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: unresponsive major surgical or invasive procedure: : right frontal craniotomy for mass history of present illness: 55f with 2 week h/o occasionally coughing up blood who was found unresponsive by husband at their home. ems was called and she had witnessed seizure at some point during transport. had dilantin load and ct at osh. ct showed 3x4 right frontal hemorrahge and she was transferred to ed. past medical history: > year pack/year smoking history social history: 2ppd smoker, no etoh family history: non-contributory physical exam: admission physical exam: o: t:97.2 bp: 124/74 hr:81 r18 o2sats97 ra gen: lethargic, nad. heent: pupils: eoms grossly full neck: supple. extrem: warm and well-perfused. neuro: mental status: lethargic requiring much prompting to cooperate and cannot fully carry out all testing orientation: oriented to person, place(hospital), and date. language: speech fluent with good comprehension and repetition. naming intact. no dysarthria or paraphasic errors. cranial nerves: i: not tested ii: pupils equally round and reactive to light, 3to2 mm bilaterally. visual fields are full to confrontation. iii, iv, vi: extraocular movements intact bilaterally without nystagmus. v, vii: facial strength and sensation intact and symmetric. viii: hearing intact to voice. ix, x: palatal elevation symmetrical. : sternocleidomastoid and trapezius normal bilaterally. xii: tongue midline without fasciculations. motor: normal bulk and tone bilaterally. no abnormal movements, tremors. strength is unable to be fully assessed due to cooperation but is moving all 4 and antigravity though slightly weaker on left side. no pronator drift sensation: intact to light touch bilaterally. toes downgoing bilaterally exam on discharge: alert, oriented to person, place and date. perrl. face is with right facial edema secondary to incision. tongue is midline, eomi. there is trace left upper extremity weakness(5-/5). no pronator drift is apprecaited. ip muscle groups are full. wound is clean dry and intact, without erythema, or drainage. pertinent results: labs on admission: 02:49pm blood wbc-17.6* rbc-4.48 hgb-13.5 hct-39.1 mcv-87 mch-30.2 mchc-34.6 rdw-13.7 plt ct-387 02:49pm blood neuts-84.9* lymphs-11.4* monos-2.6 eos-0.4 baso-0.6 02:49pm blood pt-11.7 ptt-24.6 inr(pt)-1.0 02:49pm blood glucose-108* urean-13 creat-0.7 na-139 k-4.7 cl-105 hco3-24 angap-15 02:49pm blood calcium-9.2 phos-3.2 mg-2.5 02:39am blood phenyto-10.0 imaging: head ct : non-contrast head ct: there is a large 3.5 x 4.8 cm intra-axial right frontal lobar hemorrhage, with surrounding edema and associated mass effect. the midline shift measures approximately 7 mm. underlying masses possibly present, although this may represent bland hemorrhage. mri is recommended for further evaluation. there are no other foci of intracranial hemorrhage identified. aside from mass effect from the hematoma, the ventricles, sulci, and cisterns are unremarkable in appearance. the -white matter differentiation is otherwise preserved as well. there is no evidence for acute large vascular territory infarction. visualized bones demonstrate no abnormality. paranasal sinuses and mastoid air cells are clear. impression: large right frontal lobar hemorrhage. mri is recommended for further evaluation to exclude underlying mass lesion. mri head : findings: again identified is a large right frontal hematoma. the overall size of the hematoma appears unchanged since the prior ct scans. again identified is extensive surrounding edema with local mass effect and mild right to left midline shift. there are numerous other areas of deep white matter hyperintensity in a predominantly periventricular pattern. although this could be a consequence of chronic small vessel ischemia, the possibility of demyelinating disease should be considered. after contrast administration, there is a thin rim of enhancement surrounding the hematoma. in addition, at least one small vessel is detected coursing through the center of the hematoma. these findings raise the possibility of an underlying vascular malformation as the etiology of the hemorrhage. enhancement of the periphery of the hematoma may arise after several days is a consequence of hemorrhage alone. thus, the significance of the enhancement and edema depend on the time elapsed between the hemorrhage and these images. early appearance of enhancement and edema implies an underlying lesion that could produce both, such as a neoplasm. after several days, the combination of enhancement and edema may represent