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: cortisone / percocet / prednisone / advair diskus attending: chief complaint: abdominal pain major surgical or invasive procedure: : exploratory laparotomy with ileocolectomy history of present illness: 78f s/p laparoscopic converted to open right hemicolectomy for stage 1 (t1n0) right colon cancer on , now being transferred from osh with diffuse abdominal pain and guarding on exam. she started with diffuse abdominal pain at 9am yesterday and went to at 9pm. she had some nausea and bilious emesis x5, but had been passing flatus and bowel movements. a non-contrast ct was performed and she was sent here as her abdominal exam was concerning. in ed with a.fib w/rvr, hypertension up to 200/100. past medical history: cad s/p pci (last '), pafib, chf, htn, hyperchol, interstitial lung disease, gib, gerd, cri (baseline cr 1.3-1.8), niddm, hypothyroid, tia, parkinson's, low back pain past surgical history: diverting transverse loop colostomy after colonic perforation from colonoscopy,, colostomy reversal, ventral hernia repair with mesh, laparoscopic converted to open right hemicolectomy . social history: patient is retired, lives at home with husband. former . denies alcohol or other drugs. family history: nc physical exam: on admission: vitals: t 101.1 hr 160 bp 120/90 rr 20 so2 96% gen: a&o, nad heent: no scleral icterus, mucus membranes moist cv: rrr, no m/g/r pulm: clear to auscultation b/l, no w/r/r abd: firm, nondistended, severely tender diffusely, mild rebound tenderness and voluntary guarding. dre: normal tone, no gross or occult blood ext: 1+ le edema b/l, le warm and well perfused on discharge: pertinent results: admission labs -------------- 12:30am blood wbc-29.3*# rbc-4.63# hgb-13.3# hct-42.3# mcv-91 mch-28.8 mchc-31.5 rdw-15.8* plt ct-263# 12:30am blood pt-30.3* ptt-23.7 inr(pt)-3.0* 12:30am blood glucose-182* urean-40* creat-1.6* na-143 k-6.0* cl-107 hco3-19* angap-23* : tee no intracardiac thrombus. mild mitral regurgitation. : ct abd/pelvis: - diffuse bowel wall dilatation, with lack of mural enhancement in the distal ileum, concerning for bowel ischemia or necrosis. there is an occlusion of an ileal branch of the superior mesenteric artery suggesting an embolic cause for bowel ischemia upstream of affected areas. - extensive atherosclerotic disease of the aorta and iliac arteries. : mri head - acute infarction in the left middle cerebral artery distribution involving the left parietal lobe. - small old infarct in the right cerebellum. - no evidence of susceptibility artifact to suggest intracranial hemorrhage. : kub - ileus : kub - there has been no significant change. there remains air and stool seen throughout the colon and some mildly prominent loops of small bowel. left side down decubitus radiograph, shows no free intra-abdominal gas present. surgical skin staples are seen projecting over the midline. : ct head: - evolving left parietal infarct. no evidence of hemorrhagic transformation. - global atrophy and chronic small vessel change. - small old right cerebellar infarct. 05:10am blood wbc-7.8 rbc-3.43* hgb-10.1* hct-31.3* mcv-91 mch-29.6 mchc-32.4 rdw-15.6* plt ct-454* 05:22am blood wbc-7.6 rbc-3.28* hgb-9.5* hct-30.5* mcv-93 mch-29.1 mchc-31.3 rdw-15.8* plt ct-438 05:00am blood wbc-7.8 rbc-3.15* hgb-9.3* hct-29.0* mcv-92 mch-29.4 mchc-32.0 rdw-15.9* plt ct-361 05:37pm blood wbc-8.8 rbc-3.24* hgb-9.2* hct-29.2* mcv-90 mch-28.4 mchc-31.5 rdw-16.3* plt ct-313 09:24am blood wbc-8.0 rbc-3.16* hgb-9.3* hct-28.5* mcv-90 mch-29.3 mchc-32.5 rdw-16.2* plt ct-310 01:42am blood wbc-7.3 rbc-3.02* hgb-9.2* hct-26.5* mcv-88 mch-30.6 mchc-34.9 rdw-15.9* plt ct-268 12:11am blood wbc-7.1 rbc-3.61* hgb-10.6* hct-32.7* mcv-91 mch-29.5 mchc-32.5 rdw-16.3* plt ct-307 05:12am blood wbc-5.3 rbc-3.42* hgb-10.0* hct-31.5* mcv-92 