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: no known allergies / adverse drug reactions attending: chief complaint: sdh and tsah after a fall on coumadin major surgical or invasive procedure: none history of present illness: 88 yo m w/ h/o dementia, afib, s/p ppm, chf (on coumadin), ckd (baseline cr 1.5-2.2) p/w fall and found to have sdh and traumatic sah. pt fell (trip and witnessed, ? loc, felt to be mechanical) on his way to coumadin clinic, and went to osh where his inr was 2.0, and ct head demonstrated small parafalcine sdh and bilat sah. he received vitamin k then transferred to . he was initially admitted to the nsg icu then transfered to micu for (at that time did not know baseline cr), and increasing bilateral pulmonary infiltrates. he was placed on keppra ppx. he was placed on neuro checks and had an trauma survey revealed minimally displaced, extraarticular distal right radius and ulna fractures. on he had repeat head ct that showed increased bifrontal sah and right sdh. though ct worse, exam clinically the same. per nsg patient not surgical candidate, but wanted f/u head ct on . all anti-coag being held. ortho was c/s and his arm was splinted. on collaberation w/ family, patient was thought to be close to his baseline (brief conversation, walks w/ cane). cards also c/s b/c trop leak 0.08, flat ck-mb, cardiology felt to be in setting of ckd not. cxr showed bilateral pleural effusions w/ ? focal consolidation. felt to be all volume related, got 80mg iv lasix x1 w/ good diuresis, on room air, except for at night. he is -2l length of stay. currently, denies any shortness of breath or chest pain. review of systems: denies fevers, chills, nausea, vomiting, headache, shortness of breath, or chest pain. past medical history: afib cad status post cabg x3 mi 4 years ago chf with ef 25%, status post aicd hyperlipidemia hypertension, rhabdomyolysis right hip fracture ckd s/p hypothermic episode social history: - tobacco: denies - alcohol: denies - illicits: denies family history: sister w/ parkinsons, hypertension and cad in family physical exam: at admission: t: 97 hr: 90 bp: 136/68 rr: 18 sat: 97% ra gen: cachectic, appears stated age, comfortable, nad. heent: right eyebrow laceration and hematoma. small laceration right posterior scalp neck: supple. c-collar in place extrem: dorsum right hand with abrasions, abraisions right shoulder. neuro: mental status: awake and alert, cooperative with exam orientation: aox2 (baseline) oriented to person, place "hospital" but not date. language: speech fluent with good comprehension and repetition. naming intact. no dysarthria or paraphasic errors. cranial nerves: i: not tested ii: pupils equally round and reactive to light, 3 to 2.5 mm bilaterally. visual fields are full to confrontation. iii, iv, vi: extraocular movements intact bilaterally without nystagmus. v, vii: facial strength and sensation intact and symmetric. viii: hearing intact to voice, but hoh on right ix, x: palatal elevation symmetrical. : sternocleidomastoid and trapezius normal bilaterally. xii: tongue midline without fasciculations. motor: decreased bulk throughout with normal tone bilaterally. no abnormal movements,tremors. right ue weakness bis/tris , right grip full. otherwise strength is symmetric with bilat delt weakness. otherwise strength is full throughout. sensation: intact to light touch bilaterally. toes downgoing bilaterally at discharge: vitals: 98.0 98.0 143/87 110s-140s/70s-80s 72 70s-90s (70s in am) 95-100% ra i/os: 340 / 0 | 125 +large incont / 0 am: 0/0| large incont / 0 general: awake, follows commands, responsive heent: sclera anicteric, oropharynx clear, eomi, perrl (3->2 bl). eyelids pulsing with motion. neck: no appreciable lad. jvp non-elevated. cv: irreg rhythm. 3/6sem at base radiating b/l to neck and to apex, normal s1 + s2, without rubs, gallops lungs: with quiet breathing, ctab with ?crackles at bases. after deep breaths, tachypneic with suprasternal retractions. abdomen: soft, non-tender, non-distended, bowel sounds present, no organomegaly ext: white nails. warm, well perfused, 2+ pulses, no clubbing or edema. neuro: eomi, perrl, cnii-xii intact. sensation grossly intact to light touch in upper/lower ext. 4+ strength in all extremities (testing of r arm limited by cast). ms: a&ox1 (no 'hospital'). pertinent results: 07:20pm blood wbc-7.0 rbc-3.88* hgb-12.0* hct-36.9* mcv-95 mch-31.0 mchc-32.6 rdw-15.4 plt ct-157 03:43am blood wbc-7.8 rbc-3.73* hgb-11.5* hct-35.5* mcv-95 mch-30.8 mchc-32.4 rdw-15.5 plt ct-140* 03:04pm blood wbc-7.1 rbc-3.63* hgb-10.9* hct-34.6* mcv-95 mch-29.9 mchc-31.4 rdw-15.5 plt ct-150 02:13am