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: lisinopril attending: chief complaint: high blood pressure major surgical or invasive procedure: central line placement history of present illness: 81 y/o spanish only speaking man with pmhx of dm, cad, poorly controlled htn, diastolic hf and aortic stenosis who presented with ha and chest pain after being non-compliant with bp meds for last 24-48hrs (he states was unable to get rx filled at time of discharge). of note, pt was discharged on after admission hypertensive urgency, c/b bp lability prompting w/u that is still pending. he a headache in the evening with worsening chest pressure at which time, he took his bp and decided to come to the ed because it was very high. in the ed, initial vs were: t 97.3 p 85 bp 230/130 r 24 sats 100% on ra o2. there was difficulty obtaining iv access and pt was initially treated with oral home regimen including losartan 100mg, carvedilol 25mg, hydralazine 37.5mg and percocet x 2. sbp initially responded coming down to 180s but rebounded quickly to 240s. cvl was placed in the left ij and pt was started on a nitro gtt. ekg was essentially unchanged, ct head without ich and cxr without pulm edema. nitro gtt was maxed out with minimal change in bp and pt was started on labetalol gtt (nitro weaned off). in the icu his labetolol gtt was weaned off on and he was resumed on his home medications. his bp was 120-170 but increased at night to 211/98 associated with some agitation (though fully oriented). he was given hydralazine 10mg iv with improvement in his blood pressure to 170. he continues to have a ha () but denies chest pressure, sob, palpitations, nausea, vomiting, abdominal pain. his vision is at baseline. he notes diarrhea (non-bloody) in the icu ( bm's/day). he denies fevers. also of note in the icu on he had aggitation with paranoia requiring restraints, 3mg iv ativan and 10mg iv haldol. psychiatry was consulted and thought he was acutely delerious due to hypertension and that withdrawal for etoh was very unlikely. 10 point review of systems otherwise negative. past medical history: diabetes mellitus type ii without complicatoins aortic stenosis with valve area of 1.0 afib/flutter (not anticoagulated due to fall risk & non-compliance) diastolic chf (ef of 55%) cad s/p cath in with 2vd and bms placed to distal rca orthostatic hypertension obstructive sleep apnea: uses cpap at home peptic ulcer disease history of prostate cancer anxiety l aca cva: hypotensive washout stroke neurocysticercosis: dx on ct with with mult extra calcifications. le neuropathy s/p left acl tear h/o seizure d/o, last episode , maintained on carbamazepine lll lung nodule fe deficiency anemia restless leg syndrome, insomnia, nightmares vit d deficiency remote h/o etoh abuse social history: lives with wife and grandson, . heavy etoh with withdrawal seizures but quit 30 years ago (son confirmed not actively drinking). prior cocaine and morphine but quit 30y ago. tobacco: quit 40 years ago. family history: father w cad; died of mi age 41. mother died of 'sepsis' in 30s. 5 brothers & sisters died at very young age(kids), but he does not know etiology. physical exam: vs: t 99.0 hr 83 bp 184/100 rr 20 sat 95% ra gen: well appearing elderly man in nad eye: extra-ocular movements intact, pupils equal round, reactive to light, sclera anicteric, not injected, no exudates ent: mucus membranes moist, no ulcerations or exudates neck: no thyromegaly, jvd: flat cardiovascular: regular rate and rhythm, normal s1, s2, no murmurs, rubs or gallops respiratory: clear to auscultation bilaterally, no wheezes, rales or rhonchi abd: soft, non tender, non distended, no hepatosplenomegally, bowel sounds present extremities: trace edema, no cyanosis, clubbing, joint swelling neurological: alert and oriented x3, cn ii-xii intact, normal attention, sensation normal, asterixis absent, speech fluent integument: warm, moist, no rash or ulceration psychiatric: appropriate, not anxious hematologic: no cervical or supraclavicular lad left ij in place, foley catheter in place pertinent results: on admission: wbc-8.1 rbc-4.21* hgb-11.8* hct-33.6* mcv-80* mch-28.0 mchc-35.0 rdw-16.8* plt ct-342 pt-12.6 ptt-26.5 inr(pt)-1.1 glucose-140* urean-14 creat-0.8 na-139 k-3.4 cl-100 hco3-25 angap-17 ethanol-neg urine tox screens: 06:11pm urine bnzodzp-pos barbitr-neg opiates-neg cocaine-neg amphetm-neg mthdone-neg 11:40pm urine bnzodzp-pos barbitr-neg opiates-neg cocaine-neg amphetm-pos mthdone-neg cardiac enzymes: 04:30am blood ck(cpk)-461* ck-mb-6 ctropnt-<0.01 05:04pm blood ck(cpk)-303* ck-mb-5 ctropnt-<0.01 02:12am blood ck(cpk)-336* ck-mb-6 ctropnt-<0.01 ekg: atrial fibrillation. non-specific lateral st-t wave changes cxr: impression: interval left-sided internal jugular catheter placement with tip terminating at the azygocaval junction. no evidence of pneumothorax. ct head: 1. no acute intracranial process or change compared to the prior study dated one day earlier. 