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: elective transbronchial biopsy. major surgical or invasive procedure: bronchoscopy with transbronchial biopsy intubation history of present illness: hpi: 76 yo m with afib, pacer, cad s/p cabg, ischemic chf ef <40% w/2+mr dx rul mass admitted to micu after failing extubation from an outpatient bronchoscopy. on , the patient had an elective bronchoscopy and biopsy of the lung mass by interventional pulmonolgy. he tolerated the procedure well. 1-2 minutes post procedure the patient became hypertensive (sbp 170's to 200's), tachycardic (130's), and hypoxic to the 70's on nrb. he was intubated and transferred to the ccu. failure attributed to flash pulmonary edema. he was treated with nitroglycerin gtt, lasix and saturations improved. he ruled out for mi, ecg was unchanged and pe was ruled out with cta. tte was repeated w/ ef<25% which is significantly decreased from . possible etiologies of flash edema vs copd exacerbation were considered and he has been on a 2 month slow taper of prednisone 5mg daily. he was extubated on successfully and has remained on 2l nc thoughout today. . of note, he also recently hospitalized /05 for symptomatic bradycardia. pacer placed. he presented again with sob and found to have a mass consistent with lung cancer on ct. he is ppd negative (). . he currently reports no sob and is sitting on the edge of his bed without oxygen. c/o discomfort in his right chest wall since the biopsy that has been alleviated with acetominophen. no cp/palp/n/v/anorexia. ambulating well with assist and taking pos with normal bm and urination. past medical history: 1) copd/chronic bronchitis, on chronic prednisone, fev 1.0/fvc 52% no recent pfts on file 2) afib - started coumadin currently off anti coagulation for bronch 3) s/p v/v/i placement for symptomatic bradycardia with prolonged qt leading to torsades and vt 4) cad - s/p cabg in in non-q wave mi. lima to lad, svg to rca and pva, recent normal stress nuclear study 5) h/o small cerebellar bleed w/supratherapeutic inr 6) ischemic cardiomyopathy systolic dysfunction 7) hypercholesterolemia 8) rul mass 9) negative ppd (while on steroids) 10) recent 30lb unintentional wt loss 11) syncope 12) hearing loss 13) h/o etoh abuse/dependence 14) iron deficiency anemia since , pt previously refused c-scope or iron replacement social history: h/o etoh dependence, no illicits, former smoker quit in his 50s retired, ambulates with walker at home family history: non-contributory physical exam: after call out from icu: vs: 97.4 115/70 80 18 97% on 2l tele: af gen: pleasant, cachectic man, well-appearing, conversant heent: anicteric, mmm neck: supple, jvp at 10 cm cv: irreg, nl s1, loud s2, no split, 2/6 systolic m, no r/g resp: poor air movement, decreased bs and dullness on right, exp wheezes on left abd: s/nt/nd/nabs back: no cva or spinal tenderness ext: warm, trace edema, cap refill <2sec neuro: a&ox3, appropriate, cn grossly intact, mae, gait not assessed pertinent results: ct of the chest with and without intravenous contrast impression: 1. no evidence of pulmonary embolism. 2. perihilar mass and prominent perihilar lymph nodes, as seen previously. 3. nodular opacities in the right upper lobe as seen previously. 4. new vaguely defined bibasilar nodular densities as well. 5. status post sternotomy and coronary artery calcifications. 6. severe emphysema. . trans-thoraci echocardiogram ejection fraction <25% 1. the left atrium is mildly dilated. 2. the left ventricular cavity is dilated. there is severe global left ventricular hypokinesis. overall left ventricular systolic function is severely depressed. 3. the right ventricular cavity is dilated. right ventricular systolic function appears depressed. 4. the aortic root is mildly dilated. 5. the aortic valve leaflets are mildly thickened. 6. the mitral valve leaflets are mildly thickened. trivial mitral regurgitation is seen. 7. compared to the findings of the prior study of , left ventricular systolic function has deteriorated. . head ct: there is stable widening of the extra-axial spaces, prominence in the sulci and ventricles, consistent with age-related involutional changes. the previously noted focus of hyperdensity in the lateral right cerebellum is not appreciated on this study. there are cerebellar calcifications, which are unchanged, as well as basal ganglia calcifications. some relative hypodensity in the left temporal lobe is unchanged. there are vascular calcifications. there is a small calcified extra-axial mass in right frontal region suggestive of calcified meningioma, unchanged. with the administration of contrast, there are no metastases evident. there is an opacity in the right maxillary sinus, probably a retention cyst. there is sclerosis in the right mastoid air cells, which is unchanged, and to a lesser degree on the left. impression: no evidence of metastatic disease. brief hospital course: impression/plan: pt is a 76 yo m with chf/systolic dysfunction 2+mr failure in setting of hypertensive/tachycardic stress leading to flash pulmonary edema. . # hypoxia: it was felt that this was likely to chf and chronic copd. after the flash pulmonary edema he improved greatly with lasix diuresis and when called out the floor was sat'ing in the mid 90's on room air. he was continued on an ace inhibitor and slow steroid taper was completed. he was evaluated by pt and it was determined that he did not require home o2. he was continued on his inhalers and on discharge was recommended to consider using spiriva. . # chf: as above, his symptoms improved with diuresis. echo showed new global hk and depression in ef <20%, and this was felt potentially from stunning and demand ischemia. acei was started for afterload reduction and remodeling benefits and he was started on low dose beta blocker trial and spironolactone. 