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: bactrim ds attending: chief complaint: revision r tha / orif peri-prosthetic femur fx major surgical or invasive procedure: revision r tha / orif peri-prosthetic femur fx history of present illness: ms. is an 84 yo female with hx of severe as (0.8-1.0cmsq), pulm htn, r tha ' who was transferred from with vancouver b periprosthetic fx of r femur around tha with failed femoral component. both geriatrics and cardiology consults were obtained to assist with perioperative management. echocardiogram was performed today and showed normal ef and moderate to severe as as above. pa pressure monitoring was recommended during surgery as was blood transfusion with careful diuresis. of note, the patient had undergone pulmonary evaluation for pre-op risk for possible elective aortic valve replacement given significant limitations in functional status as well as recent episode of chf . . she underwent surgical repair which was extensive given degree of osteoporosis and fracture. surgery lasted for 8+ hrs. during the surgery she lost approx 2 l blood, received 6 units prbcs, 6l of crystalloid and maintained a cvp 7-10 without requiring pressor support. she was transferred to the icu for close post-operative monitoring. . ros: the patient is unable to provide ros given sedation. past medical history: - aortic stenosis: last echo with valve area of 0.9cm sq. ef 55% - pulm htn, mild per echo in - ? copd, pfts with increased diffusion capacity, has been on spiriva - htn - hyperlipidemia - lumbar spinal stenosis - arthritis, ? ra - glaucoma - depression - osteoporosis - breast ca s/p l mastectomy in , took tamoxiphen, no recurrence - ibs - hiatal hernia surgeries: -tah/bso (irregular bleeding) right hip fracture, pinned. -diverticulitis-resected with temporary colostomy, reanastomosis -left mastectomy. -abdominal hernia repair. right hip replacement. -pelvic fracture. -right arm fracture, open reduction, internal fixation. social history: widowed. moved from to , the gables in . has supportive children. limited in adls, uses walker. past h/o of tobacco 22yrs of ppd, none currently, denies etoh family history: father with cardiovascular disease. no h/o thromboses physical exam: tmax: 37.1 ??????c (98.8 ??????f) tcurrent: 36.5 ??????c (97.7 ??????f) hr: 104 (80 - 104) bpm bp: 129/60(89) {99/41(63) - 147/111(117)} mmhg rr: 23 (8 - 24) insp/min spo2: 95% (2l) heart rhythm: st (sinus tachycardia) height: 60 inch gen: nad heent: perrl, sclera anicteric, mmm, op clear neck: no jvd, no cervical lymphadenopathy, trachea midline cor: rrr, 3/6 sem > rusb-late peaking, normal s1/s2,radial pulses +2 pulm: intubated, lungs ctab, no w/r/r abd: soft, nt, nd, +bs, no hsm, no masses ext: r hip in abduction pillow. 2 drains at surgical site. feet cool but pulses 2+ b/l. no edema. skin: no jaundice or rash brief hospital course: assesment: this is an 84 year-old female with a history of mod-severe as (valve area 0.8-1.0), mild copd, pulm htn, osteoporosis s/p repair of periprosthetic fracture of the right femur. . brief summary of icu course: # right periprosthetic femur fracture: s/p surgical repair today (r tha femoral component w/ fixation r femur) - lovenox initiated for dvt ppx - abx for 24 hr - ancef - hip abduction pillow/brace - pain control - repeat hip/femur x-ray - monitor uop . #respiratory failure: the patient was intubated post-op. the pat has been given >8l fluids intra-op and post-op. pt with history of severe as and given volume status may be difficulty weaning from vent. however, cxr in the am did not show increasing pulmonary edema. the patient as weaned from the ventilator and sucessfully extubated on . the patient was placed on nasal cannula and was weaned down to her basline o2 requirement of 2l. . #hypotension: the patient was transferred to the icu intubated post-op. she was given sedation and her map dropped to the 50's. she was given ivf bolus and 0.4 narcan and her pressures responded. on the patient was hypotensive and placed on phenylepherine. they were able to be weaned for 3 hours, but she became hypotensive with maps in the 50's. she was given a fluid bolus with little response and placed back on phenylepherine overnight. she was sucessfully weaned off pressors the next morning. her blood pressures remained at a baseline sbp 110-120's off pressors and mentating well. the patient's urine output remained 30-40cc/hrs throughout her admission to the icu. . # anemia: the patient had ~2l ebl and was given 6u prbcs given in or. her