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 / phenergan plain / aldactone / digoxin attending: chief complaint: weakness major surgical or invasive procedure: none history of present illness: 83 female with history of cad s/p cabg and des to lmca, dchf, dmii, esrd on hd (started last month), copd, hl, pvd, htn, recent admission for colitis ( to ) who reports never feeling quite same since last discharge. she was doing well until three days ago when she fell on her back without head trauma, loc, chest pain or palpatations while getting up because her legs gave up. she presented to the ed and was noted to have hypoglycemia to 42 which improved with d50. she was discharged home but represented yesterday as she still felt weak and did not think she could tolerated dialysis yesterday. . in the ed initial vital signs were 98.6 hr 68 bp 188/48 rr 16 97%ra exam was notable for poor joint sense in l>r les, stance and gait unsteady, unable to ambulate without assistance. slow but intact heel-shin. cn ii-xii intact, strength 5/5 throughout, sensation intact. no spine tenderness. patient was given kayexelate for k=5.8. cxr was done revealing mild fluid overload and could not exclude pneumonia. initially she was medically cleared for discharge from ed, but patient failed pt eval. she was seen by case management and admitted to observation for dialysis tomorrow morning since she missed hd yesterday. however, upon getting ready to transfer to the floor, bp was noted to be 208/59. she was given metoprolol and hydralazine iv with no improvement in bp. denied ha, blurry vision or cp at any time throughout episode. given the persistently elevated bp, the decision was made to admit her to the micu yesterday. . in the micu, she received dialysis this morning with removal of 2l to her dry weight of 63 kg. she was restarted on her home antihypertensive regimen with nifedipine, metoprolol and lisinopril. she was tranferred to medicine floor for further evaluation and management of her weakness. . on the floor, she does not report headache, fever, chills, chest pain, shortness of breath, myalgias, abdominal pain, back pain, nausea, vomiting or dysuria. she reports bilateral ankle pain l > r. past medical history: - cad: s/p 5v cabg ; echo 45-50%; cath showed 3v disease. cath w successful stenting of the lmca into lad with endeavor des. - chronic diastolic chf - cva: subacute stroke r mca in - copd: pft showed reduced fvc with low-normal tlc - hyperlipidemia - pvd - s/p angioplasty in lle and s/p bypass in rle - sensorineural hearing loss - partial loss in left ear, with hearing aid; complete loss in r ear - htn - chronic low back pain - esrd on hd - dm-ii - diabetic neuropathy - s/p cataract surgery - depression social history: - former school secretary - involved in senior citizens club with active social life - tobacco: 120 pack-year smoking history - etoh: rare - illicits: denies family history: - 2 parents and 6 siblings all died of dm and heart disease physical exam: physical exam: vs: 96.4 56 116/60 100%2lnc general: alert, oriented, no acute distress heent: sclera anicteric, mmm, oropharynx clear neck: supple chest: tunneled hd catheter in r subclavian lungs: bibasilar crackles cv: regular rate and rhythm, normal s1, split s2, no murmurs, rubs, gallops 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, cyanosis or edema neuro: cn 2-12 intact. le strength (able to stand up from sitted position). sensation intact. normal gait. 2+ dtr. discharge pe physical exam: vs: 96.0 p 66 bp 135/77 o2 100%ra general: nad heent: mmm, oropharynx clear neck: supple, no jvd chest: tunneled hd catheter in r subclavian lungs: ctab cv: regular rate and rhythm, normal s1, split s2, no murmurs, rubs, gallops 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, cyanosis or edema neuro: cn 2-12 intact. le strength. sensation intact. normal gait. 2+ dtr. pertinent results: 12:10pm glucose-208* urea n-57* creat-6.2*# sodium-141 potassium-5.8* chloride-100 total co2-27 anion gap-20 12:10pm calcium-9.3 phosphate-3.6 magnesium-2.0 12:10pm wbc-6.2 rbc-3.93* hgb-12.3 hct-40.2 mcv-102* mch-31.2 mchc-30.5* rdw-14.9 12:10pm neuts-61.7 lymphs-29.7 monos-5.9 eos-2.5 basos-0.2 12:10pm plt count-224 wbc 7.4, hgb 12.4 hct 39.6 plt 225 b12: 705, folate: wnl glucose 52, bun 36, cr 4.7, na 141, k 4.3 cl 96 hco3 34 tsh 1.6 ecg sinus bradycardia. left ventricular hypertrophy with secondary repolarization abnormalities. compared to the previous tracing of repolarization abnormalities are somewhat more pronounced, a non-specific finding. cxr findings compatible with fluid overload with possible pneumonia in the right lower lung. brief hospital course: 83 year old female with esrd on hd, cad s/p cabg, chronic diastolic chf, diabetic neuropathy who presented with subacute progressive weakness and subsequently missed hd admitted to icu with hypertensive urgency. . # hypertensive urgency: was likely due to volume overload from missing hd. bp was unresponsive to medications, but after hd the following day, her pressures normalized. 