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: codeine attending: chief complaint: headache major surgical or invasive procedure: : s/p cerebral angiogram for aneurysm coiling picc placed , removed at discharge history of present illness: 65 yo woman with a h/o htn, cva in unknown deficit, migraine ha presents with severe headache x 2 weeks. the patient noticed headahce in the back and top of her head that gradually worsened over the past 2 weeks, accelerating since friday. she reports associated nausea, blurry vision, no vomitting. denies neck stiffness. in the ed the patient had the following vital signs: 96.5 190/80 40 22 100%ra at 0940. recheck found the bp to be 280/110 in l, and 260/96 in the r with hr of 49. the patient was promptly given hydralazine 10mg iv once, lisinopril 20mg po once, hctz 25mg po once, nitro gtt to titrate to bp of 210. the patient's pressures promptly responded, decreasing over 20 minutes to 161/53. vitals at time of transfer at 1508: 98.6 128/40 10 98%2l past medical history: 1. r pontine/caudate stroke in 2. htn 3. hypercholesterolemia 4. depression 5. asthma 6. possible rt cavernous ica aneurysm on mra ? 7. glucose intolerance social history: she is immigrant from who used to be nursing aide. she no longer works. she lives with her sister and son. recent trips back to . immigrated in . she denies any tobacco, etoh, or drugs. independent in adls including ambulation. family history: stroke in father and sister. physical exam: on admission : 97.9 175/62 62 20 90% 2lnc (recheck 94%2lnc) 73.5kg mental status: sleepy but arousable, cooperative with exam, normal affect. orientation: oriented to person, place, and date. language: speech fluent with good comprehension. no dysarthria or paraphasic errors. ii: pupils equally round and reactive to light. visual fields are full to confrontation. discreete rt sided ptosis iii, iv, vi: very minimally decreased upward gaze rt eye; no diplopia; no nystagmus. v, vii: facial strength and sensation intact and symmetric. viii: hearing intact to voice. xii: tongue midline without fasciculations. motor: strength full power throughout. no pronator drift sensation: intact to light touch bilaterally. toes downgoing bilaterally . upon transfer to medicine service: vitals: 98.1 79 166/64 97% 4l general: alert, no acute distress heent: sclera anicteric, mmm, oropharynx clear lungs: poor air movement, diffuse wheeze, no rhonci 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 gu: no foley ext: warm, well perfused, 2+ pulses, no edema, neuro: 5/5 strength in right extremeties, 4/5 strength left extremeties, intact grip, 2+ knee reflexes and symetrical, cn grossly intact upon discharge : vs afebrile bp 140s-150s hr 77 95% ra general: alert, no acute distress heent: sclera anicteric, mmm, oropharynx clear lungs: cta b/l cv: regular rate and rhythm, 2/6 sem at lsb, no rubs or gallops abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding ext: warm, well perfused, 2+ pulses, no edema, neuro: 5/5 strength in ue and le b/l, intact grip, cn 3-12 grossly intact, normal gait pertinent results: admission : wbc-5.6# rbc-4.33 hgb-11.6* hct-35.9* mcv-83 mch-26.9* mchc-32.4 rdw-13.2 plt ct-331# neuts-44.0* lymphs-49.0* monos-3.9 eos-1.8 baso-1.2 glucose-165* urean-12 creat-0.7 na-137 k-5.2* cl-97 hco3-32 angap-13 ck(cpk)-142 ck-mb-3 ctropnt-<0.01 calcium-9.6 phos-3.7 mg-2.1 repeat k-3.6 . : csf: wbc-23 rbc-* polys-5 lymphs-89 monos-6 (tube 4) csf: wbc-19 rbc-* polys-23 lymphs-70 monos-7 (tube 1) csf: totprot-133* glucose-90 . labs on discharge : 139 103 13 ------------<130 4.0 30 0.6 mg: 1.8 5.1>-------<393 29.0 . micro: csf gram stain and culture - negative mrsa negative ucx negative , c. diff negative x2 ucx negative . imaging: ct head : no acute intracranial abnormality present. chronic changes. . cta head : 1). stable head ct without acute findings. 2). grossly stable appearance of the 5 x 5 mm wide necked internal carotid rtery aneurysm arising at the origin of the posterior communicating artery. there are irregular outpouchings arising from the aneurysm sac. 3). 3 mm anteriorly oriented aneurysm arising from the m1 segment of the left middle cerebral artery near the origin of the anterior temporal branch. 4). 2 mm posteriorly oriented basilar tip aneurysm. . cta torso for flank pain 1. no pulmonary embolism, no acute aortic pathology. 2. moderate bilateral pleural effusions with compressive atelectasis. the presence of pneumonia cannot be entirely excluded. 3. no evidence for retroperitoneal hemorrhage. there is a small amount of simple fluid within the pelvis. 4. mild body wall edema. apical septal thickening. findings are suggestive of volume overload. . ct head w/o contrast to assess for interval change 1. new right parietal infarct following pcomma coiling. 