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: penicillins / percocet attending: chief complaint: headache major surgical or invasive procedure: hd history of present illness: ms. is a 24 year old woman with esrd on hd, sle, malignant htn admitted with mild headache, mild shortness of breath and consistent abdominal pain at the site of her known left abdominal wall hematoma in the setting of hypertension. her last hd was yesterday. . upon arrival to the ed, her vitals were bp 240's systolic, hr 90's, 93% on ra. a head ct scan was done which showed no acute process. an abdominal ct was done given her femoral line pain, which also was normal. she was given nitropaste x2 initially, then switched to labetalol 100mg x2, then 200mg x2, then finally started on nicardipine drip when she showed benefit with a decrease in her bp to 170/123 and improvement in her headache. . upon arrival to the micu, patient denies any current symptoms. she reports that her headache, shortness of breath and abdominal pain all resolved with blood pressure management and pain medications. . pt was transferred to the floor when blood pressure was controlled. past medical history: 1. systemic lupus erythematosus: - diagnosed (16 years old) when she had swollen fingers, arm rash and arthralgias - previous treatment with cytoxan, cellcept; currently on prednisone - complicated by uveitis () and esrd () 2. ckd/esrd: - diagosed - initiated dialysis but refused it as of , has survived despite this - pd catheter placement 3. malignant hypertension - baseline bps 180's - 120's - history of hypertensive crisis with seizures - history of two intraparenchymal hemorrhages that were thought due to the posterior reversible leukoencephalopathy syndrome, associated with le paresis in that resolved 4. thrombocytopenia: - ttp (got plasmapheresisis) versus malignant htn 5. thrombotic events: - svc thrombosis (); related to a catheter - negative lupus anticoagulant (, , ) - negative anticardiolipin antibodies igg and igm x4 (-) - negative beta-2 glycoprotein antibody (, ) 6. hocm: last noted on echo 7. anemia 8. history of left eye enucleation for fungal infection 9. history of vaginal bleeding lasting 2 months s/p depoprovera injection requiring transfusion 10. history of coag negative staph bacteremia and hd line infection - and 11. thrombotic microangiopathy: may be etiology of episodes of worse hypertension given appears quite labile 12. obstructive sleep apnea, autocpap/ pressure setting , straight cpap/ pressure setting 7 pshx: 1. placement of multiple catheters including dialysis. 2. tonsillectomy. 3. left eye enucleation in . 4. pd catheter placement in . 5. s/p ex-lap for free air in abdomen, ex-lap normal social history: single and lives with her mother and a brother. she graduated from high school. the patient is on disability. the patient does not drink alcohol or smoke, and has never used recreational drugs. family history: negative for autoimmune diseases including sle, thrombophilic disorders. maternal grandfather with htn, mi, stroke in 70s. physical exam: vs: hr 96 bp 171/111 rr 12 o2 98% on ra physical exam: general in nad heent nc, at, eomi, perrla, mmm cvs rrr, 3/6 systolic murmur in all heart fields resp cta bl, no crackles or wheezes abd soft, hematoma raised on left anterior abdominal wall, +bs, mildly tender over hematoma ext left sided femoral hd line in place, no erythema, no edema neuro a+ox3, cn2-12 intact, pt has left sided artificial eye, motor and sensory intact pertinent results: ***labs on admission*** 07:03am wbc-5.2 rbc-2.79* hgb-8.5* hct-26.3* mcv-94 mch-30.3 mchc-32.2 rdw-19.2* 07:03am plt count-154 07:03am pt-29.5* ptt-49.2* inr(pt)-3.0* 07:03am glucose-94 urea n-53* creat-7.0* sodium-136 potassium-5.1 chloride-102 total co2-23 anion gap-16 07:03am calcium-8.8 phosphate-5.0* magnesium-1.9 12:00pm pt-43.8* ptt-56.1* inr(pt)-4.9* 12:00pm lipase-42 12:00pm