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: this 50-year-old gentleman was recently found to have a cervical bruit. ultrasound study showed bilateral greater than 80% carotid stenoses, the right being slightly worse than the left. major surgical or invasive procedure: rt cea, re-exploration for thrombosed patch, cerebral angio history of present illness: this 50-year-old gentleman was recently found to have a cervical bruit. ultrasound study showed bilateral greater than 80% carotid stenoses, the right being slightly worse than the left. past medical history: pmh: b/l asx carotid stenoses (r>l) psh: cervical fusion, shoulder surgery, appy social history: n/c family history: n/c physical exam: vs: t98.5 p 70 bp 130/75 rr 18 o2 sat 96 % ra gen: aaox3, nad neuro: has some delayed speech, but fluent and articulate. l peripheral vision defect. eomi, mild r facil palsy, r ue with pronator drift, and strength 5-/5. neck: l with bruising, steristipped. lungs: chest is clear. heart: rrr abdomen: soft and nontender. pertinent results: 07:00am blood wbc-12.4* rbc-3.91* hgb-11.9* hct-34.6* mcv-89 mch-30.4 mchc-34.3 rdw-12.5 plt ct-248 05:43am blood wbc-14.4* rbc-3.63* hgb-11.2* hct-32.3* mcv-89 mch-31.0 mchc-34.8 rdw-12.7 plt ct-220 02:52am blood wbc-14.3* rbc-3.90* hgb-11.9* hct-34.9* mcv-90 mch-30.6 mchc-34.2 rdw-13.3 plt ct-239 04:00pm blood wbc-21.3* rbc-4.14* hgb-12.6* hct-35.9* mcv-87 mch-30.4 mchc-35.0 rdw-13.2 plt ct-214 12:10pm blood wbc-18.8* rbc-4.31* hgb-13.1* hct-38.6* mcv-90 mch-30.4 mchc-33.9 rdw-13.2 plt ct-226 07:00am blood plt ct-248 07:00am blood pt-13.0 ptt-26.3 inr(pt)-1.1 05:43am blood plt ct-220 05:43am blood pt-12.1 ptt-24.4 inr(pt)-1.0 02:52am blood plt ct-239 02:52am blood pt-13.2 ptt-52.3* inr(pt)-1.1 09:39pm blood ptt-69.3* 04:00pm blood plt ct-214 04:00pm blood pt-14.0* ptt-150* inr(pt)-1.2* 12:10pm blood plt ct-226 07:00am blood glucose-113* urean-16 creat-1.0 na-140 k-4.0 cl-103 hco3-29 angap-12 05:43am blood glucose-126* urean-18 creat-0.9 na-143 k-3.9 cl-105 hco3-31 angap-11 02:52am blood glucose-133* urean-13 creat-0.8 na-141 k-4.0 cl-107 hco3-26 angap-12 04:00pm blood glucose-123* urean-16 creat-1.0 na-138 k-4.0 cl-108 hco3-24 angap-10 07:00am blood calcium-10.0 phos-3.9 mg-2.1 05:43am blood calcium-9.0 phos-3.3 mg-2.2 02:52am blood calcium-9.0 phos-4.2 mg-2.0 04:00pm blood calcium-8.4 phos-3.2 mg-1.8 ct head w/o contrast study date of 7:05 pm , vicu sched ct head w/o contrast clip # reason: r/o hemorrhagic stroke medical condition: 50 year old man with s/p r ica endarterectomy reason for this examination: r/o hemorrhagic stroke contraindications for iv contrast: none. final report ct head without contrast comparison: mri, . history: 50-year-old male status post right ica endarterectomy, evaluate for hemorrhagic stroke. technique: mdct axially acquired images through the skull were obtained. no iv contrast was administered. findings: multiple areas of hypodensity are seen within the right parietal lobe with loss of -white matter differentiation consistent with recent infarct. there is no evidence of hemorrhage or shift of normally midline structures. the ventricles and sulci are unremarkable. the visualized paranasal sinuses are clear. there is no evidence of fracture. large right parietal hypodensities consistent with recent cva. no evidence of hemorrhage. the study and the report were reviewed by the staff radiologist. mra brain w/o contrast study date of 5:31 pm , vicu sched mra brain w/o contrast; mrv head w/o contrast; mr head w/o contrast clip # reason: r/o ischemic stroke (r parietal) medical condition: 50 year old man s/p r endarterectomy ica reason for this examination: r/o ischemic stroke (r parietal) contraindications for iv contrast: none. provisional findings impression: mptb mon 2:04 pm 1. mri of the brain shows acute infarction of right mca superior division and right pca vascular territories, which is presumably embolic. 