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: dopamine / mirapex / demerol attending: chief complaint: tachycardia, hypotension, altered mental status major surgical or invasive procedure: : left open reduction and intramedullary nailing of a left intertrochanteric hip fracture history of present illness: ms. is 79yo female with parkinson's, af not anticoagulated h/o recurrent falls and osteoporosis initially admitted after unwitnessed fall, found to have l intertrochanteric femur fx pod#1 s/p open reduction and im rod placement yesterday who is transferred to micu in setting of af with rvr associated with hypotension in setting of witnessed aspiration event and untreated uti. this am, pt was found to be in af with rvr with sbps 60s when seen by pt. she was given 2l ivf with improvement in bp to 90s, also received diltiazem 10mg iv x 2 and metoprolol 5mg iv x 3 once bp was improved and hr improved to 90s. of note, she also had positive urine cx which had not yet been treated and had witnessed aspiration event in setting of altered mental status this am. . regarding presenting fall, husband heard pt fall in bathroom and found wife on ground, crying in pain. there was no reported history of seiure activity, bladder or bowel incontinence and he felt this was typical for her given her recurrent falls. . in ed, vitals 98.4 185/103 74 16 99% ra. she had one set of negative cardiac enzymes. ekg with q waves in v5 v6 and lad. ct head negative for hemorrhage. ct neck without fracture but with canal stenosis c4-c7, seen previously. hip plain films with displaced left hip intertrochanteric fracture. . on arrival, hr 80s-90s, sbp 90s/60s, improved to 110s with ivf. past medical history: 1. parkinson's disease. 2. mitral valve replacement. 3. atrial fibrillation - not on coumadin balance issues 4. dysarthria. 5. history of colitis - ?ischemic 6. hypertension. 7. hypothyroidism. 8. s/p appendectomy. 9. s/p tah bso 10. s/p thyroidectomy. 11. s/p left lumpectomy in (dr. & xrt 12. s/p right mastectomy in 13. gerd 14. osteoporosis 15. chronic constipation social history: lives with husband at home, with aids to help around the house. she never used tobacco or alcohol. she lives with husband in and is retired. needs assistance with all adls including dressing, cleaning. family history: mother with hypertension died at age . father died at age 77. brother with in 60s. no diabetes mellitus. physical exam: vitals: t: bp: p: r: 18 o2: general: alert, not oriented to place, oriented to self and husband, no acute distress, interacts appropriately with husband and son : sclera anicteric, mm dry, oropharynx clear neck: supple, jvp 7-8cm, no lad lungs: bibasilar rales, no wheezes, rhonchi cv: regular rate and rhythm, 3/6 systolic murmur llsb radiating to apex with no respirophasic variation, normal s1, prominent s2, no rubs or gallops abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly ext: warm, well perfused, 1+ pulses, no clubbing, cyanosis or edema, left thigh with dsg c/d/i, edema, mild tension, ecchymoses pertinent results: labs on admission: wbc-7.0 rbc-4.34 hgb-12.8 hct-40.6 mcv-93 mch-29.4 rdw-13.6 plt ct-238 neuts-56.5 lymphs-35.9 monos-5.2 eos-1.8 baso-0.8 pt-12.4 ptt-25.3 inr(pt)-1.0 glucose-102 urean-27* creat-1.0 na-141 k-4.6 cl-106 hco3-26 angap-14 calcium-9.0 phos-3.8 mg-1.8 . cardiac enzymes: 01:27pm blood ck(cpk)-243* 04:02pm blood ck(cpk)-590* 11:22pm blood ck(cpk)-579* 03:50am blood ck(cpk)-374* 07:00am blood ck(cpk)-681* 08:45am blood ctropnt-<0.01 01:27pm blood ck-mb-7 ctropnt-0.13* 04:02pm blood ck-mb-15* mb indx-2.5 ctropnt-0.33* 11:22pm blood ck-mb-10 mb indx-1.7 ctropnt-0.24* 03:50am blood ck-mb-7 ctropnt-0.13* 07:00am blood ctropnt-0.25* . other labs wbc-7.6 rbc-2.89* hgb-8.9* hct-27.6* mcv-96 rdw-13.8 plt ct-184 wbc-9.0 rbc-3.93* hgb-11.4 hct-34.7* mcv-88 rdw-15.8 plt ct-156 lactate-0.9 . micro: urine culture (final ): escherichia coli | ampicillin------------ =>32 r ampicillin/sulbactam-- 16 i cefazolin------------- <=4 s cefepime-------------- <=1 s ceftazidime----------- <=1 s ceftriaxone----------- <=1 s cefuroxime------------ 