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: cortisone attending: chief complaint: s/p fall major surgical or invasive procedure: trochanteric fixation nail repair cardiac catheteization picc line placement and removal history of present illness: the patient is a 77-year-old woman with a history of type 1 diabetes, systolic heart failure, coronary artery disease s/p mis and cabg who presented to the emergency department after falling down the 4 steps of her house while trying to get to her car. according to interviewers in the ed, the patient had no loss of consciousness and the narrative was one of mechanical fall. following the fall, the patient had hip pain and deformity. in the ed, the patient was waiting in triage when she became hypoxic to 80s despite supplemental oxygen and her lungs had crackles throughout. the patient has a history of systolic chf requiring diuresis. the patient's chest x-ray was consistent with pulmonary edema (likely flashed) with ra saturation in the 70s and low 90s on non-rebreather. the physicians in the ed decided to intubate the patient, which was completed without complication. the patient was originally on nitroglycerin gtt, versed/fentanyl, but the compbination of the sedatives and the nitroglycerin made her hypotensive so the nitroglycerin was stopped. the patient still gets hyypotensive with boluses for , she was started on dopamine. also in the ed, the patient was pan-ct scanned, and her only injury is a left femur fracture. orthopedics would like to surgically correct but want medical clearance first. her vitals upon leaving the ed were hr 76, bp 110/48, 100% saturation on ventilation. . on arrival to the micu, the patient was sedated and intubated but responsive. she was motuhing words but could not be understood secondary to the endotracheal tube. past medical history: 1. myocardial infarction 2. diabetes 3. type iii monoclonal ammopathy 4. hypertension 5. congestive heart failure (ejection fraction 20%) 6. ventricular tachycardia status post icd past surgical history: -4 vessel coronary artery bypass graft, ptca social history: occupation: retired drugs: tobacco: remote, quit 15 yrs ago alcohol: denies patient is single without children. she lives alone. family history: no hx of heart disease physical exam: admission- general: alert, responsive to commands, intubated heent: sclera anicteric, eomi, perrl neck: supple, jvp not apprehended secondary to c-spine collar cv: s1, s2, 2/6 systolic murmur lungs: crackles at bases of lungs bilaterally abdomen: soft, non-tender, non-distended, bowel sounds present gu: foley in place, patient producing urine ext: cool, pulses dopplerable but not palpable on feet, no pitting edema neuro: cniii-xii intact, moving all four extremities. discharge- vitals - tm/tc: 98.1/97.4 hr:74-78 bp: 102-109/51-78 rr:18-24 02 sat: 100% ra in/out: last 24h: last 8h: 300/250 weight: 50.2(54.2) . tele: sr, no vea . fs: 199/88 . general: 77 yo f, sitting in bed, breathing comfortably heent: mucous membs moist, no lymphadenopathy, jvd at 10 chest: crackles 1/2 up on left, basilar on right cv: s1 s2, no s3, rrr, abd: soft, non-tender, non-distended, bs normoactive. ext: wwp, no edema. dps, pts 1+ neuro: 4/5 strength in u/l extremities. skin: left thigh lateral staple site with no drainage, erythema and mild ttp. psych: a/o, aware of diagnosis and discussing possible rehabs. pertinent results: 08:05pm blood wbc-7.4 rbc-3.76* hgb-11.9* hct-38.5 mcv-103* mch-31.6 mchc-30.9* rdw-13.1 plt ct-306 08:05pm blood neuts-61.0 lymphs-31.9 monos-5.8 eos-0.6 baso-0.6 08:05pm blood pt-10.3 ptt-31.2 inr(pt)-0.9 08:05pm blood glucose-182* urean-20 creat-0.7 na-133 k-4.9 cl-99 hco3-26 angap-13 08:05pm blood calcium-7.9* phos-4.5 mg-2.1 11:00pm blood type-art rates-14/4 tidal v-400 peep-10 fio2-60 po2-125* pco2-50* ph-7.30* caltco2-26 base xs--1 -assist/con intubat-intubated 08:14pm blood lactate-1.9 . cxr :single supine portable view of the chest was obtained. the endotracheal tube terminates approximately 3 cm above the level of the carina. nasogastric tube is seen coursing below the level of the diaphragm, with the side port at the ge junction and distal tip likely terminating within the stomach, suggest advancement so that the side port is well within the stomach. extensive bilateral perihilar opacities likely relate to edema, although underlying consolidation may also be present. no large pleural effusion or pneumothorax is seen. the patient is status post median sternotomy and cabg. left-sided aicd is stable in position. . ct spine : 1. no fracture or subluxation. 2. bilateral lung apices opacifications better evaluated on the concurrent ct of the chest. . ct head : 1. no acute intracranial process. 2. chronic right parietal infarct. 