reaction to the hematoma itself, and are thus of little diagnostic significance. there are no prominent feeding vessels or draining veins, thus a ct angiogram is unlikely to be helpful. if it is necessary to pursue the possibility of a vascular malformation, a catheter arteriogram may be needed. conclusion: right frontal hematoma again seen with surrounding edema and a thin rim of enhancement. there may be a small vessel coursing through the substance of the hematoma. ct torso: post-contrast ct of the chest: imaged thyroid gland appears unremarkable. multiple subcentimeter mediastinal and hilar lymph nodes are identified. the aorta demonstrates mild atherosclerotic calcifications with no evidence of aneurysmal dilatation. pulmonary arteries are grossly unremarkable. the heart is not enlarged. there is no pericardial effusion. there is a somewhat hypoenhancing lobulated mass in the left posterior mid-lower hemithorax adjacent to the vertebral body and inseparable from the medial pleural space and the left hilum measuring approximately 5.9 x 4.8 cm (3:25). there are adjacent atelectatic changes as well as interlobular and intralobular septal thickening. severe emphysema is noted. there is a 2.4 x 3.2 cm spiculated mass in the right upper lobe (3:22). linear opacity in the left upper lobe may represent scarring (3:13). there is no pneumothorax. atelectatic changes of the left lower lobe are noted. abdominal ct with contrast: the liver contains a 0.9-cm area of hypoenhancement (3:52). there are also subcentimeter hypodensities in the left lobe (3:54-57), incompletely characterized. gallbladder is unremarkable. spleen, pancreas appear unremarkable. both adrenals contain large adenomas measuring up to 2.7 cm on the left and 2.5 cm on the right. both kidneys are in normal anatomic location and demonstrate symmetric enhancement. imaged bowel is unremarkable. there is no bowel obstruction or bowel wall thickening. abdominal aorta and iliac vessels demonstrate atherosclerotic calcifications with no aneurysmal dilatation. there is no intra-abdominal lymphadenopathy by size criteria. pelvic ct with contrast: small amount of air within the urinary bladder is likely secondary to instrumentation. a foley catheter is seen in the urinary bladder. there is moderate amount of urine in the urinary bladder. rectosigmoid colon is grossly unremarkable and contains stool. the uterus contains multiple fibroids, some of which are calcified and likely degenerating. there is no pelvic lymphadenopathy. osseous structures: there is a probable bone island measuring 4 mm in the left femoral head (3:113). no lesion to suggest malignancy or infection is identified. impression: 1. spiculated right upper lobe mass concerning for malignancy. hypoenhancing mass in the left mid-lower hemithorax (possibly necrotic) is pleural-based with adjacent post-obstructive pneumonia or lymphangitic spread of cancer. subcentimeter mediastinal lymphadenopathy. 2. bilateral adrenal adenomas. fibroid uterus. 3. severe emphysema. mri head : post-surgical changes are noted in the right frontal lobe and in the adjacent bone and external soft tissues, with blood products, and moderate vasogenic edema. on the post-contrast images, there is some enhancement noted in the adjacent dura as well as in the surgical bed resection cavity. there is shift of the midline structures to the left side, of about 6 mm. the ventricles and extra-axial csf spaces are unremarkable except for effacement/mass effect on the right frontal by the edema in the right frontal lobe. multiple flair hyperintense areas, noted elsewhere in the cerebral white matter are unchanged. impression: 1. post-surgical changes in the right frontal lobe and in the right frontal region, with some enhancement in the dura and in surgical bed. the changes could reflect post-surgical changes with or without residual tumor. consider followup evaluation, for better assessment and distinction. mild-to-moderate surrounding vasogenic edema and leftward shift of the midline structures with mass effect on the right frontal as described above. these are unchanged compared to the most recent ct study. right frontal mass pathology: report pending right foot biospy pathology: report pending brief hospital course: patient was transferred to after osh imaging revealed a signifcantly sized right frontal hemorrhagic mass. ct was concerning for underlying lesion; so mri was performed to confirm this. neuro and neuroradiation oncology were consulted. ct torso was also done, which was significant for pulmonary and adnrenal lesions. pulmonary