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: compazine attending: chief complaint: increasing doe major surgical or invasive procedure: none history of present illness: patient is a 47 yo female with h/o htn, osteoporosis, sleep apnea and severe copd with fev1 of 13 % who orginally presented on with 2-3 weeks of increasing dyspnea that has limited her ability to the point she had difficulty ambulating even a few steps and had increased her home 02 from 2-4l in this week period. the day prior to admission she had some rhinorrhea and cold sx. she was admitted to the icu due to increased work of breathing. she was briefly on cpap, but was quickly weaned to nc and was stable. previous symptoms suggestive of uri and possible copd exacerbation. ruled out for flu by nasal aspirate. given stressed dosed steroids and started on levofloxacin to complete a 7 day course. pt ruled out for pe with cta and mi by cardiac enzymes. for remainder of her icu stay she was on 5 l of nc as per her new baseline. in addition, she has chronic tachycardia and was started on diltiazem. . on transfer from the icu, she reports that her breathing seems to be at baseline. she was able to get up and walk about 50 feet with pt. denies cp, worsened sob, palpitations, headache, n/v. she has her chronic back pain. she does report some abdmiinal fullness and crampimg which has improved today after a bm with bowel regimen . ros: positive as above and also for occasional feeling of lightheadedness on standing, occasional sharp substernal chest pain (isolated episodes, 2-3 times in the last several weeks) now resolved. otherwise she has no symptoms of vomiting, headache, dysuria, abdominal pain, cough, change in sputum (always yellow), passing out. . in the ed: patient's intial vitals were hr 140, bp 110/80, rr 30, 02 sat 100% ra. she received xoponex, combivent neb x 1, ativan, methylprednisolone, 1 l ns, magnesium. additionally blood cultures were sent. patient had increasing work to breathe and then required cpap. . on admission to the icu, the patient required cpap, but was able to answer questions appropriately and did not have any acute symptoms of pain or dyspnea. she was quickly weaned to nasal canula and felt that her breathing had improved. past medical history: 1. copd, pfts in with fev1 0.30 (13%), fvc 1.02 (34%) and fvc/fev1 38% - on home o2 at 3l nc, on chronic steroids, hx of prolonged intubation requiring trach for resp failure in , . she was recently taken off the lung transplant list at the due to compression fractures. has previous history of asthma per omr 2. hypertension 3. anxiety 4. leukocytosis of unknown etiology with negative bmbx. 5. osteoporosis with compression fractures 6. shoulder pain 7. history of positive ppd s/p 6mos of isoniazid 8. mitral valve prolapse 9. obstructive sleep apnea on bipap (15/12 every night) social history: single, quit smoking one year ago. prior to that, she used to smoke less than a pack a day since the age of 16. she has no alcohol consumption, and lives with her mother and has one child. family history: great uncle had mi in 50s, maternal & paternal gms had cvas in 50s. physical exam: vitals: t 96.5 hr 124 bp107/58 p104 r17 o2 100% cpap gen: well-appearing woman in nad. heent: nc/at. mmm no erythema/exudate. jvp not seen. neck supple w/o lad. pulm: faint crackles b bases. cv: distant heart sounds. abd: soft, tender to palpation diffusely especially on ruq, no rebound or guarding. bowel sounds are hypoactive. no organomegaly ext: 2+ dorsalis pedis/radial pulses; no edema, clubbing, or cyanosis. neuro: aaox3. cnii-xii grossly intact. 5/5 strength throughout pertinent results: 01:00pm blood wbc-18.3* rbc-3.88* hgb-11.3* hct-33.3* mcv-86 mch-29.1 mchc-33.9 rdw-14.1 plt ct-485* 01:00pm blood neuts-94.1* bands-0 lymphs-4.1* monos-1.6* eos-0.2 baso-0.1 01:00pm blood glucose-160* urean-15 creat-0.8 na-137 k-4.5 cl-92* hco3-38* angap-12 01:00pm blood alt-22 ast-28 ld(ldh)-228 alkphos-127* amylase-50 totbili-0.1 01:00pm blood lipase-16 05:41pm blood ck-mb-8 ctropnt-0.04* 01:00pm blood calcium-9.6 phos-3.2# mg-2.0 05:41pm blood tsh-0.23* 04:10am blood free t4-1.0 09:10am blood wbc-19.0* rbc-3.62* hgb-10.1* hct-31.7* mcv-87 mch-27.9 mchc-32.0 rdw-14.5 plt ct-374 04:25am blood pt-12.5 ptt-27.0 inr(pt)-1.1 09:10am blood glucose-109* urean-12 creat-0.8 na-136 k-3.8 cl-89* hco3-41* angap-10 09:10am blood calcium-9.3 phos-3.5 mg-1.8 . cta chest w&w/o c &recons 11:55 pm indication: 37-year-old woman with copd and increasing dyspnea on exertion in the setting of chest pain. evaluate for pulmonary embolism. cta of the chest: no filling defects or pulmonary emboli are identified within the pulmonary arteries to the level of the segmental branches. scattered aortic calcifications are seen, however the aorta is within normal caliber and contour throughout its course. ct of the chest with iv contrast: soft tissue window images demonstrate no pathologically-enlarged mediastinal, hilar, or axillary lymphadenopathy. the heart and pericardium are normal in appearance. no pleural or pericardial effusions are seen. lung window images demonstrate no pulmonary nodules or parenchymal consolidation. scattered emphysematous changes are seen diffusely throughout the lungs. limited images of the superior portion of the abdomen demonstrate a cyst with calcification within the superior pole of the left kidney. the visualized parts of the liver, spleen, right kidney, adrenal glands, and pancreas are within normal limits. bone windows: compression deformities are seen within several mid thoracic vertebral bodies, of indeterminate age. ct reconstructions: multiplanar reconstructions were essential in delineating the anatomy and pathology. impression: 1. no evidence of pulmonary embolism. 2. extensive emphysematous changes are seen bilaterally. 3. hypodensity within the superior pole of the left kidney with wall calcification likely represents a complex cyst. 4. multiple compression farctures of the thoracic vertebrae. . chest (portable ap) 12:46 pm indication: shortness of breath. findings: allowing for apical lordotic projection, cardiomediastinal contours are within normal limits. there are no focal areas of consolidation within the lungs, and no pleural effusions are identified on this single projection. attenuation of the upper lobe vasculature is suggestive of underlying emphysema. impression: emphysema. no pneumonia. brief hospital course: a/p: 47 yo with copd admitted with increasing respiratory disress now stable at baseline and transferred to floor. . # respiratory distress- as the patient has severe disease and has a history of intubation and severe decompensation, the patient was felt to require micu care but rapidly improved. the cause for her decompensation is likely a viral infection given her recent fatigue and shortness of breath coupled with her occasional rhinorrhea. already r/o flu and r/o mi. (of note, bronchial washing in omr were logged incorrectly and are not from this patient) will continue to treat for copd - prednisone 40mg; plan back to prednisone 20mg over the next 3 days - completed 7 days levofloxacin for copd exacerbation - ipratroprium, atrovent q6h prn - continue home pulm meds: montelukast, advair 500-50, tiotropium 18mcg daily - viral cultures negative - riss while on steroids . # tachycardia: patient with chronic history of sinus tachycardia. cause unclear. fluid resuscitated. tfts checked. - continue dilt . # osteoporosis: patient with history of persistent fractures as a result of persistent steroid administration. - continue forteo as per outpatient regimen - con't vitamin d and calcium . # hypertension- currently normotensive, will continue on home regimen . # leukocytosis- infectious causes ruled out and afebrile. likely steroids - con't to monitor . # abdominal discomfort: likely constipation as improved with bowel movement and lft unremarkable. - continue bowel regimen . # anxiety: continue outpatient medications. . # sleep apnea: continued nightly cpap. . # pain control: likely due to chronic fractures. will continue oxycodone sr and ir for pain control as per outpatient regimen. . # fen- diet, has elevated hco3 due to chronic co2 retention at baseline, monitor lytes. medications on admission: 1. prednisone 20 mg (finished 2 weeks ago) 2. furosemide 80 mg po daily 3. advair diskus 500-50 mcg/dose disk with device 1 inh 4. montelukast 10 mg po qhs 5. verapamil 80 mg po q8h 6. nexium 40 mg po bid 7. tiotropium bromide 18 mcg capsule inh daily 8. quetiapine 25 mg po bid 9. mirtazapine 15 mg po once a day 10. gabapentin 600 mg po hs 11. oxybutynin chloride 5 mg po bid 12. citracal plus 2 tabs qam, 1 tab qhs 13. cholecalciferol (vitamin d3) unit po 2x weekly 14. dulcolax qhs prn 15. clonazepam 1 mg po qhs 16. clonazepam 0.5 mg po qam 17. sertraline 50 mg po daily 18. potassium 20 meq po bid 19. mvi po daily 20. lisinopril 5 mg po daily 21. senna qhs prn 22. potassium 20 meq qd 23. baclofen 10 mg tid 24. oxycodone sr 10 mg 25. forteo qd discharge medications: 1. fluticasone-salmeterol 500-50 mcg/dose disk with device sig: two (2) pufss inhalation twice a day. 2. tiotropium bromide 18 mcg capsule, w/inhalation device sig: one (1) cap inhalation daily (daily). 