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: latex / neurontin / morphine / percocet / augmentin / shellfish / iodine / red dye / dilaudid (pf) attending: chief complaint: chest pain major surgical or invasive procedure: none history of present illness: 52 yo iddm on insulin pump with recently discharged from on after admission for poorly controlled dm and recent discharge from psych facility after diagnosed with depression w/ psychotic features presents from osh with concern for nstemi, but found to be in dka. according to patient she has been urinating 10-12 times per day for a day or 2. she has been drinking a lot of ice tea and other liquids as well because she is thristy. yesterday afternoon the patient noticed her fsg was greater than 600. she said that prior to yesterday afternoon, her readings were not that high. she bolused herself with an insulin pump and recheck continued to be greater than 600. she had been doing really well with the pump, but had it changed over the weekend because her old one was scratched. she did not notice that the pump was having any error signals or not working properly. she went to bed the night prior to admission and woke up around 1am with cp. she took nitro and her pain improved. she fell back asleep and then woke up at 3am and had recurrent cp. she had some n/v took nitro and her pain improved, but she went to for further evaluation. at lgh trop 0.13 and fsg 800's. she was sent here for further management of possible nstemi. . in the ed, initial vitals were 98.8 101 121/66 20 100% 2l. labs and imaging significant for na: 132, hco3 13, glu 666, ag 24, wbc 20.3 ( n:91.6 l:6.8 m:1.4 e:0 bas:0.2), urine glucose 1000, ketones 80, lactate of 4.0. she was initially transferred for nstemi, and prior to her labs returning, she had bradycardia to the 40's eyes rolled to back of head, no pulse, asystolic, within 10 seconds pulse again, awake, alert. she had persistent hypotension and rij placed and started on levophed. she was also noted to have ekg changes in the ed with ste in avr and v1 and depressions in i, ii, v4-6 thought to be demand ischemia in setting of dka. insulin drip was started in the ed and 4.5l of ns was given. given bradycardia, hypotension and ekg changes, she will be admitted to the ccu for further management. prior to transfer due to sustained hypotension, she was started on dopamine. cipro and calcium gluconate was also given in the ed for unclear reasons at this time. . on arrival to the floor, patient awake, alert, very thirsty, but otherwise feeling well. . review of systems on review of systems, s/he denies any prior history of stroke, tia, deep venous thrombosis, pulmonary embolism, bleeding at the time of surgery, myalgias, joint pains, cough, hemoptysis, black stools or red stools. s/he denies recent fevers, chills or rigors. s/he denies exertional buttock or calf pain. all of the other review of systems were negative. . cardiac review of systems is notable for absence of chest pain, dyspnea on exertion, paroxysmal nocturnal dyspnea, orthopnea, ankle edema, palpitations, syncope or presyncope. past medical history: . cardiac risk factors: diabetes, dyslipidemia, hypertension 2. cardiac history: coronary artery disease, multivessel cabg angiography showing stable disease negative stress-nuclear study minimal inferoposterobasal endocardial sclerosis (echo, ) ? angina (effort and stress ) 3. other past medical history: pvd with distal occlusive disease lle right ophthalmic artery occlusion hypotension, prob vasoregulatory, with small vessel hypoperfusion diabetes mellitus, insulin-dependent, brittle, non-ketotic - diffuse vasculopathy - peripheral neuropathy, mild, but with autonomic dysfunction - retinopathy, advanced - nephropathy, mild cataracts nld bronchospastic disease "spastic colitis" / celiac dz / ischemic bowel dz; dermatitis herpetiformis disseminated zoster hypothyroidism; possible subacute thyroiditis social history: lives alone, husband died 8 years ago. has sister who is involved in her care. no cigarettes, etoh, illicit drugs. family history: family history of heart disease physical exam: admission physical exam: general: oriented x3. mood, affect appropriate. heent: ncat. sclera anicteric. perrl, eomi. conjunctiva