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: post-op hypoxia major surgical or invasive procedure: percutaneous fixation of right acetabular column fracture history of present illness: 81 f with pmh of af on coumadin, htn, hld, hypothyroidism, anxiety, depression, and ibs admitted to the ortho service with a r acetabular fracture after a mechanical fall yesterday. she was taken to the or today for an orif. intraoperatively, she had bronchospasm that resolved with albuterol. post-operatively, when she was extaubted she had diffuse wheezing and was hypoxic to 80's on nasal cannula. her o2 sat increased to 93-95% on an nrb. she was transitioned to bipap with increase in sats 95-97%. cxr showed pulmonary edema. she received lasix 10mg iv, then 20mg iv with 1600cc of urine output. she is being transferred to the icu for pulmonary edema requiring bipap. past medical history: past medical history: atrial fibrillation (chads2 is 2) hypertension hyperlipidemia hypothyroidism anxiety depression ibs s/p appendectomy social history: social history: from , retired, no tobacco, rare etoh, no drugs. married. husband is retired internist. family history: non-contributory physical exam: on evaulation in the pacu: vitals: t: afebrile bp:126/76 p:65 r: 18 o2:95% general: alert, oriented, no acute distress. breathing comfortably on nrb. heent: sclera anicteric. neck: supple, jvp ~10cm, no lad lungs: diffuse wheezing anteriorly with scattered rhonchi. 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: foley draining clear yellow urine. ext: surgical dressings on right leg. left leg and right le distal to bandaging were warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema on discharge: vitals: t: 98.8, bp: 116/61, p: 81, rr: 18, o2: 95% on ra general: pt comfortable, in nad lungs: fine crackles at the bases bilaterally, no wheezes cv: rrr, s1, s2, no murmurs/rubs/gallops ext: right leg externally rotated, no clubbing/cyanosis/edema pertinent results: on admission: . 05:19pm blood wbc-16.8* rbc-4.72 hgb-14.2 hct-41.7 mcv-89 mch-30.1 mchc-34.0 rdw-13.9 plt ct-316 05:19pm blood neuts-87.7* lymphs-7.7* monos-3.8 eos-0.4 baso-0.4 05:19pm blood pt-28.1* ptt-32.2 inr(pt)-2.8* 05:19pm blood glucose-135* urean-20 creat-0.9 na-138 k-4.5 cl-101 hco3-24 angap-18 01:54pm blood ck(cpk)-221* 09:41pm blood calcium-8.0* phos-3.3 mg-1.8 . on discharge: . 06:15am blood wbc-13.1* rbc-3.38* hgb-10.0* hct-30.6* mcv-91 mch-29.7 mchc-32.8 rdw-14.7 plt ct-481* 06:30am blood pt-18.1* ptt-29.3 inr(pt)-1.6* 06:15am blood glucose-94 urean-25* creat-0.9 na-134 k-4.2 cl-95* hco3-30 angap-13 06:30am blood calcium-9.2 phos-3.9 mg-1.9 . coags: 10:35am pt-26.5* inr(pt)-2.6* 10:02pm pt-24.5* inr(pt)-2.3* 06:40am pt-25.1* ptt-30.0 inr(pt)-2.4* 05:19pm pt-28.1* ptt-32.2 inr(pt)-2.8* . inrs and coumadin dose 8/7 4mg 1.6 4mg 1.6 4mg 2.0 4mg . ct pelvis: 1. comminuted right acetabular fracture with extension into the right iliac and inferior pubic ramus with adjacent hematoma. no evidence of active extravasation. note that traumatic bladder injury is not excluded and if this is a concern clinically, would recommend further evaluation with a ct cystogram. 2. atherosclerotic disease with abdominal aortic ectasia. 3. diverticulosis. . ct c-spine: impression: no acute fracture or traumatic malalignment. note that degenerative changes with osteophyte formation slightly efface the ventral thecal sac, which may predispose to traumatic cord injury. if the physical examination of the patient is concerning for this entity, this could be further evaluated with mri, if no contraindication. . the study and the report were reviewed by the staff radiologist . ct cystogram: . impression: . 1. no contrast extravasation to suggest urinary bladder rupture. 