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: cefaclor attending: chief complaint: hypotension, nsvt major surgical or invasive procedure: none history of present illness: this is a 20 year old female with history of anorexia nervosa for 10 years c/b multiple hopsitalizations for self injury, malnutrition, syncope. she presented voluntarilly to the ed directly from her pcp for symptoms of light headedness and dark urine for medical clearance and admission to an eating disorder clinic. . her history of eating disorder began at age 10, weight loss became a problem in high school. she has history of anxiety, depression and ptsd due to assault which have complicated her eating behaviors. she has restrictive eating patterns and excessive exercise but does not purge. she first participated in a treatment program in since then she has spent several months in different programs at , clarmon at . she has required tf via ngt and gt was also considered for a time. she was discharged in and went to to live with her parents but relapsed and stopped eating for 5 weeks (< 150cal/day), losing 35 lbs in that time. since that time she admits to chronic, substernal chest pain, episodes of syncope, and epistaxis, and mucously reddish bm. . she complains of substernal chest pain that is deep similar to previous episodes without radiation. it is always at rest and never with exertion (she runs daily), without associated diaphoresis or nausea. she describes it as a pulling sensation. cardiac history is notable for diagnosis of arrythmia during syncope evaluation which included an echocardiogram which per patient was normal, tilt table testing for autonomic dysfunction. at that time she was diagnosed with arrythmia but cannot remember the type. she was also told that she had a heart attack while in . she has chosen not to follow up with cardiology despite recommendation to do so. . in the ed, initial vs were: 98.7 74 101/66 16 100%. she then proceded to have three episodes of nsvt, each episode lasting 7 beats, 12 beats, then 9-10 beats most recently at 11:40pm. around the times of these episodes her systolic blood pressure was noted to be in the 50s without change in mental status, without sx. her blood pressure would then stablize in the 80s. she recieved 6l of ns in the ed for blood pressure. she was also given 4mg iv mag, 1 amp calcium gluconate, and 40meq k in saline. initial ekg showed diffuse st depression with qtc 580, hr 48. follow up ecg showed qtc of 450 and hr in 60s. ua was also done, first sample was dirty, repeat showed no sign of infection. vital signs on transfer were 76 83/60 18 100% ra. . on the floor, her sbp was initially in the 50s, imporved with saline bolus to the 80s. she remained asympomatic throughout. she did not have any nsvt during these episodes. she expresses that her hospitalization was not her choice, she told she would otherwise be sectioned. . . review of systems: (+) per hpi, chronic migraines (-) denies fever, chills, night sweats. denies rhinorrhea, cough or sore throat. denies shortness of breath, or wheezing. denies chest palpitations, or weakness. denies nausea, vomiting, diarrhea, abdominal pain. denies dysuria, frequency, or urgency. denies arthralgias or myalgias. denies rashes or skin changes. denies suicidal ideation or depression. past medical history: anorexia with restrictive eating and excessive exercise anxiety depression ptsd osteoporosis h/o self injury, most recently in suicidal behavior - wrist cutting, od on rx meds social history: - tobacco: none - alcohol: none - illicits: used cocaine and speed 1 week prior to admission, h/o prescribed medication use. denies ivdu. family history: eating disorder - sister ? bulemia psych history/hopsitalization - father and m grandmother with substance abuse. cardiac arrythmia - p grandmother in 30s, etoh early mi or sudden death - none physical exam: vitals: t:96.3 bp:55/28 -->96/55 p:63 r:13 o2: 97% ra general: alert, oriented, cachectic female, 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. tenderness to palpation just superior to xyphoid process. abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly gu: + foley ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema neuro: a&ox3, cn2-12 intact. psych: affect appropriate pertinent results: 07:10pm blood wbc-4.1 rbc-3.76* hgb-10.8* hct-30.6* mcv-81* mch-28.7 mchc-35.2* rdw-13.3 plt ct-331 01:17am blood wbc-3.8* rbc-3.77* hgb-10.9* hct-31.4* mcv-83 