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: compazine attending: chief complaint: abdominal pain, nausea, vomiting major surgical or invasive procedure: none history of present illness: 46 yo f with h/o chronic pancreatitis due to hypertriglyceremia, nash, admitted for pancreatitis flare requiring tpn, who presents with recurrent abdominal pain. she has done very well over the last few months until friday, when she developed sharp epigastric/ruq pain radiating to the back. she described the pain as . it initially began with food, but did not dissipate. she also experienced n/v, and was unable to tolerate pos. she denies change in bowel movements, dysuria, travel or sick contacts, or med changes. she also denies f/c, ha, cp, sob, palps, leg pain, joint swelling. she is adherent with her medications. she denies dietary changes. she visited with her gi dr. , who referred her to the ed. in the ed, vs: 97.3, 113, 134/86, 16, 96%ra. received morphine, dilaudid, antiemetics with little improvement. ct scan performed. trig levels >4000. review of systems: 10 point review of systems negative except as listed above past medical history: - hypertriglyceridemia c/b recurrent pancreatitis. recent episodes and and was on tpn both times. diagnosed in and treated initially with combo of lifesyle modifications and lipid lowering meds in absence of known coronary heat dis at that time. was evaluated in by dr. for dysipidemia; hypertg and hyperchol: d/c'd gemfibrozil and started on tricor, continued on crestor 5mg. - chronic pancreatitis w/recurrent acute - admitted in for 7 days with tg 834 that improved to 188 and discharged on tpn. admitted on for 4 days after failing outpatient treatment with tg 1500 1 week prior to admission and tg 245 upon admission and 160 upon discharge. - received mrcp for recurrent acute pancreatitis with possible pancreatic pseudocyst at osh exam. evidence of chronic pancreatitis and no pseudocyst (atrophic body and tail of pancreas w/o mass or ductal abnormality or inflammatory changes) and normal gb/intra/extrahepatic ducts. 3 admissions in - on 2nd admission, started on tricor. - admitted for recurrent acute pancreatitis with 130 and lip 258, abd ct with pancreatic head inflammation. tg up to 2902 and after 1 week decreased to 445 while npo and on tricor 145mg. had tpn. dr started her on lopid and was ineffective. : gemfibrozil - mild coronary disease - cardiac cath - nash- liver biopsy in with extensive fatty changes - anxiety/panic attacks d/o - psoriasis - treated with topical emolients. - dm - insulin-requiring x 15 years, always on insulin. - rotator cuff tear social history: is a manager of an hr department. she is married and has one 28yo son. of 1ppd x3 years. she denies alcohol or other drugs. family history: significant for triglyceridemia in her aunt, type diabetes mellitus in her maternal grandmother as well as first cousin. uncle died at age 50 from and mi. physical exam: vs: t 96.5, bp 142/89, hr 112, rr 18, 98%ra gen: awake and alert, well appearing, nad heent: mm dry, eomi, anicteric sclera neck: supple no lad heart: tachy, regular no m/r/g lung: ctab no wheezes or crackles abd: protruberant, soft, +ttp over epigastrium -> ruq, no rebound or clear guarding, + bs ext: warm well perfused skin: white scaly plaques over extensor surfaces of elbows, knees, ankles neuro: no focal deficits pertinent results: 136 / 98 / 12 / 247 5.0 / 18 / 0.5 ucg: neg 10.0 \ / 404 / 38.5 \ n:72.0 l:22.0 m:3.4 e:1.3 bas:1.2 alt: 26 ap: 87 tbili: 0.2 alb: ast: 16 ldh: dbili: tprot: : 37 lip: 26 triglyc: 4701 u/a: 0 bact, 100 gluc ct abd/pelvis : 1. no ct evidence of acute pancreatitis. no pancreatic pseudocyst. 2. fatty liver. 3. borderline splenomegaly. 4. short segmental thickening of the jejunum, non-specific could represent enteritis or a normal contracted bowel. 5. fibroid uterus. 1.7 cm right adenxal cyst, within physiologic range for follicle. 