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: right avf thrombosis major surgical or invasive procedure: avf revision/thrombectomy history of present illness: 86m with esrd on hd admitted for fistula thrombectomy, which occurred yesterday, now with systolic bp in 70s at dialysis, chest pain, ekg changes with st depressions in v3-v5. sbp rose to 100s after ivf. at hd, 1l taken off, bp dropped to 70s, fistula was used. cp started at noon, didn't resolve after 2 hours. cards did a bedside echo which showed normal wall motion, rec no need for ccu. pt still having l arm numbness. per renal, ok to use hd catheter as fistula is now working for hd. . pt states that chest pain is substernal, worse with deep inspiration, feels like a hammer pounding into his chest. does have some numbness in his l arm which he says is intermittent. chest pain has stayed constant since its onset around noon. pt's bp dropped at hd last saturday to 60s-70s rn (per records, in 80s) but he did not have any chest pain. feels that his chest pain is similar to chest pain in past that resulted in cabg x4. the most exertion pt performs at home is climbing a flight of stairs, which results in no chest pressure but he has been getting more short of breath. . per cards, no evidence of chf and no regional wall motion abnormalities on echo - appears dry. rec rate control and heparin for a fib. pt also has h/o nhl, s/p chemo and rituxan, and per oncologist is not active. . access includes 1 peripheral, r av fistula, groin hd catheter. pt also has not had bm x3 days, concern for gastric dilatation. . past medical history: cad s/p cabg x4 esrd with r avf htn hyperlipidemia non-hodgkin's lymphoma prostate ca seizure d/o pvd lumbar stenosis and disk herniation social history: patient currently lives with his wife. : previous, quit 20 years ago. etoh: none illicits: none family history: patient currently lives with his wife. : previous, quit 20 years ago. etoh: none illicits: none physical exam: vitals: t- 98.9, tmx: 99.1 bp: 118/35 113-132/59-86 hr: 71 rr: 13-18 o2: 97-100% on 2l nc i/o: 690/140 los: +5229 . general: patient is an elderly male, + chronic sun exposure/hyperpigmented skin, pleasant, tired, in nad heent: ncat, eomi. op: + upper dentures. mmm, no lesions neck: jvp visible, approximately 6cm chest: mild course expiratory breath sounds, no focal rhonchi, wheezes, crackles anterior or laterally. posterior exam limited secondary to lying flat on back s/p removal of groin line cor: rrr, normal s1/s2. ii/vi systolic murmur, loudest at rusb abdomen: mildly distended, mildly tender diffusely but without rebound or guarding. notable abdominal "fullness", particularly periumbilical extremity: rue: dressing over fistula, c/d/i. sutures intact, no erythema. +thrill le: venodynes in place, + pedal edema pertinent results: admission labs: 01:33pm blood wbc-5.1 rbc-3.45* hgb-11.3* hct-33.7* mcv-98 mch-32.8* mchc-33.6 rdw-15.6* plt ct-158 02:05am blood pt-12.3 ptt-150* inr(pt)-1.1 01:24pm blood glucose-75 urean-120* creat-10.2*# na-135 k-7.8* cl-97 hco3-20* angap-26* 05:30pm blood calcium-8.4 phos-8.2*# mg-2.4 05:30pm blood ck(cpk)-55 pertinent labs/studies: ct chest/abdomen/pelvis 1. hyperenhancing left renal mass, which may represent lymphoma or rcc. 2. multiple new pulmonary nodules in the left lung as described. a three- month followup ct is recommended for assessment of stability. 3. left adrenal mass. 4. small bilateral pleural effusions . echo: conclusions: the left atrium is moderately dilated. no atrial septal defect is seen by 2d or color doppler. due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. the right ventricular cavity is dilated. right ventricular systolic function appears to be normal but views were technically limited. the aortic root is mildly dilated at the sinus level. the number of aortic valve leaflets cannot be determined. the aortic valve leaflets are mildly thickened. there is no aortic valve stenosis. no aortic regurgitation is seen. the mitral valve appears structurally normal with trivial mitral regurgitation. the pulmonary artery systolic pressure could not be determined. there is no pericardial effusion. impression: technically limited study due to poor acoustic windows. preserved global/regional left ventricular systolic function. right ventricle may be dilated but function appears normal. no structural valve disease. no pericardial effusion. . : chest pa/lat - findings: compared to , allowing for differences in technique and rotation, no acute process or significant interval change identified. . troponin: 0.56 () -> 0.38 () dilantin: () 2.9 - dilantin increased to 200mg after this level discharge labs . 