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: arsenic toxicity major surgical or invasive procedure: lumbar puncture x 2 history of present illness: 49 y/o f w/ h/o hcv who presents from for a question of gullian- syndrome. patient states that she was in her usoh until 11 days pta when she developed a productive cough. she also developed mild numbness in her fingertips and soles of her feet. the following day she developed a fever to 102. 7 days pta she presented to osh ed with these symptoms. she was prescribed a course of azithromycin. she then developed nausea, vomiting, and diarrhea after taking the azithromycin. she re-presented to the ed and was given ivfs and sent home. over the next few days her numbness worsened with spread up her feet and then her legs. 4 days pta she presented to her pcp with complaints of the numbness. she was instructed to go to the ed if the symptoms worsened. 2 days pta she presented to with complaints of worsening numbness with spread into her abdomen and her back. she also complained of intermittent right-sided chest pressure. initially she had no weakness or bowel or bladder symptoms. 1 day pta she developed subjective weakness while ambulating to the bathroom, feeling as if her legs gave out from under her. she also had an episode of urinary incontinence. the numbness spread up her chest as well. she was seen by neurology and an mri/mra brain and lp was performed. mri was unremarkable. lp revealed 1 wbc, 500 rbc, 27 protein, 70 glucose. vital capacity was 5.3 liters and she denied sob. given concern for gbs she was sent to fur further evaluation and possible plasmapheresis. . on arrival, she reported numbness as described above - from her fingers and toes up to her upper chest and also occassional tongue and peri-oral numbness. she denied shortness of breath or further nausea, vomiting, or diarrhea (gi symptoms resolved when she completed z-pack course). she complained of weakness in her arms and legs. she has had no further fevers, cough, or sob. past medical history: hcv, s/p ribavirin treatment. now normal liver tests per patient. asthma prior ivda social history: prior ivda. quit 20 years ago. denies etoh. none since yeas ago prior tobacco. quit in works as activity director at alzheimer's unit lives with husband family history: mother - breast cancer, uterine cancer, cad sister - breast cancer physical exam: admission exam: t 98.6 bp 100/46 hr 88 rr 15 98% ra gen: pleasant female, overweight, nad, no resp. distress heent: perrl, eomi, op clear, mmm, anicteric neck: supple, no lad, non thyroidmegaly cv: rrr iii/vi sm at apex, +s4 lungs: mild bibasilar crackles, o/w normal abd: soft, nt, nd, +bs, obese, no hsm noted back: no vertebral tenderness, no cvat ext: no edema, 2+ pedal pulses neuro: a/a ox3, cn ii-xii intact, normal bulk and tone, sensation to light touch/pinprick absent on bilateral lower extremity, abdomen, chest, and back. sensation present on upper chest and back (above t3) and a segment of the lower back (about t10-l2). dtrs absent in patellar and achilles, present in upper extremities. strength 4/5 hip flexors, finger abduction , otherwise strength intact. upon discharge delt tri we wf fe ff ip qd ham df rt: 4+ 4- 4+ 5 5 5 5 3 4+ 3- 3+ left: 4+ 4- 4+ 5 5 5 5 3 4+ 3- 3+ sensation: patchy loss to pinprick in legs and trunk reflexes: absent except 1+ in right bicep and brachioradialis pertinent results: data (osh): . wbc 10.8-->8.4 hct 44.2-> 41.0 plt 368->323 bun 10, cr .8 lfts wnl trop neg tsh 1.4 hcg neg chol 205 ldl 147 hdl 37 tg 108 inr 1.3 ptt 34.4 . lp: 1 wbc 518 rbc glucose 70 protein 27.3 (15-45) gram stain: negative culture: no growth . cxr: no infiltrate . cta chest: no pe, slightly dilated ascending aorta (4.5 cm), 1.2 cm lung nodule in left upper lobe . ctv le: no dvt . mri brain: mild mucosal thickening within left maxillary sinus, o/w unremarkable mra brain: normal flow . ecg: sinus tachy at 100, normal axis, intervals, twi iii . pan-mri: no abnormal signal within the spinal cord. no evidence of cord compression. possible vertebral hemangioma in the thoracic vertebra. emg: complex, abnormal study. the electrophysiologic findings are most consistent with a generalized, moderate, sensorimotor polyneuropathy, which is predominantly demyelinating in nature and of indeterminate chronicity. the reduced activation seen in multiple muscles of the right lower extremity may be due to patient effort, however a central nervous system contribution to the patient's weakness cannot be excluded copper nl, low mma, mycopna: neg, eb cmv igg positive, igm neg. ebv igg positive, igm neg. no cryoglobulins lp: 1 wbc 29 rbc glucose 60 protein 20 gram stain: negative culture: no growth no cells arsenic: 23, nl is <23, 24hr urine collection (164.8 mcg/g cr, nl <50mgc/g cr) brief hospital course: 49 y/o f with progressive numbess following recent infection concerning for guillain- syndrome. currently no respiratory compromise. . 