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: outside hospital transfer for "stable nstemi" - unstable stemi when patient got to floor major surgical or invasive procedure: cardiac catheterization with 2 bare metal stents central venous access placement with swan-ganz catheter picc placement intra-aortic balloon pump placement endotracheal tube intubation left lower extremity fasciotomy left lower extremity surgical debridement ir guided tunneled catheterization ir guided dobhoff feeding tube tracheotomy history of present illness: this is a 57 year old female with a history of htn, dm, hyperlipidemia, and osa who presented to on with 3 days of ha, sorethroat, myalgias, and epigastric pain with some associated nausea. upon arrival to the osh ed, she had a temp of 101. per report, initial ekg was non-diagnostic but cez were initially positive with cpk of 574, mb of 11.5, and tropi of 14.96. she denied chest pain initially and shortness of breath. she had several ecgs performed there, which show initial t wave inversions in lateral leads (10am, no symptoms), followed by an ecg with inferior st elevations with an rca (iii>ii) occlusion pattern that apparently occurred with chest pain. she was started on a nitro drip and integrillin. however, it appears that the st elevations were missed and she was transferred under the auspices of an "nstemi". she had also developed acute renal failure, with a creatinine rise from 1.2 to 3.1 on . . upon arrival at , she was found to be ashen in color, and hypotensive with blood pressure of 95-105/50s, with sats of 90-93% on 5lnc. an ecg was performed, which showed the same inferior ste, and at 2:45pm a code stemi was called and she was taken to the cath lab. in the cath lab, she was found to have diffuse multivessel disease with 70% distal thrombotic left main lesion, 60% rca, diffuse disease in the lad, and 60% rca. her culprit lesion was felt to be the distal lad lesion. while preparing for a diagnostic ivus of the lmca and prior to lad pci, the patient had an episode of hypotension, bradycardia, and hypoxia. she was intubated and received atropine, epinephrine, and emergency pacing with tempory pacer wire placed. started on dopamine and levophed. she received 1 bms to her lmca and 2 bms in her distal lad. a right iliac angioplasty was also performed. an iabp was placed. the levophed was able to be weened off and milrinone was started with an increase in ci from 1.5 to 2.1 l/min. . rest of ros unable to be obtained due to intubation. past medical history: htn hyperlipidemia osa on home o2 hypothyroidism iddm gerd anxiety/depression diastolic chf social history: lives with her daughter, no alcohol or smoking or illicits. family history: father with diabetes. mother died at age 78 due to bladder cancer. father with cva at age 73. physical exam: admission pe vs: 95.7, 94/51, 85, 91% ac 100%, peep 5, tv 500, rr 18 general: intubated and sedated. oriented x3. mood, affect appropriate. heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were pink, no pallor or cyanosis of the oral mucosa. no xanthalesma. diffuse facial edema neck: supple with jvp to jaw. cardiac: pmi located in 5th intercostal space, midclavicular line. rr, normal s1, s2. no m/r/g. no thrills, lifts. no s3 or s4. lungs: no chest wall deformities, scoliosis or kyphosis. resp were unlabored, no accessory muscle use. bilateral rales. abdomen: soft, ntnd. no hsm or tenderness. abd aorta not enlarged by palpation. no abdominial bruits. extremities: no c/c/e. no femoral bruits. skin: no stasis dermatitis, ulcers, scars, or xanthomas. pulses: right: carotid 1 femoral 1+ popliteal 1+ dp 1+ pt 1+ left: carotid 1+ femoral 1+ popliteal 1+ dp 1+ pt 1+ pertinent results: admission labs : cbc: wbc 13.6 hct 26.3 plt 232 chem: na 122 k 4.8 cl 88 hco3 17 bun 53 cr 3.3 glucose 402 lfts: alt 2166 ast 3287 ld 9435 ck 967 ap 119 tbili 0.5 coags: pt 16 ptt 150 inr 1.4 micro: leg deep wound cx: yeast, sensitive to fluconazole sputum cx: colonized with klebsiella and stenotrophomonas cdiff: negative bcx: negative imaging: c. cath comments: 1. coronary angiography in this co-dominant system revealed severe three vessel coronary artery disease. the lmca had a distal 70% thrombotic lesion. the lad had diffuse disease with a proximal 60% stenosis and serial 40-50% stenoses throughout the remainder of the vessel, which was approximately 2.25mm in diameter. the lcx had a 60% stenosis at the origin, with diffuse disease in the om1 and om2, which were approximately 2.0mm in diameter. the rca had a proximal 60% stenosis, with a long 50% stenosis in the mid-vessel, which was 2.5mm in diameter. the pda and pl were diffusely diseased and small. 2. resting hemodynamics revealed elevated left- and right-sided filling pressures with mean ra pressure of 31 mmhg and mean pcw pressure of 30 mmhg. there was moderate pulmonary hypertension, with systolic pa pressure of 48 mmhg. the cardiac output was low prior to intervention and placement of intra-aortic balloon pump at 2.85 l/min, and increased to 3.78 l/min following iabp placement and initiation of milrinone. 