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: hypotension major surgical or invasive procedure: none: <br><h3>pending issues/followup:</h3> <b>1. blood pressure:</b> the patient's systolic blood pressure ranged 85-115. she was low even on 25 of metoprolol qid (at home was on toprol xl 200). she is being discharged on toprol xl 100mg daily. <br><b>2. chf:</b> her repiratory status was stable and she had sats in the high 90s on her home o2 level of 2 lpm via nc. we gave her fluids only very gently and did not diurese her. she was fluid positive about 2l over the course of her hopital stay but after transfer to the floor she had relatively equal is and os with good urine output (around 1l on day prior to discharge). we discharged her on her home dose of torseminde but held the metolazone. she will see dr. in clinic on . <br><b>3. recurrent pleural effusion:</b>she is at her baseline respiratory status. she will be seen in the interventional pulmonology clinic to have a pleurex catheter placed to facilitate <br><b>4. cancer:</b> the cells in the pleural fluid are more likely breast than uterine. she was followed by her primary oncologist, dr. . she was restarted on arimidex, an aromatase inhibitor. she will see dr. on .<br> history of present illness: 79 yo f with h/o chronic l pleural effusion, breast and uterine ca in remission admitted from ed with af with rvr, sbo and leukocytosis. patient was found to be hypotensive at facility and was brought in to ed. she was asymptomatic at the time. in the ed, initial vs were: 98.8 118 109/63 16 96. patient was given 2l ivf. ct torso showed known pleural effusion and new sbo. surgery was consulted and recommended ex-lap for loa which patient refused. see surgery note for full details. repeat vs prior to transfer: 97.8 109 96/54 100% 2l 26. on transfer to the unit, patient reports that she has some worsening sob over the last few days, but feels well now. on 2l nc at baseline for restrictive lung disease. states she is passing gas, last bm yesterday. denies cp, fever, chills, nausea, dysuria, ha, vision change or . review of sytems: (+) per hpi (-) denies fever, chills, night sweats, recent weight loss or gain. denies headache, sinus tenderness, rhinorrhea or congestion. denied cough, shortness of breath. denied chest pain or tightness, palpitations. denied nausea, vomiting, diarrhea, constipation or abdominal pain. no recent change in bowel or bladder habits. no dysuria. denied arthralgias or myalgias. past medical history: h/o stage 3 breast ca in h/o endometrial ca s/p hysterectomy afib not on coumadin falls restrictive lung disease on 2-3l nc at home dchf s/p pelvic fx in osteoporosis w multiple compression fx oa ppm for tachy/brady syndrome h/o non-sustained vt recurrent, refractory pleural effusions of unknown cause, thought to be secondary to radiation. last tap on showed adeno hypothyroidism social history: lives alone in . home health aide comes three times per week. remote tobacco use. drinks two glasses of wine each night to help her sleep. family history: two nieces with breast cancer, mother died of cad, father had emphysema. physical exam: general: alert, oriented, no acute distress heent: sclera anicteric, mmm, 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 pertinent results: 10:55pm glucose-88 urea n-19 creat-0.8 sodium-126* potassium-4.1 chloride-87* total co2-31 anion gap-12 ctropnt-0.03* probnp-4913* urine blood-neg nitrite-neg protein-neg glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-9.0* leuk-neg wbc-19.9*# rbc-4.61 hgb-15.6 hct-45.1 mcv-98 mch-33.9* mchc-34.6 rdw-13.8 neuts-95.0* lymphs-2.0* monos-2.3 eos-0.4 basos-0.2 albumin-3.3* calcium-8.6 phosphate-2.5* magnesium-1.8 glucose-90 urea n-25* creat-1.0 sodium-126* potassium-3.7 chloride-70* ct chest/a/p impression: 1. moderate sized left pleural effusion and small right pleural effusion, with enhancing pleural margins on the right, which may be secondary to an inflammatory or infectious process, though this appears similar to prior study. 2. dilated small bowel loops, with decompressed and tethered small bowel loops in the pelvis, concerning for a small-bowel obstruction. locules of extra-luminal air are noted in the mid abdomen. 3. moderate amount of free fluid in the abdomen with new nodular appearance of the peritoneum, concerning for peritoneal carcinomatosis. 4. subacute right inferior pubic ramus fracture, with insufficiency fractures of the sacral ala bilaterally. 5. stable multiple compression deformities of the thoracolumbar spine, as detailed. kub (): impression: 1. unchanged bowel gas pattern consistent with partial sbo 2. ascites. 3. bilateral pleural effusions. pleural fluid (collected ): positive for malignant cells. consistent with adenocarcinoma. -tumor cells are immunoreactive for keratin ae1/ae3/cam 5.2, b72.3 and -31. -calretinin and wt-1 stain mesothelial cells in the background. - no immunoreactivity is seen for cea, absorbed, leu m1, mammoglobin or gcdfp. -ck20 and ttf-1 show no immunoreactivity. tumor cells are positive for ck7 brief hospital course: 79 yo f with h/o afib, breast ca, uterine ca both in remission admitted from ed with afib with rvr, sbo, leukocytosis, and also with pleural fluid results from prior admission showing adenocarcinoma. # sbo: unclear etiology but appears on ct to be adhesions vs peritoneal nodules suspicious for carcinomatosis. pt denies n/v before admission. she was seen by surgery and made it very clear that she was not interested in surgery. when transferred to the floor, she was passing flatus and has minimal output for her ngt. it was removed on and the patient tolerated a liquid diet which was advanced and the patient had a bowel movement on day of discharge. she did not have any nausea or vomiting. # leukocytosis: