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: penicillins / codeine / adhesive tape / cholinesterase inhibitor(carbamate) / bactrim ds / iodine-iodine containing / pravachol / lipitor / betadine / sulfa (sulfonamide antibiotics) / anectine / magnesium citrate / crestor / niacin / zetia / pregabalin attending: chief complaint: exertional dyspnea, recent sycope major surgical or invasive procedure: aortic valve replacement (#19mm pericardial)/ myomectomy cardiac cath history of present illness: this is a 70 year old female with multiple medical issues who has known aortic stenosis which has been followed by serial echocardiograms for the past several years. early this she had a syncopal episode. she was admitted and on telemetry for 48 hours which showed no arrythmias and she ruled out for myocardial infarction. her last echocardiogram in showed severe aortic stenosis with a peak velocity of 3.8m/s. currently her symptoms include exertional dyspnea, poor exercise tolerance and fatigue. given her recent sycopal episode and known severe aortic stenosis, she has been referred for surgical evaluation. past medical history: 1. aortic stensosis 2. hypertension 3. hyperlipidemia 4. osteoarthritis - currently awaiting left hip replacement 5. diabetes mellitus type ii 6. sj??????grens syndrome 7. obstructive sleep apnea 8. fibromyalgia/nocturnal leg cramping/restless leg syndrome 9. burning tongue syndrome 10. stress incontinence 11. de quervain's tendinitis 12. venous stasis with spider veins 13. gerd 14. allergic rhinitis, history of sinusitis 15. stable left lung nodule 16. depression/anxiety 17. carpal tunnel syndrome 18. adie's pupil 19. hearing loss - bilateral hearing aids 20. back pain 21. lactose intolerance 22. actinic keratosis 23. raynauds disease 24. history of kidney stones 25. history of fatty liver - prior liver biopsy 26. constipation 27. pseudocholinesterase deficiency past surgical history: 1. tonsillectomy 2. nasal surgery 3. cholecystectomy 4. laminectomy l4-5- 5. tah/bso-- question raised whether supracervical procedure-cervix was found on exam and pap smear obtained. 6. bladder suspension, 7. right rotator cuff surgery- 8. cervical diskectomy 9. sinus surgery, 10. left knee arthroscopy? 11. left knee-arthroscopy? 12. spinal fusion l4-s1, 13. right tibial plateau for a status post two screws and fusion, 14. sinus surgery, 15. right carpal tunnel release 16. total knee replacement right, 17. right knee revision, 18. venous closure and phlebectomy for varicose veins - dr. 19. right wrist first dorsal compartment release and a right wrist arthroscopy. , dr. 20. laminetomy l2-3 , dr. social history: race: caucasian last dental exam: dental clearance obtained lives with: husband occupation: retired cigarettes: 6 pyh. quit over 30 years ago. etoh: social, denies history of etoh abuse illicit drug use: denies family history: father cabg in his 60's, died at age 72 of myocardial infarction. physical exam: pulse: 84 resp: 16 o2 sat: 100% room air b/p right: 138/80 left: general: wdwn female in no acute distress skin: dry intact heent: perrla eomi neck: supple full rom chest: lungs clear bilaterally heart: rrr irregular murmur grade 3/6 sem radiating to carotids abdomen: soft non-distended non-tender bowel sounds + extremities: warm , well-perfused edema: none varicosities: spider veins present. no gross varicosities noted. neuro: grossly intact pulses: femoral right: 2+ left: 2+ dp right: 2+ left: 2+ pt : 2+ left: 2+ radial right: 2+ left: 2+ carotid bruit: soft transmitted murmur noted bilaterally pertinent results: cardiac cath: 1. selective coronary angiography of this left dominant system demonstrated no angiographically-apparent coronary artery disease. the lmca, lad, dominant lcx, and rca were all free of any obstructive disease. 