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: service: blue surgery history of present illness: patient is a 49-year-old african-american female who underwent a sigmoid colectomy in for adenocarcinoma of the colon with one positive lymph node. she also received chemotherapy adjunctive to the surgery of 5fu and leucovorin. she has had . a ct scan of the abdomen was performed on , which demonstrated two lesions in the liver, a 3.2 cm lesion in segment for a 4.3 x 2.5 cm lesion in the inferior aspect of the right lobe near the liver edge. she was then referred to dr. for consideration of hepatic resection for this metastatic disease to the liver. 1. hypertension. 2. atrial fibrillation. 3. congestive heart failure. 4. ihss status post pacemaker placement ddd in . 5. colon adenocarcinoma with positive lymph node and status post surgery and adjuvant chemotherapy. 6. sleep apnea. 7. diabetes. past surgical history is significant for status post sigmoid colectomy in and status post brain tumor resection in , status post uvulectomy and sinus surgery. medications on admission: coumadin 2.5 mg po taken as directed, verapamil hcl 180 mg po q day, triazolam 25 mg po q hs prn, ranitidine 150 mg po bid, micro-k 20 meq q am, lactulose two tablespoons , hydrochlorothiazide 25 mg po q day, glyburide 5 mg po q day, glucophage 1000 mg po bid, flonase one spray each nostril q day, diovan 80 mg po q day, atenolol 50 mg po q day, 60 mg po bid prn. allergies: she is allergic to sulfa and penicillin which cause rash. social history: she denies any alcohol or smoking history. no history of iv drug use. family history is significant for a mother who died of cerebrovascular accident. her father died of a myocardial infarction and question of ihss at age 45. sister died at age 47 of a myocardial infarction and question of ihss. physical examination: patient is moderately obese female in no acute distress. temperature is 99.0, pulse 84. blood pressure is 140/84, respirations 20, and weight is 246 lb. skin has keloids under both mandibles and several scars on the torso. heent: no scleral icterus. oropharynx is clear. no uvula. neck is supple. no lymphadenopathy and no thyromegaly. lungs are clear to auscultation. cardiac examination is normal, s1 loud, split s2, there is a 3/6 systolic ejection murmur along the left sternal border. regular, rate, and rhythm with pacemaker. abdomen is soft, nontender, normal bowel sounds, and no masses. extremities have no peripheral edema. neurologically she is intact. laboratories: hemoglobin 12.6, hematocrit 37.7, white count of 12.3, platelets 176,000. sodium 139, potassium 4.5, chloride 102, bicarbonate 23, glucose of 305, bun of 12, creatinine of 0.7, ast of 17, alt of 27, alkaline phosphatase of 88, total bilirubin of 0.2, direct bilirubin of 0.1, cea of 34. she underwent a cardiac catheterization by dr. , which is only significant for an elevated pulmonary capillary wedge pressure of 18-20, but her coronary arteries were open, which is a moderate surgical risk. electrocardiogram showed paced rhythm with a rate of 78. cta showed one liver lesion in segment six of the right lobe measuring 2.7 x 5.2 cm. second lesion in segment 4a measuring 3.8 x 4.6 cm. there are two additional low attenuation foci. they were too small to characterize. hospital course: on the date of admission, the patient was taken to the operating room where she underwent a segment six and segment 4b resection, cholecystectomy, and intraoperative ultrasound. she tolerated this procedure well and received 3,000 crystalloid and estimated blood loss of 400 and urine output of 640. she was transferred to the pacu in stable condition. she spent the first postoperative night in the intensive care unit for close monitoring where she remained hemodynamically stable, and postoperative day #1, she was transferred to the floor for remainder of recovery. neurologically her pain was controlled with epidural for the first postoperative day. the epidural was discontinued and patient was placed on iv morphine prn. her pain has appropriately decreased and her use of pain medications has appropriately decreased. she has remained alert and oriented, and neurologically intact. respiratory status has remained stable. her o2 saturations have been in the high 90s to 100%, and has been weaned off oxygen successfully. cardiovascular status has remained stable. she is remaining hemodynamically stable. she did have an episode on postoperative day #3 where she described a "her throat was closing." due to the history of diabetes, it is unknown if this was an atypical chest pain versus perhaps some laryngeal edema secondary to intubation. she had an electrocardiogram which showed paced rhythm which was unchanged from a previous electrocardiogram. she also had a set of cardiac enzymes sent which were negative with a troponin less than 0.3, cpk of 639, mb fraction of 1. she had one other episode, but has denied having any other episodes of her throat closing. much of her symptoms have been focused only around her airway. during this period also she did not have any periods of desaturation and remained hemodynamically stable. her diet was advanced to a diabetic diet which she has been tolerating. her wound has remained clean, dry, and intact. her jp has continued to drain moderate amounts up to 50 cc/day of a darkly colored fluid. she will be discharged with a jp in place with followup in clinic for evaluation and then possible removal. her foley was discontinued. she has been voiding without any problems. endocrine wise, the patient's blood glucose levels have remained in the 200s ranging anywhere from as low as 172 to as high as 288. josalin consult was obtained and patient was recommended to be started on insulin injections for better hyperglycemic control. she was placed on nph insulin 16 units in the morning and 12 units before bedtime in an adjusted sliding scale. she received diabetic teaching while in the hospital. she will be going home with vna for injections of nph in the morning and in the evening. will follow up with dr. in the clinic on monday, . she was restarted on oral hypoglycemic medication once she was taken off the diabetic diet. hematologically, the patient's hematocrit has remained stable. has gone from 29 to 25. her platelet count had dropped down to 105 on postoperative day two from 151 on postoperative day #0. her zantac was stopped. she is placed on protonix for gastrointestinal prophylaxis. her heparin injections were continued and antibody was sent to the laboratory. the patient has been ambulating, stable, and ready for discharge with followup with dr. on in the clinic. pathology has returned on the specimen with negative margins 0.9 cm. the section 6 and 4 resection were positive for metastatic adenocarcinoma of the colon. discharge diagnoses: 1. status post liver resection of sections 4b and 4a, cholecystectomy, and intraoperative ultrasound. 2. metastatic colon adenocarcinoma to the liver. 3. hypertension. 4. diabetes mellitus. 5. ihss. 6. coronary artery disease. 7. atrial fibrillation. discharge medications: verapamil 180 mg po q day, zantac 150 mg po bid, hydrochlorothiazide 25 mg po q day prn, glyburide 5 mg po q day, glucophage 1000 mg po bid, flonase one spray each nostril q day, diovan 80 mg po q day, atenolol 50 mg po q day, 60 mg po bid, nph insulin 16 units am, 12 units q pm, lactulose two tablespoons po bid, oxycodone 5 mg po q 4-6 hours prn, and calor 20 meq po q am. condition on discharge: stable. discharge instructions: the patient will go home with vna services for wound care, jp care, and insulin teaching, nph administration . patient has been taught appropriately to empty and record jp outputs. the patient has had diabetic teaching for insulin shots. patient will follow up with dr. on and followup with dr. on . , m.d.,ph.d 02-366 dictated by: medquist36 procedure: cholecystectomy partial hepatectomy diagnoses: malignant neoplasm of liver, secondary unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled atrial fibrillation unspecified sleep apnea personal history of malignant neoplasm of large intestine cardiac pacemaker in situ acromegaly and gigantism 

Answer: The patient is high likely exposed to