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: patient recorded as having no known allergies to drugs attending: chief complaint: abdominal aortic aneurysm. major surgical or invasive procedure: aortic stent graft repair of abdominal aortic aneurysm with a zenith device history of present illness: 85m pre-op for endovascular aaa (5.3 cm), here for elective repair of aaa. past medical history: 1. parkinson's disease 2. hypertension 3. niddm 4. h/ tear 5. scoliosis/kyphosis 6. stable pericardial effusion, last echo at (followed by kanam) 7. sleep disorder 8. h/o aaa social history: lives with wife. used. quit tobacco many years ago, but smoked cigarettes/day x 10 years. veteran. retired, worked in advertising. denies alcohol use family history: nc physical exam: pe: afvss neuro: perrl / eomi mae equally answers simple commands neg pronator drift sensation intact to st 2 plus dtr neg babinski heent: ncat neg lesions nares, oral pharnyx, auditory supple / farom neg lyphandopathy, supra clavicular nodes lungs: cta b/l cardiac: rrr without murmers abdomen: soft, nttp, nd, pos bs, neg cva tenderness ext: rle - palp fem, , pt, dp lle - palp fem, , pt, dp pertinent results: renal u.s. comparison: ct of the abdomen dated . renal : the right kidney measures 10.1 cm. the left kidney measures 11.2 cm. there is no hydronephrosis, stone or solid renal mass identified. there are a couple of simple renal cysts of the left kidney, the largest of which is at the upper pole, measuring up to 4.0 cm in largest diameter. the bladder is collapsed. impression: no hydronephrosis. left renal cysts. cardiology report ecg compared to the previous tracing the ventricular response rate to atrial fibrillation is slightly slower at 110. intervals axes rate pr qrs qt/qtc p qrs t 112 0 84 368/434.42 0 31 -14 echo study measurements: left atrium - long axis dimension: 3.9 cm (nl <= 4.0 cm) right atrium - four chamber length: 5.0 cm (nl <= 5.0 cm) left ventricle - septal wall thickness: 0.9 cm (nl 0.6 - 1.1 cm) left ventricle - inferolateral thickness: 0.8 cm (nl 0.6 - 1.1 cm) left ventricle - diastolic dimension: 4.0 cm (nl <= 5.6 cm) left ventricle - systolic dimension: 2.2 cm left ventricle - fractional shortening: 0.45 (nl >= 0.29) left ventricle - ejection fraction: >= 60% (nl >=55%) aorta - valve level: 3.3 cm (nl <= 3.6 cm) aorta - ascending: 3.3 cm (nl <= 3.4 cm) aortic valve - peak velocity: 1.0 m/sec (nl <= 2.0 m/sec) mitral valve - e wave: 0.9 m/sec mitral valve - a wave: 0.3 m/sec mitral valve - e/a ratio: 3.00 mitral valve - e wave deceleration time: 287 msec tr gradient (+ ra = pasp): *47 mm hg (nl <= 25 mm hg) pericardium - effusion size: 2.8 cm interpretation: left atrium: normal la size. right atrium/interatrial septum: normal ra size. left ventricle: normal lv wall thickness, cavity size, and systolic function (lvef>55%). false lv tendon (normal variant). right ventricle: normal rv chamber size and free wall motion. aorta: normal aortic root diameter. normal ascending aorta diameter. aortic valve: mildly thickened aortic valve leaflets (3). no as. no ar. mitral valve: normal mitral valve leaflets. mild (1+) mr. tricuspid valve: normal tricuspid valve leaflets. moderate tr. pulmonic valve/pulmonary artery: normal pulmonic valve leaflets. significant pr. the end-diastolic pr velocity is increased c/w pa diastolic hypertension. pericardium: large pericardial effusion. effusion circumferential. no significant respiratory variation in mitral/tricuspid valve flows. echocardiographic signs of tamponade may be absent in the presence of elevated right sided pressures. conclusions: the left atrium is normal in size. left ventricular wall thickness, cavity size, and systolic function are normal (lvef>55%). right ventricular chambersize and free wall motion are normal. