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: zestril / coumadin attending: chief complaint: dyspnea on exertion and lower extremity edema major surgical or invasive procedure: medical intensive care unit (micu) monitoring history of present illness: this is a 62 year old female with history of pulmonary embolus in treated with heparin/coumadin complicated by large retroperitoneal bleed from a supratherapeutic inr, diastolic congestive heart failure, diabetes , obstructive sleep apnea on bipap who presents with increased dyspnea on exertion. one day prior to admission, she had increase in weight of 2 lbs and increasing lower extremity edema to mid leg bilaterally. on day of admission she had a 10 lb increase in weight and today her dypsnea on exertion became severe, her balance was off, she felt lightheaded/dizzy with standing. patient denies chest pain or fever. she admits to a chronic cough with increased sputum production and phlegm over the past several weeks. she also notes right scapula pain with inspiration over the past several weeks. she sleeps with bed elevated and has cpap machine at home. she has urinary incontinence and thinks she has had worsened symptoms recently. past medical history: 1. pulmonary emboli () status post ivc filter secondary to retroperitoneal bleed on coumadin; sadddle embolus () 2. thoracic osteomyelitis status post 6 week treatment with vancomycin. also concern for underlying tumor that is being worked up. 3. insulin dependent diabtes complicated by neuropathy and retinopathy. 4. congestive heart failure recently diagnosed per patient. echocardiagram during this admission does not demonstrate any heart failure. 5. chronic lower extremity edema 6. obesity 7. right foot ulcers 8. fibromyalgia 9. osteoarthritis, left knee status post "injection" and prior knee surgery . multiple surgeries: appendectomy, cholecystectomy (ex lap), partial hysterectomy 11. obstructive sleep apnea on bipap at night 13. l4-5 herniated disc, status post steroid injections social history: she quit smoking 23 years ago - she started at age 13 with 1 pack per day and then increased to 2-3 packs per day until she quit. she denies alcohol. she lives at home with a child who is 20 years old. she has cleaning lady. she walks independantly. family history: her brother had a stroke at age 65. there is a family history of diabetes, hypertension, and multiple sclerosis. physical exam: vitals: temperature:98.9 pulse:79 blood pressure:107/53 respiratory rate:18 oxygen saturation:95% on room air. general: pleasant morbidly obese female in no acute distress, breathing comfortably heent: extraoccular movements intact, pupils equal and reactive, moist mucous membranes. neck: unable to appreciate jvp given body habitus, no bruits. cardiac: distant heart sounds, regular rate and rhythm, no appreciable murmurs, rubs, or gallops. pulmonary: clear to ausculatation bilaterally, no respiratory distress, no accessory muscle use. back: midline lower surgical scar appreciated abdomen: obese, soft, normoactive bowel sounds, nontender, nondistended surgical scar transverse from left lower costal edge towards right hepatic area, right lower quadrant surgical scar at mcburney's point. extremities: edema, trace-1+ pitting to knee bilaterally, dorsalis pedis 1+ bilaterally, ulcer on dorsal surface of right first digit neuro: alert and oriented times 3. gait not observed. cranial nerves ii-xii grossly intact. pertinent results: hematology: wbc-9.3 hgb-13.6 hct-39.9 plt count-193 neuts-69.2 bands-0 lymphs-22.0 monos-3.8 eos-3.5 basos-1.5 . chemistries: sodium-143 potassium-4.8 chloride-105 total co2-29 urea n-36 creat-1.0 glucose-163 calcium-9.2 phosphate-2.3 magnesium-2.2 . cardiac: ck(cpk)-42 ck-mb-notdone ctropnt-0.06 probnp-50 . coagulation: pt-11.5 ptt-18.5 inr(pt)-0.9 d-dimer-4006 . urinalysis: negative. . ekg: sinus tachycardia, normal intervals, no st changes. . imaging: 1. chest x-ray: no radiographic evidence of failure. 2. chest cta: large saddle embolus involving the right and left main pulmonary arteries extending to the middle and lower lobes bilaterally. the ct obstruction index is about 50%. stable appearance of right upper lobe lung nodule. brief hospital course: this is a 62 year-old female who presented with dyspnea on exertion and lower extremity edema who was found to have saddle pulmonary emboli. . 1. pulmonary emboli: her cta was notable for a saddle embolus involving the right and left main pulmonary arteries extending to the middle and lower lobes bilaterally with an obstruction index of about 50%. she was started on heparin as a bridge to coumadin. her coumadin dose was increased until a therapeutic level was achieved. this is her second pulmonary emboli and therefore she will likely need anticoagulation for life. she will need a hypercoagulable work-up as an outpatient. she was discharged on 7.5 mg daily of coumadin. . 2. hematomas: while on anticoagulation, she developed 2 hematomas in her left flank and left groin. she had no evidence of compartment syndrome. her pain was controlled with tylenol and oxycodone. she did require red cell transfusions for blood loss anemia. . 3. hypotension: early on during this admission, she developed hypotension to 85/41. her blood pressure responded to a fluid challenge. an ekg had no signs of ischemia and a echocardiogram had no sign of right ventricular dysfunction. her hematocrit at that time was stable and there was no sign of acute bleed. she appeared intravascularly dry with an low fe urea. therefore, her hypotension was attributed to overdiuresis. her blood pressure improved with hydration. . 