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: e-mycin / penicillins / chlorpromazine hcl attending: chief complaint: vaginal bleeding, endometrial cancer major surgical or invasive procedure: insertion and removal of mirena iud, total abdominal hysterectomy, bilateral salpingoophrectomy history of present illness: is a 49-year-old gravida 0 woman who reports a long history of worsening irregular menstrual cycles. she reports that her cycles became quite irregular with heavy bleeding at times. this led to a pelvic ultrasound, which revealed an irregularity concerning for the possibility of a polyp or irregularity within the endometrial cavity. the irregular bleeding continued and she delayed care it looks like for five or six months. an attempt had at an endometrial biopsy in the past was associated with severe pain and so she was somewhat concerned about doing this. a biopsy was eventually obtained by dr. and a grade i endometrioid adenocarcinoma was identified. the uterus measured back in was 8.3 x 3.5 x 4.6 cm. the endometrial biopsy was obtained on . the decision was made to proceed with tah/bso. past medical history: past medical history: has a number of medical problems including schizoaffective disorder, bipolar disorder, borderline personality disorder, diabetes, hypertension, asthma, tobacco abuse, sleep apnea, morbid obesity, and now the endometrial cancer. past surgical history: she had eye surgery in . ob/gyn history: she reports her last pap smear was normal. she denies any history of abnormal pap smears. she denies any history of pelvic infections or ovarian cyst. social history: social history: she reports smoking two packs of cigarettes per day. she denies tobacco or drug use. she works as a receptionist. family history: family history: she reports that her mother's aunt had a cancer of unknown type. physical exam: general: she appears her stated age, in no apparent distress. heent: normocephalic, atraumatic. oral mucosa without evidence of thrush or mucositis. eyes, sclerae are anicteric. neck: supple, no masses. no thyromegaly. lymphatics: lymph node survey, negative cervical, supraclavicular, axillary, or inguinal adenopathy. chest: lungs with poor inspiratory effort, insp/exp wheezes, and decreased bs @ bases. heart: regular rate and rhythm, there are no appreciable murmurs. back: no spinal or cva tenderness. abdomen: soft, obese, nontender, and nondistended. no palpable abdominal or pelvic mass. the exam is somewhat limited due to obesity. extremities: there is no clubbing, cyanosis, or edema. pelvic: normal external genitalia. the inner labia minora is normal. the urethral meatus is normal. speculum was placed. the walls of the vagina are smooth. the cuff is normal. the cervix is normal. bimanual exam reveals a mobile uterus that is normally sized without any parametrial nodularity. there is no mass palpated at cervix. rectal exam reveals good sphincter tone without mass or lesion. pertinent results: 05:40am blood wbc-15.1* rbc-4.29 hgb-13.1 hct-39.4 mcv-92 mch-30.6 mchc-33.3 rdw-14.3 plt ct-242 09:54am blood wbc-10.7 rbc-4.17* hgb-12.6 hct-39.3 mcv-94 mch-30.2 mchc-32.1 rdw-14.3 plt ct-230 05:40am blood neuts-89.0* lymphs-7.7* monos-2.9 eos-0.1 baso-0.3 09:54am blood neuts-65.1 lymphs-27.5 monos-4.1 eos-3.1 baso-0.2 . 04:30am blood pt-12.3 ptt-22.4 inr(pt)-1.0 . 05:40am blood glucose-255* urean-11 creat-0.7 na-143 k-3.9 cl-104 hco3-31 angap-12 09:54am blood glucose-187* urean-13 creat-0.6 na-142 k-3.9 cl-104 hco3-28 angap-14 11:53am blood glucose-75 urean-21* creat-0.8 na-140 k-3.7 cl-99 hco3-35* angap-10 . 05:40am blood calcium-8.7 phos-4.4 mg-1.3* 09:54am blood calcium-8.6 phos-3.0 mg-1.5* 11:53am blood calcium-8.9 phos-3.1 mg-1.2* . 09:54am blood ck-mb-2 ctropnt-<0.01 05:00pm blood ck-mb-2 ctropnt-<0.01 09:30pm blood ck-mb-2 ctropnt-<0.01 . 11:53am blood tsh-0.97 . 