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: motrin / erythromycin base attending: chief complaint: morbid obesity major surgical or invasive procedure: : 1. laparoscopic sleeve gastrectomy and concomitant laparoscopic cholecystectomy. : 1. exploratory laparoscopy converted to laparotomy. 2. abdominal washout. 3. oversewing of the gastric sleeve staple line. 4. evacuation of clot. 5. liver biopsy. history of present illness: has class iii morbid obesity with a weight of 344 pounds as of with her initial screen weight 340 pounds on , height 66 inches and bmi of 55.5. her previous weight loss efforts have included weight watchers x 36 months -present losing 50 pounds, the diet in for 6 months losing 24 pounds, slim-fast x 12 months and losing visits x 4 as well as pcp counseling since . she is also undergoing behavioral therapy for past 36 months. she has not taken prescription weight loss medications or used over-the-counter ephedra-containing appetite suppressants/herbal supplements. she stated that her weight at age 21 was 250 pounds her lowest adult weight and her highest weight was 384 pounds in . she has had weight issues since age 14 shortly before she was diagnosed with polycystic ovary syndrome and when she graduated from high school she weighed 350 pounds. she subsequently lost 100 pounds and had maintained the loss for the following 15 years. in she was diagnosed with lupus and was placed on high doses of prednisone and gained 180 pounds over the course of 5 years. factors contributing to her excess weight include grazing a large portions, some refined carbohydrates and saturated fats as well as stressful and emotional eating. her current exercise routine is one hour twice per week of aqua-aerobics, one hour of personal training in a pool and one hour of personal training in the gym with resistance training and weights. she attributes difficulty with exercise because of her large pannus and impedance of her mobility. she denied history of eating disorders and does have depression/anxiety, is followed by a therapist working on weight issues, has not been hospitalized for mental health issues and she is on psychotropic medication that she does find useful (zoloft). past medical history: past medical history: her medical history is significant for, 1. polycystic ovarian syndrome. 2. rheumatoid arthritis. 3. discoid lupus. 4. diabetes mellitus. 5. depression. 6. obstructive sleep apnea. 7. cpap. past surgical history: the patient denies any significant surgical history. social history: she used to smoke two packs of cigarettes daily for 20 years but quit in , denies recreational drug usage, no alcohol and does consume caffeinated beverages. she works as an underwriter and is married living with her husband age 65 retired and her stepson aged 24. family history: her family history is noted for mother living at age 70 with diabetes and obesity; paternal grandmother deceased age 78 with heart disease, hyperlipidemia, stroke and arthritis; maternal grandmother deceased age 62 of cancer. physical exam: vs: constitutional: nad neuro: alert and oriented x 3 cardiac: rrr, nl s1,s2 lungs: cta b abd: wounds: ext: pertinent results: 04:57am blood wbc-9.5 rbc-3.21* hgb-9.7* hct-30.0* mcv-93 mch-30.3 mchc-32.5 rdw-14.0 plt ct-294 03:35pm blood wbc-8.9 rbc-3.22* hgb-9.7* hct-30.6* mcv-95 mch-30.1 mchc-31.8 rdw-14.0 plt ct-292 02:37am blood wbc-8.7 rbc-2.99* hgb-8.9* hct-28.0* mcv-94 mch-29.7 mchc-31.7 rdw-14.2 plt ct-281 02:58pm blood hct-28.8* 09:27am blood hct-29.4* 01:19am blood wbc-8.2 rbc-3.10* hgb-9.3* hct-28.7* mcv-92 mch-30.1 mchc-32.5 rdw-14.3 plt ct-267 03:30pm blood wbc-12.0* rbc-3.33* hgb-10.2* hct-30.5* mcv-92 mch-30.7 mchc-33.5 rdw-14.5 plt ct-264 12:15pm blood wbc-10.4 rbc-3.27* hgb-10.0* hct-30.4* mcv-93 mch-30.5 mchc-32.8 rdw-14.3 plt ct-280 06:40am blood hct-25.1* 11:16pm blood hct-28.3* 04:00pm blood wbc-9.8# rbc-3.02*# hgb-9.0*# hct-27.5* mcv-91 mch-29.9 mchc-32.9 rdw-14.6 plt ct-249 10:35am blood hct-28.3* 05:27pm blood hct-29.7* 10:10pm blood hct-30.5* 05:58pm blood hct-31.1* 02:44pm blood hct-34.9* 12:15pm blood fibrino-657* 02:37am blood glucose-132* urean-4* creat-0.5 na-143 k-3.5 cl-108 hco3-29 angap-10 01:19am blood glucose-153* urean-6 creat-0.5 na-145 k-3.7 cl-110* hco3-31 angap-8 03:30pm blood glucose-174* urean-8 creat-0.6 na-142 k-3.7 cl-107 hco3-26 angap-13 05:27pm blood glucose-136* urean-8 creat-0.8 na-145 k-4.2 cl-107 hco3-28 angap-14 02:37am blood calcium-7.8* phos-3.2 mg-1.7 01:19am blood calcium-7.7* phos-2.6* mg-2.0 03:30pm blood calcium-7.9* phos-2.6* mg-1.8 05:27pm blood calcium-8.3* phos-2.9 mg-1.7 12:27pm blood type-art po2-145* pco2-41 ph-7.40 caltco2-26 base xs-0 10:35am blood type-art po2-199* pco2-42 