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: obstructive painless jaundice pancreatic mass major surgical or invasive procedure: total pancreatectomy history of present illness: this is a 74 year old male who presents with lethargy, mild weight loss and painless obstructive jaundice and pruritis. he has a decreased appetite, and he had some diarrhea. he was seen and evaluated by dr. and had placement of a biliary stent. past medical history: a-fib, staging laparoscopy , ercp w/stent placement, eye surgery, tonsillectomy social history: engaged retired insurance executive physical exam: gen: thin, healthy man with profound jaundice and scratching. no peripheral lymphadenopathy cv: atrial fibrillation chest: clear on auscultation abd: soft, no massess, nontender ext: full range of motion, +pulses bilaterally. pertinent results: 04:34pm blood wbc-9.2 rbc-3.45* hgb-10.2* hct-29.9* mcv-87 mch-29.6 mchc-34.1 rdw-17.0* plt ct-260 02:09am blood wbc-11.3* rbc-2.96* hgb-8.9* hct-26.5* mcv-89 mch-30.0 mchc-33.6 rdw-17.1* plt ct-209 08:40am blood wbc-8.9 rbc-3.15* hgb-9.4* hct-28.3* mcv-90 mch-29.9 mchc-33.3 rdw-17.4* plt ct-214 08:22am blood pt-13.7* ptt-32.5 inr(pt)-1.2* 08:40am blood plt ct-214 04:23pm blood glucose-235* urean-28* creat-1.0 na-139 k-4.5 cl-108 hco3-24 angap-12 01:36pm blood glucose-97 urean-17 creat-0.9 na-145 k-3.2* cl-105 hco3-29 angap-14 02:44am blood glucose-100 urean-14 creat-0.7 na-142 k-3.0* cl-106 hco3-28 angap-11 08:40am blood ck(cpk)-98 08:40am blood ck-mb-notdone ctropnt-0.03* 02:44am blood calcium-7.6* phos-2.6* mg-1.7 . pathology examination diagnosis: i. gallbladder (a): 1. chronic cholecystitis. 2. no calculi or tumor. ii. pancreatic neck margin of whipple specimen (b): 1. marked atrophy, with fibrosis and chronic inflammation. 2. no tumor. iii. proximal jejunum (c-d): segment of small intestine: within normal limits. iv. whipple specimen, pancreaticoduodenectomy (e-ag): 1. adenocarcinoma of the head of pancreas, see synoptic report. 2. obstruction of the common bile duct, due to invasion of the wall by tumor. 3. marked fibrosis and atrophy of the pancreas. 4. segment of duodenum: within normal limits. v. pancreas body and tail (ah-av): 1. separate small adenocarcinoma of the pancreatic body, 1.5 cm in diameter. a. well differentiated. b. minimal invasion of the surrounding adipose tissue. c. no tumor at the inked outer margin. 2. marked fibrosis/atrophy of the pancreas with dilated pancreatic duct. 3. multiple microscopic foci of pancreatic intraepithelial neoplasia (panin), ranging from low to high grade. 4. no lymph nodes in this segment. note: dr. (for dr. ) was notified on . pancreas (exocrine): resection synopsis macroscopic specimen type: pancreaticoduodenectomy, total pancreatectomy. tumor site( tumor): pancreatic head. tumor size greatest dimension: 4.8 cm. additional dimensions: 4.5 cm x 3.4 cm. other organs/tissues received: gallbladder, jejunum.. microscopic histologic type: ductal adenocarcinoma. histologic grade: g1: well differentiated. extent of invasion primary tumor: pt3: tumor extends beyond the pancreas but without involvement of the celiac axis or the superior mesenteric artery. regional lymph nodes: pn0: no regional lymph node metastasis. lymph nodes number examined: 29. number involved: 0. distant metastasis: pmx: cannot be assessed. margins margin(s) involved by invasive carcinoma: posterior retroperitoneal (radial) margin: posterior surface of pancreas. uncinate process margin (non-peritonealized surface of the uncinate process). venous/lymphatic vessel invasion: absent. perineural invasion: present. additional pathologic findings: pancreatic intraepithelial neoplasia -- highest grade: panin: iii. . cardiology report ecg study date of 1:27:34 pm atrial fibrillation with rapid ventricular response. poor r wave progression suggest prior anteroseptal myocardial infarction. non-specific st-t wave changes. low qrs voltage in the limb leads. compared to the previous tracing of there is no significant diagnostic change. intervals axes rate pr qrs qt/qtc p qrs t 113 0 102 344/436 0 29 -16 . chest (portable ap) 10:09 am findings: in comparison with the study of , there is little overall change. some prominence of the cardiac silhouette and interstitial markings is again seen. the increased opacification at the left base is again consistent with some