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: found down in her apartment s/p fall; mental status change major surgical or invasive procedure: cardiac catheterization with stents placed history of present illness: 78 y/o w/pmh sig for tobacco, copd and dyslipidemia, presents after being found face down at home s/p fall of unclear etiology, was brought to osh and on ecg had st elevations concerning for acs. also noted to have ck 20k, right shoulder injury from fall, dysarthia, mental status change. brought to for cath. past medical history: tobacco copd dyslipidemia multiple falls (4 in last year), with broken vertebra 1y pta social history: significant tobacco use, unquantified no etoh no drugs family history: noncontributory physical exam: gen: thin elderly woman, lying on stretcher, appearing frightened and fatigued skin: pale, cool and dry, no rash heent: mmm cv: rrr nl s1 quiet s2 no mgr, +jvd lungs: decreased breath sounds and crackles at bases b/l; poor inspiratory effort; poor air movement abd: thin, soft nt/nd +bs ext: le edema, no c/c/e neuro: disoriented, slurred speech, uncooperative pertinent results: 10:15pm blood wbc-18.9* rbc-5.12 hgb-15.8 hct-46.1 mcv-90 mch-30.9 mchc-34.3 rdw-12.0 plt ct-305 05:18am blood wbc-18.0* rbc-4.32 hgb-13.5 hct-39.3 mcv-91 mch-31.2 mchc-34.4 rdw-12.1 plt ct-266 05:35am blood wbc-13.6* rbc-4.15* hgb-13.0 hct-37.9 mcv-91 mch-31.5 mchc-34.4 rdw-12.6 plt ct-218 10:35am blood hct-39.1 05:18am blood neuts-94* bands-1 lymphs-4* monos-1* eos-0 baso-0 atyps-0 metas-0 myelos-0 06:40am blood neuts-76.6* lymphs-17.8* monos-5.0 eos-0.4 baso-0.3 10:15pm blood pt-13.2 ptt-26.9 inr(pt)-1.1 10:15pm blood plt ct-305 05:35am blood plt ct-218 09:48pm blood ptt-50.7* 06:15am blood ptt-90.9* 10:15pm blood gran ct- 10:15pm blood glucose-112* urean-17 creat-0.6 na-140 k-4.0 cl-102 hco3-24 angap-18 05:18am blood glucose-197* urean-22* creat-0.6 na-141 k-3.3 cl-101 hco3-25 angap-18 06:40am blood glucose-114* urean-29* creat-0.5 na-147* k-3.7 cl-107 hco3-26 angap-18 05:35am blood glucose-123* urean-22* creat-0.5 na-140 k-3.8 cl-104 hco3-23 angap-17 10:35am blood urean-16 creat-0.5 k-3.5 10:15pm blood ck(cpk)-* 05:18am blood alt-49* ast-216* ld(ldh)-668* ck(cpk)-9183* alkphos-101 totbili-0.6 06:31pm blood ck(cpk)-5624* 07:45am blood ck(cpk)-4186* 09:30am blood ck(cpk)-4249* 10:15pm blood ck-mb-150* mb indx-1.2 10:15pm blood ctropnt-1.38* 05:18am blood ck-mb-117* mb indx-1.3 ctropnt-1.62* 06:31pm blood ck-mb-48* mb indx-0.9 ctropnt-1.47* 07:45am blood ck-mb-35* mb indx-0.8 ctropnt-1.02* 09:30am blood ck-mb-18* mb indx-0.4 05:18am blood albumin-3.6 calcium-7.9* phos-4.6* mg-1.7 uricacd-5.2 cholest-224* 06:31pm blood calcium-9.0 phos-2.3*# mg-1.7 06:40am blood calcium-9.4 phos-2.5* mg-2.1 05:35am blood calcium-8.6 phos-2.8 mg-1.8 09:30am blood %hba1c-5.9* 05:18am blood triglyc-88 hdl-80 chol/hd-2.8 ldlcalc-126 05:18am blood tsh-2.3 10:02pm blood type-art po2-55* pco2-50* ph-7.29* calhco3-25 base xs--2 intubat-not intuba 10:02pm blood lactate-1.4 brief hospital course: pt was found to have ekg with st elevations in v3-v6 and ii, iii, avf to a lesser degree, concerning for anterior stemi; ck was 20,000, but neg ck-mb, index, trop. pt received cath w/2 stents placed in lad, hemodynamics were notable for elevated wedge pressure indicating l heart failure so she was a/t ccu for closer management. cath results: final diagnosis: 1. one vessel coronary artery disease. 2. acute anterior myocardial infarction, managed by acute ptca. 3. successful stenting of the lad. comments: 1. coronary angiography of this left-dominant circulation revealed single vessel cad. the lmca was free of angiograpic disease. the lad had an ostial 80% lesion, followed by a 70% stenosis. the lcx had no flow-limiting stenoses. the rca was non-dominant and free of disease. 2. resting hemodynamics showed severely elevated right and left heart pressures and a reduced cardiac index. 