ph-7.41 caltco2-28 base xs-2 12:27pm blood glucose-146* lactate-1.2 na-140 k-3.6 cl-110* 10:35am blood glucose-115* lactate-0.8 na-141 k-3.2* cl-111* 12:27pm blood hgb-11.2* calchct-34 12:27pm blood freeca-0.99* 10:35am blood freeca-0.97* imaging: ugi sgl contrast w/ kub: impression: expected post-operative appearance of sleeve gastrectomy without obstruction or leak ecg: sinus tachycardia. delayed r wave transition. left ventricular hypertrophy. possible prior inferior myocardial infarction. compared to the previous tracing of the ventricular rate is faster and the suggestion of a possible prior inferior myocardial infarction is new. delayed r wave progression was not previously seen. brief hospital course: the patient presented to pre-op on . pt was evaluated by anaesthesia and taken to the operating room for laparoscopic sleeve gastrectomy and laparascopic cholecystectomy. there were no adverse events in the operating room; please see the operative note for details. pt was extubated, taken to the pacu until stable, then transferred to the for observation. on pod1, the patient's hematocrit trended downward to 28 (from 41.1 pre-op) with concomittant tachycardia to 110s and sanguinous jp drainage, therefore, she was transfused a total of 2 units of prbcs; heparin was discontinued. of note, on pod1, the patient complained of epigastric pain radiating to her left arm; an ekg was reassuring and troponin was within normal limits. an ugi series, also performed on pod1, was negative for a leak, therefore, her diet was advanced to stage 1, which was well tolerated. urine output remained adequate and the patient was ambulating with assistance. on pod3, due to persistent mild tachycardia, sanguinous jp output and decreasing hematocrit levels to 25 requiring an additional 2 units of prbcs, the patient returned to the operating room where she underwent an exploratory laparoscopy converted to laparotomy, abdominal washout, oversewing of the gastric sleeve staple line, evacuation of clot and liver biopsy; see operative note for details. post-procedure the patient was transferred to the surgical intensive care unit for close observation. the patient remained stable in the icu with resolution of tachycardia and stable hematocrit levels. pain was well controlled with a dilaudid pca. an ngt, placed intra-operatively was discontinued and methylene blue dye was administered orally without subsequent change in character of jp drain output, therefore, her diet was advanced to stage 1 and well tolerated. also, given concern for local tissue ischemia of small portion of patient's wound, a few staples were removed and a dry dressing was applied and changed twice daily. on pod , the patient was transferred to the general surgical . while on the floor, she continued to have stable vital signs and hematocrit levels; subcutaneous heparin was resumed on . her diet was advanced to stage 3, which was well tolerated; fsbg was monitored and metformin was resumed at half dose upon discharge. the dilaudid pca, ivf and foley were discontinued; po meds were initiated. pt evaluated the patient and provided acute treatment with recommendations for continued home pt upon discharge. ot was also consulted but did not identify any acute ot needs. on pod , the patient was discharged to home with visiting nursing services and home physical therapy. she continued to do well, was afebrile with stable vital signs. the patient was tolerating a stage 3 diet, ambulating, voiding without assistance, and pain was well controlled. both jp drains were removed prior to discharge. the patient received discharge teaching and follow-up instructions with understanding verbalized and agreement with the discharge plan. she will follow-up with dr. in clinic in 1 week. medications on admission: preadmission medications listed are correct and complete. information was obtained from patientwebomr. 1. hydroxychloroquine sulfate 200 mg po bid 2. metformin (glucophage) 1000 mg po bid 3. sertraline 50 mg po daily 4. vitamin e 1000 unit po daily 5. vitamin d 5000 unit po daily 6. multivitamins w/minerals 1 tab po daily 7. cinnamon bark *nf* dosage uncertain tablets oral daily 8. calcet creamy bites *nf* (calcium citrate-vitamin d3) 500 mg calcium -400 unit oral 9. fish oil (omega 3) 1000 mg po frequency is unknown discharge medications: 1. oxycodone liquid 5-10 mg po q4h:prn pain rx *oxycodone 5 mg/5 ml ml by mouth every four (4) hours disp #*150 milliliter refills:*0 2. ranitidine (liquid) 150 mg po bid rx *ranitidine hcl 15 mg/ml 10 ml by mouth twice a day disp #*600 milliliter refills:*0 3. acetaminophen (liquid) 650 mg po q6h:prn pain rx *acetaminophen 325 mg/10.15 ml 20 ml by mouth every six (6) hours