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: morphine / prochlorperazine / tramadol attending: chief complaint: ugib major surgical or invasive procedure: none history of present illness: 27 year old female pmhx t1dm, gastroperesis, grade1 varices on recent egd , chronic lbp mvc in , and recent admission for dka that was complicated by a right-sided pneumothorax presenting with an acute non-traumatic worsening of lower back pain. in addition, the patient complains of nausea and vomiting x10 today. no clinical features to suggest acute abd process including aortic dissection or infectious processes including epidural abscess or acute spinal cord impingement. reassuring that this is per the pt identical to prior exacerbations. there are no features on exam to suggest respiratory distress or tension pneumothorax. she also complained low back pain that was relieved. based on review of prior egd report, she does have known grade 1 varices. . ed course: hr132 bp171/116 o2 100%/ra. she vomited 20cc of coffee ground emesis. she refused ngt lavage. groin line was placed and piv. she was given 2l ns ivf and 3mg iv dilaudid for pain, reglan for gastroparesis. ekg negative for ischemic changes or qt prolongation. in addition to the lower back pain, patient is noted to be actively retching with approximately 10-20 cc of coffee-ground emesis. ekg: no changes or qt prlongation. she was started on a protonix gtt octreotide gtt. . on the floor, she reports that she felt unwell since this am with back pain and began to experience vomiting clear liquid around noon and presented to the ed. once she arrived here she vomited small amount of coffee ground emesis. denies frank hematemesis, abd pain, diarrhea. nausea and vomiting now resolved. has had occasional chills, subjective fevers. denies etoh, drugs or recent tobacco use. passing flatus. last bm on , stools every 3-4 days at baseline. of note pt states that she has been under high levels of emotional stress as she has been having high anxiety states and panic attacks surrounding sexual abuse flashbacks from age 11yo. she declines social work consult currently. . review of systems: (+) per hpi (-) denies fever, chills, night sweats, recent weight loss or gain. denies headache, sinus tenderness, rhinorrhea or congestion. denies cough, shortness of breath, or wheezing. denies chest pain, chest pressure, palpitations, or weakness. denies nausea, vomiting, diarrhea, constipation, abdominal pain, or changes in bowel habits. denies dysuria, frequency, or urgency. denies arthralgias or myalgias. denies rashes or skin changes. . past medical history: - diabetes mellitus type i: diagnosed age 16 in after her first pregnancy. followed at . - severe anxiety/panic attacks - previous admissions for nausea/vomiting with h/o esophagitis and with concern for diabetic gastroparesis on metoclopramide - esophagitis / h. pylori and again - stage i diabetic nephropathy - grade i esophageal varices seen on scope in , negative liver ultrasound, normal lfts, hep panel negative - anxiety/panic attacks - depression - hyperlipidemia - s/p mva - lower back pain since then. - s/p mva , ex-lap - g2p1ab1, s/p miscarriage in 06/00 3rd trimester, s/p c-section in , not menstruating secondary to being on depo-provera - genital herpes - h pylori, s/p 2-week triple therapy on . social history: lives with her 9 yo son. on disability. - tobacco: quit "years ago" - alcohol: glasses wine or champagne at holidays/special occasions (none recently) - illicits: none, denies ivdu family history: grandmother with diabetes, no other significant family history physical exam: admission physical vitals: t:98.0 bp:138/78 p:109 r: 17 o2:98/ra general: alert, oriented, thin aa female, sitting in bed, no acute distress : sclera anicteric, oral mucosa pink/dry, oropharynx clear neck: supple, jvp not elevated, no lad lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly gu: no foley ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema, r groin line in place pertinent results: 03:30am wbc-7.6 rbc-2.93* hgb-8.7* hct-25.1* mcv-86 mch-29.6 mchc-34.4 rdw-13.4 plt ct-185 08:05am wbc-7.5 rbc-3.39* hgb-9.5* hct-29.4* mcv-87 mch-28.1 mchc-32.3 rdw-13.9 plt ct-292 11:12pm pt-12.9 ptt-25.2 inr(pt)-1.1 03:30am glucose-250* urean-11 creat-1.1 na-136 k-3.4 cl-100 hco3-30 angap-9 08:05am glucose-278* urean-10 creat-1.0 na-134 k-4.4 cl-99 hco3-27 angap-12 03:22am alt-10 ast-14 alkphos-54 totbili-0.4 chest (pa & lat) study date of 9:41 pm findings: the lungs are well expanded and clear. the mediastinum is unremarkable. the cardiac silhouette is within normal limits for size. no effusion or pneumothorax is noted. the osseous structures are unremarkable. impression: no acute pulmonary process. no recurrent pneumothorax seen. . . chest (portable ap) study date of 5:10 pm history: chest tube pulled. findings: the right-sided chest tube has been removed. there is no pneumothorax. the lungs are clear. . . cardiology report ecg study date of 6:58:34 pm . sinus tachycardia. accelerated a-v conduction. compared to the previous tracing of no significant change. . intervals axes rate pr qrs qt/qtc p qrs t 129 118 76 312/432 79 81 60 brief hospital course: ms. is a 27y f hx of dm1, recent ptx s/p rij placement with recent admission for dka presenting with low back pain, nausea/vomiting and episode of coffee ground emesis concerning for ugib, initially monitored overnight in micu, but found to have stable hematocrit, resolved after several hours. # coffee ground emesis patient had scant amount of coffee ground emesis in the ed which resolved on arrival to floor. she continued to have nausea/vomiting but was non-bloody bilious vomiting wo coffee grounds or frank . there was low concern for ugib - thought to be self resolving vs pud given hpylori positive, has been treated in past but unclear if re-infected. she was started on protonix and octreotide gtt in the ed and was transitioned to protonix iv bid in the micu without octreotide given clinical stability. she did have grade 1 varix on egd in , though unclear etiology and no hx of prior variceal bleed. very low suspicion for variceal bleed given hd stability, hct stable and