2l of fluid was removed with hd and she returned to dry weight. she was discharged with all of her home antihypertensives and on discharge she was normotensive. # weakness/gait instability: progressive weakness seems to have been present over several months. neuro exam nonfocal. pt does have h/o spinal stenosis, pvd and diabetic neuropathy which could certainly contribute to feelings of weakness and gait instability. she also reported that this has happened after hd, which is a common hd side effect. lastly, on presentation to ed, she was hypoglycemic which might have explained weakness. a b12, folate and esr level were all normal indicating that weakness is not secondary to b12/folate deficiency or inflammatory condition like pmr. pt is followed by neurology at for previous cva and will be followed up by neurology post discharge. pt evaluated pt and determined that she was able to be discharged with home pt. . # esrd: was dialysed twice during hospital stay. will continue to hd on mwf at . she was discharged home on sevelamer, nephrocaps and iron. #type ii diabetes mellitus: throughout hospital course, pt was on iss. she was discharged on home regimen and continued with gabapentin for peripheral neuropathy. . #hyperlipidemia: pt was discharged home on normal statin dose. . #chronic back pain: likely secondary to spinal stenosis, which as per patient will not be managed surgically. . #cva prophylaxis/cad: discharged on home regimen of aspirin, clopidogrel, bb and statin. no pending results or reports at time of discharge. . medications on admission: atorvastatin - 40 mg tablet - 1 tablet(s) by mouth once a day chol b complex-vitamin c-folic acid - 1 mg capsule - 1 capsule(s) by mouth once a day selimi clopidogrel - 75 mg tablet - 1 tablet(s) by mouth once a day hx stent gabapentin - 300 mg capsule - 1 capsule(s) by mouth at bedtime leg cramps, restless leg syndrome lisinopril - 30 mg tablet - 1 tablet(s) by mouth once a day bp metoprolol tartrate - 50 mg tablet - 1 tablet(s) by mouth three times a day bp, cad nifedipine - 30 mg tablet extended rel 24 hr - 1 tablet(s) by mouth once a day for bp nitroglycerin - 0.4 mg tablet, sublingual - 1 tablet(s) sublingually as directed as needed for chest pain can repeat every 5minutes three times, call 911 if chest pain not resolved ondansetron hcl - 4 mg tablet - 1 tablet(s) by mouth twice a day as needed for nausea polyethylene glycol 3350 - 17 gram/dose powder - 2 tsp by mouth 4 oz water daily hs sevelamer hcl - (prescribed by other provider) - dosage uncertain aspirin - 325 mg tablet, delayed release (e.c.) - 1 tablet, delayed release (e.c.)(s) by mouth daily (daily) prevention insulin regular human - 100 unit/ml solution - inject sq qpm 5 units or ut dict nph insulin human recomb - 100 unit/ml suspension - inject 30 units qam, 16units q pm discharge medications: 1. atorvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 2. b complex-vitamin c-folic acid 1 mg capsule sig: one (1) cap po daily (daily). 3. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). 4. gabapentin 300 mg capsule sig: one (1) capsule po hs (at bedtime). 5. lisinopril 10 mg tablet sig: three (3) tablet po daily (daily). 6. metoprolol tartrate 50 mg tablet sig: one (1) tablet po tid (3 times a day). 7. nifedipine 30 mg tablet extended release sig: one (1) tablet extended release po daily (daily). 8. polyethylene glycol 3350 17 gram/dose powder sig: two (2) tsp po daily (daily) as needed for constipation. 9. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 10. insulin regular human 100 unit/ml solution sig: five (5) units injection at bedtime. 11. humulin n 100 unit/ml suspension sig: thirty (30) units subcutaneous qam. 12. humulin n 100 unit/ml suspension sig: sixteen (16) units subcutaneous at bedtime. 13. sevelamer hcl oral 14. ondansetron hcl 4 mg tablet sig: one (1) tablet po twice a day as needed for nausea. 15. nitroglycerin 0.4 mg tablet, sublingual sig: one (1) tablet sublingual prn as needed for chest pain: take for chest pain can repeat every five minutes for a max dose of three times, call 911 if chest pain not resolved. discharge disposition: home with service facility: vna discharge diagnosis: primary: - intermittent gait instability nos - hypertensive urgency - hyperkalemia discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - requires assistance or aid (walker or cane). discharge instructions: dear mrs. , it was a pleasure taking care of you. you were admitted to the hospital because of your gait instability and hypertensive urgency. you were hemodialysed and all of your home medications were restarted. your blood pressure improved. in addition, physical therapy re-evaluated you and believe that you can go home with services to assist with ambulation. please continue all of your home medications. weigh yourself every morning, md if weight goes up more than 3 lbs. followup instructions: please follow up with the following physicians: department: when: tuesday at 1:50 pm with: , md building: (, ma) campus: off campus best parking: free parking on site department: neurology when: tuesday at 4:30 pm with: , md, phd building: sc clinical ctr campus: east best parking: garage procedure: hemodialysis diagnoses: hyperpotassemia end stage renal disease congestive heart failure, unspecified coronary atherosclerosis of unspecified type of vessel, native or graft aortocoronary bypass status diabetes with neurological manifestations, type ii or unspecified type, not stated as uncontrolled polyneuropathy in diabetes abnormality of gait hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease other and unspecified hyperlipidemia diabetes with other specified manifestations, type ii or unspecified type, not stated as uncontrolled long-term (current) use of insulin personal history of transient ischemic attack (tia), and cerebral infarction without residual deficits noncompliance with renal dialysis spinal stenosis, unspecified region atherosclerosis of native arteries of the extremities, unspecified chronic diastolic heart failure 

Answer: The patient is high likely exposed to