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 / penicillins / shellfish / latex / bee pollen attending: chief complaint: nausea and vomitting and altered mental status. major surgical or invasive procedure: whole brain radiation. history of present illness: 73f w/ metastatic lung cancer to brain, on radiation therapy, here with severe nausea and vomiting since this morning; sent from rad clinic with severe hypertension and nausea/vomiting concerning for increased intracranial pressure. she was recently admitted to from with hypoxia and back pain; nausea and vomiting. patient's symptoms completely resolved with dexamethasone, complicated by steroid-induced psychosis. also initiated whole-brain radiation while in-house and continued to see rad onc following discharge. she had been on a dexamethasone taper following discharge. currently on 2g . . pt somnolent but arousable. states that she has not had any other symptoms, including headaches, changes in vision, dizziness, weakness, or numbness. reports exhaustion from not being able to sleep for 1.5d due to vomiting and nausea. states that she was vomiting "all day yesterday" and "every half hour" this morning. pt reports fatigue and sleepiness. pt a&o to "hospital, somewhere near , year --, 20-- don't know". . in the ed, triggered for hypertension. initial vitals were: 16:30 0 98.9 65 170/111 16 97% 2l nasal cannula. bp --> 16:45 225/119 --> 17:00 179/100 patient was somnolent but arousable. neuro exam somewhat limited by pt's lack of participation, pupils pinpoint cn 2-12 intact. lungs: bibasilar crackles. ekg: normal sinus rhythm, hr 70, left shifted axis, normal intervals. 1mm pr depression in v2, v2. peaked t waves v2, v3. t wave inversion v1. consistent with prior. labs: show elevated k to 5.6, hemolyzed. repeat lab -> k 4.0. ct head w/out contrast: vasogenic edema unchanged, but right parietal hyperdense lesion is more conspicuously hyperdense and slightly increased in size than on the prior. this degree of increased hyperdensity would not be expected in the interval and raises concern for intralesional hemorrhage. . neurosurgery consulted: feel that pt's n/v related to wbxrt and decadron taper. recommended no acute neuro intervention. increase dexa to at least 6mgq6h standing. she was started on dexamethasone 6mg iv q6hrs. on re-exam, pt's bp improved to 140s/80s w/ only dexamethasone. pt is sleeping peacefully. past medical history: 1. coronary artery disease -s/p inferior/posterior stemi with rv involvement with bms to distal rca. repeat bms x 2 to same rca lesion in 2. stage iv lung cancer metastatic to brain 3. hyperlipidemia 4. rheumatoid arthritis 5. hypertension 6. lumbar djd 7. basal cell carcinoma of the nose social history: she is widowed and lives alone in senior housing. she has four children, two daughters and two sons. one son lives out of state but the others are local. originally from . she smoked one pack a day of cigarettes for the past 60 years and continues to smoke. alcohol rare. her daughter, may be reached at . her daughter may be reached at . family history: mother died of disease. father died at age 54 from an mva. she has six brothers, one deceased from cancer ?prostate, another had alzheimer's disease. one sister alive and well. physical exam: admission physical exam: vitals: afebrile 149/84 92 14 95% ra general: alert, orientedx1-2, no acute distress heent: sclera anicteric, mmm, oropharynx clear. perrla neck: supple, jvp not elevated, no lad lungs: clear to auscultation bilaterally. mild bibasal crackles. cv: regular rate and rhythm, normal s1 + s2, sem ii/vi nonradiating abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly gu: no foley ext: warm, well perfused, 2+ pulses, no clubbing. 1+ pitting edema on lower extremity to shins bilateral. . discharge physical exam: vitals: 95.4, 142/84, 53, 20, 96%ra i/o: 780/470 + large bm this am physical exam: general: a&o x 2, no acute distress heent: sclera anicteric, mmm, oropharynx clear. perrl. neck: supple, no jvd, no lad lungs: clear to auscultation bilaterally. cv: rrr, normal s1 + s2, sem ii/vi nonradiating abdomen: soft, nt/nd, bowel sounds (+), no rebound/guarding, no hsm ext: warm, well perfused, 2+ pulses, no clubbing. no edema. pertinent results: labs at discharge: 06:20am blood wbc-13.6* rbc-4.13* hgb-12.4 hct-37.1 mcv-90 mch-30.0 mchc-33.4 rdw-16.6* plt ct-316 06:20am blood pt-12.1 ptt-22.1 inr(pt)-1.0 06:20am blood glucose-117* urean-32* creat-0.7 na-135 k-4.9 cl-99 hco3-25 angap-16 06:20am blood