3. supravalvular aortography revealed no significant aortic insufficiency, aortic dilation, or aortic dissection. 4. distal aortography revealed diffuse severe disease with 50% stenosis below the renal arteries. the renal arteries themselves were single bilaterally and without significant stenosis. difficulty was encountered during passage of the access wire. iliac angiography revealed mild disease in the left common iliac artery, with a patent internal iliac artery and widely patent common femoral artery. the right common iliac artery had an 80% stenosis, and the right internal iliac artery was occluded. the right common femoral artery was widely patent. 5. successful ptca of the right cia stenosis with a 5.0x20mm admiral balloon. 6. successful direct stenting of the lmca with a 2.5x12mm vision stent. final angiography revealed no residual stenosis, no angiographically apparent dissection and timi iii flow. 7. successful direct stenting of the proximal and mid lad with a 2.25x28mm and a 2.25x28mm vision stents. final angiography revealed no residual stenosis, no angiographically apparent dissection and timi iii flow. 8. successful placement of a temporary pacing wire in the rv with pacing required to restore heart rate. 9. successful deployement of 30cc iabp. final diagnosis: 1. three vessel coronary artery disease. 2. cardiogenic shock with low cardiac output, managed by iabp. 3. acute inferior myocardial infarction, managed by ptca of vessel. 4. elevated left- and right-sided filling pressures. 5. aortic atherosclerosis with right iliac disease. 6. successful pta of the right cia stenosis. 7. successful pci of the lmca and lad. 8. successful deployment of iabp. . ct a/p ct abdomen without contrast: the lung bases reveal small bilateral pleural effusions and associated compressive atelectasis. atherosclerotic coronary calcifications are partially imaged. there is no evidence for pericardial effusion. limited non-contrast evaluation of the liver, spleen and adrenal glands is unremarkable. the pancreas demonstrates fatty atrophy but is otherwise unremarkable. contrast from recent intravenous administration persists within the kidneys and renal collecting system, which are enhanced symmetrically without hydronephrosis or hydroureter. a nasoenteric tube terminates in the duodenum. intra-abdominal loops of large and small bowel are of normal caliber and there is no pneumoperitoneum. mild ascites is noted, predominantly perihepatically and perisplenically. there are no pathologically enlarged mesenteric or retroperitoneal lymph nodes. severe atherosclerotic calcifications involve a hypoplastic aorta. ct pelvis with contrast: the rectum, sigmoid colon is unremarkable. the uterus is unremarkable. the bladder contains a foley and non-dependent air. a small amount of free pelvic fluid is noted. bone windows reveal no worrisome lytic or sclerotic osseous lesions. diffuse subcutaneous edema is identified. ct sinus impression: 1. no focal fluid collection or abscess identified. 2. anasarca with bilateral small pleural effusions and small ascites. the study and the report were reviewed by the staff radiologist. impression: extensive sinus soft tissue changes with high-density material in both ethmoid air cells and right frontal sinus, which could be secondary to blood. however, this could be due to inspissated secretions. presence of fungal colonization should be excluded by clinical correlation. tissue from left leg the specimen is received fresh labeled with the patient's name, " ", the medical record number and "left calf." it consists of multiple fragments of soft tissue and muscle which measure in aggregate 14 cm x 8 cm x 5 cm. the skin surface appears to be and grossly necrotic in areas. serial sectioning reveals necrotic appearing muscle and soft tissue. representative sections are submitted in cassettes a-c. 11:35 am tissue lt lateral calf. gram stain (final ): no polymorphonuclear leukocytes seen. 3+ (5-10 per 1000x field): budding yeast with pseudohyphae. reported by phone to # at 2:10pm. tissue (preliminary): albicans, presumptive identification. moderate growth. anaerobic culture (preliminary): no anaerobes isolated. right upper quadrant ultrasound: the liver is normal in echogenicity with no focal masses. layering sludge is seen within the gallbladder. there is no gallbladder wall thickening, distention, or fluid collections. the common bile duct measures 5 mm. impression: gallbladder sludge. no evidence of cholecystitis. echo the left atrium is mildly dilated. no atrial septal defect is seen by 2d or color doppler. left ventricular wall thicknesses and cavity size are normal. due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded (the distal lv and apex not well seen). overall left ventricular systolic function is probably low normal (lvef 50%). there is no ventricular septal defect. right ventricular chamber size and free wall motion are normal. the diameters of aorta at the sinus, ascending and arch levels are normal. