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: low rectal villous adenoma/cancer aortic thrombus major surgical or invasive procedure: - s/p lap proctectomy, j-pouch, handsewn -anal anstomosis, diverting ileostomy s/p thrombectomy rt brachial artery - excision of aortic thrombus history of present illness: mr. is a 63 year old man who presents for surgical treatment of a low rectal villous adenoma/cancer. during his admission, an aortic mass was identified on ct scan and echo. he was referred to the cardiac surgery service for resection of this mass. past medical history: htn rectal villous adenoma social history: +tobacco ppd, russian speaking but speaks some english. supportive daughter who is able to translate, and works at in respiratory. family history: non-contributory physical exam: admission vitals- 99.2, bp 124/68, hr 96, rr 20, 100% ra gen- pleasant, sitting up in chair, no acute distress heent- +pallor. sclera non-icteric. op moist, no lesions neck- supple, no lad pulm- cta b/l. no r/r/w cv- rrr. no m/r/g. nl s1/s2 abd- sof, nt/nd. nabs. no hsm ext- no c/c/e. no rash, bruising or bleeding neuro- alert and oriented x 3. cnii- xii intact. ambulating skin- normal affect- normal rectal- brown, guaiac negative discharge vs t98.3 bp 93/65 hr 95sr rr18 o2sat 94%-ra gen: nad neuro: a&ox3, nonfocal exam pulm: cta-bilat cv rrr, no murmur. sternum stable incision cdi abdm: soft, nt/+bs. ostomy-pink. midline abdm incision w/staples, small amt serous drainage, small open area midwound, <1cm size ext: warm well perfused, 1+ peadal edema bilat pertinent results: hematology complete blood count wbc rbc hgb hct mcv mch mchc rdw plt ct 04:44pm 32.9*# chemistry renal & glucose glucose urean creat na k cl hco3 angap 04:44pm 4.7 chemistry totprot albumin globuln calcium phos mg uricacd iron 04:44pm 2.0 blood gas blood gases type temp rates tidal v peep fio2 o2 flow po2 pco2 ph caltco2 base xs 01:48pm 63* 59* 7.32* 32* 1 whole blood, miscellaneous chemistry glucose lactate na k cl 01:48pm 136* 1.5 138 4.3 106 hematology complete blood count wbc rbc hgb hct mcv mch mchc rdw plt ct 10:30am 11.3* 4.11* 11.0* 34.2* 83 26.8* 32.2 21.3* 463* basic coagulation (pt, ptt, plt, inr) pt ptt plt ct inr(pt) 05:40am 30.0* 3.1* chemistry renal & glucose glucose urean creat na k cl hco3 angap 10:30am 130* 7 0.8 136 3.9 100 25 15 cta 1. nonocclusive thrombus within the aortic arch. 2. occlusive thromboembolism of the left axillary artery 3. nonocclusive thrombus near the origin of the left internal mammary artery and thyrocervical trunk although these vessels opacify well. 4. fluid-filled loops of mildly dilated small bowel in a postoperative patient could represent ileus but are incompletely evaluated on this chest ct. abdominal radiographs may be helpful if clinically indicated. 5. mucous plugging of the right lower lobe bronchus and right lower lobe segmental bronchi. aortic thrombus and occlusive thromboembolism of the left axillary artery discussed immediately after completion of the scan at 2:40 a.m. with dr. of surgery. echo pt is intra-op for embolectomy of left arm no atrial septal defect is seen by 2d or color doppler. there is mild regional left ventricular systolic dysfunction with mild hypokinesis of the anterior and anteroseptal walls. overall left ventricular systolic function is mildly depressed (lvef= 45-50 %). the remaining left ventricular segments contract normally. right ventricular chamber size and free wall motion are normal. there is a large (2-3cm) mobile mass in the aortic arch. it is stalked with multiple fronds and is located just proximal to the left subclavian artery. the aortic valve leaflets (3) are mildly thickened. no aortic regurgitation is seen. the mitral valve leaflets are structurally normal. trivial mitral regurgitation is seen. mass consistent with thrombus or tumor with mobile atheroma being less likely. chest/coronary cta a cardiac cta was performed on this 63-year-old gentleman to evaluate the coronary arteries prior to aortic surgery for an intraluminal mass in the aortic arch. the examination was performed after 0.4 mg of nitroglycerin and an additional 5 mg of metoprolol. the heart rate was approximately 63 beats per minute. 