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: penicillins / sulfa (sulfonamides) / codeine / tagamet / prilosec / shellfish attending: chief complaint: chest pain with positive stress test, cath revealed cad. transferred to for ?cabg. pt also bleeding from r groin, unstable bp, needed emergent cabg major surgical or invasive procedure: cabg x 3 lima to lad, svg to om, svg to rca; r femoral artery repair. complicated with difficult access/svc perforation with line placement, & cardiac tamponade, chest re-opened/blood evacuated. tracheostomy (portex per-fit 7mmm-6mm inner cannula) and peg done in or. no complications. : down sized trach to #6mm history of present illness: present to outside hospital for worsening chest pain with positive stress test, cath revealed cad. transferred to for possible cabg. pt bleeding from r groin, bp unstable, treated to or for emergent cabg/ repair sfa-pseudoaneurysm past medical history: 1. hypertension 2. angina 3. hyperlipidemia 4. hypothyroidism 5. chronic renal failure-hd rt arm av fistula 6. s/p cva 3 years ago-no residual 7. depression social history: pt lives at home with a relative. family history: history of heart disease. her brother had one kidney removed for a reason not known to her. physical exam: admission vs t98 hr 91sr bp 111/58 rr 20 o2sat neuro: awake, a&o neck: bruit on left cv rrr, s1-s2, 2/6 sem pulm cta-bilat abdm: soft nt/nd ext large rt groin hematoma, legs warm discharge: vs: t97.5, hr80, bp160/44, rr24, o2sat100% neuro: alert, awake, follows commands approp, pt on passy-muir valve and tolerating, able to communicates needs verbally, denies any pain, perrla, gag impaired/cough intact, r arm/leg moves on bed/no movement noted on l side resp: tolerating trach collar on 40%, sats 99%, lung sounds clear, pt expectorates tan/thick secretions, may need suctioning every 1-2 hours, tolerates her passy-muir valve but pt prefers to not wear it at this time. cv: nsr with hr 70-80s, sbp in 150-160 (goal is 130-150s), pedal pulses palpable, l arm has av fistula for dialysis (positive for thrill/bruit), afebrile, wbc down to 15. r picc in place. gi: pt continues on nutren renal at goal 35cc/hr, abd soft, nontender, bs present, small bm today, holding colace for loose stools the past two days gu: straight cath every other day (last done for 500cc urine), pt has hx of chronic renal disease, renal service following, pt continues on hemodialysis three times per week (pt next scheduled on ), last creatinite was 2.6 endo: continues on sliding scale of humalog sc & morning dose of lantus skin: areas of ecchymosis noted on r arm, l upper shoulder; sternal incision clean/dry/intact with dsd; mediastinal (old chest tube sites) clean/dry/intact with dsd; peg with dsd; coccyx is pink/unbroken skin, applied heavy skin cream, right groin incision staples removed area open with w-d drsg pink and healing pertinent results: 03:51am blood wbc-10.8 rbc-3.29* hgb-10.2* hct-29.8* mcv-90 mch-30.9 mchc-34.2 rdw-16.5* plt ct-421 10:12pm blood wbc-12.6*# rbc-3.85* hgb-11.4* hct-34.6* mcv-90 mch-29.6 mchc-33.0 rdw-16.2* plt ct-191 03:51am blood plt ct-432 03:51am blood pt-12.4 ptt-47.7* inr(pt)-1.1 10:12pm blood plt ct-191 10:12pm blood pt-12.5 ptt-47.0* inr(pt)-1.1 11:52pm blood fibrino-129*# 03:51am blood glucose-118* urean-138* creat-3.2* na-135 k-3.8 cl-100 hco3-28 angap-11 10:12pm blood glucose-161* urean-26* creat-2.2*# na-142 k-4.2 cl-103 hco3-26 angap-17 03:21am blood alt-31 ast-57* ld(ldh)-374* alkphos-55 totbili-0.8 11:43am blood ck(cpk)-37 03:51am blood calcium-8.2* phos-3.6 mg-2.4 06:50pm blood type-art temp-36.1 rates-12/ tidal v-400 peep-5 fio2-40 po2-128* pco2-44 ph-7.40 caltco2-28 base xs-2 intubat-intubated vent-imv cxr radiology final report chest (portable ap) 7:39 am chest (portable ap) reason: 7:30am please. medical condition: 81 year old woman with cad s/p emergent cabg s/p trach/peg reason for this examination: 7:30am please. history: emergent cardiac bypass, recent endoscopic gastrostomy tube placement. findings: compared to the study three days earlier, there has been resolution of the free