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: respiratory failure/tylenol od major surgical or invasive procedure: endotracheal intubation arterial line history of present illness: this is a 51 y/o female with pmh significant for htn, niddm, hypothyroidism, who presented to an osh early this morning with uri sx and cough x 2 weeks. per the patient's husband, and later verified by the patient, she had been having uri sx and a non-productive cough for 2 weeks and occasionally low-grade temperature. she saw np recently, who recommended otc meds and also prescribed a "cough medicine", the name of which is not known. her symptoms did not improve however and her cough progressed with symptoms of respiratory distress as well, prompting her to present at an osh early this am around 3 am. at the osh, she was noted to be tachypneic in moderate distress, with vs of t 97.7, hr 77, bp 120's systolic, rr 26, sao2 91%/ra. her labs there was significant for wbc 17, hct 31, tylenol level of 70 (at 4:40 am), na 115 and abg of 7.4/28/48 on ?room air. she received 400 mg moxifloxacin there, 125 mg iv solumedrol x 1, unknown dose of lasix, and a loading dose of iv nac (10.5 gm). . upon further history, the husband states that the patient has been taking nyquil frequently due to her symptoms, however he is not sure how much she was taking as he is at work most of the day when she is at home. he notes that he thinks she finished an entire bottle of nyquil on friday (300 ml) and another half a bottle on saturday (150 ml). it is unknown what formulation of nyquil this was. he also does not know whether she was taking other cough/uri medications containing tylenol. patient has a history of depression, however the husband denies any prior si and does not believe the patient was trying to hurt herself with the nyquil. . the patient was transferred to the ed at 7 am due to lack of icu beds at the osh. initial vs were t afebrile, bp 120's, hr 80's, 95%/4 l. the patient was in moderate resp distress with somnolent ms, so was electively intubated and set at ac 450x16, peep 5, fio2 100%. an abg was unable to be obtained prior to intubation. tylenol level in the ed at 7:30 am was 45 (3 hours later from the initial level). she received vancomycin and doxycycline in the ed for cap/ca-mrsa coverage. the patient was sent to the micu for further management. upon arrival, her abg was 7.23/65/400's on the initial vent settings, so her rr was increased and tv was decreased. iv nac was also started. . ros unable to be obtained at this time. past medical history: pmh (per husband) - dm ii hypothyroidism htn asthma depression h/o diverticulitis social history: sh - lives with her husband and son in . does not work. smokes 1 ppd x >20 years. drinks approx 6 beers/week. admits cocaine use, which was positive on tox screen at time of admission. family history: fh - nc physical exam: vs: tc 96.6, bp 111/59, hr 70, rr 24, sao2 95% on ac 350x30/0.6/5 general: intubated, sedated female heent: pupils pinpoint and minimally reactive. anicteric sclerae. ett in place. neck: supple, no jvd chest: diffuse rhonchi throughout, no wheezes cv: rrr distant, no m/g/r abd: soft, nt/nd, nabs, no hsm ext: 1+ pitting pedal edema neuro: sedated, does not withdraw to pain pertinent results: ekg - nsr at 70 bpm, normal intervals and axis. no ischemic changes noted. compared to osh ekg . no prior available for comparison. . blood wbc-15.7* rbc-4.45 hgb-11.0* hct-34.5* mcv-78* mch-24.7* mchc-31.7 rdw-20.4* plt ct-245 neuts-93.4* bands-0 lymphs-3.4* monos-2.5 eos-0.6 baso-0 pt-21.3* ptt-33.0 inr(pt)-2.0* glucose-108* urean-9 creat-0.4 na-118* k-4.2 cl-83* hco3-23 angap-16 alt-25 ast-74* alkphos-150* amylase-16 totbili-2.1* dirbili-1.1* lipase-18 calcium-7.6* phos-4.9* mg-1.5* albumin-2.2* ammonia-41 tsh-0.44 hbsag-negative hbsab-positive hbcab-positive igm hav-negative hcv ab-positive ama-negative smooth-negative -negative afp-1.7 igg-2070* iga-272 igm-392* blood asa-neg ethanol-neg acetmnp-45.6* bnzodzp-neg barbitr-neg tricycl-neg . blood po2-413* pco2-65* ph-7.23* caltco2-29 base xs--1 urine bnzodzp-pos barbitr-neg opiates-neg cocaine-pos amphetm-neg mthdone-neg . blood wbc-8.3 rbc-3.71* hgb-9.2* hct-29.9* mcv-81* mch-24.7* mchc-30.7* rdw-22.2* plt ct-136* pt-16.9* ptt-34.4 inr(pt)-1.5* glucose-160* urean-11 creat-0.5 na-135 k-3.8 cl-99 hco3-34* angap-6* alt-61* ast-154* alkphos-204* totbili-1.6* calcium-7.9* phos-3.3 mg-1.8 . urine color-yellow appear-clear sp -1.015 blood-neg nitrite-neg protein-neg glucose-neg ketone-tr bilirub-neg urobiln-0.2 ph-7.0 leuks-neg rbc-0 wbc-0-2 bacteri-none yeast-none epi-0-2 urine osmolal-395 . hcv viral load (final ): 1,490,000 iu/ml. . hcv genotype (final ): hepatitis c genotype, 1. . cxr: findings: a single ap upright view of the chest is lordotic. the lateral aspect of the right costophrenic angle is excluded from the