alt(sgpt)-12 ast(sgot)-43* alk phos-96 tot bili-0.4 03:25pm urine blood-tr nitrite-neg protein-30 glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-8.0 leuk-neg 03:25pm urine rbc-* wbc-0-2 bacteria-occ yeast-none epi- 12:00pm blood pt-43.8* ptt-56.1* inr(pt)-4.9* 06:40am blood pt-18.6* ptt-38.7* inr(pt)-1.7* . ***labs on day of discharge*** 06:35am blood wbc-5.7 rbc-2.39* hgb-7.1* hct-22.1* mcv-93 mch-29.8 mchc-32.2 rdw-18.6* plt ct-136* 06:35am blood glucose-107* urean-34* creat-4.8* na-137 k-5.2* cl-101 hco3-27 angap-14 06:35am blood pt-22.8* ptt-42.3* inr(pt)-2.2* . imaging ekg sinus rhythm. possible left atrial abnormality. borderline voltage criteria for left ventricular hypertrophy. inferolateral st-t wave changes may be related to left ventricular hypertrophy. compared to the previous tracing of there is no significant diagnostic change. intervals axes rate pr qrs qt/qtc p qrs t 99 190 86 368/436 13 100 24 ct abd/pelv impression: 1. interval decrease in size to subcutaneous anterior abdominal wall hematoma. 2. infectious versus inflammatory process within the right lower lobe of the lung. small right simple pleural effusion. 3. cardiomegaly with slight decrease in size of moderate pericardial effusion. 4. right lobe liver hemangioma, unchanged. ct head impression: 1. mildly limited study given administration of small amount of iv contrast material. however, no evidence of hemorrhage or mass effect. note added at attending review: this patient was administered contrast for the abdominal ct, and the head ct was performed after part of this dose. therefore, this is neither a noncontrast examination, nor a proper contrast ct. cxr conclusion: persistent cardiomegaly and mild pulmonary edema. brief hospital course: 24 yo woman with hx of sle, ersd on hd, admitted with hypertensive urgency. . # hypertensive urgency: pt with extensive history of hypertension. patient's bp improved with nicardipine drip. became increased yesterday when the patient missed a dose of oral nicardipine, but came down after a replacement dose. restarted all home oral antihypertensives including nicardipine 30 q8h, aliskerin 150mg , labetalol 900mg tid, hydralazine 100mg tid, and clonidine 0.3mg + 0.1mg weekly at current doses. blood pressure remains labile and renal continues to follow patient. pt was transferred to the floor as blood pressure stabilized. bp has remained stable with systolics 140s-170s. in the micu, nifedipine extended release was added in place of nicardipine as pt's blood pressures seemed to rise prior to nicardipine doses. . # hyperkalemia: ocurred on the day after admission. resolved with administration of kayexalate. pt continued hemodialysis on tuthsat. . # left abdominal wall hematoma: abd ct showed a mild decrease in the size. pt reported that morphine did not help pain, and was switched to dilaudid po in the micu. however, given pt's recent prior admission required narcan following sensitivity to narcotics, dilaudid was d/c'ed on the floor. pt was continued on gabapentin, tylenol around the clock, and low-dose morphine as needed for pain. narcotics should be avoided in the future. pain should also resolve in the next few weeks as hematoma resolves. . # sle: pt was continued on prednisone at 4 mg po daily. . #esrd: renal was following during her stay. she continued hd on her t, th, sat schedule. # anemia: hct was mildly decreased from baseline during admission. this is likely secondary to aocd and in the setting of renal failure. . # svc thrombus: patient is on anticoagulation, likely lifelong. patient was supratherapeutic on coumadin on admission and coumadin was subsequently held. then inr became subtherapeutic, so heparin gtt was used to bridge. on day of discharge, inr became therapeutic, and pt was discharged home on coumadin 4mg po daily, with inr to be checked next at hemodialysis . # hocm: pt has evidence of myocardial hypertrophy on recent