air. peg is seen in the region of the gastric body. there has been interval increase in the right-sided pleural effusion, that on the left remains unchanged as well as the left basilar volume loss/consolidation. there is associated right basilar passive atelectasis and mild congestion. impression: resolved free air. new right effusion and associated volume loss and mild congestive failure. dr. approved: tue 7:45 am unilat up ext veins us left 10:28 am unilat up ext veins us left reason: r/o dvt - edema medical condition: 81 year old woman with s/p cabg x3 reason for this examination: r/o dvt - edema indication: status post cabg x 3 with left upper extremity edema, rule out dvt. no prior examinations. left upper extremity deep venous ultrasound: scale and doppler examination of the left internal jugular, axillary, brachial, and cephalic veins was performed. these demonstrate normal compressibility, contour variation and flow. of note, the patient has an arteriovenous fistula with the left brachiocephalic vein leading to a somewhat erratic waveform. no intraluminal thrombus is identified. impression: no evidence of deep venous thrombosis in the left upper extremity. the study and the report were reviewed by the staff radiologist. dr. dr. approved: fri 1:47 pm radiology final report ct head w/o contrast 5:41 pm ct head w/o contrast reason: r/o cva medical condition: 81 year old woman s/p cabg, left sided weakness reason for this examination: r/o cva contraindications for iv contrast: none. indication: status post cabg one week ago with extended intubation. now with left-sided weakness, rule out cva. no prior examinations. technique: mdct acquired axial images of the head were performed without iv contrast. findings: there is a large (6.5 x 4.1 cm) hypoattenuating confluent region of likely sub-acute infarction in the right mca distribution. there are additional areas of hypodensity involving the and white matter of both occipital lobes and cerebellar hemispheres, suggesting relatively acute embolic phenomena from a central source. no gross hemorrhagic transformation is evident, though the large right mca lesion has several punctate areas of hyperdensity suggesting early petecchial hemorrhage. there is no shift of normally midline structures, hydrocephalus, or herniation. no areas suspicious for infarct in the brainstem. osseous structures and paranasal sinuses are unremarkable. impression: large right mca infarct, likely subacute, with additional foci of infarction in both occipital lobes and cerebellar hemispheres. the distribution suggests embolic phenomena from a central source (cardiac or aortic). no overt hemorrhagic conversion and no midline shift or herniation. comment: results were discussed with dr. at 9:35 p.m. on . the study and the report were reviewed by the staff radiologist. dr. dr. approved: wed 12:07 pm renal u.s. (portable) 7:07 am renal u.s. (portable) reason: assess kidneys medical condition: 81 year old woman with atn reason for this examination: assess kidneys indication: 81-year-old with atn, assess kidneys. comparisons: none. renal ultrasound: the right and left kidneys measure 9.0 and 7.5 cm respectively. both kidneys demonstrate thinned and echogenic cortices. there is no hydronephrosis nor focal solid renal lesions identified. impression: small, echogenic kidneys consistent with chronic renal parenchymal disease. no hydronephrosis. the study and the report were reviewed by the staff radiologist. dr. dr. approved: mon 9:21 pm carotid series complete 2:18 pm carotid series complete reason: s/p cabg, slow to wake medical condition: 81 year old woman with carotid bruit, s/p cabg slow to wake reason for this examination: assess for stenosis duplex carotid ultrasound indication: carotid bruit. slow to wake status post cabg. evaluate for stenosis. findings: there was a modest amount of atherosclerotic plaque at the origins of the icas and ecas bilaterally. on the right, peak systolic velocities measured 99, 65, and 82 cm/sec respectively in the right ica, cca, and eca. the right ica/eca ratio measured 1.52. on the left, the peak