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: thorazine attending: chief complaint: transfer from osh for stroke. major surgical or invasive procedure: transesophageal echocardiography. history of present illness: the pt. is a 45 year-old right-handed woman who presented as a transfer from . she had presented there with confusion and weakness that occurred suddenly at 16:15 the day of admission. according to her mother, the patient had been feeling dizzy the morning of presentation (which is not unusual for the patient), and complained of tightness in her back and chest the day prior to presentation, but was otherwise in her usual state of health. at drama class she suddenly developed right arm weakness and began "acting funny." she also developed a facial droop and slurred speech. she did not fall. she was taken by ambulance to where she had an mri that showed an m1 occlusion. she was given a full dose of iv tpa, but her signs and symptoms did not improve, and she was transferred to for further workup. the patient provided an inaccurate history, but was able to say that she was told that she was "not her usual self" by her friends. she denies any symptoms of weakness and insists that she can move her right arm when she cannot. she notices nothing abnormal about her own speech. on review of systems, the pt. denied recent fever or chills. no night sweats or recent weight loss or gain. denied headache, sinus tenderness, rhinorrhea or congestion. denied cough, shortness of breath. denied palpitations. denied nausea, vomiting, diarrhea, constipation or abdominal pain. no recent change in bowel or bladder habits. no dysuria. denied arthralgias or myalgias. past medical history: -hyperlipidemia -hypertension -hypothyroidism -bipolar disorder -ibs social history: -worked at substitute teacher; now takes acting classes. she doesn't smoke and drinks occasionally; she uses no illicit drugs. family history: maternal grandfather had cerebral hemorrhage, and father had cad s/p stent in his 60s. no early strokes or blood clot problems. physical exam: at admission: vitals: t: afeb p: 64 r: 20 bp: 149/80 sao2: 100%fm general: awake, alert, acute distress. overweight white female. heent: normocephalic, no scleral icterus noted, clear oropharynx with moist mucus membranes neck: supple, with no jvd or carotid bruits appreciated pulmonary: lungs coarse bilaterally cardiac: regular rate and rhythm, with no murmurs abdomen: obese, soft, nontender, with normoactive bowel sounds, no masses or organomegaly noted. extremities: warm with no edema and good pulses throughout skin: no rashes or lesions noted. neurologic: mental status: the patient is awake, alert, and oriented x 3. she provides an inaccurage history. language is fluent with intact repetition but some impaired comprehension, particularly on multi-stepped tasks. she is able to name pictures, but she often makes paraphasic errors and when , she makes up the words at the end of the sentence. speech is dysarthric. patient was able to register 3 objects and recalled at 30 seconds; she re-registered and at recalled at 5 minutes. there was no apraxia. cranial nerves: olfaction not tested. pupils equal, round and reactive to light bilaterally, and visual fields individually intact to confrontation bilaterally, but with right sided hemineglect. no ptosis is noted on the right, but she seems to have a preference for keeping her left eye shut, although she will not elaborate on symptoms that make her do this. fundoscopic exam revealed sharp discs and venous pulsations. extra-ocular muscles were intact without nystagmus. sensation was reported as intact to light touch over face. there was a right facial droop, with minimal movement of that side, and a mildly weakened orbicularis oculi. hearing was intact to finger- rub bilaterally. palate and uvula elevate at midline. there is strength in trapezii and sternocleidomastoids bilaterally. tongue protrudes in midline, with no fasciculations. motor: normal bulk, no increase in tone throughout. no tremor, asterixis or drift in left arm. delt bic tri wrf wre ffl fe io ip ham ta l 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 r 0 0 0 0 0 0 0 0 0 0 5- 5- 5 5 5 sensory: no deficits to light touch, pinprick, vibratory sense, reported by patient; decreased proprioception throughout right upper extremity. right sided extinction to dss over upper extremities. coordination: normal finger to nose on the left, normal heel to shin left, but unable to perform right sided