though the patient was afebrile, she had an elevated wbc count on admission and was started on levofloxacin, vancomycin and metronidazole. cultures were negative, there was no evidence of infection and the wbc count trended down. her antibiotics were discontinued on and her white count continued to trend down and she remained afebrile. # atrial fibrillation: has h/o paroxysmal af, not on coumadin given fall risk. she was rate controlled with iv fluids and small amounts of beta blockers until she was taking pos and then she was started on po metoprolol. # hypovolemia: patient was on torsemide and metolazone. she had contraction alkalosis, hyponatremia and a concentrated appearing cbc that resolved with ivf. she also was net fluid positive at least 2l and was at her baseline respiratory status with balanced is and os over the two days prior to discharge. # hypotension: the patient's systolic blood pressure ranged 85-115. she was low even on 25 of metoprolol qid (at home was on toprol xl 200). she is being discharged on toprol xl 100mg daily. # chf, chronic diastolic: her repiratory status was stable and she had sats in the high 90s on her home o2 level of 2 lpm via nc. we gave her fluids only very gently and did not diurese her. she was fluid positive about 2l over the course of her hopital stay but after transfer to the floor she had relatively equal is and os with good urine output (around 1l on day prior to discharge). we discharged her on her home dose of torseminde but held the metolazone. she will see dr. in clinic on . # recurrent pleural effusion: she is at her baseline respiratory status. she will be seen in the interventional pulmonology clinic to have a pleurex catheter placed to facilitate # malignant pleural effusion: effusion is chronic and recurrent ?????? but last tap on had adenocarcinoma, staining pending. pt seen by dr. and aware of presence of malignant cells. the cells in the pleural fluid are more likely breast than uterine. she was followed by her primary oncologist, dr. . she was restarted on arimidex, an aromatase inhibitor. she will see dr. on . # elevated troponin: likely demand, trop flat in first 2 sets at 0.03 with normal ck. ekg without changes. troponin trended down to 0.02. medications on admission: 1. levothyroxine 50 mcg tablet sig: one (1) tablet po daily (daily). 2. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily). 3. ciprofloxacin 500 mg tablet sig: one (1) tablet po q24h (every 24 hours): take through . 4. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 5. aspirin 325 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 6. toprol xl 200 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po at bedtime. 7. potassium chloride 10 meq tablet sustained release sig: two (2) tablet sustained release po twice a day. 8. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day). 9. bisacodyl 10 mg suppository sig: one (1) suppository rectal (2 times a day) as needed for constipation. 10. metolazone 2.5 mg tablet sig: one (1) tablet po bid (2 times a day). 11. torsemide 20 mg tablet sig: one (1) tablet po bid (2 times a day). discharge medications: 1. toprol xl 100 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po once a day. disp:*30 tablet sustained release 24 hr(s)* refills:*1* 2. levothyroxine 50 mcg tablet sig: one (1) tablet po daily (daily). 3. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 4. anastrozole 1 mg tablet sig: one (1) tablet po daily (). disp:*30 tablet(s)* refills:*2* 5. torsemide 20 mg tablet sig: one (1) tablet po bid (2 times a day). 6. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed for constipation. 7. senna 8.6 mg tablet sig: 1-2 tablets po bid (2 times a day) as needed for constipation. 8. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day) as needed for constipation. 9. potassium chloride 10 meq capsule, sustained release sig: two (2) capsule, sustained release po twice a day. 10. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po once a day. discharge disposition: extended care facility: of discharge diagnosis: primary: small bowel obstruction secondary: malignant pleural effusion discharge condition: good discharge instructions: dear ms. , it was a pleasure taking care of you again. you were admitted because you may have had an obstruction in your bowel. this resolved on its own. your blood pressure was low and we are sending you home on a lower dose of your blood pressure medication. the following changes were made to your medications: start arimidex stop metolazone stop toprol xl 200mg daily start toprol xl 100mg daily please take all other medications as prescribed. please take stool softeners and laxatives to maintain regular bowel movements and prevent obstruction. weigh yourself every morning, md if weight > 3 lbs. adhere to 2 gm sodium diet call your doctor or 911 if you have severe nausea/vomiting, shortness of breath, or for any other concern. followup instructions: provider: , md phone: date/time: 3:00 provider: , md phone: date/time: 3:00 provider: . phone: date/time: 1:30 , 9am in interventional pulmonology clinic on 1, dr. . md, procedure: venous catheterization, not elsewhere classified diagnoses: congestive heart failure, unspecified chronic airway obstruction, not elsewhere classified atrial fibrillation other specified intestinal obstruction personal history of malignant neoplasm of breast personal history of malignant neoplasm of other parts of uterus hypotension, unspecified alkalosis osteoporosis, unspecified surgical or other procedure not carried out because of patient's decision sinoatrial node dysfunction hypovolemia chronic diastolic heart failure secondary malignant neoplasm of retroperitoneum and peritoneum malignant pleural effusion 

Answer: The patient is high likely exposed to