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: patient recorded as having no known allergies to drugs attending: chief complaint: hypoxia major surgical or invasive procedure: none history of present illness: the patient is a 70 yo f presenting with a 4 day history of lightheadness, fatigue, sob, and cough. she reports that she was feeling in her normal state of health until monday when she started to notice that she was lightheaded mostly when she was walking or getting up. later that day she felt that she "couldn't get enough air", only when she was sitting down. she also reports increased fatigue and a "hacking cough" with sputum production. tuesday and wedneday she reports no change in her symptoms. she went to see her pcp on wednesday and was sent to the ed because of decreased o2 sats. she denies fevers or chills. the only recent sick contact was her husband who had a "horrible cold" a few weeks ago. she has been tolerating po intake. the patient denies a history of heart disease, but is being treated for "leg swelling". over the last few weeks she has been waking up 1-2 times a week sob in the middle of the night. sitting up relieves her symptoms. she is able to walk up 1 flight of stairs without sob. she sleeps with 1 pillow (unchanged). she used to go for walks around her neighborhood but stopped 4-5 months ago because of "balance problems". she denies ever having chest pain. on arrival to ed, her vital signs were t 99.4 p100 bp 140/90 r24 o2 sat was not recorded but she was on 4l. she recieved combivent and azithromycin in ed and felt better. patietn still desats to about 90% on ra within 2 minutes. she denies chest pain/abdominal pain/nausea. past medical history: 1. rheumatoid arthritis 2. cervical cancer status post hysterectomy in 3. aortic sclerosis 4. partial thyroidectomy 5. hypertension 6. colonic polyps. social history: the patient lives with her husband, , and . she is a former smoking. she smoked less than a pak per day for greater than 20 years. quit in . family history: noncontributory physical exam: on transfer from micu: tm: 99 tc: 98.9 bp (133/42) 109-156/50-70s hr: 70-90s rr (28) 19-28 sat: 94% 2l nc i: o: 1430 abg: 7.38/74/56 gen= lying in bed in nad heent= mmm, op clear, no lad cv= rrr, nl s1/s2, no murmur/rub/gallop chest= distant breath sounds, decreased inspiratory effort abd= bs+, nt, nd, no masses ext= cool, 2+ pulses dp/pt/radial, no edema . labs: na 141, k 3.8, cl 99, bicarb 39, bun 13, cr 0.5, glucose 99, ca 8.7, mg 1.7, phos 1.8, wbc 4.2, hct 39, plt 165 abg: 7.38/74/56 pertinent results: imaging: cxr - no definite evidence of pneumonia. leftward deviation of the trachea raises suspicion of possible thyroid goiter, although this finding is unchanged since the examination of . cta: 1. no pulmonary embolus. 2. enlargement of the main pulmonary arteries, consistent with pulmonary arterial hypertension. 3. enlargement of the right lobe of the thyroid gland with partially calcified thyroid nodule. this finding may be further evaluated with thyroid ultrasound when the patient is clinically able. 4. emphysematous change. 5. bilateral adrenal adenomas. : leni echo: the left atrium is normal in size. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. regional left ventricular wall motion is normal. overall left ventricular systolic function is normal (lvef 60-70%). no masses or thrombi are seen in the left ventricle. there is no ventricular septal defect. the right ventricular free wall is hypertrophied. the right ventricular cavity is dilated. right ventricular systolic function is borderline normal. there is abnormal systolic septal motion/position consistent with right ventricular pressure overload. 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 moderate pulmonary artery systolic hypertension. there is no pericardial effusion. abg xray: 1. large amount of stool in the colon. no evidence of obstruction. mri with contrast: findings suggest noncommunicating hydrocephalus. no evidence of mass lesion chest fluoro: no evidence for diaphragmatic dysfunction. 2. cardiomegaly, with mild congestive heart failure with interstitial edema and small right pleural effusion. 3. right superior mediastinal mass, likely due to goiter. please see recent cta of , which suggested ultrasound for further assessment. 04:10pm blood wbc-4.7 rbc-4.70 hgb-15.3 hct-46.2 mcv-98 mch-32.5* mchc-33.1 rdw-14.0 plt ct-205 06:25am blood pt-13.7* ptt-27.5 inr(pt)-1.3 04:10pm blood glucose-90 urean-11 creat-0.8 na-141 k-4.5 cl-99 hco3-35* angap-12 05:05pm blood type-art po2-85 pco2-93* ph-7.25* calhco3-43* base xs-9 intubat-not intuba comment-3l nasal c 06:46pm blood type-art po2-50* pco2-87* ph-7.28* calhco3-43* base xs-10 07:37pm blood type-art po2-58* pco2-81* ph-7.30* calhco3-41* base xs-10 03:18am blood type-art temp-37.0 po2-110* pco2-88* ph-7.27* calhco3-42* base xs-9 intubat-not intuba 05:30am blood type-art po2-71* pco2-85* ph-7.32* calhco3-46* base xs-13 intubat-not intuba comment-bipap 08:26am blood type-art po2-91 pco2-86* ph-7.31* calhco3-45* base xs-12 intubat-not intuba 06:54pm blood type-art po2-51* pco2-73* ph-7.34* calhco3-41* base xs-9 11:30am blood type-art temp-37.1 rates-/28 o2 flow-1 po2-56* pco2-74* ph-7.38 calhco3-45* base xs-14 intubat-not intuba comment-nasal 08:30am blood type-art po2-62* pco2-60* ph-7.39 calhco3-38* base xs-8 intubat-not intuba comment-nasal brief hospital course: 70 yo f w/ pmh of ra (dx on methotrexate), htn, cervical ca (s/p hysterectomy in ), partial thyroidectomy, who presented with a 4 day history of lightheadness, fatigue, sob, and productive cough. she reports that her symptoms began with feeling lightheaded mostly when she was walking or getting up, then later she felt that she "couldn't get enough air", even when she was sitting down. her sob was accompanied by a cough productive of green sputum. also c/o doe and paroxysmal nocturnal dyspnea. she went to see her pcp and was sent to the ed because of decreased o2 sats. the only recent sick contact was her husband who had a cold a few weeks ago. on admission, the pt had o2 sates of 80% on ra. in ed given solu-medrol and pt was started on azithromycin which was switched to levo for empiric coverage of a potential cap. no interstitial edema or infiltrate was seen on cxr on . on the floor pt was intermittently diuresed with lasix 20 mg iv for possible chf. tte on revealed r sided rv dilatation and mod pulm htn. leni failed to show dvt and cta failed to reveal pe. . pt was less arousable on transfer to the micu on . abg revealed significant resp acidosis. an abg showed 7.25/93/85 earlier in the day. an abg taken later when her o2sat was noted to be in the high 70s on ra was 7.3/81/58. a micu referral was then called. it was felt pt had acute on chronic primary resp acidosis given high serum bicarbs in past. the pt was examined to be ventilating well and then suddenly decompensate. pt was tried on bipap in the micu, but could not tolerate it. she had one episode of desaturation to 78% on the evening of . at that time, she was slightly confused. cxr unchanged. abg showed worsening hypoxia. the patient spontaneously recovered from this. she was started on progesterone to be used as a respiratory stimulant. levofloxacin was discontinued on . it was felt the pts hypoxia was likely multifactorial from ?sleep apnea, pulm htn, copd, ?ra disease. the pts hypercapnia was felts to be possibly secondary to muscle weakness or central causes possibly exacerbated by an uri since her nifs were low (30, 60, and 20). mri of the head was negative for brainstem infarction. however, showed non-communication hydrocephalus. she was seen by the neurology team and felt to have some parkinson's symptoms. they thought that her hydrocephalus was not related to her hypoventilation. neurosurgery felt the patient was stable enough to f/u as an opt for a shunt. she was discharged on theophylline and progesterone. the team tried multiple times to complete pfts as an inpatient, but the patient refused. medications on admission: 1. methotrexate 17.5mg qweek 2. naprosyn 3. fosamax 4. hctz 12.5mg qd discharge medications: 1. methotrexate 2.5 mg tablet sig: three (3) tablet po 1x/week (th). 2. alendronate 70 mg tablet sig: one (1) tablet po qthur (every thursday). 3. hydrochlorothiazide 25 mg tablet sig: 0.5 tablet po daily (daily). 4. medroxyprogesterone 10 mg tablet sig: two (2) tablet po tid (3 times a day). disp:*180 tablet(s)* refills:*2* 5. folic acid 1 mg tablet sig: one (1) tablet po daily (daily). 6. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. disp:*100 tablet(s)* refills:*0* 7. oxygen oxygen tank continuous 24 hours oxygen delivery via nasal canula start on 2liters and titrate to oxygen saturation 88-92%. concentrator if needed. 8. outpatient lab work theophylline level on ; please call level to dr. at phone: fax: 9. commode 10. theophylline 400 mg tablet sustained release sig: one (1) tablet sustained release po hs (at bedtime). disp:*30 tablet sustained release(s)* refills:*2* discharge disposition: home with service facility: of discharge diagnosis: hypoxia - likely primary hypoventilation non-communicating hydrocephalus possible obstructive sleep apnea discharge condition: stable on 2l nc; sats 93 - 97% on 2l. discharge instructions: --please take all medications as prescribed --please return to the hospital for any increased sob, cp, increased swelling in your legs, or fevers or chills. --please keep your appointment to see dr. on . -- you will be followed by neurosurgery for placement of a drain. -- you will be followed by neurology. -- you will have pulmonary function tests. -- you will need to have a sleep study. -- you will be followed by a pulmonologist. followup instructions: needs appointment with neurology - the patient needs to follow up with neurosurgery at about her hydrocephalus for the possibility for a shunt. provider: , m.d. phone: date/time: 11:50 provider: , md phone: date/time: 3:30 provider: , md phone: date/time: 11:15 pulmonary appointment: monday 3:15. you will be seeing dr. . the location is on the on the building of . call if you have questions. neurosurgery appointment: dr. with neurosurgery. wednesday . 1pm 3b; call with questions. neurology - you have an appointment with dr. at at 8:00am. call , the clinic is on the of center at . sleep study - dr. will arrange this for you. pfts - call to set this up. procedure: non-invasive mechanical ventilation diagnoses: obstructive hydrocephalus congestive heart failure, unspecified unspecified essential hypertension aortic valve disorders other chronic pulmonary heart diseases acute and chronic respiratory failure unspecified sleep apnea other emphysema rheumatoid arthritis personal history of malignant neoplasm of cervix uteri other respiratory abnormalities mixed acid-base balance disorder acute upper respiratory infections of unspecified site 

Answer: The patient is high likely exposed to