2. extensive right acetabular fractures with adjacent hematoma, unchanged from the recent comparison studies. . cxr: reason for exam: desaturation, assess for aspiration or foreign body. . comparison is made with prior study . . mild-to-moderate cardiomegaly is stable. new diffuse lung opacities are larger in the right upper lobe and left lower lobe. the differential diagnosis is broad and include massive aspiration, hemorrhage. i doubt, this corresponds to asymmetric pulmonary edema or contusions. there is no pneumothorax or large pleural effusions . cxr ap/lat: impression: interval improvement in pulmonary vascular congestion and probable focal infiltrate at the left lung base. . echo : the left atrium is elongated. there is mild symmetric left ventricular hypertrophy with normal cavity size and regional/global systolic function (lvef>55%). the right ventricular cavity is moderately dilated with borderline normal free wall function. the diameters of aorta at the sinus, ascending and arch levels are normal. the aortic valve leaflets (3) are mildly thickened. there is no valvular aortic stenosis. the increased transaortic velocity is likely related to increased stroke volume due to aortic regurgitation. mild (1+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. trivial mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. moderate tricuspid regurgitation is seen. there is moderate pulmonary artery systolic hypertension. there is a trivial/physiologic pericardial effusion. . impression: mild symmetric left ventricular hypertrophy with normal systolic function. dilated right ventricle with moderate tricuspid regurgitation and moderate pulmonary artery systolic hypertension. . hip x-ray: impression: right acetabular fracture, status post orif as above. please see recent ct for fracture details brief hospital course: ms. is an 81-year-old woman with afib on coumadin, htn, hld, ibs and had a mechanical fall on , resulting in a right acetabular column fracture. the patient underwent an orif of her fracture. and had post operative difficulty ventilating in the pacu. she was transferred to the the icu and was treated with bipap. . 1. pulmonary edema: post-operatively, when she was extaubted she had diffuse wheezing and was hypoxic to 80's on nasal cannula. her o2 sat increased to 93-95% on an nrb. she was transitioned to bipap with increase in sats 95-97%. cxr showed pulmonary edema. she received lasix 10mg iv, then 20mg iv with 1600 cc of urine output. she was weaned to 4 l of nasal canula. she was transferred to the icu for pulmonary edema requiring bipap. . in the icu, the patient was further diuresed 3 boluses of 20 mg lasix iv and put out an additional 2 l urine. after, she put out 2 l of additional urine and was weaned to 3 l nc and was saturating at 93%. she was called out to the floor. . on the floor, the patient continued to tolerate weaning and was eventually weaned off oxygen and saturated 95% on ra. she received one additional dose of lasix on (40 mg po) and continued to improve. she had a chest x-ray showing marked improvement of her pulmonary edema. at the time of discharge she was saturating 94% on room air. . 2. pneumonia: in the icu, the patient was found to have a left lower lobe pneumonia. she was initially started on zosyn in the icu. on the floor she was changed to levofloxacin and zosyn to cover community acquired pneumonia and aspiration pneumonia. the patient had been in the hospital for less than 48 hours, so she did not need to be treated for hospital acquired pneumonia. the patient will continue on levofloxacin and flagyl for the full course and finish the medications on . she was afebrile for the five days prior to discharge. . 3. acetabular fracture: patient sustained mechanical fall at home and sustained an acetabular fracture. she underwent percutaneous fixation of right acetabular column fracture on . the patient should have her stitches removed 2 weeks following surgery. she has an appointment scheduled with orthopedics to remove these. . 5. atrial fibrillation: stable on sotolol. coumadin was initially held for surgery, but then was restarted on . she reached a therapeutic inr on the day of discharge. the patient's sotolol was continued. . 6. hyptertension: continued on home meds of hydrochlorothiazide, isosorbide dinitrate, and olmesartan with good control. . 7. depression: continued on lexapro, klonipin qhs . 