disp #*300 milliliter refills:*0 4. calcet creamy bites *nf* (calcium citrate-vitamin d3) 500 mg calcium -400 unit oral 5. fish oil (omega 3) 1000 mg po daily 6. multivitamins w/minerals 1 tab po daily 7. vitamin d 5000 unit po daily 8. miconazole powder 2% 1 appl tp tid rx *miconazole nitrate 2 % 1 application twice a day disp #*90 gram refills:*0 9. nystatin oral suspension 5 ml po qid:prn thrush duration: 7 doses swish and spit rx *nystatin 100,000 unit/ml 5 ml by mouth four times a day disp #*140 milliliter refills:*0 10. docusate sodium (liquid) 100 mg po bid:prn constipation rx *docusate sodium 50 mg/5 ml 10 ml by mouth twice a day disp #*150 milliliter refills:*0 11. metformin (glucophage) 500 mg po bid rx *metformin 500 mg/5 ml 500 mg by mouth twice a day disp #*300 milliliter refills:*1 12. sertraline 50 mg po daily rx *sertraline 20 mg/ml 50 mg by mouth daily disp #*75 milliliter refills:*1 discharge disposition: home with service facility: vna, discharge diagnosis: morbid obesity diabetes mellitus. cholelithiasis. chronic cholecystitis. sleep apnea. intraabdominal bleeding after laparoscopic gastric sleeve and cholecystectomy. discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: discharge instructions: please call your surgeon or return to the emergency department if you develop a fever greater than 101.5, chest pain, shortness of breath, severe abdominal pain, pain unrelieved by your pain medication, severe nausea or vomiting, severe abdominal bloating, inability to eat or drink, foul smelling or colorful drainage from your incisions, redness or swelling around your incisions, or any other symptoms which are concerning to you. diet: stay on stage iii diet until your follow up appointment. do not self advance diet, do not drink out of a straw or chew gum. medication instructions: resume your home medications except for the following changes. 1. please reduce your metformin to 500 mg, twice daily. please check your blood sugars twice daily and report elevated or low readings to your prescribing . please hold hydroxychloroquine (plaquenil). discuss your ability to resume this medication with dr. at your follow-up visit. *crush all pills* you will be starting some new medications: 1. you are being discharged on medications to treat the pain from your operation. these medications will make you drowsy and impair your ability to drive a motor vehicle or operate machinery safely. you must refrain from such activities while taking these medications. 2. you should begin taking a chewable complete multivitamin with minerals. no gummy vitamins. 3. you will be taking zantac liquid 150 mg twice daily for one month. this medicine prevents gastric reflux. 4. you should take a stool softener, colace, twice daily for constipation as needed, or until you resume a normal bowel pattern. 5. nystatin oral swish four times per day as needed to treat oral thrush. 6. miconazole powder applied twice daily to affected area. 5. you must not use nsaids (non-steroidal anti-inflammatory drugs) examples are ibuprofen, motrin, aleve, nuprin and naproxen. these agents will cause bleeding and ulcers in your digestive system. activity: no heavy lifting of items pounds for 6 weeks. you may resume moderate exercise at your discretion, no abdominal exercises. wound care: you may shower, no tub baths or swimming. if there is clear drainage from your incisions, cover with clean, dry gauze. your steri-strips will fall off on their own. please remove any remaining strips 7-10 days after surgery. please call the doctor if you have increased pain, swelling, redness, or drainage from the incision sites. followup instructions: department: bariatric surgery when: tuesday at 1 pm with: , rd building: sc clinical ctr campus: east best parking: garage department: bariatric surgery when: tuesday at 1:30 pm with: , md building: sc clinical ctr campus: east best parking: garage procedure: closed (percutaneous) [needle] biopsy of liver laparoscopic cholecystectomy reopening of recent laparotomy site laparoscopic vertical (sleeve) gastrectomy diagnoses: obstructive sleep apnea (adult)(pediatric) diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled hematoma complicating a procedure personal history of tobacco use hemorrhage complicating a procedure calculus of gallbladder with other cholecystitis, without mention of obstruction other specified surgical operations and procedures causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation morbid obesity personal history of urinary calculi tachycardia, unspecified laparoscopic surgical procedure converted to open procedure body mass index 50.0-59.9, adult lupus erythematosus 

Answer: The patient is high likely exposed to