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 carotid stenosis major surgical or invasive procedure: right cea with dacron patch history of present illness: this 68-year-old gentleman was recently admitted to the hospital with a right ocular stroke. he had previously had a tia some months back and had this stroke on antiplatelet agents. ultrasound showed a 40% stenosis of the right carotid artery but an arteriogram showed a large ulcerated plaque at the carotid bifurcation. he is undergoing endarterectomy today. past medical history: 1. hypercholesterolemia 2. hypertension, recently diagnosed, started meds ~2 weeks ago 3. ankylosing spondylitis social history: lives with his partner. currently retired, part-time consulting. quit tobacco , smoked 1 ppd for 20 yrs prior. has 1 and 1 glass wine with dinner every night. when on vacation drinks more wine. no other drugs. family history: father died of an aneurysm, unknown location, was "vomiting blood". mom with stroke in her 80s. brother age 61 with some kind of aphasia, neurodegenerative, started 5-6 years ago. mom's side with cad/mi. paternal gf with type i dm. physical exam: pe: afvss neuro: perrl / eomi mae equally answers simple commands neg pronator drift sensation intact to st 2 plus dtr neg babinski heent: ncat neg lesions nares, oral pharnyx, auditory supple / farom neg lyphandopathy, supra clavicular nodes lungs: cta b/l cardiac: rrr without murmers abdomen: soft, nttp, nd, pos bs, neg cva tenderness ext: rle - palp fem, , pt, dp lle - palp fem, , pt, dp pertinent results: wbc-6.7 rbc-3.33* hgb-10.9* hct-31.0* mcv-93 mch-32.9* mchc-35.3* rdw-13.2 plt ct-192 pt-12.7 ptt-33.4 inr(pt)-1.1 glucose-117* urean-16 creat-1.0 na-139 k-4.3 cl-108 hco3-25 angap-10 calcium-8.9 phos-3.5 mg-2.1 3:30 pm clinical information: acute onset of monocular blindness. ? for intra- arterial tpa. radiologists: drs. and , the attending radiologist, present and supervising the entire procedure. technique: informed consent was obtained from the patient and the patient's family after explaining the risks, indications and alternative management. risks explained included stroke, loss of vision and speech, temporary or permanent, with possible treatment with stent and coils if needed. the patient was brought to the interventional neuroradiology theater and placed on the biplane table in supine position. both groins were prepped and draped in the usual sterile fashion. access to the right common femoral artery was obtained using a 19-gauge single wall needle, under local anesthesia using 1% lidocaine mixed with sodium bicarbonate and with aseptic precautions. through the needle, a 0.35 wire was introduced and the needle taken out. over the wire, a 5 fr vascular sheath was placed and connected to a saline infusion (mixed with heparin 500 units in 500 cc of saline) with a continuous drip. through the sheath, a 4 fr berenstein catheter was introduced and connected to continuous saline infusion (with mixture of 1000 units of heparin in 1000 cc of saline). the following blood vessel was selectively catheterized and angiograms were obtained in ap, lateral, and 3-d projections: -right common carotid artery findings: evaluation of the right cca, eca, and ica demonstrate no evidence of aneurysm, vascular malformation, or vascular occlusion. however, there is luminal irregularity at the proximal segment of the cervical cca, leading to an approximately 40% of stenosis. conclusion: luminal irregularity, likely to indicate atherosclerotic disease, at the proximal segment of the right common carotid artery, suggestive of mild stenosis. no other abnormality is identified. the opthalmic artery appears patent. 1:55 pm ct head clinical information: acute loss of vision in right eye. ? bleed. findings: there are several tiny, well-defined hypodense lesions in the periventricular white matter of both cerebral hemispheres and the head of the left caudate nucleus (series 2, image 15). they are likely representative of chronic lacunar infarcts. -white matter differentiation is otherwise preserved. no intracranial mass or mass effect is evident. no intra-axial or extra-axial fluid collections or hematoma is seen. no displacement of normally midline structures is evident. conclusion: 1. chronic lacunar infarcts in the periventricular white matter of both cerebral hemispheres and the head of the left caudate nucleus. 2. no intracranial hematoma. 3. no ct features of acute major vascular territorial infarct, although a head mri with dwi images is a more sensitive study to detect acute cerebral ischemic changes. chest (pre-op pa & lat) 6:18 pm pa and lateral views of the chest: the heart is normal in size. the mediastinal and hilar contours are normal. there is calcification of the aortic knob. the pulmonary vascularity is normal. the lungs are clear. there are no focal consolidations, pleural effusions, or pneumothorax demonstrated. the osseous structures are unremarkable. impression: no acute cardiopulmonary abnormality cardiology report ecg study sinus rhythm. consider left atrial abnormality prominent precordial lead qrs voltage - is nonspecific but consider left ventricular hypertrophy since previous tracing of , probably no significant change intervals axes rate pr qrs qt/qtc p qrs t 69 152 100 398/416.71 66 48 65 brief hospital course: pt admitted on stroke code initiated stat opthamology consult obtained for acute painless vision loss. pt in icu heparin stared / npo vascular surgery consulted. plaque found right carotid artery. pt to be taken to the or. pt pre-op'd in the usual fashion. head ct negative pt stable heparin drip continued / bp control stable pt undergoes a right carotid endarterectomy and dacron patch angioplasty. he tolerates the p to the pacu in stable condition. once recovered from anesthesia. pt to the vicu in stable condition. pt delined / adat / heplocked iv lytes replenished pt stable for dc taking po / ambulatiing / urinating / pos bm medications on admission: asa 81', aggrenox 25/200", lipitor 20', protonix 40', norvasc 30', fish oil discharge medications: 1. lipitor 40 mg tablet sig: one (1) tablet po at bedtime. 2. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4-6h (every 4 to 6 hours) as needed. 3. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 4. dipyridamole-aspirin 200-25 mg cap, multiphasic release 12 hr sig: one (1) cap po bid (2 times a day). 