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: no known allergies / adverse drug reactions attending: chief complaint: hip fracture major surgical or invasive procedure: left hip open reduction and fixation history of present illness: 80 f with history of childs class b cirhosis (sbp, variceal bleed, ascites), hep c, esrd on hd (tunnel line, hd started few mo ago, has fistula in left arm), cad (sp 2 stents in the past), dm2 on insulin, who presents to hospital for hip fracture. she was in her usual state of health until yesterday when she was sitting in a chair and fell. she reported to the ed where she was found to have left subgaleal hematoma, right 7th rib frx, left proximal femur fracture. there was initial question of black stool, however on repeat exam stool was brown and gi did not feel urgent endosopy was warranted. . she was transfered to the trauma icu service for close observation until surgery. ortho, liver, acs, nephrology are all consulting. she was intially planned to go to the or today, however, her electrolytes were off and she needs hd prior to or. risks of surgery have been explained to patient's family at legnth and they are in agreement with plan to proceed with surgery for fixation of hip fx. . on arrival to the micu, pt reports she has left hip pain but otherwise denies any other symptoms. no confusion, no weakness of arms or legs, does have extensive bruising on her head from fall. . family meeting held with daughter in law and son. they are aware of how sick their mother is and understand the high mortality risk of the surgery, but they still request surgery. code status is dnr ("not okay to rescusitate if no heart beat or pulse") but okay to intubate. past medical history: cad- stents in hep c cirhosis- child b - complicated with esophageal varices sp banding, sbp/ascites in esrd on hd (possible from hep c, had attempted renal bx) gerd anemia uterine polyps social history: no drugs, pts family feels she got hep c in the hospital setting while in the . lives alone in apartment. has 2 children, 4 grandchildren. family history: mother with dm2 and mi. physical exam: physical exam on admission: vitals: t: 98, hr 62, bp 122/47, rr 18, 96% on 2l. 150cc uo. general: alert, oriented, jaundice, bruising on head, chronically ill appearing heent: sclera icteric, oropharynx clear, eomi, perrl neck: supple, jvp not elevated, no lad cv: regular rate and rhythm, normal s1 + s2, systolic murmur left sternal border lungs: anteriorly pt had no crackles bilaterally abdomen: soft, mild ascites present gu: foley ext: warm, 2+ pulses, no pedal edema neuro: strengh throughout physical exam on : vs - tm 99.0 tc 98.3 bp 138/70, hr 77, r 18, o2-sat 100% 3l (nasal cannula noted to be over patient's forehead) general - elderly woman, laying in bed in nad, alert and very talkative with russian interpreter heent - promient bruising around eyes, with hematoma over left forehead, left eye held slightly closed swelling, pupils equally round and tracking spontaneously, dry mm neck - supple, prominent carotid upstroke lungs - nonlabored, speaking quickly in full sentences, anterior auscultation ctab heart - rrr, ii/vi holosystolic murmur lsb abdomen - nabs, soft/nt/nd, no masses or hsm, no rebound/guarding extremities - wwp, left leg with lesion noted by micu and acs dressed, left hip dressing intact. moving left toes toes and ankle. poor dp on left but foot warm with good cap refill. moving all other extremities. no edema skin - no rashes or lesions lymph - no cervical lad neuro - alert, able to relay events leading to fall, symmetric face except left eye droop due to swelling, symmetric tongue, eyes tracking appropriately, pupils equally round, moving all extremities. pertinent results: labs on admission: 04:00pm blood wbc-4.9 rbc-3.20* hgb-9.2* hct-29.8* mcv-93# mch-28.9# mchc-31.0 rdw-15.3 plt ct-107* 04:00pm blood neuts-71.9* lymphs-20.5 monos-4.6 eos-2.5 baso-0.5 09:38pm blood pt-12.2 ptt-31.5 inr(pt)-1.1 04:00pm blood glucose-220* urean-60* creat-3.8*# na-129* k-5.1 cl-96 hco3-19* angap-19 04:00pm blood alt-32 ast-51* alkphos-138* totbili-0.5 04:00pm blood lipase-63* 04:00pm