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: penicillins attending: chief complaint: left leg ulcers major surgical or invasive procedure: s/p aorto-innominate artery bypass/aorto-> l common carotid bypass s/p l carotid->l subclavian bypass(8 mm ptfe)/thoracic aortic stent graft history of present illness: this 64bf has a history of pvd and foot ulcers and was admitted from dr. office for vac placement and possible angiograms. past medical history: -- dm2 -- chronic foot ulcers/pvd -- htn -- oa -- obesity -- asthma -- leg pain/neuropathy -- depression -- anemia -- h/o mrsa bacteremia , also septic arthritis treated at . right thalamic hemorrhage resulting in a gait disorder and incontinence of urine, followed by dr. . old cvas. neuropathy, peripheral. anxiety and panic disorder. status post total abdominal hysterectomy. hypercholesterolemia. social history: the patient lives with her daughter and her three kids since being d/c'ed from a nursing home last . has seven children, many grandchildren. smokes to 1 pack per day. family history: brother died of an mi in his 30's, she denies diabetes mellitus in the family. cancer in parents (mother died in 40s, father in 80s), at least two siblings, but unsure what kind. physical exam: discharge general nad vitals 98.8, 118/58, 92 sr, 20 rr, 98% ra, 124.2 kg neuro a/o x3 mae r=l strength, generalized weakness pulm cta but diminished bilat bases no rhochi/wheezes card rrr no murmur/rub/gallop abd soft nontender nondistended obese + bs bm ext warm pulses with doppler no edema iv access midline rt ac inc sternal healing no erythema no drainage staples intact - plan for removal left subclavian incision healing no erythema no drainage staples intact - plan for removal right groin incision - no drainage or erythema covered with dsd staples intact plan for removal left ankle ulcer tissue pink healing no drainage - vac dc'd and wet - dry dressing , area 6cm l x 1.5 cm w x .25 cm d left calf circular open area that is pink healing no drainage dry dressing skin care eval s/p surgery, she developed a drug rash and has dry desquamation overall body. there are several open blistered sites on her left forearm and one open site on her right forearm. all unroofed blisters are partial thickness ulcers with pink wound beds. there is minimal drainage from the sites. the wound edges are irregular. the periwound tissue has blistered skin and dry exfoliation. there are no s/s of infection. goals of wound care: resolved skin issues recommendations: pressure relief per pressure ulcer guidelines support surface: barimaxx ii with ets turn and reposition every 1-2 hours and prn heels off bed surface at all times multipodis splints to b/l le's if oob, limit sit time to one hour at a time and sit on a pressure relief cushion, 4"foam. elevate le's while sitting. commercial wound cleanser or normal saline to irrigate/cleanse all open wounds. pat the tissue dry with dry gauze. apply aquaphor ointment to the intact dry skin upper and lower extremities, torso apply adaptic (nonadherent dsg) to the open ulcers (unroofed blisters) cover with dry gauze secure with netting, no tape on skin. change dressing daily. support nutrition and hydration. swallowing assessment: po assessment was conducted with ice chips, water and nectar thick liquid via tsp, cup and straw sip, custard, applesauce and whole & crushed meds in applesauce and one bite of ground up crackers in custard. swallows were slow / delayed. laryngeal elevation felt adequate to palpation. there was no cough, no throat clear and no change in voice quality after eating or drinking. however, the pt. consistently said that she felt like coughing after drinking water. she said she did not feel like coughing after drinking nectar thick liquids. we were unable to obtain a reliable o2 saturation despite trying on her finger, toe or ear. she seemed to swallow ground and pureed solids but did best when she alternated between bites and sips. she could not swallow the whole pill w/nectar or in applesauce. so, we crushed the pill in custard and swallowed it with a sip of nectar to follow. summary / impression: may be aspirating thin liquids because she says she feel like coughing consistently after drinking water. however, she appears safe to drink nectar thick liquids and to eat pureed or ground solids if she alternates between bites and sips. she could not swallow a whole pill today with nectar thick juice or whole in applesauce, but she swallowed her pill crushed in custard w/a sip of nectar to follow. this swallowing pattern correlates to a dysphagia outcome severity scale (doss) rating of level 4, mild to moderate dysphagia with 2 consistnecy restrictions and intermittent supervision/cueing. this dysphagia is likely due to her old strokes. recommendations: 1. diet of ground solids and nectar thick liquids with pills crushed in puree 2. supervision w/meals alternate between bites and sips 3. if there are further concerns about aspiration on this diet, we would be happy to perform a fees evaluation. she would not be a candidate for a videoswallow because she is too large to fit into the fluoroscope. these recommendations were shared with the patient, nurse and medical team. ____________________________________ , m.s., ccc-slp pager # pertinent results: 07:23am blood wbc-10.7 rbc-2.71* hgb-8.0* hct-23.9* mcv-88 mch-29.5 mchc-33.4 