4. lower extremity edema: on admission, she had increased lower extremity edema above her baseline. there was no evidence of heart failure on echocardiogram. she was initially overdiuresed resulting in hypotension, as above. once her blood pressure had stabilized, she was restarted on her outpatient lasix dose with decrease in lower extremity edema. she appeared to be overdiuresed on her previous outpatient dose of lasix; therefore, she was discharged on a lower dose (20 mg daily). . 5. urinary tract infection: she was noted to have cloudy urine and a urine culture was positive for klebsiella. she was treated with a 7-day course of ceftriaxone. . 6. diabetes: she had been on 36 units of lantus as an outpatient. her sugars were under poor control (a1c = 9.3), so her lantus was increased to 42 units. this regimen yielded good glucose control. . 7. obstructive sleep apnea: she was maintained on cpap at night. . 8. right toe ulcer: she had been seen by for debridement of her ulcer. she was maintained on wet-to-dry saline dressing changes daily. . 9. back pain: she was maintained on her outpatient gabapentin and baclofen. . 10. fen: low sodium cardiac diabetic diet. she had hyperkalemia on admission that was treated. she had no further episodes of hyperkalemia. . 11. prophylaxis: anticoagulation with heparin/coumadin, colace/senna, ppi, ambulation. . 12. access: peripheral iv . 13. full code . 14. dispo: she was discharged to home once she was therapeutic on coumadin for 48 hours. she will follow-up in clinic 4 days post-discharge for an inr and hematocrit check. medications on admission: 1. spectravite 2. gabapentin 800mg qid 3. baclofen 10mg () 4. spironolactone 25mg' 5. diovan 40mg' 6. lasix 80mg' 7. protonix 40mg' 8. mirapex 0.5mg' 9. ranitidine 300mg' 10. aspirin 81mg' 11. lipitor 10mg' 12. citalopram 40mg' 13. bethenachol 25mg qid 14. tramadol 100mg qid discharge medications: 1. multivitamin capsule sig: one (1) cap po daily (daily). 2. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 3. gabapentin 400 mg capsule sig: two (2) capsule po qid (4 times a day). 4. baclofen 10 mg tablet sig: asdir tablet po tid (3 times a day): take 10 mg (1 tablet) in the morning, 10 mg in the afternoon, and 20 mg (2 tablets) at bedtime. 5. pramipexole 0.25 mg tablet sig: two (2) tablet po qd (). 6. atorvastatin 10 mg tablet sig: one (1) tablet po hs (at bedtime). 7. citalopram 20 mg tablet sig: two (2) tablet po daily (daily). 8. multivitamin capsule sig: one (1) cap po daily (daily). 9. tramadol 50 mg tablet sig: two (2) tablet po qid (4 times a day). 10. bethanechol chloride 25 mg tablet sig: one (1) tablet po qid (4 times a day). 11. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day): take while still taking oxycodone. disp:*60 capsule(s)* refills:*2* 12. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation: continue while taking oxycodone. disp:*30 tablet(s)* refills:*0* 13. warfarin 5 mg tablet sig: 1.5 tablets po hs (at bedtime). disp:*30 tablet(s)* refills:*2* 14. oxycodone 5 mg tablet sig: 1-3 tablets po q3-4h (every 3 to 4 hours) as needed: take until leg pain resolves. disp:*45 tablet(s)* refills:*0* 15. ferrous sulfate 325 (65) mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*2* 16. acetaminophen 325 mg tablet sig: two (2) tablet po q4h (every 4 hours): until left leg pain resolves. disp:*100 tablet(s)* refills:*2* 17. insulin glargine 100 unit/ml solution sig: forty two (42) units subcutaneous at bedtime. 18. lasix 20 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* discharge disposition: home with service facility: health vna discharge diagnosis: saddle pulmonary embolism discharge condition: stable. she has large left medial thigh hematoma that is stable in size. her left leg pain is stable if not slightly improved. her respiratory status is stable. discharge instructions: please take all medications as prescribed and keep all follow-up appointments. . call your doctor or go to emergency room if you develop sudden worsening shortness of breath, fever/chills, lightheadedness, chest pain, palpitations, bleeding that doesn't stop or anything else that you find worrisome. followup instructions: you have the following appointment to have your inr checked: provider: , phone: date/time: 1:40 . you also have the following appointments: provider: mri phone: date/time: 10:00 provider: , md phone: date/time: 11:00 md procedure: venous catheterization, not elsewhere classified non-invasive mechanical ventilation transfusion of packed cells diagnoses: hyperpotassemia thrombocytopenia, unspecified obstructive sleep apnea (adult)(pediatric) urinary tract infection, site not specified friedl?nder's bacillus infection in conditions classified elsewhere and of unspecified site acute posthemorrhagic anemia diabetes with neurological manifestations, type ii or unspecified type, not stated as uncontrolled polyneuropathy in diabetes ulcer of other part of foot long-term (current) use of insulin morbid obesity anticoagulants causing adverse effects in therapeutic use contusion of thigh hypovolemia backache, unspecified diastolic heart failure, unspecified other pulmonary embolism and infarction contusion of abdominal wall 

Answer: The patient is high likely exposed to