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: lisinopril / sulfamethoxazole/trimethoprim / atorvastatin / compazine / amitriptyline / lactose / tetanus / pneumococcal vaccine / nitroglycerin attending: chief complaint: abdominal pain major surgical or invasive procedure: none history of present illness: 67 yo woman with cad, obesity, hypertension, copd, chronic pain syndrome, chronic pancreatitis, here with abdominal pain x 5 days, radiating to back with associated nausea, without vomiting. this is similar to her episodes of prior pancreatitis. she tried to eat a bland diet, and took extra oxycodone and tramadol, but she continued to have pain and presented to the ed. this pain is gnawing, in her epigastrium, and radiating toward her back. it is different from her pain from reflux and her chronic chest pain. she has had increased soft stools, that are lighter in color. no diarrhea. no blood in her stool. she has had no fevers, no chills. she has had a headache and dizziness for the past week. she has lost 5 lbs since last discharged 10 days ago. she had chronic shortness of breath, and chronic chest pain. chronic difficulty initiating a urinary stream. no rashes. otherwise, reviewed in 13 systems and negative. in the er, she had stable vital signs and pain with palpation of her epigastrium. she received morphine 8 mg, zofran, and 1 l iv fluids. labs were essentially unremarkable. ekg was unchanged. cxr was done prior to departure. past medical history: hypertension hyperlipidemia diabetes mellitus, type ii, now on metformin coronary artery disease s/p des to the rca, with chronic atypical chest pain chronic diastolic chf pulmonary hypertension (pa systolic 54 in ) history of tobacco abuse copd and asthma chronic pain/fibromyalgia chronic pancreatitis, with pancreatic cystic lesion. gerd stroke in with trace residual weakness of right arm and face obesity social history: lives at home alone and gets out very rarely. the patient has a 43 pack-year tobacco history. she quit smoking in . she consumed alcohol in the past but quit 25 yrs ago; no history of illicit drugs or ivdu. she has not worked since . she is on disability. she has two daughters who are her hcps: and . family history: extensive history of mis (ages 58-60) in siblings and mother. throughout. sister with chf. another sister with pulmonary fibrosis. physical exam: exam vs t current 97 bp 141/83 hr 65 rr 18 93% 2l o2sat gen: in nad. heent: perrl, eomi. no scleral icterus. no conjunctival injection. mucous membranes moist. no oral ulcers. neck: supple, no lad, no obvious jvp elevation. lungs: bilateral scant wheezes, with decreased breath sounds, prolonged exp phase. normal respiratory effort, breathing comfortably cv: rrr, no murmurs, rubs, gallops. abdomen: soft, +bs. tender in epigastrium to deep palpation, mild tenderness in ruq. extremities: warm and well perfused, no cyanosis, clubbing, edema. neurological: alert and oriented x 3, cn ii-xii intact. no pronator drift. fast finger movements intact. full strength in feet. skin: no rashes or ulcers. psychiatric: appropriate. gu: deferred. pertinent results: admission labs: - 10:05am glucose-140* urea n-15 creat-0.8 sodium-136 potassium-6.2* (repeat 3.8) chloride-95* total co2-32 anion gap-15 alt(sgpt)-17 ast(sgot)-59* alk phos-60 tot bili-0.4 lipase-38 ctropnt-<0.01 - 10:05am wbc-5.6 (neuts-60.8 lymphs-31.7 monos-4.4 eos-2.3 basos-0.8) rbc-3.77* hgb-11.0* hct-32.8* mcv-87 mch-29.1 mchc-33.5 rdw-14.4 plt count-176 - 10:50am urine blood-neg nitrite-neg protein-25 glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-7.0 leuk-neg color-yellow appear-clear sp -1.021 rbc-0 wbc-0 bacteria-occ yeast-none epi-0-2 prior to discharge: 07:40am blood wbc-8.2 rbc-3.40* hgb-9.7* hct-28.9* mcv-85 mch-28.6 mchc-33.7 rdw-14.8 plt ct-236 07:17am blood neuts-85.5* lymphs-7.7* monos-6.6 eos-0.1 baso-0.1 07:40am blood glucose-93 urean-31* creat-2.7* na-140 k-3.5 cl-111* hco3-20* angap-13 12:51pm blood ld(ldh)-598* ck(cpk)-376* totbili-0.3 07:40am blood calcium-9.1 phos-2.8 mg-1.9 12:51pm blood caltibc-295 vitb12-1364* folate-11.0 hapto-269* ferritn-112 trf-227 12:51pm blood tsh-0.24* 10:18pm blood type-art po2-58* pco2-41 ph-7.33* caltco2-23 base xs--4 upep: multiple protein bands seen, with albumin predominating based on ife (see separate report), no monoclonal immunoglobulin seen negative for bence- protein interpreted by , md, phd spep: no specific abnormalities seen interpreted by , md, phd cxr : chest, pa and lateral: the lungs are clear, other than mild lingular and retrocardiac atelectasis. a small left pleural effusion persists. the heart is normal in size. the aorta is mildly tortuous. there is no pneumothorax, pneumomediastinum, or pneumoperitoneum. mild degenerative changes are noted in the thoracic spine. impression: