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: no known allergies / adverse drug reactions attending: chief complaint: tachycardia, worsened right sided chest/abdominal pain major surgical or invasive procedure: none history of present illness: 52 year old female with history of hyperlipidemia, hypretension and colon cancer treated previously with surgery, chemo (folfiri plus avastin, previously treated with folfox)and xrt in (approx 1 month ago) with known metastases and progresion of disease, for which no longer treatment is being received. she came to a few days ago from for 2nd opinion and currently living with her sister. she presents with right sided trunk (chest & abd) pain along with tachycardia. she has had ongoing pleuritic right chest pain for 1 month. also admits to productive cough. she denies any central chest pain. she denies any dizziness. she is unable to walk at baseline secondary to weakness and per her family this has been the case for quite some time. she is on vicodin for her pain but in the last 2 days the pain has been worse. she denies fevers. past medical history: - colon cancer s/p ln dissection - hypertension - hypercholesterolemia - nerve system problem, wheelchair bound since , describes that started in her legs and feels numbness/tingling and has weakness. social history: single and lives alone. has 7 children. came from to on saturday. was a homemaker. now living with her sister in . she has a cousin as well here. - tobacco: past smoker, 20 pack year history - alcohol: negative family history: noncontributory physical exam: admission physical exam: vitals: 129/76, 126 hr, 98/ra general: alert, oriented, no acute distress heent: sclera anicteric, mmm, oropharynx clear neck: supple, jvp not elevated, no lad lungs: decreased breathsounds right base. otherwise clear. cv: tachycardic with regular rhythm, normal s1 + s2, no murmurs, rubs, gallops abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly. surgical scar midline inferior to umbilicus with smaller ruq scars gu: foley in place skin: hickman left chest wall with very mild surrounding erythema, femoral cvl right appears normal ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema . discharge physical exam: vitals: 98, 150/85, 105 (90's-100's) regular, rr 14, sat% 98ra general: alert, orientedx3, no acute distress, lying semi-flat in bed heent: sclera anicteric, mmm, oropharynx clear neck: supple, jvp not elevated, no lad lungs: it was difficult to auscultate to her back comfortably given her neurological condition. overall air entry is faint bilaterally posteriorly, right worse than left. no wheezes heard but fine insp crackles at the right base and axilla. cv: tachycardic with regular rhythm, normal s1 + s2, no murmurs, rubs, gallops abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly. surgical scar midline inferior to umbilicus with smaller ruq scars skin: hickman catheter removed, no tenderness or erythema extremities: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema. hand and feet contracture neuro: aox3, power in proximal muscles in both upper extremities 4+/5. power of proximal muscles in both lower extremties 3+/5. pertinent results: cbc and coags: blood wbc-9.1 rbc-3.77* hgb-11.1* hct-31.7* mcv-84 mch-29.4 mchc-35.0 rdw-13.0 plt ct-368 blood wbc-9.4 rbc-3.72* hgb-11.0* hct-31.3* mcv-84 mch-29.5 mchc-35.0 rdw-13.0 plt ct-381 blood pt-13.8* ptt-34.8 inr(pt)-1.2* blood pt-13.2 ptt-34.6 inr(pt)-1.1 . blood chemistry: blood glucose-114* urean-9 creat-0.4 na-138 k-3.9 cl-103 hco3-25 angap-14 blood glucose-90 urean-7 creat-0.4 na-136 k-4.7 cl-98 hco3-27 angap-16 blood alt-14 ast-22 ld(ldh)-247 ck(cpk)-214* alkphos-93 totbili-0.5 blood alt-13 ast-20 ld(ldh)-263* alkphos-113* totbili-0.5 blood lactate-1.0 . troponin: 11:30am blood ctropnt-<0.01 03:22am blood ck-mb-2 ctropnt-<0.01 11:30am blood calcium-8.6 phos-3.4 mg-1.8 07:10am blood albumin-3.4* calcium-9.3 phos-3.7 mg-2.2 . iron, b12 and folate: 03:22am blood caltibc-207* vitb12-412 folate-16.5 trf-159* . urine: urine blood-neg nitrite-neg protein-neg glucose-neg ketone-10 bilirub-neg urobiln-4* ph-6.0 leuks-neg urine color-yellow appear-clear sp -1.013 . oncology: blood cea-449* . micro: blood culture pending . images: ct torso with contrast : impression: 1. no evidence of pulmonary embolus, as clinically questioned. 