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: hypotension following hd major surgical or invasive procedure: central venous catheter placement history of present illness: 44 y/o female with pmhx of dm2, esrd, htn who was above her dry weight so recieved 2 sessions of hd in a row and was to get 3rd round of hd today. however patient feeling weak and lightheaded this am and noted to have low bp at hd so sent to ed. patient blood pressure in the ed was sbps in 70s so started on small amount of levophed and sbp increased to 170s with cp and ha so levophed stopped. bp again dropped to sbp 80s so levophed restarted. patient also with a cough for a couple days and empirically given levo/vanc. in ed patient wbc within normal limits and lactate 1.6. in the ed patient requiring levophed which was difficult to take off and was told by renal not to give fluids. a femoral line was placed in ed but femoral artery was stuck twice. past medical history: type ii dm, +retinopathy esrd on hd htn hx pre-eclampsia chf- hyperdynamic lvef 75-80%; diastolic dysfunction sleep apnea -> cpap, home o2 prn cva with residual l arm and leg weakness upper extremity arm swelling and ue thrombus with hx of b/l subclavian vein thrombus/stenosis with mutliple unsucessful attempts to recanalize and eventual r av fistula ligation social history: no etoh, hx tobacco quit 1 year ago, used to smoke 3 ppd x 33 years. lives with cousin, , , on disability family history: adopted, unknown physical exam: pe: t 96.1 hr 88 bp 88/44 off levo rr 22 o2sat 100% on 2l gen: nad heent: perrl, eomi, sclera icteric, op clear, mm dry neck: no jvd appreciated lungs: cta b/l; l dialysis cath in place, non-tender or erythematous cardiac: rrr s1/s2, holosystolic murmur grade iii/vi @ lusb abdomen: obese, soft nt, nabs groin: l femerol line in place, no hematoma ext: from, no edema in le or ue neuro: aaox3 sensory grossly inttact, ms pertinent results: tte: 1. the left atrium is mildly dilated. 2. there is moderate symmetric left ventricular hypertrophy. the left ventricular cavity is unusually small. 3. regional left ventricular wall motion is normal. left ventricular systolic function is hyperdynamic (ef>75%). 4. there is a severe resting left ventricular outflow tract obstruction. 5. right ventricular chamber size and free wall motion are normal. 6. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. 7. the mitral valve leaflets are severely thickened/deformed. there is severe mitral annular calcification. mild to moderate (2+) mitral regurgitation is seen. mild to moderate mitral stenosis is present as a result of the mitral annular calcification 8. mild tricuspid regurgitation is seen. 9. there is moderate pulmonary artery systolic hypertension. 10. there is a small pericardial effusion. impression: moderate symmetric left vetricular hypertrophy with lvot obstruction whose severity is likely worse due to levophed and hypovolemia. 01:44pm blood wbc-6.4 rbc-4.36 hgb-13.2 hct-41.5 mcv-95 mch-30.2 mchc-31.7 rdw-20.2* plt ct-219 05:44am blood wbc-4.3 rbc-3.37* hgb-10.2* hct-31.7* mcv-94 mch-30.2 mchc-32.1 rdw-20.4* plt ct-149* 01:44pm blood neuts-74.9* lymphs-14.4* monos-7.0 eos-3.4 baso-0.3 02:15pm blood neuts-75.7* lymphs-14.8* monos-5.4 eos-3.7 baso-0.3 02:15pm blood pt-21.4* ptt-150* inr(pt)-2.1* 01:44pm blood plt ct-219 05:44am blood pt-15.1* ptt-28.8 inr(pt)-1.4* 05:44am blood plt ct-149* 01:44pm blood glucose-105 urean-51* creat-8.2* na-133 k-5.1 cl-92* hco3-23 angap-23* 05:44am blood glucose-106* urean-60* creat-8.6*# na-133 k-4.6 cl-95* hco3-23 angap-20 01:44pm blood alt-14 ast-17 alkphos-73 amylase-124* totbili-0.3 02:15pm blood ck(cpk)-248* 09:25pm blood ck(cpk)-230* 02:58am blood ck(cpk)-222* 10:46pm blood ck(cpk)-195* 04:25am blood ck(cpk)-196* 02:50pm blood ck(cpk)-193* 02:15pm blood ctropnt-0.56* 09:25pm blood ck-mb-10 mb indx-4.3 ctropnt-0.68* 02:58am blood ck-mb-10 mb indx-4.5 ctropnt-0.64* 10:46pm blood ck-mb-7 ctropnt-0.52* 04:25am blood ck-mb-7 ctropnt-0.54* 02:50pm blood ck-mb-7 ctropnt-0.51* 01:44pm blood calcium-9.3 phos-7.2* mg-1.9 05:44am blood calcium-9.3 phos-5.6* mg-2.5 02:15pm blood tsh-2.9 02:15pm blood cortsol-17.2 02:58am blood cortsol-8.1 04:48am blood cortsol-28.8* 02:27pm blood lactate-1.6 09:46pm blood lactate-1.2 09:46pm blood freeca-1.09* . sputum gram stain-final; respiratory culture-final inpatient blood culture aerobic bottle-pending; anaerobic bottle-pending inpatient blood culture aerobic bottle-pending; anaerobic bottle-pending inpatient blood culture aerobic bottle-pending; anaerobic bottle-pending emergency blood culture aerobic bottle-pending; anaerobic bottle-pending brief hospital course: 44 f with h/o dm2, esrd, chf who presents with hypotension status post an extra dialysis session. the following is a summary of her hospital course by problem. . #. hypotension: the patient was hypotensive on admission likely secondary to volume depletion from hemodialysis. she was initially placed on levophed. a tte showed ef > 75%, severe lvot worsened by levophed and hypovolemia, 2+ mr and 1+ tr. the levophed was discontinued after she was hydrated with a total of 3.5 l in the icu. -stim test was normal. she had no evidence of infection, and initial broad spectrum antibiotics were discontinued. her metoprolol was restarted and titrated up to 37.5 mg (home dose of 50 mg ), and can be further titrated up as an outpatient. she was not restarted on an ace-i given her relative hypotension, left ventricular outflow tract obstruction and the possibility of exacerbating the venturi effect, though this can be decided by her pcp as an outpatient. her target