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. trivial mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. there is borderline pulmonary artery systolic hypertension. there is a small pericardial effusion. there are no echocardiographic signs of tamponade. left calf debridement: skin with ulceration with underlying muscle and soft tissue with necrosis, acute and chronic inflammation and yeast and hyphal forms consistent with . mri spine: impression: study is somewhat limited by persistent patient motion artifact, as well as the lack of diffusion-weighted sequence, with: 1. no finding to specifically suggest anterior spinal cord infarction. 2. no evidence of acute spinal epidural or subdural hematoma, or other cord compressive process. 3. widely capacious spinal canal. 4. grossly unremarkable appearance to the thoracoabdominal aorta, with no focal aneurysmal dilatation or evidence of occlusion or significant stenosis. echo: the left atrium and right atrium are normal in cavity size. the right atrial pressure is indeterminate. left ventricular wall thicknesses are normal. there is mild regional left ventricular systolic dysfunction with distal apical hypokinesis. the remaining segments contract normally (lvef = 50 %). tissue doppler imaging suggests a normal left ventricular filling pressure (pcwp<12mmhg). right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. no mitral regurgitation is seen. the left ventricular inflow pattern suggests impaired relaxation. there is mild pulmonary artery systolic hypertension. there is an anterior space which most likely represents a fat pad. impression: regional dysfunction c/w distal lad disease. impaired left ventricular relaxation. mild pulmonary hypertension. emg: clinical interpretation: complex abnormal study. there is electrophysiologic evidence for a severe ongoing neurogenic process in all 4 extremities. given the severity of abnormalities in the lower extremities as compared to the upper, possibilites include critical illness neuropathy, with a superimposed acute focal process involving the anterior cell innervation to the lower extremities, as in an acute myelopathy. l tib/fib xray impression: no bony abnormality identified. discharge labs : cbc: wbc 9.8 hct 30.6 plt 367 chem: na 137k 4.6 cl 98 hco3 31 bun 14 cr 2.0 glucose 229 ca 8.4 mg 1.8 phos 3.3 brief hospital course: this is a 57 year old female with htn, dm, hyperlipidemia who presents with acute inferior stemi and cardiogenic shock. . # s/p st elevation mi: admitted with chest pain, went to cath lab, where cath revealed 70% rca proximal lesion with good flow and diffuse lmca and prox lad stenoses. she received 1 bms to her lmca and 2 bms in her distal lad. a right iliac angioplasty was also performed. during procedure, pt became bradycardic and nearly coded, requiring atropine and a temporary wire (dc'd on ). she was urgently intubated, and dopamine/milrinone was started. she was continued on asa, plavix, integrellin and statin however bb was held given hemodynamic instability. balloon pump dc'd on when pt was discovered to have lle compartment syndrome. she was on and off of her bb with pressors. eventually she required amiodarone for aflutter correction and this along with metoprolol both rate and rhythm controlled her. # acute on chronic systolic heart failure: pt was in cardiogenic shock with poor cardiac output, requiring pressors/inotropes and balloon pump, and became volume overloaded. balloon pump had to be d/c'd in the setting of lle compartment syndrome. she was eventually diuresed aggressively with cvvh, and was then felt to be volume depleted. she was eventually weaned off of pressors, her ef was largely preserved at 50%. she intermittently became hypotensive with acute blood loss s/p multiple lle debridment. she was intermittently requiring pressors and cvvh in this setting. she was eventually started on milrinone on hd days, and metoprolol was held to allow for large volume shifts associated with hd. #arrythmias: in nsr in the unit but had an episode of sinus arrest in cath lab. temp pacer in but now mostly native complexes, pacer removed . her heart rate ranged from tachycardic to normal sinus. she was observed to be at various times in atrial tachycardia, sinus tachycardia, atrial fibrillation, atrial flutter, the atrial tachycardia, atrial fibrillation, and atrial flutter eventually resolved with amiodarone on board. she remained in nsr for the remainder of her hospitalization. # acute renal failure: likely started before presentation to from poor forward flow from initial cardiogenic failure and probably exacerbated by 320 ccs of contrast recieved in cath lab. she developed muddy brown casts on urine analysis. due to hyperkalemia to 6.8 and anuria immediately post cath, she was treated with cvvhd for volume overload and hyperkalemia. she failed repeated trials off of crrt. eventually it was felt that she no longer required volume removal and she