mch-29.3 mchc-31.8 rdw-15.9* plt ct-245 05:25am blood wbc-4.1 rbc-3.44* hgb-10.1* hct-31.5* mcv-92 mch-29.4 mchc-32.1 rdw-15.8* plt ct-200 05:20am blood wbc-3.0* rbc-3.64* hgb-10.9* hct-32.8* mcv-90 mch-29.8 mchc-33.1 rdw-15.8* plt ct-157 05:10am blood wbc-4.0# rbc-3.83* hgb-11.4* hct-34.1* mcv-89 mch-29.8 mchc-33.5 rdw-15.9* plt ct-132* 12:30am blood neuts-93* bands-0 lymphs-2* monos-5 eos-0 baso-0 atyps-0 metas-0 myelos-0 12:30am blood hypochr-normal anisocy-normal poiklo-1+ macrocy-normal microcy-normal polychr-normal ovalocy-1+ tear dr 11:10am blood pt-24.3* ptt-26.1 inr(pt)-2.3* 05:10am blood plt ct-454* 05:10am blood pt-25.3* ptt-28.1 inr(pt)-2.4* 05:22am blood plt ct-438 05:22am blood pt-39.7* ptt-29.9 inr(pt)-4.1* 05:00am blood plt ct-361 05:00am blood pt-39.0* ptt-29.5 inr(pt)-4.0* 05:37pm blood plt ct-313 09:24am blood plt ct-310 01:42am blood plt ct-268 01:42am blood pt-39.8* ptt-28.6 inr(pt)-4.1* 12:11am blood plt ct-307 12:11am blood pt-38.6* ptt-26.7 inr(pt)-3.9* 05:12am blood pt-38.4* ptt-27.4 inr(pt)-3.9* 11:20am blood pt-34.5* ptt-68.9* inr(pt)-3.5* 12:58pm blood pt-17.7* ptt-45.5* inr(pt)-1.6* 05:20am blood plt ct-157 05:20am blood pt-16.7* ptt-44.1* inr(pt)-1.5* 05:10am blood pt-16.1* ptt-26.0 inr(pt)-1.4* 03:20pm blood pt-17.6* ptt-25.5 inr(pt)-1.6* 03:10am blood pt-16.8* ptt-28.7 inr(pt)-1.5* 12:26pm blood plt ct-120* 12:26pm blood pt-23.0* ptt-32.7 inr(pt)-2.1* 03:29am blood pt-31.2* ptt-35.1* inr(pt)-3.1* 07:22am blood pt-19.8* ptt-29.8 inr(pt)-1.8* 12:30am blood pt-30.3* ptt-23.7 inr(pt)-3.0* 11:10am blood glucose-90 urean-13 creat-1.3* na-146* k-3.6 cl-111* hco3-23 angap-16 05:10am blood glucose-90 urean-13 creat-1.2* na-141 k-3.1* cl-112* hco3-21* angap-11 05:22am blood glucose-93 urean-16 creat-1.3* na-141 k-3.8 cl-108 hco3-21* angap-16 05:00am blood glucose-91 urean-15 creat-1.3* na-142 k-4.1 cl-111* hco3-21* angap-14 05:37pm blood glucose-110* urean-15 creat-1.3* na-140 k-4.2 cl-111* hco3-20* angap-13 07:23am blood creat-1.3* na-140 k-4.2 cl-113* 01:42am blood glucose-125* urean-17 creat-1.4* na-139 k-4.0 cl-110* hco3-21* angap-12 12:11am blood glucose-136* urean-16 creat-1.1 na-141 k-3.4 cl-110* hco3-22 angap-12 05:12am blood glucose-94 urean-17 creat-1.2* na-143 k-3.4 cl-111* hco3-21* angap-14 05:25am blood glucose-109* urean-23* creat-1.3* na-143 k-3.3 cl-111* hco3-21* angap-14 12:44pm blood glucose-118* urean-29* creat-1.4* na-142 k-3.4 cl-108 hco3-23 angap-14 05:20am blood glucose-102* urean-30* creat-1.4* na-142 k-3.3 cl-107 hco3-23 angap-15 05:10am blood glucose-120* urean-36* creat-1.4* na-143 k-3.6 cl-107 hco3-24 angap-16 07:55pm blood glucose-121* urean-36* creat-1.4* na-140 k-3.5 cl-105 hco3-20* angap-19 01:35am blood glucose-97 urean-39* creat-1.8* na-142 k-3.8 cl-110* hco3-21* angap-15 03:10am blood glucose-90 urean-36* creat-1.7* na-141 k-4.6 cl-108 hco3-22 angap-16 05:00am blood alt-9 ast-13 ld(ldh)-178 alkphos-40 totbili-0.3 12:30am blood alt-14 ast-42* alkphos-41 totbili-0.3 05:50pm blood ck-mb-5 ctropnt-0.04* 01:35am blood ck-mb-2 ctropnt-0.05* 11:10am blood calcium-8.4 phos-3.9 mg-1.8 05:10am blood calcium-8.0* phos-3.5 mg-1.9 05:22am blood calcium-8.0* phos-4.0 mg-1.9 05:00am blood calcium-7.8* phos-4.2 mg-2.0 05:37pm blood calcium-7.9* phos-3.7 mg-2.0 12:11am blood calcium-8.2* phos-3.3 mg-2.0 05:12am blood calcium-7.8* phos-2.9 mg-2.3 05:25am blood calcium-8.0* phos-2.5* mg-1.9 12:44pm blood calcium-8.1* phos-3.1 mg-2.0 05:10am blood calcium-7.9* phos-3.9 mg-2.1 cholest-97 05:35am blood calcium-8.3* phos-4.2 mg-2.1 01:35am blood calcium-8.2* phos-3.7# mg-2.3 03:10am blood calcium-8.7 phos-5.5* mg-2.1 12:26pm blood calcium-7.9* phos-4.5 mg-2.0 05:25am blood triglyc-193* 05:10am blood triglyc-212* hdl-16 chol/hd-6.1 ldlcalc-39 05:10am blood vanco-19.5 06:00am blood vanco-13.7 05:00am blood digoxin-0.9 03:10am blood