tasks. reflexes: 3+right biceps, 2+ biceps left, 0+ bilat triceps, 2+ brachioradialis, 3+ patellar right, 2+ left and 2+ right ankle jerk and 1+ left ankle jerk. the patient had mute toe on the right and down on the left on plantar response. gait: did not assess secondary to fall risk, s/p tpa nihss: 9 (2 for facial paresis, 4 for motor right arm, 1 for dysarthria, and 2 for extinction) . upon transfer to the floor: vitals: t: afeb (97) p: 70 r: 18 bp: 126/82 sao2: 99 2l nc general: awake, alert but needs prompting during exam to keep her focussed; cooperative with exam in no acute distress. heent: no scleral icterus, mmm neck: supple, no jvd no carotid bruits pulmonary: lungs clear bilaterally cardiac: regular rate and rhythm, no murmurs abdomen: obese, soft, nontender, with normoactive bowel sounds, no masses or organomegaly. extremities: warm, no edema and good pulses throughout skin: no rash or lesions . neurologic: mental status: the patient is awake, alert, and oriented to person, place and time. language is fluent with intact repetition but some impaired comprehension on multi-stepped tasks. she is able to name pictures, no paraphasic errors; intact. attention: moyb: ; dow backwards: wednesday. speech is dysarthric. patient was able to register 3 objects, recalled at 30 s; at 5 minutes. there was no apraxia. cranial nerves: i: olfaction not tested. ii: pupils equal, round and reactive to light bilaterally (2mm bilaterally), and visual fields intact to confrontation bilaterally; no hemineglect. no ptosis. iii, iv, vi: extra-ocular muscles intact without nystagmus. sensation to light touch intact over face. vii: a right facial droop, involving the lower half only. viii: hearing was intact to finger- rub bilaterally. ix-x: palate and uvula elevate at midline. :there is 5/5 strength in trapezii and sternocleidomastoids bilaterally. xii: tongue protrudes in midline, with no fasciculations. motor: normal bulk, no increase in tone throughout. no tremor, asterixis or drift in left arm. pronator drift on r. srenght decreased in deltoid, triceps, biceps, hamstrings on l (4 to 4+). sensory: no deficits to light touch, pinprick, vibratory sense, proprioception intact throughout, no extinction to dss in le. coordination: normal finger to nose on the left and right, although slow, normal heel to shin left, slow on right. reflexes: 3+right biceps, 2+ biceps left, 1+ bilat triceps, 2+ brachioradialis, 2+ patellar right, 2+ left, and 1+ right ankle, 1+ left ankle. the patient had mute toe on both sides. gait: not assessed. pertinent results: laboratory data at admission: wbc 14.9, hb 12.2, hct 36.8, plt 401, n 83, 4%bands, 6%l, calc 10.5, mag 2.1, phos 4.3, na 140, k 4.3, cl 103, hco3 28, bun 26, creat 1.4, gluc 124, ptt 20.4, inr 1.0, ua neg . laboratory data upon transfer to floor : wbc-11.0 rbc-4.09* hgb-12.6 hct-37.7 mcv-92 mch-30.7 mchc-33.3 rdw-13.2 plt ct-390 glucose-104 urean-24* creat-1.3* na-149* k-4.0 cl-112* hco3-25 calcium-10.5* phos-3.6 mg-2.2 . hba1c-5.4 . triglyc-291* hdl-62 chol/hd-3.8 ldlcalc-114 nsr, twi iii, v5-6, flat avf . radiologic data: brain mri from : left m1 occlusion . ct head without contrast : early left mca territory infarction. no evidence of hemorrhage. . ct head without contrast : evolving infarcts in the most proximal portion of the middle cerebral artery, with apparent recanalization of the more distal portion. no intraparenchymal hemorrhage identified. . ct head : findings: within the mid left m1 portion of the middle cerebral artery, there is a small long filling defect, which is most apparent on the axial source images. this is consistent with a residual thrombus within the mid to distal left mca. however, there is opacification of the mca distal to this filling defect indicating that it is not complete occlusion. the remaining branches of the circle of appear normal with no evidence of aneurysm or thrombus. however, there is no acom artery visualized but it may just be that it is hypoplastic and below the resolution of the scan. the non-contrast head ct demonstrates multiple hypodensities in the territory of the left mca. this includes the left caudate, putamen and several cortical regions. these are unchanged from prior examination and represent areas of infarction. there is some mild mass effect from edema associated with these areas. there is no appreciable midline shift. there is no hydrocephalus. no intra or extraaxial hemorrhages identified. impression: residual thrombus within the left mid to distal