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: lisinopril / aspirin attending: chief complaint: dyspnea major surgical or invasive procedure: none history of present illness: 87f with h/o asthma, recently dx dchf, htn and hld presenting with worsening dyspnea and le swelling. she reports that he symptoms have been long standing (months-years), but worsening recently. last week, she went to the ed for back pain, but had also noted that she was more sob and her ankles were starting to swell. she has had doe for 'a long while' but generally does not feel her ankles swell up. on friday night (1 day prior to admission), the patient reports that she began feeling 'breathless'. she denies cp, diaphoresis, palpitations, n/v. she felt that she couldn't catch her breath and was evening having trouble speaking in full sentances. this extent of dyspnea has not happened before. her daughter came to visit and reports that she was almost gasping for air and very unsteady on her feet. she recently went to her pcp reporting her milder symptoms (doe, le swelling) and was told to stop taking her hctz and start on furosemide 10 mg daily (which she started on thursday or friday). she also reports stable orthopnea, but denies nocturnal cough or pnd. as per ems reports, the patient was found to be 89% on ra, improving to 100% on a nrb in the ambulance. upon arrival to the ed, her initial vitals were 97.2 56 132/65 20 100% 10l. her exam revealed basilar crackles and 2+ pitting edema to the mid-shins. her oxygen saturation dropped to 90% on ra. labs were significant for hco3 38, bnp 2986, and trop 0.02. her cxr was read as central pulmonary vascular engorgement. a bedside tte by the ed staff was reportedly negative for pericardial fluid. she received furosemide 40 mg iv x1 with reported uop of 150 cc. she was admitted to for further management of a chf exacerbation. vitals prior to tranfer: 53 135/70 28 94% 2l nc. upon arrival to the floor, the patient reports feeling that her breathing is much improved. she continues to feel minimally sob and her breathing appears minimally labored. she denies cp, palpitations, n/v, abd pain, d/c, or ha. she denies significant changes in her salt intake recently. she endorses a lb weight gain over the summer. on review of systems, she denies any prior history of stroke, tia, deep venous thrombosis, pulmonary embolism, bleeding at the time of surgery, myalgias, joint pains, cough, hemoptysis, black stools or red stools. she denies recent fevers, chills or rigors. she denies exertional buttock or calf pain. all of the other review of systems were negative. cardiac review of systems is notable for absence of chest pain, palpitations, syncope or presyncope. past medical history: 1. cardiac risk factors: (-)diabetes, (+)dyslipidemia, (+)htn 2. cardiac history: -cabg: none -percutaneous coronary interventions: none -pacing/icd: none 3. other past medical history: -sarcoidosis -ocular hypertension -tendinitis, calcific, shoulder -obesity -cardiomegaly -lymphadenopathy -hypertension, essential -hypercholesterolemia -gout -asthma -disc disorder of lumbar region -mitral valve prolapse -osteoarthritis social history: originally from jamaca, moved to in . -tobacco history: denies -etoh: -illicit drugs: denies family history: no family history of early mi, arrhythmia, cardiomyopathies, or sudden cardiac death; otherwise non-contributory. physical exam: #admission physical exam: vs: 98.2, 156/75, 57, 20, 90-100% on 2l general: wdwn in nad. oriented x3. mood, affect appropriate. heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. no xanthelasma. neck: supple with jvp of cm above the clavical cardiac: pmi located in 5th intercostal space, midclavicular line. rr, normal s1, s2. +late systolic murmur. no thrills, lifts. no s3 or s4. lungs: no chest wall deformities, scoliosis or kyphosis. resp were minimally labored, no accessory muscle use. +bibasilar crackles. no wheezes/rhonchi. abdomen: soft, ntnd. no hsm or tenderness. nabs