blood wbc-6.0 rbc-3.54* hgb-10.7* hct-34.2* mcv-96 mch-30.1 mchc-31.2 rdw-15.3 plt ct-129* 06:15am blood wbc-5.4 rbc-3.86* hgb-11.5* hct-37.2* mcv-97 mch-29.8 mchc-30.9* rdw-15.1 plt ct-142* 05:53am blood wbc-5.3 rbc-3.95* hgb-11.9* hct-38.4* mcv-97 mch-30.1 mchc-31.0 rdw-15.2 plt ct-163 05:12am blood wbc-4.8 rbc-3.63* hgb-11.3* hct-34.7* mcv-96 mch-31.1 mchc-32.6 rdw-15.6* plt ct-148* 07:20pm blood pt-21.6* ptt-32.5 inr(pt)-2.1* 03:43am blood pt-16.6* ptt-31.5 inr(pt)-1.6* 09:17am blood pt-15.0* ptt-31.2 inr(pt)-1.4* 03:04pm blood pt-13.5* ptt-32.4 inr(pt)-1.3* 02:13am blood pt-14.1* ptt-29.7 inr(pt)-1.3* 06:15am blood pt-12.8* inr(pt)-1.2* 07:20pm blood glucose-134* urean-57* creat-1.8* na-140 k-4.5 cl-101 hco3-26 angap-18 03:43am blood glucose-154* urean-57* creat-1.8* na-140 k-5.1 cl-101 hco3-28 angap-16 03:04pm blood glucose-108* urean-57* creat-1.9* na-141 k-4.5 cl-102 hco3-29 angap-15 02:13am blood glucose-93 urean-60* creat-1.9* na-142 k-4.6 cl-103 hco3-30 angap-14 06:15am blood glucose-63* urean-64* creat-1.9* na-146* k-4.3 cl-105 hco3-26 angap-19 05:53am blood glucose-98 urean-65* creat-1.9* na-146* k-4.0 cl-104 hco3-30 angap-16 05:12am blood glucose-92 urean-59* creat-1.8* na-147* k-3.9 cl-106 hco3-30 angap-15 07:20pm blood ck(cpk)-61 03:43am blood alt-37 ast-45* ck(cpk)-99 alkphos-71 totbili-1.4 06:15am blood alt-21 ast-21 alkphos-59 totbili-1.9* 05:53am blood alt-20 ast-20 alkphos-62 totbili-1.5 07:20pm blood ck-mb-3 ctropnt-0.08* 03:43am blood ck-mb-3 ctropnt-0.08* 07:20pm blood calcium-9.2 phos-3.6 mg-2.5 03:43am blood albumin-4.1 calcium-9.7 phos-3.7 mg-2.5 03:04pm blood calcium-9.5 phos-3.8 mg-2.4 02:13am blood calcium-9.4 phos-4.3 mg-2.5 06:15am blood calcium-9.2 phos-3.7 mg-2.4 05:53am blood calcium-9.8 phos-3.5 mg-2.5 brief hospital course: the patient is an 88 year old gentleman with multiple medical problems who was admitted initially to the neurosurgery service for sdh and sah. he appeared at his neurological baseline (aox ). inr was reversed at admission. . #sdh and sah neuro: repeat hct showed enlargement of right occipital sdh. given his multiple medical problems (dementia, chf with ef 25%, crf), he is not a candidate for surgical intervention. no shift caused by sdh. inr was reversed and he was monitored clinically. fall was likely mechanical in nature. on , a repeat head ct was stable without extension or new hemorrhage. his neuro exam remained stable throughout his stay. he was followed by neurosurgery. he was continued on keppra for seizure prophylaxis. per neurosurgery, it was confirmed that he could be restarted on aspirin 81mg. he should continue to hold coumadin until his outpatient appointment with neurosurgery. #sob/tachypnea/schf increasing bilateral pulmonary infiltrates on repeat cxr. cardiology c/s was placed in ed who recommended diuresis. the patient was diuresed with iv lasix. a tte on hd3 revealed significant global systolic dysfunction and dilated left ventricle consistent with multivessel coronary artery disease. he was restarted on his metoprolol and the dose was titrated up his home dose of 100mg daily. he was started lisinopril 2.5mg after discussion with outpatient provider, was restarted on home lasix 40 mg po daily. . #renal insufficiency: baseline creatinine 1.5-1.8, although as been as high as 2.2 in . mild in setting of sdh and traumatic sah. i his creatinine continued to trend down and on discharge was 1.8. his foley was out and he was voiding well, but incontinent. he was started on lisinopril 2.5mg. should have repeat chem 7 within 3 days of discharge. . #fall: likely mechanical. no recollection of events related to fall or syncopal episode. no evidence by icd of an arrhythmia (ie. vt or vf). troponins were borderline elevated, likely due to renal insufficiency as his ck-mb was flat, and ecg was consistent with strain pattern not ischemia. cards saw the pt in the ed. no infectious source. on telemetry, he had one run of 8 beats of nsvt. he had no evidence of infection or metabolic disease to explain his fall. no report of seizure activity. c-collar was cleared clinically and radiographically. pt recommended rehab. . # distal radial/ulnar fractures: he was followed by the ortho trauma service. his right arm was initial spinted and later a short arm cast was placed. he should keep it elevated and non-weight bearing. . cad: pt with ef 25% s/p aicd placement and signficiant coronary disease and h/o mi and cabg. elevated troponins and flat ck-mb, in setting of . ecg c/w strain pattern. prior troponins at 0.11. likely exacerbated in setting of . cardiology reviewed imaging on admission and recommended diuresis. a