tolerated intermittent hd without pressors. likely now dialysis-dependent with oliguria, however renal consultants believe that urine output should be followed closely as she continues to have potential to regain renal function. # lle compartment syndrome: treated with removal of balloon pump and fasciotomy on . in this setting she developed rhabdomyolysis with a peak ck of >100,000. this eventually trended down to normal ranges with cvvh and fasciotomy. wound vac was placed by vascular surgery who observed her on a daily basis. she was debrided on and planned for closure however the wound was felt to be too big and not appropriate for grafting. at that time deep tissue cultures grew out albicans. vascular and plastics colaboratively decided to allow for healing by secondary intention (vs. graft placement). she was started on fluconazole, with duration of treatment for osteomyelitis given proximity of this deep tissue infection to bone. she received multple further debridments in the or and at the bedside. wound vac was in place on both leg wounds. she has follow up with vascular surgery and plastic surgery as outpt. # respiratory failure: likely due to acute pulmonary edema in the setting of cardiogenic failure. she required vent support and was given lasix and ultimately cvvhd for volume overload. after volume overload was corrected she eventually required less and less respiratory support, however as she was intubated for greater than 2 weeks, she was trach'd in the or. she eventually tolerated cpap, and trach mask. passy-muir trials were successful on . # elevated lfts: markedly elevated at admission. likely shock liver combined with rhabdo. statin was temporarily held. liver function tests eventually trended down on there own. they again started to trend upwards on fluconazole. however, she was also on amiodarone and high dose statin at that time. lfts should be followed as outpt and medications should be adjusted if lfts continue to trend upwards. # anemia: s/p 27 units prbc, 2 units fft, 2 units platelets, 2 units cryo. ms. had persistent anemia throughout her stay which required greater than many units of of prbc. dic, hemolysis, and anemia of chronic disease, were all worked up and considered as causes, and eventually hepatic dysfunction was settled on as the cause, given concomitant coagulopathy. as she stabilized from a hepatic perspective, she continued to have chronic anemia from renal disease, worsened by acute blood loss anemia due to leg debridment. currently receiving epo with hd. hct has been stable for several days. # gi bleed: on she was noted to have frankly melanotic stool. gi was called who felt she was oozing secondary to hepatic dysfunction. the melena resolved with iv protonix for 72 hours, and then . gi bleed self resolved. # id: in the setting of intermittent fevers and wbc elevations to the 30's she was empirically started on vanc and cefepime to cover skin flora infecting her leg. she was ruled out for c.diff several times and cultures never revealed a source aside from klebsiella in her sputum, and coag negative staph in her a-line (thought to be contaminant). her deep tissue cultures revealed albicans. id followed her and she was discharged only on at least a 30 day course of fluconazole, with instructions to follow up with id in 3 weeks to determine if abx regimen at that point is sufficient. monitoring of liver function, cbc, and markers of inflamation should be followed at rehab and faxed to the id doctor, dr. . # iddm: initially high bs on admission. she was initially treated with insulin gtt and then transitioned to long acting with iss. was consulted and recomended iss given her highly variable insulin clearance given her volatile renal function. once a regular hd schedule is begun, it is expected that her insulin requirements will stabilize. discharged on 12u lantus qam + humalog ssi. insulin sliding scale may be titrated as outpt to achieve glucose of 150-250. #lower extremity plegia - pt was in state of reduced mental status during the critical portion of her hospital course. when she aroused sufficiently to be able to participate in questioning and physical exam maneuvers it was discovered that she was unable to move either of her lower extremities and had minimal to no sensation in both. neurology was consulted. spinal mri showed no sign of anterior spinal infarct given h/o hypotension in setting of baloon pump. however, emg showed evidence of critical illness neuropathy with sign of anterior involvement. pt should be followed up with neurology as outpt in one month for reassesment of diagnosis and prognosis of lower extremity function. # fen: ms was fed through tube feeds. multiple feeding options were used throughout hospitalization, including og/ngt, dobhoff, and attempted peg placement which failed body habitus. thoracic surgery felt that laparoscopic g-tube placement was an option but that her medical issues should be optimized further before surgery, as they felt that this was somewhat risky. goal is