3. successful stenting of the proximal lad with two 2.5 mm cypher drug-eluting stents. final angiography showed no residual stenosis, no apparent dissection and normal flow (see ptca comments). hemodynamics:ra 18 rv 51/17 pa 51/27 pcw 30 pa sat 65% co 2.44 ci 1.69 the patient was noted to be confused on arrival to the ccu and it was not clear if this was new or not, though after discussion with family it seems to be a worsening of a baseline confusion that the patient has exhibited for the past 6 months or so. 1. cardio a. coronaries--received stents as above to lad; was started on asa, plavix, lipitor 80mg po qd though with difficulty as pt was initially refusing to take all medications; she never missed a dose of plavix however. b. pump--fluid overloaded initially in chf, diuresed with lasix while in the ccu, echo performed that revealed ef 20-25%; pt was started on metoprolol tid and captopril tid, but eventually switched over to atenolol 100 mg po qd, lisinopril 5.0 po qd with adequate control of her bp and hr c. rhythm--nsr with occassional st from agitation during the overnight hours; not a candidate for icd given dnr/dni status and narrow qrs; was initially not started on heparin or coumadin because of history of falls, but then her pcp was emailed (dr. and he said that he would like her started on anticoagulation, which she was prior to d/c with coumadin and briding heparin drip (no initial bolus); she will need careful monitoring given her mental status and history of falls (including the one that got her into the hospital on this admit) 2. pulm: pt presented with chf/pulmonary edema, which responded well to lasix diuresis; the pt did not require more than a nasal canulla to keep her oxygenation adequate. she was noted to have evidence of copd on her cxr so atrovent and ipratropium nebs were prescribed with good effect. ?rul infiltrate on cxr at osh, pt was started on flagyl/levaquin for coverage of asp pna. 3. id: pt was noted to have elevated wbc count though she remained afebrile; she came from the osh with possible aspiration pneumonia from a cxr read at the osh that we did not have access to at . we started a 7d course of levquin 250mg po qd and flagyl 500mg po tid for presumed asp pna; a cxr on showed clear pulm parenchyma. wbc trended down with the antibiotics. 5. gi: the patient was noted to have difficulty eatting solid foods when she arrived to the floor after being in the unit, so a speech and swallow consult was sought that recommended thin liquids and pureed foods. the patient had poor po intake, denied hunger or thirst, but was encouraged to eat. 6. gu: foley cath was removed once patient was transferred to the floor; ua showed trace blood but otherwise negative 7. heme: stable 8. endo: ssi qid 9. neuro: patient was unreliable historian; in speaking with her son and daughters, it seems that she has had some mental status decline over the last 6 months or so with worsening in the weeks prior to her admission; the patient initially would not cooperate enought to perform a detailed neuro exam; she was sent for a head ct which revealed a right lacunar infarct that was old, no new cva evidence; geriatrics consultants felt that this was likely a delirium on top of a baseline dementia, recommending outpatient neuropsych testing once her delirium resolves. the patient had waxing and mental status over the course of her admission, with zyprexa seeming to decreased her overnight agitation but still with occassional paranoid psychosis. prior to d/c however the pt was improved and speaking reasonably about how she knew she could not live alone anymore but that she didn't want to live in a group home either. she should have neuropsych testing as an outpatient to further define her deficits. 10. psych: pt with mdd; we d/c'd amytriptylline on her arrival given the adverse side effect profile of this med; she was started on haldol initially, then zyprexa qhs for her paranoid agitation but consult advised against continuing this med in an unmonitored setting given the risks associated with it. she will likely need another antidepressant, non-anticholinergic, to be determined by her pcp or psychiatrist to treat her disorder on an outpatient basis. 11. ppx: bowel regimen 12. communication: hcp is pt's son ; his phone numbers: h, c, w; he is bringing in a copy of the hcp form that he has filled out with his mother previously; spoke with son on re: probability of d/c soon to rehab; he is concerned re:long term plan; will discuss with him more in future. 