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: addendum: please note the neurological exam at the time of disharge- she was opening her eyes spontaneusly and tracking past midline on right side. she is non verbal but is able to follow some commands. she has facial droop on right side. she is spastic on right side with clonus and is hemiplegic on right side. her plantar is upgoing on right side. chief complaint: called by emergency department for code stroke major surgical or invasive procedure: tpa and merci history of present illness: ms. is a 73 year-old right-handed woman with a presumed past medical history including dm ii, hyperlipidemia, cardiac arrhythmia, and prior right parietal and external capsule strokes who presents with the sudden of onset of aphasia, right facial droop, and right-sided weakness. her daughter and husband explain that ms. was in her usual state of health when she went to bed at about 10 pm on . while initial interviews suggested that 10 pm was the patient's last known well time, it was ultimately discovered that ms. was still well when she awakened at about 3 am to go to the bathroom. her husband recalls that, at that time, she ambulated independently and did not appear to have weakness or facial droop. at about 4 am, he woke up next to her in bed because she was "scratching" her abdomen. he apparently witnessed the subsequent development of right facial droop and hemiparesis between 4 am and 4:30 am. concerned, the family drove the patient to the for further care. the family maintains that ms. has not been herself since the stroke(s) eight months pta but deny specific illness and discomfort in the recent past. review of potential contraindications to tpa: * absolute - negative for: stroke or head trauma within 3 months of admission, hx of intracranial hemorrhage, major surgery within 2 weeks of admission, pregnancy, persistent sbp > 185 or dbp > 110, platelets < 100, 000 or inr > 1.7 * relative - negative for: gu or gi procedure within 3 weeks of admission, lp within 1 week of admission, improvement in stroke sx, seizure, glucose < 50, >400, nihss <4, >22 neurological review of systems: difficult to assess general review of systems: - positive for: as above, shortness of breath - negative for: chest discomfort, shortness of breath, cough, abdominal pain, rash. past medical history: - right parietal, external capsule strokes - 7-8 months pta - "cardiac arrythmia" - dm ii - hld - per report: labile htn in few weeks pta - chronic abdominal pain - back pain social history: - visiting from - married - has 8 children family history: - positive for stroke (father, age ) physical exam: physical examination: vitals: t: 97.6 p: 104 r: 16 bp: 163/69 sao2: 90 ra general: awake, cooperative. heent: normocepahlic, atruamatic, no scleral icterus noted. neck: supple. no carotid bruits appreciated. cardiac: tahcycardic rate, irregularly irregular rhythm, normal s1 and s2. pulmonary: lungs clear to auscultation bilaterally. abdomen: round. normoactive bowel sounds. soft. non-tender, non-distended. extremities: warm, well-perfused. skin: no rashes or concerning lesions noted. neurologic examination: mental status: * degree of alertness: alert. * language: language is dysarthric and sparse. comprehension appears intact; pt able to correctly follow midline and appendicular commands. cranial nerves: * i: olfaction not evaluated. * ii: perrl 3 to 2mm and brisk. visual fields full to confrontation. * iii, iv, vi: limited upgaze. eom otherwise intact without nystagmus. * v: facial sensation intact to light touch in the v1, v2, v3 distributions (per report of interpreter). * vii: right facial droop. * viii: hearing intact to finger-rub bilaterally. * ix, x: palate not visible. * : unable to assess. * xii: tongue protrudes minimally but in midline. motor: * bulk: no evidence of atrophy. * tone: increased in right lower extremity. rue with spasticity. * drift: right ue falls to bed. strength: * left upper extremity: 5 throughout delt, biceps, triceps, finger flex * right upper extremity: 0 throughout delt, biceps, triceps, finger flex * left lower extremity: 4+ throughout iliopsoas, quad, ham, tib ant, gastroc * right lower extremity: some voluntary adduction (2), wiggles right toes reflexes: * left: 3 throughout biceps, triceps, bracheoradialis, patellar * right: 3 throughout biceps, triceps, bracheoradialis, patellar * babinski: mute bilaterally sensation: * light touch: intact bilaterally in lower extremities, upper extremities, trunk, face per report * pinprick: intact bilaterally intact bilaterally in lower extremities, upper extremities, trunk, face per report * vibration: intact bilaterally at level of medial malleolus per report coordination * finger-to-nose: intact on left gait: * not evaluated pertinent results: 06:25am blood wbc-11.7* rbc-3.67* hgb-11.2* hct-33.5* mcv-91 mch-30.5 mchc-33.4 rdw-13.7 plt ct-339 02:50am blood wbc-10.3 rbc-3.48* hgb-10.7* hct-31.6* mcv-91 mch-30.7 mchc-33.8 rdw-13.7 plt ct-289 06:25am blood pt-13.4 ptt-53.8* inr(pt)-1.1 11:59am blood fibrino-431* 06:25am blood glucose-150* urean-12 creat-0.8 na-142 k-3.7 cl-107 hco3-22 angap-17 02:22am blood ctropnt-0.02* 11:59am blood ck-mb-notdone ctropnt-0.02* 11:59am blood %hba1c-7.8* 11:59am blood triglyc-71 hdl-65 chol/hd-2.7 ldlcalc-97 imaging: cta : 1. abrupt cutoff of flow within the left m1 segment, associated with hyperdense vessel and in this patient with acute onset of right sided symptom is concerning for an acute embolus. no significant cortical edema is appreciated at this time. 2. normal variant origin of the vertebral arteries from the external carotid arteries. 3. chronic right hemispheric infarcts. 4. focal gas collection anterior to the esophagus likely represents an esophageal diverticulum though it is incompletely evaluated and should be correlated with patient's clinical course. initial evaluation could take the form of barium swallow as indicated. angio ... ct head : there is no acute intracranial hemorrhage. there is no definite low-attenuation region in the left hemisphere. hypodensities in the right frontal and parietal lobes with associated mild volume loss is unchanged. there is preservation of the -white matter. ventricles and sulci are normal in size and appearance and the basilar cisterns are preserved. no osseous abnormality is identified. the paranasal sinuses and mastoid air cells are well aerated. impression: 1. no evidence of significant cortical edema. 