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: tramadol attending: chief complaint: 5.2cm descending thoracic aneurysm major surgical or invasive procedure: thoracic endovascular aortic aneurysm repair with lumbar drain placement history of present illness: ms. is a 69-year-old woman with hypertension and dyslipidemia referred by dr. for evaluation of a thoracic aortic aneurysm and has undergone serial cts for surveillance the past two years. the aneurysm was found in during workup for her long-standing chest pain/epigastric pain. she underwent evaluation at that time and was not felt to be appropriate for surgery due to small size of the aneurysm and she is not felt to be a candidate for endovascular repair. she since then had some growth but with persistent chest/epigastric pain, which tends to be brought on by exertion. she does not know of any family history of aneurysm and she has never smoked. given the persistence of her epigastric discomfort, size of her thoracic aortic aneurysm measured at 5.2cm and her relatively increased risk given her smaller stature and her gender, it was decided to go forward with elective endovascular repair. past medical history: hypertension dyslipidemia descending thoracic aortic aneurysm gerd arthritis pneumonia psh: hysterectomy, cataracts social history: denies tobacco/alcohol use or illicit drug use. lives with son in ,ma. family history: no history of aneurysm or premature coronary artery disease physical exam: upon discharge: tmax 99.6, hr 76, bp 114/68, rr 20, o2 sat 95% ra general: elderly appearing female lying in bed in nad neuro: a&ox3, haitian creole speaking lungs: decreased breath sounds at bases cardiac: rrr, no mrg appreciated abd: soft, nondistended with normal bowel sounds, no rebound/guarding groin puncture sites: cdi, no erythema extremities: no cce lle: palp bilat dp/pt pertinent results: : ct torso: 1. status post thoracic evar with a partially visualized stent that appears appropriately positioned. bibasilar atelectasis. no acute findings in the abdomen to explain the patient's symptoms. 2. stable right renal cyst. 3. probable slight narrowing at the celiac artery origin, which is due to atherosclerotic disease. : bilateral lenis: no right or left lower extremity deep venous thrombosis. : cxr final report study: pa and lateral chest, . clinical history: 69-year-old woman with fever. evaluate for pneumonia. findings: comparison is made to previous study performed four hours earlier. there is again seen consolidation at the lung bases concerning for aspiration or multifocal pneumonia. there are no signs for overt pulmonary edema. there is an aortic stent identified which is intact. there is also a right ij line with distal tip in the mid svc, unchanged. no pneumothoraces are present. : cxr final report chest radiograph technique: pa and lateral radiographs of chest were reviewed in comparison to prior radiographs through to . findings: right internal jugular line has been removed. left descending aortic stent is seen in situ. since , the right lower lung opacity which was likely a combination of effusion and atelectasis has significantly resolved. mild amount of pleural effusion, however, still persists. right lower lung and middle lobe atelectasis is present. increased retrocardiac density reflecting left lower lung atelectasis and mild-to-moderate left pleural effusion are similar in appearance. cardiomediastinal silhouette is stable in appearance. impression: since , right lower lung opacity which was likely a combination of atelectasis and moderate amount of effusion has significantly improved with mild residual fluid and minimal right basal and middle lobe atelectasis. left lower lung atelectasis and mild-to-moderate pleural effusion is unchanged. : study: abdominal son. indication: 69-year-old female with abdominal pain. comparison: none. right upper quadrant son images demonstrate normal liver size and echotexture. no focal hepatic lesions are seen. there is no intra- or extra-hepatic biliary ductal dilatation. the gallbladder appears within normal limits. there is no splenomegaly. limited images of the right kidney demonstrate three simple cysts within the right kidney, the largest of which is seen in the lower pole measuring 2.3 x 2.0 cm in size. there is a probable right renal parapelvic cyst. a small left pleural effusion is seen. the head and body of the pancreas appear within normal limits. the tail is obscured by overlying bowel gas. impression: simple renal cysts in the right kidney. small left pleural effusion. 