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: a.c.e inhibitors attending: chief complaint: syncope major surgical or invasive procedure: ng tube placement history of present illness: 78 yo female with h/o dm,htn, pvd, who presented with two days of feeling unwell. she was unable to urinate x2 days and has not had a bm in the last day. today she stood up and syncopized after attempting to have bm and was unresponsive. ems was called and sbp was in the 90s with hr initially in the 60s and trending down to the 50s. she was also c/o epigastric pain. on arrival to the er, the pt immediately syncopized. her hr decreased to the 30s-40s and sbps decreased to the 50s-70s. ekg demonstrated a junctional rhythm. she received 0.5 mg of atropine x 2, glucagon 5 mg x1 and ivfs wide open, for a total of 6l ns. this resulted in improvement of hr and bps. labs demonstrated an elevated lactate as high as 5.2 and potssium of 8.2. she was treated with sodium bicarb, calcium gluconate, insulin and d50 x2. she also received 30 mg po kayexalate. repeat k was 6. renal was called and ua appeared c/w pre-renal etiology. of note, when foley was placed initially, only 100 cc of urine was drained. she later had a total of 200-300 cc of uop after 6l of ns. additionally, she was on a nrb during her time in the er and then her sats dropped to the 70s-80s. she was thought to be volume overloaded,so started on bipap with improvement in sats. she was also started on cefepime, flagyl and levofloxacin to cover pna and possible abdominal infection. of note, she had a non-contrast ct of the abdomen, which demonstrated possible thrombosis of the sma and heterogenous attenuation of the liver. ct of the chest demonstrated possible b/l pna. she was evaluated by surgery who did not think there was any surgical intervention indicated at the time. she was stable on bipap and trasnferred to the micu. . upon speaking with pt in the micu (grandson translating), she has been feeling crampy abd pain for several days. her biggest complaint is that she tried to have a bm but was unable. upon questioning she stated she had worse lower back pain and some substernal cp over the lsat week. cp is a substernal, pressure that improved with exertion and was intermittent. she denied diaphoresis, sob, f/c. . upon further discussion with the patient and family, it was discovered the patient had been taking high dose nsaids for several days prior to admission. past medical history: 1. non-insulin-dependent diabetes mellitus. 2. hyperlipidemia. 3. hypertension. 4. gastroesophageal reflux disease. 5. backpain-lumbar radiculopathy 6. osteoporosis 7. pvd: s/p right leg angiogram 6. admit in , s/p syncopal event and fall, after which she had backpain, constipation, abdominal distention and urinary incontinence. had spinal mri with t1/t2 lesions c/w hemangioma and t12 compression fx. several disc bulges were noted but no cord compression. also had narcotic ileus. social history: the patient denies alcohol or tobacco use. she lives in with her family. she is and speaks creole dialect. family history: n/c physical exam: vs: t: 98.9 bp: 141/65 hr: 59 rr: 21 o2 sat: 94% on 6l nc gen: well appearing, pointing to her abdomen heent: anicteric, dry mm neck: supple, obese pulmonary: exp wheezes b/l, moving air well cardio: bradycardic with regular rate abd: soft, very distended, nt, +bs ext: 1+ edema b/l neuro: pt mentating and moving all extremities pertinent results: echo : the left atrium is normal in size. left ventricular wall thickness, cavity size and regional/global systolic function are normal (lvef >55%) right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. the mitral valve leaflets are mildly thickened. physiologic mitral regurgitation is seen (within normal limits). there is borderline pulmonary artery systolic hypertension. there is no pericardial effusion. . ct abd/chest w/out contrast (prelim read): limited study for evaluation of bowel ischemia in the absence of iv contrast. heterogenous attenuation of the liver, with large geographic areas of low attenuation, may reflect fatty change but in the appropriate clinical setting, ischemia or inflammation are alternative possibilities. focal hyperdense segment of sma, occasionally associated with acute thrombus. be further evaluated with mesenteric vessel doppler, considering patient's clinical status does not permit contrast administration. bibasilar pulmonary consolidation, aspiration versus bilateral pneumonia. . c. cath : 1. central aortic hypertension 2. moderarate celiac artery lesion 3. severe ltpt and pa lesion with one vessel run off to the l foot via pa 4. successful atherectomy and pta of the l tpt lesion 5. successful pta of the l pa lesion . ekg: narrow junctional rhythm with rate of 59, rbbb brief hospital course: 78 yo female with dm ii, htn, pvd, admitted to micu () with arf and resulting syncope in setting of high dose ibuprofen. . # acute renal failure: admitted with a creatnine of 2.4 and severe hyperkalemia. fena 0.23% c/w pre-renal etiology. also in setting of high dose nsaid use, with likely resultant decrease of renal blood flow. resolved with ivf. she will have a renal function check in 1 week. if her renal function is stable at that time, she will resume her . she received clear instructions to avoid nsaids in the future. . # syncope: likely secondary to high junctional rhythm and multiple metabolic derranagements on admission. with high junctional rhythm at the time of syncope in ed, with hyperkalemia to 8, treated with atropine, gluccagon, insulin, bicarb and calcium. no further events on telemetry in the micu. bb and ccb initially held in the micu, bb reintroduced