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: headache major surgical or invasive procedure: formal angiogram of the brain history of present illness: 42 yo m with history of hypertension transferred from osh with ivh. he is a challenging historian but as per records he devloped nausea, vomiting, and mild headache earlier today and appeared slow to respond to questions and was taken to . there he was found to have bp 213/133 p 72 rr 18 t 97.5 100% ra and was noted to be "slow to respond" but otherwise nonfocal exam. he received multiple doses of lopressor and labetalol for his continued hypertension and underwent ct head which revealed intraventricular hemorrhage in lateral, 3rd, and 4th ventricles, greater on right than left and transferred to for further management. upon arrival bp 213/121 p 79 and was started on a nicardipine drip. he was seen by neurosurgery who recommended neurology admission. patient denies any recent fevers, chills, cough, chest pain, shortness of breath, dizziness, visual changes, focal weakness, sensory changes, bowel or bladder changes. he reports generalized fatigue. past medical history: - hypertension (says pcp recently took him off meds) -15-inch titanium rod placed in left femur social history: lives with parents, works at drug pharmacy, says he is a " of all trades." denies tobacco or drugs. occasional alcohol use. family history: father with stroke at unknown age. no history of aneurysms. physical exam: vs; bp 213/121 (current 157/90 on nicardipine drip) p 100 rr 19 98% on 2l gen; lying in bed, nad heent; nc/at, mucous membranes moist, oropharynx clear cv; rrr, no murmurs pulm; cta b/l abd; soft, nt, nd extr; no edema neuro ms; drowsy but arousable to voice. somewhat tangential, requiring redirection to obtain history. a&ox3. speech mildly slurred. naming repetition and comprehension intact. follows basic commands. no apraxia or neglect. cn; perrl 6mm-->5mm, eomi, no nystagmus. visual fields full. face sensation intact v1-v3. mild nlf flattening on right. palate symmetric. tongue midline. motor; normal bulk, mild increased tone in legs. no pronator drift. 5/5 strength in r and l delt, bicep, tricep, wre, ff, ip, ham, quad, ta, gastrocs. sensory; intact to light touch and pinprick throughout reflexes; 2+ and symmetric at biceps, brachioradialis, patellars and achilles. plantar response is withdrawl b/l. coordination; no dysmetria on fnf gait; deferred pertinent results: 06:40am blood wbc-9.2 rbc-5.42 hgb-16.4 hct-49.0 mcv-90 mch-30.3 mchc-33.5 rdw-12.8 plt ct-246 05:47pm blood neuts-89.6* lymphs-6.7* monos-2.6 eos-0.4 baso-0.8 10:40am blood pt-13.8* ptt-29.6 inr(pt)-1.2* 06:40am blood glucose-87 urean-22* creat-1.2 na-133 k-4.0 cl-95* hco3-26 angap-16 06:40am blood alt-46* ast-20 ld(ldh)-270* alkphos-95 totbili-0.6 02:48am blood alt-103* ast-50* alkphos-81 totbili-0.9 06:40am blood alt-64* ast-55* ld(ldh)-265* alkphos-91 totbili-1.0 04:08am blood ck-mb-3 ctropnt-<0.01 06:40am blood albumin-4.6 calcium-9.4 phos-3.9 mg-2.3 11:45am blood triglyc-42 hdl-61 chol/hd-2.7 ldlcalc-97 08:25pm blood tsh-1.3 05:47pm blood asa-neg ethanol-neg acetmnp-neg bnzodzp-neg barbitr-neg tricycl-neg 02:48am blood renin-2.78 07:20am blood aldosterone- 1 ng/dl (normal < 26) 04:30pm blood insulin-like growth factor-1- normal nchct technique: noncontrast head ct. comparison: outside hospital ct from earlier same date. findings: compared to prior study from 15:46 p.m. about three hours prior, there has been no change. otherwise, intraventricular blood extending from bilateral lateral ventricles continuously to the foramina of luschka at the fourth ventricle is stable. calcified structure in the left sylvian fissure can represent an aneurysm. there is no large territorial infarct. there is no evidence of uncal herniation or transtentorial herniation. there is no bony lesion to suggest malignancy or infection. left small bullosa is seen. mild mucosal thickening in the right maxillary sinus and sphenoid sinuses is noted. impression: 1. stable distribution of extensive intraventricular hemorrhage. 