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: hypertensive emergency. major surgical or invasive procedure: none. history of present illness: mrs. is a 72 yo woman with a h/o poorly controlled htn, cri (recent baseline 3.5-4.2), and dm2 who presented with hypertension and chest pain. she was recently admitted to the medicine service from - for peripheral extremity tingling and shortness of breath. during this admission, she was ruled out for an mi, transfused 2 units prbc for anemia, and spironolactone was stopped secondary to hyperkalemia. over the past few days at home, she c/o a sore throat, cough and congestion. she states that her husband has similar sxs. her cough is productive of whitish sputum. she has not had any fevers or sweats, but c/o chills. she c/o several months of doe with climbing 10 steps at her home, worse when she is carrying her laundry. at these times, she also c/o left sided cp which is dull in nature, nonradiating, and lasts for up to one minute. her last episode was last night. she does not c/o pnd/orthopnea. she had increased bilateral le edema over the past few days and came into the ed for evaluation. she states her appetite has been poor recently and she has lost lbs over the past few months. she c/o nausea but no emesis. no bleeding from her stools. she c/o dysuria, no hematuria, no decreased frequency or quantity of urine. she also has constipation and complains of gas. she has a right inguinal hernia which has been more bothersome lately. she does not c/o ha, abdominal pain, or focal neurologic sxs. in the ed, her bp was initially 210/120. she was given lopressor 5 mg iv x 3, 25 mg po x 1, asa 325 mg po x 1, clonidine 0.2 mg po x 1 and then started on a labetolol gtt at 2 mg/min which was subsequently increased to 4 mg/min. she was then given lisinopril 20 mg po x1, and lantus 30 units. her sbp improved to 180/80. she did not have any cp. her wbc was found to be 15 and she was given a dose of levofloxacin 500 mg po x 1. past medical history: 1) chronic renal insufficiency: followed by dr. at . (baseline over the past 3 months 3.5-4.2). 2) htn: prior mra showed three left renal arteries with superior artery significant for renal artery stenosis. several recent admissions with htn urgency in micu/ccu. 3) small hiatal hernia with severe gerd sx. 4) dm2: started insulin . 5) osteoporosis. 6) vertebral fractures. 7) history of depression. 8) anxiety. 9) hypercholesterolemia 10) chronic constipation. 11) sickle cell trait. 12) osteoarthritis. 13) status post left knee replacement. 14) history of mechanical falls. 15) total hysterectomy - about 20 years ago. social history: patient from barbados, lives with husband, never used tobacco, no etoh. family history: father died of old age, mother had dm, htn physical exam: pe: 96.0 180/80 55 19 100%ra gen: a+o x 3, nad, laying in bed, thin aa female heent: perrl, eomi, op clear without exudates, no lad or thyromegaly cv: rrr, no m/r/g, jvd 6 cm lungs: ctab abd: soft, distended, ntnd +bs, +left inguinal hernia that was nontender ext: 1+ pitting edema bilaterally, decreased peripheral pulses neuro: 5/5 strength in all extremities, decreased sensation at feet bilaterally, cn ii-xii intact pertinent results: labs: discharge cbc: wbc 5.5, hct 32.4, plt 156 discharge electrolytes: na 134, k 4.6, cl 102, hco3 19, bun 129, cr 4.8, glucose 72, ca 8.2, mg 2.1, ph 7.3 troponin trend: 0.2 -> 0.18 -> 0.18 -> 0.19 -> 0.19 -> 0.17 u/a: wnl microbiology: blood culture: negative. urine culture: negative. imaging: chest (portable ap) there is prominence of the pulmonary vasculature indicating mild congestive heart failure with cardiomegaly and small bilateral pleural effusion. no pneumothorax is seen. impression: mild congestive heart failure with cardiomegaly. echo conclusions: the left atrium is moderately dilated. the right atrium is markedly dilated. there is moderate symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. overall left ventricular systolic function is normal (lvef>55%). tissue velocity imaging e/e' is elevated (>15) suggesting increased left ventricular filling pressure (pcwp>18mmhg). right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) are mildly thickened. there is no aortic valve stenosis. trace aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. mild to moderate (+) mitral regurgitation is seen. there is moderate pulmonary artery systolic hypertension. there is a small pericardial effusion. compared with the prior study (tape reviewed) of , systolic function appears slightly more vigorous today and systemic blood pressure at the time of the study is lower today. brief hospital course: mrs. is a 72 year old woman with a history of diabetes, chronic kidney disease that has recently been deteriorating (over last few months baseline creatinine has increased from 2 to 4), and poorly controlled hypertension on multiple antihypertensive agents. she was admitted to micu on with hypertensive emergency characterized by sbp in 220's, anginal chest pain, shortness of breath and edema in lower extremities. in micu, a labetalol drip was required to control blood pressure, but she is now back on her home regimen of antihypertensives with the only change being a slight increase in her dose of isosorbide mononitrate. at this point she was transferred to the medical floor. 