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. no aortic regurgitation is seen. the mitral valve leaflets are structurally normal. mild (1+) mitral regurgitation is seen. moderate tricuspid regurgitation is seen. significant pulmonic regurgitation is seen. the end-diastolic pulmonic regurgitation velocity is increased suggesting pulmonary artery diastolic hypertension. there is a large, circumferential, echolucent pericardial effusion extending 2-2.8cm around the right and left ventricles. there is mild right ventricular diastolic invagination, but no respiratory accentuation of transmitral e wave velocity. echocardiographic signs of tamponade may be absent in the presence of elevated right sided pressures. compared with the report of the prior study (tape unavailable for review) of , the size of the pericardial effusion is larger, and mild right ventricular diastolic collapse is now seen. based on aha endocarditis prophylaxis recommendations, the echo findings indicate a moderate risk (prophylaxis recommended). clinical decisions regarding the need for prophylaxis should be based on clinical and echocardiographic data. cta abd w&w/o c & recons; cta pelvis w&w/o c & recons ct angiogram: atheromatous plaque along the normal caliber included portion of the lower descending thoracic aorta, the upper abdominal aorta is normal in caliber measuring 2.3 cm. the common hepatic and splenic arteries have separate origins. interval endo stent repair of the infrarenal abdominal aortic aneurysm with the stent graft extending from less than 1 cm above the origin of the renal arteries,both of which are patent. the stented aorta measures less than 2 cm ap at the level of the renal artery origins. no evidence of endoleak. the infrarenal aneurysm sac at its largest measures up to 5.1 cm ap x 5 cm transverse (series 3a, image 93). distal stent limbs extend to the mid right common iliac and distal left common iliac artery. both internal and external iliac arteries are normal in caliber and patent. minor retrograde filling of the noted. ct scan of abdomen with intravenous contrast: large pericardial effusion measuring up to 4 cm in depth (larger than on the prior ct of ). small bibasilar pleural effusions, left lower lobe collapse and partial atelectasis of the posterior right lower lobe. nasogastric tube in situ with the tip lying in the nondistended gastric body. the liver, spleen, pancreas, both adrenal glands appear normal. a small amount of free intraabdominal fluid mainly along the right pericolic gutter and mild circumferential thickening of the gallbladder wall. these findings with the appearances of the lung base may be secondary to cardiac congestion, for example. no intra- or extrahepatic biliary dilatation. some vicarious excretion of contrast noted within the gallbladder. some residual contrast noted in both kidneys on enhanced ct following recent angiography. both kidneys show symmetric post-contrast enhancement. hyopattenuating, partially exophytic renal cortical cyst arising from the left upper pole medially measures up to 3.9 cm. no abnormal large bowel loop dilatation or focal segmental stricture to strongly suggest ischemic bowel on the ct. ct scan of pelvis with intravenous contrast: no free pelvic fluid. urinary catheter within the bladder, which is empty at the time of scanning. no bone lesions demonstrated. degenerative change noted in the lumbar spine with moderate lumbar scoliosis convexed to the left side. conclusion: 1. no abnormal bowel loop dilatation or segmental thickening to strongly suggest bowel ischemia on the current ct. celiac and superior mesenteric artery are widely patent. 2. interval endo stent repair of the infrarenal abdominal aortic aneurysm. no evidence of endoleak. the infrarenal aneurysm sac measures up to a maximal diameter 5.1 cm ap. glucose-106* urea n-46* creat-1.4* sodium-137 potassium-4.5 chloride-100 total co2-22 anion gap-20 urine blood-neg nitrite-neg protein-neg glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-5.0 leuk-neg urine color-straw appear-clear sp -1.011 pt-13.8* ptt-28.7 inr(pt)-1.3 plt count-135* wbc-7.1 rbc-4.25* hgb-12.8* hct-37.2* mcv-88 mch-30.1 mchc-34.4 rdw-14.3 calcium-9.8 phosphate-3.7# magnesium-2.2 brief hospital course: pt admittted 11/06/05admitted for preoperative hydration. endovascular aaa repair with zenith stent graft.developed hypotension and acidosis with respiratory arrest post ativan sedation ( patient with history of sleep apnea). patient intubated( for airway protection ) and transfered to icu.patient's cardiac enzymes ck/mb negative. elevated troponin 0.3 but patient with renal insuffiency (cr 1.9) ekg no acute changes.patient required vasopressors for hemodymainac support.t max 103-102 wbc 17.3 cxr with volume overload. patient diuresed. cardology