2. chronic microvascular disease and lacunar infarct. . cta head to assess for interval change: s/p pcomm a coiling without vasospasm. r pca appears patent without thrombus. unchanged 18-mm r pca infarct is likely embolic. stable 4-mm l m1 and 2-mm tip of basiliar aneurysms. . echo: mildly dilated la. no asd noted. there is mild symmetric lvh with normal cavity size. regional lv wall motion is normal. left ventricular systolic function is hyperdynamic (ef>75%). tissue doppler imaging suggests an increased left ventricular filling pressure (pcwp>18mmhg). there is a moderate resting lv outflow tract obstruction. a mid-cavitary gradient is identified. no vsd. rv chamber size and free wall motion are normal. the diameters of aorta at the sinus, ascending and arch levels are normal. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion. there is no valvular aortic stenosis. the increased transaortic velocity is likely related to high cardiac output. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. there is no systolic anterior motion of the mitral valve leaflets seen. trivial mitral regurgitation is seen. there is moderate pulmonary artery systolic hypertension. there is no pericardial effusion. compared with the report of the prior study (images unavailable for review) of , the lvef is now hyperdynamic with lvot obstruction present. . ekg: normal axis. hr 70s. st depressions v2-v3. p wave inversions v1-v2, t wave inversion v5-v6. brief hospital course: icu course: 65 yo woman with a h/o poorly controlled htn (sbp 170 at home), cva in with residual l sided weakness, migraine ha presents with severe headache x 2 weeks. lp showed blood but no evidence of meningitis. ct head was done and was negative for any vascular anomaly or trauma. a cta head was then done which showed a right ica aneurysm measuring 5x5 mm; 3 mm aneurysm at the left middle cerebral artery; 2 mm basilar tip aneursym. on , she underwent rigth ica aneurysm coiling by neurosurgery. in the icu, pt had chest pain with st depression on ekg and cardiology was consulted. cardiology felt chest pain was due to demand ischemia from hypovolemia and recommended beta blocker and volume repletion. cardiac enzymes negative. echo done with results above. on , she underwent ct torso for flank pain and persistent hypercapnea with results above. she was placed on bipap intermittently in the icu. head imaging done to assess for interval change was done with results above. she has no new deficits from new parietal infarct s/p coiling. she was seen by speech and swallow who recommended pureed solids and thin liquids. she was hypertensive post-procedure and transferred from sicu to micu for blood pressure control. lisinopril was increased to 40mg daily, metoprolol increased to 100mg tid, felodipine continued at 10mg daily. hctz changed to chlorthalidone daily. she was weaned from labetolol drip. the patient was transferred to the floor for further management of her blood pressure. medicine service course: # right ica aneurysm: stable on floor. s/p coiling , repeat head cta without bleed. per neurosurgery recs, no specific bp requirements in regards to aneurysm. . # hypertension: upon arrival to the floor, pt's bp was still elevated. she was initially started on a nitrate with drop in her sbp to 90s. given her lvot, she was felt to be somewhat preload dependent and nitrate and felodipine stopped. chlorthalidone also stopped. her bp regimen was simplified to lisinopril 40mg daily and toprol xl 50mg daily with sbp 140s-150s. she will require further titration of her bp meds as outpatient. . # hypercarbia: in the icu, pt was noted to have hypercarbic respiratory acidosis with metabolic compensation. her o2 saturation decreased overnight while sleeping. ct chest demonstrated effusion but no significant evidence of copd. pt was given cpap overnight. her sao2 during the day was stable 95-97% ra. she was set up with expedited sleep study (to occur ) as outpatient to evaluate for osa and need for home cpap. for interim, pt was discharged with home o2 for nighttime use. . # urinary frequency - pt complained of dysuria and frequency. ua positive and pt treated with cipro for possible uti given foley. ucx negative and dysuria resolved so antibiotics stopped. frequency may have been due to chlorthalidone. . # h/o stroke: pt has residual mild left sided weakness. no new neurological deficits this admission. - continue asa, plavix . # anemia: initially with slow hct drop from 35 --> 27 which then remained stable. cta head and torso without bleed or hemorrhage. ua only shows trace rbcs, so unlikely cause of hct drop. iron and ferritin normal. stool guaiac negative x1. pt to have further evaluation as outpatient. . # thyroid disorder: low tsh and borderline t3/t4 consistent with sick euthyroid. levothyroxine started earlier during hospital course was discontinued by medicine service. pt should have repeat tfts as outpatient. . # diarrhea: pt complained of diarrhea, which resolved without intervention. c diff negative x2. . # hypercholesterolemia: not on outpatient statin. . # depression: continue sertraline medications on admission: home meds per neuro admission note: 1. felodipine 10mg daily 2. atenolol 100mg daily 3. plavix 75mg daily 4. simvastatin 40mg daily 5. sertraline 100mg daily 6. hctz 25mg daily 7. trazodone 50mg prn 8. albuterol prn 9. flovent discharge medications: 1. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for pain, headache. 2. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 3. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). 4. lisinopril 40 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* 5. trazodone 50 mg tablet sig: one (1) tablet po at bedtime if needed as needed for insomnia. 6. toprol xl 50 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:*2* 7. simvastatin 40 mg tablet sig: one (1) tablet po once a day. 8. sertraline 100 mg tablet sig: 1.5 tablets po once a day. 9. albuterol sulfate 90 mcg/actuation hfa aerosol inhaler sig: 1-2 puffs inhalation as needed as needed for shortness of breath or wheezing. 10. flovent hfa 110 mcg/actuation aerosol sig: two (2) puffs inhalation twice a day. 11. oxygen please use nasal cannula oxygen at 2 liters/minute at all times. discharge disposition: home with service facility: vna discharge diagnosis: primary diagnosis: 5 x 5 mm right ica aneurysm 3 mm aneurysm at m1 segment left mca 2 mm basilar tip aneurysm right parietal infarct hypothyroidism hypertension discharge condition: mental status: clear and coherent level of consciousness: alert and interactive activity status: ambulatory - independent discharge instructions: ms. , you were admitted to for evaluation of your high blood pressure and headache. we made changes to your blood pressure medications with good control of your blood pressure. you may take tylenol for your headache. physical therapy saw you and felt you were safe to discharge home. changes to your medications: 1. stop felodipine 2. stop atenolol 3. stop hydrochlorothiazide (hctz) 4. start lisinopril 40mg daily 5. start toprol xl 50mg daily 6. start aspirin 325mg daily 7. use oxygen at night while you sleep. this will help your blood pressure. 8. use a walker. this will help prevent you from falling. 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 what to report to office: ?????? changes in vision (loss of vision, blurring, double vision, half vision) ?????? slurring of speech or difficulty finding correct words to use ?????? severe headache or worsening headache not controlled by pain medication ?????? a sudden change in the ability to move or use your arm or leg or the ability to feel your arm or leg ?????? trouble swallowing, breathing, or talking ?????? numbness, coldness or pain in lower extremities ?????? temperature greater than 101.5f for 24 hours ?????? new or increased drainage from incision or white, yellow or green drainage from incisions ?????? bleeding from groin puncture site *sudden, severe bleeding or swelling (groin puncture site) lie down, keep leg straight and have someone apply firm pressure to area for 10 minutes. if bleeding stops, call our office. if bleeding does not stop, call 911 for transfer to closest emergency room! medications: ?????? take aspirin 325mg (enteric coated) once daily. ?????? please take plavix as prescribed. followup instructions: the sleep lab will contact you regarding a sleep study. they will also be in touch with your pcp, . . provider: , md (primary care doctor) phone: date/time: 10:00 building, provider: . (psychiatry) phone: date/time: 11:40 ra (/ complex), provider: , m.d. (neurology) phone: date/time: 3:30 , specialty: radiology (appointment for mra scan) date/ time: thursday, , 2:30pm location: clinical center, basement radiology suite phone number: md: specialty: neurosurgery date/ time: thursday, , 4pm location: , , phone number: provider: , dpm (podiatry) phone: date/time: 3:00 ba ( complex), procedure: venous catheterization, not elsewhere classified spinal tap incision of lung non-invasive mechanical ventilation arteriography of cerebral arteries endovascular (total) embolization or occlusion of head and neck vessels diagnoses: acidosis other iatrogenic hypotension obstructive sleep apnea (adult)(pediatric) anemia, unspecified pure hypercholesterolemia unspecified pleural effusion unspecified essential hypertension pulmonary collapse other specified forms of chronic ischemic heart disease urinary frequency cerebral aneurysm, nonruptured other late effects of cerebrovascular disease cerebral embolism with cerebral infarction chronic obstructive asthma, unspecified hypovolemia migraine, unspecified, without mention of intractable migraine without mention of status migrainosus iatrogenic cerebrovascular infarction or hemorrhage third or oculomotor nerve palsy, partial nonspecific abnormal findings in cerebrospinal fluid euthyroid sick syndrome 

Answer: The patient is high likely exposed to