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: percocet / morphine sulfate attending: chief complaint: bilateral le weakness major surgical or invasive procedure: revi t2 transpedicular decompression of epidural metastasis. history of present illness: 63 y/o female with a history of renal cell carcinoma with metastases to the spine underwent a c5-t2posterior fusion and was discharged to rehab on . she presented from osh after c/o bilateral lower extremity weakness x 6 days. the patient states that she first noticed weakness in her lower extremities on . while at the rehab hospital,she reports that she was unable to stand and fell over.she was sent to hospital for mri of her c-spine to determine the cause of her weakness. she was then transferred to for direct admit for compression of t2. past medical history: diabetes,hyperlipidemia,hypertension,peripheral vascular disease,s/p r superficial femoral artery stenting x 2,cad, cardiac catheterization revealing a 95-99% proximal stenosis of the lad; s/p pci stenting in c5-t2posterior fusion and was discharged to rehab on social history: she continues to live in and will occasionally help out at her relatives' chinese restaurant answering phones does not drink or smoke family history: non-contributory physical exam: pe on admission: t:97.8 bp:146/76 hr:83 r:18 o2sats:96% gen: wd/wn, comfortable, nad. neuro: mental status: awake and alert, cooperative with exam, normal affect. orientation: oriented to person, place, and date. motor: d b t we wf ip q h at g r 5 5 5 0 0 0 0 0 0 l 5 5 5 0 0 0 0 0 0 sensation: intact to light touch + clonus pe on discharge: incision well healing with sutures intact motor: ip q h at g r 3 4 4 4 4 5 l 2 4 4 4 4 5 on discharge: a&ox3 motor: b t d ip q h at g r 4+ 4+ 4 2 5 5 5 5 5 l 4+ 4+ 4 2 5 5 5 5 5 abd- soft, positive bowel sounds ng tube in place not to suction pertinent results: 11:38pm type-art po2-273* pco2-43 ph-7.47* total co2-32* base xs-7 intubated-not intuba 11:38pm glucose-234* lactate-0.7 na+-136 k+-4.3 cl--95* 11:38pm hgb-11.8* calchct-35 11:38pm freeca-1.21 11:30pm glucose-257* urea n-17 creat-0.7 sodium-137 potassium-4.6 chloride-99 total co2-28 anion gap-15 11:30pm estgfr-using this 11:30pm wbc-3.1* rbc-3.85*# hgb-10.6*# hct-33.5*# mcv-87 mch-27.6 mchc-31.8 rdw-17.2* 11:30pm plt count-253# 11:30pm pt-10.7 ptt-23.4 inr(pt)-0.9 mr cervical spine w/o contrast: findings: in comparison with the most recent examination of the thoracic spine dated , there is significant change consistent with a pathological fracture, involving the t2 vertebral body with associated right paraspinal and epidural mass causing narrowing of both neural foramina and also producing spinal cord compression with more than 55% of spinal canal narrowing. again seen is evidence of post-surgical changes, consistent with posterior decompression and fusion, apparently unchanged since the prior examination and causing multiple metal artifacts, however, there is no evidence of abnormal signal within the thoracic spinal cord at t2 level. the sagittal stir images demonstrate low signal intensity within the vertebral body of t2, consistent with bone cement from a prior vertebroplasty. bilateral pleural effusions are again visualized. soft tissue edema and minimal amount of fluid is visualized at the surgical bed and also in the prevertebral space, apparently unchanged since the most recent examination. impression: evidence of pathological fracture at t2 vertebral body, causing at least 50% of spinal canal stenosis and spinal cord compression as described in detail above. there is no evidence of frank signal changes within the thoracic spinal cord at the level of the vertebral collapse. there is evidence of post-vertebroplasty changes at t2 level, with right paraspinal mass and epidural mass involving both neural foramina. c-spine non-trauma views; t-spine c1 through the upper portion of c7 is visualized. no prevertebral soft tissue swelling. skin staples noted posteriorly. there is diffuse osteopenia. the posterior spinous process of c3 appears truncated and there is some overlying subcutaneous emphysema. otherwise, no focal lytic or sclerotic lesion is detected. bony alignment is normal and no subluxation is seen. allowing for beam angulation, hardware alignment is nominal, without loosening. placement of the pedicle screws in the cervical spine. assessment is somewhat limited due to beam angulation, but is likely unremarkable. thoracic spine: there are bilateral spinal rods. no hardware loosening is identified. an intervertebral fusion device is seen at the level of t6, in nominal alignment. the t2 vertebral body and associated retropulsed methyl methacrylate was better demonstrated on the ct scan from -- this area is obscured by overlying humerus. from t3-t12, vertebral body heights and alignment are preserved. no obvious focal lytic or sclerotic lesion. there is increased retrocardiac density, consistent with left lower lobe collapse and/or consolidation. possible fluid tracking along right lung minor fissure, not fully evaluated here. impression: 1. stabilization hardware extending from the lower cervical through upper/mid thoracic spine. no hardware displacement or failure. 2. poor visualization of the posterior tip of the c3 spinous process, with nearby locule of subcutaneous air -- ? related to bony destruction. 3. c7-t2 not well visualized due to overlying anatomy. the patient is s/p c6 vertebrectomy. otherwise, cervical and thoracic vertebral bodies are intact and normally aligned. however, subtle bone lesions might not be apparent radiographically. 4. please refer to ct scan for assessment of abnormalities of c2. 