06:05am blood wbc-6.2 rbc-3.23* hgb-10.3* hct-30.8* mcv-95 mch-31.9 mchc-33.6 rdw-16.5* plt ct-202 06:05am blood glucose-87 urean-29* creat-6.5*# na-141 k-3.8 cl-102 hco3-30 angap-13 brief hospital course: prior to floor transfer: patient is a 86m with esrd on hd admitted for fistula thrombectomy, which occurred , admitted to the micu after devloping systolic bp in 70s at dialysis, chest pain, ekg changes with st depressions in v3-v5. this was thought possibly to occur in the setting of blood loss related to av fistula thrombectoy. sbp rose to 100s after ivf. at hd, 1l taken off, bp dropped to 70s, fistula was used. cp started at noon, didn't resolve after 2 hours. cards did a bedside echo which showed normal wall motion, rec no need for ccu and to medically manage. the patient was initially covered with broad spectrum antibiotics including amp, cipro, flagyl which were eventually d/c given no evidence for infectious etiology of hypotension. . hospital course also notable for abdominal pain. given hct drop, ct c/a/p performed. no leaking aaa or similar seen, but a left renal mass was observed, possible concerning for recurrent lymphoma vs. rcc. per micu team, discussion with onc attending revealed that patient was likely not a candidate for further treatment at this time. . on the floor: 1. hypotension - as above, the likely etiology of the patient's hypotension was bleed from surgery. he was covered with antibiotics in the micu, but did not exhibit infection. on the floor the patient remained normotensive and eventally a low dose beta-blocker was added given his recent nstemi which he tolerated well. this was then changed to long acting toprol. patient would likely ultimately benefit from addition of an ace inhibitor as pressures allow. this can be added as an outpatient at the discretion of the patient's pcp. . 2. nstemi - as above, the patient experienced an nstemi in the setting of hypotension and hct drop. per cardiology, the patient was medically managed with asa, plavix, and statin without plan for acute intervention given the medical comorbidities. given his hypotension and bleed a beta-blocker and heparin drip were held. his blood pressure improved on the floor and he was started on a bb. he had no further events on the floor. consideration for follow-up with cardiology and potential stress test can be made as on outpatient. however, multiple co-morbidities may defer further evaluation or invasive procedures regardless. as above, the patient may additionally benefit from addition of an ace if his bp remains wnl. this may be started as an outpatient at the discretion of the patient's pcp and other treaters. . 2a. pafib - patient with history of pafib. patient is currently on toprol xl with normal heart rates. patient was not initiated on anti-coagulation given hct drop, and hypotension earlier this admission. consideration towards initiation of anti-coagulation should be performed as an outpatient after acute illness resolved with consideration towards embolic risk as well as malignancy and recent bleeding event, although this likely occurred in the setting of surgical procedure. . 3. anemia - the patient received 3u prbcs during the micu course, after his thrombectomy. on the floor his hematocrit remained stable and was closely followed and his iron studies revealed a component of anemia of chronic disease. his stabilized by the time of discharge. . 4. renal mass - the patient's renal mass is concerning for recurrent lymphoma vs. rcc. per conversation with micu team, the patient's treating oncologist is aware of the renal mass and is being followed. pulmonary and liver nodules, on ct are new however since last imaging. unfortunately, given multiple medical comorbidities, patient not thought to be a likely candidate for therapy regardless of etiology. he will have ongoing follow-up with his oncologist as an outpatient. . 5. esrd on hd - the patient received dialysis with his new fistula with no complications. he remained stable at dialysis and had close care by the renal team. he will continue to receive dialysis as scheduled on mwf. . 