were dry/pink, oral mucosa dry neck: supple, jvp not visualized. cardiac: tachycardic, normal s1, s2. no m/r/g. lungs: resp were unlabored, no accessory muscle use. adventitious breath sounds throughout, no wheezes or rhonchi. abdomen: soft, ntnd. no hsm or tenderness. extremities: no c/c/e. pulses: right: carotid 2+ dp 2+ pt 2+ left: carotid 2+ dp 2+ pt 2+ pertinent results: admission labs 12:50pm wbc-20.3*# rbc-3.54* hgb-11.3* hct-35.2* mcv-100*# mch-31.9 mchc-32.0 rdw-13.0 plt ct-285 12:50pm neuts-91.6* lymphs-6.8* monos-1.4* eos-0 baso-0.2 12:50pm pt-11.0 ptt-26.0 inr(pt)-1.0 12:50pm glucose-666* urean-34* creat-1.5* na-132* k-5.1 cl-95* hco3-13* angap-29* 12:50pm alt-35 ast-44* ck(cpk)-140 alkphos-101 totbili-1.0 12:50pm lipase-408* 12:50pm albumin-3.9 calcium-8.7 phos-4.0 mg-2.4 10:29pm tsh-23* 10:29pm t4-4.1* 01:54pm t4-3.4* free t4-0.71* 12:26pm lactate-3.9* 02:40pm lactate-4.0* 01:35pm urine color-straw appear-clear sp -1.017 01:35pm urine -neg nitrite-neg protein-tr glucose-1000 ketone-80 bilirub-neg urobiln-neg ph-5.0 leuks-neg 01:35pm urine rbc-0 wbc-<1 bacteri-none yeast-none epi-0 cardiac enzymes 12:50pm ck-mb-9 12:50pm ctropnt-0.32* 06:31pm ck-mb-32* mb indx-5.8 ctropnt-3.06* 12:27am ck-mb-81* mb indx-6.4* ctropnt-7.68* 05:43am ck-mb-91* mb indx-6.8* ctropnt-8.22* imaging: tte : left atrium: normal la size. right atrium/interatrial septum: mildly dilated ra. normal ivc diameter (<=2.1cm) with <50% decrease with sniff (estimated ra pressure (5-10 mmhg). left ventricle: normal lv wall thickness. normal lv cavity size. severe regional lv systolic dysfunction. no lv mass/thrombus. no vsd. right ventricle: mildly dilated rv cavity. mild global rv free wall hypokinesis. aorta: normal aortic diameter at the sinus level. aortic valve: normal aortic valve leaflets (3). no as. no ar. mitral valve: mildly thickened mitral valve leaflets. mild (1+) mr. tricuspid valve: normal tricuspid valve leaflets. moderate tr. normal pa systolic pressure. pulmonic valve/pulmonary artery: normal pulmonic valve leaflet. no ps. physiologic pr. pericardium: no pericardial effusion. general comments: emergency study performed by the cardiology fellow on call. conclusions the left atrium is normal in size. the estimated right atrial pressure is 5-10 mmhg. left ventricular wall thicknesses are normal. the left ventricular cavity size is normal. there is severe regional left ventricular systolic dysfunction with mid- and distal anterior/anteroseptal/apical hypokinesis, as well as hypokinesis of the basal inferior/inferoseptal segments. there is milder hypokinesis of the remaining segments (lvef = 25-30%). no masses or thrombi are seen in the left ventricle. there is no ventricular septal defect. the right ventricular cavity is mildly dilated with mild global free wall hypokinesis. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic stenosis or aortic regurgitation. the mitral valve leaflets are mildly thickened. mild (1+) mitral regurgitation is seen. moderate tricuspid regurgitation is seen. the estimated pulmonary artery systolic pressure is normal. there is no pericardial effusion. impression: severe regional left ventricular systolic dysfunction, c/w multivessel cad. mild right ventricular systolic dysfunction. mild mitral regurgitation. moderate tricuspid regurgitation. cxr: findings: a new right internal central jugular venous catheter terminates in the uppermost part of the atrium. the patient is status post coronary artery bypass graft surgery. the cardiac, mediastinal, and hilar contours appear unchanged. there is no evidence for pneumothorax or pleural effusion. new streaky left basilar opacities suggest minor atelectasis. otherwise, the lungs appear clear. impression: new right internal central jugular venous catheter protruding slightly into the right atrium; no evidence for pneumothorax. brief hospital course: ms. is a 52 year old female with diabetes mellitus on insulin pump and coronary artery disease (cad) status post bypass surgery (cabg) who presented to from osh with diabetic ketoacidosis (dka) and concern for demand ischemia. her course was complicated by vagal-mediated asystole and subsequent decreased ejection fraction on echo with cardiac enzyme elevation. # hypotensive