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: chest pain major surgical or invasive procedure: intubation ng tube placement thrombolysis right ij placement hemodialysis catheter replacement arterial line placement history of present illness: 71 year old female with a history of dm2, htn, gerd, who presented with chest pain which began on . she denied shortness of breath, nausea, vomiting, abdominal pain, diarrhea, fevers, chills. she reported that she has been ambulating 3 x daily. she denies history of malignancy, or prior clot. she had a histerectomy, ap repair, coldoplasty and colostomy on and . she returned to the or for presumed rectal tear on pod#5 and was treated with vancomycin, gentamicin, and metronidazole and was discharged on a 14 day course of po augmentin. in the ed, she had cp, nausea, vomiting. 100% on nrb, tachycardic, and abdominal distention. she underwent a cta of the chest, abdomen, pelvis, which showed b/l pulmonary embolism and dilated rv. she was started on heparin and transferred to the micu. past medical history: ob/gynhx: - svd x3, sab x3 - postmenopausal for >20yrs - no abnl paps or stis pmh: dmii - metformin htn - valsartan, nifedipine, hctz, lisinopril gerd - omeprazole hypercholesterolemia - simvastatin social history: no smoking, no alcohol. emigrated from islands. lives in with her husband; works for a cleaning service. family history: non-contributory physical exam: vs t 97.1, hr 88, bp 130/55, rr 16, sat 100/4l. gen: comfortable woman, in nad. family in room. heent: no conjunctival pallor. no icterus. mmm. op clear. cv: rrr. nl s1, s2. no murmurs, rubs or lungs: ctab, good bs bl, no w/r/c abd: nabs. soft, nt, nd. no hsm ext: wwp, no cce. 2+ dp pulses bl skin: no rashes/lesions, ecchymoses. neuro: a&ox3. appropriate. cn 2-12 intact. bilateral decreased strength 4+ in deltoids. grossly normal ensation throughout. pertinent results: 07:30am blood wbc-10.6 rbc-3.25* hgb-9.5* hct-28.5* mcv-88 mch-29.1 mchc-33.1 rdw-14.2 plt ct-363 05:40am blood wbc-6.7 rbc-2.87* hgb-8.8* hct-26.2* mcv-91 mch-30.6 mchc-33.5 rdw-16.4* plt ct-302 07:30am blood pt-13.4 ptt-25.4 inr(pt)-1.1 05:40am blood pt-26.1* ptt-30.5 inr(pt)-2.6* 07:30am blood glucose-281* urean-22* creat-1.3* na-138 k-4.3 cl-103 hco3-21* angap-18 05:40am blood glucose-74 urean-29* creat-2.9* na-142 k-4.2 cl-108 hco3-26 angap-12 07:30am blood alt-14 ast-21 ck(cpk)-29 alkphos-83 totbili-0.3 05:22am blood alt-5200* ast-* ld(ldh)-* ck(cpk)-662* alkphos-78 totbili-0.80 10:43am blood alt-48* ast-28 ld(ldh)-274* alkphos-86 totbili-0.5 07:30am blood lipase-68* 07:30am blood ctropnt-0.03* 01:50pm blood ck-mb-notdone ctropnt-0.42* probnp-1496* 12:46am blood ck-mb-12* mb indx-3.3 ctropnt-0.62* 05:22am blood ck-mb-15* mb indx-2.3 ctropnt-0.81* 04:45am blood ck-mb-notdone ctropnt-0.02* 05:16am blood albumin-3.1* calcium-7.2* phos-5.0*# mg-1.2* 05:40am blood calcium-7.8* phos-2.9 mg-2.0 03:46am blood caltibc-170* ferritn-452* trf-131* 10:27am blood ammonia-36 09:49pm blood tsh-1.2 03:00pm blood hbsag-negative hbsab-negative hbcab-positive 03:00pm blood hcv ab-negative imaging: cardiac echo : markedly dilated and hypokinetic right ventricle with evidence of pressure overload. relative sparing of the apical right ventricle. at leaset moderate pulmonary hypertension. small left ventricular cavity with hyperdynamic function and mild resting outflow tract obstruction. cta chest : 1. large bilateral pulmonary emboli. 2. signs of right heart strain with 2:1 rv to lv short-axis ratio. 3. improved post-infectious processes from rectal perforation and surgical intervention. 4. persistent left gonadal vein enlargement. bilat lower ext veins port study date of 5:15 pm no son evidence for dvt in the lower extremities. knee (ap, lat & oblique) left study date of 3:10 pm no previous images. mild hypertrophic spurring involving all compartments. in the absence of a weightbearing view, it is difficult to evaluate the joint space. specifically, no evidence of acute fracture or dislocation and no acute joint effusion. superior patellar spurring is seen. tunneled w/o port study date of 12:26 pm successful placement of 15.5 french, 23-cm (tip-to-cuff) hemodialysis catheter via the left internal jugular vein. the tip is in the right atrium and the catheter is ready to use. brief hospital course: 71 f with dm2, htn, gerd, admitted with saddle pe following abdominal surgery, leading to pea arrest on , now extubated, with improving mental status, and on hd for atn. micu course: she had labile blood pressures and was started on levophed. she got 4l ivf. her