tte was performed on hd3 and revealed significant global systolic dysfunction and dilated left ventricle consistent with multivessel coronary artery disease. he was restarted on aspirin and started on lisinopril 2.5mg. he was continued on pravastatin and metoprolol was titrated up to home dose. . # afib: he appeared to be in sinus rhythm with multiple pvcs through his stay. his coumadin was held, in the setting of the head bleed. after the ct and exam were stable, he was restarted on aspirin. his beta-blocker was titrated up to his home dose. he should continue to hold coumadin until he is reevaluated by neurosurgery at his follow-up appointment. # hypernatremia: he developed a mild hypernatremia (na 147 - free water deficit 2l). it was thought to be due to limited po intake and he was thirsty and has been reliant on assistance for all eating/drinking. he was given 500cc 1/2 ns. should have repeat chem 7 within 3 days of discharge. transitional issues: - start tylenol prn for pain - start calcium carbonate and vitamin d to help with low bone density - start keppra for seizure prophylaxis and discuss with neurosurgery - start lisinopril 2.5 mg daily for heart failure, hold for sbp < 100 and discuss at cardiology follow-up - stop coumadin. restart if neurosurgery recommends at follow-up appointment. - scheduled for a repeat x-ray and follow-up with orthopedics - scheduled for a repeat head ct and follow-up with neurosurgery - scheduled for follow-up with cardiology - dnr/i medications on admission: preadmission medications listed are correct and complete. information was obtained from family/caregiver. 1. metoprolol succinate xl 100 mg po daily 2. pravastatin 10 mg po daily 3. warfarin 3.75 mg po daily16 4. aspirin 81 mg po daily 5. furosemide 40 mg po daily discharge medications: 1. aspirin 81 mg po daily 2. furosemide 40 mg po daily 3. pravastatin 10 mg po daily 4. calcium carbonate 500 mg po tid 5. acetaminophen 650 mg po tid 6. levetiracetam 500 mg po bid 7. lisinopril 2.5 mg po daily hold for sbp<100 8. metoprolol succinate xl 100 mg po daily 9. vitamin d 800 unit po daily discharge disposition: extended care facility: green nursing & rehab center - discharge diagnosis: subdural hematoma subarachnoid hemorrhage right radial and ulnar distal fracture systolic heart failure with pulmonary edema discharge condition: mental status: confused - always. level of consciousness: alert and interactive. activity status: out of bed with assistance to chair or wheelchair. discharge instructions: dear mr. , it was a pleasure participating in your care at . you came into the hospital because you fell and had a head bleed. we reversed your anticoagulation and stopped your coumadin. you were in the icu because of fluid in your lungs and kidney failure. your repeat head ct showed that the bleeding your brain was stable and your mental thinking has appeared to stabilize. we restarted your home heart medications. goes up more than 3 lbs. followup instructions: department: orthopedics when: tuesday at 1:20 pm with: ortho xray (scc 2) building: sc clinical ctr campus: east best parking: garage department: orthopedics when: tuesday at 1:40 pm with: , np building: campus: east best parking: garage department: radiology when: monday at 11:30 am with: cat scan building: cc campus: west best parking: garage *nothing to eat or drink 3 hours prior to the cat scan. department: neurosurgery when: monday at 12:30 pm with: , md building: lm bldg () campus: west best parking: garage department: cardiac services when: wednesday at 10:00 am with: , md building: sc clinical ctr campus: east best parking: garage procedure: closure of skin and subcutaneous tissue of other sites diagnoses: congestive heart failure, unspecified acute kidney failure, unspecified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified atrial fibrillation coronary atherosclerosis of unspecified type of vessel, native or graft aortocoronary bypass status unspecified fall chronic kidney disease, unspecified long-term (current) use of anticoagulants automatic implantable cardiac defibrillator in situ hyperosmolality and/or hypernatremia acute on chronic systolic heart failure subdural hemorrhage following injury without mention of open intracranial wound, with no loss of consciousness open wound of other and multiple sites of face, without mention of complication subarachnoid hemorrhage following injury without mention of open intracranial wound, with no loss of consciousness closed fracture of lower end of radius with ulna dementia, unspecified, without behavioral disturbance 

Answer: The patient is high likely exposed to