mca at the m1 segment. however, there is no occlusion as contrast does pass distally. infarct in the territory of the left mca as before. . carotid us: minimal plaque with bilateral less than 40% carotid stenosis. brief hospital course: 1. stroke: the pt received intravenous tpa at the osh. upon transfer to the , her nih stroke scale was 9. a ct scan of the head was performed on arrival which revealed a dense left mca and loss of insular ribbon on the left along with effacement of the sulci in the left hemisphere in the territory of the inferior division of the l mca. a repeat ct scan of the head on hospital day two demonstrated no evidence of hemorrhage. a repeat ct with contrast (under mucomyst renal protection) on showed a residual thrombus, a stable infarct and re-canalization of the previously occluded blood vessel. she was given lipitor 80mg, and asa and aggrenox were started once the hemorrhage had stabilized. . on the morning of the second hospital day, the pt's deficits had improved, especially with regard to strength in her upper extremity which was flaccid on admission and had improved to power in antigravity muscles. she continued to improve slowly. upon discharge she is able to walk, with residual weakness in her r-extremities and face. . she was ruled out for myocardial infarction with three sets of negative cardiac enzymes. carotid doppler ultrasound revealed less than 40% stenosis bilaterally. she had transthoracic echocardiogram performed which revealed a normal lvef, no focal wall motion abnormalities and no evidence of patent foramen ovale. she therefore underwent a transesophageal echocardiogram on hospital day 3. this revealed no evidence of intracardiac thombus, patent foramen ovale or atrial septal defect. as the underlying cause of the pt's stroke was unknown, a hyper-coagulability work-up was sent. the atiii, protc and prot s are pending. she underwent a speech and swallow evaluation which she passed without limitations. 2. fen: , cardiac diet 3. prophylaxis: pantoprazole, colace, senna 4. hypothyroidism: levoxyl was continued 5. psychiatry: carbamazepine, lithium carbonate sr, olanzapine. lithium trough 0.8; tegretol 6.5. no changes were made in dosing. medications on admission: carbamazepine 200mg--take two tabs in in the morning and three at bedtime hydrochlorothiazide 25mg--one by mouth every day levoxyl 75mcg--one by mouth every day lipitor 40 mg--1 tablet(s) by mouth once a day lithium carbonate 300mg--take two pills at bedtime valisone 0.1%--apply sparingly to affected areas twice a day zyprexa 2.5mg--take one pill in the morning and one pillin afternoon when needed zyprexa 5mg--take one pill at bedtime discharge medications: 1. olanzapine 5 mg tablet, rapid dissolve sig: one (1) tablet, rapid dissolve po daily (daily). 2. lithium carbonate 300 mg tablet sustained release sig: two (2) tablet sustained release po qhs (once a day (at bedtime)). 3. carbamazepine 200 mg tablet sig: two (2) tablet po qam (once a day (in the morning)). 4. carbamazepine 200 mg tablet sig: three (3) tablet po qhs (once a day (at bedtime)). 5. levothyroxine sodium 75 mcg tablet sig: one (1) tablet po daily (daily). 6. pantoprazole sodium 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 7. acetaminophen 325 mg tablet sig: 1-2 tablets po q4-6h (every 4 to 6 hours) as needed for fever or pain. 8. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 9. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed. 10. atorvastatin calcium 80 mg tablet sig: one (1) tablet po daily (daily). 11. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 12. dipyridamole-aspirin 200-25 mg cap, multiphasic release 12 hr sig: one (1) cap po bid (2 times a day). discharge disposition: extended care facility: for the aged - discharge diagnosis: 1. stroke in the left medial cerebral artery discharge condition: good discharge instructions: please take your medications as instructed. please note the follow up appointments outlined below. if your symptoms get worse please seek medical help. followup instructions: please follow up at the clinic, , building, , 5pm. please follow up with your primary care physician as soon as you get discharged from rehab. md, procedure: diagnostic ultrasound of heart diagnoses: pure hypercholesterolemia unspecified acquired hypothyroidism depressive disorder, not elsewhere classified bipolar disorder, unspecified irritable bowel syndrome cerebral thrombosis with cerebral infarction 

Answer: The patient is high likely exposed to