3. moderate-to-severe small vessel disease and atherosclerotic calcifications of the carotid arteries . ct a/p : 1. acute left intertrochanteric femoral fracture with adjacent hematoma 2. diffuse ground-glass opacities in both lungs consistent with pulmonary edema and bilateral posterior lung opacifications likely representing atelectatic changes, less likely aspiration or contusion. 3. no acute vascular or visceral injury. no evidence of aortic injury and no pulmonary embolism. 4. left lateral 7th rib fracture seen on radiograph from this same date () is not visualized on ct, however this might be related to technical reasons . hip xr : impression: left intertrochanteric fracture. . echo : the left atrium and right atrium are normal in cavity size. the estimated right atrial pressure is 5-10 mmhg. left ventricular wall thicknesses and cavity size are normal. there is mild to moderate regional left ventricular systolic dysfunction with hypokinesis of the sepum, inferior, and inferolateral walls. the remaining segments contract normally (lvef = 40 %). the estimated cardiac index is normal (>=2.5l/min/m2). tissue doppler imaging suggests an increased left ventricular filling pressure (pcwp>18mmhg). right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. trace aortic regurgitation is seen. the mitral valve leaflets are structurally normal. there is no mitral valve prolapse. mild (1+) mitral regurgitation is seen. there is mild pulmonary artery systolic hypertension. there is moderate pulmonary artery systolic hypertension. there is no pericardial effusion. . impression: suboptimal image quality. normal left ventricular cavity size with regional systolic dysfunction suggestive of multivessel cad (lad and pda distribution). mild mitral regurgitation. pulmonary artery hypertension. incresaed pcwp. compared with the report of the prior study (images unavailable for review) of , left ventricular systolic function is now improved and the estimated pa systolic pressure is now lower. brief hospital course: 76 yo woman with h/o dm1, cad, chf admitted for left hip fracture and acute congestive heart failure requiring intubation. . # ischemic cardiomyopathy: acute on chronic systolic and diastolic heart failure. -patient was diuresed, and her symptoms improved. she briefly required intubation. the patient spent time on several services while in-house, and at one point there was concern for an acute st elevation on ekgs, so she was taken to the cardiac cath lab. at that time, chronic total occlusion of her lad was diagnosed, and no intervention was performed. the patient will need her heart failure regimen titrated while at rehab, including ace-i, beta-blocker and diuretics. she needs additional diuresis acutely, which should be performed at rehab. additionally, given her chronic angina and cad, she may benefit from renexa as an outpatient, and her imdur should be increased as tolerated. . # femur fx-s/p internal fixation: -occured in setting of mechanical fall. the patient underwent uncomplicated repair with placement of nail by orthopaedics. due to intra-operative blood loss, she required transfusion of blood products. she was discharged to an acute rehab facility for additional physical therapy. . # hyponatremia: -most likely secondary to pain induced siadh, coupled with hypervolemic hyponatremia. this improved with pain medication and diuresis. in the future, she may benefit from a vaptan . # type i dm: -her insulin regimen was titrated in house based on finger sticks and changing po intake. . ====== transitional issues: -renexa should be considered as anti-anginal -titrate ace-i, beta-blocker, and diuretic (torsemide) -restart aldactone as tolerated -dry weight is 108 pounds, weight at discharge is 112 pounds. medications on admission: home medications: confirmed with pharmacy asa 325mg daily plavix 75mg daily metoprolol 100mg daily lisinopril 10mg daily imdur 30mg daily aldactone 25mg daily furosemide 40mg daily atorvastatin 40mg daily ntg prn insulin actonel 35mg weekly ca/d b12 er 1000mcg daily ferrous sulfate silver sulfadiazine cream 1% x 14 days (finished discharge medications: 1. torsemide 20 mg tablet sig: four (4) tablet po daily (daily): hold sbp < 90. 2. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 3. atorvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 4. nitroglycerin 0.3 mg tablet, sublingual sig: one (1) tablet, sublingual sublingual asdir (as directed) as needed for chest pain. 5. acetaminophen 500 mg tablet sig: two (2) tablet po tid (3 times a day). 6. oxycodone 5 mg tablet sig: 0.5-1 tablet po every four (4) hours as needed for pain . 7. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 8. ferrous sulfate 300 mg (60 mg iron) tablet sig: one (1) tablet po daily (daily). 9. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day): hold for diarrhea. 10. bisacodyl 10 mg suppository sig: one (1) suppository rectal daily (daily) as needed for constipation. 11. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). 12. enoxaparin 40 mg/0.4 ml syringe sig: one (1) injection subcutaneous daily (daily) for 3 weeks. 13. metoprolol succinate 25 mg tablet extended release 24 hr sig: one (1) tablet extended release 24 hr po once a day. 14. isosorbide mononitrate 30 mg tablet extended release 24 hr sig: 0.5 tablet extended release 24 hr po daily (daily). 15. insulin glargine 100 unit/ml solution sig: seven (7) units subcutaneous at bedtime. 16. lisinopril 2.5 mg tablet sig: one (1) tablet po once a day: hold sbp <100. 17. spironolactone 25 mg tablet sig: 0.5 tablet po once a day: hols sbp < 90. 18. actonel 35 mg tablet sig: one (1) tablet po once a week. 19. vitamin b-12 1,000 mcg tablet extended release sig: one (1) tablet extended release po once a day. 20. calcium 600 + d(3) 600 mg(1,500mg) -400 unit tablet sig: one (1) tablet po twice a day. 21. furosemide 10 mg/ml syringe sig: sixty (60) mg injection once a day as needed for for sob or weight gaiin more than 2 pounds in 1 day. discharge disposition: extended care facility: - discharge diagnosis: left femoral neck fracture acute on chronic systolic congestive heart failure st elevation myocardial infarction anemia hyponatremia diabetes mellitus type 1 discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: out of bed with assistance to chair or wheelchair. discharge instructions: you had a left hip fracture and needed an operation to fix the fracture. after the operation, you had a small heart attack and an emergency cardiac catheterization showed that you had a lot of old blockages in your heart arteries but we were unable to open them. we have adjusted your medicines to help to prevent your angina episodes. it is very important that you stay at your dry weight of 112 pounds. weigh yourself every morning, call dr. if weight goes up more than 3 lbs in 1 day or 5 pounds in 3 days. . we made the following changes to your medicines: 1. start tylenol and oxycodone as needed for hip pain 2. start colace, senna and dulcolox suppository as needed for constipation 3. start lovenox for 4 weeks to prevent a blood clot. 4. decrease metoprolol to 25 mg daily as your blood pressure is low 5. decrease imdur to 15 mg daily, this may be increased if you have chest pain 6. decrease insulin to 7units daily at bedtime 7. decrease lisinopril to 2.5 mg daily as your blood pressure is low 8. decrease aldactone to 12.5mg daily until your blood pressure is better. followup instructions: name: , w. location: medical care ctr address: , , phone: please discuss with the staff at the facility a follow up appointment with your pcp when you are ready for discharge. department: cardiac services when: wednesday at 10:30 am with: , np building: campus: east best parking: garage department: orthopedics when: thursday at 10:40 am with: , np building: campus: east best parking: garage procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours coronary arteriography using two catheters left heart cardiac catheterization insertion of endotracheal tube insertion of other (naso-)gastric tube closed reduction of fracture with internal fixation, femur excision of lingual thyroid percutaneous transluminal coronary angioplasty [ptca] procedure on single vessel central venous catheter placement with guidance diagnoses: other iatrogenic hypotension thrombocytopenia, unspecified coronary atherosclerosis of native coronary artery congestive heart failure, unspecified unspecified essential hypertension coronary atherosclerosis of autologous vein bypass graft cardiac complications, not elsewhere classified other opiates and related narcotics causing adverse effects in therapeutic use other specified forms of chronic ischemic heart disease constipation, unspecified acute respiratory failure other and unspecified angina pectoris long-term (current) use of insulin accidental fall on or from other stairs or steps osteoporosis, unspecified iron deficiency anemia, unspecified automatic implantable cardiac defibrillator in situ surgical operation with implant of artificial internal device causing abnormal patient reaction, or later complication,without mention of misadventure at time of operation acute myocardial infarction of unspecified site, initial episode of care other disorders of neurohypophysis chronic total occlusion of coronary artery leukocytopenia, unspecified acute on chronic combined systolic and diastolic heart failure closed fracture of intertrochanteric section of neck of femur benzodiazepine-based tranquilizers causing adverse effects in therapeutic use coronary vasodilators causing adverse effects in therapeutic use diabetes mellitus without mention of complication, type i [juvenile type], uncontrolled monoclonal paraproteinemia 

Answer: The patient is high likely exposed to