and tolerated well. ccb being held in the setting of bradycardia. . # hypoxia: in the ed with desaturation to 70-80%, requiring facemask. treated initially with levofloxacin and flagyl until . also diuresed with concern for volume overload. on room air throughout the remainder of her hospitalizaiton. suspect that acute desaturation in ed is secondary to aspiration pneumonitis (bilateral infiltrates seen on ct scan) in setting of syncope and altered mental status. echo for w/u of syncope revealed e/o rv hypokinesis. subsequent cta was negative for pe. . # hypertension: in micu with sbp 170s. reintroduced home regimen of bb without complications. however, she was noted to have junctional rhythm on admission (see below) and thus her diltiazem was discontinued. her was held in the setting of renal failure. norvasc was started for bp control. . # pulmonary hypertension: unclear etiology. no smoking history, no evidence of pe on cta. clinical history not suggestive of sleep apnea. she would benefit from a pulmonary follow up as outpt for further w/u of her pulmonary hypertension. . # abdominal distension: with self-reported constipation, and abdominal distension in the micu. ngt placed and discontinued in micu. abdominal exam remained benign. treated initially with levofloxacin and flagyl empirically (); all antibiotics discontinued since then. her distension likely reflects ileus versus constipation. she tolerated a regular diet on discharge. . # transaminitis: ast/alt 400s on admission, continued to trend down. suspect component of ischemic hepatopathy with junctional rhythm and hypotension. but also with question of fatty liver on ct scan. if her lfts continue to be elevated, further w/u with son as an outpt is recommended. . # question of sma thrombosis: question of sma thrombosis on cta scan on admission. clinical picture did not seem c/w acute mesenteric artery thrombosis. she remained abdominal pain free and without changes in her bowel habits. she was continued on her outpt regimen of asa, plavix, statin for her history of pvd. medications on admission: amitriptyline 20 mg qhs atenolol 25 m daily atorvastatin 10 mg daily plavix 75 mg daily diltizaem 120 mg q12 hour gabapentin 300 mg glucophage 1000 mg vicodin 5-500 mg tab q 6-8 hrs prn ibuprofen 600 mg q6 hours prn insulin ss lantus 68 units sc daily lyrica 50 mg tid protonix 40 mg qod valsartan 160 mg daily asa 325 mg daily discharge medications: 1. atorvastatin 10 mg tablet sig: one (1) tablet po once a day. 2. plavix 75 mg tablet sig: one (1) tablet po once a day. 3. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 4. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 5. insulin glargine subcutaneous 6. gabapentin 300 mg capsule sig: one (1) capsule po bid (2 times a day). 7. pregabalin 25 mg capsule sig: two (2) capsule po tid (). 8. glucophage 1,000 mg tablet sig: one (1) tablet po twice a day. 9. senna 8.6 mg tablet sig: one (1) tablet po bid prn as needed. disp:*30 tablet(s)* refills:*0* 10. bisacodyl 5 mg tablet, delayed release (e.c.) sig: two (2) tablet, delayed release (e.c.) po daily (daily) as needed. disp:*30 tablet, delayed release (e.c.)(s)* refills:*0* 11. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*2* 12. amlodipine 5 mg tablet sig: two (2) tablet po daily (daily). disp:*60 tablet(s)* refills:*2* 13. atenolol 25 mg tablet sig: one (1) tablet po once a day. discharge disposition: home with service facility: health care discharge diagnosis: primary acute renal failure hyperkalemia ileus transaminitis bradycardia, junctional rhythm secondary anemia hypertension type ii diabetes mellitus peripheral vascular disease hyperlipidemia vertigo discharge condition: good, tolerating pos, saturating on room air discharge instructions: you were admitted with kidney failure. you were found to have elevated levels of potassium. you were treated with hydration and your kidney function normalized. you also had a low heart rate from an elevated potassium. all of these issues normalized once your kidney function improved. it is very important that you discontinue your pain medications including ibuprofen, tylenol and other pain medications such as vicodin with opioid properties (such as oxycodone, percocet, etc). your amitriptyline was also discontinued. your lorsartan was discontinued because of your recent contrast administration with ct scan. this should be restarted by dr. as an outpt. your diltiazem was also discontinued. you were started on a medication called norvasc. please take all of your other medications as directed. please return to the emergency room or see your pcp if you have any of the following symptoms: chest pain, difficulty breathing, palpitations, loss of consciousness or any other serious concerns. followup instructions: we have scheduled the following appointment for you with dr. : provider: , md phone: date/time: 12:45 it is important that you have the following labs drawn at your appointment with dr. : chem 7 and lfts. you are being given a requisition to have these labs drawn. you should also schedule an appointment with pulmonary clinic in the next 1-2 months. they can be reached at (. procedure: arterial catheterization diagnoses: acidosis hyperpotassemia unspecified essential hypertension acute kidney failure, unspecified peripheral vascular disease, unspecified other and unspecified hyperlipidemia other specified cardiac dysrhythmias pneumonitis due to inhalation of food or vomitus paralytic ileus diabetes mellitus without mention of complication, type ii or unspecified type, uncontrolled hyperosmolality and/or hypernatremia shock, unspecified 

Answer: The patient is high likely exposed to