mch-29.0 mchc-34.8 rdw-13.1 plt ct-298 08:45am blood wbc-3.6* rbc-3.40* hgb-10.0* hct-28.6* mcv-84 mch-29.4 mchc-35.0 rdw-13.3 plt ct-290 06:30am blood wbc-4.0 rbc-3.34* hgb-9.5* hct-27.7* mcv-83 mch-28.4 mchc-34.2 rdw-13.5 plt ct-299 06:35am blood wbc-4.0 rbc-3.48* hgb-9.9* hct-29.2* mcv-84 mch-28.5 mchc-33.9 rdw-13.4 plt ct-291 07:10pm blood neuts-38.0* lymphs-54.9* monos-4.6 eos-1.7 baso-0.8 01:17am blood neuts-42.8* lymphs-50.6* monos-3.3 eos-1.7 baso-1.5 01:17am blood pt-15.4* ptt-34.2 inr(pt)-1.4* 07:10pm blood glucose-78 urean-5* creat-0.9 na-140 k-3.0* cl-96 hco3-33* angap-14 01:17am blood glucose-146* urean-3* creat-0.7 na-145 k-3.0* cl-113* hco3-26 angap-9 06:54am blood glucose-51* urean-2* creat-0.5 na-145 k-3.8 cl-117* hco3-24 angap-8 02:51pm blood glucose-74 urean-2* creat-0.6 na-144 k-3.5 cl-113* hco3-24 angap-11 08:45am blood glucose-60* urean-1* creat-0.6 na-142 k-3.6 cl-110* hco3-22 angap-14 06:30am blood glucose-75 urean-3* creat-0.5 na-142 k-3.1* cl-109* hco3-27 angap-9 05:38pm blood glucose-65* urean-3* creat-0.5 na-142 k-5.1 cl-110* hco3-25 angap-12 06:35am blood glucose-57* urean-3* creat-0.5 na-143 k-4.2 cl-109* hco3-27 angap-11 01:17am blood alt-22 ast-21 ld(ldh)-157 ck(cpk)-100 alkphos-38 totbili-0.8 06:30am blood alt-56* ast-60* alkphos-41 totbili-1.1 07:10pm blood calcium-9.3 phos-3.4 mg-1.6 01:17am blood albumin-3.5 calcium-7.6* phos-1.4*# mg-2.4 iron-40 cholest-120 06:54am blood calcium-8.0* phos-2.5* mg-1.8 02:51pm blood calcium-8.0* phos-2.6* mg-1.6 08:45am blood calcium-7.6* phos-3.4 mg-1.5* 06:30am blood albumin-3.3* calcium-8.0* phos-3.3 mg-2.1 05:38pm blood calcium-8.8 06:35am blood calcium-8.5 phos-3.8 mg-2.1 . other labs 01:17am blood caltibc-191* ferritn-68 trf-147* 01:17am blood triglyc-68 hdl-63 chol/hd-1.9 ldlcalc-43 01:17am blood prolact-6.4 tsh-0.39 07:10pm blood asa-neg ethanol-neg acetmnp-neg bnzodzp-neg barbitr-neg tricycl-neg 01:31am blood type- temp-35.7 ph-7.37 comment-green top 01:31am blood lactate-1.9 01:31am blood freeca-1.05* . urine 07:00pm urine color-yellow appear-hazy sp -1.029 07:00pm urine blood-lg nitrite-neg protein-25 glucose-neg ketone-150 bilirub-neg urobiln-neg ph-9.0* leuks-tr 07:00pm urine rbc-* wbc- bacteri-many yeast-none epi->50 07:00pm urine casthy-* 07:00pm urine mucous-few 07:00pm urine ucg-neg 07:00pm urine bnzodzp-pos barbitr-neg opiates-neg cocaine-neg amphetm-neg mthdone-neg 11:00pm urine color-straw appear-clear sp -1.006 11:00pm urine blood-neg nitrite-neg protein-neg glucose-1000 ketone-tr bilirub-neg urobiln-neg ph-8.0 leuks-neg . . cardiology . cardiology report ecg study date of 10:02:42 pm normal sinus rhythm. compared to tracing #1 the q-t interval has shortened and the st-t wave changes have decreased considerably. the q-t interval has also shortened. tracing #2 . cardiology report ecg study date of 11:44:02 pm normal sinus rhythm. the q-t interval has shortened further. the non-specific st-t wave changes noted on the prior tracings have continued to improved. tracing #3 read by: , m. . cardiology report ecg study date of 8:41:02 pm sinus bradycardia, rate 48, with occasional ventricular premature beats. q-t interval prolongation. rsr' pattern in lead v2 with qrs duration of 86 milliseconds. t wave inversion in leads avl and v2-v4. no previous tracing available for comparison. consider electrolyte abnormality. tracing #1 read by: , m. . ardiology report ecg study date of 12:02:56 pm baseline artifact. sinus rhythm. low voltage. early precordial t wave inversions. since the previous tracing of the axis is less vertical. t waves may be improved. tracing #1 read by: , a. . cardiology report ecg study date of 2:30:50 pm sinus rhythm. t wave abnormalities. since the previous tracing t wave abormalities may be more marked. q-t interval is somewhat longer. consider hypokalemia. tracing #2 read by: , a. . echocardiogram: findings left atrium: normal la size. right atrium/interatrial septum: normal ra size. left ventricle: normal lv wall thickness, cavity size and regional/global systolic function (lvef >55%). tdi e/e' < 8, suggesting normal pcwp (<12mmhg). no resting lvot gradient. no vsd. right ventricle: normal rv chamber size and free wall motion. aorta: normal aortic diameter at the sinus level. normal ascending aorta diameter. aortic valve: normal aortic valve leaflets (3). no as. no ar. mitral valve: normal mitral valve leaflets with trivial mr. no mvp. normal mitral valve supporting structures. tricuspid valve: normal tricuspid valve leaflets with trivial tr. normal tricuspid valve supporting structures. no ts. normal pa systolic pressure. pulmonic valve/pulmonary artery: normal pulmonic valve leaflet. no ps. physiologic pr. normal main pa. no doppler evidence for pda pericardium: no pericardial effusion. conclusions: the left atrium is normal in size. left ventricular wall thickness, cavity size and regional/global systolic function are normal (lvef 60%). tissue doppler imaging suggests a normal left ventricular filling pressure (pcwp<12mmhg). there is no ventricular septal defect. 