8. hypothyroidism: continued on levothyroxine medications on admission: multivitamins 1 tab po/ng daily olmesartan 40 mg oral daily calcium carbonate 500 mg po/ng tid clonazepam 0.5 mg po/ng qhs simvastatin 40 mg po/ng daily escitalopram oxalate 10 mg po daily sotalol 80 mg po/ng hydrochlorothiazide 12.5 mg po/ng daily vitamin d 800 unit po/ng daily isosorbide dinitrate 10 mg po/ng levothyroxine sodium 137 mcg po/ng daily coumadin 4 mg po daily discharge medications: 1. calcium carbonate 500 mg tablet, chewable sig: one (1) tablet, chewable po tid (3 times a day). 2. warfarin 2 mg tablet sig: two (2) tablet po once daily at 4 pm: please have your inr checked regularly and your dose adjusted accordingly. 3. metronidazole 500 mg tablet sig: one (1) tablet po q8h (every 8 hours) for 1 days: course to finish on . 4. levofloxacin 250 mg tablet sig: three (3) tablet po q48h (every 48 hours) for 1 days: course to finish on . 5. escitalopram 10 mg tablet sig: one (1) tablet po daily (daily). 6. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 7. cholecalciferol (vitamin d3) 400 unit tablet sig: two (2) tablet po daily (daily). 8. enoxaparin 30 mg/0.3 ml syringe sig: thirty (30) mg subcutaneous q12h (every 12 hours): please continue until (inr = 2 on ). . 9. hydrochlorothiazide 12.5 mg capsule sig: one (1) capsule po daily (daily). 10. levothyroxine 137 mcg capsule sig: one (1) capsule po daily (daily). 11. olmesartan 20 mg tablet sig: two (2) tablet po daily (). 12. sotalol 80 mg tablet sig: one (1) tablet po bid (2 times a day). 13. isosorbide dinitrate 10 mg tablet sig: one (1) tablet po bid (2 times a day). 14. multivitamin tablet sig: one (1) tablet po daily (daily). 15. loperamide 2 mg capsule sig: one (1) capsule po tid (3 times a day) as needed for diarrhea. 16. acetaminophen 325 mg tablet sig: two (2) tablet po tid (3 times a day). 17. senna 8.6 mg tablet sig: one (1) tablet po hs (at bedtime). 18. colace 100 mg capsule sig: one (1) capsule po twice a day as needed for constipation. 19. acetaminophen-codeine 300-30 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for pain. 20. bisacodyl 10 mg suppository sig: one (1) suppository rectal daily (daily) as needed for constipation. discharge disposition: extended care facility: healthcare, nh discharge diagnosis: primary: acetabular fracture pulmonary edema pneumonia secondary: hypertension atrial fibrillation discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - requires assistance or aid (walker or cane). partial weight bearing on right. discharge instructions: it was a pleasure to participate in your care ms. . you were admitted to the hospital for a fracture of your right hip and had surgery. following surgery, you had difficulty breathing because you had too much fluid in your lungs. you were transferred to the intensive care unit to use a machine that could help you to breathe. you also developed a pneumonia and we treated you with antibiotics. your breathing improved when we gave you medicine to remove fluid from your lungs. you were transferred from the icu to the floor and were able to stop using the oxygen. physical therapy worked with you and recommended that you go to a rehab facility. we made the following changes to your medications: 1. added lovenox - your rehab will continue this for the next 2. added calcium 3. added vitamin d 4. added acetaminophen-codeine 300-30 mg tablet po q6h (every 6 hours) as needed for pain. followup instructions: follow-up appointment with dr. wednesday at 11:20am on center. please arrive at 11am for x-rays before your visit. additionally, please follow up with the doctor at the rehab facility. as well, please call your primary doctor for follow-up within one week of leaving the facility. procedure: open reduction of fracture with internal fixation, other specified bone diagnoses: pneumonia, organism unspecified anemia, unspecified congestive heart failure, unspecified unspecified essential hypertension unspecified acquired hypothyroidism atrial fibrillation unspecified fall constipation, unspecified long-term (current) use of anticoagulants acute diastolic heart failure closed fracture of acetabulum 

Answer: The patient is high likely exposed to