to maintain an albumin of > 2.5 to be an operative candidate for peg placement. she was discharged with ability to take thin liquids and pureed foods. she also had a dobhoff tube placed in the stomach for additional tube feeds. oral intake should be encouraged. medications should not be administered through ngt, as it tends to clog. please administer medications crushed in puree orally. medications on admission: clonidine 0.3mg patch qwk lasix 40mg po bid diovan 320mg po daily zaroxolyn 2.5mg po daily asa 81mg po daily prozac 20mg po daily levothyroxine 100mcg po daily prilosec 20mg po daily atenolol 100mg po daily zocor 80mg po daily meclizine 2.5mg po daily potassium 10meq po daily novolog iss lantus 30 units qhs vit d 50k units qwk discharge medications: 1. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily): for at least one year (), if possible. 2. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 3. docusate sodium 50 mg/5 ml liquid sig: 10 ml (100 mg) po bid (2 times a day). 4. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily). 5. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day). 6. ferrous sulfate 300 mg (60 mg iron)/5 ml liquid sig: five (5) ml (300 mg) po bid (2 times a day). 7. atorvastatin 80 mg tablet sig: one (1) tablet po daily (daily). 8. amiodarone 200 mg tablet sig: one (1) tablet po daily (daily). 9. fluconazole 200 mg tablet sig: one (1) tablet po q24h (every 24 hours): started , to continue at least 30 days. f/u id recs at outpatient appointment. on hd days, please administer dose after hd. . 10. pantoprazole 40 mg iv q12h 11. heparin flush (10 units/ml) 2 ml iv prn line flush picc, heparin dependent: flush with 10ml normal saline followed by heparin as above daily and prn per lumen. 12. insulin lispro 100 unit/ml solution sig: per sliding scale subcutaneous asdir (as directed). 13. insulin glargine 100 unit/ml solution sig: twelve (12) units subcutaneous qam: titrate as needed. 14. heparin (porcine) 5,000 unit/ml solution sig: 4000- unit dwell injection prn (as needed) as needed for 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. 15. outpatient lab work please check weekly cbc with diff and lfts and fax to dr. at . start: thursday 16. outpatient lab work please check crp and esr monthly and fax results to dr. at . start date: 17. fluconazole 200 mg tablet sig: one (1) tablet po q24h (every 24 hours) for 30 days. 18. fentanyl 12 mcg/hr patch 72 hr sig: one (1) patch 72 hr transdermal q72h (every 72 hours). 19. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po tid (3 times a day): please hold the night dose prior to hd days and all doses on hd days. thanks. 20. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for fever. 21. albuterol sulfate 90 mcg/actuation hfa aerosol inhaler sig: six (6) puff inhalation q4h (every 4 hours) as needed for wheezing. 22. calcium acetate 667 mg capsule sig: two (2) capsule po tid w/meals (3 times a day with meals). 23. dextrose 50% 12.5 gm iv prn hypoglycemia protocol 24. heparin flush (10 units/ml) 2 ml iv prn line flush picc, heparin dependent: flush with 10ml normal saline followed by heparin as above daily and prn per lumen. 25. lactulose 10 gram/15 ml syrup sig: thirty (30) ml po q8h (every 8 hours) as needed for constipation. 26. midodrine 5 mg tablet sig: two (2) tablet po tid (3 times a day): three doses to be given once the night prior to hd, once am of hd, and one dose post-hd. 27. morphine sulfate 2-4 mg iv q4h:prn pain hold for sedation or sbp < 95 , rr < 10, 28. ranitidine hcl 15 mg/ml syrup sig: one y (150) mg po daily (daily). 29. sodium bicarbonate 650 mg tablet sig: one (1) tablet po q8h (every 8 hours) as needed for clogged ngt. 30. amylase-lipase-protease 30,000-8,000- 30,000 unit tablet sig: one (1) tablet po q8h (every 8 hours) as needed for clogged ngt. discharge disposition: extended care facility: medical center - discharge diagnosis: primary diagnoses stemi cardiogenic/distributive shock left lower extremity compartment syndrome discharge condition: the patient is hemodynamically stable without any pressor requirement. she tolerates her tracheotomy well and successfully passed a passy-muir placement trial. her neurologic status is difficult to determine; the patient generally responds to simple commands but is intermittently either uncooperative or otherwise nonresponsive to questioning. she moves both upper extremities and her head spontaneously but has not been noted to have spontaneous movement of either lower extremity during this hospitalization. discharge instructions: ms. was seen at for st-elevation myocardial infarction complicated by shock. she spent an extended period of time in the hospital's intensive care unit for treatment of shock. an intra-aortic balloon pump was initially placed to aid heart flow but this led to a complication of left lower extremity compartment syndrome, which necessitated surgery on the left leg. mrs. required mechanical ventilation for respiratory failure. because she was intubated for a prolonged