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 appears structurally normal with trivial mitral regurgitation. there is no mitral valve prolapse. the estimated pulmonary artery systolic pressure is normal. there is no pericardial effusion. impression: normal study . radiology . cxr findings: there are low lung volumes. the cardiomediastinal contours are within normal limits. apparent increased hazy opacity in the right mid to lower lung zone likely represents a combination of atelectasis and overlying soft tissues. this could be further evaluated with dedicated pa and lateral. no pleural effusion or pneumothorax. the osseous structures are grossly unremarkable. . impression: no acute cardiopulmonary process. right lung hazy opacity likely represents combination of superimposition of soft tissues and atelectasis. . portable abdominal xr findings: - or orogastric tube is seen with tip overlying the region of the stomach. the ascending, transverse and descending colon are dilated to a maximum diameter of 6.5 cm. stool is seen within the colon and rectum. decubitus film demonstrates no evidence for free air. few air-fluid levels are seen within the colon. . impression: dilated air and stool-filled colon suggestive of ileus. brief hospital course: brief summary: the patient was a 20 year old female with a ten year history of anorexia nervosa who presented voluntarily to the emergency department on for treatment of malnutrition. she was noted to have episodes of non-sustained ventricular tachycardia (nsvt) and hypotension in the setting of abnormal electrolytes. the patient refused to eat solid foods; thus, the eating disorder protocol was initiated, necessitating a nasogastric tube and tube feeds. early in her hospital stay, the patient refused her tube feeds. the psychiatry service was consulted. legal guardianship documents were filed. medical intensive care unit course: the patient was brought to the icu because of hypotension and nsvt. she was fluid resuscitated with ns, and her electrolytes (potassium, magnesium, and phosphate) were repleted. an ekg showed a slightly prolonged qt with no ischemic changes. she was monitored on telemetry and had no more episodes of nsvt. an echocardiogram was obtained and showed a normal study. nutrition was consulted and she was started on the eating disorder protocol, on a liquid diet as she refused solid food. psychiatry also saw the patient and recommended to continue with the protocol and to let them know if she refused her feeds to reassess her capacity to make those decisions. social work was involved to help organize a family meeting. an ng tube was placed and feeding was started via the eating disorders protocol. ms. continued to have mild derangements in her electrolytes which were repleted. she refused her feeds and psychiatry was involved to obtain guardianship. there were no further episodes of vt and she remained hemodynmicaly stable. medical floor course: the patient was transferred to the medical floor on hospital day two. on the floor, the patient accepted her tube feeds. her weight stabilized at approximately 82 pounds. she complained of nausea and abdominal discomfort with her tube feeds. petition for medical guardianship was initiated. on , her ng tube had to be resited because of damage from requent use; the abdominal x-ray confirming its proper placement showed a large volume of stool inside the colon. the patient estimated it had been 5 weeks since her last bowel movement, but reported she was passing flatus. that evening she vomited involuntarily after her tube feed. she vomited again the following day (). on , she took in po calories successfully. the patient required intermittent supplementation with oral and intravenous potassium; however, as she began to take her tube feeds