no acute cardiopulmonary process. renal ultrasound, bladder ultrasound with post void residual: impression: no evidence of hydronephrosis, stone, or mass. echogenic appearance to the kidneys are suggestive of parenchymal renal disease. brief hospital course: this is a 67 year old woman with a history of hypertension, diastolic heart failure, severe copd on 3 l home oxygen, pulmonary hypertension, cad with stent to rca in and frequent readmissions for chronic "idiopathic pancreatitis" who presented with typical abdominal pain flare. this improved with bowel rest, narcotics, and anti-emetics. after several days of hospitalization, she developed acute fever, delirium and . all cns medications were stopped including antihistamines, ultram, and morphine and her delirium resolved. her fever also resolved after 5 days of empiric ciprofloxacin for abnormal ua but negative urine cultures. the etiology of was unknown (normal bun and creatinine increased from 1 to 4.6) but we held diuretics and gave lots of iv fluids despite history of chf. kidney function did not recover despite iv fluids, and she developed wheezing, respiratory distress, and cxr showed increased pulmonary edema. she received lasix 80 iv, bipap, and 24 hour admission to the micu. her respiratory distress resolved and did not require further lasix treatment. however, the etiology of remains unclear. she had no hydronephrosis on ultrasound and her post void residual was minimal on 2 occasions. she did not receive contrast or nephrotoxins. fena indicated intrinsic renal problem. nephrology was hesitant regarding renal biopsy because of obesity. her creatinine did improve from 4 to 2.7 and upon discharge the patient reached a plateau. - creatinine improved but has plateu'd at 2.7. her electrolytes are stable. it is very unclear what her is secondary to, and renal is concerned about an obstructive process, despite a renal u/s being negative (including post void residual via formal bladder ultrasound study) and bladder scan being normal, as her cr mainly improved when a foley was in place the week prior. we placed a foley put in again as a trial, however, it was removed per the patients wishes. she was set up with early follow up with both renal (dr. and urology (dr. within 1 week of discharge. pulmonary edema - resolved with diuresis and improving renal function. she was continued on a beta-blocker and nitrate. the dose of her nitrate was increased for optimal blood pressure control, as the lasix was discontinued in the setting of . chronic pain/pancreatitis - she was on tramadol, oxycodone, cymbalta at home. due to delirium earlier in the course, all meds were discontinued, with improvement in her mental status. due to persistent pain, she was restarted on a low-dose which she patient tolerated. this was discussed with her pcp, . . the plan is to continue the low-dose oxycodone, without any scripts upon discharge. she will discuss her pain regimen in more detail with dr. . she will follow-up with her gastroenterologist, dr. after discharge. she needs an mri with secretin 4 weeks after her symptoms resolve to evaluate a pancreatic head mass. cad s/p pci - o active issues. on asa, bb, nitrate, statin. no ace-i currently in the setting of . copd - on home 2 l, nebs prn. stable. hematuria - 2 episodes the week prior to discharge of gross hematuria withoit change in renal function. her sediment was reviewed by renal and was unremarkable. the hematuria resolved. she will needs outpatient evaluation and f/u with pcp and urology. hematoma - she developed rlq hematoma heparin sc. stable site, hct stable. monitoring, hep sc d/c'd. dm, type ii - she had just been started on metformin as an outpatient, but this was discontinued in the setting of . due to her renal failure, she was started on 10 units of lantus with optimal control of blood glucose. she was discharged on 10 units of lantus, as oral medications are currently not recommended in the setting of her acute kidney injury. medications on admission: confirmed with patient on admission. fluticasone-salmeterol 250-50 isosorbide mononitrate 60 mg daily lipase-protease-amylase 1 pill pantoprazole 40 mg daily (due to insurance restrictions) ranitidine 150 mg daily tramadol 50 mg tid sucralfate 1 gram aspirin 81 mg daily calcium carbonate 500 mg cholecalciferol 400 unit daily oxycodone 5 mg 2 tabs q6hrs prn ipratropium nebs prn albuterol nebs prn furosemide 40 mg carvedilol 50 mg olmesartan 40 mg daily rosuvastatin 40 mg daily duloxetine 60 mg daily trazodone 100 mg qhs prn insomnia discharge medications: 1. carvedilol 25 mg tablet sig: two (2) tablet po twice a day. 2. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 3. rosuvastatin 40 mg tablet sig: one (1) tablet po once a day. 4. fluticasone-salmeterol 250-50 mcg/dose disk with device sig: one (1) disk with device inhalation (2 times a day). 