2. partial opacification of the anterior ethmoid cells, not significantly unchanged. brief hospital course: 81 yo man with labile poorly controlled hypertension admitted with hypertensive emergency, delirium, cad, diastolic heart failure, seizure d/o, dm and anxiety/depression. 1. hypertensive emergency: the patient has admitted with systolic's >>200's. he was initially admitted to the icu where bp control was attempted. secondary causes were considered. once the bp was in better control, the patient transferred to floor. on occasion, the sbp would be in 120's when patient was resting, but it was noticed that the patient's mood plays a significant role in raising the sbp to >210's. without significant medical intervention, the systolics could spontaneously drop back down to 120's. we determined that this patient has severe anxiety and depression. one of the practices that he does at home is check his bp >30x/day and when he notices that it is high, his pressure increases... then it is self-escalating. these psychiatric issues also lead him to having poor sleep and thus further exacerbates his bp. we found that it was very important to use spanish interpreters frequently when interacting with him. 2. anxiety/depression: psychiatry consulted during admission. they assisted with recommendations on how to manage these issues while avoiding delirium from benzodiazapine use. these issues are deeply ingrained and will require further outpatient management. the patient is also dealing with significant home stressors---his geriatric wife has cancer, one of his sons was killed in an accident, another son is an alcoholic, etc... 3. cad, native vessel: continue aspirin, , bb, statin. 4. chronic diastolic heart failure, not exacerbated: continue antihypertensive regimen as above, monitor for pulmonary edema. 5. seizure disorder: stable, his last seizure was in . continued his home carbamazepine 300mg and lyrica 100mg tid. 6. afib/flutter: continue bb, aspirin. he is not anticoagulated at baseline due to fall risk and lack of compliance. 7. diabetes mellitus, type ii, without complications: restart metformin, continue ssi with qid bg checks and dm diet, on aspirin, . 8. osa: treat with cpap in house. 9. pud: continue ranitidine. 10. dispo: he will be discharged home with several services: nursing, physical therapy, social work, and whatever psych services are available. medications on admission: medications on recent discharge-(pt reports non-compliance as unable to obtain meds from pharmacy until monday ) potassium chloride 20 meq daily losartan 100 mg tablet carvedilol 25 mg tablet atorvastatin 40 mg tablet daily clonidine 0.2 mg/24 hr patch qthur amlodipine 10 mg tablet daily hydralazine 37.5 mg tablet po q6hr ranitidine hcl 300mg daily nitroglycerin 0.3 mg tablet sl prn sertraline 125mg daily pregabalin 100 mg capsule tid latanoprost 0.005 % drops sig: one (1) drop ophthalmic hs aspirin, buffered 325 mg daily metformin 500 mg tablet carbamazepine 300mg ferrous sulfate 325 mg daily isosorbide mononitrate 60 mg daily discharge medications: 1. aspirin 325 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po daily (daily). disp:*30 tablet, delayed release (e.c.)(s)* refills:*0* 2. isosorbide mononitrate 60 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po daily (daily). disp:*30 tablet sustained release 24 hr(s)* refills:*0* 3. carbamazepine 100 mg tablet, chewable sig: three (3) tablet, chewable po bid (2 times a day). disp:*180 tablet, chewable(s)* refills:*0* 4. losartan 50 mg tablet sig: two (2) tablet po bid (2 times a day). disp:*120 tablet(s)* refills:*0* 5. hydrochlorothiazide 12.5 mg capsule sig: one (1) capsule po daily (daily). disp:*30 capsule(s)* refills:*0* 6. sertraline 50 mg tablet sig: 2.5 tablets po daily (daily). 