2. calcified structure in the left sylvian fissure can represent an aneurysm. cta head and neck technique: ct of the head was acquired without contrast. following this, using departmental protocol, ct angiography of the head acquired. the examination is limited due to delays in acquisition and optimum bolus was not obtained. findings: ct head: there is intraventricular hemorrhage identified involving right lateral ventricle, third ventricle, with some extension to the left lateral ventricle. a small area of hyperdensity is also identified in the left sylvian fissure region. ct angiography head: ct angiography of the head demonstrates a vascular prominence adjacent to the left middle cerebral artery. however, due to incomplete vascular opacification, it is unclear whether this is due to an aneurysm or due to a prominent venous structure. a repeat ct angiography or a conventional angiography of the head would be helpful for further assessment. the remaining vascular structures appear patent. impression: 1. intraventricular hemorrhage is identified on ct of the head along with a small area of hypodensity in the left middle cranial fossa. 2. ct angiography is limited due to delay in acquisition, but demonstrates a small area of contrast enhancement in the left middle cranial fossa adjacent to the sphenoid margin and adjacent to the left middle cerebral artery. it is unclear whether this is due to an mca aneurysm or due to venous filling. repeat ct angiography of the head or conventional angiography would be helpful for further assessment. renal ultrasound comparison: none. findings: the right kidney measures 12.3 cm and the left kidney measures 11.8 cm. no masses, stones or hydronephrosis were present. within the right kidney, renal resistive indices measure within cortical vessels range between 0.58 and 0.65. within the main renal artery, resistive indices was measured at 0.6. in the left kidney, resistive indices in the cortical vessels range between 0.58 and 0.65. resistive index in the main renal artery was 0.59. there is normal flow and waveform within bilateral main renal veins. impression: normal renal ultrasound. no secondary evidence for renal artery stenosis. mri and mra head, brain and neck technique: mri of the brain was performed -sagittal t1, axial t1, axial flair, axial t2, and diffusion with adc map sequences without intravenous contrast. after the administration of intravenous contrast, axial t1 and sagittal mprage sequences were performed. coronal and axial mprage sequences were reformatted from the sagittal post-contrast mprage sequence. three-dimensional time-of-flight mr angiography of the head was performed with 3d reformations. comparison: no prior mr for comparison. ct and cta of the head performed on was reviewed. ct of the head from and were also reviewed. findings: mr head without and with contrast the intraventricular hemorrhage, predominantly in the right lateral ventricle and fourth ventricle with a smaller volume of hemorrhage within the left lateral ventricle and third ventricle, is not significantly changed compared with the prior ct examination. no new foci of hemorrhage are identified. the ventricles are unchanged in size and not enlarged. there are a few prominent extra-axial t2 flow voids in the anterior aspect of the left middle cranial fossa in the region of the previously described enhancing abnormality with punctate focus of calcficiation noted on the prior ct examinations. a more focal area measures up to 5-8mm in greatest dimension with a lobulated appearance. this structure is adjacent to the mca m1-m2 branches without definite arterial component noted on time-of-flight sequence. no significant mass effect upon the surrounding structures. on the post-contrast mprage sequence (sequence 106, images 46 through 51), this region has the appearance of prominent venous tributaries without associated prominent arteries. no evidence of parenchymal hemorrhage or restricted diffusion is noted. there is minimal mucosal thickening of the sphenoid sinuses and ethmoid sinuses. mra head: patent visualized major intracrnaial arteries without focal flow limiting stenosis or occlusion or obvious arterial aneurysm. the distal vertebral arteries are not completely included. the right distal vertebral artery is diminutive in caliber. impression: 1. stable intraventricular hemorrhage. no evidence of ventricular enlargement. 