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: morphine / betadine / iodine / demerol / lisinopril attending: chief complaint: dyspnea major surgical or invasive procedure: bronchoscopy history of present illness: this is a 55 year old caucasian female with a pmh significant for tracheo-bronchomalacia, paradoxical vocal cord dysfunction, gerd, osa, who presents with dyspnea. . reports that she was in her usual state of good health until , when she developed acute angioedema and anaphylaxis that was thought to be secondary to lisinopril. due to persistence of dyspnea, however, further workup by ip demonstrated tracheo-bronchomalacia. patient received a y stent and has had limited improvement from bronchodilators and steroids. has had multiple hospital and icu admissions (one intubation) during this past year, with prior bronchoscopy also demonstrating paradoxical vocal cord movement. she has been treated with maximal ppi therapy as well. . patient was admitted to the hospital approximately 3 weeks ago with dyspnea. at that time, she had developed a persistent non-productive cough. denies any sputum production. no fever, chills, nausea, vomiting, or diarrhea. or pleuritic chest pain. during her hospitalization, she was evaluated by ent and found no further evidence of paroxysmal vocal cord movements. ip performed a flexible bronchoscopy on which demonstrated severe granulation tissue at the right distal end of the y-stent. y stent was removed by rigid bronchoscopy, as it was of little benefit and could have been making her symptoms worse. she felt better after discharge only for a few days. . today, patient felt faint while walking, shortness of breath, and with the development of stridor. she was able to walk to ed (where she works). in the hospital ed, was given racemic epi, nebulizers, ativan, iv 125 solumedrol. patient was medlighted to for further management, and stridor resolved en route. was speaking full sentences with no stridor upon arrival to . initial vital signs were: hr 72, bp 124/80 rr 16, 93% 3l nc. here, was given ativan 1mg iv x 1. cxr was without acute process. ip was consulted and recommended icu admission for close airway monitoring and speech and swallow evaluation. . on arrival to the medical floor, patient reports that her breathing is back at baseline. . review of systems: (+) per hpi (-) denies fever, chills, night sweats, recent weight loss or gain. denies headache, sinus tenderness, rhinorrhea or congestion. denies chest pain, chest pressure, palpitations, or weakness. denies nausea, vomiting, diarrhea, constipation, abdominal pain, or changes in bowel habits. denies dysuria, frequency, or urgency. denies arthralgias or myalgias. denies rashes or skin changes. past medical history: 1. tracheobronchomalacia s/p 2 stents,most recent placed 2. hypertension 3. hyperlipidemia 4. numerous right hand surgeries s/p r hand trauma 5. s/p cholecystectomy 6. s/p appendectomy 7. s/p tonsillectomy 8. back surgery (unclear procedure) 9. hyperglycemia in setting of steroids 10. osa, on home bipap 11. obesity social history: lives with mother, father, and brother in . works as patient coordinator at hospital and has strong support network at work. - tobacco: denies any history. - alcohol: denies. - illicits: denies. family history: mother and father with htn, mother with . h/o lung diseases physical exam: vitals: t: 98 bp: 101/69 p: 72 r: 16 o2: 93% 3l nc general: alert, oriented, nad heent: sclera anicteric, dry mucous membranes, oropharynx clear neck: supple, jvp not elevated, no lad lungs: intermittent inspiratory stridor heard across neck. bibasilar crackles but good air movement. no wheezes or rhonchi. cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly gu: no foley ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema neuro: aox3, 5/5 strength in all 4 ext psych: stable mood, saddened affect skin: no rashes pertinent results: on admission: 06:35pm blood wbc-4.8# rbc-3.90* hgb-12.0 hct-36.1 mcv-93 mch-30.8 mchc-33.3 rdw-14.3 plt ct-179 06:35pm blood neuts-74.8* lymphs-20.3 monos-1.9* eos-2.7 baso-0.3 06:35pm blood plt ct-179 06:35pm blood glucose-125* urean-12 creat-0.9 na-138 k-4.3 cl-100 hco3-27 angap-15 03:48am blood calcium-9.4 phos-4.2 mg-2.1 . on discharge: 06:48am blood wbc-4.8 rbc-4.12* hgb-12.8 hct-37.9 mcv-92 mch-31.0 mchc-33.8 rdw-14.2 plt ct-196 06:45am blood neuts-56.7 lymphs-36.1 monos-5.4 eos-1.5 baso-0.3 06:48am blood plt ct-196 06:48am blood glucose-115* urean-14 creat-0.8 na-141 k-3.8 cl-105 hco3-25 angap-15 06:35pm blood ck(cpk)-77 06:48am blood calcium-9.5 phos-4.4 mg-2.0 . brief hospital course: pt is a 55 year old caucasian female with a pmh significant for tracheo-bronchomalacia, paradoxical vocal cord dysfunction, gerd, osa, who presented with dyspnea. she was admitted to the micu on and transferred to the general medicine service on . her brief hospital course was notable for: . micu course: . # dyspnea/stridor: unclear precipitant, but patient with known tracheo-bronchomalacia s/p recent removal of y stent and paradoxical vocal cord dysfunction. stridor suggests focal vocal cord issue. the patient also has a great deal of anxiety at baseline that likely exacerbated her symptoms. the patient's symptoms improved after nebulizers, steroids, recemic epinephrine and benzodiazepines. the patient was placed on standing nebulizers, benzonatate and guafenesin and her steroids were discontinued. she was continued on her home maximal ppi therapy of fexofenadine, omeprazole and zantac. by hospital day 2, the patient's symptoms had improved to the point where she was stable for transfer to the floor. unlikely to benefit significantly from steroids. symptoms improved s/p nebulizers, steroids, racemic epi, and benzos. be further exacerbated by underlying gerd, stress/anxiety, borderline pulmonary hypertension. no