lactate peaked at 4.2. on she had a pea arrest. she was coded for 10 minutes and was intubated. she recieved alteplase and bicarbonate. on , she was weaned off pressors and started on cvvh for acute renal failure. her mental status was poor, but she would open eyes to commands. she was extubated on . ng tube was removed on . she had an afib paroxism and was treated with 5mg iv lopressor. a bedside swallow evaluation not concerning aspiration. pulmonary embolism: her hemodynamics have been stable following lysis of pe. she has been off pressors since . she had evidence of rv failure that was likely pe. as her pe was felt to be likely surgery, a hypercoagulability work-up was not considered indicated. patient was started on heparin as a bridge to coumadin. heparin and coumadin were held briefly for tunneled hd line placement. she was weaned off oxygen. on day of discharge, patient was therapeutic on coumadin, though her dosing was still being adjusted. in the future, she may need follow-up echo to assess for resolution of rv failure. palpitations and afib paroxism: she had an episode of afib in the icu that was was likely reactive to heart strain and fluid contraction due to aggressive cvvh. her tsh was normal. she had no further episodes of afib. she did have palpitations on the floor that were associated with increasing pvcs on telemetry. her cvl was removed as this had advanced into her ventricle, her electrolytes were repleted and she was diuresed. cardiac enzymes were negative. she was restarted on beta blocker therapy. given her episode of afib was likely provoked by pe and cvl irritation, this would not probably be an indication for lifelong anticoagulation as it was secondary to a stressor that is now resolved. knee pain: patient developed left knee pain on . although she had risk factors for gout (renal failure, volume changes), she did not have an effusion on exam. knee films showed no effusion or fracture, but bone spurs including in the region of pain. she was managed with tylenol as needed for pain and she improved with increased ambulation. colostomy: patient with end colostomy. she was seen by a colostomy nurse who found ostomy to be intact but with mucocutaneous junction separation. report of stool per rectum likely mucous production from pouch. frank stool per rectum would be concerning for a fistula, but no evidence of this. she was treated with stomadhesive powder as needed. she has follow-up with as an outpatient for continued management. anoxic brain injury: patient has been steadily improving following pea arrest. on admission to floor, exam notable for bilateral decreased strength. patient had a normal speach and swallow evaluation. she was seen by pt and ot who recommended continued therapy. her neuro exam continued to be nonfocal and improving. acute renal failure: patient with atn secondary to hypotensive event. creatinine has improved on cvvh. urine output was increasing, suggesting potential for renal recovery. hd started on . tunneled left subclavian hd line placed on . her urine output has continued to increase daily, suggesting that she may not be perminantly dialysis dependent. she will continue to be followed by renal on this issue. additionally, ir was contact prior to discharge and confirmed her tunnelled line could be pulled if her kidneys fully recover, despite her therapeutic inr. this will be coordinated by her renal follow-up. hypertension: her antihypertensives initially held in setting of hypotension from pe. blood pressure was then trending up. she was started on metoprolol that was uptitrated to 50 mg tid. she was discharged on toprol xl. her ace was held. she should restart on an ace-i as an oupatient once cr stabilizes for protection in setting of cri and hypertension benefit. positive ua: patient had ua with numerous wbc, likely atn. now making urine. culture grew yeast. foley was discontinued and repeat ua did not indicate infection. thrombocytopenia: patient's platelets trending down initially but then normalized. drop was likely secondary to consumption as it resolved while on heparin and ppi. shock liver: secondary to hypoperfusion. her lfts have been improving daily and then normalized. diabetes: metformin was held while inpatient. she was started on an insulin sliding scale and glargine was uptitrated as needed. upon discharge, she continued on the insulin sliding scale with plan to restart metformin if kidneys recover in the future. contact: son , medications on admission: valsartan 320 mg daily simvastatin 40 mg tablet sig: one (1) tablet po daily omeprazole 20 mg daily nifedipine 30 mg daily metoprolol tartrate 50 mg hydrochlorothiazide 12.5 mg daily lisinopril 40 mg daily metformin 850 mg twice a day. acetaminophen 500 mg, 1-2 tablets po q6h as needed aspirin 81 mg once a day discharge medications: 1. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 2. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed. 3. metoprolol succinate 100 mg tablet sustained release 24 hr sig: 1.5 (one and a half) tablet sustained release 24 hrs po once a day. 4. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed. 5. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day) as needed for constipation. 6. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily). 7. b complex-vitamin c-folic acid 1 mg capsule sig: one (1) cap po daily (daily). 8. insulin lispro 100 unit/ml solution sig: u u subcutaneous four times a day: per sliding scale. 9. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 10. outpatient lab work inr check prn for warfarin dosing; bun, creatinine daily faxed to # , attn: dr. 11. line care heparin flush (5000 units/ml) 4000- unit dwell prn line flush. dialysis catheter (tunneled 2-lumen): dialysis nurse only: withdraw 4 ml prior to flushing with 10 ml ns followed by heparin as above according to volume per lumen. 12. warfarin 2.5 mg tablet sig: one (1) tablet po once daily at 4 pm. 13. calcium carbonate 500 mg tablet, chewable sig: one (1) tablet, chewable po bid (2 times a day): with meals. 14. insulin dosing insulin sc sliding scale & fixed dose. fingerstick qachs. insulin sc fixed @ bedtime: glargine 10 units. humalog sc sliding scale @ breakfast, lunch, dinner, bedtime: glucose and insulin dose, 0-65mg/dl 1 amp d50, 66-120mg/dl 0 units, 121-160mg/dl 2 units, 161-200mg/dl 4 units, 201-240mg/dl 6 units, 241-280mg/dl 8 units, 281-320mg/dl 10 units, 321-361mg/dl 12 units, > 361mg/dl notify m.d. *** instructons for npo patients: use insulin dosing *** discharge disposition: extended care facility: high gate manor discharge diagnosis: saddle pulmonary embolism pulseless-electrical activity arrest anoxic brain injury acute renal failure hepatic shock atrial fibrillation hypertension thrombocytopenia diabetes discharge condition: stable. discharge instructions: you were admitted because you had a blood clot in your lungs. this clot caused your heart to stop. we were able to restart your heart, but your kidneys, liver, and brain were damaged during the time when your heart was not beating. all three of these organs, however, seem to be recovering. you will need dialysis to replace the function lost in your kindeys. by the time of discharge, you kidneys were recovering and you will likely not be on dialysis permanently. please keep all scheduled appointments. please take all medications as prescribed. seek medical advice if you notice fevers, chills, difficulty breathing, chest pain, bleeding that doesn't stop or any other symptoms that are concerning to you. followup instructions: renal: thursday with dr. . rehab will be contact with timing of appointment next week. primary care: provider: , md phone: date/time: 2:00 obgyn: provider: , md phone: date/time: 1:00 surgery: provider: , md phone: date/time: 3:15 procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube enteral infusion of concentrated nutritional substances hemodialysis injection or infusion of thrombolytic agent venous catheterization for renal dialysis venous catheterization for renal dialysis arterial catheterization transfusion of packed cells cardiopulmonary resuscitation, not otherwise specified diagnoses: anemia in chronic kidney disease hypocalcemia subendocardial infarction, initial episode of care acute kidney failure with lesion of tubular necrosis acute posthemorrhagic anemia acute and subacute necrosis of liver iron deficiency anemia secondary to blood loss (chronic) hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified atrial fibrillation chronic kidney disease, unspecified acute respiratory failure hypotension, unspecified cardiac arrest disorders of phosphorus metabolism long-term (current) use of insulin other specified surgical operations and procedures causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation iatrogenic pulmonary embolism and infarction anticoagulants causing adverse effects in therapeutic use other and unspecified coagulation defects diabetes with other specified manifestations, type ii or unspecified type, uncontrolled disorders of magnesium metabolism epistaxis exostosis of unspecified site 

Answer: The patient is high likely exposed to