rdw-16.5* plt ct-311 06:10am blood neuts-95.5* bands-0 lymphs-1.9* monos-1.3* eos-1.0 baso-0.4 07:30pm blood wbc-5.5 rbc-4.54 hgb-12.1 hct-37.2 mcv-82 mch-26.7* mchc-32.5 rdw-14.9 plt ct-158 07:30pm blood neuts-65.6 lymphs-26.2 monos-4.7 eos-3.2 baso-0.3 05:38am blood pt-16.4* inr(pt)-1.5* 07:23am blood plt ct-311 07:30pm blood plt ct-158 07:30pm blood pt-11.4 ptt-26.1 inr(pt)-1.0 03:03am blood esr-65* 10:41am blood glucose-156* urean-25* creat-1.1 na-140 k-3.7 cl-109* hco3-22 angap-13 07:30pm blood glucose-130* urean-23* creat-1.1 na-142 k-3.8 cl-107 hco3-24 angap-15 11:20pm blood ck(cpk)-188* 04:45am blood alt-40 ast-39 ld(ldh)-310* alkphos-136* amylase-52 totbili-0.3 04:45am blood lipase-44 11:20pm blood ck-mb-4 ctropnt-0.02* 10:41am blood calcium-8.2* phos-3.7 mg-2.3 07:30pm blood calcium-9.1 phos-3.0 mg-2.3 radiology final report chest (pa & lat) 8:42 am chest (pa & lat) reason: evaluate effusion medical condition: 64 year old woman with r innom. aneurysm reason for this examination: evaluate effusion portable upright chest, 8:52 a.m., . indication: followup effusion. findings: compared with 5/16 and with , haziness at the right lung base is consistent with the right pleural effusion seen on ct of and does not appear grossly changed. the left hemidiaphragm is elevated compared with the pre-op study consistent the left lower lobe collapse on ct. the superimposed left pleural effusion appears perhaps slightly smaller. the known right innominate artery aneurysm and recent aortic stent graft are again noted. no overt chf. impression: overall, no definite/obvious significant interval changes appreciated. dr. approved: tue 12:00 pm radiology final report cta chest w&w/o c&recons, non-coronary 1:16 pm cta chest w&w/o c&recons, non- reason: r/o leak medical condition: 64 year old woman with s/p aortic reconstruction reason for this examination: r/o leak contraindications for iv contrast: none. history: 64-year-old woman post aortic reconstruction, evaluate for leak. technique: multidetector contiguous axial images of the neck and chest were obtained following the administration of intravenous contrast. delayed images of the neck through the chest were obtained. non-contrast study of the chest was also obtained. findings: compared to prior study of , there has been repair of the aneurysmal dilatation of the innominate artery. stent graft is seen extending from the distal portion of the ascending thoracic aorta through the arch and through the proximal portion of the descending thoracic aorta. no leak is identified. injection of contrast was performed via the left arm, and there are a large amount of collaterals seen extending along the posterior chest wall to the azygos and hemiazygos veins which enter the right atrium via the ivc. the svc, and proximal left subclavian vein are thrombosed in the interval. there are no filling defects in the pulmonary arterial vasculature. no pulmonary embolism is identified. at the site of surgical clips in the left upper neck, there is a large hematoma measuring 3.6 x 6.8 cm. lung windows demonstrate atelectasis of the left lower lobe, moderate and to a lesser degree on the right. small bilateral pleural effusions are present. few images through the upper abdomen demonstrate a simple cyst arising from the upper pole of the left kidney measuring 5.5 cm in diameter. a calcified granuloma is seen in the spleen. findings were discussed with dr. . bridges on . impression: 1. no leak post aortic reconstruction. 2. no pulmonary embolism. 3. left neck hematoma as described above. 4. interval development of thrombosis of the superior vena cava and proximal left subclavian vein. the study and the report were reviewed by the staff radiologist. dr. . dr. approved: sun 11:13 am cardiology report ecg study date of 9:25:12 am sinus tachycardia with diffuse low voltage. q waves in leads iii and avf consistent with prior inferior myocardial infarction. compared to the previous tracing of no diagnostic change. read by: , intervals axes rate pr qrs qt/qtc p qrs t 102 130 80 294/352.85 48 -10 75 cardiology report echo study date of patient/test information: indication: intra-op tee for aortic stenting status: inpatient date/time: at 11:04 test: tee (complete) doppler: full doppler and color doppler contrast: none tape number: 2007aw07-: test location: anesthesia west or cardiac technical quality: adequate referring doctor: dr. dr. interpretation: findings: left ventricle: mild symmetric lvh. normal lv cavity size. right ventricle: normal rv chamber size and free wall motion. aortic valve: three aortic valve leaflets. mildly thickened aortic valve leaflets. no as. no ar. mitral valve: mildly thickened mitral valve leaflets. mild (1+) mr. tricuspid valve: mild tr. pulmonic valve/pulmonary artery: physiologic (normal) pr. general comments: a tee was performed in the location listed above. i certify i was present in compliance with hcfa regulations. no tee related complications. the patient was under general anesthesia throughout the procedure. the patient appears to be in sinus rhythm. results were personally effusion. conclusions: there is mild symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. right ventricular chamber size and free wall motion are normal. there are three aortic valve leaflets. the aortic valve leaflets are mildly thickened. there is no aortic valve stenosis. