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: ace inhibitors / -angiotensin receptor antagonist / precedex attending: chief complaint: tongue swelling major surgical or invasive procedure: intubation and mechanical ventilation history of present illness: t is a 54 yo male with a h/o hep c, currently on pegasys, telaprevir and ribavirin (started on ), htn on lisinopril and ckd who went to bed at midnight and woke up two hours later with tongue swelling. according to the wife he had an uneventful day prior to admission and went to bed about midnight. he woke up around 2:30am complaining of a funny sensation of his tonigue and some swelling. he tried to go back to sleep but felt as if his tongue was continuing to get swollen therefore he decided to drive to the ed for further evaluation. he has never experienced anything like this before. he has some pruritis associated with hep medications but no overt allergic reactions. the wife denies any wheezing or difficulty breathing and did not note a rash. he has previously had a reaction to hair dye where he broke out in hives and ?pustules. of note, he has been on lisinopril since at least and does not appear to have ever had a reaction. . in the ed, initial vs were: pulse: 100, rr: 18, bp: 142/84, rhythm: sinus tachycardia, o2sat: 99%, o2flow: ra, pain: 4. he was given epinephrine auto injector, methylprednisolone 125mg, diphenhydramine 50mg and famotadine 20mg. his tongue swelling was noted to be getting worse and it was decided to intubate the patientfor airway protection. he was given midazolam, ketamine and propofol. . on arrival to the micu, he was sedated and intubated. he was moving all extremities and appeared agitated therefore his propofol was increased as was his fentanyl. he was noted to have a large protruding tongue. past medical history: hep c- currently being treated with telaprevir, peggylated interferon and ribavirin () hypertension ckd stage iii social history: he lives in jp and is married. he worked as a personal care attendant but is currenlty unemployed. no etoh, alcohol or illicit drug use. pt. has 1 child with this partner, 2 others with other partners. family history: no h/o liver dz or ca. father had an mi at age 62. mother and 8 sibs in good health. no history of significant allergic reactions. physical exam: admission exam: vitals: bp: 147/87 p: 79 18 o2: 100 vent: 500/14/5/100 fio2 general: intubated and sedated heent: large edematous tongue that was protruding out of his mouth cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops lungs: rhonchi noted bilaterally, no wheezes, good air movement abdomen: soft, non-tender, non-distended, bowel sounds present, no organomegaly ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema physical exam on discharge: general: aaox3, nad heent: tongue normal in size, mm dry cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops lungs: ctab abdomen: soft, non-tender, non-distended, bowel sounds present, no organomegaly ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema pertinent results: admission labs: 05:50am blood wbc-2.4* rbc-3.08* hgb-10.2* hct-30.5* mcv-99* mch-32.9* mchc-33.3 rdw-14.6 plt ct-234 03:00pm blood pt-11.4 ptt-27.7 inr(pt)-1.1 03:15am blood gran ct-4190 05:29pm blood ret aut-1.8 05:50am blood glucose-135* urean-20 creat-1.8* na-124* k-4.3 cl-87* hco3-24 angap-17 03:00pm blood alt-38 ast-50* ck(cpk)-103 alkphos-69 totbili-0.7 01:45pm blood ck-mb-1 ctropnt-<0.01 08:12pm blood ck-mb-1 ctropnt-<0.01 03:00pm blood albumin-3.3* calcium-8.7 phos-3.5 mg-1.7 05:29pm blood hapto-<5* 03:15am blood triglyc-87 05:50am blood osmolal-260* 03:00pm blood c3-105 c4-30 09:20am blood type-art temp-36.1 rates-14/14 tidal v-500 peep-5 fio2-100 po2-505* pco2-39 ph-7.43 caltco2-27 base xs-2 aado2-172 req o2-38 intubat-intubated 09:20am blood lactate-1.0 10:24am blood tryptase-3 cxr (): as compared to the previous radiograph, the patient has been intubated. the tip of the endotracheal tube projects 3 cm above the carina. relatively low lung volumes. borderline size of the cardiac silhouette, mild retrocardiac atelectasis. the presence of a minimal left pleural effusion cannot be excluded. . tte (): the left atrium and right atrium are normal in cavity size. left ventricular wall thickness, cavity size and regional/global systolic function are normal (lvef >55%). right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic stenosis or aortic regurgitation. the mitral valve leaflets are mildly thickened. mild (1+) mitral regurgitation is seen. there is borderline pulmonary artery systolic hypertension. there is no pericardial effusion. impression: normal global and regional biventricular systolic function. mild mitral regurgitation. . discharge labs: 07:50am blood wbc-4.5 