100 ml of contrast material was used. there is excellent filling of the coronary arteries; however, because of a language barrier the patient did move during the filming which reduces diagnostic quality of the study. the images were acquired in a retrospective gated fashion. there is a small amount of calcification in the left anterior descending coronary artery with the calcium score in the 35th percentile for stated age and gender. one would not expect significant coronary artery disease with this calcium score. the functional images are not satisfactory because of motion. the cardiac output, however, did appear to be satisfactory and there was no abnormal wall motion. although the study is less than ideal there would not appear to be significant disease throughout the arterial tree. the circulation is right dominant. echo the left atrium is normal in size. no spontaneous echo contrast or thrombus is seen in the body of the left atrium or left atrial appendage. no atrial septal defect is seen by 2d or color doppler. left ventricular wall thicknesses and cavity size are normal. the right ventricular cavity is mildly dilated with normal free wall contractility. there are three aortic valve leaflets. the aortic valve leaflets are mildly thickened. there is no aortic valve stenosis. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. no mitral regurgitation is seen. there is no pericardial effusion. tee visualization of the thrombus performed. pedunculated and mobile tumor (2-2.5 cm) wide attached to the distal aortic arch proximal to the left subclavian artery. epiaortic scanning performed with the surfqace probe for exact localization of the tumor. post cpb: preserved biventricular systolic function. no change in valve structure and function the echo density could not be visualized in the distal aortic arch.. le ultrasound no deep venous thrombosis in right or left common femoral, superficial femoral, or popliteal veins. radiology preliminary report chest (pa & lat) 10:48 am chest (pa & lat) reason: r/o inf, eff medical condition: 63 year old man with reason for this examination: r/o inf, eff history: rule out effusion, infiltrate. chest, two views. the lungs are hyperinflated and the diaphragms are flattened, consistent with copd. the patient is status post sternotomy. there is cardiomegaly. there is a small left effusion versus pleural thickening and minimal blunting in the right costophrenic angle posteriorly as well. there is extensive parenchymal scarring, including scarring at the right lung apex. clips are seen over the right upper chest laterally. no definite pneumothorax. no acute chf or infiltrate. compared with , the sheath has been removed. the pleural effusions are slightly more apparent. bilateral upper lobe scarring and subcentimeter pulmonary nodules, better assessed on the torso ct at which time findings were felt to be unchanged since . dr. brief hospital course: the patient was admitted to the surgery service for post operative evaluation and treatment from a laparoscopic proctectomy, j-pouch, handsewn coloanal anstomosis, diverting ileostomy on; for details, please see operative note. the patient initially recovered in the pacu, and was transferred to the floor for further managment . he acutely developed a cold left upper extremity and the vascular surgery service was consulted. iv heparin was started and cta revealed a left axillary thrombus which was occlusive and an aortic arch thrombus. he was taken urgently to the operating room where he underwent a left brachial thromboembolectomy with good result. the cardiac surgical service was consulted given his aortic arch mass, a cta of his coronaries was negative. on , mr. was taken to the operating room where he underwent an excision of an aortic thrombus. postoperatively he was taken to the cardiac surgical intensive care unit. he awoke neurologically intact and was extubated on the day of surgery. on pod1 his chest tube were removed and anticoagulation was begun. he was transferred to the cardiac surgery floor on pod1. over the next several days the patient had an uneventful post-operative course and on pod5 it was decided he was stable and ready for discharge home. his inr will be followed by dr . phone medications on admission: lisinopril 2.5', mvi' discharge medications: 1. nicotine 14 mg/24 hr patch 24 hr sig: one (1) patch 24 hr transdermal daily (daily). disp:*15 patch 24 hr(s)* refills:*4* 2. oxycodone 5 mg tablet sig: 1-2 tablets po every four (4) hours as needed for fever or pain for 2 weeks: take with tylenol. disp:*30 tablet(s)* refills:*0* 3. tylenol 325 mg tablet sig: 1-2 tablets po every four (4) hours as needed for pain for 2 weeks: take with oxycodone. 