cessation of emesis. gi was not consulted in the ed on presentation and given her clinical stability in the micu and low suspicion for ongoing gib, micu team did not consult gi as she did not require egd. she was transitioned to po meds: antiemetics, po dilaudid and pantoprazole. she was bolused with ns for dehydration and poor po intake prior to presentation - and tachycardia. femoral line (placed in the ed) was discontinued prior to transfer to the floor. her diet was advanced to clears and then as tolerated. on transfer to the floor, patient's of nausea/vomiting had resolved. # gastroparesis chronic cause of her nausea/vomiting. nausea/vomiting flares are often triggered by stressors such as the low back pain, per patient, though she reports they are not the same as her gastroparesis flares. she was continued on home reglan and lantus. her pain was controlled with iv dilaudid and transitioned to po dilaudid when her vomiting decreased. transitioned back to po oxycodone on arrival to the floor which is what she was given at discharge on prior hospitalization (given 15 pills with no need for refills at that time). patient's had resolved by discharge. # low back pain related to hx of mva, now has chronic pain. psychiatric issues could be contributing to back pain . was on dilaudid in micu but was transitioned back to oxycodone on arrival to floor and has pills left from previous hospitalization to take as an outpatient. heat packs helped with pain. continued on home gabapentin. # ptsd patient has hx of sexual abuse, had psych consult on previous admission, resulting in setup of outpatient psych eval for day program. she feels these social stressors weigh down her significantly, and that the stress may have triggered last dka episode. citalopram was continued at home dose. outpatient psych eval rescheduled for this . # dm1 patient presented with dka on previous admission, sugars have been stable on home regimen. she gets lantus at baseline with humalog sliding scale adjusted by carb counting and fasting sugars. by time of transfer to floor, she was tolerating pos and was back on home regimen. she did have one episode of hypoglycemia with sugar to 39 on the morning of discharge which resolved with dextrose. # htn patient was continued on home lisinopril. # communication: patient, mother/ mother # code: full code during this hospitalization medications on admission: 1. gabapentin 300 mg capsule sig: one (1) capsule po tid (3 times a day). 2. camphor-menthol 0.5-0.5 % lotion sig: one (1) appl topical prn (as needed) as needed for itching. 3. lidocaine 5 %(700 mg/patch) adhesive patch, medicated sig: one (1) adhesive patch, medicated topical daily (daily) as needed for lower back pain: 12 hours on, 12 hours off as needed for lower back pain. 4. lisinopril 10 mg tablet sig: one (1) tablet po daily (daily). 5. citalopram 20 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 6. lantus 100 unit/ml solution sig: 20 u subcutaneous at bedtime. 7. metoclopramide 10 mg tablet sig: one (1) tablet po qidachs. 8. oxycodone 5 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for pain. disp:*15 tablet(s)* refills:*0* discharge medications: 1. gabapentin 300 mg capsule sig: one (1) capsule po q8h (every 8 hours). 2. lidocaine 5 %(700 mg/patch) adhesive patch, medicated sig: one (1) adhesive patch, medicated topical daily (daily). 3. lisinopril 10 mg tablet sig: one (1) tablet po daily (daily). 4. citalopram 20 mg tablet sig: one (1) tablet po daily (daily). 5. metoclopramide 10 mg tablet sig: one (1) tablet po qid (4 times a day): qachs. 6. lantus 100 unit/ml solution sig: twenty (20) units subcutaneous at bedtime. 7. camphor-menthol 0.5-0.5 % lotion sig: one (1) unit topical twice a day as needed for itching. 8. humalog 100 unit/ml solution sig: per home sliding scale subcutaneous qachs: per home sliding scale. 9. (patient had also been given oxycodone from previous hospitalization and has some tablets left, but this is not a home medication to be continued) discharge disposition: home discharge diagnosis: primary: nausea and vomiting low back pain secondary: diabetes mellitus type 1 discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: dear ms. , you were admitted to the hospital because you were having nausea and vomiting and your vomit looked like it may have been old , you were monitored overnight in the intensive care unit to make sure you did not have any bleeding, then transfered to the regular floor. your sugars were under good control this hospitalization, but you did have one episode of low sugars while you were sleeping. please be very careful about this at home. no changes have been made to your medications. please be sure to keep the psychiatric evaluation appointment in this . as we discussed, it will be very helpful for you to help gain coping strategies to help you get past the difficult times you have been through. followup instructions: please be sure to keep all of your followup appointments. psychiatry evaluation: , at 9:15am , , ma, department: spine center when: thursday at 10:00 am with: , md building: sc clinical ctr campus: east best parking: garage primary care: department: when: at 1:45 pm with: , md building: sc clinical ctr campus: east best parking: garage department: div. of gastroenterology when: at 10:00 am with: , md building: ra (/ complex) campus: east best parking: main garage procedure: venous catheterization, not elsewhere classified diagnoses: nephritis and nephropathy, not specified as acute or chronic, in diseases classified elsewhere other chronic pain acute posthemorrhagic anemia depressive disorder, not elsewhere classified other and unspecified hyperlipidemia long-term (current) use of insulin hematemesis dehydration lumbago diabetes with neurological manifestations, type i [juvenile type], uncontrolled diabetes with renal manifestations, type i [juvenile type], uncontrolled gastroparesis esophageal varices without mention of bleeding posttraumatic stress disorder diabetes with other specified manifestations, type i [juvenile type], uncontrolled panic disorder without agoraphobia genital herpes, unspecified 

Answer: The patient is high likely exposed to