film. the cardiac silhouette appears normal in size. there is significant prominence of the interstitial markings bilaterally. there are ill-defined fluffy airspace opacities throughout both lung fields. fullness at the hila bilaterally could represent an element of pulmonary edema. there is significant scoliosis of the thoracic spine. impression: findings consistent with a diffuse bilateral, multifocal airspace process, such as ards or multifocal pneumonia. component of interstitial edema is likely. . ruq u/s: right upper quadrant ultrasound: the liver is heterogeneous in echotexture and shrunken with a nodular contour, consistent with cirrhosis. a subcentimeter simple cyst is noted within the hepatic dome. additionally, within the right lobe, there is a subtle, ill-defined hypoechoic lesion measuring 1.7 x 2.8 x 2.6 cm. remaining liver appears unremarkable. the gallbladder displays evidence of cholelithiasis, along with mild-to-moderate wall thickening and wall edema. a moderate amount of ascites is noted surrounding the liver and within the lower quadrants bilaterally. doppler ultrasound: portal vein is patent with normal hepatopetal flow. hepatic venous and arterial systems display appropriate waveforms with a slightly increased resistive indices noted within the main hepatic artery, likely related to underlying parenchymal disease. common bile duct is normal measuring approximately 0.35 and 0.5 cm. no intrahepatic ductal dilatation is identified. impression: 1. shrunken and nodular liver, consistent with cirrhosis. cholelithiasis with wall thickening and wall edema, most likely secondary to third spacing from underlying liver disease. 2. unremarkable hepatic vascular doppler ultrasound. 3. moderate amount of intra-abdominal ascites. 4. possible abnormal hypoechoic lesion within the right lobe. this could be further assessed with dedicated mri or contrast-enhanced multiphasic ct. . tte: the left atrium is normal in size. there is mild symmetric left ventricular hypertrophy with normal cavity size and systolic function (lvef>55%). 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 global and regional biventricular systolic function. no pathologic valvular abnormality seen. . cxr: chest pa and lateral: there continues to be improvement of multifocal air space consolidation with residual areas of opacification. diffuse bilateral reticular opacities are coarser with slightly improved aeration in the right lung base. this could represent the beginnings of a fibrotic repair with post-inflammatory bronchiectasis. no pleural effusion. cardiomediastinal silhouette is unchanged. impression: diffuse bilateral reticular opacities with slight improved aeration of the right lung base, which could represent post-inflammatory bronchiectasis and beginnings of a fibrotic repair. brief hospital course: # respiratory failue - bilateral airspace disease on cxr, most likely secondary to community acquired pna, +/- , given pao2/fio2 ratio. she was intubated and started on abx (vancomycin and levofloxacin). urine legionella was negative. after 4 days, vancomycin was discontinued as cultures remained negative. she was diuresed and treated for reactive airways with nebulizers and solumedrol. she was extubated on day 5, and did well. she completed a 7 day course of levofloxacin. oxygen was gradually titrated down over the course of several days. lasix (initially lasix gtt in icu, then 40mg iv bid, then 80 po bid at time of discharge) for component of pulmonary edema, with good effect and brisk diuresis. subsequent cxr demonstrated improved aeration with coarsening of interstitial markings, perhaps indicating an element of fibrotic repair. by the time of discharge she was weaned off oxygen and able to ambulate without shortness of breath, though still satting only in the low 90's. she was discharged with the intent of continuing diuresis and with close follow-up in place. . # tylenol toxicity - initially treated with nac protocol. after her history became more clear, it was felt that this was an accidental overdose. psychiatry was consulted, who agreed there was no evidence of intention to harm. she should be instructed to limit her acetaminophen use in the future to 2gm/day. . # hcv cirrhosis - imaging demonstrated a cirrhotic-appearing liver on ruq ultrasound. subsequent workup demonstrated that mrs. was hcv positive, with hcv vl of 1.5 million, genotype 1. she was previously unaware of her hcv status or diagnosis of cirrhosis. she was hav ab negative, hbv sab and cab positive. she did have evidence of hepatic dysfunction, with inr between 1.5-2.0 (although component of acetaminophen toxicity makes it difficult to assess her baseline), albumin 2.2, and hyponatremia as below. afp was 1.7. she was set up with an appointment with a hepatologist near her home, dr. , on for follow-up. an egd was not done in-house