digoxin-0.7* brief hospital course: ms. was taken emergently to the or for exploratory laparatomy on . she was transferred to the sicu in fair condition postoperatively, intubated and sedated. her hospital course is discussed below by system: neuro: patient's pain was controlled with pca and transitioned to iv and po pain medications when appropriate. during her icu stay, she was noted to have word finding difficult and sundowning. family felt that patient was confused but otherwise at baseline and her neurologic exam was nonfocal. as her overall condition improved and sundowning resolved, her word finding difficulty became more apparent and an mri of her head was performed on with acute infarction in the left middle cerebral artery distribution involving the left parietal lobe noted. she was started on a heparin drip and her afib was controlled as below. over the following 48 hours, her speech improved and a speech and swallow evaluation was performed prior to starting po intake. patient improved daily until when she developed hypertension into the 200s with associated worsening speech. a ct head was performed which showed no hemorrhagic conversion and evolving stroke. she was continued on coumadin once therapeutic on heparin, and her dose of this was titrated to an appropriate level. she had been initially supratherapeutic with a maximum inr during her admission of 4.1, following which her coumadin was held. this was restarted on 0.5mg of warfarin at discharge with a plan to follow her inr at rehab. cv: patient was in afib rvr upon admission. iv metoprolol was used for rate control. tee showed no evidence of intracardiac thrombus to explain her synchronous embolization to her small bowel and brain. patient required multiple iv antihypertensives (metop, labetalol, hydralazine) for bp control. on , patient's hypertensive episode prompted a transfer to icu where she was controlled with a labetalol drip to maintain systolic blood pressure <140. patient was eventually transitioned to po metoprolol and iv metoprolol prn and transferred back to the general surgery service. following transfer she was started on lisinopril and her blood pressure remained stable and appropriate and continued on an increased dose of lopressor. her blood pressure was improved and appropriate. resp: patient showed evidence of moderate pulmonary edema and was diuresed with iv lasix. she was given nebulizer treatments and encourage to use her is. her o2 was weaned. abd: patient's abdomen was distended with a prolonged ileus postoperatively. initial attempts at diet advanced with speech and swallow recommendations were met with abdominal distension and pain. on , patient complained of severe abdominal pain with nausea. kub showed an ileus. ng tube was placed with 500 cc of bile drained and improvement in pain. ng tube was removed while patient in icu and abominal distension was improved. her diet was advanced to a regular diet and calorie counts were followed. she was given supplementation with ensure and was instructed to continue this on discharge. wound: the midline surgical incision was closed with staples post-operatively. the inicsion line was intact without signs of infection. these staples were removed on discharge and replaced with steri-strips. the patient was to wear an abdominal binder when out of bed. renal: patient's mild renal insufficiency was unchanged throughout admission. heme: patient received one unit of ffp prior to ex lap on , one unit of prbc on and one unit of prbc on for low hct. her inr rose from 1.4 to 3.5 with one dose of coumadin once therapeutic on heparin. her inr peaked at 4.1 and then trended down. she was kept therapeutic on her coumadin thereafter with a low dose. patient was also kept on heparin sc with venodynes for dvt prophylaxis. id: the patient was ruled out