6. normal appendix. brief hospital course: ms. is a 46yo woman with hx of chronic pancreatitis secondary to hypertriglyceremia, nash, prior hospitalization for acute pancreatitis requiring tpn, who presented with recurrent abdominal pain for 5 days with radiation to mid-back, nausea, and vomiting. her gastroenterologist, dr , referred the patient to the ed since these symptoms were very similar to her prior events of acute pancreatitis. she had normal amylase and lipase levels. abdominal ct demonstrated a sentinel loop with segmental thickening of the jejunum, although no evidence of acute pancreatitis. her triglyceride levels were markedly elevated to 4701 indicating a precipitating factor for acute pancreatitis. she was admitted for pain control and not tolerating po's. # pain control: the patient's pain was difficult to control well during this hospitalization. she was given iv dilaudid and trialed on a variety of doses and frequencies. pain management was consulted and recommended an iv dilaudid pca, which she was on for approximately 24 hours resulting in excellent pain control. she was then given oral hydromorphone resulting in good pain control. she was also started on gabapentin for pain control. # nausea: the patient had a great deal of nausea and did not tolerate po diet. she was given iv fluids for hydration. she was kept npo due to pain and nausea. tpn was initiated on after not tolerating po diet for approximately 1 week. she kept on tpn while being advanced to a clear diet, which she tolerated with some nausea, even when taking anti-nausea medications before meals. she was advised to limit the variety of foods during meals in order to minimize nausea. # hypoxia: had an episode of hypoxia overnight on where she complained of shortness of breath on awakening. her o2 sat was 69% on room air, was given supplemental oxygen, and transferred to the . she was given lasix for suspected volume overload and was diuresed. ekg showed sinus tachycardia. she had a normal cxr and normal chest cta ruling out pulmonary edema or effusion and ruling out pe. an echo revealed normal lvef>55%, normal r and l ventricular size and function, and only revealing mild 1+ mitral regurgitation but no mitral valve prolapse. she intermittently required supplemental oxygen and was transferred back to the medicine 1 day later. we think hypoxia was due to narcotic-induced sleep apnea. # hypertriglyceridemia: she was continued on tricor and an increased dose of crestor during this hospitalization. her tg levels decreased significantly. # diabetes: given a decreased dose of glargine twice daily while she was npo and was on a regular insulin sliding scale. # acid reflux: patient complained of acid reflux symptoms and was given pantoprazole and maalox. # constipation: approximately 1 week into hospitalization, her abdominal exam demonstrated increased distension and she had not had a bowel movement while here. she was passing flatus. a kub demonstrated normal bowel gas pattern with relative paucity of gas; there was no evidence of ileus, obstruction, or free air. miralax was added to her bowel regimen, after which the patient's abdominal exam began to improve. upon discharge, she was sent home with visiting nurse assistance, on tpn, and on oral pain medication. she will follow up with her gastroenterologist, who will need to manage her nutrition and pain while outpatient. she will also need to follow up with her primary care physician for this hospitalization, acute pancreatitis, hypertriglyceridemia, and diabetes. medications on admission: fenofibrate nanocrystallized - 145 mg tablet - 1 (one) tablet(s) by mouth once a day hydromorphone - (prescribed by other provider) - 2 mg tablet - 2 tablet(s) by mouth every four hours as needed for pain insulin aspart - (prescribed by other provider: . - 100 unit/ml solution - sliding scale insulin detemir - (prescribed by other provider: . at ) - 100 unit/ml solution - 24 units twice a day omega-3 acid ethyl esters - 1 gram capsule - 2 capsule(s) by mouth twice a day pantoprazole - (prescribed by other provider: ) - 40 mg tablet, delayed release (e.c.) - 1 tablet(s) by mouth twice a day paroxetine hcl - (prescribed by other provider) - 20 mg tablet - 1 (one) tablet(s) by mouth once a day rosuvastatin - 5 mg tablet - 1 tablet(s) by mouth once a day trazodone 50mg hs:prn medications - otc aspirin - (prescribed by other provider) - 81 mg tablet, delayed release (e.c.) - tablet(s) by mouth discharge medications: 1. fenofibrate micronized 145 mg tablet sig: one (1) tablet po daily (daily). 2. hydromorphone 2 mg tablet sig: 1-2 tablets po q3h (every 3 hours) as needed for pain. disp:*64 tablet(s)* refills:*0* 3. levemir 100 unit/ml solution sig: one (1) subcutaneous twice a day: 12 units in am and 12 units in pm while on tpn. 4. novolog 100 unit/ml solution sig: asdir subcutaneous asdir: sliding scale. 