4. imodium a-d 2 mg tablet sig: 1-2 tablets po every 4-6 hours as needed for liquid stool: do not exceed 16mg in 24hours. 5. lisinopril 2.5 mg tablet sig: one (1) tablet po once a day. 6. multivitamin tablet sig: one (1) tablet po once a day. 7. furosemide 20 mg tablet sig: one (1) tablet po once a day for 2 weeks. disp:*14 tablet(s)* refills:*0* 8. oxycodone-acetaminophen 5-325 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for pain. disp:*40 tablet(s)* refills:*0* 9. potassium chloride 20 meq tab sust.rel. particle/crystal sig: one (1) tab sust.rel. particle/crystal po once a day for 2 weeks. disp:*14 tab sust.rel. particle/crystal(s)* refills:*0* 10. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* 11. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 12. nicotine 14 mg/24 hr patch 24 hr sig: one (1) patch 24 hr transdermal daily (daily) for 1 weeks. disp:*7 patch 24 hr(s)* refills:*0* 13. nicoderm cq 7 mg/24 hr patch 24 hr sig: one (1) transdermal once a day for 2 weeks: start after 14mg patch completed. disp:*14 * refills:*0* 14. warfarin 2 mg tablet sig: as directed tablet po once a day: target inr 2.5-3 take 4mg on & then as directed by dr . disp:*60 tablet(s)* refills:*2* 15. cohesive seals misc sig: qs # miscellaneous as needed. disp:*1 box* refills:*11* 16. convatec surfit nattura wafer sig: # 1 box as needed. disp:*2 boxes* refills:*11* 17. convatec surfit natura pouch sig: # 10/box as needed. disp:*2 boxes* refills:*11* 18. convatec stomadhesive pouch sig: # as needed. disp:*1 bottle* refills:*0* 19. safe and simple stoma wipes sig: #sns00525 25/pk as needed. disp:*2 pk* refills:*11* discharge disposition: home with service facility: all care vna of greater discharge diagnosis: primary: low rectal villous adenoma/cancer aortic thrombus s/p removal thrombectomy of brachial artery secondary: htn mi ' discharge condition: stable tolerating a regular diet adequate pain control with oral medication discharge instructions: 1) monitor wounds for signs of infection. these include redness, drainage or increased pain. in the event that you have drainage from your sternal wound, please contact the at (. for drainage from the abdominal wound please call dr office @ 2) report any fever greater then 100.5. 3) report any weight gain of 2 pounds in 24 hours or 5 pounds in 1 week. 4) no lotions, creams or powders to incision until it has healed. you may shower and wash incision. gently pat the wound dry. please shower daily. no bathing or swimming for 1 month. use sunscreen on incision if exposed to sun. 5) no lifting greater then 10 pounds for 10 weeks. 6) no driving for 1 month. 7) call with any questions or concerns. monitoring ostomy output/prevention of dehydration: -keep well hydrated. -replace fluid loss from ostomy daily. -avoid only drinking plain water. include gatorade and/or other vitamin drinks to replace fluid. -try to maintain ostomy output between 500ml to 1000ml per day. -if ostomy output >1 liter, take 4mg of imodium, repeat 2mg with each episode of loose stool. do not exceed 16mg/24 hours. md procedure: extracorporeal circulation auxiliary to open heart surgery diagnostic ultrasound of heart transfusion of packed cells exteriorization of large intestine anastomosis to anus incision of vessel, upper limb vessels anterior resection of rectum with synchronous colostomy incision of vessel, aorta diagnoses: tobacco use disorder unspecified essential hypertension peripheral vascular complications, not elsewhere classified embolism and thrombosis of thoracic aorta malignant neoplasm of rectum arterial embolism and thrombosis of upper extremity 

Answer: The patient is high likely exposed to