for c. diff suring this admission. consulting teams: during this admission the patient was followed closely by neurology, geriatric medicine, speech and swallow, phyiscal therapy, and social work. medications on admission: coumadin 2', asa 81', toprol xl 75', digoxin 0.125qod, lipitor 40', omeprazole 20', glipizide 2.5', fentanyl patch 50, topamax 25', sinemet 25/100''', seroquel 25'am-50'pm-100'hs, remeron 30'hs, divalproex 250am/500pm, ativan 0.5'''prn, ambien 10'prn, mvi, colace 100", cacarb 1000''', fe 65', fish oil, ?lasix 20', toprol 75', mirtazapine 30', omeprazole 20', discharge medications: 1. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed for constipation. 2. furosemide 20 mg tablet sig: one (1) tablet po bid (2 times a day). 3. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po once a day. 4. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 5. digoxin 125 mcg tablet sig: one (1) tablet po every other day (every other day). 6. atorvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 7. glipizide 5 mg tablet sig: 0.5 tablet po daily (daily). 8. topiramate 25 mg tablet sig: one (1) tablet po daily (daily). 9. carbidopa-levodopa 25-100 mg tablet sig: one (1) tablet po tid (3 times a day). 10. quetiapine 25 mg tablet sig: one (1) tablet po qam (once a day (in the morning)). 11. quetiapine 50 mg tablet sig: one (1) tablet po qpm (once a day (in the evening)). 12. quetiapine 100 mg tablet sig: one (1) tablet po qhs (once a day (at bedtime)). 13. mirtazapine 30 mg tablet sig: one (1) tablet po hs (at bedtime). 14. divalproex 250 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po qam (once a day (in the morning)). 15. divalproex 500 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po qpm (once a day (in the evening)). 16. lorazepam 0.5 mg tablet sig: one (1) tablet po q8h (every 8 hours) as needed for anxiety. 17. multivitamin,tx-minerals tablet sig: one (1) tablet po daily (daily). 18. lisinopril 5 mg tablet sig: 0.5 tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 19. metoprolol tartrate 25 mg tablet sig: 2.5 tablets po bid (2 times a day). disp:*150 tablet(s)* refills:*2* 20. acetaminophen 325 mg tablet sig: two (2) tablet po q6h (every 6 hours) as needed for pain. disp:*50 tablet(s)* refills:*0* 21. warfarin 1 mg tablet sig: tablet po qhs (once a day (at bedtime)) for 1 doses: please give at 1600 on and recheck inr on . goal inr 2.0-3.0, pt have been difficult to manage, very sensitive to warfarin. discharge disposition: home with service facility: in discharge diagnosis: mesenteric ischemia ileal resection cva discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - requires assistance or aid (walker or cane). discharge instructions: you were admitted to the hospital after a an open colectomy for surgical management of your mesenteric ischemia. it is thought that this mesenteric ischemia was caused by a blood clot in the membranes attatched to your intestine caused by your heart condition atrial fibrillation. during this time, it is thought that you also suffered from a stroke related to a blood clot which traveled to your brain. it is very important that you continue your coumadin therapy which ahs been difficult to manage, however, will be managed by the hospital providers. you have recovered from this surgery well and you are now ready to be discharged to rehabilitation. from the stoke, you have difficulty saying words and it is our hope as well as the hope of the neurology team that this will improve over time with the help of occpational therapy and speech therapy. please continue to hope and work for improvement in your symptoms. please participate in physical therapy to regain your strength. you have tolerated a regular diet, passing gas and your pain is controlled with pain medications by mouth. please monitor your bowel