1. hypertension: her blood pressure stayed stable on her regimen of multiple anti-hypertensives (labetolol, valsartan, lisinopril, amlodipine, hydralazine, imdur, clonidine, lasix). her difficult to control blood pressure is almost certainly due to her extensive renal disease and ultimately her treatment for her blood pressure will require hemodialysis. this was emphasized to her and she is at this point reluctant to start hd. since there was no acute need for hd during this hospitalization, she was discharged to home and she will let her pcp (dr. and her renal physician (dr. know about her plans for hemodialysis in the future. 2. chest pain: her chest pain and initial ekg changes (deep t wave inversions) were thought to be due to her initial hypertension in the ed. the cardiology service was notified and involved in her care and thought she had demand ischemia in the setting of hypertension. her ekg changes resolved with correction of her blood pressure and her cardiac enzymes remained flat (their slight elevation was likely due to her chronic renal failure). an echocardiogram was done which revealed normal systolic function and no wall motion abnormalities. she was continued on her anti-hypertensives as well as aspirin. she will likely have a p-mibi as an outpatient at the discretion of her pcp. 2. cri: she was followed by her nephrologist, dr. , while she was hospitalized. her renal function and hypertension have reached the level where she will soon likely need hemodialysis. again, she was resistant to starting this during this hospitalization and will discuss this with her family before contacting dr. and dr. regarding the timing of starting hemodialysis. her renal medications included sevelamer 1600 tid and epo 10,000 units weekly. 3. dm: she was continued on lantus with a sliding scale and was in adequate control during her hospitalization. at discharge she was instructed to take lantus 28 units daily and continue to use a sliding scale. 4. anemia: her anemia is thought to be a combination of her sickle cell trait, chronic disease, and her renal disease. at discharge her hct was stable around 32 and she was restarted on epo. 5. gerd: she was maintained on pantoprazole twice daily. medications on admission: 1. labetalol 800 mg po tid 2. atorvastatin 10 mg po daily 3. pantoprazole 40 mg po once a day. 4. ferrous sulfate 325 po daily 5. lisinopril 20 mg po bid 6. valsartan 100 mg po hs 7. hydralazine 100 mg po tid 8. clonazepam 1 mg po daily 9. clonidine 0.9 mg let po bid 10. isosorbide mononitrate 90 mg sustained release po daily 11. folic acid 1 mg daily 12. procrit 10,000 unit/ml 10,000 units injection once a week. 13. insulin lantus 30 units qam 14. lasix 30 mg po twice a day 15. mvi 1 tablet daily 16. b12 50 mcg po daily 17. tylenol prn arthritis 18. sevelemer 800 mg three times daily 19. asa 81 mg daily 20. amlodipine 10 mg daily discharge medications: 1. labetalol 200 mg tablet sig: four (4) tablet po tid (3 times a day). 2. atorvastatin 10 mg tablet sig: one (1) tablet po daily (daily). 3. ferrous sulfate 325 (65) mg tablet sig: one (1) tablet po daily (daily). 4. lisinopril 20 mg tablet sig: one (1) tablet po bid (2 times a day). 5. losartan 50 mg tablet sig: two (2) tablet po daily (daily). 6. hydralazine 50 mg tablet sig: two (2) tablet po q8h (every 8 hours). 7. clonidine 0.3 mg tablet sig: three (3) tablet po bid (2 times a day). 8. isosorbide mononitrate 60 mg tablet sustained release 24hr sig: two (2) tablet sustained release 24hr po daily (daily). disp:*60 tablet sustained release 24hr(s)* refills:*2* 9. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 10. multivitamin capsule sig: one (1) cap po daily (daily). 11. cyanocobalamin 100 mcg tablet sig: 0.5 tablet po daily (daily). 12. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 13. furosemide 20 mg tablet sig: 1.5 tablets po bid (2 times a day). 14. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q12h (every 12 hours). 15. sevelamer 800 mg tablet sig: one (1) tablet po tid (3 times a day). 16. amlodipine 5 mg tablet sig: one (1) tablet po daily (daily). 17. epoetin alfa 4,000 unit/ml solution sig: 10,000 u injection once a week. discharge disposition: home with service facility: homecare discharge diagnosis: 1. hypertensive emergency 2. demand ischemia 3. esrd discharge condition: stable on her home bp regimen. tte unchanged. needs to have a p-mibi for a complete evaluation to rule out coronary disease as did have demand ischemia in the setting of severe hypertension discharge instructions: please take all your medications as directed. please take insulin (lantus): note new dose; 28u qhs. please come to the emergency room should you experience any cp/dyspnea/fevers/chills or other concerning symptoms followup instructions: 1. please follow up with your pcp within next weeks. 2. please follow up with your kidney doctors within next weeks 3. your pcp should refer you for a stress test to make sure you do not have coronary artery disease procedure: transfusion of packed cells diagnoses: hyperpotassemia end stage renal disease anemia, unspecified esophageal reflux diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled diaphragmatic hernia without mention of obstruction or gangrene hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease dysthymic disorder osteoporosis, unspecified sickle-cell trait 

Answer: The patient is high likely exposed to