2g na diet, fluid restrict, chf teaching, daily wts were done. at the time of discharge the pt was euvolemic and did not require any po lasix daily. he will follow up with his pcp in the next week to determine if this might be needed in the future. . # lung mass: bronchoscopic biopsy showed squamous cell lung cancer. pt was informed of this result and his pcp recommended that he see dr. in oncology, so the pt was given the phone number to call and make an appointment. he was instructed to discuss with his pcp if he should see a ct surgeon for evaluation if this might be a possibility. . # af s/p pacer: hr was initially high, but then was controlled with diltiazem. this was then changed to toprol and hr and bp was in good range. he underwent a head ct to rule out metastases, and when no mets were seen, he was restarted on coumadin at his previous dose. . # metabolic alkalosis: it was felt that the pt had a mild volume contraction given aggressive diuresis in setting of co2 retention and baseline hco3 of 30s when outpt. o2 sats were in the mid 90's on room air and the pt was not given supplemental oxygen to increase this so that further co2 retention would occur. . # h/o cad: presumed stable, ruled out for mi in setting of stress, recent nuclear study within normal limits. he was started on asa, statin, bb and continue ace-i for secondary prevention. . # microcytic anemia: stable. new since . outpatient c-scope needed . # wt loss 30lb: stable. likely due to malignancy. . f/e/n: cardiac, 2g na diet, no ivf access: pivs contact: wife prophylaxis: sc heparin, ppi while on steroids code status: full code medications on admission: complete list unclear per pt and wife, adherence unclear mdi 250/50 1 puff coumadin 2.5mg (stopped taking 1 week ago) protonix 40mg qday prednisone taper since 2 months ago (on 5mg qday to finish thursday) lisinopril (per cards but wife did not have this med listed) not clear why pt not on bb, asa or statin with cad hx discharge medications: 1. cepacol 2 mg lozenge sig: one (1) lozenge mucous membrane prn (as needed). 2. fluticasone-salmeterol 250-50 mcg/dose disk with device sig: one (1) disk with device inhalation (2 times a day). 3. acetaminophen 325 mg tablet sig: 1-2 tablets po q4-6h (every 4 to 6 hours) as needed for pain/fvr. 4. docusate sodium 100 mg capsule sig: one (1) capsule po hs (at bedtime). 5. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed. 6. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). disp:*30 tablet, chewable(s)* refills:*2* 7. lisinopril 5 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 8. atorvastatin 10 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 9. trazodone 50 mg tablet sig: one (1) tablet po hs (at bedtime) as needed for insomnia. 10. methyl salicylate-menthol 15-15 % ointment sig: one (1) appl topical tid (3 times a day) as needed. 11. 103-18 mcg/actuation aerosol sig: two (2) puffs inhalation every 4-6 hours as needed for shortness of breath or wheezing. disp:*1 inhaler* refills:*2* 12. spironolactone 25 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 13. toprol xl 25 mg tablet sustained release 24hr sig: one (1) tablet sustained release 24hr po once a day. disp:*30 tablet sustained release 24hr(s)* refills:*2* 14. tiotropium bromide 18 mcg capsule, w/inhalation device sig: one (1) cap inhalation daily (daily). disp:*1 cap(s)* refills:*2* discharge disposition: home with service facility: homecare discharge diagnosis: hypoxic failure chf exacerbation discharge condition: stable discharge instructions: if you develop fevers, chills, shortness of breath, chest pain, or trouble breathing, please call your pcp or come to the ed. followup instructions: please follow up with your pcp, . in the next week. call to make an appointment. please discuss with him if he has a recommendation for a thoracic surgeon. you will also likely need to get pulmonary function tests, which can be arranged by dr. . please also call to make an appointment with dr. in oncology (. provider: call phone: date/time: 11:30 provider: clinic phone: date/time: 1:00 procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours insertion of endotracheal tube closed endoscopic biopsy of lung diagnoses: mitral valve disorders congestive heart failure, unspecified chronic airway obstruction, not elsewhere classified atrial fibrillation aortocoronary bypass status systolic heart failure, unspecified acute respiratory failure malignant neoplasm of upper lobe, bronchus or lung iron deficiency anemia, unspecified cardiac pacemaker in situ 

Answer: The patient is high likely exposed to