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: iodine; iodine containing / sulfa (sulfonamides) / penicillins / darvon / ativan / ambien attending: chief complaint: transfer for nstemi major surgical or invasive procedure: cardiac catheterization placement and removal of temp. dialysis line history of present illness: this is a 77 year old female with h/o mi, pvd and stage v ckd. she was recently hospitalized in early at for a perforated gastic ulcer s/p surgical repair with a complicated post-op course with mi and repiratory failure requiring intubation. she was discharged to rehab on . on , she developed respiratory distress and was brought to good samarita. she became hypotensive and was placed on neo briefly. thought was that she was septic from pna and uti, treated with ceftriaxone and vancomycin. she was placed on bipap for respiratory distress. then she developed chest pain and ekg was interpreted as stemi in the precordial leads, which was later read as j pt elevations by the consultant cardiologist. she had ck's to 30's, mb 7.8 and troponins was 0.66 and 0.56. she had recurrent chest pain, and was sent to for cath. . at catheterization, she had an 80% lcx that was fixed with a bms. she has a totally occluded rca that was fed by collaterals. lm and lad had minimal dz. wedge pressure was 20. . ros: denies chest pain, sob, orthopnea, pna, claudications, peripheral edema. denies fevers, chills, abd pain, n/v/d. + back and shoulder pain which is chronic. past medical history: # hypertension. # hyperlipidemia. # history of coronary artery disease, mild angina, history of mi, unclear documentation. # history of cva with mild residual left sided symptoms. # s/p l and r carotid stent # s/p stenting of the distal aorta and both iliac arteries # renal insufficiency (baseline cr 4) with renal stone and renal dysfunction and a solitary kidney. # h/o perforated gastric ulcer s/p surgery . cardiac history: cabg: none percutaneous coronary intervention: none pacemaker/icd placed: none social history: lives at home with husband. distant smoking history. social alcohol use. no illicit drug use now or in the past. family history: noncontributory. physical exam: vitals: 96.7, 99/79, 102, 20, 99% 4lnc gen: a+ox3, nad, pleasant heent: pupils equal and round, eomi, op clear, mmm neck: jvp about 7 cm, carotid bruits bilaterally, r>l cv: tachy, regular, s1 and s2, no m/g/r pulm: ctab, no w/r/r abd: midline scar healing, soft, nt, nd, +bs ext: no peripheral edema, bruit femoral bilaterally pulses: 2+ dp pulse, 1+ pt pulse bilaterally pertinent results: 02:45pm type-art o2 flow-4 po2-86 pco2-33* ph-7.38 total co2-20* base xs--4 intubated-not intuba comments-nasal pron 02:45pm glucose-133* k+-4.2 02:45pm hgb-9.4* calchct-28 o2 sat-96 01:50pm glucose-143* urea n-78* creat-3.9*# sodium-134 potassium-4.0 chloride-101 total co2-17* anion gap-20 01:50pm estgfr-using this 01:50pm alt(sgpt)-9 ast(sgot)-10 ck(cpk)-20* alk phos-86 amylase-100 tot bili-0.2 dir bili-0.1 indir bil-0.1 01:50pm ck-mb-notdone 01:50pm albumin-2.6* 01:50pm %hba1c-5.6 01:50pm wbc-5.2 rbc-2.98* hgb-8.9* hct-26.0* mcv-87 mch-30.0 mchc-34.4 rdw-15.9* 01:50pm neuts-94.9* bands-0 lymphs-3.7* monos-0.9* eos-0.5 basos-0 01:50pm hypochrom-normal anisocyt-normal poikilocy-normal macrocyt-normal microcyt-normal polychrom-normal 01:50pm plt smr-normal plt count-245 . . ekg: osh ekg : sinus tach 120 bpm, na, ni, j-pt elevations vs ste v1 to v2 3mm, std v5, v6, i, avl 1-2mm. ekg post cath: sinus tach 100 bpm, na, ni, j-pt elevations vs ste v1 to v2 2mm, std v6, i 1mm. . telemetry: . 2d-echocardiogram: none . ett: none . cardiac cath: rhc: pap 42/15/6, pcw 20 (30 at beginning of case, then got lasix) lhc: lm no dz lad minimal dz lcx 80% thrombotic stenosis then severe diffuse dz beyond, stented with bms rca occluded proximally and fills by collaterals from lad brief hospital course: #nstemi - patient was transfered from osh for chest pain and elevated troponins. catheterization here showed occluded left circumflex and occluded right coronary artery filled by collaterals. a bare metal stent was placed to the left circumflex artery. she was chest pain free after the procedure. she was maintained on asa, plavix, beta-blocker, and statin. an ace-inhibitor was held because of her poor renal function. # acute systolic heart failure: patient presented to osh with chf exacerbation and shortness of breath. here her ef was decreased at 30-40%, and unknown previous. she was diuresed and her blood pressure was aggressively controlled. she was weaned from oxygen and did well. she is not on lasix currently given her renal failure and euvolemic status. ***her volume status should be monitored at the rehab facility and her lasix should be administered as needed.*** creatinine should be monitored if she is placed back on lasix therapy. #severe mr: patient was noted to have severe mitral regurtitation on echo. the chronicity of this was unknown. she does not seem to be a good surgical candidate for valvular repair or replacement. her blood pressure was controlled. she should follow up with her outpatient cardiologist regarding this matter. . # ckd: stage v kidney disease from hypertension. her outpatient nephrologist anticipated that it likely progressing to renal failure requiring hemodialysis. after cardiac cath. she did recieve one session of dialysis after placement of a temporary dialysis line. she did not require other dialysis session and it seems her serum creatinine is at her baseline. she will still likely need dialysis at some point in the future. the renal team made a note that a fistula should not be place on the left given left subclavian steel syndrome. she will need to be monitored as before by her nephrologist. #mental status changes - at