/o contrast 10:42 pm ct abdomen w/o contrast; ct pelvis w/o contrast reason: eval for leaking aaa medical condition: 80 year old man with ab pain, known aaa reason for this examination: eval for leaking aaa contraindications for iv contrast: none. indication: 80-year-old man with abdominal pain and known abdominal aortic aneurysm. comparisons: prior abdominal ultrasound from . at that time, the abdominal aortic aneurysm measured 43 x 35 cm (transverse x ap). technique: axial non-contrast ct images of the abdomen and pelvis were obtained without intravenous contrast, and sagittal and coronal reconstructions were also performed. no oral contrast was administered. intravenous contrast was not administered because of renal insufficiency. ct of the abdomen with iv contrast: there is subsegmental atelectasis in the right lower lobe, but no effusions. there are coronary artery calcifications. the hepatic density is rather elevated, consistent with amiodarone therapy for example. the gallbladder is somewhat distended with dependent gallstones. there is no surrounding stranding. there is no intra- or extrahepatic biliary ductal dilatation. the distal common duct measures approximately 8 mm in diameter without evidence of stones. there are some scattered pancreatic calcifications. calcifications in the aorta and splenic artery. the spleen appears normal and is not enlarged. the adrenal glands are unremarkable. of note, there are enlarged periportal lymph nodes. the largest measures 19 x 14 mm. there is a 25 mm hypoattenuating focus in the right kidney, which has previously been ascertained as a simple cyst by ultrasound. there is also a tiny 5 mm hyperdense cyst in the upper pole. there is a calcification, probably in the left kidney. both kidneys are atrophic. the maximum dimensions of the abdominal aortic aneurysm are 45 x 41 mm in axial dimensions (ap x transverse), and the maximum diameter is 40 cm. the appearance is likely unchanged allowing for differences in technique, and there is no evidence of a surrounding hematoma. there is also a common iliac artery aneurysm on the right measuring 27 mm in diameter. the stomach, small and large bowel are within normal limits. there is no retroperitoneal or mesenteric lymphadenopathy, or free air or fluid. ct of the pelvis with iv contrast: there are prostate calcifications. the sigmoid, rectum, seminal vesicles are unremarkable, and the bladder appears normal. there is a normal appearance appendix, with its tip herniating into the right inguinal ring. bone windows: there are marked degenerative changes of thoracolumbar spine, but no suspicious lytic or blastic lesions. impression: 1. likely similar appearance of abdominal aortic aneurysm, allowing for differences in technique, with maximum diameter of 40 mm. 2. moderately distended gallbladder, with stones. 3. no intra- or extrahepatic biliary ductal dilatation. 4. prominent periportal lymph nodes. 5. elevated density of the hepatic parenchyma, which could be seen in amiodarone therapy for example. the study and the report were reviewed by the staff radiologist. dr. dr. approved: 2:51 pm radiology final report liver or gallbladder us (single organ) 12:47 am liver or gallbladder us (singl reason: eval for cholecystis, stones medical condition: 80 year old man with diffuse ab pain, r>l; elevated lfts reason for this examination: eval for cholecystis, stones indications: 80-year-old man with diffuse abdominal pain. comparisons: ct of the same day. technique: right upper quadrant ultrasound. findings: the echotexture of the liver appears normal, and no focal lesions are identified. there is no intra- or extra-hepatic biliary ductal dilatation. the visualized proximal portion of the pancreas appears normal. the main portal vein demonstrates appropriate hepatopetal flow. the gallbladder is moderately distended. some tenderness is present about the gallbladder, more so than in adjacent areas. there is layering sludge within the gallbladder and multiple shadowing stones. although much of the wall is normal in thickness, there are areas of focal wall thickening, with intramural edema in some areas, particularly along the mid and fundal portions up to a maximum thickness of 6 mm. there is no ascites. impression: high suspicion for