blood ctropnt-0.04* 04:00pm blood ctropnt-0.03* 04:00pm blood albumin-2.8* calcium-7.8* phos-6.8*# mg-2.1 04:00pm blood afp-2.6 labs on : 07:31am blood wbc-4.8 rbc-2.69* hgb-7.8* hct-26.1* mcv-97 mch-29.1 mchc-29.9* rdw-16.1* plt ct-85* 07:31am blood pt-12.2 ptt-30.3 inr(pt)-1.1 07:31am blood glucose-167* urean-38* creat-3.3*# na-135 k-4.1 cl-97 hco3-29 angap-13 07:31am blood alt-22 ast-44* ld(ldh)-188 alkphos-80 totbili-1.1 07:31am blood calcium-7.7* phos-5.3* mg-2.1 imaging: ct c-spine : mild spondylolistheses seen at c3-c4 and c4-c5, which could be seen with substantial degenerative changes including facet joint degenerative changes. however, correlation with physical findings is recommended regarding any potential concern for ligamentous injury. hemorrhage in the paranasal sinuses which could be seen in the setting of fractures that are occult or not imaged on this study. ct head : 1. large left frontal subgaleal hematoma, including hemorrhage among the visualized paranasal sinuses, which may reflect bony injury which is not imaged. although there is no definite fracture, slight irregularity of the partly visualized nasal bones could reflect an incompletely imaged fracture site. 2. no evidence of acute intracranial injury. 3. slight increase in largely calcified meningioma along the right frontal convexity. 4. new small lacunar infarcts since the remote prior examination. ct torso : 1. non-displaced fracture of the proximal left femur superimposed on chronic abnormalities. 2. mildly displaced right seventh rib fracture with additional rib fractures that appear more likely subacute or older although more recent non-displaced fractures are difficult to entirely exclude. 3. large quantity of ascites which is of low density suggesting simple fluid. this is suspected to reflect underlying liver disease,noting slightly irregular contour to the liver and mild splenomegaly. however, other etiologies including malignancy are not entirely excluded, although no nodularity or masses are noted. 4. widespread vascular disease. echo : the left atrium is elongated. left ventricular wall thicknesses are normal. the left ventricular cavity is small. left ventricular systolic function is hyperdynamic (ef 75%). a mild mid-cavity gradient is identified. right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. no aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. there is severe mitral annular calcification. there is a minimally increased gradient consistent with trivial mitral stenosis. mild (1+) mitral regurgitation is seen. there is mild pulmonary artery systolic hypertension. there is no pericardial effusion. carotid us : impression: there is plaque in the distal common carotid arteries and at the bifurcation extending into the internal and external carotid arteries. however, no significant stenoses on either side. flow in the vertebrals is prograde. ruq us with dopplers : 1. extensive ascites. 2. nodular contour to the liver and shrunken appearance consistent with cirrhosis. splenomegaly. 3. limited doppler examination with patent main portal vein and main hepatic artery. cxr : there are low lung volumes. right central catheter tip is in the upper right atrium. there is no pneumothorax or pleural effusion. there is mild vascular congestion. there are small bilateral pleural effusions. again noted is calcification of the mitral annulus. brief hospital course: principle reason for admission mrs is an 80 f with history of childs class b cirhosis (sbp, variceal bleed, ascites), hep c, esrd on hd, cad s/p 2 stents, dm2 on insulin who was evaluated in the ed as a trauma activation, with the following injuries identified: left subgaleal hematoma, right 7th rib fracture, left subtrochanteric fracture. she was then admitted to the ticu for further evaluation and management, before being transferred to the micu for close monitoring prior to her left orif by ortho on . she tolerated the surgery well and was transferred to the medical floor on . active problems # hip fracture: patient underwent orif on . she was extremly high risk given her underlying medical comorbidities (including childs