2. unchanged appearance of chronic right hemispheric infarcts. echo : the left atrium is mildly dilated. no atrial septal defect is seen by 2d or color doppler. left ventricular wall thickness, cavity size and regional/global systolic function are normal (lvef 70%). there is no ventricular septal defect. right ventricular chamber size and free wall motion are normal. there are focal calcifications in the aortic arch. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. mild (1+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. mild (1+) mitral regurgitation is seen. there is borderline pulmonary artery systolic hypertension. there is no pericardial effusion. brief hospital course: ms. is a 73 year-old right-handed woman with a presumed past medical history including dm ii, hyperlipidemia, cardiac arrhythmia, and prior right parietal and external capsule strokes who presented with sudden onset of aphasia, right facial droop, and right-sided weakness. clinical examination was notable for minimal, dysarthric speech, right facial droop, right upper extremity plegia and spasticity, right lower extremity paresis with increased tone, and diffusely brisk reflexes. the deficits localize to the left mca territory. as she was out of the window for intra-venous tpa, the patient was taken to the angio suite. the angio confirmed that the left distal mca stem was closed. she was given a total of 9mg of ia tpa and started to open up the mca stem. the superior division cleared nicely, however, the inferior division might be closed. the merci device was also used to clear some thrombus from her mca stem. it was decided not to go after the inferior mca division, since the patient was getting out of a reasonable time window and because she had already 9mg of ia tpa on board. the patient was then transferred to the icu. she was extubated on that same day. she was kept flat and her sbp/dbp was kept below 185/105. a repeat head ct did not show any hemorrhages. she was restarted on asa and heparin the following day (). she was transferred out of the icu on to the floor for further care. she was closely monitered for her neuro exam. she was seen and evaluated by physical and occupational therapy for gait and stability assesment. she was evlauted for swallow and speech tharpy as well. she was started on tube feeds ( nasogastric). however she was being follwoed by swallow tharpy on close basis and they felt that she was improving though gradually and may not need peg tube in long term planning. however she should be further evaluated for swallow function and if she does not improve, she should be considered for peg tube. she was continued on iv heparin which was later bridged to lovenox and coumadin for a therapeutic inr of . she was monitered continously on telemetry in setting of acute stroke and a fib. she had an episode of rapid afib lasting for few seconds on night. the rate was immediately controlled after administertion of metoprolol 5 mg iv. her ekg did not show significant st/t changes and cardiac enzymes were negative. suggested plan of care after discharge 1. physical, occupational , speech tharapy 2. swallow and nutrition evaluation and continue tube feeds, if she does not tolerate then she would need peg tube 3. bridge on lovenopx till inr becomes therapeutic on coumadin 4. management of a fib, blood pressure aand other medical issues as felt appropritae by medical team 5. prevention of bed sores and close watch over possible development of infections such as uti/pna. please note the neurological exam at the time of disharge- she was opening her eyes spontaneusly and tracking past midline on right side. she is non verbal but is able to follow some commands. she has facial droop on right side. she is spastic on right side with clonus and is hemiplegic on right side. her plantar is upgoing on right side. medications on admission: -amiodarone 200 mg po bid -simvastatin 20 mg po -glyburide 5 mg po daily -buscopam 10 mg po daily -dipridamol 75 mg po daily discharge medications: 1. simvastatin 10 mg tablet sig: two (2) tablet po daily (daily). 2. amiodarone 200 mg tablet sig: one (1) tablet po bid (2 times a day). 3. docusate sodium 50 mg/5 ml liquid sig: two (2) po bid (2 times a day). 4. insulin regular human 100 unit/ml solution sig: one (1) injection asdir (as directed): as per insulin sliding scale 200-250 4 units, 250-300 6 units, 300-350 8 units, more than 350 md. 5. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 6. warfarin 5 mg tablet sig: one (1) tablet po once daily at 4 pm: measure inr every day, for dose adjustement. 7. hydralazine 20 mg/ml solution sig: ten (10) mg injection q6h (every 6 hours) as needed for sbp > 180. 8. enoxaparin 80 mg/0.8 ml syringe sig: eighty (80) mg subcutaneous (2 times a day): continue till inr becomes , stop after that. 9. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po once a day. 10. tylenol 325 mg tablet sig: 1-2 tablets po q6h prn as needed for pain. discharge disposition: extended care facility: - discharge diagnosis: left mca stroke, s/p ia tpa and merci discharge condition: mental status:confused - always level of consciousness:lethargic but arousable activity status:bedbound discharge instructions: you were admitted for evaluation of stroke. you had ct scan of your brain which showed stroke on left mca distribution. you recieved thrombolytic and endovascular therapy for acute stroke. please take your medicines as prescribed. please call 911 or your doctor if you develop any concerning symptoms. followup instructions: please follow up with following providers- scheduled appointments : provider , md, ms phone: date/time: 9:00 provider , md phone: date/time: 2:00 md, procedure: enteral infusion of concentrated nutritional substances injection or infusion of thrombolytic agent arteriography of cerebral arteries procedure on single vessel endovascular removal of obstruction from head and neck vessel(s) diagnoses: unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled atrial fibrillation other and unspecified hyperlipidemia long-term (current) use of insulin long-term (current) use of anticoagulants cerebral artery occlusion, unspecified with cerebral infarction aphasia spastic hemiplegia and hemiparesis affecting dominant side 

Answer: The patient is high likely exposed to