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: codeine / morphine attending: chief complaint: hypotension major surgical or invasive procedure: none history of present illness: 70-year old gentleman with a history of diabetes, chronic kidney disease (baseline cr 1.4) and diastolic chf (ef lvef>55) originally presenting from rehab facility on for one day of hypotension 3 days after slipping and falling. per report had been getting twice his usual dose of valsartan for unclear reasons. no chest pain, not sob, but sweaty and mildly nauseated. review of systems on admission was notable for malaise since his admission for chest pain at the start of . he feels generally weak and apathetic, which is unusual for him. he has also had a non-productive cough for several weeks, for which he was started on azithromycin five days ago. he has recently been constipated. he denies recent fevers, chills, difficulty urinating or headaches. in the emergency department his vs were t 98, bp 94/48 improving to 134/99, hr 60, rr 18 and 100% on ra. he was found to have a new leukocytosis and crackles on lung exam and was given vanc, zosyn and flagyl for a hospital-acquired pneumonia. a right ij was placed and he was given 3.5l of normal saline with improvement of bps. he had elevated lfts and an abdominal and pelvic ct scan was done, revealing a moderate pericardial effusion. he was admitted to the icu for suspected sepsis. past medical history: type 2 diabetes mellitus - diagnosed in ckd stage iii anemia of ckd hypertension pontine cva w/ residual left leg weakness chronic bronchitis osa copd obesity hyperlipidemia gout bph h/o bcc s/p r shoulder replacement social history: he is a retired teacher. he does not smoke or drink alcohol currently but used both remotely in . he admits to occasional marijuana. prior to his worsening weakness and last hospitalization on he lived alone and did his own shopping/cooking and was independent with adls/iadls. he was admitted now after having 2-3 weeks of rehab and he had been home for only 1 day. he has no children and has never been married but has siblings with whom he keeps in touch with regularly. family history: largely noncontributory. the patient's mother had a type of sarcoma but he is uncertain of additional details. physical exam: vs: t 97.9 bp 102/64 hr 91 rr 22 o2sat 96 on room air bs 179 gen: obese, comfortable, nad heent: mmm neck: jvp flat cardiac: irregular irregular no r/g/m chest: mild bibasilar crackles, otherwise ctab abdomen: soft, nt, nd, nabs extremities: 1+ bilateral nonpitting edema neuro: axx3, cnii-xii grossly intact, eomi skin: diaphoretic pertinent results: labs on admission: 05:45pm blood wbc-17.2* rbc-4.58* hgb-13.7* hct-40.8 mcv-89 mch-30.0 mchc-33.7 rdw-15.3 plt ct-301 05:45pm blood neuts-88.4* lymphs-6.0* monos-4.6 eos-0.7 baso-0.4 05:45pm blood glucose-175* urean-37* creat-2.6*# na-134 k-3.8 cl-90* hco3-31 angap-17 05:45pm blood alt-85* ast-64* ck(cpk)-53 alkphos-352* totbili-0.9 05:45pm blood calcium-8.9 phos-3.6 mg-2.3 06:14pm blood glucose-174* lactate-1.8 na-134* k-3.1* cl-87* calhco3-33* 06:14pm blood freeca-1.02* labs on discharge: 04:50am blood wbc-13.9* rbc-4.02* hgb-12.0* hct-35.8* mcv-89 mch-29.7 mchc-33.4 rdw-15.6* plt ct-417 03:32am blood neuts-85.7* lymphs-7.9* monos-5.3 eos-0.8 baso-0.3 04:50am blood glucose-73 urean-34* creat-1.6* na-141 k-3.7 cl-99 hco3-30 angap-16 01:38am blood calcium-8.9 phos-2.9 mg-2.7* imaging: liver or gallbladder us : 1. gallbladder sludge without secondary findings to suggest acute cholecystitis. 2. diffusely echogenic liver consistent with fatty infiltration. other forms of liver disease and more advanced liver diseases including significant hepatic fibrosis/cirrhosis cannot be excluded in this examination. hypoechoic focus adjacent to the gallbladder fossa most likely represents focal sparing. ct pelvis w/o contrast study date of : 1. moderate sized pericardial effusion, which is larger compared to . 