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: history of present illness: patient was admitted to the micu for hypercarbic respiratory distress. the patient is a -year-old woman with history of chronic obstructive pulmonary disease and congestive heart failure with diastolic dysfunction, recent - admit for to for dyspnea and increased lethargy with hypercarbia requiring micu admit. arterial blood gases was 7.28, 77, 51, during which she was diuresed aggressively and had prednisone treated for chronic obstructive pulmonary disease flare. she was discharged to d' and returned home on . per daughter, patient was at baseline on and . day prior to admission, , patient's daughter noted that patient was becoming increasingly lethargic and tremulous similar to prior episodes of hypercarbia. reports no fevers, chills, chest pain or shortness of breath. no cough, sputum, shortness of breath, change in chronic paroxysmal nocturnal dyspnea or two pillow orthopnea, diet or medication discretion. upper respiratory infection symptoms, urinary tract infection symptoms, nausea, vomiting, diarrhea, abdominal pain, increasing peripheral edema. past medical history: 1. chronic obstructive pulmonary disease. 2. atrial fibrillation, paroxysmal. 3. congestive heart failure with diastolic dysfunction. 4. disease. 5. hypothyroidism. 6. obstructive sleep apnea. 7. right breast carcinoma, status post xrt. allergies: no known drug allergies. social history: 180 year pack history of tobacco, quit several years ago. she lives with her daughter. physical examination: temperature 97.1??????, heart rate 75, blood pressure 151/60, 93% on bi-pap, respiratory rate of 30. overweight woman in moderate respiratory distress on bi-pap. sclerae anicteric, moist oral mucosa. neck thick, supple, jugular venous pulse obscured by bi-pap mask. lungs: decreased breath sounds throughout, worse at base, bibasilar crackles, no wheezes. cv: regular, distant heart sounds, normal s1-s2. ii/vi holosystolic murmur at left lower sternal border. no rubs or gallops. abdomen: soft, nontender, nondistended. extremities: pretibial edema 1+ bilaterally, no calf tenderness. neurological: cranial nerves ii through xii intact. tremulous. positive asterixis, moves all four extremities. tremulousness improves after bi-pap. laboratory data: on admission, white count 5.8, hematocrit 38.3, platelets 144, diff of 64 neutrophils, 25 lymphs. creatinine is 0.7, ck is 49, troponin less than .01. abg is 7.19, 111, 36, question of venous gas. chest x-ray: congestive heart failure with bilateral pleural effusions. electrocardiogram: sinus rhythm at 75, normal axis, lvh by voltage criteria and avl no significant change from . hospital course: the patient was admitted to the micu for her hypercarbia and respiratory distress, likely multifactorial. patient was diuresed with lasix, nebs and solu-medrol for treatment of chronic obstructive pulmonary disease exacerbation. patient was also treated with levofloxacin since question of pneumonia on her chest x-ray. the patient wished not to use the bi-pap and not to be intubated in the event of respiratory failure. she continued to refuse the bi-pap throughout her hospitalization and requires increased oxygen use at night and nebulizers at home. the patient was transferred to the floor on at her baseline. she did well. she continued to diurese gently. at baseline patient has poorly decompensated congestive heart failure with poor compliance although she claims to be compliant. on the patient had sleep study which showed severe apnea and desaturation but refused bi-pap phase and has adamantly refused since then. she sleeps bolt upright at home, also long smoking history with chronic obstructive pulmonary disease, on home 02. she complains of excessive daytime sleepiness, weight gain, fatigue and voice hoarseness. the patient was diuresed and supplemented with kcl to decrease metabolic alkalosis and improve ventilatory response. she was continued on chronic 02 with goal 02 sats from 90-92% and continued recommendations for nocturnal bi-pap to help with obstructive sleep apnea and improve ventilation, pulmonary hypertension. however, patient has continued to refuse. discharge status: stable, on satting 92% on 2 liters nasal cannula. patient refusing bi-pap, wants to be "do not resuscitate" but not dni. discussed with dr. and patient's daughter who is her health care proxy. disposition: discharged to home with services. final diagnoses: 1. congestive heart failure. 2. hypercarbia. 3. delirium. recommended follow up: cardiology primary care with dr. in one to two weeks. discharge medications: 1. isosorbide dinitrate 10 mg p.o. three times a day. 2. levothyroxine sodium 100 mcg p.o. once daily. 3. aspirin 81 mg p.o. once daily. 4. diltiazem 30 mg p.o. twice a day. 5. advair 250/50 1 puff twice a day. 6. quetiapine 25 mg ?????? to 1 tablet p.o. q.h.s. p.r.n. agitation. 7. pantoprazole 40 mg p.o. once daily. 8. furosemide 80 mg p.o. once daily. 9. colace 100 mg p.o. three times a day. 10. senokot 2 tablets p.o. twice a day. 11. warfarin 5 mg p.o. once daily for three days, then adjust it for goal line r2 to 3. 12. combivent 1 puff q3-4h p.r.n. , m.d. dictated by: medquist36 procedure: non-invasive mechanical ventilation diagnoses: congestive heart failure, unspecified unspecified acquired hypothyroidism chronic airway obstruction, not elsewhere classified atrial fibrillation personal history of malignant neoplasm of breast other and unspecified angina pectoris unspecified sleep apnea long-term (current) use of anticoagulants obesity, unspecified 

Answer: The patient is high likely exposed to