shock: patient with hypotensive shock on admission. infectious work up negative except leukocytosis which was attributed to dka and resolved with metabolic improvement. clinical findings and hpi concerning for hypovolemic shock in the setting of dka, poor po intake and vomiting. she was aggressively volume resuscitated and had resolution of hypotension. was briefly on pressors but these were weaned off within the first 24 hours as volume resuscitation continued. # dka: patient with dm on insulin pump. as per her last admission in , she had difficulty controlling her sugars with wide ranges of fsg from 50's - 500s. her glucose control is complicated by psychiatric issues. has seen her in the past and made adjustments to her pump, but she seems to have been undertreating her elevated finger sticks at home and it is possible that her pump has not been functioning properly since it was changed over the weekend. she was managed protocol with insulin gtt transitioned to sc insulin and electrolyte repletion with resolution of her acidosis and elevated suagrs within the first 24 hours. saw the patient and we transitioned her back on to her pump on hd 2. she did well on the pump with some minor adjustments to her basal rate. she will follow up with dr. in the outpatient setting for further management of her iddm. # cad s/p cabg: patient with history of ischemic heart disease who had new ekg changes after asystolic event in the ed. concern for demand ischemia in the setting of hypotension and dka. she had known cad with many plaques and her ekg was most consistent with global hypoperfusion rather than unstable plaques. her outpatient cardiologist was contact to discuss catheterization as an inpatient versus outpatient. given global hypokinesis on her echo despite ekg changes and increase in cardiac enzymes, it was felt that there was likely some cardiac stunning in the setting of dka, acidosis and asystolic event. repeat echo 3 days after her admission to the hospital showed improvement in her ejection fraction. she was continued aspirin, plavix durin her hospital stay. once her pressures normalized and she was off pressors, she was given cozaar 25mg, but this caused some relative hypotension and she was symptomatic with lightheadedness and dizziness. her cozaar was lowered to 6.25mg po daily. she was started on metoprolol tartrate while in the hospital, but upon discharge she was continued on her home bisoprolol 2.5mg po bid. she will follow up with dr. for further management of her cad. # elevated wbc: likely elevated in the setting of dka. infectious work up negative with cultures pending. she is afebrile and while has had some recent sick contacts, is not having any symptoms concerning for infection. nausea and vomiting was likely related to her hyperglycemia. she was given cipro/flagyl in the ed, but not continued in the icu. her wbc trended down and normalized within 48 hours. # hypothyroidism: tsh elevated to 23 with low t4 so increased levothyroxine to 175 mcg daily. # behavioral changes: patient had recently discharged from psych facility for depression with psychotic features. she is currently stable from psychiatric standpoint. continued aripirazole 2 mg daily, diazepam 2 mg tid # asthma: provided prn albuterol, atrovent. . sister - transitional issues - continued management of iddm and insulin pump by endocrinologist - cad management as per dr. medications on admission: preadmission medications listed are correct and complete. information was obtained from patientpharmacy. 1. fluticasone-salmeterol diskus (100/50) 1 inh ih :prn sob takes as needed due to trouble controlling sugars 2. aspirin 81 mg po daily 3. cozaar 25 mg po daily:prn sbp>150 patient takes as needed due to hypotension with daily use. 4. diazepam 2 mg po tid:prn anxiety, dizziness 5. epipen *nf* (epinephrine) 0.3 mg/0.3 ml injection as needed anaphylaxis 6. humulin r *nf* (insulin regular human) 100 unit/ml injection per sliding scale 7. clopidogrel 75 mg po daily 8. albuterol inhaler puff ih q6h:prn sob 9. montelukast sodium 10 mg po daily:prn allergies 10. levothyroxine sodium 150 mcg po daily 11. zebeta *nf* (bisoprolol fumarate) 5 mg oral 12. aripiprazole 2 mg po qhs 13. ranitidine 150 mg po daily 