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: percocet attending: chief complaint: abdominal pain major surgical or invasive procedure: 1. portal lymphadenectomy 2. repair of hepatic artery with saphenous vein interposition graft history of present illness: 55-year-old woman who originally presented in after experiencing several months of severe right upper quadrant pain. an abdominal ultrasound on revealed gallstones and concern for a 4-mm gallbladder polyp without any evidence of cholecystitis. she underwent a ct scan on that also showed gallstones with excessive calcifications in the gallbladder and an ultrasound was recommended for further evaluation. she continued to have pain. further imaging and work-up included a ct scan on that demonstrated ongoing cholelithiasis with a prominent gallbladder and common bile duct/gallbladder neck. she underwent a laparoscopic-converted-to-open cholecystectomy performed by you on for persistent epigastric and right upper quadrant pain with gallstones and calcifications of her gallbladder seen on ct scan. pathology revealed adenocarcinoma of the gallbladder and positive lymph nodes. since her surgery she has had severe nausea requiring compazine three times a day. she has not had any vomiting, but has had a 13-lb. weight loss in this period. she states that the pain she had prior to her surgery has mostly improved, with some periodic episodes of right upper quadrant pain; however, the nausea is what bothers her the most. she denies any fevers or chills and has had only one episode of night sweats. she has minimal incisional pain and is back to eating a regular diet, although she states that she has no appetite secondary to the nausea. past medical history: t2n1 left breast cancer status post lumpectomy with chemotherapy and radiation in , status post a five-year course of tamoxifen and now maintained on femara. she also has a history of uterine cancer in , carpal tunnel syndrome, anxiety, depression, peptic ulcer disease, bronchitis, claustrophobia, and nephrolithiasis. psh: laparoscopic-converted-to- open cholecystectomy on , , left breast lumpectomy in , and a partial hysterectomy in . social history: 20-pack/year smoking history(currently smoking one pack/day). she denies any drug use or alcohol use. family history: her mother died at 67 from copd. her father died of unknown causes. physical exam: on exam: vitals signs stable. she is an alert female in no acute distress. heent: no scleral icterus. perrla. mucous membranes moist. neck: no cervical lymphadenopathy. cardiac:regular rate and rhythm. lungs: clear to auscultation bilaterally. abdomen: soft, nondistended. minimal tenderness at a well-healing right subcostal incision and periumbilical incision with evidence that staples have been removed recently. there is no erythema or drainage or evidence of hernia. no masses. extremities: no peripheral edema. palpable distal pulses. pertinent results: 04:20pm blood wbc-8.7 rbc-3.95* hgb-12.3 hct-34.4* mcv-87 mch-31.0 mchc-35.6* rdw-14.0 plt ct-126* 04:20pm blood pt-16.3* ptt-54.2* inr(pt)-1.4* 04:20pm blood glucose-136* urean-8 creat-0.6 na-139 k-4.1 cl-106 hco3-23 angap-14 04:20pm blood alt-1031* ast-853* alkphos-85 amylase-43 totbili-2.0* 04:20pm blood calcium-7.9* phos-3.6 mg-1.3* 02:00am blood wbc-12.9* rbc-3.40* hgb-10.7* hct-29.9* mcv-88 mch-31.3 mchc-35.6* rdw-14.0 plt ct-114* 02:00am blood pt-18.0* ptt-44.1* inr(pt)-1.6* 02:00am blood glucose-132* urean-5* creat-0.5 na-133 k-3.8 cl-103 hco3-24 angap-10 02:00am blood alt-1014* ast-449* ld(ldh)-454* alkphos-113* totbili-0.8 05:35am blood wbc-12.6* rbc-3.29* hgb-10.4* hct-28.8* mcv-88 mch-31.6 mchc-36.1* rdw-13.7 plt ct-105* 05:35am blood glucose-117* urean-4* creat-0.5 na-136 k-3.6 cl-106 hco3-20* angap-14 05:35am blood alt-599* ast-133* alkphos-124* totbili-0.9 05:35am blood albumin-3.0* calcium-8.2* phos-1.5* mg-1.7 05:20am blood wbc-9.3 rbc-3.09* hgb-9.7* hct-27.3* mcv-88 mch-31.4 mchc-35.6* rdw-13.7 plt ct-140* 05:20am blood glucose-88 urean-6 creat-0.4 na-136 k-3.1* cl-103 hco3-25 angap-11 05:20am blood alt-388* ast-54* alkphos-120* totbili-0.6 05:20am blood albumin-2.9* calcium-7.9* phos-2.7 mg-1.8 05:00am blood wbc-6.1 rbc-3.16* hgb-9.9* hct-27.4* mcv-87 mch-31.3 mchc-36.1* rdw-13.8 plt ct-184 05:00am blood pt-18.7* ptt-32.0 inr(pt)-1.7* 05:00am blood glucose-102* urean-4* creat-0.5 na-134 k-3.3 cl-101 hco3-27 angap-9 05:00am blood alt-268* ast-37 alkphos-115* totbili-0.6 05:00am blood albumin-3.2* calcium-8.1* phos-2.6* mg-1.8 pathology: i. hepatic artery lymph node, lymph node dissection (a):one lymph node, no carcinoma seen (0/1). ii. superior portal vein lymph node, lymph node dissection (b-c):five lymph nodes, no carcinoma seen (0/5). iii. portal tissue, gallbladder fossa resection (d):adenocarcinoma, moderately differentiated. iv. portal node tissue, lymph node dissection (e):1. adenocarcinoma, moderately differentiated (see note).2. insipisated gallstone with histiocytic giant cell reaction. liver usg: impression: arterial waveform seen at the porta hepatis, but no intrahepatic arterial waveforms appreciated. : cta abdomen impression: 1. occlusion of the main hepatic artery at the porta hepatis. 2. some reconstitution of flow of the right hepatic artery. small segment v right liver lobe infarct. 3. s/p left hepatic artery ligation with infarct involving segments ii and iii of the left hepatic lobe. 4. postsurgical simple fluid in the lesser sac, in the anterior left perihepatic space and paracolic gutters bilaterally. 