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: amoxicillin / ciprofloxacin / percocet / augmentin attending: chief complaint: chest pain major surgical or invasive procedure: cardiac catheterization egd history of present illness: 65 year old female past medical history significant for prader-willi syndrome, htn, hyperlipidemia, developmental delay, 2 previous mi's, s/p cath in 96, 98, unknown results. pt reports onset of chest pain, substernal non radiating, no associated n/v/diaphoresis x 1 hour at rest in day program. pt to , chest pain free on arrival. ekg nsr@61, st elevation v3, repeat nsr. ck-mb 34.9, cpk 261, trop t 0.081. bp 140/76, hr 60. 1 liter ns given. pt given heparin bolus 3800 units, heparin ggt at 1000 units, plavix loaded 600 mg, sent to . of note, pt previously admitted for chest pain nstemi to for similar complaint nstemi, ck 266, mb 22.4, trop 0.07. echo at that time with normal ef, nml wall motion, 1+ mr. she also reports fall this sunday with abrasion, associated with loss of balance, as per group home, pcp . past medical history: prader-willi syndrome 2 previous ntemi's hypertension ileostomy 96 schizo-affective disorder siadh - last admission social history: lives in a group home. parents deceased x 20 + years. healthcare proxy is , . unable to assess hx further. family history: unknown physical exam: admission exam vitals- 97.8, 158/75, 64, 18, 98%, 0/10 pain general- short, smiling female in no acute distress, with bandage on head. heent- abrasion forehead left, blood on gauze. no other abrasions or lacerations. perrl. no jvp appreciated. cv- rrr, no m/r/g lungs- ctab, no wheezes noted. abdomen- surgical scar vertical, non tender, slight distenstion. + bs groin- 2 + fem pulses extr- no edema, cyanosis, clubbing, foot deformity bilaterally, 2+dp small hands. pertinent results: 09:50pm ck-mb-20* mb indx-9.7* ctropnt-0.09* 09:50pm ck(cpk)-207* 10:22pm ptt-150* - c.cath 1. selective coronary angiography revealed a right dominant system with lmca, lad and lmcx that were free of angiographically apparent disease and an rca that had a 20% proximal lesion but was otherwise free of disease. 2. left ventriculography showed normal function. 3. limited hemodynamic assessment showed low normal systemic aortic pressures. findings 1. coronary arteries are normal. 2. normal ventricular function. . - echo the left atrium is normal in size. left ventricular wall thicknesses are normal. the left ventricular cavity is unusually small. due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. overall left ventricular systolic function is normal (lvef 70%). no masses or thrombi are seen in the left ventricle. there is no ventricular septal defect. right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. trivial mitral regurgitation is seen. the estimated pulmonary artery systolic pressure is normal. there is no pericardial effusion. . - chest (pa & lat) 1. right retrocardiac opacity which likely represents pneumonia. 2. leftward deviation of the trachea. this may be due to a multinodular goiter. ct chest examination can be performed if clinically indicated. . - egd small hiatal hernia esophageal erosion angioectasias in the fundus, stomach body and antrum angioectasias in the duodenal bulb, first part of the duodenum and second part of the duodenum otherwise normal egd to second part of the duodenum brief hospital course: 1) chest pain ms. chest pain was initally considered to be unstable angina in the setting of moderately elevated enzymes and two previous mi's in the past. other things in the differential diagnosis included gerd, costochondral pain, coronary vasospasm, myocarditis and pleuritic pain. there were no acute ekg changes. troponin was borderline at 0.08 and mb mildly positive. the patient underwent cardiac catheterization which demonstrated 20% proximal rca stenosis, but was otherwise clean and no intervention was deemed necessary. her symptoms may have been related to coronary vasospasm, however her upper gi pathology noted on egd (see below), was also likely contributed. given non-flow limiting coronary artery disease and upper gi bleed, she was maintained off asa and plavis. 2) upper gi bleed: ms. developed hematemesis/coffee-ground emesis following plavix load and heparin drip. heparin, plavix and aspirin were held and she was started on iv ppi. egd showed diffuse angioectasias throughout stomach and down to duodenal bulb, along with esophageal erosions. she was transferred to micu for further managment and developed melana. she was transfused a total of 4u prbcs, 2ffp and 1 bag platelets. hct stabilized and she was transferred to the floor. her gi bleeding was most likely precipitated by heparin/plavix. given diffuse nature of avms, no endoscopic intervention was possible. the surgical service was consulted, however they did not recommend surgery (which would need to be extensive), given stabilization of the patient's hematocrit. she has scheduled follow-up with gasteroenterology at and they will decide whether or not to perform a follow-up egd. she should have a colonoscopy as an outpatient. 