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: fentanyl / penicillins / ace inhibitors attending: chief complaint: hypertensive urgency, chest pain major surgical or invasive procedure: left subclavian central line placement history of present illness: 84 yo woman with pmh dm/htn sent in from rehab after she awoke this morning with left sided/substernal chest pain. the pain radiated to her back and was pressure like. she got some relief with nitroglycerin and maalox. she also felt nauseated and diaphoretic. she denies shortness of breath, leg pain. . since hip surgery in , she has had multiple falls. in the ed, sbps >240 and she had chest pain. ekg was thought to show tw she was on ntg gtt and given morphine iv and labetalol 20mg x 2 with sbps still >200. the cardiology fellow was consulted who did not feel she was having an acute coronary event, so she was transferred to the icu for management of her hypertensive urgency/emergency and chest pain. . ros: she reports dull abdominal pain and nausea as her current top complaint, . her chest pain is slightly better, non quantitated. she vomited twice today. she has constant lower back pain, at baseline. she has had blurry vision for the last 2 weeks. she denies fever, chills, shortness of breath, numbness, weakness. past medical history: cad, s/p cabg , mi , persistent angina. ef 65%, normal valves at total hip replacement at nebh diabetes mellitus gerd lumbar stenosis/chronic lower back pain diverticulosis bleed htn h/o cva optic nerve with seizure - hashimotos thyroiditis interstitial pneumonitis blurred vision note bilateral edema hyponatremia malnutrition anemia frequent falls ckd baseline creat 1.6 social history: resident at rehab, widowed for >30 years, quit smoking 20 years ago, denies alcohol family history: father died at 51 of heart disease, 3 brothers and 1 sister died of heart disease, daughter is alive and healthy physical exam: pe: v: 96.8 bp 185/76 (max sbp 250) p82 r20 97% ra gen: sleeping, no apparent distress when asleep or awake heent: pupils equal round and reactive, op clear, mmm neck: right ij with iv in place resp: clear bilaterally cv: rrr nl s1s2 no murmurs abd: soft, nontender, no organomegaly ext: trace bilateral edema. left elbow with bandage in place neuro: alert, oriented to " icu" and "". pertinent results: admission lab results: 09:45am wbc-5.8 rbc-3.98* hgb-12.4 hct-35.2* mcv-89 mch-31.1 mchc-35.1* rdw-16.2* 09:45am neuts-79.3* lymphs-12.5* monos-6.4 eos-1.3 basos-0.4 09:45am glucose-135* urea n-31* creat-1.2* sodium-128* potassium-7.5* chloride-96 total co2-24 anion gap-16 11:17am k+-4.6 09:45am calcium-8.8 phosphate-3.8 magnesium-2.1 09:45am pt-10.9 ptt-25.8 inr(pt)-0.9 09:45am ctropnt-<0.01 06:45pm ctropnt-<0.01 08:34am blood ck-mb-notdone ctropnt-<0.01 12:30pm urine color-yellow appear-clear sp -1.025 12:30pm urine blood-tr nitrite-neg protein-tr glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-5.0 leuk-neg 12:30pm urine rbc-0-2 wbc-0-2 bacteria-0 yeast-none epi-0 . other pertinent lab results: 10:00am blood alt-9 ast-23 alkphos-102 amylase-40 totbili-0.7 10:00am blood lipase-31 10:00am blood caltibc-192* ferritn-1881* trf-148* 10:00am blood tsh-5.1* 10:00am blood free t4-1.6 09:58am blood cortsol-27.5* 04:07pm blood lactate-1.1 10:00am blood metanephrines (plasma)-pnd . basic labs prior to discharge: 10:00am blood wbc-12.3* rbc-3.79* hgb-11.4* hct-33.5* mcv-89 mch-30.1 mchc-34.1 rdw-16.3* plt ct-245 10:00am blood glucose-105 urean-15 creat-0.9 na-129* k-4.0 cl-92* hco3-24 angap-17 10:00am blood calcium-8.6 phos-2.6*# mg-1.7 iron-95 . imaging: cta chest done : impression: 1) no pulmonary embolus or aortic dissection. 2) reticular interstitial and ground glass pattern in the lungs which is most compatible with pulmonary fibrosis. . cxr to check placement of left subclavian central line, r/o ptx impression: chest: a left pneumothorax is present. . cxr checked daily, with slow resolution of small pneumothorax. . cxr impression: 1. the left pneumothorax is not visualized. 