times during the hospitalization, the patient appeared confused. this was thought related to pain and psychiatric medications. the doses of these medications were decreased and she seemed to improve. she did continue to complain of anxiety; a balance is needed between treating her anxiety and making her somulent with medications. it is also likely that a uti was contributing to her mental status changes. the uti will be treated with a 7day course of ciprofloxacin. her foley was removed. . #uti - associated with a chronic indwelling foley. she will be treated with ciprofloxacin 500mg daily and is to complete a 7 day course. the foley was removed and voiding should be encouraged rather than replacement of the foley. urine culture at the time of discharge was pending. rehab facility should follow up urine culture to assure proper antibiotic coverage. # htn: the patient did have labile blood pressures while in the hospital that were difficult to control at times. we believe that her blood pressure was a likely precipitant of her initial presentation with heart failure. pressures were controlled with the addition and titration of amlodipine and carvedilol. . # pvd: s/p bilateral carotid stenting. it was necessary to take blood pressures in her legs because of her known subclavian stenosis. medications on admission: lipitor 80 lasix 20 iv aspirin 325 metoproolol 25 q6 heparin insulin nexium zofran ceftriaxone vancomycin risperdal tramadol xalantan eye drops . allergies: iodine; iodine containing / sulfa (sulfonamides) / penicillins / darvon / ativan / ambien discharge medications: 1. aspirin 325 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). 2. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). 3. atorvastatin 80 mg tablet sig: one (1) tablet po daily (daily). 4. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 5. latanoprost 0.005 % drops sig: one (1) drop ophthalmic hs (at bedtime): both eyes. 6. amlodipine 5 mg tablet sig: two (2) tablet po daily (daily). 7. acetaminophen 500 mg tablet sig: one (1) tablet po q6h (every 6 hours). 8. tramadol 50 mg tablet sig: 0.5 tablet po q8h (every 8 hours) as needed for pain. 9. risperidone 0.5 mg tablet sig: 0.5 tablet po bid (2 times a day) as needed. 10. senna 8.6 mg tablet sig: 1-2 tablets po bid (2 times a day) as needed for constipation. 11. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 12. ciprofloxacin 500 mg tablet sig: one (1) tablet po q24h (every 24 hours) for 7 days: last day . 13. carvedilol 25 mg tablet sig: one (1) tablet po twice a day. 14. lidocaine 5 %(700 mg/patch) adhesive patch, medicated sig: one (1) adhesive patch, medicated topical daily (daily): 12 hours on and 12 hours off. apply to back area. discharge disposition: extended care facility: life care center of discharge diagnosis: nstemi, s/p cath and placement of bms pneumonia acute systolic and diastolic heart failure stage 5 chronic kidney disease peripheral vascular disease discharge condition: stable discharge instructions: you were seen in the hospital for treatment of a heart attack, pnuemonia and chf exacerbation. you had a cardiac catheterization which showed a blockage of an artery in your heart. a bare metal stent was placed. you have been placed on aspirin and plavix to prevent further clotting of your arteries. these two medications will also prevent your stent from clotting. please do not stop taking these medications unless otherwise directed by your cardiologist. you have also been placed on ciprofloxacin 500mg daily for treatment of a urinary tract infection, please complete a 7 day course of this medication, last day is . your renal function was also closely monitored while in the hospital. you required 1 session of dialysis. please follow up with your outpatient nephrologist to discuss any further need for dialysis in the future. for your congestive heart failure, please weigh yourself daily, if you increase by > 3lbs then notify your doctor as you may need to be placed back on lasix for diuretic therapy and removal of excess fluid. please adhere to a 2gm sodium diet. please take your medications as prescribed and follow up as indicated below if you experience worsening chest pain, shortness of breath, fevers, chills, fainting, nausea, vomiting, palpitations or any other concerning symptoms then please call your doctor or report to the nearest emergency room. followup instructions: please call cardiologist, dr. at ( and make a follow up appointment within 1-2 weeks from your rehab discharge. please call your pcp, . at to make a follow up appointment within 1-2 weeks from your rehab discharge. please call your outpatient nephrologist, dr. at ( to make a follow up appointment within 1-2 weeks from your rehab discharge. procedure: insertion of non-drug-eluting coronary artery stent(s) combined right and left heart cardiac catheterization coronary arteriography using two catheters hemodialysis venous catheterization for renal dialysis transfusion of packed cells cranial or peripheral nerve graft insertion of one vascular stent excision of lingual thyroid percutaneous transluminal coronary angioplasty [ptca] procedure on single vessel diagnoses: pneumonia, organism unspecified chronic kidney disease, stage v subendocardial infarction, initial episode of care coronary atherosclerosis of native coronary artery mitral valve disorders urinary tract infection, site not specified congestive heart failure, unspecified unspecified protein-calorie malnutrition peripheral vascular disease, unspecified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease other and unspecified hyperlipidemia anxiety state, unspecified acute combined systolic and diastolic heart failure subclavian steal syndrome 

Answer: The patient is high likely exposed to