class b cirrhosis, esrd, cardiac histoey and diabetes). she tolerated the procedure well. she was kept on dilaudid and iv tylenol with good pain control in the icu. on the floor, she was transitioned to tramadol and standing low dose tylenol. due to her esrd, patient was not on lovenox for dvt ppx, but should continue on heparin 5000 sq tid at least until seen by orthopedics on followup in two weeks. # mechanical fall: after obtaining add'l history, micu team felt that the fall was mechanical in nature. abbreviated syncope workup was normal with flat troponins, unremarkable tte, no significant carotid stenosis and no evidence of infection on cxr and blood cx. pt was discharged to acute rehab in good condition. # left shin wound: appears to be related to fall. noted by micu team on day of tranfer out of untit. she was evaluated by acs and orthopedics who felt there was nothing to do other than wound care. chronic problems # hep c cirrhosis: childs class b. decompensated with history of ascites, variceal bleed s/p banding and hospitalization for sbp. patient was afebrile with a soft belly and no clinically signficant ascites. stool was brown. banding apparently done at . after speaking with liver team, it was decided to treat patient with ciprofloxacin for sbp prophylaxis and nadolol for varices. # htn: patient on home regimen of metoprolol succinate 100 daily, nifedipine er 90mg daily, and hctz 25mg daily. patient started on metoprolol tartrate 100 in micu. sbp's ran in the 90's to 110's, so hctz and nifedipine were held in the icu. hctz, metoprolol were not continued prior to . she was discharged on home nifedipine and nadolol. # esrd on dialysis: etiology thought to be due to recent hospitalizations for sbp and variceal bleeds. received hd prior to surgery per renal recs and again on . she was started on sevelamer 1600 tid, and continued caco3, and vitamin d. glyburide, hctz, and nsaids were discontinued. # dm: on lantus 10 and glyburide 2.5 at home. hiss was started in micu. patient was placed back on home lantus on the floor. glyburide was not continued on due to esrd. # rib fracture: controlled pain control as above. # hx of cad: continued asa and metoprolol. # depression: continued sertraline 25 daily. medication changes stop alendronate stop glyburide stop hydrochlorothiazide stop ibuprofen stop konsyl stop metoprolol decrease tylenol to 650mg every 8 hours increase tramadol to 50mg every 6 hours as needed for pain start heparin 5000u sq injection three times daily until otherwise directed by your orthopedic surgeon start sevelamer 1600mg three times daily with meals start aspirin 81 mg start ciprofloxacin 500mg daily start nadolol 20mg daily start lactulose 15ml titrate to soft bowel movements daily transitional issues -uptitrate nadalol as needed for bp -continue heparin 5000 tid until otherwise directed by orthopedics medications on admission: calcium carbonate + vit d600, 1 tab po bid colace 100mg po bid ferrous sulfate 325mg po bid fluticasone nasal spray 50mcg, 2 sprays fosamax 70mg po weekly glyburide 2.5mg po bid hctz 25mg po qod ibuprofen 400mg po tid prn pain konsyl 6g, 1 pack in 1 cup of water po qd lantus 10usq qd lidoderm patch 5%, nifedipine er 90mg omeprazole 20mg po qd toprol xl 100mg po qd tramadol 25mg po bid acetaminophen 650mg po q4-6hrs prn pain vitamin b12 100mg qd vit d 1000u qd simvastatin 20mg qd zoloft 25mg po qd medications: 1. calcium 600 + d(3) 600 mg(1,500mg) -400 unit tablet sig: one (1) tablet po twice a day. 2. colace 100 mg capsule sig: one (1) capsule po twice a day. 3. ferrous sulfate 300 mg (60 mg iron) tablet sig: one (1) tablet po bid (2 times a day). 4. fluticasone 50 mcg/actuation spray, suspension sig: two (2) spray nasal (2 times a day). 5. insulin glargine 100 unit/ml solution sig: ten (10) units subcutaneous once a day. 6. lidocaine 5 %(700 mg/patch) adhesive patch, medicated sig: one (1) adhesive patch, medicated topical daily (daily) as needed for pain: apply to shoulder. 7. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily). 8. tramadol 50 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for pain. 9. acetaminophen 325 mg tablet sig: two (2) tablet po q8h (every 8 hours). 