2. unchanged interstitial lung disease. no pulmonary edema. brief hospital course: this is an 84 year old woman with history of cad s/p cabg and htn who presented with hypertensive urgency in the setting of chest pain, nausea, vomiting, and abdominal pain with new oxygen requirement and altered mental status. hospital course by problem: . # hypertensive urgency - the patient was initially put on a labetolol gtt, which was weaned off. she was continued on isosorbide mononitrate, losartan, and metoprolol. hctz was held due to hyponatremia. she had one episode of hypotension to sbps mid 60s, for which a central line was placed, but her bp improved with fluid boluses, and she was subsequently hypertensive, requiring a labetolol gtt again. she never required vasopressors. she was quickly weaned off the labetalol gtt, and metoprolol was decreased to 75 mg po tid because she was noted to have orthostatic hypotension. hypertension responded well to hydralazine po 10mg qid prn. on the day prior to discharge, she again became hypotensive, with unclear etiology (no new medications or combinations of meds that day, evidence of new infection). blood pressure responded to fluid boluses. blood pressure management was discussed with the patient's daughter and the geriatrics team. hypertension seems to have a strong component of anxiety in this patient, and she responded well to small, 0.25mg doses of lorazepam. given the risks of hypotension in this patient, and her ongoing labile blood pressure, it was decided to discharge her on her current antihypertensive regimen (metoprolol, losartan, and isosorbide mononitrate), and to treat acute elevations of blood pressure for anxiety, with small doses of ativan. additional antihypertensive medications should be avoided if possible, particularly hydralazine which can contribute to delirium. . in addition, plasma metanephrines were sent at request of patient's pcp, results were pending at time of discharge. . # altered mental status/delirium - this was initially thought likely due to receiving ativan and compazine in close proximity to each other. these were held for a time and ms improved, though she waxes and wanes during the day with periods of confusion and inattention. she does very well during the day, especially when she is with her daughters. she generally responds well to redirection, and in particular to talking with her daughter. . # hypoxia - o2 sats improved after receiving iv furosemide, suggesting she was volume overloaded initially. weaned off of oxygen without difficulty. . # dropped heart beats, possible mobitz ii block - noted on telemetry to have occasional missed beats, with what appeared to be mobitz ii. discussed with daughter who would prefer to hold off on cardiac consultation for this problem. that goals of care are moving toward comfort (see below), consideration of pacemaker placement is deferred for now. . # chest pain - pain was atypical in nature, but there was initial concern as she does have a history of cad/cabg, and slight ekg changes were noted in the lateral leads, though this was noted only on 1 ekg and then normalized. ces were neg x 3. she was continued on asa, bb, , nitrate, and statin. . # nausea, vomiting, abdominal pain - abdominal pain seems to be primarily related to her chronic back pain, and per daughter she has had chronic nausea since . complained of ruq pain, but lfts and pancreatic enzymes were normal. responded well to compazine and maalox. ppi increased to 20mg and pain improved. . # anemia - has had a chronic normocytic anemia. iron studies showed normal iron stores, increased ferritin, low tibc and low transferrin consistent with chronic inflammation. . # diabetes - she was continued on 4 units glargine qhs, iss, dm diet. . # back pain - she was continued on oxycontin. . # depression - she was continued on citalopram. . # hyponatremia - originally thought to be hypovolemic hyponatremia, and improved slightly with ivf, but then back to na 128. hctz held, but she remained hyponatremic. cortisol was elevated consistent with acute illness, tsh mildly elevated but free t4 was normal. sodium has been stable 129-130 for the last several days of her hospital course. will need repeat na as an outpatient. . # pneumothorax- the patient developed a pneumothorax after placement of a l cvl. this was followed with serial cxrs and resolved. . # hypothyroidism - continued levothyroxine. tsh was slightly elevated, but with normal free t4. . # code status - dnr/dni, confirmed with daughter, who is hcp. goals of care are moving toward comfort at this point. palliative care consult at hsl might be