systolic velocities measured 93, 70, and 88 cm/sec respectively in the left ica, cca, and eca. left ica/cca ratio was 1.32. the peak systolic velocity in the left vertebral artery was 81 cm/sec with normal arterial waveforms. however, the peak velocity in the right vertebral artery was 17, and to and fro flow was noted with tardus parvus. there is also decreased triphasic flow in the right brachial artery. these are suggestive of a right subclavian steal. impression: less than 40% stenosis in both carotids. right subclavian steal. dr. approved: mon 11:19 pm patient/test information: indication: abnormal ecg. chest pain. hypertension. mitral valve disease. status: inpatient date/time: at 14:25 test: tee (complete) doppler: full doppler and color doppler contrast: none tape number: 2007aw2-: test location: anesthesia west or cardiac technical quality: adequate referring doctor: dr. measurements: left ventricle - ejection fraction: 35% to 40% (nl >=55%) interpretation: findings: left atrium: normal la size. no spontaneous echo contrast in the body of the la. no thrombus in the laa. right atrium/interatrial septum: normal ra size. pfo is present. left-to-right shunt across the interatrial septum at rest. left ventricle: mild symmetric lvh with normal cavity size. mild symmetric lvh. normal lv cavity size. lv wall motion: basal anterior - normal; mid anterior - normal; basal anteroseptal - normal; mid anteroseptal - normal; basal inferoseptal - normal; mid inferoseptal - normal; basal inferior - normal; mid inferior - normal; basal inferolateral - normal; mid inferolateral - normal; basal anterolateral - normal; mid anterolateral - normal; anterior apex - normal; septal apex - normal; inferior apex - normal; lateral apex - normal; apex - normal; right ventricle: normal rv chamber size and free wall motion. aorta: simple atheroma in ascending aorta. complex (>4mm) atheroma in the aortic arch. complex (>4mm) atheroma in the descending thoracic aorta. complex (mobile) atheroma in the descending aorta. aortic valve: three aortic valve leaflets. mildly thickened aortic valve leaflets (3). no as. no ar. mitral valve: mildly thickened mitral valve leaflets. no ms. mild (1+) mr. tricuspid valve: normal tricuspid valve leaflets with trivial tr. pulmonic valve/pulmonary artery: normal pulmonic valve leaflets with physiologic pr. general comments: a tee was performed in the location listed above. i certify i was present in compliance with hcfa regulations. no tee related complications. the patient received antibiotic prophylaxis. the tee probe was passed with assistance from the anesthesioology staff using a laryngoscope. the patient was under general anesthesia throughout the procedure. conclusions: pre-cpb:1. the left atrium is normal in size. no spontaneous echo contrast is seen in the body of the left atrium. no thrombus is seen in the left atrial appendage. 2. a patent foramen ovale is present. a left-to-right shunt across the interatrial septum is seen at rest. 3. there is mild symmetric left ventricular hypertrophy with normal cavity size. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. 4. right ventricular chamber size and free wall motion are normal. 5. there are simple atheroma in the ascending aorta. there are complex (>4mm) atheroma in the aortic arch. there are complex (>4mm) atheroma in the descending thoracic aorta. there are complex (mobile) atheroma in the descending aorta. 6. there are three aortic valve leaflets. the aortic valve leaflets (3) are mildly thickened. there is no aortic valve stenosis. no aortic regurgitation is seen. 7. the mitral valve leaflets are mildly thickened. mild (1+) mitral regurgitation is seen. 8. after an episode of acute st depression, the anterior wall of the the lv showed profound hypokinesis. post-cpb: on infusion of phenylephrine. improved global lv systolic function from ischemic episode prebypass. lvef now 40%. anterior basal and apical hypokinesis. trace mr. asd remains mild. electronically signed by , md on 16:21. physician: brief hospital course: admitted with chest pain on and underwent cardiac catherization