5. univasc 15 mg tablet sig: one (1) tablet po once a day. 6. aspirin 325 mg tablet sig: one (1) tablet po once a day. discharge disposition: home discharge diagnosis: carotid stenosis. tia history of htn history of hyperlipdemia discharge condition: stable discharge instructions: discharge instructions following carotid endarterectomy . this information is designed as a guideline to assist you in a speedy recovery from your surgery. please follow these guidelines unless your physician has specifically instructed you otherwise. please call our office nurse if you have any questions. dial 911 if you have any medical emergency. . activity: . there are no specific restrictions on activity. gradually increase your level of activity back to normal depending upon the way you feel. fatigue is expected for the first several weeks. resume driving when you are able to comfortably move your head without pain or stiffness. . please call us immediately for any of the following problems: . weakness, numbness, tingling involving your arm, leg or face . . loss of vision . . difficulty speaking . . severe headache (mild headache is common) . . increasing swelling, pain, drainage or redness of the neck wound, . watch for signs and symptoms of infection. these are: a fever greater than 101 degrees, chills, increased redness, or pus draining from the incision site. if you experience any of these or bleeding at the incision site, call the doctor. . exercise: . limit strenuous activity for 2 weeks. . no driving untill cleared by your surgeon. he should be able to clear you to drive when you are able to comfortably move your head without pain or stiffness . if you can do this before your appointment with the doctor, call and ask him if you can drive. no heavy lifting greater than 20 pounds for the next 7 days. . avoid excessive turning of the head, nodding of the head for the next 7 days. . bathing/showering: . you may bathe or shower immediately upon coming home. do not put your neck / head into the water. a clear dressing will cover your neck incision and this should be left in place for three (3) days. remove it after this time and wash your incision gently with soap and water. dissolving sutures, which do not have to be removed, were used. shaving is permitted when the dressing is removed. . wound care: . suture / staples may be removed before discharge. if they are not, an appointment will be made for you to return for removal. . when the sutures / staples are removed the doctor may or may not place pieces of tape called steri-strips over the incision. these will stay on about a week and you may shower with them on. if these do not fall off after 10 days, you may peel them off with warm water and soap in the shower. . avoid taking a tub bath, swimming, or soaking in a hot tub for two weeks after surgery. . medications: . you may resume taking medication you were on prior to your surgery unless specifically instructed otherwise by your physician will be given a new prescription for pain medication, which should be taken every three (3) to four (4) hours only if necessary. . remember that narcotic pain meds can be constipating and you should increase the fluid and bulk foods in your diet. (check with your physician if you have fluid restrictions.) if you feel that you are constipated, do not strain at the toilet. you may use over the counter metamucil or milk of magnesia. appetite suppression may occur; this will improve with time. eat small balanced meals throughout the day. . cautions: . no smoking! we know you've heard this before, but it really is an important step to your recovery. smoking causes narrowing of your blood vessels which in turn decreases circulation. if you smoke you will need to stop as soon as possible. ask your nurse or doctor for information on smoking cessation. . no strenuous activity for 4-6 weeks after surgery. . diet: . there are no special restrictions on your diet postoperatively. poor appetite is expected for several weeks and small, frequent meals may be preferred. . for people with vascular problems we would recommend a cholesterol lowering diet: follow a diet low in total fat and low in saturated fat and in cholesterol to improve lipid profile in your blood. additionally, some people see a reduction in serum cholesterol by reducing dietary cholesterol. since a reduction in dietary cholesterol is not harmful, we suggest that most people reduce dietary fat, saturated fat and cholesterol to decrease total cholesterol and ldl (low density lipoprotein-the bad cholesterol). exercise will increase your hdl (high density lipoprotein-the good cholesterol) and with your doctor's permission, is typically recommended.. you may be self-referred or get a referral from your doctor. . if you are overweight, you need to think about starting a weight management program. your health and its improvement depend on it. we know that making changes in your lifestyle will not be easy, and it will require a whole new set of habits and a new attitude.. if interested you can may be self-referred or can get a referral from your doctor. . if you have diabetes and would like additional guidance, you may request a referral from your doctor. . follow-up appointment: . be sure to keep your medical appointments. the key to your improving health will be to keep a tight reign on any of the chronic medical conditions that you have. things like high blood pressure, diabetes, and high cholesterol are major villains to the blood vessels. don't let them go untreated! . please call the office on the first working day after your discharge from the hospital to schedule a follow-up visit. this should be scheduled on the calendar for seven to fourteen days after discharge. normal office hours are 8:30-5:30 monday through friday. . please feel free to call the office with any other concerns or questions that might arise followup instructions: 2 weeks dr. . callfor appointment. procedure: endarterectomy, other vessels of head and neck infusion of vasopressor agent procedure on single vessel diagnoses: other iatrogenic hypotension unspecified essential hypertension occlusion and stenosis of carotid artery without mention of cerebral infarction other and unspecified hyperlipidemia personal history of other diseases of circulatory system profound impairment, one eye, impairment level not further specified retinal vascular occlusion, unspecified 

Answer: The patient is high likely exposed to