2. extensive loculated right pleural fluid, with multiple foci of nodular pleural enhancement, concerning for malignant pleural disease. 3. consolidation of the right middle and right lower lobes, with markedly heterogeneous attenuation of the lung parenchyma including multiple areas of non-enhancement which appear mass-like, possibly reflecting the presence of necrotic metastases (suggested by the presence of additional bilateral pulmonary nodules) versus necrotizing pneumonia, or a combination of the above. 4. multiple low-attenuation liver lesions, necrotic mediastinal lymph nodes and numerous additional pulmonary nodules, all concerning for additional sites of metastatic disease. 5. cholelithiasis. . cxr : large right-sided pleural effusion with associated atelectasis, cannot exclude developing infectious infiltrate, aerated right and left lung are within normal limits, levoconcave scoliosis . ekg: sinus tachycardia rate 125, nani, twf i, avl, v4-v6, twi ii, iii and avf. respiratory variation to qrs height. . echo : the left atrium is normal in size. left ventricular wall thickness, cavity size, and global systolic function are normal (?? lvef 50%). the number of aortic valve leaflets cannot be determined. the mitral valve leaflets are not well seen. there is a very small circumferential, predominantly anterior pericardial effusion. there are no echocardiographic signs of tamponade (based on absence of respiratory variation of mv/tv inflow as rv could not be well visualized). impression: very poor technical quality. left ventricular function is probably normal, a focal wall motion abnormality cannot be fully excluded. the right ventricle is not well seen. no pathologic valvular abnormality seen. pulmonary artery systolic pressure could not be determined. . cxr : ap upright view of the chest: hickman catheter terminates in the upper svc, as before. moderate-to-large right-sided pleural effusion has increased compared to the prior exam. apparent widening of the mediastinum is related to pleural fluid tracking along the medial aspect of the right upper lung. there is no new consolidation. the cardiac silhouette cannot be evaluated in the setting of large right pleural effusion. left hilar contour is normal. there is no overt edema. dextroconvex scoliosis of the thoracic spine noted. impression: increased moderate partially-loculated right pleural effusion. brief hospital course: 52 year old woman with hyperlipidemia, hypertension, and colon cancer previously treated with chemo, surgery, radiotherapy, followed by progression of disease to lung/liver presented with sub-acute right chest pleuritic pain and dyspsnea, most likely due to her poor lung condition. . # tachycardia: appears sinus on ekg. most likely secondary to pain/discomfort though was mildly fluid responsive so may in part be due to hypovolemia. less likely pe as cta was negative. she was admitted to icu for further evaluation of her tachycardia. ct showed no pericardial effusion. malignancy itself can cause tachycardia. tte was obtained to evaluate compressive physiology, however the images were of poor quality and some details were not possible to evaluate. tte showed most likely a normal ejection fraction with no evidence of tamponade. on discharge her heart rate was slightly slower (90's-100's) than admission (120's-140's). . # chest pain: given location and pleuritic nature, most likely due to pleural effusion. no leukocytosis/fever or increased cough to confirm infected. ekg with st abnormalities and no prior for comparison. cardiac enzymes were negative. she was monitored on telemetry and notable only for tachycardia to 110s. she was treated with oxycodone and tylenol for pain. given lack of findings of pneumonia on cta, antibiotics that were started in the ed were discontinued. blood cultures sent and are still pending to this date. she was discharged on vicodin because she doesn't have insurance and can't pay for oxycodone. she was also provided with stool softeners to avoid constipation. . # dyspnea: likely due to pleural effusion. her saturation was high 90s on room air. might be difficult to drain effusion as locaulated given lack of signs of infection. given the normal oxygen saturation on room air and loculated