01:24pm blood type-art po2-73* pco2-48* ph-7.38 caltco2-29 base xs-1 06:00am blood type-art po2-140* pco2-47* ph-7.38 caltco2-29 base xs-2 12:43pm blood type-art temp-37.0 rates-/14 o2 flow-3 po2-104 pco2-36 ph-7.54* caltco2-32* base xs-8 intubat-not intuba . cxr the et tube tip is 3.3 cm above the carina. the low lung volumes exaggerate the size of the cardiomediastinal silhouette which appears to be slightly enlarged compared to the prior study. the patient is in mild volume overload with bilateral pleural effusions demonstrated, right most likely more than left. no pneumothorax is seen. . cxr there is increased lower lobe atelectasis and slightly worsened right middle lobe atelectasis. the mediastinal contour is obscured by the lung abnormality. left lower lobe atelectasis is persistent, if any, there are small bilateral pleural effusions. . cxr since yesterday, aeration in both bases improved. bilateral pleural effusion, if present, are tiny. there are no signs of pulmonary edema or new focal area of consolidation. heart size is still enlarged, could be in part due to patient position and ap technique. no other change. . ecg sinus arrhythmia. non-specific t wave change in leads iii and avf. compared to the previous tracing of the p wave is less peaked brief hospital course: ms. is a 49yo presented for planned tah/bso for endometrial cancer. in the preop holding area, the anesthesia team evaluated the pt and noted that her oxygen saturation at baseline was 90%. she had audible wheezes throughout the room. by her own admission, she has been smoking more than she has in the past. she denies any fever. incentive spirometry was given to the patient, but despite this, her oxygen saturation remained low. there was a concern for the possibility of an inability to wean the ventilator upon completion of surgery and again the possibility of pulmonary issues postoperatively. because of this concern, her planned surgery was cancelled. as it was not initially clear when the procedure could be rescheduled, the patient was consented for and underwent placement of a mirena iud. the mirena iud has been shown to be somewhat effective in treating some endometrial cancers, but in this case, it is more of a temporizing given her significant vaginal bleeding. . the decision was then made to admit the patient for optimization of her pulmonary status. one main goal of this hospitalization was to prevent the patient from smoking as much as she had been. she was given a nicotine patch and a pulmonology consultation was obtained. her medications were optimized, with the addition of a course of steroids and 7 days of levoquin, which she completed. on hd#2, her case was discussed with the attending anesthesiologist who had initially assessed her. he agreed that after 4-5 days of steroids, antibiotics, oxygen therapy, and not smoking, she would likely be more stable to complete the initially planned procedure. it was thus scheduled for hd#6. . as her glucose fingersticks were extremely high, consult was obtained for optimization of diabetes medications. actos was discontinued and lantus was added, along with a more aggressive insulin sliding scale. her fs were subsequently much improved. . on hd#6, ms. was taken to the operating room, where tah/bso was performed. please see the operative note for full details on this uncomplicated procedure. postoperatively, extubation was not attempted secondary to her poor respiratory status and she was transferred to the icu. she was subsequently extubated on pod#1 and transferred back to the med/ floor on pod#2, after further optimization of her pulmonary status. her postoperative course was complicated by the following issues: *) pulmonary status: pt did have an oxygen requirement following transfer to the floor. she was maintained on her bi-pap overnight. her levoquin was d/c'd following the surgery, but prednisone was continued until tapering was started on the day of discharge. her oxygen saturation ranged from 94-98% on ra-2l o2 by nc during the day and 90-95% on 2l bi-pap at night. she also received scheduled albuterol and atrovent nebulizer treatments. the pulmonary service