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: ace inhibitors / lisinopril attending: chief complaint: " total body swelling" and brbpr . time of encounter: at 7:30pm major surgical or invasive procedure: intubation. s/p extubation history of present illness: 53 yo primarily spanish speaking female with obesity hypoventilation on home cpap with multiple hospital admissions for hypercarbic respiratory failure, osa, panhypopituitarism, pulmonary htn, diastolic chf, brought in by ems to ed on as requested by daughter. the main complaints being total body swelling with concern for fluid over load and brbpr unclear amount frequency and duration. pt her self is poor historian and can not give report with regard to ros. . she was found to be in hypercarbic resp failure and was intubated for that. in the icu, she was also diuresed with iv lasix. she was started on high dose prednisone. she was eventually transitioned to cpap. past medical history: 1)obstructive sleep apnea on home cpap, 16cm h20 2)obesity hypoventilation - multiple admissions for hypercarbic respiratory failure; pft's consistent with a restrictive defect - pfts: fvc 39%, fev1 37%, fev1/fvc 96%, tlc 59%, dlco reduced 3)asd with right-left shunt (12% shunt fraction documented in nuclear study from ) 4)pulmonary artery hypertension: echo in demonstrated a tr gradient of 33mmhg ?????? followed by 5)hypertension 6)pan-hypopituitarism with partially empty sella on desmopressin, levothyroxine, prednisone ?????? followed by dr. 7)diastolic chf with dilated ra/la on previous echo 8)angioedema (unclear history, possibly related to ace-i) social history: lives with daughter and 3 grandchildren . originally from . goes to program history of tobacco use, no h/o etoh or ivdu family history: non-contributory physical exam: ros: gen: - fevers, - chills, - weight loss eyes: - photophobia, - visual changes heent: - oral/gum bleeding cardiac: - chest pain, - palpitations, - edema gi: - nausea, - vomitting, + diarhea, - abdominal pain, - constipation, - hematochezia, + pulm: - dyspnea, - cough, - hemoptysis heme: - bleeding, - lymphadenopathy gu: - dysuria, - hematuria, - incontinence skin: - rash endo: - heat/cold intolerance msk: - myalgia, - arthralgia, - back pain neuro: - numbness, - weakness, - vertigo, - headache . vs - 98.8, 90/62, 62, 16, 97%/2l general - short, obese woman, sitting in bed in no obviouse discomfort heent - perrl, eomi. strabismus lungs - good air entry, ctab heart - rrr, 3/6 sem heard across the precordium abdomen - soft, nt, obese, bs+ extremities - slightly warm with trace erythema but no evidence of open lesions; 1+ pedal edema bilaterally pertinent results: 10:25pm blood wbc-6.9# rbc-3.04* hgb-8.0* hct-28.2* mcv-93 mch-26.4* mchc-28.4* rdw-16.0* plt ct-101* 04:48am blood wbc-11.6* rbc-3.04* hgb-8.2* hct-27.4* mcv-90 mch-27.0 mchc-29.9* rdw-17.5* plt ct-173 10:25pm blood pt-15.0* ptt-32.0 inr(pt)-1.3* 10:25pm blood glucose-121* urean-26* creat-1.4* na-141 k-4.4 cl-99 hco3-37* angap-9 05:37pm blood glucose-101 urean-8 creat-1.9* na-147* k-3.5 cl-100 hco3-39* angap-12 03:46am blood ck(cpk)-42 10:25pm blood ck(cpk)-44 10:25pm blood ctropnt-0.02* 03:46am blood ck-mb-3 ctropnt-0.01 11:39pm blood type-art po2-145* pco2-91* ph-7.23* caltco2-40* base xs-6 05:42am blood type-art po2-75* pco2-71* ph-7.40 caltco2-46* base xs-14 11:39pm blood lactate-0.7 . cxr massive cardiomegaly with improving pulmonary edema . cxr little change in the congestive failure and bilateral pleural effusions, more prominent on the left. brief hospital course: patient is a 54 year old woman with history of morbid obesity, obesity hypoventilation, osa, panhypopituitarism, diastolic congestive heart failure who presented with hypercarbic respiratory failure was intubated and in the intensive care unit and transferred to the medical service on . . #hypercarbic respiratory failure: resolved; patient is chronically hypercarbic in the 60-70s due to chronic obstructive sleep apnea/obesity hypoventilation syndome. in the past no clear percipitant was found and most likely a combination of chf, poor underlying lung function and perhaps non compliance with home cpap; however, pt states that she is compliant at home. . #obesity hypoventilation/obstructive sleep apnea: chronic, causing hypercarbia. once extubated was placed on cpap nightly and 3l 02 via nc . did not keep last appointment with outpatient sleep lab. now set up for close follow up for sleep and weight management. patient needs to faithfully use her cpap at home and close f/u with sleep physicians. . #acute on chronic blood loss anemia: in the past had acute blood loss anemia from gastritis and guaiac positive emesis in the past thought to be likely likely high dose steroids given. patient was transfused 1 unit of prbc