fluid collection and predominating tumor burden in her right lung (likely unamenable to re-expansion) thoracentesis was deferred as unlikely to help her. . # malignancy: no outside hospital records with the patient. requested information from dr. at her community hospital in . we received some reports which stated that she has metastatic colon cancer (kras mutation positive) and that she was for hospice care. oncology was consulted and recommended cea and follow up in the oncology clinic. hickman line was removed . . # anemia: baseline hgb 11-12 per osh report. she had no signs of active bleeding. hct and hgb was trended daily and labs sent for vitamin b12, folate and iron studies which revealed normal b12 and folate, however iron studies were suggestive of anemia of chronic disease, most likely due to her malignancy. . # paralysis: unclear underlying disorder but chronic. more records need to be obtained from osh to understand etiology. . # hypertension: currently well controlled, continued her home anti-hypertensive medication. . # hyperlipidemia: on simvastatin. . # communication: patient, sister would be hcp; mothers phone number is . sisters name is . medications on admission: vicodin prn metoprolol 25mg po bid simvastatin 80mg po qhs discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*2* 2. metoprolol tartrate 25 mg tablet sig: one (1) tablet po twice a day. 3. simvastatin 80 mg tablet sig: one (1) tablet po at bedtime. 4. vicodin 5-500 mg tablet sig: one (1) tablet po every six (6) hours as needed for pain: you should not drive or drink alcohol while taking this medication. only take as directed. do not take more tylenol in addition to this medication. . 5. senna 8.6 mg tablet sig: one (1) tablet po twice a day as needed for constipation. disp:*60 tablet(s)* refills:*0* discharge disposition: home discharge diagnosis: primary diagnosis: metastatic colon cancer secondary diagnoses: tachycardia hypertension hyperlipidemia discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: out of bed with assistance to chair or wheelchair. discharge instructions: it was a great pleasure taking care of you as your doctor. . you were admitted to because of right sided body pain (chest and belly) and difficulty breathing. . you were admitted to icu for further management of your fast heart rate. your pain was well controlled with tylenol and oxycodone. . it was found that your heart rate is slightly faster than normal. ct scan of your chest in concern of a clot in your lung vessels. fortunately, the ct scan didn't show any clots in the vessels of your lung. however, your ct scan did show evidence of your known cancer. . *** the line in your chest was removed prior to your discharge. *** . we made the following changes in your medications: please start docusate sodium tablet 100 mg twice daily please start senna tablet 8.6 mg twice daily as needed for constipation please continue vicodin 5-500 one pill every 6 hours as needed (take only as directed, do not drink alcohol while taking, do not take additional tylenol in addition to vicodin). please continue metoprolol tablet 25 mg twice daily please continue simvastatin tablet 80 mg at bedtime . . please schedule an appointment with a primary care physician if you have any within/around . if not, please call in the next 2-3 days at () to schedule an appointment with a new primary care physician. you would like, i(dr ) will be more than happy to be your primary care physician. . please follow with your appointment with a new cancer doctor d below. followup instructions: . department: hematology/oncology when: wednesday at 10:00 am with: , md building: sc clinical ctr campus: east best parking: garage department: hematology/oncology when: wednesday at 10:00 am with: dr. building: sc clinical ctr campus: east best parking: garage procedure: central venous catheter placement with guidance diagnoses: malignant neoplasm of liver, secondary unspecified essential hypertension other and unspecified hyperlipidemia personal history of malignant neoplasm of large intestine secondary malignant neoplasm of lung tachycardia, unspecified paraplegia anemia in neoplastic disease neoplasm related pain (acute) (chronic) difficulty in walking wheelchair dependence 

Answer: The patient is high likely exposed to