4 s ciprofloxacin---------<=0.25 s gentamicin------------ <=1 s meropenem-------------<=0.25 s nitrofurantoin-------- <=16 s piperacillin/tazo----- <=4 s tobramycin------------ <=1 s trimethoprim/sulfa---- =>16 r . . other studies: ekg: normal sinus rhythm, rate 74. left axis deviation. left ventricular hypertrophy. compared to the previous tracing of septal repolarization abnormalities have resolved. /o9 ct head w/o: no evidence of hemorrhage ct spine w/o: no acute fracture or dislocation. extensive multilevel degenerative changes, as detailed on prior report from with mild central canal stenosis at the levels of c4-c7. grade 1 anterolisthesis of c3 on c4 vertebral bodies. hip x-ray: displaced left hip intertrochanteric fracture hip x-ray: eight films from the or demonstrate interval placement of an intramedullary rod spanning the femoral fracture. at the end of the procedure, the alignment is near anatomic. echo: the left atrium and right atrium are normal in cavity size. there is mild symmetric left ventricular hypertrophy with normal cavity size and regional/global systolic function (lvef>55%). right ventricular chamber size and free wall motion are normal. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. trace aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. a mitral valve annuloplasty ring is present. the mitral annular ring appears well seated with normal gradient. mild to moderate (+) mitral regurgitation is seen. there is mild pulmonary artery systolic hypertension. there is a trivial/physiologic pericardial effusion. compared with the report of the prior study (images unavailable for review) of , mild pulmonary artery systolic hypertension is now present and the severity of mitral regurgitation is slightly increased. cta: no evidence of central pe. small pleural effusions with subsequent atelectasis. no other parenchymal opacities. healed rib fractures. . brief hospital course: this is a 79 woman transferred to micu for hypotension and tachycardia initially admitted s/p fall treated with open reduction and im rod placement. # hypotension: likely multifactorial triggered by af with rvr with poor perfusion in setting of npo status and decreased po intake. bp now improved after ivf and with rate control as below. we ruled out pe with a negative cta. her uti likely did not cause sepsis related hypotension given her clinical picture. however, her uti was treated with ceftriaxone and blood cultures were drawn. we obtained an echo to make sure she had adequte ef. also, we obtained serial cardiac enzymes to confirm that she was not having an acute mi. he was transfused 3 units of prbc while in the micu for anemia. this coupled with ivf, resolved that patient's hypotension. her hematocrit and vitals were stable upon discharge. # af: pt has history of af and had episode of af with rvr this am, possibly triggered by anemia/hypotension. cardiology has been following and recommended rate control with metoprolol 25mg po bid in addition to norpase 100 tid. her rate was well controlled upon discharge. . # anemia: patient's hematocrits have been stable after the blood transfusion. . # intertrochanteric fx: s/p surgery for l intertrochanteric fx, started on lovenox today. receieved cefazolin x1 for the operation. her pain has been controlled with tylenol and oxycodone prn. she will require further physical rehabilitation at rehab. . #. s/p fall-- most likely consistent with mechanical fall versus brief episode of afib with rbr. head ct neagtive for acute process on admission. likely related to parkinsons and gait disturbance given recurrent falls. . #. parkinson's- continued sinemet, discharged on azilect per home regimen . #. htn--restart on quapril, norvasc upon discharge. . #. hypothyroidism-- continue home levothyroxyl. . #. osteoporosis--ca and vitd. . # fen: speach and swallow saw the patient and recommended nectar thick liquids, with ground founds. will require further speech and swallow evaluation with video study as outpatient. . # prophylaxis: lovenox 40mg sc daily and home ppi . # code: dnr/dni confirmed with husband . # communication: patient and husband c son medications on admission: sinemet cr 50/200 tid, sinemet 25/100 half tab tid, levoxyl 112mcg qd, prevacid 30mg , norpace 100mg tid, micro-k 6pills but dose unknown per day tid, mvi, toprol xl 25 qd, norvasc 5 , azilect 1mg qd, quinapril 20 qd, evista 60 , 325 qd, coenzyme 1200mg q10 qday discharge medications: 1. carbidopa-levodopa 50-200 mg tablet sustained release sig: one (1) tablet po tid (3 times a day). 