biopsy was pursued, however this was refused by the patient's legal proxy due to "previous familial bad experiences". on , she was taken to the or for right crani for tumor debulking and diagnosis. preliminary pathology was consistant with metastatic melanoma. dermatology was consulted post-op. she was maintained overnight in the icu for frequent neurochecks, and sbp control. she had no events overnight. on the morning of pod #1, she had very mild lue/lle weakness (constistent with pre-op), but otherwise doing well and neurology intact. she was transferred out of the icu to the floor. she was seen again by dermatology, who did a biopsy of a suspicious looking lesion on the bottom of her right foot, that was once previously diagnosed as a dysplastic nevi. (it was subsequently removed).pathology of this lesion was not available at the time of discharge pod #2 , pt seen by pt/ot, who determined she would be appropriate for disposition to home with services and 24h observation by her family. she was given instruction for follow up with med-onc, dermatology, neuro-onc and radiation oncology. medications on admission: none discharge medications: 1. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for pain, fever. 2. keppra 750 mg tablet sig: two (2) tablet po twice a day. disp:*120 tablet(s)* refills:*0* 3. colace 100 mg capsule sig: one (1) capsule po twice a day: continue to take as long as you require narcotic pain medication. disp:*30 capsule(s)* refills:*0* 4. dexamethasone 1.5 mg tablet sig: two (2) tablet po q6 () for 1 days. disp:*12 tablet(s)* refills:*0* 5. dexamethasone 2 mg tablet sig: one (1) tablet po q6 () for 1 days. disp:*6 tablet(s)* refills:*0* 6. dexamethasone 2 mg tablet sig: one (1) tablet po q12h (every 12 hours). disp:*60 tablet(s)* refills:*0* 7. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po once a day. disp:*30 capsule, delayed release(e.c.)(s)* refills:*0* 8. dilaudid 2 mg tablet sig: 1-2 tablets po every 4-6 hours as needed for pain. disp:*40 tablet(s)* refills:*0* 9. vna services/evaluation discharge disposition: home with service facility: vna discharge diagnosis: right frontal hemorrhagic mass, with vasogenic edema **prelim pathology: metastatic melanoma seizure pulmonary mass adrenal mass suspicious mole on the right foot: pathology pending at discharge. discharge condition: neurologically stable discharge instructions: general instructions wound care: ?????? you or a family member should inspect your wound every day and report any of the following problems to your physician. ?????? keep your incision clean and dry. ?????? you may wash your hair with a mild shampoo 24 hours after your sutures are removed. ?????? do not apply any lotions, ointments or other products to your incision. ?????? do not drive until you are seen at the first follow up appointment. ?????? do not lift objects over 10 pounds until approved by your physician. diet usually no special diet is prescribed after a craniotomy. a normal well balanced diet is recommended for recovery, and you should resume any specially prescribed diet you were eating before your surgery. be sure however, to remain well hydrated, and increase your consumption of fiber, as pain medications may cause constipation. medications: ?????? take all of your medications as ordered. you do not have to take pain medication unless it is needed. it is important that you are able to cough, breathe deeply, and is comfortable enough to walk. ?????? do not use alcohol while taking pain medication. ?????? medications that may be prescribed include: -narcotic pain medication such as dilaudid (hydromorphone). -an over the counter stool softener for constipation (colace or docusate). if you become constipated, try products such as dulcolax, milk of magnesia, first, and then magnesium citrate or fleets enema if needed). often times, pain medication and anesthesia can cause constipation. ?????? you have been discharged on keppra (levetiracetam), you will not require blood work monitoring. ?????? unless directed by your doctor, do not take any anti-inflammatory medicines such as motrin, aspirin, advil, and ibuprofen etc, as this can increase your chances of bleeding. ?????? you are being sent home on steroid medication, make sure you are taking a medication to protect your stomach (prilosec, protonix, or pepcid), as these medications can cause stomach irritation. make sure to take your steroid medication with meals, or a glass of milk. activity: the first few weeks after you are discharged you may feel tired or fatigued. this is normal. you should