2. the previously described left anterior middle cranial fossa enhancing abnormality noted on prior cta does demonstrate prominent t2 flow void without flow signal on time-of-flight mra imaging. it is adjacent to the m1-m2 branches, but does not definitely have dilated arteries within the resolution of noncontrast mra. the appearance suggests possible venous abnormality such as a malformation with a focal venous varix/aneurysm. given the close proximity to the mca branches, an arterio-venous communication cannot be excluded based on this study alone even though there are no dilated arteries of the mra. neurology and interventional neuroradiology consult are recommended for possible conventional angiography to exclude an avm/avf and any additional lesions. the above findings were discussed with dr. at 10:40 a.m., . ct chest, abdomen and pelvis technique: contiguous axial images were obtained through the chest, abdomen and pelvis with the administration of iv contrast. multiplanar reformats were generated and reviewed. ct of the chest: pleural plaque is noted at the right lung base. left axillary nodes measure up to 6 mm and do not meet ct size criteria for pathologic enlargement. mediastinal and hilar lymph nodes do not meet ct size criteria for pathologic enlargement. there is mild left ventricular hypertrophy. there is no evidence of pericardial effusion. otherwise, the visualized lungs appear unremarkable. ct of the abdomen: the liver shows hypodensity in the right lobe (3, 70) which is too small to characterize. there is evidence of intra- and extra-hepatic biliary dilation with the common bile duct measuring up to 9 mm (3, 73). the gallbladder shows no evidence of gallstones. the spleen, pancreas and bilateral adrenal glands are unremarkable. both kidneys enhance and excrete contrast symmetrically without evidence of hydronephrosis or stones. a hypodensity in the interpolar region of the right kidney measures 30 x 21 mm and likely represents renal cyst. bilateral subcentimeter hyperdensities in both kidneys are too small to characterize but likely represent simple cysts. the intra-abdominal loops of large and small bowel are unremarkable. there is no free air or free fluid within the abdomen. retroperitoneal and mesenteric lymph nodes do not meet ct size criteria for pathologic enlargement. ct of the pelvis: the bladder, distal ureters, rectum and sigmoid colon appear unremarkable. osseous structures: the visualized osseous structures appear unremarkable. impression: 1. no evidence of bilateral adrenal disease. no evidence of pheochromocytoma is noted along the course of the abdominal aorta. 2. pleural plaque at the right lung base. 3. left ventricular hypertrophy. 4. hypodensity in the liver which is too small to characterize and likely represents a hepatic cyst. 5. mild intra- and extra-hepatic biliary dilation. 6. hypodensity in the interpolar region of the right kidney measures 30 x 21 mm and likely represents renal cyst. bilateral subcentimeter hyperdensities in both kidneys are too small to characterize but likely represent simple cysts. formal angiogram underwent cerebral angiography which showed significant tortuosity of the aortic arch and the origins of the common carotid artery and the vertebral artery. the right vertebral artery was seen to be significantly stenosed with significant supply through the left vertebral as seen on the mri/mra. he had also area of stenosis in the left middle cerebral artery followed by a dilatation in the distal m1 segment. no definite evidence of aneurysm or avm. echocardiogram the left atrium is mildly dilated. the estimated right atrial pressure is 0-5 mmhg. there is moderate symmetric left ventricular hypertrophy. overall left ventricular systolic function is normal (lvef>55%). there is no left ventricular outflow obstruction at rest or with valsalva. right ventricular chamber size and free wall motion are normal. 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 no mitral valve prolapse. the pulmonary artery systolic pressure could not be determined. there is no pericardial effusion. impression: mild symmetric left ventricular hypertrophy with preserved global and regional biventricular systolic function. no valvular pathology or pathologic flow identified. brief hospital course: hypertension, intraventricular hemorrhage, headache and constipation were significant issues for this admission: headache presenting complaint and attributed to intraventricular hemorrhage. headache continued through the admission, abating toward the end. there was some correlation between blood pressure and headache. headache was improved at discharge and medications fioricet and tramadol were given for control after discharge. intraventricular hemorrhage no underlying aneurysm was found. this was felt to be most likely secondary to small-vessel lenticulostriate bleed originating in right medial head of the caudate, although it was also possible that this represented a primary intraventricular bleed. formal angiogram revealed tortuous vessels that were felt to represent vascular disease