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. mild (1+) mitral regurgitation is seen. electronically signed by , md on 07:08. physician: brief hospital course: admitted to vascular service for left leg venous stasis ulcers which was infected, she was sterted on iv antibiotics and vac placed . she was worked up for mass that was compressing trachea that revealed innominate artery aneurysm. cardiac surgery was consulted and she underwent preoperative workup. she underwent recontruction and bypass of aneurysm in two phase on and , see operative report for further details. she was transferred to the csru and requiring pressors for blood pressure management. she awoke neurologically intact and over the next few days was weaned off pressors and diuresised. she extubated on without complications and continued to progress. she remained in the csru for respiratory and blood pressure monitoring. she had swallowing evaluation due to concerns for aspiration that she did well and was cleared for nectar thickended. she was started on anticoagulation for thrombosis rt subclavian. she continued to do well and was transferred to 2 on for continued treatment. she continued to work with physical therapy and was ready for discharge to rehab. medications on admission: remeron 30 mg po daily lopressor 50 mg po bid mevacor 20 mg po daily mvi vicodin prn plavix 75 mg po daily celexa 10 mg po daily discharge medications: 1. atorvastatin 20 mg tablet sig: one (1) tablet po daily (daily). 2. citalopram 20 mg tablet sig: one (1) tablet po daily (daily). 3. ferrous gluconate 300 mg tablet sig: one (1) tablet po daily (daily). 4. ascorbic acid 500 mg tablet sig: one (1) tablet po bid (2 times a day). 5. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 6. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po bid (2 times a day). 7. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day) for 1 months. 8. albuterol 90 mcg/actuation aerosol sig: four (4) puff inhalation q6h (every 6 hours). 9. fluticasone 110 mcg/actuation aerosol sig: two (2) puff inhalation (2 times a day). 10. bisacodyl 10 mg suppository sig: one (1) suppository rectal daily (daily). 11. ranitidine hcl 150 mg tablet sig: one (1) tablet po daily (daily) for 1 months. 12. enoxaparin 120 mg/0.8 ml syringe sig: one (1) subcutaneous q12h (every 12 hours): until inr 2.0. 13. camphor-menthol 0.5-0.5 % lotion sig: one (1) appl topical qid (4 times a day) as needed. 14. mineral oil-hydrophil petrolat ointment sig: one (1) appl topical tid (3 times a day) as needed. 15. white petrolatum-mineral oil cream sig: one (1) appl topical qid (4 times a day) as needed. 16. heparin lock flush (porcine) 100 unit/ml syringe sig: two (2) ml intravenous daily (daily) as needed: each port of midline daily and as needed. 17. insulin sliding scale insulin sc (per insulin flowsheet) sliding scale fingerstick qachsinsulin sc sliding scale breakfast lunch dinner bedtime humalog humalog humalog humalog glucose insulin dose insulin dose insulin dose insulin dose 0-60 mg/dl 4 oz. juice 4 oz. juice 4 oz. juice 4 oz. juice 61-100 mg/dl 0 units 0 units 0 units 0 units 101-130 mg/dl 2 units 2 units 2 units 0 units 131-150 mg/dl 4 units 4 units 4 units 0 units 151-180 mg/dl 6 units 6 units 6 units 2 units 181-210 mg/dl 8 units 8 units 8 units 4 units 211-240 mg/dl 10 units 10 units 10 units 6 units ordered by , m, apn beeper#: on @ 2112 acknowledged by rn on @ 2140 by ,, rn processed by pharmacy on @ 2118 by , order #: 18. warfarin 2 mg tablet sig: two (2) tablet po once (once) for 1 doses: for only, then md to order daily dose. discharge disposition: extended care facility: - discharge diagnosis: innominate artery aneurysm pvd htn niddm depression iron deficiency anemia cri s/p breast ca s/p cva ^chol. vascular dementia discharge condition: good. discharge instructions: follow medications on discharge instructions. do not drive for 4 weeks. do not lift more than 10 lbs. for 10 weeks. shower daily, let water flow over wounds, pat dry with a towel. call our office for temp.>101.5, sternal drainage. do not use creams, lotions, or powders on wounds. please call with any questions or concerns followup instructions: make an appointment with dr. for 2 weeks. (vasc. foot surgeon) make an appointment with dr. for 4 weeks. make an appointment with dr. after discharge from rehab procedure: venous catheterization, not elsewhere classified venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more diagnostic ultrasound of heart enteral infusion of concentrated nutritional substances other repair of aneurysm transfusion of packed cells transfusion of platelets other immobilization, pressure, and attention to wound aorta-subclavian-carotid bypass aorta-subclavian-carotid bypass endovascular implantation of graft in thoracic aorta diagnoses: thrombocytopenia, unspecified tobacco use disorder urinary tract infection, site not specified unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled personal history of malignant neoplasm of breast chronic kidney disease, unspecified cellulitis and abscess of leg, except foot iron deficiency anemia, unspecified ulcer of heel and midfoot vascular dementia, uncomplicated cerebral atherosclerosis venous (peripheral) insufficiency, unspecified other diseases of trachea and bronchus ulcer of ankle aneurysm of artery of neck 

Answer: The patient is high likely exposed to