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: history of present illness: the patient is a 73-year-old woman with pulmonary sarcoidosis, type 2 diabetes, severe pulmonary hypertension who presents with dyspnea. the patient reports that her shortness of breath has been steadily worsening since and she has required more oxygen up from her baseline of 6 liters to as much as 10 liters. she denies chest pain. her dyspnea has progressed to the point that even moving around in bed increases it. she occasionally goes up to as high as 10 liters at home. she otherwise ambulatory and has also had an increase in lower extremity edema since she did not take her lasix yesterday, but there has been no asymmetry in her legs. of note, the patient drinks iron supplementation and drinks juice with this. otherwise, there are no nephrotoxins or potassium-containing foods. past medical history: 1. sarcoidosis with pulmonary and ocular involvement. 2. type 2 diabetes. 3. diastolic congestive heart failure. 4. pulmonary hypertension. 5. iron-deficiency anemia as well as multifactorial anemia from hemoglobin c trait. 6. gastroesophageal reflux disease. allergies: no known drug allergies. medications on admission: 1. prednisone 13 mg q. day. 2. accupril 20 mg q. day. 3. lasix 140 mg q. day. 4. avandia 4 mg q. day. 5. albuterol q. 4 to 6 hours p.r.n. 6. xanax p.r.n. 7. iron sulfate 325 mg q. day. social history: lives with her daughter who has cerebral palsy. she has multiple family supports. she lives in a house. she has no tobacco or alcohol use. she is actively working as a secretary. family history: noncontributory. physical examination: temperature is 97.8, pulse 74, blood pressure 128/79, respiratory rate 24, o2 sat 100% on 6 liters. in general, she is a pleasant woman who is dyspneic. her mucous membranes are moist. her neck exam: she has jugular venous distention to the angle of her mandible. lungs have crackles in the upper lung zones. her heart is regular with no murmurs, rubs, or gallops. it is difficult to discern due to breathing. subsequently, she has a ii/vi systolic ejection murmur at the left sternal border that is discernible. her abdomen is soft, nontender, nondistended; normoactive bowel sounds. she has 2+ pitting edema of her lower extremities. laboratory data: she had a white count of 5.5, hematocrit 25.7 slightly lower than baseline, platelets 151. her sodium was 142, potassium 6.4, chloride 107, bicarbonate 30, bun 39, creatinine 1.4, glucose 42. her ekg was normal sinus rhythm. there was a q in v1. there were t-wave inversions in iii and bifid t-waves v2 and v3. she had a chest x-ray on admission that showed no acute cardiopulmonary pathology, however, a left upper lobe opacity consistent with sarcoidosis. summary of hospital course: 1. pulmonary and sarcoid: the patient's physical exam and chest film did not suggest left heart failure despite her symptoms of lower extremity edema. these were more likely secondary to progressive right heart congestive heart failure which could explain the lower extremity edema as well as her known intrinsic pulmonary disease. the differential diagnosis of her chronic right heart failure and pulmonary hypertension was brought. the patient was not tachycardiac, which lowers the differential of pe and chronic thromboembolia, although this could not be ruled out. she does have a history of sarcoidosis, although pulmonary function tests have not worsened over the past several years. at the time of admission it was felt that she had progressive right heart strain from sarcoidosis. on the second day of admission she had an echocardiogram which was notable for a normal ejection fraction, however, a right ventricular wall that was hypertrophied and a markedly dilated right ventricular cavity as well as moderate global right ventricular free wall hypokinesis. there was also abnormal septal motion in position consistent with right ventricular pressure and volume overload. in addition, she had an estimated pasp of 142 to 164. she had, as well, 3+ tricuspid regurgitation. these findings were as compared to an echo four years ago. a pulmonary consult was obtained to further tease out why she has worsening right heart failure. she had a ct angiogram of her chest which was notable for no pulmonary emboli but mildly dilated pulmonary vessels consistent with pulmonary hypertension. there were emphysematous changes seen throughout the lungs as well as nonspecific pleural thickening in the right lung apex and a 7 mm vague nodular density in the right lower lobe. given the concerns for progressive right heart failure, a cardiology consult was obtained to consider a right heart catheterization. prior to this, however, the patient underwent pulmonary function tests which were notable for an fvc and fev1 of 50 and 46%, respectively, in a ratio of 91%. there was no change with bronchodilators. this is felt to be consistent with some obstructive disease as well as a restrictive component. this was further suggested by her lung volumes, which were total lung capacity 97% of predicted, frc of 121%, and rv of 162%. these are more consistent with obstructive lung disease. more impressively, the dlco was 11% of predicted. at this point a cardiology consult was obtained to consider her for right and left heart catheterization. initially they recommended conservative treatment with calcium channel blocker. however, given the concerns for potentially worsening and throwing the patient into severe right heart failure, ultimately it