14. hydrochlorothiazide 25 mg po daily:prn leg swelling discharge medications: 1. aripiprazole 2 mg po qhs 2. aspirin 81 mg po daily 3. clopidogrel 75 mg po daily 4. losartan potassium 6.25 mg po daily hold for sbp<100 5. diazepam 2 mg po tid:prn anxiety, dizziness 6. levothyroxine sodium 175 mcg po daily 7. ranitidine 150 mg po daily 8. insulin pump sc (self administering medication)insulin aspart (novolog) (non-formulary) basal rates: midnight - 0600: .3 units/hr 0600 - 1500: .35 units/hr 1500 - 1800: .3 units/hr 1800 - 2330: .35 units/hr 2330 - 2400: .3 units/hr meal bolus rates: breakfast = 1:15 lunch = 1:15 dinner = 1:15 snacks = 1:15 high bolus: correction factor = 1:15 correct to 170 mg/dl md acknowledges patient competent md has ordered consult md has completed competency 9. albuterol inhaler puff ih q6h:prn sob 10. fluticasone-salmeterol diskus (100/50) 1 inh ih :prn sob takes as needed due to trouble controlling sugars 11. epipen *nf* (epinephrine) 0.3 mg/0.3 ml injection as needed anaphylaxis 12. hydrochlorothiazide 25 mg po daily:prn leg swelling 13. montelukast sodium 10 mg po daily:prn allergies 14. outpatient lab work please check complete metabolic panel (electrolyte panel), as well as creatinine. 15. zebeta *nf* (bisoprolol fumarate) 2.5 oral discharge disposition: home discharge diagnosis: primary diagnosis diabetic ketoacidosis coronary artery disease discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: dear ms. , you were admitted to the hospital because you were in diabetic ketoacidosis. you had a temporary stop in your heart beat which we think was caused by stunning of your heart from the acido in your . you do have significant blockages of the arteries in your heart, which are old, and so when your heart is under stress from other metabolic causes you have relative decreased flow. your pressure was low on admission to the hospital, and it was thought to be due to this heart stunning. while in the hospital, your acidosis was corrected with insulin and intravenous fluids. you were seen by the clinic who helped adjust your insulin needs for your insulin pump. please make sure you continue to use your insulin pump as directed, and keep your follow up appointment with the clinic. please see your attached medication sheet to review any changes that have been made to your medications while at the hospital. the following medications were changed: cozaar 25mg daily ---> cozaar 6.25mg ( pill) by mouth daily zebeta 5mg twice a day ---> zebeta 2.5mg by mouth twice a day it has been a pleasure taking care of you! it is very important for you to keep all of your follow-up appointments listed below. bring your medications to each appointment so that your doctors adjust as needed. it was a pleasure taking care of you in the hospital! followup instructions: department: endocrinology- diabetes center name: dr. when: thursday at 12:30 pm location: diabetes center address: one place, , phone: department: cardiology name: dr. when: friday at 11:00 am. location: doctors & vinch cardiology, pc address: , ste 703w, , phone: procedure: arterial catheterization diagnoses: nephritis and nephropathy, not specified as acute or chronic, in diseases classified elsewhere unspecified essential hypertension hyposmolality and/or hyponatremia unspecified acquired hypothyroidism coronary atherosclerosis of unspecified type of vessel, native or graft aortocoronary bypass status asthma, unspecified type, unspecified other and unspecified hyperlipidemia cardiac arrest other shock without mention of trauma long-term (current) use of insulin old myocardial infarction atherosclerosis of native arteries of the extremities, unspecified leukocytosis, unspecified diabetes with neurological manifestations, type i [juvenile type], uncontrolled diabetes with renal manifestations, type i [juvenile type], uncontrolled diabetes with ophthalmic manifestations, type i [juvenile type], uncontrolled diabetes with ketoacidosis, type i [juvenile type], uncontrolled legal blindness, as defined in u.s.a. background diabetic retinopathy chronic total occlusion of artery of the extremities insulin pump status peripheral autonomic neuropathy in disorders classified elsewhere 

Answer: The patient is high likely exposed to