7. quetiapine 50 mg tablet sig: one (1) tablet po twice a day as needed for insomnia. disp:*60 tablet(s)* refills:*0* 8. pregabalin 100 mg capsule sig: one (1) capsule po three times a day. disp:*90 capsule(s)* refills:*0* 9. metformin 500 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*0* 10. latanoprost 0.005 % drops sig: one (1) drop ophthalmic hs (at bedtime). disp:*qs 1 month* refills:*0* 11. clonidine 0.2 mg/24 hr patch weekly sig: one (1) patch weekly transdermal qthur (every thursday). disp:*4 patch weekly(s)* refills:*0* 12. nitroglycerin 0.3 mg tablet, sublingual sig: one (1) tablet, sublingual sublingual prn (as needed) as needed for chest pain: take under tongue as needed for chest pain every 5 minutes, up to 3 doses total. if chest pain persists, seek medical attention. disp:*20 tablet, sublingual(s)* refills:*0* 13. potassium chloride 20 meq packet sig: one (1) packet po once a day. disp:*30 packet* refills:*0* 14. coreg 12.5 mg tablet sig: two (2) tablet po twice a day. disp:*120 tablet(s)* refills:*0* 15. atorvastatin 20 mg tablet sig: two (2) tablet po at bedtime. disp:*60 tablet(s)* refills:*0* 16. amlodipine 5 mg tablet sig: two (2) tablet po once a day. disp:*60 tablet(s)* refills:*0* 17. hydralazine 25 mg tablet sig: 1.5 tablets po every six (6) hours. disp:*180 tablet(s)* refills:*0* 18. ranitidine hcl 150 mg capsule sig: two (2) capsule po once a day. disp:*60 capsule(s)* refills:*0* discharge disposition: home with service facility: vna discharge diagnosis: primary diagnoses: 1. hypertension 2. anxiety secondary diagnoses: 1. obstructive sleep apnea 2. atrial fibrillation and flutter 3. type 2 diabetes mellitus 4. coronary artery disease 5. diastolic congestive heart failure 6. peptic ulcer disease discharge condition: you are in fair condition. discharge instructions: you have been treated for both your hypertension and your anxiety during this hospital admission. we have found that the increase in your blood pressure is in some part related to your stresses and anxiety. you should continue in being managed for these conditions as well as your other medical problems. among the many factors contributing to your anxiety, one of them is the status of your blood pressure. you should usually limit the checking of your blood pressure to no more than once a day. for your condition called congestive heart failure it is important that you monitor your weight each day. weigh yourself every morning, call your doctor if your weight increases by more than 3 pounds from your regular weight. you should also limit your salt (sodium) to 2 grams a day. limit fluids to less than 1.5 liters a day. medication changes: 1. quetiapine 50mg one tablet by mouth twice a day (for anxiety and sleeping problem) 2. hydrochlorthiazide 12.5mg one tablet by mouth once a day (for high blood pressure) seek medical attention if you have worsening of your condition or have other concern. followup instructions: please follow up with your primary care provider within the next 1-2 weeks. please also make an appointment to follow up with your psychiatrist. call dr. at . other appointments you have scheduled already: , md phone: date/time: 1:30 gi (st-3) gi rooms date/time: 1:30 , md phone: date/time: 2:00 procedure: venous catheterization, not elsewhere classified diagnoses: obstructive sleep apnea (adult)(pediatric) coronary atherosclerosis of native coronary artery pure hypercholesterolemia congestive heart failure, unspecified atrial fibrillation personal history of malignant neoplasm of prostate aortic valve disorders diabetes with neurological manifestations, type ii or unspecified type, not stated as uncontrolled polyneuropathy in diabetes personal history of tobacco use atrial flutter dysthymic disorder family history of ischemic heart disease epilepsy, unspecified, without mention of intractable epilepsy personal history of transient ischemic attack (tia), and cerebral infarction without residual deficits personal history of noncompliance with medical treatment, presenting hazards to health delirium due to conditions classified elsewhere chronic diastolic heart failure peptic ulcer of unspecified site, unspecified as acute or chronic, without mention of hemorrhage or perforation, without mention of obstruction alcohol abuse, in remission malignant hypertensive heart disease with heart failure 

Answer: The patient is high likely exposed to