regularly, her potassium levels stabilized. on , she was approximately 200cc into her am feed, when she developed nausea and vomited. when she stood to return to her bed, she had a vasovagal episode. vitals were stable. a repeat abdominal x-ray showed a bowel ileus, involving the rectum, descending, transverse and ascending colon. digital rectal examination revealed no obstruction or fecal impaction. the patient reported she had not passed flatus for 2 days. the patient was made npo except for medications, and her bowel regimen was expanded to include intravenous metoclopramide and milk of magnesia around the clock. she declined enemas. on , she passed flatus and liquid stool; she has continued to pass stool since that time. on she restarted her caloric intake, taking 720cc of boost po, without requiring any ng feeds. as of , her ileus has resolved and she was having loose bowel movements. the patient gained temporary legal guardianship (by virtue of her biological father) on the day of transfer, . she was transferred to an eating disorder unit at an outside hospital. medications on admission: klonapin 1mg qam + 1mg prn, 2mg qhs clonidine 0.2mg qhs for nightmares discharge medications: 1. multivitamin tablet sig: one (1) tablet po daily (daily). 2. acetaminophen 325 mg tablet sig: two (2) tablet po q6h (every 6 hours) as needed for pain. 3. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 4. senna 8.6 mg tablet sig: 1-2 tablets po bid (2 times a day). 5. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection tid (3 times a day): this does not need to be administered if pt is ambulating 3x day. 6. thiamine hcl 100 mg tablet sig: one (1) tablet po daily (daily). 7. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 8. calcium carbonate 200 mg (500 mg) tablet, chewable sig: one (1) tablet, chewable po q 8h (every 8 hours). 9. cholecalciferol (vitamin d3) 400 unit tablet sig: two (2) tablet po daily (daily). 10. clonazepam 1 mg tablet sig: two (2) tablet po qhs (once a day (at bedtime)). 11. clonazepam 1 mg tablet sig: one (1) tablet po am (). 12. menthol-cetylpyridinium 3 mg lozenge sig: one (1) lozenge mucous membrane prn (as needed) as needed for throat pain. 13. ondansetron 4 mg tablet, rapid dissolve sig: tablet, rapid dissolves po q8h (every 8 hours) as needed for n/v. 14. polyethylene glycol 3350 17 gram/dose powder sig: one (1) po daily (daily): please hold if >2 bms/day. 15. calcium carbonate 200 mg (500 mg) tablet, chewable sig: one (1) tablet, chewable po three times a day as needed for heart burn. 16. metoclopramide 5 mg tablet sig: one (1) tablet po four times a day: please titrate to two bowel movements per day. 17. magnesium hydroxide 400 mg/5 ml suspension sig: thirty (30) ml po bid (2 times a day): please titrate to two bowel movements per day. . discharge disposition: extended care discharge diagnosis: primary: anorexia nervosa secondary: electrolyte abnormalities non-sustained ventricular tachycardia malnutrition discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: dear ms. : it was a pleasure taking care of you at . you were admitted to the hospital because you were malnourished, you electrolytes were imbalanced, and this was causing your heart to have an abnormal rhythm. you were placed on an eating disorder protocol and you were eventually able to tolerate your tube feeds. your electrolytes stabilized. your heart rhythm normalized. you developed an ileus in which your bowels were paralyzed. you were given stool softeners, laxatives, and a bowel stimulating , which helped you recover from this. you are now healthy enough to be transferred to an eating disorder unit. your medications are attached and will be relayed to the eating disorder unit. followup instructions: you will be tranferred to an eating disorder unit. procedure: enteral infusion of concentrated nutritional substances central venous catheter placement with guidance diagnoses: other specified intestinal obstruction cocaine abuse, unspecified paroxysmal ventricular tachycardia constipation, unspecified dysthymic disorder other specified cardiac dysrhythmias osteoporosis, unspecified paralytic ileus headache dehydration lumbago electrolyte and fluid disorders not elsewhere classified orthostatic hypotension nutritional marasmus posttraumatic stress disorder hypoglycemia, unspecified anorexia nervosa dietary surveillance and counseling 

Answer: The patient is high likely exposed to