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 attending: chief complaint: dka, epigastric pain major surgical or invasive procedure: none history of present illness: 72f with hx dm, esrd on hd presenting with dka, epigastric abdominal pain. pt was recently admitted on the surgical service from with an infected av fistula. she was started on vancomycin. she underwent debridement of skin and hematoma cavity with closure of the skin defect with a rhomboid flap. she developed bleeding post-op and a permacath was placed for access. she also had a period of decreased responsiveness during hd. workup included a negative ct scan, negative ces, cxr revelaed chf, eeg could not be obtained. she was discharged to the . . at hd today, she c/o n/v and ?coffee ground emesis. heme positive at hd. she also had epigastric abdominal pain. she was transferred to the ed for evaluation. in the ed she was hemodynamically stable, hct stable. guiac negative. was found to be in dka with an anion gap 25. started on an insulin gtt at 10 units/hr. had a low grade temp to 99.8, mildly elevated wbc to 11 with a left shift. started on vanco/levo/flagyl. left ij line was placed. per cxr, tip in right brachiocephalic vein, was pulled back and repositioned but still in brachiocephalic vein. bp was high with systolics in 200s. given anzement for nausea. past medical history: pmh: -esrd on hd tthsat - left av fistual s/p thrombectomy and revision -type 2 diabetes c/b triopathy -hypertension -cva with vascular dementia -anemia -congestive heart failure withejection fraction of 55%. -osteoarthritis -cataracts social history: sh: no tob, etoh, illicits, lives at family history: noncontributory physical exam: pe: 98.7 90 208/71 16 99ra gen: french creole speaking, nad heent: perrl, eomi, jvp not elevated cv: rrr, no m/r/g lungs: cta b abd: soft, minimal bs, +tenderness to palpation over ruq and epigastrium ext: no edema, 1+dps neuro: intact pertinent results: . ekg: nsr, 88 bpm, lad, lafb, peaked t's across precordium, no st elevations or depressions, no change from previous . cxr : comparison is made to the study performed one hour earlier. again seen is a right-sided central line with tip overlying the right atrium. left-sided subclavian line appears to have been pulled back several centimeters. however, the distal tip is again seen within the right brachiocephalic vein pointed upwards. . ct abd/pelvis: preliminary read - c/w chronic pancreatitis with atrophy, course calcifications, gb distention without gallstones or ductal dilation. . tte : the left atrium is mildly dilated. there is mild symmetric left ventricular hypertrophy with normal cavity size and systolic function (lvef>55%). regional left ventricular wall motion is normal. right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. the mitral valve leaflets are mildly thickened. mild to moderate (+) mitral regurgitation is seen. there is moderate pulmonary artery systolic hypertension. there is no pericardial effusion. . pmibi : no ischemic changes 11:33pm type-art po2-99 pco2-30* ph-7.43 total co2-21 base xs--2 11:33pm lactate-2.4* 08:15pm glucose-339* urea n-70* creat-10.3* sodium-140 potassium-4.1 chloride-99 total co2-17* anion gap-28* 08:15pm ggt-16 08:15pm triglycer-33 08:15pm calcium-9.3 phosphate-6.2* magnesium-2.1 02:46pm acetone-moderate 02:46pm wbc-11.1* rbc-4.76 hgb-14.7 hct-46.9 mcv-99* mch-31.0 mchc-31.4 rdw-17.1* 02:46pm hypochrom-normal anisocyt-2+ poikilocy-1+ macrocyt-1+ microcyt-1+ polychrom-1+ schistocy-1+ burr-1+ 02:46pm plt smr-normal plt count-213 02:46pm pt-12.9 ptt-28.7 inr(pt)-1.1 02:08pm albumin-4.5 calcium-9.7 02:08pm wbc-10.9 rbc-4.89# hgb-15.0# hct-48.5*# mcv-99* mch-30.7 mchc-30.9* rdw-16.6* 02:08pm neuts-94* bands-0 lymphs-3* monos-3 eos-0 basos-0 atyps-0 metas-0 myelos-0 nuc rbcs-1* 02:08pm hypochrom-1+ anisocyt-1+ poikilocy-normal macrocyt-1+ microcyt-occasional polychrom-1+ 02:08pm plt smr-normal plt count-222 brief hospital course: 72 yo woman with h/o esrd on hd, type ii diabetes mellitus, presenting with anion gap metabolic acidosis and abdominal pain. during her hospitalization the following issues were addressed: . # ag metabolic acidosis: labs revealed a positive acetone, raising concern for dka. ddx also included uremia. she was initially admitted to the icu and placed on an insulin gtt. hyperglycemia and acidosis resolved by day two. she was dialyzed on day two, and chemistries remained within normal range for the remainder of her hospitalization. she was continued on her outpatient insulin regimen of 15units 70/30 at breakfast and a regular insulin sliding scale. . # abdominal pain: pain resolved on admission. abdominal ct showed signs of chronic pancreatitis including stranding, and lab studies revealed an elevated ast that resolved. ddx also included diabetic gastroparesis. . # ?gib/coffee ground emesis: there was a question of coffee ground emesis on admission. stool was guiaic negative, and hematocrit remained stable throughout her hospitalization 40-45. no further work-up was intiated. she will follow-up for outpatient egd. . htn: bp initially elevated on admission as patient missed hemodialysis. she was treated with iv lopressor and hydralazine, and bp normalized. htn remained stable on outpatient regimen on metoprolol and lisinopril for remainder of her hospitalization. . # dispo: she was discharged back to the . communication is with the patient and her daughter . she is a full code. medications on admission: - tylenol prn - venofer (iron) 100 mg iv qweek - epo u qhd - zemplar 5 mcg qhd - colace - humulin 70/30 30 units qd - lactulose 30 cc prn - nephrocaps 1 tab daily - percocet prn - asa 325 daily - phoslo 667 tid - toprol xl 50 mg daily - zestril 10 mg qhs - sensipar 60 mg daily discharge medications: 1. epoetin alfa 10,000 unit/ml solution sig: one (1) injection injection asdir (as directed): tiw at hemodialysis. 2. lisinopril 10 mg tablet sig: one (1) tablet po hs (at bedtime). 3. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 4. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). 5. b complex-vitamin c-folic acid 1 mg capsule sig: one (1) cap po daily (daily). 6. cinacalcet 30 mg tablet sig: two (2) tablet po daily (daily). 7. calcium acetate 667 mg capsule sig: two (2) capsule po tid w/meals (3 times a day with meals). 8. insulin insulin 70/13; 30units at breakfast 9. colace 100 mg capsule sig: one (1) capsule po twice a day. 10. aspirin 325 mg tablet sig: one (1) tablet po once a day. discharge disposition: extended care facility: - discharge diagnosis: hyperglycemia metabolic acidosis chronic pancreatitis type ii diabetes mellitus esrd on hemodialysis discharge condition: stable discharge instructions: if you develop abdominal pain, chest pain, shortness of breath, fever, or any other concerning symptom, please call your primary care physician /or return to the emergency department. followup instructions: please follow-up with your primary care physician within the next 1-2 weeks to review your hospital course and medications. procedure: venous catheterization, not elsewhere classified hemodialysis diagnoses: end stage renal disease hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease long-term (current) use of insulin chronic pancreatitis diabetes with renal manifestations, type ii or unspecified type, not stated as uncontrolled diabetes with ketoacidosis, type ii or unspecified type, not stated as uncontrolled 

Answer: The patient is high likely exposed to