3) aspiration pneumonia/pneumonitis the patient developed crackles after the episode of hematemesis. this finding raised concern for pneumonia versus an aspiration pneumonitis. cxr demonstrated retrocardiac opacity, but the patient remained afebrile, without a leukocytosis or symptoms. thus, antibiotic coverage was not initiated. lungs were clear at discharge and the patient was stable on room air. she underwent a bedside speech and swallow evaluation, along with a video swallow study. this revealed mild oropharyngeal dysphagia with aspiration of clear liquids. she should adhere to a soft solids/thickened liquid diet to avoid future aspiration. she will need outpatient follow-up for tracheal deviation demonstrated on cxr. there was some concern for thyroid pathophysiology. tsh was slightly elevated. levothyroxine was increased to 100 micrograms per day. she will need repeat thyroid studies 6 weeks following discharge. 4) siadh she was continued on salt tablets for known hyponatremia likely secondary to anti-psychotic induced siadh. she was continued on her home doses of anti-psychotics for her schizo-affective disorder. given the patient's need for physical therapy and ambulation with a walker, she was discharged to a rehabilitation facility. medications on admission: plavix 75 mg metoprolol 50 daily zestril 5 mg lipitor 20 mg asa 325 mg protonix 40 qd salt tablets depakote 750 ditropan xl 15 hs risperdal 4 pamelor 50 hs synthroid 75 mcg tylenol glucosamine multivitamins discharge medications: 1. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 2. atorvastatin 20 mg tablet sig: one (1) tablet po daily (daily). 3. metoprolol tartrate 50 mg tablet sig: one (1) tablet po daily (daily). 4. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 5. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed. 6. divalproex 500 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po bid (2 times a day): please take 750 mg twice a day just as you previously had. . 7. nortriptyline 25 mg capsule sig: two (2) capsule po hs (at bedtime). 8. nitroglycerin 0.3 mg tablet, sublingual sig: one (1) tablet, sublingual sublingual prn (as needed). 9. oxybutynin chloride 5 mg tablet sig: one (1) tablet po tid (3 times a day). 10. multivitamin capsule sig: one (1) cap po daily (daily). 11. amlodipine 5 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 12. fluticasone 50 mcg/actuation aerosol, spray sig: two (2) nasal once a day. 13. sodium chloride 1 g tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*5* 14. risperidone 1 mg tablet sig: four (4) tablet po bid (2 times a day). 15. sucralfate 100 mg/ml suspension sig: ten (10) ml po qid. disp:*1 month* refills:*5* 16. levothyroxine 100 mcg tablet sig: one (1) tablet po daily (daily). discharge disposition: extended care facility: lifecare of discharge diagnosis: primary: chest pain - cath with clean coronaries- no intervention performed. secondary: upper gi bleed siadh hypertension, schizoaffective disorder hypothyroidism discharge condition: stable discharge instructions: you were admitted with chest pain and had elevated enzymes. you had a cardiac catheterization which showed clean coronaries, and no intervention was thus needed. you had an upper gi bleed which has resolved. -please do not take aspirin or plavix given gi bleed. - addition of norvasc 5 mg. -please take your salt tablets as you previously had, and go to get your sodium level checked tomorrow with dr. . -please keep all appointments -please return to the hospital if you are experiencing chest pain, shortness of breath, fainting or any other symptoms concerning to you. followup instructions: please follow-up with dr. in 2 weeks. you can make an appointment by calling . he should check your hematocrit. - given your levothyroxine dose was increased, you should have repeat thyroid function tests checked in 6 weeks. - you should have an outpatient colonoscopy . please follow-up with dr. (cardiology) on at 2:30pm. . . please follow-up with dr. (gasteroenterology) on monday, at 3pm. bldg. . phone: md procedure: angiocardiography of left heart structures other endoscopy of small intestine left heart cardiac catheterization coronary arteriography using a single catheter transfusion of packed cells transfusion of other serum transfusion of platelets diagnoses: unspecified essential hypertension acute posthemorrhagic anemia unspecified acquired hypothyroidism other and unspecified hyperlipidemia pneumonitis due to inhalation of food or vomitus old myocardial infarction other chest pain other disorders of neurohypophysis angiodysplasia of stomach and duodenum with hemorrhage other specified disorders of esophagus schizoaffective disorder, unspecified prader-willi syndrome other antipsychotics, neuroleptics, and major tranquilizers causing adverse effects in therapeutic use 

Answer: The patient is high likely exposed to