extremities: no cyanosis/clubbing, 2+ pitting edema to the knees b/l. skin: no stasis dermatitis, ulcers, scars, or xanthomas. pulses: right: dp 1+ left: dp 1+ - difficult to palpate given edema. discharge physical exam vs: t 98.5 bp 160/85 p71 r 20 i/o , bmx1 (net neg 1.5l) general: wdwn in nad. oriented x3. mood, affect appropriate. heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. no xanthelasma. neck: supple with jvp of 10-12cm cardiac: pmi located in 5th intercostal space, midclavicular line. rr, normal s1, s2. +late systolic murmur. no thrills, lifts. no s3 or s4. lungs: no chest wall deformities, scoliosis or kyphosis. resp were minimally labored, no accessory muscle use. +bibasilar crackles, improved. no wheezes/rhonchi. abdomen: soft, ntnd. no hsm or tenderness. nabs extremities: no cyanosis/clubbing, 2+ pitting edema to the knees b/l. skin: no stasis dermatitis, ulcers, scars, or xanthomas. pulses: right: dp 1+ left: dp 1+ pertinent results: #admission labs: 10:35pm urine color-straw appear-clear sp -1.006 10:35pm urine blood-neg nitrite-neg protein-neg glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-5.5 leuk-tr 10:35pm urine rbc-<1 wbc-4 bacteria-none yeast-none epi-2 trans epi-<1 10:35pm urine hyaline-4* 08:50pm glucose-110* urea n-20 creat-0.9 sodium-145 potassium-4.2 chloride-100 total co2-38* anion gap-11 08:50pm estgfr-using this 08:50pm ck(cpk)-79 08:50pm ctropnt-0.02* 08:50pm ck-mb-3 probnp-2986* 08:50pm calcium-9.5 phosphate-3.4 magnesium-2.0 08:50pm ferritin-52 08:50pm tsh-4.7* 08:50pm wbc-3.2* rbc-4.45 hgb-12.7 hct-40.9 mcv-92 mch-28.7 mchc-31.2 rdw-15.3 08:50pm neuts-73.6* lymphs-15.9* monos-8.6 eos-1.6 basos-0.4 08:50pm plt count-232 . #pertinent labs: 05:56am blood wbc-2.9* rbc-4.16* hgb-12.0 hct-38.9 mcv-94 mch-28.8 mchc-30.8* rdw-14.9 plt ct-202 05:30am blood wbc-3.3* rbc-4.14* hgb-12.1 hct-38.5 mcv-93 mch-29.3 mchc-31.6 rdw-15.2 plt ct-216 05:30am blood pt-11.0 ptt-28.9 inr(pt)-1.0 05:56am blood glucose-92 urean-14 creat-0.7 na-144 k-3.9 cl-96 hco3-46* angap-6* 03:40pm blood glucose-127* urean-16 creat-0.7 na-143 k-4.0 cl-95* hco3-45* angap-7* 05:30am blood glucose-86 urean-16 creat-0.7 na-146* k-3.7 cl-95* hco3-48* angap-7* 01:20pm blood glucose-108* urean-15 creat-0.8 na-145 k-4.1 cl-96 hco3-44* angap-9 05:56am blood alt-20 ast-23 ld(ldh)-238 alkphos-70 totbili-0.6 07:35pm blood alt-21 ast-24 ld(ldh)-222 alkphos-74 totbili-0.7 05:30am blood ctropnt-0.01 08:50pm blood ctropnt-0.02* 05:56am blood totprot-6.2* albumin-3.6 globuln-2.6 calcium-9.1 phos-2.5* mg-2.2 07:35pm blood totprot-6.2* albumin-3.7 globuln-2.5 03:40pm blood calcium-9.3 phos-1.2*# mg-2.3 05:30am blood calcium-8.8 phos-3.1 mg-1.8 05:30am blood free t4-1.1 05:56am blood rheufac-7 07:35pm blood -negative 03:10pm blood type-art o2 flow-2 po2-73* pco2-95* ph-7.30* caltco2-49* base xs-15 intubat-not intuba 06:51pm urine hours-random totprot-18 06:51pm urine u-pep-negative f . #microbiology: 10:35 pm urine **final report ** urine culture (final ): mixed bacterial flora ( >= 3 colony types), consistent with skin and/or genital contamination. . # tte : the left atrium is normal in size. no atrial septal defect is seen by 2d or color doppler. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. regional left ventricular wall motion is normal. left ventricular systolic function is hyperdynamic (ef>75%). there is a mild resting left ventricular outflow tract obstruction. there was no change in the left ventricular outflow tract gradient with valsalva maneuver. a mid-cavitary gradient is also identified due to hyperdynamic state. there is no ventricular septal defect. the right ventricular free wall is hypertrophied. the right ventricular cavity is dilated with borderline normal free wall function. the diameters of aorta at the sinus, ascending and arch levels are normal. the aortic valve leaflets (3) are mildly thickened. there is no valvular aortic stenosis. the increased transaortic velocity is likely related to high cardiac output. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. trivial mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. there is moderate pulmonary artery systolic hypertension. there is no pericardial effusion. # chest ct . multiple bilateral pulmonary nodules and areas of ground-glass opacities, many of these were present on the prior examination, though, some appear progressed. bilateral calcified hilar lymph nodes. together, these findings could be consistent with pulmonary sarcoidosis though in the absence of biopsy, definitive diagnosis would be difficult. no significant lymphadenopathy is seen on the current exam. 2. pulmonary hypertension. 3. unusual protrusion of ampulla not completely evaluated. endoscopy with ultrasound recommended to exclude ampullary lesion. brief hospital course: brief clinical course: 87f with h/o asthma, recently dx dchf, htn and hld presenting with worsening dyspnea and le swelling. . icu course the patient was briefly transferred to the icu during her hospital course for hypercarbia and concern for impending respiratory failure. she continued on non-invasive ventilation without improvement in her hypercarbia. she appeared to have a compensated respiratory acidosis without any changes in mental status. her tachypnea persisted throughout and she was transferred back to the floor with further work-up pending and the pulmonary consult team on board. active issues: # co2 retention: pt retains significant co2 at baseline, likely from underlying pulmonary sarcoidosis (though this is a clinical, not a tissue diagnosis). her pco2 was as high as 97, and she had co2 narcosis intermittently. she responded well to bipap, and co2 was downt o 60-70 range by discharge. she was started on modafenil to improve her awakeness and decrease co2 retention. also, because sarcoid may play a role, we gave her a course of prednisone which she will continue to taper down after discharge (started at 40mg, tapering 10mg q3day). set up for home bipap (did not qualify for cpap because no sleep study yet, so sent on bipap but at cpap settings). should get outpt sleep study. also sent on home ambulatory o2 only for use during ambulation, given she desated to 80's when walked. # acute on diastolic chronic chf: patient with worsening le edema and dyspnea to the point where she was unable to complete her sentances this am. she has had gradually worsening symptoms over the months to years, but reports that it has acutely worsened in the past week to the point where she was seen to be gasping for air, unable to speak in full sentances and 89% on ra. patient was recently started on furosemide, but only a day prior to admission. most recent tte with preserved ef, but this was in . cxr on admission with central pulmonary vascular engorgement. she was given furosemide 40 mg iv in the ed, and feels her breathing is much improved. repeat tte ; see report above (dilated rv, elevated pas pressures, ef of 75%. bnp 2986, c/w clinical picture of acute on chronic worsening of chf. we placed the patient on strict i&os, daily weights, low salt diet, fluid restriction of 2l. we restarted her home diuresis regimen of 10mg po lasix daily. much improved on discharge. . # coronaries: patient with no known reports of cad, but with multiple risk factors. she denies cp, tightness, n/v. trop very mildly elevated to 0.02, likely representing demand from her dyspea. ekg without overt signs of ischemia. patient reports gi intolerance of asa. we trend cardiac enzymes, trops stable 0.02, mb 3. she may benefit from asa, but reports gi intolerance. . # rhythm: patient current in nsr, without reports of known arrhtymias. noted to be bradycardic (hrs in the 50s), asymptomatic. verapamil on hold given patient is normotensive. we monitored the patient on telemetry; no events. . # hypertension currently slightly hypertensive. will not write for verapamil overnight given reports of dizziness from certain brands of this medication. we continued losartan. . # hyperlipidemia last