5. oxycodone 5 mg tablet sig: 0.5 tablet po bid (2 times a day) as needed for pain. 6. lipase-protease-amylase 12,000-38,000 -60,000 unit capsule, delayed release(e.c.) sig: one (1) cap po tid w/meals (3 times a day with meals). 7. calcium carbonate-vitamin d3 500 mg(1,250mg) -400 unit tablet sig: one (1) tablet po twice a day. 8. ipratropium bromide 0.02 % solution sig: one (1) neb inhalation q6h (every 6 hours). 9. albuterol sulfate 2.5 mg /3 ml (0.083 %) solution for nebulization sig: one (1) neb inhalation q4h (every 4 hours) as needed for wheezing. 10. amlodipine 5 mg tablet sig: two (2) tablet po daily (daily). disp:*60 tablet(s)* refills:*2* 11. isosorbide mononitrate 60 mg tablet sustained release 24 hr sig: 1.5 tablet sustained release 24 hrs po daily (daily). disp:*45 tablet sustained release 24 hr(s)* refills:*2* 12. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day): hold for loose stools. disp:*60 tablet(s)* refills:*2* 13. bisacodyl 10 mg suppository sig: one (1) suppository rectal hs (at bedtime) as needed for constipation. disp:*30 suppository(s)* refills:*0* 14. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day): hold for loose stools. disp:*60 capsule(s)* refills:*2* 15. insulin glargine 100 unit/ml solution sig: ten (10) subcutaneous at bedtime. disp:*qs bottle* refills:*2* 16. freestyle lancets misc sig: one (1) miscellaneous once a day: check bg in a.m. prior to breakfast daily. disp:*30 lancets* refills:*2* 17. freestyle lite meter kit sig: one (1) glucometer miscellaneous once a day. disp:*1 glucometer* refills:*2* 18. freestyle lite strips strip sig: one (1) miscellaneous once a day. disp:*30 strips* refills:*2* discharge disposition: home with service facility: discharge diagnosis: acute on chronic pancreatitis acute diastolic heart failure with pulmonary edema acute kidney injury (acute renal failure) delirium obesity severe copd pulmonary hypertension non cardiac chest pain coronary artery disease discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you were admitted with a flare of your chronic pancreatitis. this improved with bowel rest. it is important that you continue to eat a restricted diet with no lactose, fat, or fried foods until your pain has completely resolved. as we discussed, you will need to have either dr. or dr. reschedule your pancreas mri 4 weeks after your symptoms have resolved. you also had acute heart failure and you were treated with lasix. you developed acute renal failure from unclear causes and this has stabilized. you will close follow-up with the nephrologists and urologists to further monitor and evaluate your kidney function. several medications were changed while you were in the hospital, mainly due to the kidney injury & the delirium/confusion that occured. please note the following changes: 1. stop these medications: cymbalta, tramadol, clonzapam, trazadone olmesatan (benicar), lasix, metformin 2. start these medications: - lantus (insulin) 10 units at dinnertime - amlodipine 10 mg daily 3. dose changes of current medications: - increase imdur to 90 mg daily (1.5 tablets daily) - decrease oxycodone to 2.5 mg twice daily (0.5 tablet twice daily) please eigh yourself every morning, md if weight goes up more than 3 lbs. followup instructions: department: rheumatology when: friday at 11:00 am with: , md building: lm bldg () campus: west best parking: garage department: when: monday at 11:00 am with: , md building: campus: east best parking: garage department: div. of gastroenterology when: wednesday at 1:45 pm with: , md building: ra (/ complex) campus: east best parking: main garage department: west clinic when: wednesday at 3:00 pm with: , md building: de building ( complex) campus: west best parking: garage department: surgical specialties when: friday at 10:00 am with: , md building: campus: east best parking: garage procedure: venous catheterization, not elsewhere classified diagnoses: anemia, unspecified coronary atherosclerosis of native coronary artery esophageal reflux acute kidney failure with lesion of tubular necrosis urinary tract infection, site not specified congestive heart failure, unspecified toxic encephalopathy diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute on chronic diastolic heart failure other chronic pulmonary heart diseases percutaneous transluminal coronary angioplasty status hypopotassemia long-term (current) use of insulin hypoxemia obesity, unspecified chronic obstructive asthma with (acute) exacerbation gross hematuria chronic pancreatitis myalgia and myositis, unspecified acute pancreatitis hemoperitoneum (nontraumatic) chronic pain syndrome other dependence on machines, supplemental oxygen 

Answer: The patient is high likely exposed to