echo. she was not symptomatic during her stay. she was continued on her beta blocker. . # depression/anxiety. she was continued on celexa and clonazepam prn. . # osa: cpap for sleep with 7 pressure. . # fen: repleted lytes prn / regular diet . # ppx: coumadin, bowel regimen . # access: piv/ permanent dialysis cath l fem . # code: full . # contact: (mother) medications on admission: clonidine 0.3mg + 0.1mg / 24 hr patch weekly qwednesday hydralazine 100mg po q8h labetalol 900mg po tid morphine 7.5mg q8h prn nicardipine 30mg po tid aliskiren 150 prednisone 4mg po qday clonazepam 0.5 mg celexa 20mg po qday gabapentin 300 mg acetaminophen 325 mg q6h prn ergocalciferol (vitamin d2) 50,000 unit po once a month coumadin 4 mg daily discharge medications: 1. morphine 15 mg tablet sig: 0.5 tablet po every eight (8) hours as needed for breakthrough pain for 2 weeks. 2. hydralazine 50 mg tablet sig: two (2) tablet po q8h (every 8 hours). 3. clonidine 0.3 mg/24 hr patch weekly sig: one (1) patch weekly transdermal qwed (every wednesday). 4. aliskiren 150 mg tablet sig: one (1) tablet po bid (2 times a day). 5. prednisone 1 mg tablet sig: four (4) tablet po daily (daily). 6. citalopram 20 mg tablet sig: one (1) tablet po daily (daily). 7. gabapentin 300 mg capsule sig: one (1) capsule po bid (2 times a day). 8. clonazepam 0.5 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for anxiety. 9. clonidine 0.1 mg/24 hr patch weekly sig: one (1) patch weekly transdermal qwed (every wednesday). 10. warfarin 1 mg tablet sig: four (4) tablet po once a day. 11. acetaminophen 325 mg tablet sig: 1-2 tablets po every six (6) hours as needed for pain. 12. nifedipine 90 mg tablet sustained release sig: one (1) tablet sustained release po daily (daily). :*30 tablet sustained release(s)* refills:*1* 13. labetalol 300 mg tablet sig: three (3) tablet po three times a day. :*260 tablet(s)* refills:*1* 14. respiratory therapy please adjust settings of cpap machine to a lower volume as it is uncomfortable for the patient. discharge disposition: home discharge diagnosis: hypertensive urgency discharge condition: good, hemodynamically stable, afebrile, pain controlled discharge instructions: you were admitted for headaches and very high blood pressures. you were started on an iv medication for your blood pressure which controlled it. you were then started back on your home medications with improvement of your blood pressure. one new medication was added as your hypertension was difficult to control. you were also started on a heparin drip while restarting your coumadin since you have a known clot in your veins. you will need to continue your coumadin at 4mg daily and have your inr checked at dialysis next week. please take all medications as prescribed. it is important that you do not miss doses of your medications since your blood pressure is very sensitive to missed doses. please keep all scheduled appointments. medications changes include: 1. stop nicardipine 2. start nifedipine cr 90mg by mouth daily 3. increase labetalol to 900mg by mouth 3 times daily 4. continue at warfarin 4mg by mouth daily if you develop any of the following concerning symptoms, please call your pcp or go to the ed: fevers, chills, chest pains, shortness of breath, nausea, vomiting, or headaches. followup instructions: please call your pcp, . at to set up a follow-up appointment in 1-2weeks. please continue your hd tuthsat. procedure: hemodialysis diagnoses: hypertensive chronic kidney disease, malignant, with chronic kidney disease stage v or end stage renal disease systemic lupus erythematosus hyperpotassemia end stage renal disease long-term (current) use of anticoagulants personal history of venous thrombosis and embolism other vascular complications of medical care, not elsewhere classified phlebitis and thrombophlebitis of upper extremities, unspecified 

Answer: The patient is high likely exposed to