calcium-9.3 phos-4.2 mg-2.3 . studies & imaging: ecg: baseline artifact. sinus rhythm with atrial premature beats. left axis deviation. left anterior fascicular block. inferior myocardial infarction, age indeterminate. compared to the previous tracing of the atrial premature beats are new. rate pr qrs qt/qtc p qrs t 70 154 76 388/405 66 -55 46 . ct head w/o con: increased size of the hyperattenuated focus with a more amorphous appearance raises suspicion for a possible intralesional hemorrhage of the right parietal metastasis. otherwise, unchanged degree of vasogenic edema in the right parietal lobe. the other masses demonstrated on the previous mr are not well identified on this nonenhanced ct study. . ecg: sinus rhythm with premature atrial and ventricular complexes. marked left axis deviation. inferior myocardial infarction of indeterminate age. delayed r wave progression. compared to the previous tracing of the findings are similar. rate pr qrs qt/qtc p qrs t 72 150 76 376/397 62 -53 29 brief hospital course: this is the brief hospital course for a 73 year-old female with non-small cell lung carcinoma metastatic to the brain who presented here for evaluation of nausea, vomitting, and altered mental status. the following medical issues were addressed during this admission: . # brain metastases: she presented with nausea, vomitting, and hypertension. ct scan was suspicious for intralesional brain hemorrhage in the right parietal metastasis and notable for an unchanged degree of vasogenic edema in that same parietal lobe. her nausea and vomitting were thought to be due to her intracranial processes and changes caused by weaning from decadron and the most recent episode of whole brain radiation which the patient underwent. she was started on 6 mg dexamethasone every 6 hours per neurosurgery recommendations, and after discussion with the cardiology service primary medicine team, and her family, her plavix was discontinued as the risks of intracranial bleeding was thought to outweigh the benefits of blood thinning to prevent myocardial ischemia and stent re-stenosis. . # hypertension: she presented with systolic blood pressures in the 220s. this was thought to be due to her intracranial process following weaning from decadron and also cerebral changes post-whole brain radiation. she was started on 6 mg dexamethasone every 6 hours per neurosurgery recommendations, and her systolic blood pressures normalized to 110s to 140s. . # altered mental status: psychiatry was consulted given the patient's history of steroid induced psychosis, and they recommended starting seroquel nightly at 12.5mg and once the patient's qtc was checked for prolongation, she was increased to a dose of 25mg nightly prior to bedtime. . # rheumatoid arthritis: this issue was stable and the patient remains on her methotrexate and steroids for disease control. . # coronary artery disease: this issue was stable and the patient continues on asa 81 mg daily, but has been discontinued from her clopidogrel dose for reasons listed above. . # hyperlipidemia: this issue was stable and the patient continues on simvastatin 40 mg daily. . the patient was discharged home to the facility in where she was prior to admission. she was upset that she was not going home, but cooperated. she will have 2 more radiation treatments for her brain disease, and remains dnr/dni. medications on admission: 1. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). 2. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 3. nitroglycerin 0.3 mg tablet, sublingual sig: one (1) tablet, sublingual sublingual prn (as needed) as needed for chest pain: q5min as needed for chest pain. 4. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 5. metoprolol succinate 25 mg tablet extended release 24 hr sig: one (1) tablet extended release 24 hr po daily (daily). 6. gabapentin 100 mg capsule sig: one (1) capsule po q8h (every 8 hours). 7. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 8. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 9. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 10. polyethylene glycol 3350 17 gram/dose powder sig: one (1) po daily (daily) as needed for constipation. 11. acetaminophen 325 mg tablet sig: two (2) tablet po q6h (every 6 hours) as needed for pain or fever. 12. haloperidol 0.5 mg tablet sig: two (2) tablet po tid (3 times a day) as needed for agitation. 