to assess for varices. she did have moderate ascites, and was discharged on maintenance lasix, though it is unclear whether she will need to remain on this long-term. of note, ruq u/s also demonstrated a 1.7 x 2.8 x 2.6 cm hypoechoic lesion in the right lobe of the liver, which will need to be followed up as an outpatient by ct or mri. . # hyponatremia - markedly hyponatremic on admission to 118. thought to be a mixed picture at first, and in retrospect likely complicated by concommittant cirrhosis. urine na was 10, elevated urine osms of 400, fena 0.1%. after a brief trial of normal saline, which did not raise her sodium, it was thought that she was hypervolemic, and diureseis was initiated via lasix drip, with good effect. after cessation of lasix drip, her sodium again began to drop to 130, and again responded to maintainance lasix iv and then po. . # dm - metformin was held while in-house. she was initially covered with glargine and humalog sliding scale, but did require an insulin gtt while she was on solumedrol. after solumedrol was stopped, she was converted back to standing and sliding scale insulin. . # hypothyroidism - the patient was continued on home dose of levothyroxine, 50mcg daily. . # htn - her home atenolol was held initially but restarted after her extubation and she became hypertensive. . # depression/delerium - effexor were held during her icu stay due to mild to moderate delerium, and was restarted at the time of discharge. the patient's mental status cleared significantly over the course of her hospital stay. . # f/e/n - diabetic diet. electrolytes were repleted as needed. . # pneumoboots were used for dvt prophylaxis . . # communication - with husband, (c) ; (h) . # the patient was a full code. medications on admission: (doses confirmed with the husband) levothyroxine 50 mcg daily singulair 10 mg po daily atenolol 25 mg daily lorazepam 2 mg po qid prn (taking at least 3x/day) metformin 500 mg effexor xr 225 mg daily discharge medications: 1. levothyroxine 50 mcg tablet sig: one (1) tablet po daily (daily). 2. atenolol 25 mg tablet sig: one (1) tablet po daily (daily). 3. lorazepam 1 mg tablet sig: one (1) tablet po tid prn as needed for anxiety or back spasm. disp:*21 tablet(s)* refills:*0* 4. fluticasone-salmeterol 250-50 mcg/dose disk with device sig: one (1) disk with device inhalation (2 times a day). disp:*2 disk with device(s)* refills:*2* 5. metformin 500 mg tablet sig: one (1) tablet po twice a day. 6. lasix 80 mg tablet sig: one (1) tablet po twice a day. disp:*60 tablet(s)* refills:*2* 7. albuterol 90 mcg/actuation aerosol sig: one (1) puff inhalation every 4 hours as needed for shortness of breath, coughing or wheezing. disp:*1 * refills:*2* 8. montelukast 10 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 9. effexor xr 150 mg capsule, sust. release 24 hr sig: one (1) capsule, sust. release 24 hr po once a day. disp:*30 capsule, sust. release 24 hr(s)* refills:*0* discharge disposition: home discharge diagnosis: -respiratory failure -acetaminophen toxicity -hepatitis c -cirrhosis -hyponatremia -delerium -hypothyroidism -dm -htn -depression/anxiety discharge condition: good. mental status improved, lfts stable, respiratory status at baseline. discharge instructions: -it is important that you continue to take your medications as directed. - your effexor was stopped during your hospitalization and restarted at discharge at a lower dose. you should discuss with your new pcp whether this dose needs to be titrated. -contact your doctor or come to the emergency room should your symptoms return. also seek medical attention if you develop any new fever, chills, trouble breathing, chest pain, nausea, vomiting or unusual stools. followup instructions: you have an appointment with dr. , internal medicine, at 2pm. we would like you to see a doctor within a few days after discharge. if you are not going to see dr. on , please call dr. at for an earlier appointment. . you have an appointment with dr. in liver clinic on at 4pm. please call for directions. . dr. of the liver department at will have his office call to schedule a follow up appointment with him in the next wks. procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube diagnoses: toxic encephalopathy cirrhosis of liver without mention of alcohol chronic hepatitis c without mention of hepatic coma diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled hyposmolality and/or hyponatremia unspecified acquired hypothyroidism cocaine abuse, unspecified dysthymic disorder acute respiratory failure pneumonitis due to inhalation of food or vomitus other ascites poisoning by aromatic analgesics, not elsewhere classified delirium due to conditions classified elsewhere benign essential hypertension accidental poisoning by aromatic analgesics, not elsewhere classified 

Answer: The patient is high likely exposed to