5. left pleural collapse and/or consolidation and possible fluid layering in the minor fissure. le doppler final report impression: no evidence of deep vein thrombosis in either leg. the study and the report were reviewed by the staff radiologist. brief hospital course: 63f w/ met renal cell cancer s/p c5-t2 posterior fusion by dr on was admitted with bilateral le weakness. mri and x-ray imaging revealed evidence of pathological fracture at t2 vertebral body, causing at least 50% of spinal canal stenosis and spinal cord compression. she was taken to the or urgently for a decompression. she was transfered to the icu in an intubated state postoperatively. she was an a decadron taper. on she was extubated. she had significant improvement in her leg strength. her jp drain was pulled. transfer orders were written. she had minimally distended abdomen but was passing flatus. kub done showed dilated loops of bowel. she became more distended and ngt placed. after multiple bowel meds, she had bowel movement. ngt was kept to low continuous suction. radiation oncology was consulted for future treatment which has been arranged for . she was evaluated by pt/ot and found appropriate for acute rehab. on her abdomen was less distended with bowels sounds, ng tube was taken off suction to allow for a diet and see if she tolerates small amounts of food. on , patient has been able to tolerate sips and we will advance diet. she will be discharged to rehab facility with ng tube in place not to suction and continue aggressive bowel regimen. medications on admission: aspirin 81 mg po daily 2. fentanyl 50 mcg/hr patch 72 hr 72 hr transdermal q72h 3. cholecalciferol (vitamin d3) 400 unit tablet po daily 4. simvastatin 40 mg (2) tablet po daily 5. pioglitazone 15 mg (2) tablet po daily 6. insulin regular human 100 unit/ml solution sliding scale coverage 7. glipizide 5 mg tablet po bid 8. levetiracetam 500 mg po bid 9. docusate sodium 100 mg po bid 10. acetaminophen 325 mg po q6h 11. valsartan 40 mg tablet po daily 12. metoprolol tartrate 25 mg po bid 13. methocarbamol 500 mg po tid 14. famotidine 20 mg po bid 15. calcium carbonate 500 mg po tid 17. senna 8.6 mg tablet po bid 18. bisacodyl 5 mg delayed release (e.c.) po daily prn constipation. 19. hydromorphone 2 mg po q4h as needed for pain. 20. clopidogrel 75 mg po daily start on . 21. prochlorperazine edisylate 5 mg/ml solution sig: ten (10) mg injection q6h (every 6 hours) as needed for nausea. discharge medications: 1. docusate sodium 50 mg/5 ml liquid sig: one (1) po bid (2 times a day). 2. calcium carbonate 500 mg/5 ml (1,250 mg/5 ml) suspension sig: one (1) po tid (3 times a day). 3. acetaminophen 650 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for pain. 4. insulin regular human 100 unit/ml solution sig: one (1) injection asdir (as directed). 5. famotidine 20 mg tablet sig: one (1) tablet po bid (2 times a day). 6. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day). 7. meclizine 12.5 mg tablet sig: two (2) tablet po q6h (every 6 hours) as needed for vertigo. 8. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for pain. 9. methylnaltrexone 12 mg/0.6 ml solution sig: one (1) subcutaneous every other day (every other day). 10. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po bid (2 times a day). 11. lactulose 10 gram/15 ml syrup sig: thirty (30) ml po bid (2 times a day). 12. glycerin (adult) suppository sig: one (1) suppository rectal daily (daily). 13. ondansetron 4-8 mg iv q8h:prn nausea/vomiting 14. ciprofloxacin 400 mg iv q12h duration: 7 days discharge disposition: extended care facility: discharge diagnosis: met renal cell cell cancer hardware failure c5-t2 posterior fusion . discharge condition: stable discharge instructions: ?????? do not smoke. ?????? keep your wound clean / no tub baths or pool swimming until seen in follow up/daily showers ?????? no pulling up, lifting more than 10 lbs., or excessive bending or twisting. ?????? limit your use of stairs to 2-3 times per day. ?????? take your pain medication as instructed; you may find it best if taken in the morning when you wake-up for morning stiffness, and before bed for sleeping discomfort. ?????? do not take any anti-inflammatory medications such as motrin, advil, aspirin, and ibuprofen etc. for 3 months. ?????? increase your intake of fluids and fiber, as pain medicine (narcotics) can cause constipation. we recommend taking an over the counter stool softener, such as docusate (colace) while taking narcotic pain medication. call your surgeon immediately if you experience any of the following: ?????? pain that is continually increasing or not relieved by pain medicine. ?????? any weakness, numbness, tingling in your extremities. ?????? any signs of infection at the wound site: redness, swelling, tenderness, and drainage. ?????? fever greater than or equal to 101?????? f. ?????? any change in your bowel or bladder habits (such as loss of bowl or urine control). followup instructions: follow up instructions/appointments please return to 5 on for radiation therapy ??????please return to dr office for removal of your sutures after you have finished radiation therapy. ??????please call ( to schedule an appointment with dr. to be seen in 6 weeks. ??????you will need x-rays/ct-scan prior to your appointment. the following appointments have already been scheduled for you: provider: scan phone: date/time: 10:00 procedure: imageless computer assisted surgery excision or destruction of lesion of spinal cord or spinal meninges other exploration and decompression of spinal canal other exploration and decompression of spinal canal diagnoses: coronary atherosclerosis of native coronary artery urinary tract infection, site not specified unspecified essential hypertension diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled peripheral vascular disease, unspecified percutaneous transluminal coronary angioplasty status constipation, unspecified other and unspecified hyperlipidemia secondary malignant neoplasm of brain and spinal cord long-term (current) use of insulin paralytic ileus other diseases of lung, not elsewhere classified personal history of malignant neoplasm of kidney secondary malignant neoplasm of bone and bone marrow paraplegia secondary malignant neoplasm of other parts of nervous system arthrodesis status myelopathy in other diseases classified elsewhere pathologic fracture of vertebrae 

Answer: The patient is high likely exposed to