continued to follow the patient and by the time of discharge to rehab, she was felt to be operating at a stable baseline. *) sedation: during most nights postoperatively, the patient was noted to be difficult to arouse from sleep. often, sternal rub or the equivalent was required to wake ms. and keeping her awake proved even more difficult. her vital signs were always stable during these episodes, and while sitting up during the day, no abnormalities or mental status changes from baseline were noted. the medicine team was consulted and her history was reviewed. the team felt that she was likely difficult to arouse at baseline secondary to her lung disease and that the combination of narcotics, psychiatric medications, and benzodiazapenes were contributing. holding parameters for these medications (including no benzos/narcotics after 6pm) were applied. *) ekg changes: an ekg obtained during an episode of sedation revealed t wave changes. three sets of cardiac enzymes were negative and the pt was without symptoms. she was maintained on telemetry and had multiple episodes of sinus arrhythmia, but the character of such was deemed overall benign by the medicine consultants. *) t2dm: the service continued to follow this patient and insulin regimen was adjusted prn. she will continue metformin, lantus insulin, and sliding scale insulin on discharge, but should not be restarted on actos. *) htn: her blood pressures continued to be elevated with vasotec, so hctz was added to the regimen. this resulted in much better control of her hypertension. *) psych: she was maintained on her home medications. these medications do likely contribute to her somnolence and prn medications were held for sedation. she should follow up with psychiatry as soon as possible after discharge from rehabilitation. the patient was discharged on hd#13/pod#7 for transfer to a rehabilitation facility. she has a follow up appointment scheduled with dr. . medications on admission: albuterol sulfate - 90 mcg hfa aerosol inhaler - 2 puffs inhalation q4-6 hours as needed for cough/wheeze benztropine - (prescribed by other provider: ) - 1 mg tablet - 1 tablet(s) by mouth twice a day clonazepam - (prescribed by other provider: ) - 0.5 mg tablet - 1 tablet(s) by mouth twice a day clozapine - (prescribed by other provider) - 100 mg tablet - 1 tablet(s) by mouth q am, 4 qhs enalapril maleate - 5 mg tablet - 1 tablet(s) by mouth once a day fluticasone - 44 mcg aerosol - 2 twice a day ibuprofen - 600 mg tablet - 1 tablet(s) by mouth q 6 hours insulin detemir - (dose adjustment - no new rx) - 100 unit/ml insulin pen - inject 50 units sq at bedtime 1 box (5 x 3 ml) ipratropium-albuterol - 103 mcg (90 mcg)-18 mcg/actuation aerosol - 1 po 2 puffs qid lorazepam - (prescribed by other provider: ) - 0.5 mg tablet - 1 tablet(s) by mouth three times a day as needed for anxiety metformin - 850 mg tablet - 1 tablet(s) by mouth three times a day montelukast - 10 mg tablet - 1 tablet(s) by mouth once a day olanzapine - (prescribed by other provider: . - 2.5 mg tablet - 1 tablet(s) by mouth twice a day as needed for agitation oxybutynin chloride - 10 mg tab,sust rel osmotic push 24hr - 1 tab(s) by mouth once a day pantoprazole - 40 mg tablet, delayed release (e.c.) - 1 tablet(s) by mouth once a day - no substitution salmeterol - 50 mcg disk with device - one puff po twice a day simvastatin - 40 mg tablet - 1 tablet(s) by mouth once a day tramadol - 50 mg tablet - 1 tablet(s) by mouth twice a day as needed for pain trazodone - (prescribed by other provider: ) - 150 mg tablet - 1 tablet(s) by mouth at bedtime zoloft - 100mg tablet - 2 by mouth every morning per dr. medications - otc blood sugar diagnostic - strip - use as directed to check blood sugars once a day lancets - misc - use to check blood sugars once a day miconazole nitrate - 2 % powder - apply to affected areas once a day multivitamins with iron - tablet - 1 tablet(s) by mouth once a day discharge medications: 1. metformin 850 mg tablet sig: one (1) tablet po tid (3 times a day). 