time, a tracheostomy was placed with a special valve so she could talk through her tracheostomy hole. additionally, her hospital course was complicated by acute renal failure. she required regular dialysis during her hospitalization and it is felt that she will be dependent on dialysis from this point. she will need continued wound care for the left leg, and is followed by vascular and plastic surgery. an ultimate plan has not been decided as to how her wound will be closed at this time; she will need to follow up with these services as an outpatient. during her hospital course, mrs. was found to have severe lower extremity weakness. she was seen by the neurologists who believe that her weakness is due from her prolonged critical illness. however, during her heart attack she may have suffered from a stroke in the spinal cord. she will need to be followed by neurology as an outpatient. during surgical debridement, her deep tissue culture was found to grow out albicans, sensitivities pending. per the recommendations of our infectious disease specialists, she was placed on fluconazole, with instructions to continue for at least 3 weeks through her next outpatient appointment, at which time further recommendations will be made regarding duration of treatment. while on the fluconazole, she will need to have weekly monitored blood work with cbc with differential and lfts. she will need continued dialysis, most likely three times a week. many changes were made to mrs. medication regimen. please see attached sheet for medication administration. please return to the emergency room or call mrs. physician if she develops increased lower extremity pain or discharge, fevers, chest pain, shortness of breath or any other concerning symptom. followup instructions: vascular surgery - please follow up with dr. on at 10:15. . suite 5c. please call with questions. plastic surgery - please follow up at the plastic surgery clinic on at 3:00pm. infectious disease - follow up should be scheduled with dr. on at 10am. please call with questions. neurology - follow up should be scheduled with dr. in 1 month. clinic should call with appointment date/ time. phone number: ( procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of non-drug-eluting coronary artery stent(s) insertion of non-drug-eluting coronary artery stent(s) combined right and left heart cardiac catheterization coronary arteriography using two catheters insertion of endotracheal tube enteral infusion of concentrated nutritional substances hemodialysis angioplasty of other non-coronary vessel(s) arteriography of femoral and other lower extremity arteries venous catheterization for renal dialysis percutaneous [endoscopic] gastrostomy [peg] insertion of temporary transvenous pacemaker system temporary tracheostomy fasciotomy excisional debridement of wound, infection, or burn aortography implant of pulsation balloon arteriography of other intra-abdominal arteries pulmonary artery wedge monitoring insertion of non-drug-eluting peripheral (non-coronary) vessel stent(s) bronchoscopy through artificial stoma revision of tracheostomy excision of lesion of muscle transposition of cranial and peripheral nerves insertion of two vascular stents excision of lingual thyroid percutaneous transluminal coronary angioplasty [ptca] procedure on single vessel insertion of three vascular stents procedure on two vessels diagnoses: thrombocytopenia, unspecified anemia in chronic kidney disease end stage renal disease coronary atherosclerosis of native coronary artery esophageal reflux congestive heart failure, unspecified friedl?nder's bacillus infection in conditions classified elsewhere and of unspecified site acute and subacute necrosis of liver acute kidney failure, unspecified unspecified protein-calorie malnutrition unspecified acquired hypothyroidism hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease dysthymic disorder acute respiratory failure defibrination syndrome cardiogenic shock cardiac catheterization as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure other complications due to other cardiac device, implant, and graft acute myocardial infarction of inferolateral wall, initial episode of care surgical operation with implant of artificial internal device causing abnormal patient reaction, or later complication,without mention of misadventure at time of operation other specified complications of procedures not elsewhere classified ventilator associated pneumonia accidents occurring in residential institution diastolic heart failure, unspecified candidiasis of skin and nails dependence on respirator, status other bone involvement in diseases classified elsewhere other tracheostomy complications nontraumatic compartment syndrome of lower extremity atherosclerosis of other specified arteries diabetes with other specified manifestations, type i [juvenile type], not stated as uncontrolled dermatophytosis of other specified sites acute osteomyelitis, lower leg 

Answer: The patient is high likely exposed to