reconsulted for hypotension and bradycardia.check tsh to r/o hypothyroism secondary to amiodarone.tsh 2.5 cortisol insuffiency. started on cortisone.continued on broad spectrum antibiotics. consullted for glycemic control. transplant consultedfor ? abdominal sepsis. liver function tests normal.they did not feel there was an abdominal source for patient's elevated white count of fever. gi consulted for guiac positive stools and loose stools. cta of abd negative for ischemic bowel.sigmoidoscopy defered for concerns of seeding endovascular prothesis and lack of evidence for bowel ischemia ie rectal bleeding.c.diff sent x2 which have been negative.patient will require continued diuresis over the next seven days with a potassium supplement. see patient's d/c rx. patients amidarone is on a wean. please see d/c rx for instructions.patient will need to followup with dr. weeks. please call for appointment. . patient will d/c to rehab with foley inplace. please d/c on arrival, medications on admission: sinemet 25/100"', mirapex 0.5"', lopressor 50", triamterene 37.5 qod, hctz 25 qod discharge medications: 1. acetaminophen 325 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed. 2. tramadol 50 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed. 3. metronidazole 500 mg tablet sig: one (1) tablet po tid (3 times a day): dc on . 4. pramipexole 0.25 mg tablet sig: one (1) tablet po tid (3 times a day). 5. carbidopa-levodopa 25-100 mg tablet sig: one (1) tablet po tid (3 times a day). 6. multivitamin,tx-minerals tablet sig: one (1) tablet po daily (daily). 7. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). 8. amiodarone 200 mg tablet sig: two (2) tablet po tid (3 times a day). 9. prednisone 10 mg tablet sig: one (1) tablet po daily (daily) for 2 days: end of steroid taper. stop on . 10. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). discharge disposition: extended care facility: for the aged - discharge diagnosis: abdominal aortic aneurysm atrial fibrillation respiratory distress,( reinbuated ) non-iorn gap metabolic acidosis cortisol non-responder postoperative hypootension secondary to adrenal insuffiency postoperative bradycardia history of parkinsons's history of dm2, noninsulin dependant history of - tear history of scoliosis/kyphosis history of percardial effusion, stable, last echo @ ( followed by dr. history of sleep apnea discharge condition: stable discharge instructions: discharge instructions following endovascular aortic aneurysm surgery . this information is designed as a guideline to assist you in a speedy recovery from your surgery. please follow these guidelines unless your physician has specifically instructed you otherwise. please call our office nurse if you have any questions. dial 911 if you have any medical emergency. . activity: . there are no specific restrictions on activity. you should be as active as is comfortable. resume driving when you are comfortable without the need for pain medication. . please call us immediately for any of the following problems: . redness in or drainage from your incisions . . new pain, numbness or discoloration of your feet or toes . . new abdominal or back pain. . watch for signs and symptoms of infection. these are: a fever greater than 101 degrees, chills, increased redness, or pus draining from the incision site. if you experience any of these or bleeding at the incision site, call the doctor. . exercise: . limit strenuous activity for 4 weeks. . resume driving when you are comfortable without the need for pain medication. . no heavy lifting greater than 20 pounds for the next 7 days. . bathing/showering: . you may shower immediately upon coming home. no bathing. dissolving sutures, which do not have to be removed were probably used. your wounds are covered with a clear, plastic dressing which should be left in place for three (3) days. remove it after this time and wash your incisions gently with soap and water. . you may have staples. . wound care: . sutures / staples may be removed before discharge. if they are not, an appointment will be made for you to return for removal. . when the sutures / staples are removed the doctor may or may not place pieces of tape called steri-strips over the incision. these will stay on about a week and you may shower with them on. if these do not