2. oxybutynin chloride 5 mg tablet sig: two (2) tablet po bid (2 times a day). 3. clozapine 100 mg tablet sig: one (1) tablet po qam (once a day (in the morning)). 4. sertraline 100 mg tablet sig: two (2) tablet po daily (daily). 5. clozapine 100 mg tablet sig: four (4) tablet po hs (at bedtime). 6. clonazepam 0.5 mg tablet sig: one (1) tablet po bid (2 times a day). 7. olanzapine 2.5 mg tablet sig: one (1) tablet po bid (2 times a day) as needed. 8. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 9. acetaminophen 325 mg tablet sig: two (2) tablet po q6h (every 6 hours) as needed: do not exceed 4g acetaminophen daily. tablet(s) 10. trazodone 50 mg tablet sig: three (3) tablet po hs (at bedtime) as needed. 11. lorazepam 0.5 mg tablet sig: one (1) tablet po tid prn (). 12. hydrochlorothiazide 12.5 mg capsule sig: one (1) capsule po daily (daily). 13. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 14. enalapril maleate 5 mg tablet sig: one (1) tablet po daily (daily). 15. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day) as needed. capsule(s) 16. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4h (every 4 hours) as needed: hold after 6pm. 17. ibuprofen 600 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed. 18. fluticasone-salmeterol 250-50 mcg/dose disk with device sig: puff inhalation (2 times a day). 19. ipratropium-albuterol 18-103 mcg/actuation aerosol sig: puffs inhalation once a day as needed. 20. prednisone 10 mg tablet sig: one (1) tablet po once a day for 3 days. 21. albuterol 90 mcg/actuation aerosol sig: two (2) puff inhalation q4h (every 4 hours) as needed for shortness of breath or wheezing. 22. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) inh inhalation q4h (every 4 hours) as needed for shortness of breath or wheezing. 23. insulin glargine 100 unit/ml solution sig: thirty five (35) units subcutaneous qam: 20 units qpm. 24. humalog 100 unit/ml solution sig: 5-19 units subcutaneous four times a day: please see insulin sliding scale. 25. nicotine 21 mg/24 hr patch 24 hr sig: one (1) patch transdermal once a day. discharge disposition: extended care facility: rehab discharge diagnosis: endometrial cancer, copd exacerbation discharge condition: stable discharge instructions: please call your doctor or return to the hospital if you have: -increased pain -redness or unusual discharge from your incision -inability to eat or drink because of nausea and/or vomiting -fevers/chills -chest pain or shortness of breath -any other questions or concerns other instructions: -you should not drive for 2 weeks and while taking narcotic pain medications -no intercourse, tampons, or douching for 6 weeks -no heavy lifting or vigorous activity for 6 weeks -you can shower and clean your wound, but do not use perfumed soaps or lotions. be sure to pat completely dry after washing. -you may resume your regular diet -many of your medications have been changed during this hospitalization. please refer to the your discharge medication list for appropriate medications. followup instructions: provider: , md phone: date/time: 11:00 provider: , md phone: date/time: 1:00 you should also follow up with your primary care physician and as soon as possible following discharge from rehab. md procedure: non-invasive mechanical ventilation other removal of both ovaries and tubes at same operative episode peritoneal lavage other and unspecified total abdominal hysterectomy insertion of intrauterine contraceptive device diagnoses: obstructive sleep apnea (adult)(pediatric) tobacco use disorder diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled pulmonary collapse morbid obesity chronic obstructive asthma with (acute) exacerbation acute bronchitis mixed acid-base balance disorder laparoscopic surgical procedure converted to open procedure schizoaffective disorder, unspecified malignant neoplasm of corpus uteri, except isthmus corpus luteum cyst or hematoma 

Answer: The patient is high likely exposed to