2. carbidopa-levodopa 25-100 mg tablet sustained release sig: one (1) tablet po tid (3 times a day). 3. levothyroxine 112 mcg tablet sig: one (1) tablet po daily (daily). 4. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 5. raloxifene 60 mg tablet sig: one (1) tablet po daily (). 6. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). 7. disopyramide 100 mg capsule sig: one (1) capsule po q8h (every 8 hours). 8. enoxaparin 40 mg/0.4 ml syringe sig: one (1) injection subcutaneous daily (daily). 9. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). 10. oxycodone 5 mg tablet sig: .5 to 1 tablet po q6h (every 6 hours) as needed for pain. 11. acetaminophen 500 mg tablet sig: one (1) tablet po q6h (every 6 hours) as needed for pain. 12. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 13. quinapril 20 mg tablet sig: one (1) tablet po daily (daily). 14. ciprofloxacin 250 mg tablet sig: one (1) tablet po q12h (every 12 hours) for 5 days. 15. sodium chloride 0.9% flush 3 ml iv q8h:prn line flush peripheral line: flush with 3 ml normal saline every 8 hours and prn. 16. azilect 1mg daily discharge disposition: extended care facility: for the aged - discharge diagnosis: left intertrochanteric hip fracture, 3-part. atrial fibrillation with rapid ventricular response urinary tract infection. discharge condition: vital signs stable. good condition discharge instructions: you were admitted with a fall. you had your hip replaced and during your stay you had rapid heart beat that required treatment in the icu. your heart rate was stabilized and you are being discharged to a rehab for further physical therapy and care. continue to be weight bearing as tolerated on your left leg continue your lovenox injections for a total of 4 weeks after surgery please resume all your medications as prescribed by your doctor. you were given new medications; please take them as instructed. . if you have any increased redness, drainage, or swelling, or if you have a temperature greater than 101.5, please call the office or come to the emergency department. physical therapy: activity: out of bed w/ assist left lower extremity: touchdown weight bearing treatments frequency: staples/sutures out 14 days after surgery dry sterile dressing daily or as needed for drainage or comfort followup instructions: please follow up with , np in orthopaedics in 2 weeks, please call to schedule that appointment. followup instructions: please follow up with in orthopaedics in 2 weeks, please call to schedule that appointment. . provider: , .d. phone: date/time: 3:30 provider: phone: date/time: 9:00 provider: , .d. phone: date/time: 2:30 procedure: open reduction of fracture with internal fixation, femur closed reduction of fracture without internal fixation, femur diagnoses: other iatrogenic hypotension esophageal reflux urinary tract infection, site not specified unspecified essential hypertension acute posthemorrhagic anemia unspecified acquired hypothyroidism atrial fibrillation personal history of malignant neoplasm of breast abnormality of gait paralysis agitans osteoporosis, unspecified other constipation altered mental status dementia in conditions classified elsewhere without behavioral disturbance heart valve replaced by transplant hypovolemia syncope and collapse fall from other slipping, tripping, or stumbling closed fracture of intertrochanteric section of neck of femur acquired absence of breast and nipple dysphagia, oropharyngeal phase history of fall inhalation and ingestion of other object causing obstruction of respiratory tract or suffocation foreign body in pharynx 

Answer: The patient is high likely exposed to