that revealed coronary artery disease. emergently went to or for coronary artery bypass graft due to worsening chest pain, see operative report for further details. complicated with svc perforation during central line placement, chest re-opened for cardiac tamponade. blood evacuated and hemodynamic stabilized. pod 2 neurology was consulted due to no movement left side, underwent stroke work up which revealed right mca infarct. due to inability to protect airway she had a tracheostomy and peg placement on . she continues with hemodialysis via left arm av fistula. physiocal therapy, occupational therapy, and speech therapy consulted please see notes for further details. she was ready for transfer to rehab on post op day 26 medications on admission: lopressor 25" aspirin 81' levothyroxine 75' lasix 20 q3rd day simvastatin doxazosin 4" protonix 40' isordil discharge medications: 1. aspirin 81 mg tablet, chewable : one (1) tablet, chewable po daily (daily). 2. docusate sodium 50 mg/5 ml liquid : ten (10) cc's po bid (2 times a day). 3. atorvastatin 20 mg tablet : one (1) tablet po daily (daily). 4. levothyroxine 75 mcg tablet : one (1) tablet po daily (daily). 5. heparin (porcine) 5,000 unit/ml solution : 5000 (5000) units injection (2 times a day). 6. amlodipine 5 mg tablet : two (2) tablet po daily (daily). 7. amiodarone 200 mg tablet : one (1) tablet po once a day. 8. metoprolol tartrate 50 mg tablet : one (1) tablet po bid (2 times a day). 9. metoprolol tartrate 25 mg tablet : one (1) tablet po daily (daily). 10. insulin glargine 100 unit/ml solution : twenty (20) units subcutaneous once a day. 11. lansoprazole 30 mg susp,delayed release for recon : thirty (30) mg po once a day. 12. nystatin 100,000 unit/ml suspension : five (5) ml po qid (4 times a day). 13. epoetin alfa 10,000 unit/ml solution : one (1) injection asdir (as directed): with hd . 14. lansoprazole 30 mg tablet,rapid dissolve, dr : one (1) tablet,rapid dissolve, dr daily (daily). 15. insulin sliding scale please see sliding scale discharge disposition: extended care facility: - discharge diagnosis: s/p cabgx3 (lima-lad, svg-om, svg-rca) crf(hd), left forearm av fistula htn ^chol hypothyroid s/p cva rt renal artery stenosis discharge condition: good discharge instructions: keep wound clean and dry. wet to dry dressing right groin take all medications as prescribed call for any fever, redness or drainage from wounds followup instructions: dr in 4 weeks dr after discharge from rehabilitation md procedure: insertion of intercostal catheter for drainage venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more single internal mammary-coronary artery bypass extracorporeal circulation auxiliary to open heart surgery (aorto)coronary bypass of two coronary arteries diagnostic ultrasound of heart enteral infusion of concentrated nutritional substances percutaneous [endoscopic] gastrostomy [peg] reopening of recent thoracotomy site temporary tracheostomy other repair of aneurysm transfusion of packed cells transfusion of other serum transfusion of platelets transfusion of coagulation factors diagnoses: other iatrogenic hypotension end stage renal disease subendocardial infarction, initial episode of care coronary atherosclerosis of native coronary artery acute kidney failure with lesion of tubular necrosis acquired coagulation factor deficiency unspecified acquired hypothyroidism atherosclerosis of aorta atrial fibrillation hematoma complicating a procedure accidental puncture or laceration during a procedure, not elsewhere classified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease hemorrhage complicating a procedure other specified procedures as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure iatrogenic pneumothorax peripheral vascular complications, not elsewhere classified cerebral embolism with cerebral infarction iatrogenic cerebrovascular infarction or hemorrhage acute pericarditis, unspecified aneurysm of artery of lower extremity other agents affecting blood constituents causing adverse effects in therapeutic use 

Answer: The patient is high likely exposed to