2. limited resting hemodynamics revealed normal systemic arterial pressures, with a central aortic pressure of 121/61, mean 88 mmhg. . carotid u/s: right ica no stenosis. left ica no stenosis. . echo: pre-bypass: the left atrium is moderately dilated. at least one pulmonary vein may be entering the right atrium. no atrial septal defect is seen by 2d or color doppler. left ventricular wall thicknesses and cavity size are normal. overall left ventricular systolic function is normal (lvef>55%). right ventricular chamber size and free wall motion are normal. there are complex (>4mm) atheroma in the descending thoracic aorta. there are three aortic valve leaflets. the aortic valve leaflets are severely thickened/deformed. there is critical aortic valve stenosis (valve area <0.8cm2). trace aortic regurgitation is seen. the mitral valve leaflets are moderately thickened. there is moderate thickening of the mitral valve chordae. mild (1+) mitral regurgitation is seen. there is no pericardial effusion. post cpb: 1. preserverd -ventricular systolci function. 2. bioprosthetic valve in aortic position. wewll seated and stable with good leaflet excursion. pg + 28 mm hg. 3. chordal with trivial mr. 4. no other change. . 06:18am blood wbc-7.9 rbc-2.72* hgb-7.5* hct-24.2* mcv-89 mch-27.6 mchc-30.9* rdw-13.5 plt ct-195# 05:30pm blood wbc-12.8* rbc-4.12* hgb-11.9* hct-37.6 mcv-91 mch-28.8 mchc-31.5 rdw-13.4 plt ct-300 02:28am blood pt-14.5* ptt-35.8 inr(pt)-1.4* 06:18am blood glucose-113* urean-19 creat-0.5 na-138 k-4.4 cl-101 hco3-32 angap-9 05:30pm blood glucose-125* urean-21* creat-0.5 na-140 k-3.6 cl-104 hco3-25 angap-15 brief hospital course: mrs. was admitted on following her cardiac cath which revealed no coronary artery disease. she underwent further testing this day for preparation of surgery the following day. on she was brought to the operating room where she underwent an aortic valve replacement (#19mm pericardial)?myomectomy. please see operative note for surgical details. following surgery she was transferred to the cvicu for invasive monitoring in stable condition. later this day she was weaned from sedation, awoke neurologically intact and extubated. on post-op day one she was started on beta-blockers and diuretics and gently diuresed towards her pre-op weight. pod#2 she was transferred to the step-down floor for further care. chest tubes and epicardial pacing wires were removed per protocol. she remained hemodynamically stable in sinus rhythm. with aggressive pulmonary toilet and ambulation she titrated off oxygen. her pain was well controlled with ultram and nsaids. she was evaluated by by physical therapy. the remainder of her postoperative course was essentially uneventful. she continued to make steady progress and was discharged to in on pod# 4. all follow up appointmets were advised. medications on admission: albuterol sulfate - 90 mcg hfa aerosol inhaler - qid prn azelastine - 137 mcg (0.1 %) aerosol, spray - 1 spray/nostril(s) twice a day as needed for seasonal allergies clonazepam - 2 mg tablet, rapid dissolve - 1 tablet(s) by mouth at bedtime duloxetine - 60 mg capsule, delayed release(e.c.) - 1 capsule(s) by mouth once a day fluvastatin - 80 mg tablet extended release 24 hr - 1 tablet(s) by mouth 3-4times/week lisinopril - 40 mg tablet - 1 tablet(s) by mouth once a day metformin - 500 mg tablet extended rel 24 hr - 1 tab(s) by mouth once a day omeprazole - 20mg capsule, delayed release(e.c.) - one every morning one touch ultrasmart test strips - - test four times a day pramipexole - 0.5 mg tablet - 1 tablet(s) by mouth hs prn rls prednisone - (prescribed by other provider) - 20 mg tablet - 2 tablet(s) by mouth take 40mg tues pm, 40mg wed4/11 am. premedications for dye allergy called into pt's pharmacy per dr. ranitidine hcl - (prescribed by other provider) - 150 mg tablet - 1 tablet(s) by mouth take 1 tablet tues pm, 1 tablet wed am premed for contrast allergy zolpidem - (on hold from to unknown for trial off) - 10 mg tablet - 1 tablet(s) by mouth at bedtime medications - otc aspirin - 81 mg tablet, chewable - 1 tablet(s) by mouth qd with meal calcium carbonate-vitamin d3 - (prescribed by other provider) - 600 mg calcium (1,500 mg)-400 unit tablet - tablet(s) by mouth once a day lancets - misc - test three times a day omega-3 fatty acids-vitamin e - (otc) - dosage uncertain discharge medications: 1. pramipexole 0.5 mg tablet sig: one (1) tablet po qhs, prn () as needed for rls. 2. fluvastatin 40 mg capsule sig: two (2) capsule po twice a day. 3. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po bid (2 times a day). 4. duloxetine 20 mg capsule, delayed release(e.c.) sig: three (3) capsule, delayed release(e.c.) po daily (daily). 