3. fluticasone 110 mcg/actuation aerosol sig: two (2) puff inhalation (2 times a day). 4. montelukast 10 mg tablet sig: one (1) tablet po daily (daily). 5. prednisone 20 mg tablet sig: two (2) tablet po daily (daily) for 7 days: two tabs (=40mg) daily on and , then 20mg daily ( back to home dose). 6. mirtazapine 15 mg tablet sig: one (1) tablet po hs (at bedtime). 7. gabapentin 300 mg capsule sig: two (2) capsule po hs (at bedtime). 8. quetiapine 25 mg tablet sig: one (1) tablet po three times a day as needed for anxiety. 9. oxybutynin chloride 5 mg tablet sig: one (1) tablet po bid (2 times a day). 10. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po hs (at bedtime) as needed for constipation. 11. sertraline 50 mg tablet sig: one (1) tablet po daily (daily). 12. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 13. calcium carbonate 500 mg tablet, chewable sig: one (1) tablet, chewable po tid (3 times a day). 14. ergocalciferol (vitamin d2) 50,000 unit capsule sig: one (1) capsule po 2x/week (mo,fr). 15. baclofen 10 mg tablet sig: one (1) tablet po tid (3 times a day) as needed for pain. 16. oxycodone 10 mg tablet sustained release 12hr sig: one (1) tablet sustained release 12hr po q12h (every 12 hours). 17. furosemide 80 mg tablet sig: one (1) tablet po daily (daily). 18. insulin lispro (human) 100 unit/ml solution sig: two (2) units subcutaneous asdir (as directed): 2 units for fsbg 151-200, 4 units for fsbg 201-250, 6 units for fsbg 251-300, 8 units for fsbg 301-350, 10 units for fsbg 351-400. 19. clonazepam 0.5 mg tablet sig: one (1) tablet po qam (once a day (in the morning)). 20. clonazepam 1 mg tablet sig: one (1) tablet po qhs (once a day (at bedtime)). 21. verapamil 120 mg tablet sig: one (1) tablet po q8h (every 8 hours). 22. lisinopril 5 mg tablet sig: one (1) tablet po daily (daily). 23. hexavitamin tablet sig: one (1) cap po daily (daily). 24. teriparatide 750 mcg/3 ml pen injector sig: three (3) ml subcutaneous daily () as needed for osteoporosis. 25. oxycodone 5 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for pain. 26. senna 8.6 mg tablet sig: one (1) tablet po hs (at bedtime) as needed for constipation. 27. albuterol sulfate 90 mcg/actuation aerosol sig: one (1) puff inhalation every 4-6 hours as needed for dyspnea. 28. ipratropium bromide 18 mcg/actuation aerosol sig: puff inhalation every 4-6 hours as needed for dyspnea. 29. potassium chloride 20 meq packet sig: one (1) packet po once a day: 1 packet = 20 meq. discharge disposition: extended care facility: - discharge diagnosis: 1. copd, pfts in with fev1 0.30 (13%), fvc 1.02 (34%) and fvc/fev1 38% - on home o2 at 4l nc, on chronic steroids, hx of prolonged intubation requiring trach for resp failure in , . she was recently taken off the lung transplant list at the due to compression fractures. has previous history of asthma per omr 2. hypertension 3. anxiety 4. leukocytosis of unknown etiology with negative bmbx. 5. osteoporosis with compression fractures 6. shoulder pain 7. history of positive ppd s/p 6mos of isoniazid 8. mitral valve prolapse 9. obstructive sleep apnea on bipap (15/12 every night) discharge condition: stable. requires 4 liters oxygen by nasal cannula. discharge instructions: call your doctor for increasing shortness of breath or increasing oxygen needs or anything that is medically concerning to you. followup instructions: provider: breathing test phone: date/time: 2:25 provider: / phone: date/time: 2:45 call dr for an appointment within the next month. md, procedure: non-invasive mechanical ventilation diagnoses: obstructive sleep apnea (adult)(pediatric) mitral valve disorders unspecified essential hypertension long-term (current) use of steroids obstructive chronic bronchitis with (acute) exacerbation other chronic pulmonary heart diseases anxiety state, unspecified other specified cardiac dysrhythmias abdominal pain, epigastric other abnormal glucose pathologic fracture of vertebrae other osteoporosis acute upper respiratory infections of unspecified site 

Answer: The patient is high likely exposed to