2. right fetal posterior cerebral artery is likely an explanation for involvement of right pca territory with infarction in this patient recently status post right carotid endarterectomy. final report history: 50-year-old male status post recent right endarterectomy of the internal carotid artery. now with concern for infarction. comparison: intraoperative angiogram, . technique: multiplanar t1- and t2-weighted images of the brain without iv gadolinium; 3d time-of-flight mra of the brain and circle of with multiplanar reconstructions. mr of the brain without iv gadolinium: on the diffusion-weighted images, are noted large areas of hyperintense signal abnormality which involves the right middle cerebral artery superior division territory as well as right parietooccipital area consistent with acute infarction. corresponding hyperintense flair signal abnormality at these sites indicates that infarction is not hyperacute. there is no associated susceptibility artifact to indicate hemorrhage. there is no significant mass effect and no shift of normally midline structures or hydrocephalus. the flair images are suboptimal due to significant motion artifact. impression: acute/subacute infarction involving the right mca superior division and right pca territories. infarction is presumably embolic in etiology. 3d time-of-flight mra of the brain and circle of : a fetal posterior cerebral artery is noted on the right. there is normal cerebral arterial anatomy of the left hemisphere with a small left posterior communicating artery. the anterior and posterior circulations are patent without evidence of occlusion, stenosis, aneurysm or vascular malformation. impression: fetal right posterior cerebral artery is likely explanation for presumably embolic infarction of right pca territory (in addition to right mca superior division territory) in this patient with history of recent right carotid endarterectomy. no current evidence of occlusion or stenosis. the study and the report were reviewed by the staff radiologist mrv head w/o contrast study date of 5:31 pm , vicu sched mra brain w/o contrast; mrv head w/o contrast; mr head w/o contrast clip # reason: r/o ischemic stroke (r parietal) medical condition: 50 year old man s/p r endarterectomy ica reason for this examination: r/o ischemic stroke (r parietal) contraindications for iv contrast: none. provisional findings impression: mptb mon 2:04 pm 1. mri of the brain shows acute infarction of right mca superior division and right pca vascular territories, which is presumably embolic. 2. right fetal posterior cerebral artery is likely an explanation for involvement of right pca territory with infarction in this patient recently status post right carotid endarterectomy. final report history: 50-year-old male status post recent right endarterectomy of the internal carotid artery. now with concern for infarction. comparison: intraoperative angiogram, . technique: multiplanar t1- and t2-weighted images of the brain without iv gadolinium; 3d time-of-flight mra of the brain and circle of with multiplanar reconstructions. mr of the brain without iv gadolinium: on the diffusion-weighted images, are noted large areas of hyperintense signal abnormality which involves the right middle cerebral artery superior division territory as well as right parietooccipital area consistent with acute infarction. corresponding hyperintense flair signal abnormality at these sites indicates that infarction is not hyperacute. there is no associated susceptibility artifact to indicate hemorrhage. there is no significant mass effect and no shift of normally midline structures or hydrocephalus. the flair images are suboptimal due to significant motion artifact. impression: acute/subacute infarction involving the right mca superior division and right pca territories. infarction is presumably embolic in etiology. 3d time-of-flight mra of the brain and circle of : a fetal posterior cerebral artery is noted on the right. there is normal cerebral arterial anatomy of the left hemisphere with a small left posterior communicating artery. the anterior and posterior circulations are patent without evidence of occlusion, stenosis, aneurysm or vascular malformation. impression: fetal right posterior cerebral artery is likely explanation for presumably embolic infarction of right pca territory (in addition to right mca superior division territory) in this patient with history of recent right carotid endarterectomy. no current evidence of occlusion or stenosis. the study and the report were reviewed by the staff radiologist. mr head w/o contrast study date of 5:31 pm , vicu sched mra brain w/o contrast; mrv head w/o contrast; mr head w/o contrast clip # reason: r/o ischemic stroke (r parietal) medical condition: 50 year old man s/p r endarterectomy ica reason for this examination: r/o ischemic stroke (r parietal) contraindications for iv contrast: none. provisional findings impression: mptb mon 2:04 pm 1. mri of the brain shows acute infarction of right mca superior division and right pca vascular territories, which is presumably embolic. 