lipid panel as per atrius records; - c/w pravastatin . # ocular hypertension/glaucoma - c/w home meds: dorzolamide and lataanprost in place of bimatoprost which is nonformulary/ . # asthma resp exam currently with +crackles, improving, but no wheezes. she reports using her inhaler. - albuterol nebs prn. -will get outpatient pfts and f/u with pulm. . transitional issues: -patient will require vna serices and telemonitoring - unusual protrusion of ampulla not completely evaluated. endoscopy with ultrasound recommended to exclude ampullary lesion. - taper steroids - bipap at home - home o2 - will need sleep study medications on admission: preadmissions medications listed are incomplete and require futher investigation. information was obtained from patientatriuswebomr. 1. furosemide 10 mg po daily 2. bimatoprost *nf* 0.03 % ou qhs 3. pravastatin 20 mg po daily 4. losartan potassium 100 mg po daily 5. verapamil sr 360 mg po q24h 6. dorzolamide 2% ophth. soln. 1 drop both eyes 7. magnesium oxide 400 mg po daily 8. albuterol inhaler puff ih q6h:prn sob 9. multivitamins 1 tab po daily 10. brimonidine tartrate 0.15% ophth. 1 drop both eyes discharge medications: 1. brimonidine tartrate 0.15% ophth. 1 drop both eyes 2. dorzolamide 2% ophth. soln. 1 drop both eyes 3. furosemide 10 mg po daily 4. losartan potassium 100 mg po daily 5. multivitamins 1 tab po daily 6. pravastatin 20 mg po daily 7. albuterol inhaler puff ih q6h:prn sob 8. bimatoprost *nf* 0.03 % ou qhs 9. magnesium oxide 400 mg po daily 10. modafinil *nf* 100 mg oral daily reason for ordering: patient with co2 narcosis, med recommended by pulmonary attending start in am of rx *modafinil 100 mg 1 tablet(s) by mouth daily disp #*30 tablet refills:*0 11. home o2 oxygen at 2l/minute continueous for portability pulse dose system diagnosis: chf, pulmonary sarcoidosis, sat on room air 88% 12. bipap 10mmhg/10mmhg with heated humidification 13. cpap 10mmhg 14. prednisone 30 mg po daily duration: 3 days rx *prednisone 10 mg 0. . . take 3 tablets by mouth once daily on tuesday and wednesday , then take 2 tablets by mouth once daily for 3 days, then take 1 tablet by mouth for 3 days, then stop disp #*15 tablet refills:*0 discharge disposition: home with service facility: vna discharge diagnosis: primary diagnosis pulmonary hypertension pulmonary sarcoidosis chf secondary diagnosis hypertension hyperlipidemia gout asthma discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: ms , it was a pleasure participating in your care while you were admitted to . as you know you were admitted because you were having shortness of breath. there was initally concern that your heart was not relaxing well however an echo of your heart did not show this. you were seen by the lung doctors follow-up with an out patient lung doctor (pulmonologist) for further testing to determine why you are short of breath. weigh yourself every morning, md if weight goes up more than 3 lbs. followup instructions: name: ,md specialty: primary care location: address: , , phone: when: monday, at 2:20pm name: , md specialty: pulmonary location: address: , 5th fl, , phone: when: we are working on a follow up appointment in the next two weeks. you will be called at home with an appointment. if you do not hear in two business days, please call above number for status. procedure: non-invasive mechanical ventilation diagnoses: congestive heart failure, unspecified unspecified essential hypertension gout, unspecified acute on chronic diastolic heart failure asthma, unspecified type, unspecified other chronic pulmonary heart diseases unspecified glaucoma sarcoidosis other and unspecified hyperlipidemia osteoarthrosis, unspecified whether generalized or localized, site unspecified obesity, unspecified do not resuscitate status hyperosmolality and/or hypernatremia scoliosis [and kyphoscoliosis], idiopathic lung involvement in other diseases classified elsewhere mixed acid-base balance disorder 

Answer: The patient is high likely exposed to