atelectatic change in the retrocardiac region. . complete blood count wbc rbc hgb hct mcv mch mchc rdw plt ct 05:00am 12.5* 3.51* 10.5* 31.1* 89 30.0 33.8 17.7* 258 enzymes & bilirubin alt ast ck(cpk) alkphos amylase totbili 06:14pm 68* 73* 125 224* 13 18.4* . cta chest w&w/o c&recons, non-coronary 12:50 pm conclusion: 1. large bibasilar effusions with increased interstitial markings and ground glass opacities throughout both lungs suggestive of pulmonary edema from fluid overload or chf. 2. no central or segmental pulmonary emboli, however, given the extent of effusions and passive atelectasis, subsegmental pulmonary emboli in the lower lobes cannot be excluded. 3. abdominopelvic ascites with no evidence of abscess. 4. postoperative changes in the upper abdomen in keeping with recent laparotomy. stable pneumobilia and intra-hepatic biliary dilatation. 5. subcentimeter hypodensities in the liver and left kidney likely represent cysts or hemangiomas. . chest (portable ap) 9:04 am impression: no significant changes in moderate right and small left pleural effusions. bilateral parenchymal opacification predominantly apical distribution is atypical for pulmonary edema and pneumonia is another consideration. . tte (complete) done at 10:37:50 am conclusions the left atrium is dilated. the right atrium is markedly dilated. left ventricular wall thickness, cavity size and regional/global systolic function are normal (lvef >55%) there is no ventricular septal defect. right ventricular chamber size and free wall motion are normal. the aortic root is mildly dilated at the sinus level. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. trace aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. mild (1+) mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. moderate tricuspid regurgitation is seen. there is borderline pulmonary artery systolic hypertension. there is no pericardial effusion. . brief hospital course: this is a 74 year old male with painless obstructive jaundice. he went to the or on for: total pancreatectomy with splenic preservation and open cholecystectomy. pain: he had an epidural for pain control. he was then switched to a pca and once tolerating clears, was started on po pain meds. gi/abd: he was npo, ivf and a ngt. per the whipple pathway, the ngt was removed on pod 3. his diet was slowly advanced along. his incision was c/d/i with staples in place. his abdomen was soft and nontender. he did not have a drain in place. he was on tpn for nutritional support. this was weaned off as he was able to tolerate a regular diet. we encouraged a diet with supplemental shakes. post-op hyperglycemia: he was followed by to blood sugar management. he was getting lantus qhs and a humalog sliding scale. post-op hypotension/hypovolemia: the early morning of pod 6, the patient had a fall from standing when getting up to use the bathroom. later that morning he was found to have a bp of 74/68 and was tachycardic to the 140's. he received several fluid boluses without immediate effect. he was asymptomatic. cardiology consult was called and they were considering cardioversion. his hr settled out in the 90-100's. his bp gradually improved and his uop slowly picked up. he received 1 unit prbc. his hct was stable and he did not appear to have a bleed. . post-op tachycardia: diltiazem drip. changed to po diltiazem. he was switched to po lopressor for rate control. his dose was titrated up as his bp tolerated it. he continued to have elevated hr. pod , after transfer to the pacu, he was started on a diltiazem drip. he was then switched to po diltiazem and his hr was well rate controlled. . post-op orthostasis: on pod 8, when working with pt, he continued to be unsteady and orthostatic with a drop in bp to 80's. at time of discharge he was able to take short walks with supervision. he was still quite deconditioned and will require rehab. . respiratory: he was started on cipro on for possible pneumonia. . acute chf: on pod , he developed chf and had some respiratory distress. he was transferred to the pacu, as no icu beds were available. he was placed on a oxygen face mask and maintained his o2 sats. he also received lasix for diuresis with good results. he continued to receive aggressive diuresis with lasix . at time of discharge he still had significant le edema, and his weight was near his baseline. we repleated his potassium as needed. . sepsis: when he decompensated on pod 10, with chf and possible sepsis, he was started on vanco, flagyl and continued on cipro. vancomycin and zosyn were continued for 10 days. medications on admission: diltiazem 120', warfarin 7.5', zolpidem 5qhs, vicodin discharge medications: 1. albuterol sulfate 2.5 mg/3 ml solution for nebulization sig: one (1) inhalation q6h (every 6 hours) as needed. 2. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 3. diltiazem hcl 90 mg tablet sig: one (1) tablet po q6h (every 6 hours): hold hr<60, bp<100. 4. furosemide 20 mg tablet sig: one (1) tablet po daily (daily): continue for le edema and pleural effusion. 5. potassium chloride 10 meq capsule, sustained release sig: two (2) capsule, sustained release po once a day: continue while taking lasix. monitor potassium level. 6. warfarin 3 mg tablet sig: one (1) tablet po once a day: monitor inr and adjust dose accordingly. 7. insulin glargine 100 unit/ml solution sig: eight (8) subcutaneous at bedtime. units 8. humalog 100 unit/ml solution sig: sliding scale subcutaneous four times a day: see sliding scale. discharge disposition: extended care facility: healthcare center - discharge diagnosis: pancreatic cancer rapid a-fib post-op blood loss anemia post-op hypovolemia post-op hypotension post-op orthostasis post-op sepsis post-op malnutrition post-op deconditioning post-op lower extremity edema post-op hypokalemia discharge condition: good tolerating a diet able to walk short distances with assistance incision c/d/i pain well controlled discharge instructions: incision care: keep clean and dry. -you may shower, and wash surgical incisions. -avoid swimming and baths until your follow-up appointment. -please call the doctor if you have increased pain, swelling, redness, or drainage from the incision sites. . please call your doctor or return to the er for any of the following: * you experience new chest pain, pressure, squeezing or tightness. * new or worsening cough or wheezing. * if you are vomiting and cannot keep in fluids or your medications. * you are getting dehydrated due to continued vomiting, diarrhea or other reasons. * signs of dehydration include dry mouth, rapid heartbeat or feeling dizzy or faint when standing. * you see blood or dark/black material when you vomit or have a bowel movement. * your skin, or the whites of your eyes become yellow. * your pain is not improving within 8-12 hours or not gone within 24 hours. call or return immediately if your pain is getting worse or is changing location or moving to your chest or back. * you have shaking chills, or a fever greater than 101.5 (f) degrees or 38(c) degrees. * any serious change in your symptoms, or any new symptoms that concern you. . * please resume all regular home medications and take any new meds as ordered. * do not drive or operate heavy machinery while taking any narcotic pain medication. you may have constipation when taking narcotic pain medications (oxycodone, percocet, vicodin, hydrocodone, dilaudid, etc.); you should continue drinking fluids, you may take stool softeners, and should eat foods that are high in fiber. * continue to increase activity daily and work towards daily ambulation. * no heavy lifting (> lbs) until your follow up appointment. followup instructions: please follow-up with dr. in 2 weeks. call to schedule an appointment. please follow-up with for blood glucose control. call to schedule an appointment. procedure: venous catheterization, not elsewhere classified parenteral infusion of concentrated nutritional substances insertion of other (naso-)gastric tube cholecystectomy transfusion of packed cells total pancreatectomy diagnoses: pneumonia, organism unspecified other iatrogenic hypotension acute posthemorrhagic anemia unspecified septicemia unspecified protein-calorie malnutrition atrial fibrillation sepsis hypopotassemia pulmonary collapse malignant neoplasm of head of pancreas diabetes mellitus without mention of complication, type ii or unspecified type, uncontrolled hypovolemia accidents occurring in residential institution removal of other organ (partial) (total) causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation obstruction of bile duct tachycardia, unspecified chronic cholecystitis malignant neoplasm of body of pancreas 

Answer: The patient is high likely exposed to