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: fall major surgical or invasive procedure: right hip hemiarthroplasty history of present illness: ms. is an 80 year old female with a history of previously undiagnosed emphysema (no pulmonary function tests on record) who was transferred from an outside hospital after a right femoral neck fracture status post mechanical fall. she was outside on walking her dogs when she missed a brick step, falling to her right side. she was able to ambulate afterwards into her home, where she called the ambulance. she did not hit her head, denies loss of consiousness, and has full recollection of the event. she denies headaches/visual changes. she was taken to an outside hospital, found to have right hip fracture and an increasing oxygen requirement. she got 2mg iv dilaudid and was transferred to for further care. in the emergency department, her initial vital signs were 98 80 172/105 18 87% ra. she was put on 4l nc, with saturations improving to 92%. she was then placed on facemask with fi02 50%, satting at 96%. she was given zofran once for nausea. the ed ordered a ct thorax, which was negative for pe but did demonstrate severe emphysema as well as a large hiatal hernia. ortho was consulted. she underwent right hip arthroplasty on without complication under general anesthesia. she had 200 ml ebl, received 800 ml lr with 200 ml urine output (net positive 400 ml). she was intubated and extubated without difficulties. in the peri-operative period, she received ancef x 2 doses. in the pacu, she had persistent requirement of facemask and nasal cannula for adequate oxygenation. at one point, she was weaned to 4 l nc with pox 86-90 but upon falling asleep was requiring facemask and nasal cannula in high 70s/low 80s. she was given duoneb x 1 with minimal imiprovement. ros otherwise positive for intermittent gerd and occasional urinary frequency at night. ms. has "lung problems" at baseline, as per her pcp. has an extensive smoking history, but quit 10 years ago. as per patient, she has never required oxygen and has never been diagnosed with copd. she does become 'fatigued' with exertion however. denies chronic cough. denies wheezing. denies paroxysmal nocturnal dyspena or orthopnea. she was transferred to the floor on after her oxygen saturations improved. past medical history: - hiatal hernia: has known about this for quite some time, s/p egd last month to evaluate. patient has intermittent gerd, was offered surgery by gi but refused. - emphysema: no formal pfts on record - denies other medical history social history: lives in with partner, works as real estate , 150 pack year smoking history, quit 10 years ago. 1 drink/day. no drugs. at baseline walks without assistive devices family history: father - diabetes, mother - healthy brother - died of mi in his 50s physical exam: admission physical exam 98 80 172/105 18 87% ra general: alert, oriented, no acute distress heent: sclera anicteric, mmm, oropharynx clear, eomi, perrl neck: supple, jvp not elevated, no lad cv: regular rate and rhythm, normal s1 + s2, 2+ systolic murmur heard best left sternal border lungs: poor air entry throughout, no rales/rhonchi/wheezing appreciated abdomen: soft, non-distended, bowel sounds present, no organomegaly, no tenderness to palpation, no rebound or guarding gu: no foley ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema msk: hip exam deferred due to pain neuro: cnii-xii intact, upper and lower extremity strength testing deferred. discharge physical exam: vs - 98.1 146/92 90 20 92% 3l general: alert, oriented, no acute distress neck: jvp not elevated cv: regular rate and rhythm, normal s1 + s2, no murmurs lungs: good air movement abdomen: soft, non-distended, no tenderness to palpation ext: no clubbing, cyanosis or edema msk: right hip with no erythema or drainage around incision line. some ecchymoses. pertinent results: admission labs: 02:30am blood wbc-13.4* rbc-5.04 hgb-14.6 hct-44.8 mcv-89 mch-28.9 mchc-32.6 rdw-14.3 plt ct-268 02:30am blood neuts-90.0* lymphs-6.4* monos-2.4 eos-0.3 baso-0.8 02:30am blood pt-10.5 ptt-26.7 inr(pt)-1.0 02:30am blood glucose-182* urean-13 creat-0.6 na-137 k-3.8 cl-102 hco3-20* angap-19 02:30am blood alt-24 ast-29 alkphos-112* totbili-0.5 02:30am blood albumin-4.7 calcium-9.0 phos-3.2 mg-1.7 02:30am blood %hba1c-5.7 eag-117 10:29pm blood type-art po2-58* pco2-43 ph-7.38 caltco2-26 base xs-0 discharge labs: 07:45am blood wbc-8.8 rbc-3.40* hgb-10.0* hct-30.2* mcv-89 mch-29.5 mchc-33.2 rdw-13.9 plt ct-207 07:45am blood pt-11.2 ptt-25.0 inr(pt)-1.0 07:45am blood glucose-121* urean-7 creat-0.6 na-135 k-4.3 cl-99 hco3-28 angap-12 07:45am blood calcium-8.2* phos-2.3* mg-1.7 08:54am blood type-art po2-62* pco2-32* ph-7.51* caltco2-26 base xs-2 imaging: cxr : no acute cardiothoracic process. large hiatal hernia containing at least stomach. ct chest - indication: 80-year-old with hypoxia after fall (hip fracture). technique: ct angiography of the chest was obtained with arterial phase imaging. axial, coronal, sagittal and oblique reformats were acquired. comparison: none. findings: cta of the chest: there is no pneumomediastinum, mediastinal hemorrhage, pericardial or large pleural effusion. there is no pulmonary embolism. there are moderate-to-severe atherosclerotic calcifications of the thoracic aorta and the coronary arteries. moderate-to-severe centrilobular emphysema is seen most pronounced in the upper lobes. there is a right azygos lobe (incidental finding). there is a large bochdalek hernia containing fat, stomach (upside down stomach), and colon (with diverticula) without evidence of bowel obstruction or gastric strangulation. this large hernia causes streak-like atelectasis of the right lower lobe. the partially visualized abdomen demonstrates a left liver lobe cystic lesion, likely a simple cyst or hemangioma. bones: there is moderate to severe osteopenia. there are no suspicious lytic or sclerotic bony lesions. impression: 1. large hiatal hernia containing fat, stomach (upside down stomach), and colon (with diverticula) - no obstruction or acute findings. 