cholecystitis. the study and the report were reviewed by the staff radiologist. dr. dr. approved: 2:51 pm patient/test information: indication: coronary artery disease. height: (in) 70 weight (lb): 193 bsa (m2): 2.06 m2 bp (mm hg): 154/89 hr (bpm): 58 status: inpatient date/time: at 12:11 test: tte (complete) doppler: full doppler and color doppler contrast: none tape number: 2006w011-0:00 test location: west echo lab technical quality: adequate referring doctor: dr. measurements: left atrium - long axis dimension: 3.8 cm (nl <= 4.0 cm) left atrium - four chamber length: *5.8 cm (nl <= 5.2 cm) right atrium - four chamber length: 4.6 cm (nl <= 5.0 cm) left ventricle - septal wall thickness: 1.0 cm (nl 0.6 - 1.1 cm) left ventricle - inferolateral thickness: 1.0 cm (nl 0.6 - 1.1 cm) left ventricle - diastolic dimension: 5.2 cm (nl <= 5.6 cm) left ventricle - ejection fraction: 35% to 40% (nl >=55%) aorta - valve level: 3.4 cm (nl <= 3.6 cm) aorta - ascending: 3.3 cm (nl <= 3.4 cm) aortic valve - peak velocity: *2.3 m/sec (nl <= 2.0 m/sec) aortic valve - peak gradient: 21 mm hg aortic valve - mean gradient: 10 mm hg mitral valve - e wave: 0.8 m/sec mitral valve - a wave: 0.8 m/sec mitral valve - e/a ratio: 1.00 mitral valve - e wave deceleration time: 139 msec interpretation: findings: left atrium: normal la size. right atrium/interatrial septum: normal ra size. left ventricle: normal lv cavity size. moderately depressed lvef. right ventricle: normal rv chamber size and free wall motion. aorta: normal aortic root diameter. aortic valve: mildly thickened aortic valve leaflets (3). mild (1+) ar. mitral valve: mildly thickened mitral valve leaflets. mild thickening of mitral valve chordae. mild (1+) mr. pericardium: no pericardial effusion. general comments: compared with the findings of the prior study, there has been no significant change. conclusions: 1. the left ventricular cavity size is normal. overall left ventricular systolic function is moderately depressed. posterior akinesis and lateral and distal septal hypokinesis are present. 2. the aortic valve leaflets (3) are mildly thickened. mild (1+) aortic regurgitation is seen. 3. the mitral valve leaflets are mildly thickened. mild (1+) mitral regurgitation is seen. 4. compared with the findings of the prior study of , there has been probably no significant change. electronically signed by , md on 12:44. physician: , . brief hospital course: pt was monitored post ercp and treated with abx ercp report date: , endoscopist(s): , md , md (fellow) patient: ref.phys.: , m.d.; per- , md phd birth date: (80 years) instrument: tjf 160 048 40 25 indications: cholecystitis and concern for cholangitis. ercp to evaluate further. medications: general anesthesia asa class: p2 procedure: the procedure, indications, preparation and potential complications were explained to the patient, who indicated his understanding and signed the corresponding consent forms. the patient was placed in the prone position and an endoscope was introduced through the mouth and advanced under direct visualization until the second part of the duodenum was reached. careful visualization was performed. the procedure was not difficult. the quality of the preparation was good. the patient tolerated the procedure well. there were no complications. findings: esophagus: limited exam of the esophagus was normal stomach: limited exam of the stomach was normal duodenum: limited exam of the duodenum was normal major papilla: a single non-bleeding diverticulum with small opening was found on the rim of the major papilla. cannulation: cannulation of the biliary duct was successful and deep with a sphincterotome using a free-hand technique. contrast medium was injected resulting in complete opacification. the procedure was not difficult. cannulation of the pancreatic duct was not attempted. biliary tree: a moderate diffuse dilation was seen at the common bile duct. these findings are compatible with biliary obstruction. procedures: a 9cm by 10 f cotton biliary was placed successfully in the common bile duct. impression: papilla major diverticulum biliary dilation compatible with biliary obstruction cbd placement recommendations: continue icu management consider cholecystectomy repeat ercp in 1 month to remove and clear cbd - will need . additional notes: images sub-optimal in the icu with a c arm. cbd dilatation probable cbd stone. given coagulopathy not possible. stnet placed. will require definitive ercp in weeks. _________________________________ , md _________________________________ , md (fellow) pt is to f/u with dr. for removal and spincterotomy medications on admission: lopressor 25" amiodarone 200" asa 81' lipitor 80' isosorbide mn 30' flogard 2.2" plavix 75' coumadin 4 t/tr/sa/sn coumadin 3 m/w/f hydralazine 25'" discharge medications: 1. amlodipine 5 mg tablet sig: one (1) tablet po daily (daily). 2. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 3. metoprolol tartrate 25 mg tablet sig: 1.5 tablets po bid (2 times a day). disp:*90 tablet(s)* refills:*0* 4. isosorbide mononitrate 60 mg tablet sustained release 24hr sig: one (1) tablet sustained release 24hr po qam (once a day (in the morning)). disp:*30 tablet sustained release 24hr(s)* refills:*2* 5. amiodarone 200 mg tablet sig: one (1) tablet po daily (daily). 6. atorvastatin 80 mg tablet sig: one (1) tablet po daily (daily). 7. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). 1. amlodipine 5 mg tablet sig: one (1) tablet po daily (daily). 2. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 3. metoprolol tartrate 25 mg tablet sig: 1.5 tablets po bid (2 times a day). disp:*90 tablet(s)* refills:*0* 4. isosorbide mononitrate 60 mg tablet sustained release 24hr sig: one (1) tablet sustained release 24hr po qam (once a day (in the morning)). disp:*30 tablet sustained release 24hr(s)* refills:*2* 5. amiodarone 200 mg tablet sig: one (1) tablet po daily (daily). 6. atorvastatin 80 mg tablet sig: one (1) tablet po daily (daily). 7. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). 8. augmentin 500-125 mg tablet sig: one (1) tablet po twice a day for 7 days. disp:*14 tablet(s)* refills:*0* 9. warfarin 3 mg tablet sig: one (1) tablet po qmowefr (monday -wednesday-). disp:*30 tablet(s)* refills:*0* 10. warfarin 2 mg tablet sig: two (2) tablet po qtuthsasu (). disp:*30 tablet(s)* refills:*0* 11. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed. disp:*10 tablet(s)* refills:*0* discharge disposition: extended care facility: - discharge diagnosis: - acute cholecystitis - ercp pancreatitis discharge condition: - good discharge instructions: - weigh yourself every morning, md if weight > 3 lbs. - adhere to 2 gm sodium diet - fluid restriction: - you may resume all home medications with the changes that have been made during your hospitalization - you may resume your regular, salt restricted diet - you may shower - md or return to er if t>101.5, chills, nausea, vomiting, chest pain, shortness of breath, severe abdominal pain, or any other concern. pt had abd pain and a chemical pancreatitis, it is very important for the patient to return if he complains of any abd. pain at all or if there are any signs of complications related to his gallbladder followup instructions: - you need to follow up with the gastro-intestinal doctors and . you had a plastic placed and will need to have that removed in 3 weeks time you will likely need to stop your coumadin prior to spincterotomy at time of ercp - you should follow-up with dr. in 3 weeks. please call his office at ( to schedule an appointment. - provider: , m.d. phone: date/time: 8:30 - provider: , surgery (nhb) date/time: 11:00. please call to confirm this/or an earlier appointment. - you should also follow-up with your primary doctor for a blood pressure check and further monitoring of your blood pressure. md, procedure: endoscopic insertion of stent (tube) into bile duct transfusion of other serum diagnoses: abnormal coagulation profile congestive heart failure, unspecified unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled atrial flutter percutaneous transluminal coronary angioplasty status occlusion and stenosis of carotid artery without mention of cerebral infarction other and unspecified hyperlipidemia old myocardial infarction unspecified disorder of kidney and ureter other specified disorders of biliary tract abdominal aneurysm without mention of rupture cholangitis acute pancreatitis calculus of gallbladder and bile duct with acute cholecystitis, with obstruction 

Answer: The patient is high likely exposed to