2. right fetal posterior cerebral artery is likely an explanation for involvement of right pca territory with infarction in this patient recently status post right carotid endarterectomy. final report history: 50-year-old male status post recent right endarterectomy of the internal carotid artery. now with concern for infarction. comparison: intraoperative angiogram, . technique: multiplanar t1- and t2-weighted images of the brain without iv gadolinium; 3d time-of-flight mra of the brain and circle of with multiplanar reconstructions. mr of the brain without iv gadolinium: on the diffusion-weighted images, are noted large areas of hyperintense signal abnormality which involves the right middle cerebral artery superior division territory as well as right parietooccipital area consistent with acute infarction. corresponding hyperintense flair signal abnormality at these sites indicates that infarction is not hyperacute. there is no associated susceptibility artifact to indicate hemorrhage. there is no significant mass effect and no shift of normally midline structures or hydrocephalus. the flair images are suboptimal due to significant motion artifact. impression: acute/subacute infarction involving the right mca superior division and right pca territories. infarction is presumably embolic in etiology. 3d time-of-flight mra of the brain and circle of : a fetal posterior cerebral artery is noted on the right. there is normal cerebral arterial anatomy of the left hemisphere with a small left posterior communicating artery. the anterior and posterior circulations are patent without evidence of occlusion, stenosis, aneurysm or vascular malformation. impression: fetal right posterior cerebral artery is likely explanation for presumably embolic infarction of right pca territory (in addition to right mca superior division territory) in this patient with history of recent right carotid endarterectomy. no current evidence of occlusion or stenosis. brief hospital course: this 50-year-old gentleman was recently found to have a cervical bruit. ultrasound study showed bilateral greater than 80% carotid stenoses, the right being slightly worse than the left. patient comes in for an a scheduled l cea. admitted to vascular suergery/dr. . patient taken to or for l cea. tolerated procedure well, recovered in pacu. post-operatively patient was noted to have l ue paralysis and lle weakness with l facial droop. patient was taken back to or emergently for: 1. exploration of right neck. 2. thrombectomy of right carotid artery. 3. removal of distal intimal injury. 4. repeat dacron patch angioplasty of the previous repair after removal of the old patch. 5. biplanar carotid and intracranial carotid arteriogram. a jp drain was placed for drainage. post-operatively the patient was extubated and neurological status improved. he was transferred to the icu and was anticoagulated with dextran and heparin gtt. patient remained anticoagulated and was then transferred to the vicu. the jp drain was removed on pod #2. on pod #3, the stroke team evaluated the patient. the team felt that an embolic +/- hypoperfusion stroke occurred. neurological findings were as follows: neurologically, he is alert, oriented to self, date and location. his affect is flat and responses slightly delayed but speech is fluent and articulate. cranial nerve exam discloses sharp discs w/o hollenhorst plaques, perrl, l periph field defect, resting gaze to the right but eomi. mild r facial palsy. r ue strength 5-/5 w/ associated pronator drift. strenth in l ue and b/l le intact. sensation intact but intermittent dsse on r. symmetric reflexes except r babinski response. gait normal. no dysmetria. the patient was stable from a cardiovascular standpoint; vital signs were routinely monitored. the patient was stable from a pulmonary standpoint; vital signs were routinely monitored. early ambulation and incentive spirometry were encouraged throughout this hospitalization. post operatively, the patient was made npo with ivf. the patient's diet was advanced when appropriate, which was tolerated well. the patient's white blood count and fever curves were closely watched for signs of infection. no infections were identified. the patient's blood sugar was monitored throughout this stay and remained stable. at the time of discharge, the patient was doing well, afebrile with stable vital signs. the patient was tolerating a regular diet, ambulating, voiding without assistance, and pain was well controlled. pt cleared the patient for home on . he had his staples removed and was discharged home. medications on admission: crestor 10', asa 325' discharge medications: 1. rosuvastatin 5 mg tablet sig: two (2) tablet po daily (daily). 