13. code: code was reversed from dnr/dni on arrival so pt could have cath, then changed back after cath to dnr/dni; per son who is hcp, pt is now dnr/dni; other sons and daughters in agreement 14. dispo: for short term rehab on discharge, though both pt and ot as well as the medical team feel that this patient should not be allowed to return home to live by herself; she has proven that she is a fall risk and should not be put at risk for another unwitnessed fall such as the one that led to this hospitalization; when thinking clearly she seems to recognize the need for her to live in a setting where she has more support, though she repetitively states that she does not want to live in a group home. medications on admission: amytriptyline discharge medications: 1. clopidogrel bisulfate 75 mg tablet sig: one (1) tablet po qd (once a day). tablet(s) 2. acetaminophen 325 mg tablet sig: 1-2 tablets po q4-6h (every 4 to 6 hours) as needed. 3. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po qd (once a day) as needed. 4. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed. 5. ipratropium bromide 18 mcg/actuation aerosol sig: two (2) puff inhalation qid (4 times a day). 6. atorvastatin calcium 80 mg tablet sig: one (1) tablet po once a day. 7. levofloxacin 250 mg tablet sig: one (1) tablet po q24h (every 24 hours) for 3 days: possible aspiration pneumonia; please take 9/16,9/17,. 8. metronidazole 500 mg tablet sig: one (1) tablet po tid (3 times a day) for 3 days: possible aspiration pneumonia; please take 9/16,9/17,. 9. olanzapine 2.5 mg tablet sig: two (2) tablet po hs (at bedtime): for sundowning and nighttime paranoid psychosis; please discontinue if no longer in monitored setting (post rehab or later). 10. aspirin 325 mg tablet sig: one (1) tablet po qd (once a day). 11. ipratropium bromide 0.02 % solution sig: one (1) neb inhalation q6h (every 6 hours) as needed for shortness of breath or wheezing. 12. lisinopril 5 mg tablet sig: one (1) tablet po qd (once a day). 13. atenolol 100 mg tablet sig: one (1) tablet po qd (once a day). 14. warfarin sodium 5 mg tablet sig: one (1) tablet po qd (once a day): goal inr 2-2.5; careful titration needed given history of falls; check inr daily for first week. 15. docusate sodium 150 mg/15 ml liquid sig: ml po bid (2 times a day) as needed for constipation. 16. heparin sod (porcine) in d5w 100 unit/ml parenteral solution sig: six hundred (600) units intravenous per hour: please maintain ptt between 60-100 until inr goal of 2.0-2.5 is met; monitor careful with daily ptt checks given pt's fall risk. discharge disposition: extended care facility: & rehabilitation center discharge diagnosis: 1. old anterior myocardial infarct 2. congestive heart failure 2. acute fall 3. rhabdomyolysis 4. delirium 5. possible dementia 6. old right lacunar stroke discharge condition: stable discharge instructions: please take all your medications as prescribed, especially the plavix which is the most important medicine for your heart. if you stop taking the plavix you will very likely have another heart attack and need to go back to the hospital, and you may not survive another heart attack. please cooperate to the best of your ability with the rehabilitation specialists at the short term rehab facility. they will help you get back into shape so that you can get back on your feet again. followup instructions: please go to the short term rehab facility on discharge to get stronger and back on your feet. you will need to see your primary care doctor, dr. , () on at 1:30pm, to be evaulated after your hospitalization at . you will need pulmonary function testing and neuropsychiatric testing that dr. can set up for you. you will also need to see a cardiologist, and either you, your children or one of your care providers should call ( to set up an appointment at . the appointment should be made as a follow up to your recent cardiac catheterization performed by dr. , though it can be with another cardiologist. you should try to make an appointment for within the next month if possible. lastly, you have been set up with an appointment with the clinic, dr. , for monday at 2pm at . the office is located in the , . the phone number for the office is (). procedure: angiocardiography of left heart structures injection or infusion of platelet inhibitor left heart cardiac catheterization coronary arteriography using a single catheter insertion of drug-eluting coronary artery stent(s) diagnoses: coronary atherosclerosis of native coronary artery tobacco use disorder congestive heart failure, unspecified acute myocardial infarction of other anterior wall, initial episode of care chronic airway obstruction, not elsewhere classified other and unspecified hyperlipidemia pneumonitis due to inhalation of food or vomitus 

Answer: The patient is high likely exposed to