function closely. you have had a bowel movement. after anesthesia it is not uncommon for patient??????s to have some decrease in bowel function but your should not have prolonged constipation. some loose stool and passing of small amounts of dark, old appearing blood are explected however, if you notice that you are passing bright red blood with bowel movments or having loose stool without improvement please call the office or go to the emergency room if the symptoms are severe. if you are taking narcotic pain medications there is a risk that you will have some constipation. please take an over the counter stool softener such as colace, and if the symptoms does not improve call the office. if you have any of the following symptoms please call the office for advice or go to the emergency room if severe: increasing abdominal distension, increasing abdominal pain, nausea, vomiting, inability to tolerate food or liquids, prolonges loose stool, or constipation. you have a long vertical incision on your abdomen the staples have been removed prior to your discharged and steri-strips have been applied. this incision can be left open to air or covered with a dry sterile gauze dressing if the incision becomes irritated from clothing. please monitor the incision for signs and symptoms of infection including: increasing redness at the incision, opening of the incision, increased pain at the incision line, draining of white/green/yellow/foul smelling drainage, or if you develop a fever. please call the office if you develop these symptoms or go to the emergency room if the symptoms are severe. you may shower, let the warm water run over the incision line and pat the area dry with a towel, do not rub. please wear an abdominal binder provided to you at all times while out of bed. no heavy lifting for at least 6 weeks after surgery unless instructed otherwise by dr. or dr. . you may gradually increase your activity as tolerated but clear heavy excersise after follow up. you may take tylenol as recommended for pain. please do not take more than 4000mg of tylenol daily. do not drink alcohol while taking narcotic pain medication or tylenol. you will take 0.5mg coumadin today . your inr today is 2.3. the rehab facility will need to check daily inrs until your inr is stable and therapeutic, with a goal inr of 2.0-3.0. thank you for allowing us to participate in your care! our hope is that you will have a quick return to your life and usual activities. good luck! followup instructions: please plan to follow up in dr. clinic in approximately 2 weeks. call ( to make an appointment. procedure: diagnostic ultrasound of heart open and other right hemicolectomy other small-to-large intestinal anastomosis application or administration of an adhesion barrier substance diagnoses: acidosis pure hypercholesterolemia congestive heart failure, unspecified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled unspecified acquired hypothyroidism hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified atrial fibrillation percutaneous transluminal coronary angioplasty status chronic kidney disease, unspecified paralysis agitans surgical operation with anastomosis, bypass, or graft, with natural or artificial tissues used as implant causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation postinflammatory pulmonary fibrosis long-term (current) use of anticoagulants paralytic ileus personal history of malignant neoplasm of large intestine cerebral embolism with cerebral infarction acute diastolic heart failure acute vascular insufficiency of intestine aphasia precipitous drop in hematocrit delirium due to conditions classified elsewhere iatrogenic cerebrovascular infarction or hemorrhage peritonitis (acute) generalized dysphagia, oropharyngeal phase 

Answer: The patient is high likely exposed to