weight for dialysis will need to be adjusted higher as an outpatient to avoid overdialysis. . # left ventricular outflow tract obstruction: this was seen on tte to be exacerbated by her hypovolemia. she was rehydrated with ivf. her metoprolol was titrated up for rate control to improve diastolic filling. her ace-i was held for possibility of exacerbating the venturi effect and because of her relative hypotension. vasodilatory drugs should be avoided. . # esrd - the patient has a tunneled line in place in her left subclavian. she was dialyzed without removing any volume on . renal followed her during this admission, and she was redialyzed on . the pre-weight was 81.3 kg with a note that the bedscale was broken. a post weight was not recorded. her target weight for dialysis will need to be adjusted higher as an outpatient to avoid overdialysis. she will have a transplant evaluation with dr. and a social worker on . - continue phoslo . # dm2 - the patient is on actos 30 mg once daily as an outpatient. in the icu, she was covered with a sliding scale, and her actos was held. she had excellent glucose control this admission on a humalog sliding scale and will be discharged with instructions to restart her actos. . # chest pain/epigastric discomfort: the patient had 3 episodes of chest pain in the micu that were concerning for ischemic etiology with new twi in iii, avf on ekg. she had an atrial tachycardia post-dialysis on to the 160s associated with "heartburn" but that improved with ivf and iv lopressor. she subsquently had several episodes of heartburn on the evening of that improved with morphine and then with a gi cocktail. cardiac enzymes have shown a flat mb fraction and troponin, negative x 3. she will continue on her aspirin, and her metoprolol will be titrated up as tolerated. no ace-i for now given relative hypotension and lvot. she will continue on protonix and maalox as needed. . # history of bilateral subclavian clots. her inr was subtherapeutic on 2 mg coumadin during this admission and her dose was increased to 3 mg qd. her inr was 1.4 on discharge and will need to be followed as an outpatient. medications on admission: 1. docusate sodium 100 mg po bid 2. senna 8.6 mg po bid 3. protonix 4. albuterol 90 mcg/actuation aerosol 5. b complex-vitamin c-folic acid 1 mg daily 6. claritin 10 mg po once a day. 7. epoetin alfa 10,000 unit/ml s 9. warfarin 2 mg tablet po hs 11. metoprolol tartrate 50 mg tablet po bid 12. trazadone 25mg qhs 13. aspirin 81 mg daily 16. lisinopril 5 mg tablet po once a day. 17. actos 30 mg po once a day. 18. phoslo discharge medications: 1. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 2. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day): stop if you have diarrhea. 3. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day): stop if you have diarrhea. 4. calcium acetate 667 mg capsule sig: two (2) capsule po tid w/meals (3 times a day with meals). 5. actos 30 mg tablet sig: one (1) tablet po once a day. 6. metoprolol tartrate 25 mg tablet sig: 1.5 tablets po bid (2 times a day). disp:*90 tablet(s)* refills:*2* 7. aspirin 81 mg tablet sig: one (1) tablet po once a day. 8. trazodone 50 mg tablet sig: 0.5 tablet po hs (at bedtime). 9. epogen 10,000 unit/ml solution sig: one (1) injection per her nephrologist. 10. warfarin 3 mg tablet sig: one (1) tablet po hs (at bedtime). 11. maalox max quick dissolve 1,000-60 mg tablet, chewable sig: one (1) ml po qid (4 times a day) as needed for heartburn. disp:*1 month supply* refills:*2* 12. b complex-vitamin c-folic acid 1 mg capsule sig: one (1) capsule po once a day. 13. claritin 10 mg tablet sig: one (1) tablet po once a day. discharge disposition: home with service facility: vna discharge diagnosis: hypotensive episode after dialysis hypertension diabetes type ii end stage renal disease sleep apnea diastolic heart failure, left ventricular outflow tract obstruction discharge condition: good discharge instructions: 1. please take all medications as prescribed. your metoprolol is at a lower dose (37.5 mg) than before, but can be increased by your primary care doctor if your blood pressure remains good. do not restart your lisinopril until you have spoken to your primary care doctor. 2. please keep all follow-up appointments. 3. please seek medical attention if you develop shortness of breath, chest pain, lightheadedness, nausea, vomiting, diarrhea or have any other concerning symptoms. followup instructions: please make a follow-up appointment with your primary care doctor, dr. at , within the next weeks. provider: , . follow-up appointment should be in 2 weeks . please get your inr (coumadin level) checked within the next 3 days by either your vna or at dr. office and ask dr. to adjust your coumadin dose as needed. provider: . , od phone: date/time: 2:00 provider: phone: date/time: 10:00 provider: , transplant social work date/time: 11:00 you have an appointment with at on at 3 pm. procedure: venous catheterization, not elsewhere classified hemodialysis diagnoses: end stage renal disease mitral valve disorders congestive heart failure, unspecified accidental puncture or laceration during a procedure, not elsewhere classified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease unspecified sleep apnea kidney dialysis as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure hypovolemia diseases of tricuspid valve chronic diastolic heart failure hypotension of hemodialysis diabetes with ophthalmic manifestations, type ii or unspecified type, not stated as uncontrolled background diabetic retinopathy 

Answer: The patient is high likely exposed to