on (prior to admission), and did not require further transfusion. pt was treated with ppi, and bleeding appeared to resolve, and h/h remained stable. . # acute renal failure: patient's cr maxed at 2.3, renal failure was possibly secondary to overdiuresis and bactrim use. this improved with loosening of fluid restriction and holding of her lasix and valsartan. creatinine on discharge was 1.8. the patient was instructed to restart her lasix and valsartan on . . # acute on chronic diastolic heart failure: improved. patient needs to use cpap nightly to help prevent exacerbations. # hypernatremia: resolved with loosening of fluid restriction and discontinuation of lasix. . # wheezing, mild) albuterol . # benign hypertension: continued lopressor, clonidine. restart valsartan on . . # panhypopituitarism: thought to be secondary to "empty sella". prednisone 5mg, levoxyl, and desmopressin. . # uti: was on bactrim, changed to cipro and course finished. . # fen: cardiac diet, low sodium, repleate lytes po # code full medications on admission: 1. levothyroxine 75 mcg tablet sig: two (2) tablet po daily (daily). 2. levofloxacin 500 mg tablet sig: one (1) tablet po q24h (every 24 hours) for 5 days. disp:*5 tablet(s)* refills:*0* 3. desmopressin 0.1 mg tablet sig: one (1) tablet po daily (daily). 4. prednisone 5 mg tablet sig: one (1) tablet po daily (daily). 5. aspirin ec 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po once a day. 6. clonidine 0.1 mg tablet sig: one (1) tablet po once a day. 7. furosemide 40 mg tablet sig: one (1) tablet po daily (daily). 8. cholecalciferol (vitamin d3) 400 unit tablet sig: one (1) tablet po once a day. 9. calcium carbonate 500 mg tablet, chewable sig: one (1) tablet, chewable po three times a day. 10. miconazole nitrate 2 % powder sig: one (1) appl topical (2 times a day) as needed for apply to inner thighs. 11. valsartan 80 mg tablet sig: one (1) tablet po qpm (once a day (in the evening)). 12. valsartan 40 mg tablet sig: one (1) tablet po qam (once a day (in the morning)). 13. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). 14. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 15. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) neb inhalation every six (6) hours as needed for shortness of breath or wheezing. neb discharge medications: 1. levothyroxine 75 mcg tablet sig: one (1) tablet po daily (daily). 2. desmopressin 0.1 mg tablet sig: one (1) tablet po daily (daily). 3. prednisone 5 mg tablet sig: one (1) tablet po daily (daily). 4. aspirin ec 81 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po once a day. 5. clonidine 0.1 mg tablet sig: one (1) tablet po daily (daily). 6. calcium carbonate 500 mg tablet, chewable sig: one (1) tablet, chewable po tid (3 times a day). 7. cholecalciferol (vitamin d3) 400 unit tablet sig: one (1) tablet po daily (daily). 8. metoprolol tartrate 25 mg tablet sig: one (1) tablet po twice a day. 9. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q12h (every 12 hours). 10. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) neb inhalation q6h (every 6 hours) as needed for shortness of breath or wheezing. 11. lasix 40 mg tablet sig: one (1) tablet po once a day: restart on , do not take for 2 days after discharge. 12. valsartan 40 mg tablet sig: one (1) tablet po qam: hold for 2 days after discharge, restart on . 13. valsartan 80 mg tablet sig: one (1) tablet po qpm: restart on , do not atke for 2 days after discharge. discharge disposition: home with service facility: americare at home inc discharge diagnosis: # obesity hypoventilation syndrome # obstructive sleep apnea # acute on chronic blood loss anemia # acute renal failure # acute on chronic diastolic heart failure # hypernatremia # hypertension; benign # panhypopituitarism # urinary tract infection discharge condition: stable discharge instructions: weigh yourself every morning, md if weight > 3 lbs. adhere to 2 gm sodium diet fluid restriction: 1500 cc/day followup instructions: patient to schedule f/u with her pcp: , i. in weeks. procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours non-invasive mechanical ventilation arterial catheterization diagnoses: thrombocytopenia, unspecified obstructive sleep apnea (adult)(pediatric) urinary tract infection, site not specified congestive heart failure, unspecified acute posthemorrhagic anemia acute kidney failure, unspecified iron deficiency anemia secondary to blood loss (chronic) acute on chronic diastolic heart failure acute and chronic respiratory failure ostium secundum type atrial septal defect blood in stool primary pulmonary hypertension obesity, unspecified hyperosmolality and/or hypernatremia other dependence on machines, supplemental oxygen panhypopituitarism 

Answer: The patient is high likely exposed to