rbc-2.58* hgb-8.5* hct-26.2* mcv-101* mch-32.9* mchc-32.5 rdw-15.0 plt ct-192 07:50am blood glucose-128* urean-13 creat-1.4* na-134 k-4.3 cl-95* hco3-30 angap-13 07:50am blood calcium-9.2 phos-4.9* mg-1.8 01:37am blood alt-28 ast-28 alkphos-57 totbili-0.3 01:37am blood vitb12-819 folate-11.8 c1 esterase inhibitor assay: >100 (wnl) brief hospital course: primary reason for admisson: pt is a 54 yo male with a h/o hep c, currently on pegasys, telaprevir and ribavirin, htn (on lisinopril) and ckd who went to bed at midnight and woke up two hours later with tongue swelling. . active problems: . angioedema: his angioedema primarily affected his tongue. potential causes of his angioedema included lisinopril, hepatitis c treatment or food ingestion. lisinopril is certainly the most well known cause of angioedema and can occur even many years after initiation of therapy. peggylated interferon is also a rare cause of angioedema. no reports of ribivirin or telepravir causing angioedema, but telepravir is newly on the market and could be a potential cause. no unusual ingestions or new foods. also on the differential includes c1-inhibitor deficiency; an assay was sent for this and the result was normal. pt was intubated via fiber optic nasal scope in the ed and upon arrival to the micu was sedated and paralyzed. he was started on propofol/fentanyl gtt with rass goal -5. the pt required high dose propofol for sedation and became bradycardic to the 30s, though he was never hypotensive. his propofol was stopped and he was started on dexmetetomidine. adequate sedation could not be achieved with dexmetetomidine and he was transitioned to a versed gtt. he was given methlyprednisolone 80mg iv q8h, benadryl 50mg iv q8h and famotidine 20mg iv q12h. all home medications were held. his tongue swelling improved and he was extubated without incident. he was transitioned to po prednisone, benadryl and famotidine on the day of transfer to the medical floor. on the floor he remained stable, so was discharged with a prednisone taper and continued on fexofenadine while on the taper. benadryl was stopped due to complaints of somnolence. outpatient follow up arranged with allergy department. . # pancytopenia: present on admission, most likely drug effect, would favor telaprevir associated bone marrow suppression. there are also rare reports of captopril causing angioedema and pancytopenia; unclear if this happens with lisinopril. wbc and platelets rebounded to normal limits after all medications were held. anemia persisted, unclear etiology, potentially renal disease. haptoglobin was decreased raising concern for hemolysis, but coombs test was negative, no schistocytes seen on smear and t bili was normal. recommend pcp follow up. . # hyperkalemia: pt had intermittent hyperkalemia (potassium between 5.3 and 5.9). renal consulted given hyperkalemia, metabolic acidosis and hyponatremia intially on admission. renal recommended obtaining transtubular potassium gradient. ttkg returned at 6.27, which was consistent with mineralocorticoid deficiency. however, for this test to be valid, una should be >25, and his was <10. as such, the test characteristics are unclear. however, given the clinical context, would favor mineralocorticoid deficiency and recommend formal stim testing once no longer on steroids (renal did not recommend starting fludricortisone). another potential etiology of the hyperkalemia was heparin-induced type iv rta, as he developed hyperkalemia whenever sq heaprin was re-started. electrolytes were stable and creatinine at baseline at the time of discharge so he was given script for outpatient chem-7 to be faxed to his pcp for continued outpatient follow up of renal function. . # htn: pt has been hypertensive since weaning sedation and d/c??????ing lisinopril. on the day of transfer from the icu we started amlodipine 10mg po qday and labetalol 100 mg tid. on the floor pressures were well-controlled on this regimen, ranging from sbp 130-160s. due to concern that prednisone was contributing to hypertension, anti-hypertensives were not further uptitrated (as prednisone will be tapered on discharge) and he will follow up with his pcp regarding further hypertensive management. pt instructed not to take ace-i or arbs in the future. if down-titration of anti-hypertensives is indicated in the future, recommend discontinuing labetalol in favor of a once daily medication. . # nsvt: had a small run of nsvt on which was self limiting in the setting of precedex. precedex was therefore added to his allergy list. . chronic problems: . # ckd: cr remained at baseline throughout the admission. lisinopril was discontinued angioedema. . # hepatititis c: currently being treated with triple therapy. we held all hep c meds per liver. he will follow up with dr. in 2 weeks