fall off after 10 days, you may peel them off with warm water and soap in the shower. . medications: . unless told otherwise, you should continue taking all of the medications that you were on before surgery. you will be given a new prescription for pain medication, which should be taken every three (3) to four (4) hours if necessary. . remember that narcotic pain meds can be constipating and you should increase the fluid and bulk foods in your diet. (check with your physician if you have fluid restrictions.) if you feel that you are constipated, do not strain at the toilet. you may use over the counter metamucil or milk of magnesia. appetite suppression may occur; this will improve with time. eat small balanced meals throughout the day. . cautions: . no smoking! we know you've heard this before, but it really is an important step to your recovery. smoking causes narrowing of your blood vessels which in turn decreases circulation. if you smoke you will need to stop as soon as possible. ask your nurse or doctor for information on smoking cessation. . avoid heavy lifting (over 10 pounds) for 4-6 weeks after surgery. . no strenuous activity for 4-6 weeks after surgery. . diet: . there are no special restrictions on your diet postoperatively. poor appetite is expected for several weeks and small, frequent meals may be preferred. . for people with vascular problems we would recommend a cholesterol lowering diet: follow a diet low in total fat and low in saturated fat and in cholesterol to improve lipid profile in your blood. additionally, some people see a reduction in serum cholesterol by reducing dietary cholesterol. since a reduction in dietary cholesterol is not harmful, we suggest that most people reduce dietary fat, saturated fat and cholesterol to decrease total cholesterol and ldl (low density lipoprotein-the bad cholesterol). exercise will increase your hdl (high density lipoprotein-the good cholesterol) and with your doctor's permission, is typically recommended. you may be self-referred or get a referral from your doctor. . if you are overweight, you need to think about starting a weight management program. your health and its improvement depend on it. we know that making changes in your lifestyle will not be easy, and it will require a whole new set of habits and a new attitude.. if interested you can may be self-referred or can get a referral from your doctor. . if you have diabetes and would like additional guidance, you may request a referral from your doctor. follow-up appointment: . be sure to keep your medical appointments. the key to your improving health will be to keep a tight reign on any of the chronic medical conditions that you have. things like high blood pressure, diabetes, and high cholesterol are major villains to the blood vessels. don't let them go untreated! . you should be seen in the office approximately ten (10) days to two (2) weeks following discharge from the hospital. a ct scan of the abdomen will have to be preformed just prior to that visit and this will be scheduled with your visit when you call the office. . please call the office on the first working day after your discharge from the hospital to schedule a follow-up visit. normal office hours are 8:30-5:00 monday through friday. . please call the office with any questions or concerns that might develop. followup instructions: call dr office and schedule an appointment for 2 weeks. he can be reached at . procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours insertion of endotracheal tube endovascular implantation of other graft in abdominal aorta transfusion of packed cells infusion of vasopressor agent diagnoses: acidosis mitral valve disorders congestive heart failure, unspecified unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled other pulmonary insufficiency, not elsewhere classified cardiac complications, not elsewhere classified atrial fibrillation chronic kidney disease, unspecified paralysis agitans unspecified disease of pericardium other specified cardiac dysrhythmias unspecified sleep apnea abdominal aneurysm without mention of rupture scoliosis [and kyphoscoliosis], idiopathic diseases of tricuspid valve benzodiazepine-based tranquilizers causing adverse effects in therapeutic use 

Answer: The patient is high likely exposed to