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: hematuria major surgical or invasive procedure: cystoscopy history of present illness: this is a 89 yo f with a pmhx of recently diagnosed bladder mass suspicious for tcc, dementia (possibly body), dmii, h/o cva and possibly seizures who p/f with complaints of worsening hematuria. . the patient got her labs drawn at hosue and her hct was found to be down to 25.3 from 29.3 . she was also reported to be complaining of worsening weakness, dizziness and decreased po intake. she was sent to the ed. . there her vs were stable and a 3 way foley was placed. urology saw the patient and advised continued flushing and medicine admission. the patient was recently seen by dr. a cystoscopy was done on which showed an anterolateral and posterior wall tumor. urine cytology was suspicious for urotherlial dysplasia. a ct was also done as part of that work up which revealed two bladder masses concerning for tcc. the patient was admitted for w/u for her arf and hematuria. . on the floor, the patient c/o constipation. otherwise she denies complaints. . 12 points ros is otherwise negative . past medical history: 1. seizure 2. dmii with multiple admissions for hypoglycemia 3. dementia (possibly body with reported occasional hallucinations) 4. cva 5. tia 6. hypertension 7. diverticulosis 8. gerd 9. stage i cervical cancer 10. h/o zoster of the upper lip 11. osteoporosis social history: former etoh, quit smoking 50 years ago, now lives at family history: noncontributory physical exam: admission pe 97.8 144/62 75 18 99 ra bg 197 general: aaox1 (only knows name, unsure of location or date) in nad, speaks in difficult to comprehend speech heent: mm somewhat dry, op reveals white film on tongue, partially removable neck: no lad, no obvious thryoid masses cv: slightly irregular rate, no rmg lungs: ctab no wrr abdomen: active bs x4, ttp in epigastrum, mild, no hsm extremities: wwp, pulses +1 and equal, ble edema 1+ neuro: cn wnl, ms per above, strength and sensation wnl psyc: somewhat tangential, difficult to understand . pt expired pertinent results: admission labs: 11:45pm urine color-red appear-cloudy sp -1.014 11:45pm urine blood-lg nitrite-neg protein-300 glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-8.0 leuk-lg 11:45pm urine rbc->182* wbc->182* bacteria-few yeast-none epi-3 11:45pm urine mucous-rare 10:45pm wbc-5.1 rbc-3.06* hgb-8.3* hct-27.6* mcv-90 mch-27.1 mchc-30.0* rdw-13.7 10:45pm neuts-74.7* lymphs-16.9* monos-6.9 eos-1.2 basos-0.3 10:45pm plt count-300 07:11pm lactate-0.9 07:01pm glucose-161* urea n-48* creat-1.4* sodium-135 potassium-5.1 chloride-105 total co2-19* anion gap-16 07:01pm estgfr-using this 07:01pm calcium-8.6 phosphate-2.6* magnesium-2.5 07:01pm wbc-5.1# rbc-3.14* hgb-8.6* hct-28.1* mcv-90 mch-27.3 mchc-30.5* rdw-13.5 07:01pm neuts-72.9* lymphs-19.4 monos-6.5 eos-1.0 basos-0.2 07:01pm plt count-297# 07:01pm pt-10.9 ptt-27.7 inr(pt)-1.0 06:50pm urine color-red appear-cloudy sp -1.020 06:50pm urine blood-lg nitrite-neg protein->300 glucose-neg ketone-neg bilirubin-neg urobilngn-0.2 ph-9.0* leuk-lg 06:50pm urine rbc->182* wbc-31* bacteria-mod yeast-none epi-17 . other labs of hospital course, prior to death: 04:49am blood wbc-10.8 rbc-2.58* hgb-7.2* hct-23.7* mcv-92 mch-28.0 mchc-30.5* rdw-14.2 plt ct-254 06:25am blood neuts-72.5* lymphs-18.3 monos-7.7 eos-1.4 baso-0.2 04:49am blood plt ct-254 02:50pm blood fibrino-621* 02:50pm blood fdp-10-40* 02:32am blood glucose-144* urean-32* creat-1.9* na-144 k-4.0 cl-111* hco3-25 angap-12 04:24am blood alt-35 ast-41* ld(ldh)-404* alkphos-78 totbili-0.4 09:34am blood ck-mb-4 ctropnt-0.03* 02:56pm blood ck-mb-5 ctropnt-0.03* 04:03am blood ck-mb-5 ctropnt-0.07* 06:25am blood hapto-486* 03:52am blood phenyto-1.6* 03:15pm blood phenyto-1.8* 02:39am blood freeca-1.16 . imaging: ct multidetector ct imaging of the chest was performed without intravenous contrast. sagittal and coronal reformats were generated and reviewed. ct of the chest without intravenous contrast: the major airways are patent to subsegmental levels bilaterally. multiple round soft tissue nodules are seen in both lungs, the largest at the junction of the left lower lobe and lingula measuring 2.3 x 2.0 cm. the pleural-based mass in the right upper lobe measures 1.6 x 0.9 cm (3:21). there is moderate-sized simple right pleural effusion with compressive atelectasis of a major portion of the right lower lobe. there is no left pleural effusion. few enlarged lymph nodes are seen in the paratracheal, prevascular, subcarinal and hilar regions, with the largest lymph node in the prevascular region measuring 13 mm (2:17). few of thesenodes are calcified, suggestive of prior granulomatous disease. the imaged portion of the heart is unremarkable, except for extensive coronary arterial calcification. there is no pericardial effusion. no significant mediastinal, hilar, or axillary adenopathy is seen. the main and lobar pulmonary arteries are dilated, with the main pulmonary artery measuring 3.2 cm, consistent with pulmonary arterial hypertension. the thoracic aorta has moderate atherosclerotic calcification without aneurysmal dilation. this study is not tailored for evaluation of the subdiaphragmatic organs, within this limitation, imaged portion of the liver and spleen are unremarkable. bones and soft tissues: no bone lesions suspicious for infection or malignancy are detected. mild degenerative changes are seen in the thoracic spine. impression: 1. in this patient with clinical concern for bladder cancer, multiple pulmonary nodules are concerning for metastatic disease. few mostly calcified mediastinal lymph nodes relate to prior granulomatous disease. 2. pulmonary arterial hypertension. 3. moderate-sized simple right pleural effusion. portable tte (complete) done at 11:32:35 am final general comments: suboptimal image quality - poor echo windows. conclusions the left atrium is mildly dilated. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. overall left ventricular systolic function is normal (lvef 70%). there is considerable beat-to-beat variability of the left ventricular ejection fraction due to an irregular rhythm/premature beats. the right ventricular free wall is hypertrophied. the right ventricular cavity is dilated with borderline normal free wall function. 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. trivial mitral regurgitation is seen. moderate to severe tricuspid regurgitation is seen (may be underestimated due to the technically suboptimal nature of this study). there is severe pulmonary artery systolic hypertension. there is no pericardial effusion. impression: severe, chronic or acute-on-chronic right ventricular afterload excess chest port. line placement study date of 5:14 am findings: as compared to the previous radiograph, the patient has been intubated. the tip of the endotracheal tube projects 4.6 cm above the carina. the size of the cardiac silhouette in the left lung is unchanged. on the right, however, is a relatively extensive pleural effusion, combined to an area of perihilar atelectasis. these could reflect mucus plugging or acute lung disease such as aspiration or blleding. the lung disease. bilat lower ext veins study date of 1:16 pm impression: no evidence of right lower extremity deep vein thrombosis. chest (portable ap) study date of 2:52 pm right internal jugular line is in place with its tip at the level of mid svc. there is substantial interval increase in the right pleural effusion, questionable intervention should be of concern. cardiomegaly is substantial. there is evidence of interval development of minimal pulmonary edema. no pneumothorax is seen. unilat lower ext veins left study date of 10:13 am impression: no evidence of left lower extremity deep vein thrombosis. chest (portable ap) study date of 5:25 am findings: in comparison with the study of , there is little overall change. continued mild to large layering pleural effusion on the right with compressive atelectasis. similar opacification at the left base consistent with atelectasis and small pleural effusion. in the appropriate clinical setting, supervening pneumonia would have to be considered. known bilateral pulmonary nodules are seen in better detail on the recent ct scan. brief hospital course: this is a 89 yo f with a pmhx of recently diagnosed bladder masses suspicious for tcc, dementia, dm ii who p/w arf, persistent hematuria and fatigue and decreased po intake. . pt was initially admitted to the medical service for evaluation and treatment of her anemia which was presumably due to microscopic/macroscopic hematuria. she was seen by urology for evaluation for suspected bladder cancer. she underwent a cystoscopy which showed bladder masses that were biopsied. these were presumed metastatic disease. on the morning of the patient was noted to be unresponsive after being turned upon having a bowel movement. she had no pulse during this arrest and a code blue was called for pea arrest with return of pulse after 2 cycles chest compressions and 1mg epi x2 and 1amp bicarb. she was intubated and transferred to the . femoral line was attempted peri-code but was arterial and removed. pt was intubated during the code. cxr in the unit showed white out of the entire right lung suggesting layering of her known pleural effusion (likely malignancy related, see below). cxr also suggested some new widening of the mediastinum. right ij was placed. later that day she was extubated. she did not exhibit much neurologic function; would respond to painful stimuli but no other responses. ekg showed right axis deviation. tte showed pulmonary hypertension and evidence of rv strain. out of c/f pe heparin was started empirically. vanc/zosyn also started for c/f possible pneumonia. the pt continued to not improve neurologically and was not responding to pain. neurology was consulted and found her to have positive brainstem reflexes but little evidence of cortical function. after several days of no improvement her family decided to make the pt . ivf, heparin and antibiotics were stopped and the patient passed away peacefully that evening. the family was made aware and was present at the bedside. the family refused autopsy and the medical examiner refused the case. medications on admission: alendronate 70 q week asa 325 qd atenolol 200 qd ferrous sulfate 325 qd hctz 50 qd lisinopril 40 qd mvi nifedipine 60 er qd latanoprost .005 1 drop to right eye qd docusate 100 minoxidil 1.25 pantroprazole 40 erythromycin opth apply to left eye risperidone .75 qhs ultram 50 tid aepe 650 q6h prn discharge medications: patient expired discharge disposition: expired discharge diagnosis: patient expired discharge condition: patient expired discharge instructions: patient expired followup instructions: patient expired md procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours insertion of endotracheal tube other transurethral excision or destruction of lesion or tissue of bladder closed [transurethral] biopsy of bladder central venous catheter placement with guidance diagnoses: pneumonia, organism unspecified esophageal reflux acute posthemorrhagic anemia diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute kidney failure, unspecified obstructive chronic bronchitis with (acute) exacerbation other convulsions constipation, unspecified acute respiratory failure cardiac arrest cardiogenic shock osteoporosis, unspecified other late effects of cerebrovascular disease gross hematuria secondary malignant neoplasm of lung dementia in conditions classified elsewhere without behavioral disturbance enlargement of lymph nodes other pulmonary embolism and infarction dementia with lewy bodies benign essential hypertension malignant neoplasm of other specified sites of bladder malignant pleural effusion 

Answer: The patient is high likely exposed to