2. plavix 75 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* 3. nicotine 7 mg/24 hr patch 24 hr sig: one (1) patch 24 hr transdermal daily (daily). 4. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*2* 5. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed. disp:*60 tablet(s)* refills:*0* 6. metoprolol tartrate 25 mg tablet sig: one (1) tablet po twice a day. disp:*60 tablet(s)* refills:*2* 7. oxycodone 5 mg tablet sig: 1-2 tablets po every six (6) hours as needed for pain. disp:*30 tablet(s)* refills:*0* discharge disposition: home discharge diagnosis: r carotid stenosis cervical spodylosis s/p fusion discharge condition: good discharge instructions: division of vascular and endovascular surgery carotid endarterectomy surgery discharge instructions what to expect when you go home: 1. surgical incision: ?????? it is normal to have some swelling and feel a firm ridge along the incision ?????? your incision may be slightly red and raised, it may feel irritated from the staples 2. you may have a sore throat and/or mild hoarseness ?????? try warm tea, throat lozenges or cool/cold beverages 3. you may have a mild headache, especially on the side of your surgery ?????? try ibuprofen, acetaminophen, or your discharge pain medication ?????? if headache worsens, is associated with visual changes or lasts longer than 2 hours- call vascular surgeon??????s office 4. it is normal to feel tired, this will last for 4-6 weeks ?????? you should get up out of bed every day and gradually increase your activity each day ?????? you may walk and you may go up and down stairs ?????? increase your activities as you can tolerate- do not do too much right away! 5. it is normal to have a decreased appetite, your appetite will return with time ?????? you will probably lose your taste for food and lose some weight ?????? eat small frequent meals ?????? it is important to eat nutritious food options (high fiber, lean meats, vegetables/fruits, low fat, low cholesterol) to maintain your strength and assist in wound healing ?????? to avoid constipation: eat a high fiber diet and use stool softener while taking pain medication what activities you can and cannot do: ?????? no driving until post-op visit and you are no longer taking pain medications ?????? no excessive head turning, lifting, pushing or pulling (greater than 5 lbs) until your post op visit ?????? you may shower (no direct spray on incision, let the soapy water run over incision, rinse and pat dry) ?????? your incision may be left uncovered, unless you have small amounts of drainage from the wound, then place a dry dressing over the area that is draining, as needed ?????? take all the medications you were taking before surgery, unless otherwise directed ?????? take one full strength (325mg) enteric coated aspirin daily, unless otherwise directed ?????? call and schedule an appointment to be seen in 2 weeks for staple/suture removal what to report to office: ?????? changes in vision (loss of vision, blurring, double vision, half vision) ?????? slurring of speech or difficulty finding correct words to use ?????? severe headache or worsening headache not controlled by pain medication ?????? a sudden change in the ability to move or use your arm or leg or the ability to feel your arm or leg ?????? trouble swallowing, breathing, or talking ?????? temperature greater than 101.5f for 24 hours ?????? bleeding, new or increased drainage from incision or white, yellow or green drainage from incisions followup instructions: dr. or phone:( call to make an fu appointment in 1 month provider: , phone: please call to make a fu appointment in 4 weeks. you will need l carotid duplex prior to visit. procedure: arteriography of cerebral arteries endarterectomy, other vessels of head and neck endarterectomy, other vessels of head and neck incision of vessel, other vessels of head and neck procedure on single vessel procedure on vessel bifurcation diagnoses: occlusion and stenosis of carotid artery without mention of cerebral infarction occlusion and stenosis of multiple and bilateral precerebral arteries without mention of cerebral infarction cervical spondylosis without myelopathy arthrodesis status occlusion and stenosis of carotid artery with cerebral infarction facial weakness other specified hemiplegia and hemiparesis affecting nondominant side 

Answer: The patient is high likely exposed to