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: s/p pea arrest major surgical or invasive procedure: intubation central line placement nasogastric tube placement history of present illness: 57 yo f w/ h/o bipolar d/o, esrd on hd (initiated 2mos ago), initially admitted to medicine on for manic behavior, recently transferred to psych on 4 yesterday, who is transferred now to micu after pea arrest while undergoing hd this afternoon. . per report, while patient was undergoing hd this afternoon she became hypoxic, then apneic. at approximately 11:20am, patient went into pea arrest with a narrow complex rhythm. cpr was initiated and code blue called. patient intubated at approx 11:23am. given 1mg epi at 11:25am, then 1mg atropine at 11:30am. at approx 11:35am, patient regained a pulse (@ 170) and blood pressure (sbp 170). patient transferred to the micu for further management. . on arrival to micu, patient hypotensive w/ sbp's 70-80's. patient bolused total 2l ns. cvp 12-14. k low at 2.5, given 40meq kcl. hct down 24.2 --> 21.1. 1u prbc's ordered. cxr showed ett at carina, pulled back 2cm. cxr also w/ bilateral opacities concerning for aspiration. cultures drawn, and patient started on vanco and zosyn. . patient's pcp present and informed micu team of dnr/dni status. this dnr/dni status is documented in omr from the 2 most recent d/c summaries dated , and . patient's pcp confirms this status. also documented in most recent progress notes in chart. . i have contact patient's mother, and 2 sisters and ). there is no formal hcp identified. and were unaware of sister's wishes to be dnr/dni. they were initially uncomfortable with that status and wished for her to be full code. after discussion with the pcp, family felt more comfortable and agreed that they would like to uphold the patient's stated wishes that she would like to be dnr/dni. past medical history: # esrd on hd - started in , mwf, ckd felt to be d/t lithium toxicity; revision surgeries to avf ( most recent) # osteoarthritis/djd # bipolar disorder # h/o pancreatitis # pancreatic divisim # hypertension # h/o nephrogenic diabetes insipidus secondary to lithium # obesity # chronic cough # asthma - pft's : fev1 1.33(63%); fvc 1.70(60%); fev1/fvc 78(106%) . psych history: (per prior notes). no hospitalizations since >20 years. previously multiple hospitalizations for what seem to be manic episodes with psychotic features. was stable on lithium for several years, has also been treated with risperdal. (but pt. has been resistant and often non-compliant to increased doses of risperdal, goal had been 2-4mg po bid). h/o cutting wrist in late 60's, but no suicidality or dangerousness otherwise known. psychiatrist, dr. (mmhc): social history: lives in alone, consultant, no tob/etoh/ivdu (per prior d/c summary) family history: dm - grandmother physical exam: vs: t: 96.2; hr: 90; bp: 118/64 (on 0.1 levophed); rr 16; o2 97% ac: 500x16/5/0.6 abg: 7.38/50/190 (on fio2 100%) cvp = gen: middle age woman, lying in bed, intubated heent: pinpoint pupils bilaterally, minimally responsive, anicteric, mmm, op clear, ett in place neck: jvp difficult to assess given habitus cv: rrr, normal s1s2, no murmurs, no s3/s4 chest: cta bilat anteriorly. no crackles/wheezes. abd: nabs, soft, nd, nt, no masses ext: no edema neuro: intubated, not following commands, not responsive to noxious stimuli pertinent results: 07:50am wbc-8.5 rbc-2.37* hgb-7.8* hct-24.9* mcv-105* mch-32.9* mchc-31.3 rdw-17.1* 07:50am plt count-218 07:50am glucose-93 urea n-36* creat-5.5* sodium-129* potassium-3.8 chloride-95* total co2-22 anion gap-16 07:50am calcium-10.0 phosphate-5.8* magnesium-1.9 11:30am pt-12.3 ptt-32.5 inr(pt)-1.1 . ekg: nsr @ 93; normal axis/intervals; qtc 470; biphasic pw v1; qw iii (unchanged from prior) . cxr: ett just above carina; bilateral opacities at bases . brief hospital course: . #) pea arrest/hypotension: unclear etiology for pea during dialysis. reports of hypoxia and apnea suggest this as etiology. unclear reason for apnea, possibly to osa, seizure or aspiration event. hct down to 21 which suggest hypovolemia blood loss anemia as possibility, but no obvious sources on exam. lytes relatively normal w/ exception of k which was repleted. cardiogenic shock unlikely given unchanged ekg. s/p 2l ns and now giving 1u prbcs. pe also possible, although less likley. cxr w/o evidence of pneumothorax, but evidence of bilateral opacities suggesting aspiration event. hypotension likely cardiac depression s/p arrest. echo s/p event w/ normal lv/rv dysfxn. head ct neg for ich. s/p 2u prbcs for low hct. cta neg for pe. levophed weaned off. guaiac negative. hematocrit and bp remained stable for the remainder of her stay. . # pneumonia: she was treated with 8 days of zosyn and vancomycin for suspected aspiration pneumonia. she remain afebrile with flat wbc and stable respiratory status. . # mental status: patient's mental had not improved several days after the event. she inconsistently followed commands. neurology was consulted to comment on prognosis. mri