6. seizure disorder - the patient was continued on phenytoin per outpatient regimen. his levels were sub-therapuetic with adjustment this admission. the patient should have levels repeated during his rehab stay with goal . if patient remains sub-therapeutic, his dilantin should be titrated as appropriate. he remained seizure free during his course. continuation of this medication can be re-addressed as an outpatient given notes which indicate thoughts towards discontinuing this medication. . 7. dispo: the patient was discharged to nursing facility for ongoing rehabilitation . 8. code status: patient is dnr/dni, this was confirmed with the patient and his wife this admission medications on admission: doxepin 25mg qhs lisinopril 10mg omeprazole 20mg phenytoin 100mg simvastatin 20mg daily pentoxifylline 400mg daily quinine 260mg daily temazepam 15mg discharge medications: 1. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po twice a day. 2. phenytoin sodium extended 100 mg capsule sig: two (2) capsule po bid (2 times a day). 3. atorvastatin 80 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 4. pentoxifylline 400 mg tablet sustained release sig: one (1) tablet sustained release po q24h (every 24 hours). 5. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4-6h (every 4 to 6 hours) as needed for prn pain. disp:*30 tablet(s)* refills:*0* 6. senna 8.6 mg tablet sig: 1-2 tablets po bid (2 times a day). disp:*45 tablet(s)* refills:*2* 7. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*2* 8. aspirin, buffered 325 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 9. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 10. calcium acetate 667 mg capsule sig: one (1) capsule po tid w/meals (3 times a day with meals). disp:*90 capsule(s)* refills:*2* 11. aluminum-magnesium hydroxide 225-200 mg/5 ml suspension sig: 15-30 mls po qid (4 times a day) as needed for nausea. 12. polyvinyl alcohol-povidone 1.4-0.6 % dropperette sig: drops ophthalmic prn (as needed). 13. metoprolol succinate 25 mg tablet sustained release 24hr sig: one (1) tablet sustained release 24hr po daily (daily). 14. nitroglycerin 0.4 mg tablet, sublingual sig: one (1) tablet, sublingual sublingual prn (as needed) as needed for chest pain: may repeat upto 3 times every 5 minutes. 15. prochlorperazine 10 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for nausea. discharge disposition: extended care facility: rehab hospital discharge diagnosis: primary: 1. rue av fistula thrombosis. 2. nstemi 3. hypotension nos. 4. new 4.6 x 4.8 cm left renal mass. 5. new 3.5 x 3 cm left adrenal mass. 6. multiple new left pulmonary nodules. 7. ckd stage v on hd 8. blood loss anemia. secondary: 1. low grade nhl. 2. seizure d/o nos. 3. cad s/p cabg. 4. htn. 5. prostate ca discharge condition: stable. tolerating oral medications and nutrition discharge instructions: 1. call transplant office if fever, chills, nausea, vomiting, decreased urine output, diarrhea, weight gain of 3 pounds in a day, edema or redness/bleeding/pain at incision. malfunction of av fistula, bleeding/redness/increased drainage at fistula or numbness/discoloration or increased swelling in right arm continue hd m-w-f. . please take all medications as directed. . please make and attend the recommended follow-up appointments followup instructions: scheduled appointments : . please call the office of your primary care physician to make an to be seen within one to two weeks. . you have an with your oncologist, dr. , md. is on at 09:30, located on 9. please call his office at at your convenience if you have any scheduling needs or questions. . you have an with dr. from the division of transplant surgery. your is on at 3:00. please call his office at with any questions or scheduling needs. . please call the office of your nephrologist, dr. e. reyad to make an for follow up. procedure: hemodialysis venous catheterization for renal dialysis transfusion of packed cells revision of arteriovenous shunt for renal dialysis diagnoses: chronic kidney disease, stage v hyperpotassemia anemia in chronic kidney disease subendocardial infarction, initial episode of care coronary atherosclerosis of native coronary artery atrial fibrillation aortocoronary bypass status peripheral vascular disease, unspecified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease other and unspecified hyperlipidemia other malignant lymphomas, unspecified site, extranodal and solid organ sites epilepsy, unspecified, without mention of intractable epilepsy other complications due to renal dialysis device, implant, and graft hypotension of hemodialysis 

Answer: The patient is high likely exposed to