of high poorly controlled blood pressure and possible atherosclerosis. hypertension bp control was poor, and po meds were introduced gradually. nicardipine gtt was d/c'd by icu team on hd2 and pt managed with iv hydralazine boluses. as of , po regimen was amlodipine 10mg (started , d/c'd by icu, then re-started ), lisinopril 40mg (started at 20 on and increased to 40 on ), labetalol 200mg tid (started on at 100, increased to 200 on am). icu team gave one dose of clonidine 0.2. oral regimen was up-titrated until adequate control was gained and he was discharged on this regimen (see below) with follow-up arranged for both renal and neurology. renin, tsh, igf1, aldoterone were normal. no pheochromocytoma was seen on ct. renal arteries were patent. left ventricular hypertrophy and vascular effects are present suggesting that this has been long-standing, but specific etiology was not identified. blood pressure was in the 140s-150s systolic on discharge. constipation resolved with appropriate bowel regimen. medications on admission: none. discharge medications: two-week scripts were given along with 90 days so that he could get free supply of the first and sort out veteran coverage for the latter: 1. simvastatin 20 mg tablet sig: one (1) tablet po daily (daily). disp:*14 tablet(s)* refills:*0* 2. simvastatin 20 mg tablet sig: one (1) tablet po once a day. disp:*90 tablet(s)* refills:*2* 3. chlorthalidone 25 mg tablet sig: one (1) tablet po once a day. disp:*14 tablet(s)* refills:*0* 4. chlorthalidone 25 mg tablet sig: one (1) tablet po once a day. disp:*90 tablet(s)* refills:*2* 5. butalbital-acetaminophen-caff 50-325-40 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for headache for 14 days. disp:*84 tablet(s)* refills:*0* 6. tramadol 50 mg tablet sig: one (1) tablet po every eight (8) hours as needed for headache for 7 days. disp:*21 tablet(s)* refills:*0* 7. amlodipine 10 mg tablet sig: one (1) tablet po once a day. disp:*14 tablet(s)* refills:*0* 8. amlodipine 10 mg tablet sig: one (1) tablet po once a day. disp:*90 tablet(s)* refills:*2* 9. labetalol 200 mg tablet sig: two (2) tablet po every eight (8) hours. disp:*84 tablet(s)* refills:*0* 10. labetalol 200 mg tablet sig: two (2) tablet po every eight (8) hours. disp:*540 tablet(s)* refills:*2* 11. clonidine 0.1 mg/24 hr patch weekly sig: one (1) transdermal once a week for 1 doses: remove present patch and place on . disp:*1 patch* refills:*0* 12. lisinopril 10 mg tablet sig: one (1) tablet po daily (daily). disp:*14 tablet(s)* refills:*0* 13. lisinopril 10 mg tablet sig: one (1) tablet po once a day. disp:*90 tablet(s)* refills:*2* discharge disposition: home discharge diagnosis: primary intraventricular hemorrhage hypertension discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you came to the hospital after having an intraventricular hemorrhage (bleed into the fluid filled lateral ventricle of your brain). you were also markedly hypertensive. we controlled your blood pressure with medications. you underwent angiography which showed that your blood vessels have been affected by high blood pressure, but did not show any other underlying abnormality that would result in your bleed. it is very important that you take you antihypertensive medications - if you do not, you may have a further hemorrhage. please follow-up with the hypertension clinic for continuing medication adjustment. we have given you a script for one more clonidine patch, so that you can take the old one off and put this on next wednesday . this way you will have this on until you are seen by the kidney doctors (renal/nephrology) for your hypertension. followup instructions: *** before you come to any appointments, please complete your registration (providing details of your insurance and doctor) with the hospital. please call when you get home. we have ordered a follow-up mri to be done prior to your appointment with neurology, for follow-up of your intraventricular hemorrhage: provider: . & phone: date/time: 4:30 your mri will likely be on . they will call with a time. you are also scheduled to follow-up with dr. , renal specialist for your hypertension/bp control. his office is located on , building : provider: . phone: date/time: 1:00 md, procedure: arteriography of cerebral arteries arterial catheterization diagnoses: obstructive hydrocephalus intracerebral hemorrhage other constipation malignant essential hypertension family history of stroke (cerebrovascular) meningismus 

Answer: The patient is high likely exposed to