1) numbness/weakness - pt was monitored for any evidence of respiratory insufficiency, however had good lung volumes and inspiratory force on initial evaluation in the icu. mri of her spine was obtained and was unrevealing. work-up was initiated consisting of laboratory evaluation for vitamin b12 deficiency, syphillis, hiv, hepatitis-related, diabetes-related, thyroid, paraneoplastic (lung nodule on x-ray) which were all negative. the patient was transferred to neurology after being consulted. on transfer, the patient had a sensory level to about c5 on the abdomen, and asymmetric sensory findings on the back up to t10, paraparesis with radicular signs at c4,5, she also complained of gait ataxia, most likely due to sensory loss and areflexia. initial though was a myelopathy with polyradiculopathy. gbs was a possible initail diagnosis, but because the patient had a level, other etiologies were explored. other etiologies included cryglobulinemia because h/o hcv, mycoplasma (due to previous uri sx), lyme, ebv, or cmv, as well as a 24hr urine & blood heavy metal screen to look for arsenic. the patient had recently moved to a new house in early , two weeks prior to initial symptoms. pt was cmv igg positive and ebv igg positive, but igm levels were negative and mri showed no signs of myelitis. she was negative for lyme and cryoglubulinemia. throughout the course, the patient had progressive weakness of both ip/hamstrings/ta , though weaker on the right compared to the left. she also had weak deltoids , biceps , though more weakness on the right than the left. she also had intermittent increased tone on the left foot. repeat lp showed 1wbc 29rbc protein:20 glucose:69. emg showed a moderate sensorimotor demyelination process, however there were some axonal features as well. because the patient had progressive weakness, the patient was started on ivig therapy. initially the patient had improvement of symptoms with the ivig with return of sensation to her fingers. she did have episodes of flushing with the ivig which was treated with benadryl. she had four treatments of ivig throughout her hospital course. on hd 7, the blood heavy metal screen showed borderline levels of arsenic (23, nl is <23). the suspicion for arsenic was confirmed with elevated levels in the 24hr urine collection (164.8 mcg/g cr, nl <50mgc/g cr). an addiontional random urine collection was made to determine if the elevated arsenic level was due to organic arsenic (found in shellfish) or inorganic arsenic (found in runoff/well water). the town of ( , ) was notified about the patient, and inquired about levels of arsenic in their well water. tests showed no elevated levels or arsenic, however no recent levels were taken, and they have begun their investigation. . 2) lung nodule: cxr showed a lul nodule, which chest ct showed a calcified lul granuloma. she has a short smoking history, and denies and recent weight loss. . 3) htn: no prior history of htn. on norvasc, lopressor. bps high/normal on presentation. the lopressor was continued through her hospital course. - cont. lopresor . 4) chest pain: atypical pain. relieved by morphine at osh. cta neg for pe, ecg not suggestive of acs. tylenol/nsaids did not relieve the chest pressure, ao she was placed on nitroglycerin prn for the chest pressure she described. subsequent ecgs showed no signs of ischemia. . 5) f/e/n: low salt diet. check lytes . 6) ppx: sq heparin, bowel regimen 7) disp: the patient was discharged to rehab with instructions to follow up in the outpatient neurology clinic. medications on admission: outpt meds: neurontin 25 hs estrogen and progestin combination (activella) daily prozac 40 daily meds on xfer: norvasc 2.5 daily lopressor 50 neurontin 25 hs activella ecotrin 81 daily prozac 40 daily protonix 40 daily nortriptyline 25 hs ativan prn q4 ambien 5mg prn insomnia morphine 2mg q2 hrs prn sl nitro prn chest pain nkda discharge medications: 1. docusate sodium 100 mg tablet sig: one (1) tablet po bid (2 times a day). 2. heparin (porcine) 5,000 unit/ml solution sig: one (1) injection injection tid (3 times a day). 3. fluoxetine 20 mg capsule sig: two (2) capsule po daily (daily). 4. albuterol sulfate 0.083 % solution sig: 1-2 puffs inhalation q6h (every 6 hours) as needed. 5. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 6. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q4-6h (every 4 to 6 hours) as needed for pain. 7. metoprolol tartrate 25 mg tablet sig: one (1) tablet po tid (3 times a day). 8. gabapentin 100 mg capsule sig: one (1) capsule po tid (3 times a day). 9. miconazole nitrate 2 % powder sig: one (1) appl topical prn (as needed). 10. nitroglycerin 0.3 mg tablet, sublingual sig: one (1) tablet, sublingual sublingual prn (as needed) as needed for chest pressure. 11. zolpidem 5 mg tablet sig: one (1) tablet po hs (at bedtime). 12. dolasetron 12.5 mg/0.625 ml solution sig: one (1) intravenous q8h (every 8 hours) as needed. discharge disposition: extended care facility: - discharge diagnosis: polyneuropathy arsenic toxicity discharge condition: stable discharge instructions: please call your primary care physician or return to the emergency room if you experience worsening weakness, increasing numbness, shortness of breath, visual changes, difficulty speaking, difficulty swallowing. followup instructions: please call the neurology clinic at for a follow up appointment in the next four to six weeks. md, procedure: spinal tap incision of lung diagnoses: unspecified essential hypertension unspecified viral hepatitis c without hepatic coma unspecified hereditary and idiopathic peripheral neuropathy toxic effect of arsenic and its compounds accidental poisoning by arsenic and its compounds and fumes 

Answer: The patient is high likely exposed to