regarding further management of hcv. transitional issues: - outpatient follow up with allergy; consider scratch testing for interferon, ribavirin, or telaprevir - pt at risk for recurrent episodes of angioedema in the near future. will complete prednisone taper as instructed per allergy and take fexofenadine while on steroids as well. - severe reaction thought to be lisinopril. no ace-i or arbs in the future - question of heparin induced hyperkalemia (unsure of this was incidental) - follow up bp on new regimen of hctz, labetalol, amlodipine - follow up repeat electrolytes on - follow up anemia medications on admission: hydrochlorothiazide - 25 mg tablet - 1 tablet(s) by mouth once a day - no substitution lisinopril - 30 mg tablet - 1 tablet(s) by mouth once a day ribavirin 600 mg telaprevir 750 mg tid pegasys 180 mcg weekly injections discharge medications: 1. hydrochlorothiazide 12.5 mg capsule sig: two (2) capsule po daily (daily). 2. prednisone 10 mg tablet sig: as directed tablet po once a day for 8 days: taper instructions: 4 tabs on ; 3 tabs on ; 2 tabs on ; 1 tab on ; then stop. disp:*16 tablet(s)* refills:*0* 3. fexofenadine 180 mg tablet sig: one (1) tablet po once a day for 8 days: take while on steroids; can stop after steroid taper is complete. 4. labetalol 100 mg tablet sig: one (1) tablet po tid (3 times a day). disp:*90 tablet(s)* refills:*0* 5. outpatient lab work chem-7 diagnosis: type iv rta please fax results to pcp . (fax #) 6. amlodipine 10 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*0* discharge disposition: home discharge diagnosis: primary diagnosis: angioedema secondary diagnoses: hypertension hepatitis c cirrhosis discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you came to the hospital because you had swelling of your tongue. you were admitted to the icu and intubated to protect your breathing. an allergist was consulted and felt this was likely an allergic reaction to lisinopril, though other causes could also be possible. you were given steroids and the swelling improved so you were extubated. you should never take lisinopril again, and you should also avoid similar medications, which includes all drugs called "ace inhibitors" and "angiotension receptor blockers." these are drugs used to treat hypertension. while you were in the hospital your kidney function was found to be abnormal. due to concerns that your hcv medications could be related to your kidney dysfunction or to your tongue swelling, these were stopped. your kidney function improved. since your lisinopril was stopped, you were started on two new medications to control your blood pressure in its place. you should follow up with dr. to determine when or if it is safe to restart the hcv medication. the following changes were made to your medications: stopped lisinopril stopped peggylated inferferon stopped ribivirin stopped telepravir started prednisone 10mg tablet - this will be tapered as directed: take 4 tabs on ; take 3 tabs on ; take 2 tabs on ; take 1 tab on ; then stop. started fexofenadine () 180 mg once a day while on steroids; can stop after steroid taper is complete started amlodipine 10mg daily for hypertension started labetalol 100 mg three times a day for hypertension followup instructions: the following appointments have been made for you: department: internal medicine when: thursday at 9:40 am with: , md, mph building: (, ma) campus: off campus best parking: free parking on site *please note, your appointment for has been rescheduled to the date above. department: liver center when: monday at 10:00 am with: , pa building: lm bldg () campus: west best parking: garage department: div of allergy and inflam when: tuesday at 11:00 am with: , md building: one place (, ma) campus: off campus best parking: parking on site procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours insertion of endotracheal tube central venous catheter placement with guidance diagnoses: acidosis hyperpotassemia anemia, unspecified chronic hepatitis c without mention of hepatic coma hyposmolality and/or hyponatremia hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified chronic kidney disease, stage iii (moderate) acute respiratory failure other specified cardiac dysrhythmias hypotension, unspecified antiviral drugs causing adverse effects in therapeutic use long-term (current) use of other medications angioneurotic edema, not elsewhere classified intravenous anesthetics causing adverse effects in therapeutic use leukocytopenia, unspecified other sedatives and hypnotics causing adverse effects in therapeutic use other and unspecified agents primarily affecting the cardiovascular system causing adverse effects in therapeutic use other drug-induced pancytopenia 

Answer: The patient is high likely exposed to