13. dexamethasone 2 mg tablet sig: 1.5 tablets po q12h (every 12 hours): initiating taper on of 3mg q12 for 5 more days, 2g x7d, 1g x7d, 1g qd x7d and then stop . disp:*90 tablet(s)* refills:*0* 14. esomeprazole magnesium 40 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po once a day. 15. methotrexate (anti-rheumatic) 2.5 mg tablets, dose pack sig: six (6) tablets, dose pack po once a week: take weekly on sunday. 16. calcium citrate + d 315-200 mg-unit tablet sig: two (2) tablet po twice a day. 17. cyanocobalamin (vitamin b-12) 1,000 mcg tablet sig: one (1) tablet po once a day. discharge medications: 1. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 2. senna 8.6 mg tablet sig: 1-2 tablets po bid (2 times a day) as needed for constipation. 3. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 4. polyethylene glycol 3350 17 gram/dose powder sig: one (1) spoonful po daily (daily). 5. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 6. metoprolol succinate 25 mg tablet extended release 24 hr sig: one (1) tablet extended release 24 hr po daily (daily). 7. gabapentin 100 mg capsule sig: one (1) capsule po q8h (every 8 hours). 8. cyanocobalamin (vitamin b-12) 500 mcg tablet sig: two (2) tablet po daily (daily). 9. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 10. quetiapine 25 mg tablet sig: one (1) tablet po qhs (once a day (at bedtime)). 11. dexamethasone 2 mg tablet sig: three (3) tablet po q6h (every 6 hours). 12. calcium citrate + d 315-200 mg-unit tablet sig: two (2) tablet po twice a day. 13. methotrexate (anti-rheumatic) 2.5 mg tablets, dose pack sig: six (6) tablets po q sundays. 14. haloperidol 1 mg tablet sig: one (1) tablet po three times a day as needed for acute agitation: please only use if acute agitated. 15. acetaminophen 325 mg tablet sig: two (2) tablet po every six (6) hours as needed for fever or pain. 16. nitroglycerin 0.3 mg tablet, sublingual sig: 1-2 tablets sublingual every 5-10 minutes as needed for chest pain for 3 doses. 17. esomeprazole magnesium 40 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po once a day. 18. folic acid 1 mg tablet sig: one (1) tablet po once a day. discharge disposition: expired facility: health care center discharge diagnosis: non-small cell lung carcinoma metastases to brain coronary artery disease hypertension steroid psychosis discharge condition: mental status: confused - always. level of consciousness: alert and interactive. activity status: ambulatory- requires assistance or aid (walker/cane). discharge instructions: dear , it was a pleasure to take care of you during your hospital stay. you were admitted to the hospital because your family and neighbors noticed a change in your mental status. tests were run to look inside your brain at the sites where the cancer is. the tests did not show any current areas of bleeding, but this will be a constant concern for you from here on out. for this reason, your doctors have decided, along with your children, that it is in your best interest to no longer take the medication called plavix. this medicine is a blood thinner and can predispose you to brain bleeding. you were originally on the medication because of your heart disease. stopping the medication will place you at a high risk of getting a blockage in one of your heart's artery's again. we discussed this with your children and your other doctors here at the hospital, and everyone agreed that the risks of taking this medication heavily outweighed the benefit. please stop the following medications: -plavix (clopidegrel) please increase the dose of the following medications: -quetiapine (seroquel) now 25mg every night at bedtime followup instructions: you are already scheduled for the remaining two radiation treatments. please have the staff at arrange transportation for you to these appointments and back. the appointments are: . tuesday, @ 2:45pm wednesday, @ 2:45pm . both of the appointments are at in on the in the department of radiation oncology. . you may be contact by your oncologist for additional follow-up. meanwhile, the physicians at the facility will be caring for your immediate, acute medical needs. procedure: other radiotherapeutic procedure diagnoses: coronary atherosclerosis of native coronary artery unspecified essential hypertension percutaneous transluminal coronary angioplasty status nausea with vomiting other and unspecified hyperlipidemia secondary malignant neoplasm of brain and spinal cord malignant neoplasm of bronchus and lung, unspecified cerebral edema rheumatoid arthritis do not resuscitate status other disorders of neurohypophysis 

Answer: The patient is high likely exposed to