05:08pm blood wbc-9.3 rbc-3.04* hgb-9.5*# hct-28.8* mcv-95 mch-31.2 mchc-32.9 rdw-12.9 plt ct-248 04:56am blood wbc-15.1*# rbc-2.91* hgb-9.1* hct-27.4* mcv-94 mch-31.2 mchc-33.1 rdw-12.8 plt ct-199 01:53am blood wbc-14.7* rbc-3.17* hgb-9.9* hct-29.4* mcv-93 mch-31.2 mchc-33.7 rdw-14.0 plt ct-182 02:45am blood wbc-13.7* rbc-3.04* hgb-9.3* hct-28.3* mcv-93 mch-30.6 mchc-32.8 rdw-13.7 plt ct-170 06:00am blood wbc-10.9 rbc-2.78* hgb-8.8* hct-26.2* mcv-94 mch-31.7 mchc-33.7 rdw-14.0 plt ct-183 05:16am blood wbc-9.6 rbc-2.82* hgb-8.7* hct-26.4* mcv-93 mch-30.7 mchc-32.9 rdw-13.6 plt ct-270 06:30am blood wbc-11.2* rbc-2.99* hgb-9.3* hct-28.0* mcv-94 mch-31.1 mchc-33.2 rdw-13.9 plt ct-303 07:15am blood wbc-10.5 rbc-2.86* hgb-8.8* hct-26.7* mcv-93 mch-30.9 mchc-33.1 rdw-13.3 plt ct-420 07:15am blood pt-14.9* ptt-30.5 inr(pt)-1.3* 05:08pm blood glucose-157* urean-13 creat-0.9 na-145 k-3.6 cl-111* hco3-23 angap-15 12:23pm blood glucose-131* urean-10 creat-0.7 na-135 k-3.8 cl-101 hco3-27 angap-11 01:53am blood glucose-123* urean-9 creat-0.8 na-135 k-4.5 cl-102 hco3-23 angap-15 06:00am blood urean-10 creat-0.8 na-135 k-3.6 cl-99 05:16am blood glucose-101* urean-8 creat-0.7 na-136 k-3.6 cl-100 hco3-26 angap-14 06:30am blood glucose-97 urean-12 creat-0.8 na-137 k-3.8 cl-99 hco3-28 angap-14 07:15am blood glucose-98 urean-12 creat-0.9 na-135 k-3.8 cl-101 hco3-27 angap-11 05:08pm blood ck(cpk)-64 12:23pm blood alt-10 ast-21 alkphos-74 totbili-1.0 10:56am blood ck(cpk)-27* 06:14pm blood ck(cpk)-22* 03:04am blood ck(cpk)-26* 08:06pm blood alt-13 ast-24 alkphos-102 amylase-38 totbili-0.4 08:06pm blood lipase-24 12:23pm blood lipase-11 05:08pm blood ck-mb-2 ctropnt-<0.01 04:56am blood ctropnt-<0.01 12:23pm blood ctropnt-<0.01 10:56am blood ck-mb-1 ctropnt-<0.01 06:14pm blood ck-mb-1 ctropnt-<0.01 03:04am blood ck-mb-1 ctropnt-<0.01 07:15am blood calcium-8.3* phos-3.3 mg-2.2 brief hospital course: mrs. was consented and underwent a thoracic endovascular aneurysm repair with lumbar drain placement on . she tolerated the procedure well and remained hemodynamically stable. she was extubated and transferred to the cvicu for close monitoring. she awoke neurologically intact without any deficits. the lumbar drain was removed later that day for bleeding around the drain. on pod 1, she complained of abdominal pain. ct showed a properly positioned thoracic aortic stent, and no acute abdominal findings to explain patient's symptoms. her pain was controlled on dilauded. she was kept npo. she was transfused 1unit prbcs for postoperative anemia with hematocrit of 27. on pod 2, she was weaned off neosynephrine drip and was stable for transfer to the vicu for further recovery and close monitoring. she was febrile to 103.5. sputum, blood and urine cultures, and chest xray were done. chest xray was concerning for a left lower lobe pneumonia. sputum cultures grew out rare growth gram negative rods. she was started on vancomycin, levofloxacin, and flagyl empirically. her diet was advanced, which she tolerated well. on pod 3, physical therapy was consulted for strength and mobility and continued to see her throughout her stay. on pod 4, she continued to complain of epigastric pain. ecg was unchanged and cardiac enzymes were negative times three. on pod 5, she was febrile to 101. right ij was removed and tip was sent for culture which was negative. urine cultures were negative. cxr was repeated which showed large right lower lobe pleural effusion and unchanged pneumonia in left lower lobe. she was aggressively diuresed. bilateral lower extremity ultrasound was negative for dvt. on pod 6, chest xray showed improvement in right pleural effusion. she continued to complain of epigastric/abdominal pain, so abdominal ultrasound was peformed which showed a simple renal cyst. physical therapy recommended rehab, however, patient did not have insurance benefits for rehab or , she will be discharged to home with her son with a rolling walker. throughout her admission, she continued to complain of epigastric pain, which was believed to be consistant with her chronic reflux after an extensive workup. she was switched to protonix 40mg po bid. she will follow up with her primary care physician next week and gastroenterologist to discuss her gerd symptoms. on the day of discharge, iv antibiotics were discontinued and she was started on a 5 day course of moxifloxacin for hospital acquired pneumonia. she was discharged to home on . she was afebrile with stable vital signs, tolerating small frequent meals, voiding adequate amounts, ambulating with a walker, with pain well controlled. medications on admission: omeprazole 20mg po daily hydrochlorothiazide 25mg po daily lisinopril 40mg po daily pravastatin 20mg po daily aspirin 81mg 2 tabs po daily cyanocobalamin 1000mcg po daily ?amlodipine 2.5mg po daily naproxen prn discharge medications: 1. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 2. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day). 3. aspirin 81 mg tablet, chewable sig: two (2) tablet, chewable po daily (daily). 4. moxifloxacin 400 mg tablet sig: one (1) tablet po once a day for 5 days: start date=. disp:*5 tablet(s)* refills:*0* 5. pravastatin 20 mg tablet sig: one (1) tablet po daily (daily). 6. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q12h (every 12 hours): see pcp for refills. disp:*60 tablet, delayed release (e.c.)(s)* refills:*0* 7. cyanocobalamin (vitamin b-12) 1,000 mcg tablet sig: one (1) tablet po once a day. 8. hydromorphone 2 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for pain for 7 days. disp:*20 tablet(s)* refills:*0* 9. acetaminophen 500 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for fever for 7 days. 10. hydrochlorothiazide 25 mg tablet sig: one (1) tablet po once a day. discharge disposition: home discharge diagnosis: 5.2cm descending thoracic aneurysm discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - requires assistance or aid (walker or cane). discharge instructions: please do not restart lisinopril and amlodipine until follow up with dr. . your blood pressure was too low here in the hospital to restart those. please discuss restarting these medications with dr. at your appointment next week. you should also discuss your reflux disease and re-connect with your gastroenterologist. medications: ?????? take aspirin once daily per your home regimen ?????? do not stop aspirin unless your vascular surgeon instructs you to do so. ?????? continue all other medications you were taking before surgery, unless otherwise directed ?????? you make take tylenol or prescribed pain medications for any post procedure pain or discomfort what to expect when you go home: it is normal to have slight swelling of the legs: ?????? elevate your leg above the level of your heart (use pillows or a recliner) every 2-3 hours throughout the day and at night ?????? avoid prolonged periods of standing or sitting without your legs elevated it is normal to feel tired and have a decreased appetite, your appetite will return with time ?????? drink plenty of fluids and eat small frequent meals ?????? it is important to eat nutritious food options (high fiber, lean meats, vegetables/fruits, low fat, low cholesterol) to maintain your strength and assist in wound healing ?????? to avoid constipation: eat a high fiber diet and use stool softener while taking pain medication what activities you can and cannot do: ?????? when you go home, you may walk and go up and down stairs ?????? you may shower (let the soapy water run over groin incision, rinse and pat dry) ?????? your incision may be left uncovered, unless you have small amounts of drainage from the wound, then place a dry dressing or band aid over the area that is draining, as needed ?????? no heavy lifting, pushing or pulling (greater than 5 lbs) for 1 week (to allow groin puncture to heal) ?????? after 1 week, you may resume sexual activity ?????? after 1 week, gradually increase your activities and distance walked as you can tolerate ?????? no driving until you are no longer taking pain medications ?????? call and schedule an appointment to be seen in weeks for post procedure check and cta followup instructions: provider: , md phone: date/time: 10:45 , , provider: , md phone: date/time: tues 1:20am 300 , , procedure: venous catheterization, not elsewhere classified arteriography of other intrathoracic vessels aortography endovascular implantation of graft in thoracic aorta endovascular implantation of graft in thoracic aorta diagnoses: esophageal reflux unspecified essential hypertension other and unspecified hyperlipidemia thoracoabdominal aneurysm, without mention of rupture arthropathy, unspecified, site unspecified 

Answer: The patient is high likely exposed to