5. moderate right and small left effusions with associated atelectasis. brief hospital course: the patient was admitted to the surgery service for evaluation and treatment. she was taken to the or on . please refer to the operative note for details of the surgery. post operative course: neuro: the patient received morphine with good effect and adequate pain control. when tolerating oral intake, the patient was transitioned to oral pain medications. cv: the patient was stable from a cardiovascular standpoint; vital signs were routinely monitored. pulmonary: the patient was stable from a pulmonary standpoint; vital signs were routinely monitored. good pulmonary toilet, early ambulation and incentive spirometry were encouraged throughout this hospitalization. gi/gu/fen: post operatively, the patient was made npo with ivf. the patient's diet was advanced when appropriate, which was tolerated well. a usg of the liver was done that showed arterial waveform at the porta hepatis, but no intrahepatic arterial waveforms appreciated. this was followed by a cta of the abdomen to assess the hepatic vasculature.this showed occlusion of the main hepatic artery at the porta hepatis. there was some reconstitution of flow of the right hepatic artery. the patient's intake and output were closely monitored, and ivf were adjusted when necessary. the patient's electrolytes were routinely followed during this hospitalization, and repleted when necessary. id: the patient's white blood count and fever curves were closely watched for signs of infection. endocrine: the patient's blood sugar was monitored throughout this stay; insulin dosing was adjusted accordingly. hematology: the patient's complete blood count was examined routinely; no transfusions were required during this stay. prophylaxis: the patient received subcutaneous heparin during this stay, and was encouraged to get up and ambulate as early as possible. she was started on a heparin infusion and coumadin post operatively. after 3 days, the heparin infusion was stopped and lovenox was started. she would have to continue to be on lovenox until her inr becomes therapeutic on coumadin after discharge. at the time of discharge, the patient was doing well, afebrile with stable vital signs. the patient was tolerating a regular diet, ambulating, voiding without assistance, and pain was well controlled. medications on admission: cyclobenzaprine 10 mg p.o. tid prn anxiety, lexapro 20 mg po qd, nexium 40 mg po qd, femara 2.5 mg po qd, prochloperazine 10 mg po bid prn nausea, and zolpidem 10 mg po qpm prn sleep. discharge medications: 1. enoxaparin 60 mg/0.6 ml syringe sig: 0.6 ml subcutaneous (2 times a day). disp:*14 ml* refills:*1* 2. escitalopram 10 mg tablet sig: two (2) tablet po daily (daily). 3. hydromorphone 2 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for pain. disp:*30 tablet(s)* refills:*0* 4. coumadin 1 mg tablet sig: five (5) tablet po once a day: dose will be adjusted based on lab: inr per dr. office. disp:*150 tablet(s)* refills:*2* 5. nexium 40 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po once a day. 6. outpatient lab work stat pt/inr on thursday , friday , saturday and results t be fax'd to dr. office 7. medications on hold check with dr. re: resuming femara 8. coumadin 5 mg tablet sig: one (1) tablet po once a day for 1 months: dose will be adjusted based on lab: inr per dr. office. . disp:*30 tablet(s)* refills:*0* 9. prochlorperazine maleate 10 mg tablet sig: one (1) tablet po twice a day as needed for nausea. 10. cyclobenzaprine 10 mg tablet sig: one (1) tablet po three times a day as needed for anxiety. 11. zolpidem 10 mg tablet sig: one (1) tablet po at bedtime as needed for sleep. discharge disposition: home with service facility: all care vna discharge diagnosis: gallbladder ca hepatic artery dissection/ligation discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: please call dr. office if you have: fever (101 or greater), chills, nausea, vomiting, jaundice, increased abdominal pain, abdominal bloating, incision redness/bleeding/drainage, easy bruising, any bleeding. you will need to have blood work drawn on thursday, friday and saturday for coumadin management. the vna will be drawing the labs for you and getting the results to dr office. they will adjust your coumadin accordingly you may shower no driving while taking pain medication no heavy lifting/straining you will need to give yourself lovenox injections twice daily. visiting nurse (vna)services have been arranged to help you with this administration. followup instructions: provider: scan phone: date/time: 8:45 (please arrive at clinical center building at 7:45. do not eat or drink 3 hours prior to cat scan. you will then follow up with dr. as noted below. provider: , md, phd: date/time: 9:40 md, procedure: division or crushing of other cranial and peripheral nerves regional lymph node excision repair of blood vessel with tissue patch graft diagnoses: tobacco use disorder accidental puncture or laceration during a procedure, not elsewhere classified personal history of malignant neoplasm of other parts of uterus embolism and thrombosis of other specified artery personal history of malignant neoplasm of other gastrointestinal tract secondary and unspecified malignant neoplasm of intra-abdominal lymph nodes accidental cut, puncture, perforation or hemorrhage during surgical operation 

Answer: The patient is high likely exposed to