leukocytosis, fever, or radiographic evidence of pneumonia. now breathing comfortably on 3l on nc with good oxygen saturations. . # hypertension: given blood pressures in the 90s-100s on admission, home antihypertensive medications which may have contributed to lightheadedness were held. this included amlodipine, metoprolol, furosemide, clonidine. . # hyperlipidemia: stable, continue home simvastatin. . # osa: cpap at night. . # depression: patient reportedly with moderate difficulty in coping with prolonged course of her illness. she was continued on her home sertraline and lorazepam. . medicine wards course: . # stridor: the pt was noted to have 1-3 episodes of stridor per day, most of which resolved spontaneously. those episodes which did not resolve spontaneously, resolved after doses of guiafensein and/or ativan. the pt was seen by the ip and ent service. the ip service felt that the pt's presentation of paroxysmal stridor was not likely related to trancheobronchomalacia. she underwent bronchoscopy on and tolerated the procedure well. during the procedure the ip team noted findings consistent with paroxysmal vocal cord dysfunction. the ent team felt that her symptoms were most likely related to paroxysmal vocal cord dysfunction and that she would benefit from speech therapy and execises. at the time of discharge she was set up with an appointment to be seen at the vocal cord dysfunction clinic on thursday . . #hypotension: pt was initially hypotensive from 90s-100s while in the hospital. in this setting her home bp meds were held. she gradually became normotensive. at the time time of discharge her home doses of clonidine, lasix, and amlodipine were still stopped. she was instructed to stop these medications until being told to restart them by her pcp. was scheduled with her pcp 10 days of discharge. . all other chronic medical issues for this patient were stable and no further changes were made to her outpatient medication regimen other than those described above. she was discharged to home on in good condition with appropriate outpatient follow-up scheduled. medications on admission: 1. ipratropium bromide 0.02 % solution inh q6h 2. amlodipine 5 mg tablet po daily 3. metoprolol succinate 100 mg tablet sr 24 hr once a day 4. furosemide 20 mg tablet 0.5 tablet po daily 5. clonidine 0.2 mg tablet po bid 6. benzonatate 100 mg capsule po tid 7. fluticasone-salmeterol 500-50 mcg/dose disk inhalation 8. fexofenadine 60 mg tablet po bid 9. omeprazole 20 mg capsule, delayed release po bid 10. simvastatin 10 mg tablet po daily 11. guaifenesin 600 mg tablet sustained release po bid 12. zantac 300 mg tablet po at bedtime. 14. sertraline 50 mg tablet sig: one (1) tablet po daily (daily). 15. albuterol sulfate 2.5 mg /3 ml (0.083 %) inhalation q 8h 16. lorazepam 1 mg tablet po every four hours as needed for cough, feeling of severe shortness of breath discharge medications: 1. ipratropium bromide 0.02 % solution sig: one (1) neb inhalation every six (6) hours as needed for shortness of breath or wheezing. 2. benzonatate 100 mg capsule sig: one (1) capsule po tid (3 times a day). 3. fluticasone-salmeterol 500-50 mcg/dose disk with device sig: one (1) disk with device inhalation (2 times a day). 4. fexofenadine 60 mg tablet sig: one (1) tablet po bid (2 times a day). 5. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po bid (2 times a day). 6. simvastatin 10 mg tablet sig: one (1) tablet po daily (daily). 7. ranitidine hcl 150 mg tablet sig: two (2) tablet po hs (at bedtime). 8. sertraline 50 mg tablet sig: one (1) tablet po daily (daily). 9. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) inhalation q6h (every 6 hours). 10. lorazepam 1 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for cough, dyspnea. 11. guaifenesin 600 mg tablet sustained release sig: one (1) tablet sustained release po twice a day. 12. metoprolol succinate 100 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po once a day. discharge disposition: home discharge diagnosis: primary: paroxysmal vocal cord dysfunction secondary: tracheobronchomalacia, anxiety discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. vital signs stable, breathing comfortably on room air discharge instructions: you were admitted to the on after you experienced shortness of breath and stridor. your condition has improved and on you are being discharged to home in good condition, ambulatory, and with stable vital signs. it has been a pleasure participating in your medical care. . we have made the following changes to your home outpatient medication regimen: . stop taking furosemide 20 mg qd stop taking clonidine 0.2 mg po bid stop taking amlodipine 5 mg qd . you will likely be able to restart these medications in the near future, but should wait to restart them until you are instructed to do so by your primary care doctor. are for high blood pressure and we have held them since your blood pressure was low, and then normal while you were in the hospital. followup instructions: an appointment has been made for you to be seen in a specialty clinic for vocal cord dysfunction. your appointment is tomorrow tuesday at 9:30 am, with dr.. his office is at 1 square, at the intersection of and new streets. the office phone # is , feel free to call with any questions or concerns. . we have made an appointment to see your primary care doctor, dr. on weds at 3pm. please call his office if you cannot make this appointment or need to reschedule. procedure: fiber-optic bronchoscopy diagnoses: obstructive sleep apnea (adult)(pediatric) other and unspecified hyperlipidemia anxiety state, unspecified stridor other diseases of trachea and bronchus polyp of vocal cord or larynx shortness of breath other diseases of vocal cords abnormal innervation syndrome of eyelid 

Answer: The patient is high likely exposed to