2. small bilateral pleural effusions, with opacification of the right lower , reflect atelectasis or consolidation. 3. diverticulosis, without evidence of diverticulitis. 4. single locule of air within the anterior subcutaneous fat in the lower abdomen. this may relate to subcutaneous injection. clinical correlation suggested. chest (portable ap) study date of : comparison is made with prior study . enlarged cardiomediastinal silhouette is stable. patient has known pericardial effusion and mild cardiomegaly. minimal bibasilar atelectases larger on the right side are unchanged. there is no pneumothorax or enlarging pleural effusions. right ij catheter remains in place. impression: stable appearance of the chest. brief hospital course: hypotension likely related to the recent increase in his valsartan. there was some concern that he might have an increasing pericardial effusion based on his chest ct. an echocardiogram showed no evidence of tamponade. observed in micu for 24 hours and pressures rising and stable. transferred to floor for further monitoring. 1. hypotension: resolved with ivf. given response to fluids most likely due to doubling of dose of and possibly some volume depletion and not sepsis. only sirs criteria was leukocytosis. initial concern for tamponade but no evidence of evolving effusion on echo. valsartan dose decreased to 40mg daily from 80mg . lasix dose decreased from 80mg daily from . 2. acute on chronic renal failure: the patient's cr is now resolving to 1.7 from a peak of 2.6 vs a baseline of ~ 1.4. most likely cause is pre-renal exacerbated by high levels of and hypotension. 3. leukocytosis: improving. 17.2 on admission --> 13.9 day discharge. ua negative. no clinical symptoms of pneumonia and cxr suggests atelactasis. afebrile throughout admission. cultures negative on discharge. 4. pericardial effusion: new pericardial effusion on ct scan not present three weeks ago but without significant effusion on echo. no clinical symptoms of tamponade. 5. atrial fibrillation: currently in nsr. patient had newly diagnosed afib on his last admission ~ 4 weeks prior to the current admission. continue diltiazem and digoxin. 6. inr elevated 3.8 on day of discharge, recommended to hold coumadin on day of discharged and start decreased coumadin dose 2 mg on . 7. type 2 diabetes mellitus: patient has difficult to control diabetes and is followed at the . his most recent a1c was 8.3%. was on insulin 100 units tid 8. diastolic chf: no sign of acute chf episode. continued outpatient medications. decreased lasix to 80mg daily from . can increase if patient becomes fluid overloaded. recommend daily weights and strict i/o, if becomes positive increase lasix. patient will follow up with cardiology dr. in weeks. 9. elevated transaminases: stable from prior admission when changes consistent with fatty liver were seen on ultrasound. 10. depression: patient reports poor mood and satisfaction. tsh was normal. he was continued on his effexor and celexa. 11. hyperlidemia: continued rosuvastatin and niacin. 12. gout: continued allopurinol 13. copd: continue advair, albuterol and ipratropium. 14. history of cva: continue plavix. 15. osa: pt refuses to use cpap medications on admission: medications at home (per ): - allopurinol 300mg daily - carvedilol 25mg - clopidogrel 75mg daily - digoxin 125 mcg qod, alternating with 250mcg - diltiazem sr 360mg daily - duloxetine dr 20mg - advair 100-50 1 puff - furosemide 80mg - insulin humalog ss - humulin 22 units daily ((- insulin regular hum u-500 120units qam, 110 units qnoon, 110units qpm.)) - duoneb q6hrs prn - multivitamin 1 tablet daily - niacin 500mg sr - ranitidine 300mg daily - rosuvastatin 40mg daily - valsartan 80mg ?? - warfarin 3.5mg daily - acetaminophen 650mg q6hrs prn - milk of mag 30mg daily prn - fexofenadine 60mg discharge medications: 1. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). 2. fluticasone-salmeterol 100-50 mcg/dose disk with device sig: one (1) disk with device inhalation (2 times a day). 