2. no pulmonary embolism. 3. severe atherosclerotic disease of the thoracic aorta and coronary arteries. 4. severe centrilobular emphysema. 5. left liver lobe cystic lesion, likely cyst or hemangioma. 6. moderate to severe osteoporosis. hip xray: indication: 80-year-old after fall. findings: there is a fracture of the right femoral neck fracture with varus angulation. no fracture of the pelvic bones, femur, proximal tibia of fibula. there are mild degenerative changes of the right knee joint with joint space narrowing. atherosclerotic calcification are seen at the superifical femoral and popliteal arteries. impression: right femoral neck fracture with varus angulation. brief hospital course: ms. is an 80 year old female with a history of previously undiagnosed emphysema (no pulmonary function tests on record), transferred from an outside hospital after a right femoral neck fracture status post mechanical fall, who had an uncomplicated right hip hemiarthroplasty on , with post-operative course complicated by hypoxemia. active issues: #right femoral neck fracture- patient transferred from osh to for right hip hemiarthroplasty. no complications during the surgery, ebl 200 cc. she was monitored in the micu afterwards due to hypoxemia (below). no evidence of vascular compromise or compartment syndrome while in house. her pain was controlled with oxycodone 5-15 mg prn as well as acetaminophen. per ortho recs patient will stay on lovenox 40 qhs x 2 weeks. physical therapy was also consulted who advised wbat with assist to pivot. she will continue pt at rehab. #hypoxemia- the differential for ms. hypoxia was likely multifactorial. she has a large hiatal hernia, splinting from pain, as well as underlying emphysema. she was monitored in the icu on after her procedure on and had improvement in her spo2. cta chest demonstrated no evidence of pulmonary embolism or fat embolism. she never required any noninvasive or invasive respiratory support and had no evidence of hypercarbia on an abg. she was rapidly weaned to 2l nc and transferred to the floor on . while on the floor her oxygen saturation was weaned to 92-94% on 2l. she was given albuterol/ipratropium nebulizers and incentive spirometry. abg prior to discharge showed improved oxygenation, as well as no evidence of carbon dioxide retention. #transitional issues: -patient should have outpatient pfts and echo to eval for pulmonary hypertension as an outpatient. -monitor respiratory status, and continue nebulizer treatments as needed. -patient to follow up with dr. for orthopedic care at his office. medications on admission: preadmission medications listed are correct and complete. information was obtained from patient. 1. aspirin 81 mg po daily 2. multivitamins 1 tab po daily discharge medications: 1. acetaminophen 650 mg po q6h 2. aspirin 81 mg po daily 3. multivitamins 1 tab po daily 4. docusate sodium 100 mg po bid 5. enoxaparin sodium 40 mg sc qhs duration: 2 weeks 6. oxycodone (immediate release) 5-15 mg po q4h:prn pain hold for sedation, rr < 10 rx *oxycodone 5 mg tablet(s) by mouth every four hours disp #*30 tablet refills:*0 7. senna 1 tab po bid:prn constipation 8. bisacodyl 10 mg pr daily:prn constipation 9. polyethylene glycol 17 g po daily discharge disposition: extended care facility: seashore point and rehabilitation - discharge diagnosis: primary diagnoses: right femoral neck fracture hypoxemia secondary diagnoses: emphysema hiatal hernia discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity: ambulatory - requires assistance or aid (walker or cane) discharge instructions: dear ms. , you were admitted for a fracture of your bone and for trouble breathing. while you were in the hospital you had surgery to correct your bone fracture. you were in the icu briefly due to your breathing difficulties, but they improved with extra oxygen. we would recommend you follow up with your primary care physician to address your breathing difficulties. please note, the following changes have been made to your medications: - start oxycodone as needed for pain control - start acetaminophen for pain control - start ipratropium and albuterol inhalers to help your breathing followup instructions: department: health express, orthopedics when: monday at 10:40 am with: , md where: , phone: *please arrive 20minutes early for an xray when you leave rehab, please call your pcp's office for an appointment: , f. . procedure: partial hip replacement diagnoses: personal history of tobacco use diaphragmatic hernia without mention of obstruction or gangrene constipation, unspecified osteoporosis, unspecified other emphysema hypoxemia metabolic encephalopathy fall from other slipping, tripping, or stumbling closed fracture of unspecified part of neck of femur activities involving walking an animal 

Answer: The patient is high likely exposed to