become a little stronger every day. activity is the most important measure you can take to prevent complications and to begin to feel like yourself again. in general: ?????? follow the activity instructions given to you by your doctor and therapist. ?????? increase your activity slowly; do not do too much because you are feeling good. ?????? you may resume sexual activity as your tolerance allows. ?????? if you feel light headed or fatigued after increasing activity, rest, decrease the amount of activity that you do, and begin building your tolerance to activity more slowly. ?????? do not drive until you speak with your physician. ?????? do not lift objects over 10 pounds until approved by your physician. ?????? avoid any activity that causes you to hold your breath and push, for example weight lifting, lifting or moving heavy objects, or straining at stool. ?????? do your breathing exercises every two hours. ?????? use your incentive spirometer 10 times every hour, that you are awake. when to call your surgeon: with any surgery there are risks of complications. although your surgery is over, there is the possibility of some of these complications developing. these complications include: infection, blood clots, or neurological changes. call your physician immediately if you experience: ?????? confusion, fainting, blacking out, extreme fatigue, memory loss, or difficulty speaking. ?????? double, or blurred vision. loss of vision, either partial or total. ?????? hallucinations ?????? numbness, tingling, or weakness in your extremities or face. ?????? stiff neck, and/or a fever of 101.5f or more. ?????? severe sensitivity to light. (photophobia) ?????? severe headache or change in headache. ?????? seizure ?????? problems controlling your bowels or bladder. ?????? productive cough with yellow or green sputum. ?????? swelling, redness, or tenderness in your calf or thigh. call 911 or go to the nearest emergency room if you experience: ?????? sudden difficulty in breathing. ?????? new onset of seizure or change in seizure, or seizure from which you wake up confused. ?????? a seizure that lasts more than 5 minutes. important instructions regarding emergencies and after-hour calls ?????? if you have what you feel is a true emergency at any time, please present immediately to your local emergency room, where a doctor there will evaluate you and contact us if needed. due to the complexity of neurosurgical procedures and treatment of neurosurgical problems, effective advice regarding emergency situations cannot be given over the telephone. ?????? should you have a situation which is not life-threatening, but you feel needs addressing before normal office hours or on the weekend, please present to the local emergency room, where the physician there will evaluate you and contact us if needed. followup instructions: follow up appointment instructions ??????please return to the office in days (from your date of surgery) for removal of your sutures and a wound check. this appointment can be made with the nurse practitioner. please make this appointment by calling . if you live quite a distance from our office, please make arrangements for the same, with your pcp. ??????you have an appointment in the brain clinic on at 1 pm. the brain clinic is located on the of , in the building, . their phone number is . please call if you need to change your appointment, or require additional directions. ??????you will need an mri of the brain as this was done during your acute hospitalization. **you also have an appointment in the clinic with dr. on at 4pm. this office is located on the : 9. there phone number is (. please call if you require further directions or need to change your appointment. **you have sutures on your right foot from your foot biopsy. you will need to have those sutures removed within two weeks. please call the dermatology office(located on the ). their phone number is (. **your ct scan of your torso was also revealing for adrenal and pulmonary masses, in addition to emphysema. these findings should be followed up by your pcp. procedure: other operations on extraocular muscles and tendons other excision or destruction of lesion or tissue of brain closed biopsy of skin and subcutaneous tissue diagnoses: tobacco use disorder other convulsions intracerebral hemorrhage secondary malignant neoplasm of brain and spinal cord unspecified disorder of adrenal glands cerebral edema other emphysema multiple sclerosis swelling, mass, or lump in chest melanoma of skin, site unspecified 

Answer: The patient is high likely exposed to