10. cyanocobalamin (vitamin b-12) 100 mcg tablet sig: one (1) tablet po once a day. 11. simvastatin 10 mg tablet sig: two (2) tablet po daily (daily). 12. sertraline 25 mg tablet sig: one (1) tablet po daily (daily). 13. heparin (porcine) 5,000 unit/ml solution sig: one (1) ml injection tid (3 times a day). 14. sevelamer carbonate 800 mg tablet sig: two (2) tablet po tid w/meals (3 times a day with meals). 15. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 16. ciprofloxacin 500 mg tablet sig: one (1) tablet po q24h (every 24 hours). 17. nadolol 20 mg tablet sig: one (1) tablet po once daily at 4 pm. 18. lactulose 10 gram/15 ml (15 ml) solution sig: fifteen (15) ml po asdir: titrate to bm daily. 19. nifedipine 90 mg tablet extended rel 24 hr sig: one (1) tablet extended rel 24 hr po once a day. disposition: extended care facility: - diagnosis: 1. left hip open reduction and fixation 2. mechanical fall 3. decompensated cirrhosis 4. end stage kidney disease 5. diabetes mellitus condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - requires assistance or aid (walker or cane). instructions: dear ms. , you were admitted to because you suffered a fall at home and broke your hip and ribs. you underwent surgery to fix the hip and we gave you medicine to help control the pain. it is very important for you to undergo physical therapy to help gain strength back in your legs. please note the following changes to your medications: stop alendronate stop glyburide stop hydrochlorothiazide stop ibuprofen stop konsyl stop metoprolol decrease tylenol to 650mg every 8 hours increase tramadol to 50mg every 6 hours as needed for pain start heparin 5000u sq injection three times daily until otherwise directed by your orthopedic surgeon start sevelamer 1600mg three times daily with meals start aspirin 81 mg start ciprofloxacin 500mg daily start nadolol 20mg daily start lactulose 15ml titrate to soft bowel movements daily you will need to follow up with your liver and kidney doctors. your rehabilitation hospital will arrange follow up with your primary care doctor from their facility. it has been a pleasure taking care of you. followup instructions: department: orthopedics when: thursday at 1:40 pm with: ortho xray (scc 2) building: sc clinical ctr campus: east best parking: garage department: orthopedics when: thursday at 2:00 pm with: , np building: campus: east best parking: garage ***the liver dept is working on an appt for you and will call you at the rehab with your appt. if you dont hear from the office by tuesday, please call them at to book. you will also need to follow up with your primary care doctor and your kidney doctor. hospital will help arrange these appointments. procedure: venous catheterization, not elsewhere classified hemodialysis open reduction of fracture with internal fixation, femur diagnoses: anemia in chronic kidney disease end stage renal disease nephritis and nephropathy, not specified as acute or chronic, in diseases classified elsewhere renal dialysis status coronary atherosclerosis of native coronary artery esophageal reflux cirrhosis of liver without mention of alcohol portal hypertension unspecified viral hepatitis c without hepatic coma depressive disorder, not elsewhere classified percutaneous transluminal coronary angioplasty status hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease long-term (current) use of insulin blood in stool other ascites do not resuscitate status closed fracture of one rib esophageal varices in diseases classified elsewhere, without mention of bleeding closed fracture of other facial bones diabetes with renal manifestations, type ii or unspecified type, not stated as uncontrolled hip joint replacement ulcer of other part of lower limb contusion of face, scalp, and neck except eye(s) closed fracture of intertrochanteric section of neck of femur accidental fall from chair spontaneous bacterial peritonitis osteoarthrosis, unspecified whether generalized or localized, pelvic region and thigh other secondary thrombocytopenia 

Answer: The patient is high likely exposed to