3. duloxetine 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po bid (2 times a day). 4. multivitamin tablet sig: one (1) tablet po daily (daily). 5. niacin 500 mg capsule, sustained release sig: one (1) capsule, sustained release po qhs (once a day (at bedtime)). 6. rosuvastatin 20 mg tablet sig: two (2) tablet po daily (daily). 7. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po q6h (every 6 hours) as needed for constipation. 8. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 9. fexofenadine 60 mg tablet sig: one (1) tablet po bid (2 times a day). 10. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 11. insulin regular hum u-500 conc 500 unit/ml solution sig: one hundred (100) units injection tid w/ meals (). 12. acetaminophen 650 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for pain: max 4 grams a day. 13. digoxin 125 mcg tablet sig: one (1) tablet po daily (daily). 14. albuterol sulfate 90 mcg/actuation hfa aerosol inhaler sig: two (2) puff inhalation q6h (every 6 hours) as needed for wheezing. 15. carvedilol 12.5 mg tablet sig: two (2) tablet po bid (2 times a day): hold for sbp < 100. 16. trazodone 50 mg tablet sig: one (1) tablet po hs (at bedtime) as needed for insomnia. 17. ranitidine hcl 150 mg tablet sig: two (2) tablet po daily (daily). 18. allopurinol 300 mg tablet sig: one (1) tablet po daily (daily). 19. valsartan 40 mg tablet sig: one (1) tablet po daily (daily): hold for sbp < 90. 20. furosemide 80 mg tablet sig: one (1) tablet po daily (daily): hold for sbp < 90. 21. diltzac er 360 mg capsule, sustained release sig: one (1) capsule, sustained release po once a day: hold for sbp < 90, hr < 60. 22. warfarin 2 mg tablet sig: one (1) tablet po once a day: start . due to elevated inr 3.8 holding dose . discharge disposition: extended care facility: for the aged - discharge diagnosis: 1. hypotension 2. diastolic heart failure 3. prerenal acute renal failure on ckd 4. pericardial effusion without tamponade 5. type 2 diabetes mellitus 6. atrial fibrillation 7. gout discharge condition: good discharge instructions: you were admitted for low blood pressure which was felt to be secondary to blood pressure medication because of this we have decreased your valsartan. we have made changes to your medication - please follow the list given to rehab. follow-up with your primary care doctor and cardiologist. call your doctor if you experience dizziness, chest pain, shortness of breath or any other concerning symptoms. weigh yourself every morning, md if weight goes up more than 3 lbs. adhere to 2 gm sodium diet. you are being discharged to rehab. followup instructions: appointments scheduled: provider: , md phone: date/time: 11:30 schedule an appointment with your cardiologist dr. in weeks. schedule an appointment with your primary care doctor e from rehab. dr. community health center procedure: venous catheterization, not elsewhere classified diagnoses: other iatrogenic hypotension anemia in chronic kidney disease obstructive sleep apnea (adult)(pediatric) abnormal coagulation profile congestive heart failure, unspecified acute kidney failure, unspecified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified gout, unspecified atrial fibrillation other chronic pulmonary heart diseases depressive disorder, not elsewhere classified pulmonary collapse chronic kidney disease, stage iii (moderate) unspecified disease of pericardium other late effects of cerebrovascular disease long-term (current) use of anticoagulants diabetes mellitus without mention of complication, type ii or unspecified type, uncontrolled obesity, unspecified anticoagulants causing adverse effects in therapeutic use leukocytosis, unspecified chronic diastolic heart failure obstructive chronic bronchitis without exacerbation other disorders of muscle, ligament, and fascia other and unspecified agents primarily affecting the cardiovascular system causing adverse effects in therapeutic use 

Answer: The patient is high likely exposed to