hct was 23.1 and was transfused 1uprbc on and an additional 1u prbc on . - monitor crit . # aortic stenosis (mod-severe - valve area 0.8-1.0cmsq): seen by cardiology pre-op. received prbc transfusion prior to surgery, b-blocker continued perioperatively. did well during surgery w/ cvp 7-10 and sbp 100-110 without need for pressors. the patient's cvp was maintained >7 and maps were maintained > 65 with fluid and pressors. the patient was followed by cardiology. long term plan for elective av replacement. . # copd - mild by pfts. poor respiratory reserve felt to be secondary to as/cardiac the patient was continued on flovent and albuterol prn. . # osteoporosis - vitd/ca post-op and cont. bisphosphonate . # gerd -continue ppi . # fen: cardiac diet, monitor volume status closely given as, replete lytes prn . # ppx: lovenox post-op, bowel regimen, ppi . # access: r subclavian cvl was pulled on dueto the line being in vertebral vein. a new rik was placed on , a-line, piv x 2 . # code: full code per medical record, will confirm with family in am . # comm: (daughter): ( . brief summary of floor course: the patient was transferred to the floor on where she continued to do well. on she was deemed safe for discharge to rehabilitation. at the time of discharge the patient was tolerating a regular diet and feeling well. the patient was afebrile with stable vital signs. the patient's hematocrit was stable, and the patient's pain was adequately controlled on a po regimen. the operative extremity was neurovascularly intact and the wound was benign. the patient was discharged to rehabilitation in a stable condition. the patient's weight-bearing status was touchdown weight bearing on the rle. she is to be in a hip abduction pillow when in bed. when out of bed, she should be in her hip abduction brace with hip abducted to 30 degrees. medications on admission: medications: home meds per omr: albuterol 90mcg hfa 2 puffs prn atenolol 100mg daily brimonidine 0.15% drops 1gtt ou celexa 20mg daily flovent hfa 110mcg 2 puffs floanse 50mcg spary furosemide 20mg daily lisinopril 20mg daily lorazepma 0.5mg prn anxiety risedronate 35mg qwk simvastatin 20mg daily asa 81mg daily . on transfer: furosemide 20 mg po daily latanoprost 0.005% ophth. soln. 1 drop both eyes hs acetaminophen 650 mg po q6h lisinopril 10 mg po daily albuterol mdi 2 puff ih q4h:prn cough morphine sulfate 2-4 mg iv q4h:prn pain amlodipine 5 mg po daily multivitamins 1 tab po daily aspirin 81 mg po daily ondansetron 4 mg iv q8h:prn nausea/vomiting atenolol 50 mg po daily oxycodone (immediate release) 5-10 mg po q4h:prn pain bisacodyl 10 mg pr hs:prn pantoprazole 40 mg po q24h brimonidine tartrate 0.15% ophth. 1 drop both eyes cefazolin 2 gm iv q8h duration: 3 doses first post-op dose administered 2 hours after entering pacu for a combined total of 3 doses risedronate *nf* 35 mg oral sat citalopram hydrobromide 20 mg po daily senna 1 tab po bid:prn enoxaparin sodium 40 mg sc qpm simvastatin 20 mg po daily fluticasone propionate 110mcg 2 puff ih discharge medications: 1. acetaminophen 325 mg tablet sig: two (2) tablet po q6h (every 6 hours). 2. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 3. simvastatin 10 mg tablet sig: two (2) tablet po daily (daily). 4. albuterol 90 mcg/actuation aerosol sig: two (2) puff inhalation q4h (every 4 hours) as needed for cough. 5. risedronate 35 mg tablet sig: one (1) tablet po sat (). 6. fluticasone 110 mcg/actuation aerosol sig: two (2) puff inhalation (2 times a day). 7. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 8. multivitamin tablet sig: one (1) tablet po daily (daily). 9. enoxaparin 40 mg/0.4 ml syringe sig: one (1) syringe subcutaneous once a day for 3 weeks: to be followed by aspirin 325mg daily for 3 weeks. 10. brimonidine 0.15 % drops sig: one (1) drop ophthalmic (2 times a day). 11. oxycodone 5 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed for pain. 12. latanoprost 0.005 % drops sig: one (1) drop ophthalmic hs (at bedtime). 13. citalopram 20 mg tablet sig: one (1) tablet po daily (daily). 14. aluminum-magnesium hydroxide 225-200 mg/5 ml suspension sig: 15-30 mls po qid (4 times a day) as needed. 15. calcium carbonate 500 mg tablet, chewable sig: one (1) tablet, chewable po tid (3 times a day). 16. cholecalciferol (vitamin d3) 400 unit tablet sig: two (2) tablet po daily (daily). 17. travatan 0.004 % drops sig: one (1) ophthalmic daily (). 18. furosemide 20 mg tablet sig: one (1) tablet po daily (daily). 19. atenolol 50 mg tablet sig: one (1) tablet po daily (daily). 20. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day). 21. bisacodyl 10 mg suppository sig: one (1) suppository rectal hs (at bedtime): hold once constipation resolves. 22. lisinopril 5 mg tablet sig: one (1) tablet po daily (daily). discharge disposition: extended care facility: - discharge diagnosis: r periprosthetic femur fracture discharge condition: stable discharge instructions: experience severe pain not relieved by medication, increased swelling, decreased sensation, difficulty with movement, fevers >101.5, shaking chills, redness or drainage from the incision site, chest pain, shortness of breath or any other concerns. 2. please follow up with your pcp regarding this admission and any new medications and refills. 3. resume your home medications unless otherwise instructed. 4. you have been given medications for pain control. please do not operate heavy machinery or drink alcohol when taking these medications. as your pain improves, please decrease the amount of pain medication. this medication can cause constipation, so you should drink plenty of water daily and take a stool softener (e.g., colace) as needed to prevent this side effect. 5. you may not drive a car until cleared to do so by your surgeon or your primary physician. 6. please keep your wounds clean. you may get the wound wet or take a shower starting 5 days after surgery, but no baths or swimming for at least 4 weeks. no dressing is needed if wound continues to be non-draining. any stitches or staples that need to be removed will be taken out by a visiting nurse at 2 weeks after your surgery. 7. please call your surgeon's office to schedule or confirm your follow-up appointment at 4 weeks. 8. please do not take any nsaids (i.e. celebrex, ibuprofen, advil, motrin, etc). 9. anticoagulation: please continue your lovenox for 3 weeks to prevent deep vein thrombosis (blood clots). after completing the lovenox, please take aspirin 325mg daily for an additional three weeks. 10. wound care: please keep your incision clean and dry. it is okay to shower after pod#5 but do not take a tub-bath or submerge your incision until 4 weeks after surgery. please place a dry sterile dressing on the wound each day if there is drainage, otherwise leave it open to air. check wound regularly for signs of infection such as redness or thick yellow drainage. staples will be removed by vna in 2 weeks. if you are going to rehab, the rehab facility can remove the staples at 2 weeks. 11. vna (once at home): home pt/ot, dressing changes as instructed, wound checks, and staple removal at 2 weeks after surgery. 12. activity: touch down weight bearing on the operative leg. hip abduction pillow when in bed, hip abduction brace abducted to 30 degrees when out of bed. no strenuous exercise or heavy lifting until follow up appointment. physical therapy: touch down weightbearing rle. hip abduction pillow when in bed. hip abduction brace abducted to 30 degrees when out of bed. treatments frequency: physical therapy. lovenox injections. wound checks. vna to remove staples at 2 weeks. followup instructions: please call to schedule a follow up appointment with dr . provider: , md phone: date/time: 1:00 cc: md procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours open reduction of fracture with internal fixation, femur transfusion of packed cells revision of hip replacement, femoral component hip bearing surface, ceramic-on-ceramic diagnoses: other iatrogenic hypotension esophageal reflux congestive heart failure, unspecified unspecified essential hypertension acute posthemorrhagic anemia chronic airway obstruction, not elsewhere classified aortic valve disorders other chronic pulmonary heart diseases personal history of malignant neoplasm of breast unspecified glaucoma depressive disorder, not elsewhere classified diaphragmatic hernia without mention of obstruction or gangrene osteoporosis, unspecified osteoarthrosis, unspecified whether generalized or localized, site unspecified other constipation obesity, unspecified chronic diastolic heart failure insomnia, unspecified peri-prosthetic fracture around prosthetic joint hip joint replacement acquired absence of both cervix and uterus irritable bowel syndrome spinal stenosis, lumbar region, without neurogenic claudication acquired absence of breast and nipple noncollision motor vehicle traffic accident while boarding or alighting injuring passenger in motor vehicle other than motorcycle mechanical loosening of prosthetic joint 

Answer: The patient is high likely exposed to