appropriate (daughter expressed interest in this), if the geriatrics team agrees. medications on admission: -aspirin 81 po qd -calcium carbonate 650 po tid -tylenol 650 mg po q6h standing -vitamin d 1000 u po daily -celexa 20 mg po qd (incr from 10mg on ) -colace 100 mg po daily (stopped ) -flonase 1 sprays each nostril daily -hydrodiuril 50 mg po daily (decreased from 75mg on ) -insulin glargine 4 units daily (decreased from 8 units on ) -insulin regular sliding scale -imdur 120 mg po daily -levothyroxine 112 mcg po daily -ativan 0.25 mg po bid (stopped , was consistently before that time) -losartan 50 mg po bid -metoprolol 75 mg po bid (decreased from 100mg on ) -prilosec 20 mg po daily -oxycontin 30 am 20 hs mg po bid (incr from 20 on ) -oxycodone 5 mg prn (twice daily on average) -compazine 10 mg po bid (stopped ) -sennakot 2 tabs po qhs -simvastatin 20 mg po qhs (decreased from 40mg on ) discharge medications: 1. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 2. calcium carbonate 650 (1,625) mg tablet sig: one (1) tablet po three times a day. 3. acetaminophen 325 mg tablet sig: two (2) tablet po q6h (every 6 hours). 4. cholecalciferol (vitamin d3) 1,000 unit tablet sig: one (1) tablet po once a day. 5. citalopram 20 mg tablet sig: one (1) tablet po daily (daily). 6. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 7. fluticasone 50 mcg/actuation spray, suspension sig: one (1) spray nasal daily (daily). 8. insulin glargine 100 unit/ml solution sig: four (4) units subcutaneous at bedtime. 9. insulin regular human 100 unit/ml solution sig: as prescribed injection four times a day: per sliding scale. 10. isosorbide mononitrate 60 mg tablet sustained release 24 hr sig: two (2) tablet sustained release 24 hr po hs (at bedtime). 11. levothyroxine 112 mcg tablet sig: one (1) tablet po daily (daily). 12. lorazepam 0.5 mg tablet sig: 0.5 tablet po bid (2 times a day) as needed for anxiety: for anxiety or for elevated blood pressure. 13. losartan 50 mg tablet sig: one (1) tablet po bid (2 times a day). 14. metoprolol tartrate 25 mg tablet sig: three (3) tablet po tid (3 times a day). 15. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po bid (2 times a day). 16. oxycodone 30 mg tablet sustained release 12 hr sig: one (1) tablet sustained release 12 hr po qam (once a day (in the morning)). 17. oxycodone 20 mg tablet sustained release 12 hr sig: one (1) tablet sustained release 12 hr po qpm (once a day (in the evening)). 18. oxycodone 5 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for pain. 19. senna 8.6 mg tablet sig: two (2) tablet po at bedtime. 20. simvastatin 10 mg tablet sig: two (2) tablet po daily (daily). 21. aluminum-magnesium hydroxide 225-200 mg/5 ml suspension sig: 15-30 mls po tid (3 times a day) as needed for heartburn or stomach upset. 22. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po q6h (every 6 hours) as needed for constipation. discharge disposition: extended care facility: for the aged - ltc discharge diagnosis: primary diagnoses: hypertensive urgency, chest pain, orthostatic hypotension, delirium, pneumothorax, hyponatremia. secondary diagnoses: diabetes mellitus type 2. discharge condition: stable discharge instructions: you were hospitalized with chest pain and high blood pressure. please take all medications as prescribed. we have made the following changes: -we have stopped your hydrodiuril (hydrochlorothiazide) -we have increased your metoprolol to 75mg three times a day -we have increased your omeprazole to 20mg twice a day if you experience chest pain, extremely high or low blood pressure, shortness of breath, or any other new or concerning symptoms, please call your doctor. followup instructions: please followup with your doctor rehab. procedure: venous catheterization, not elsewhere classified diagnoses: anemia, unspecified unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled hyposmolality and/or hyponatremia unspecified acquired hypothyroidism aortocoronary bypass status other specified forms of chronic ischemic heart disease iatrogenic pneumothorax hypoxemia drug-induced delirium backache, unspecified hip joint replacement orthostatic hypotension pathologic fracture of vertebrae benzodiazepine-based tranquilizers causing adverse effects in therapeutic use 

Answer: The patient is high likely exposed to