was decided to take the patient to the catheterization lab. while initially there were concerns about the risks of a right heart catheter, the potential benefits of pulmonary histodilation were thought to outweigh these. she subsequently went to the catheterization lab and had both a right and left heart catheterization. these results were quite interesting. her right heart catheterization revealed a pulmonary artery pressure of 118/43 with a pulmonary vascular resistance of 878. with 100% oxygen her pulmonary pressures went down slightly to 111/38 with her pulmonary vascular resistance dropping to 546. even further, with nitrous oxide administration her pressures dropped to 92/28 with a pulmonary vascular resistance of 275. these results were impressive, and at this point it was decided to take the patient with a swan to the medical intensive care unit for further titration of calcium channel blockers and potential vasodilators. while she was in the micu the patient was started on nifedipine with her pulmonary pressures closely monitored. she was rapidly titrated up to nifedipine 80 mg p.o. q. 6 hours with a small improvement in her pulmonary vascular resistance. symptomatically, however, the patient felt significantly better. at this point, though, given the modest improvement, it was decided to start the patient on sildenafil to improve her pulmonary vascular resistance. she was started on escalating doses of sildenafil with significant improvement in her pulmonary vascular resistance as well as in her symptoms. her pvr fell to as low as 412 on the viagra therapy. after her brief stay in the medical intensive care unit the patient was transferred back out to the floor for further management. at this time the patient did have mild hypervolemia and mild congestive heart failure perhaps due to the increased venous pressure into left side of her heart. she was given one dose of intravenous lasix and was restarted back on oral lasix for home use. the concern was that patient is preload dependent and overdiuresing her could potentially worsen both left and right heart function. in addition to all of the above, the patient was anemic, and given her strong need to have increased oxygen content, the patient was transfused to a hematocrit greater than 30. of any one particular intervention, this was probably the most successful. after just two units of packed red blood cells with her hematocrit above 30, the patient reported significantly improved symptoms. she was kept above 30 for the remainder of her admission, and this in the future should be considered a prime goal of care. she was continued on her iron supplementation for iron-deficiency anemia. 2. hyperkalemia: the patient presented with a potassium of 6.2. this is likely due to mildly reducing her function as well as increased juice consumption at home. there were no peak t waves. the patient was given kayexalate with improvement, and there were no further complications of hyperkalemia. 3. anemia: the patient has a multifactorial anemia that has been followed as an outpatient by dr. , who is a hematologist. the patient has, in the past, deferred a bone marrow biopsy to evaluate whether sarcoidosis could be contributing to her anemia. this may be considered in the future, but currently keeping her hematocrit above 30 seems to be a reasonable goal with blood transfusions. 4. hypertension: the patient was admitted on accupril. however, though this is beneficial for her systolic hypertension and renal protection and diabetes, it was felt that the more impressing goal would be to improve her pulmonary vascular resistance, and so her blood pressure medications were changed from accupril to nifedipine with stable blood pressure. 5. code: the patient is currently a full code. that being said, she is aware of her medical problems and is considering her code status, but at the time of this dictation the patient is a full code. disposition: to home with services. discharge condition: stable. discharge diagnoses: 1. sarcoidosis. 2. pulmonary hypertension. 3. right-sided heart failure. 4. chronic obstructive pulmonary disease. 5. diabetes. 6. anemia. discharge instructions: 1. the patient will contact dr. , her pulmonologist, to make an appointment in the next two weeks. 2. she will also contact dr. to make an appointment for the next week. 3. a referral was made by this intern to the sleep apnea study center, and they are willing to take her once she schedules an appointment. 4. the patient will be contact by interventional pulmonology to consider and discuss the option of transtracheal oxygen therapy. 5. finally, she will contact pulmonary rehabilitation to begin pulmonary rehab. a prescription was left for the patient. discharge medications: 1. prednisone 13 mg q. day. 2. sildenafil citrate 50 mg t.i.d. 3. lasix 60 mg q. day. 4. rosiglitazone 4 mg q. day. 5. iron sulfate 325 mg q. day. 6. atrovent nebulizer, one nebulizer q. 6 hours p.r.n. 7. nifedipine 90 mg q. day. , m.d. dictated by: medquist36 d: 15:19 t: 19:21 job#: procedure: combined right and left heart cardiac catheterization coronary arteriography using two catheters angiocardiography of left heart structures transfusion of packed cells diagnoses: hyperpotassemia congestive heart failure, unspecified acute on chronic diastolic heart failure other chronic pulmonary heart diseases sarcoidosis other emphysema diseases of tricuspid valve lung involvement in other diseases classified elsewhere 

Answer: The patient is high likely exposed to