5. albuterol sulfate 90 mcg/actuation hfa aerosol inhaler sig: 1-2 puffs inhalation q6h (every 6 hours) as needed for shortness of breath or wheezing. 6. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours) as needed for pain, fever. 7. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 8. aspirin 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 9. potassium chloride 20 meq packet sig: one (1) packet po q12h (every 12 hours) for 10 days. 10. bisacodyl 10 mg suppository sig: one (1) suppository rectal daily (daily) as needed for constipation. 11. insulin regular human 100 unit/ml solution sig: one (1) injection achs: per sliding scale. 12. metformin 500 mg tablet sig: 0.5 tablet po daily (daily). 13. metoprolol tartrate 25 mg tablet sig: 0.25 tablet po bid (2 times a day). 14. tramadol 50 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for pain. disp:*40 tablet(s)* refills:*0* 15. lasix 20 mg tablet sig: one (1) tablet po twice a day for 10 days. discharge disposition: extended care facility: - discharge diagnosis: aortic stensosis s/p aortic valve replacement past medical history: hypertension hyperlipidemia osteoarthritis - currently awaiting left hip replacement diabetes mellitus type ii sj??????grens syndrome obstructive sleep apnea fibromyalgia/nocturnal leg cramping/restless leg syndrome burning tongue syndrome stress incontinence de quervain's tendinitis venous stasis with spider veins gerd allergic rhinitis, history of sinusitis stable left lung nodule depression/anxiety carpal tunnel syndrome adie's pupil hearing loss - bilateral hearing aids back pain lactose intolerance actinic keratosis raynauds disease history of kidney stones history of fatty liver - prior liver biopsy constipation pseudocholinesterase deficiency discharge condition: alert and oriented x3 nonfocal ambulating with steady gait incisional pain managed with ultram and nsaids incisions: sternal - healing well, no erythema or drainage leg right/left - healing well, no erythema or drainage. edema discharge instructions: please shower daily including washing incisions gently with mild soap, no baths or swimming until cleared by surgeon. look at your incisions daily for redness or drainage please no lotions, cream, powder, or ointments to incisions each morning you should weigh yourself and then in the evening take your temperature, these should be written down on the chart no driving for approximately one month and while taking narcotics, will be discussed at follow up appointment with surgeon when you will be able to drive no lifting more than 10 pounds for 10 weeks please call with any questions or concerns females: please wear bra to reduce pulling on incision, avoid rubbing on lower edge **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** followup instructions: you are scheduled for the following appointments surgeon: dr. office will contact you to arrange an appointment dr. phone: date/time: 11:00 provider clinic phone: date/time: 10:15 cardiologist: dr. date/time: 12:20 please call to schedule appointments with your primary care dr. in weeks **please call cardiac surgery office with any questions or concerns . answering service will contact on call person during off hours** procedure: venous catheterization, not elsewhere classified extracorporeal circulation auxiliary to open heart surgery coronary arteriography using two catheters left heart cardiac catheterization open and other replacement of aortic valve with tissue graft diagnoses: obstructive sleep apnea (adult)(pediatric) anemia, unspecified esophageal reflux unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled aortic valve disorders personal history of tobacco use depressive disorder, not elsewhere classified other and unspecified hyperlipidemia anxiety state, unspecified unspecified hearing loss myalgia and myositis, unspecified examination of participant in clinical trial raynaud's syndrome other chronic nonalcoholic liver disease venous (peripheral) insufficiency, unspecified restless legs syndrome (rls) solitary pulmonary nodule sicca syndrome other specified diseases of blood and blood-forming organs 

Answer: The patient is high likely exposed to