5. lovaza 1 gram capsule sig: two (2) capsule po twice a day. 6. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q12h (every 12 hours). 7. paroxetine hcl 20 mg tablet sig: one (1) tablet po daily (daily). 8. rosuvastatin 5 mg tablet sig: two (2) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 9. acetaminophen 325 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for pain. 10. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 11. alum-mag hydroxide-simeth 200-200-20 mg/5 ml suspension sig: 15-30 mls po tid (3 times a day) as needed for reflux. disp:*1 month supply* refills:*0* 12. gabapentin 300 mg capsule sig: one (1) capsule po q8h (every 8 hours). disp:*30 capsule(s)* refills:*0* 13. zofran 4 mg tablet sig: 1-2 tablets po three times a day: has allergy to compazine. disp:*30 tablet(s)* refills:*0* 14. total parenteral nutrition sig: one (1) once a day for 2 weeks: start at total volume per 24hr. wean down gradually to total volume per 12hours. vol 1400ml/d, amino acids 80g/d, dextrose 320g/d, fat 0g/d, nacl 90, naac 0, napo4 10, kcl 60, kac 0, kpo4 0, mgso4 18, caglu 5. . disp:*1 14* refills:*0* discharge disposition: home with service facility: home solutions discharge diagnosis: primary diagnoses: - acute pancreatitis from hypertriglyceridemia - hypertriglyceridemia - flash pulmonary edema secondary diagnoses: - mild coronary artert disease - non-alcoholic steatohepatitis - anxiety - psoriasis - diabetes mellitus discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. abdominal exam: vitals: discharge instructions: dear ms. , you were admitted to the hospital for abdominal pain from acute pancreatitis that likely occurred because of a high blood levels of triglycerides. you had abdominal pain that was difficult to control on iv dilaudid and after 1 week of different combinations of dosage and timing, we had a pain management doctor see you. we followed his recommendations to start you on a pca of dilaudid and start you on gabapentin for pain. you used the pca of dilaudid for 1 day. afterwards, we started giving you oral doses of hydromorphone for pain. you had a lot of nausea while you were in the hospital and we gave you zofran for nausea. we also gave you iv fluids to make sure you did not become dehydrated because of the pancreatitis and because you were not eating. we kept you on a plan to not feed you because of pain and nausea, but gave you total parenteral nutrition (tpn), which is nutrition through an iv, starting on . you were able to tolerate clear fluids without pain although you continued to have some nausea. you should continue to take your anti-nausea meds as needed prior to your meals. try to stick with one type of clear (broth for example) that works for you, and drink small portions throughout the day. we made the following medication changes during this hospitalization: (1) for pain, please take dilaudid 2-4 mg q3 hours as needed for pain. don't operate machinery or take this medication if you are sleepy. (2) we decreased levemir to 12 units in the morning and at night. (3) we increased rosuvostatin to 10 mg daily. (4) we started zofran which you can take up to three times a day for nausea, especially around mealtimes. (5) we started gabapentin 300 mg three times a day to help you with pain control - do not take this medicine if you feel sleepy. (6) we started tpn which is to ensure you have good nutrition while you are still having trouble eating. followup instructions: 1) please follow up with your primary care physician monday at 1115 am. 2) please follow up with your gastroenterologist (dr on wed at 945 am. procedure: venous catheterization, not elsewhere classified parenteral infusion of concentrated nutritional substances diagnoses: acidosis obstructive sleep apnea (adult)(pediatric) coronary atherosclerosis of native coronary artery esophageal reflux mitral valve disorders other opiates and related narcotics causing adverse effects in therapeutic use pure hyperglyceridemia anxiety state, unspecified long-term (current) use of insulin other constipation hypoxemia chronic pancreatitis diabetes with other specified manifestations, type ii or unspecified type, uncontrolled other psoriasis acute pancreatitis other chronic nonalcoholic liver disease acute edema of lung, unspecified panic disorder without agoraphobia 

Answer: The patient is high likely exposed to