showed no structural abnormalities. eeg showed diffuse slowing suggesting mild encephalopathy and l temporal subcortical and cortical dysfunction. the prognosis is unclear as no data is available to guide determination of prognosis in patient with intact brainstem function. repeat eeg again showed encephalopathy but no seizure activity. her encephalopathy was felt to be most likely hypoxic encephalopathy with contribution from metabolic abnormalities. her hypercalcemia was thought to possibly be contributing to her mental status, so she was started on cinacalcet for secondary hyperparathyroidism. she continued to have electrolyte management by hemodialysis. she will follow up with dr. of neurology. . #) esrd on hd: patient was started on hd approximately 2 mos ago for renal failure secondary to lithium, with some possible contribution of hypertensive nephropathy. she was followed by nephrology. she was maintained on hemodialysis on a mwf schedule. she has a l tunnelled hd catheter. . #) bipolar disorder: her psychiatric medications were held in the setting of her neurologic dysfunction. psychiatry was consulted and agreed with this management. her future requirements for psychiatric medications are unclear at this time. she will likely need periodic reassessment by neurology and possibly psychiatry. . #) anemia: likely predominantly secondary to renal failure. she received 2u prbc in the period immediately following her cardiac arrest. she was guaiac negative and had no signs of hemolysis. she received epo with dialysis. her hematocrit was subsequently stable. . #) asthma/copd: continued on flovent and atrovent mdi. . #) fen: started on tube feeds via ng tube. the family declined peg tube as they and the team felt it would not be consistent with the patient's wishes. the family requested that the ng tube be maintained for now. . #) code status: extensive family meetings were held with the team, pcp, the family regarding the goals of care. the team and family agreed to make the patient dnr/dni after extubation. tracheostomy and peg tube was also felt to be inconsistent with the patient's wishes. given her unclear neurologic prognosis, the family requested to continue ng tube with tube feeding and hemodialysis for now, but to maintain dnr/dni. . medications on admission: meds on transfer: nephrocaps po daily metoprolol 25 mg po bid albuterol nebs inh q6h heparin 5,000u sc tid pantoprazole 40 mg po q24h fluticasone-salmeterol 250-50 mcg/dose docusate 50 mg/5 ml po bid bisacodyl 10 mg po daily prn acetaminophen 325 mg po q4-6h as needed sevelamer 800 mg 1.5 tablets po tid epoetin alfa 10,000 unit/ml at hd haloperidol 5 mg po q4-6h as needed for agitation. lorazepam 1 mg po q4-6h as needed. discharge medications: 1. docusate sodium 50 mg/5 ml liquid : fifty (50) mg po bid (2 times a day). 2. heparin (porcine) 5,000 unit/ml solution : 5000 (5000) mg injection tid (3 times a day). 3. bisacodyl 5 mg tablet, delayed release (e.c.) : one (1) tablet, delayed release (e.c.) po daily (daily) as needed. 4. epoetin alfa 10,000 unit/ml solution : as dir u injection asdir (as directed): defer to dialysis unit. . 5. fluticasone 110 mcg/actuation aerosol : two (2) puff inhalation (2 times a day). 6. sevelamer 800 mg tablet : two (2) tablet po tid (3 times a day). 7. lanthanum 500 mg tablet, chewable : two (2) tablet, chewable po tid (3 times a day). 8. b complex-vitamin c-folic acid 1 mg capsule : one (1) cap po daily (daily). 9. metoprolol tartrate 25 mg tablet : one (1) tablet po bid (2 times a day). 10. lansoprazole 30 mg tablet,rapid dissolve, dr : one (1) tablet,rapid dissolve, dr daily (daily). 11. cinacalcet 30 mg tablet : one (1) tablet po daily (daily). 12. ipratropium bromide 0.02 % solution : one (1) neb inhalation q6h (every 6 hours) as needed for shortness of breath or wheezing. 13. outpatient lab work please check chem 10 on and give results to dr. at (. discharge disposition: extended care facility: - discharge diagnosis: s/p pea arrest hypoxic encephalopathy secondary hyperparathyroidism discharge condition: good, respiratory status stable discharge instructions: please administer all medications as prescribed. . please transport patient to all follow up appointments. . patient is on a mwf dialysis schedule. followup instructions: 1) neurology: , md, phd; ; at 1:00pm. . 2) please call pcp, . (, to schedule a follow up appointment. procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more enteral infusion of concentrated nutritional substances hemodialysis transfusion of packed cells diagnoses: other iatrogenic hypotension anemia in chronic kidney disease end stage renal disease asthma, unspecified type, unspecified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease acute respiratory failure pneumonitis due to inhalation of food or vomitus anoxic brain damage secondary hyperparathyroidism (of renal origin) nephrogenic diabetes insipidus bipolar i disorder, most recent episode (or current) manic, unspecified 

Answer: The patient is high likely exposed to