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: iodine / capital with codeine attending: chief complaint: headache, confusion, speech disturbance major surgical or invasive procedure: tpa infusion pm history of present illness: hpi; mr. is an 86-year-old man with hx cad s/p cabg and stent, hld, prior tia three weeks ago, presenting as a code stroke for aphasia. he was hospitalized overnight at three weeks prior after episode of aphasia and possibly hemibody weakness. his wife was told he had a tia and an mri brain was negative for acute stroke. he was discharged home the next day and has been doing well since. he was last normal at 16:00 on the day of his admission. shortly after this he complained of headache and then appeared confused. he had difficulty following commands and speaking. no episodes of shaking, unresponsiveness, or stereotyped movements. past medical history: 1) cad s/p angioplasty in , s/p mi followed by cabgx5 (), stents and (bms) 2) hypercholesterolemia 3) pernicious anemia 4) tubular adenomas in colon 5) bph - s/p turp, last psa 6) testicular nodule 7) trigeminal neuralgia 8) memory loss / dementia 9) hearing loss 10) appendectomy social history: denies tobacoo, alcohol, intravenous drug use; married w/ 4 children 4 grandchildren; retired from mark pharmaceutical company (designed cyclotron labs) family history: sister w/ breast ca, no family history of colon/prostate ca. 2 brothers w/ aneurysms. no cad or known heart disease physical exam: physical examination on admission nih stroke scale score was 10: 1a. level of consciousness: 0 1b. loc question: 2 1c. loc commands: 1 2. best gaze: 0 3. visual fields: 2 4. facial palsy: 1 5a. motor arm, left: 0 5b. motor arm, right: 0 6a. motor leg, left: 0 6b. motor leg, right: 0 7. limb ataxia: 0 8. sensory: 0 9. language: 2 10. dysarthria: 1 11. extinction and neglect: 1 physical examination; vs; bp 189/105 p 67 rr 20 100% on 4l nc gen; lying in bed, nad heent; nc/at, mucous membranes moist, oropharynx clear cv; rrr, no murmurs pulm; cta anteriorly abd; soft, nt, nd extr; no edema neuro; ms; awake, alert, makes eye contact. to state name then perseverates, repeating his name in response to further questions. frequent paraphasias and neologisms. unable to name any objects correctly. unable to repeat a sentence. unable to read. follows some one step commands inconsistently (closes eyes but does not stick out tongue or squeeze hand to command). cn; perrl 3mm-->2mm, mild left gaze preference but crosses midline. decreased blink to threat to stimuli on the right. face sensation intact to light touch. subtle right nlf flattening. tongue midline. motor; normal bulk and tone, no pronator drift, tremor, or asterixis. maintains all extremities antigravity for ten seconds without drift. further testing limited due to cooperation. sensory; intact to light touch and pinprick throughout. reflexes; toes downgoing b/l. coordination; no dysmetria on fnf b/l. pertinent results: nchct impression: 1. chronic infarction involving the right subinsular region, with evidence of chronic microvascular infarction and chronic right thalamic lacunar infarct. mri is more sensitive for the detection of acute infarction. 2. calcified left cerebellopontine angle 1.1 x 0.8 cm mass, likely a meningioma, though mr can be obtained for further characterization. 3. sequelae of prior surgery involving the left suboccipital region. flp - tc 205, trig 151, hdl 33, ldl 142 mri/mra - impression: 1. small acute/ subacute infarct in left periventricular white matter. 2. changes of small vessel ischemic disease. 2. tortuous intracranial vessels without high-grade stenosis or occlusion. 3. no significant abnormality is noted in mra neck. tte the left atrium is mildly dilated. left ventricular wall thicknesses and cavity size are normal. regional left ventricular wall motion is normal. overall left ventricular systolic function is low normal (lvef 50-55%). right ventricular chamber size and free wall motion are normal. the ascending aorta is mildly dilated. the aortic arch is mildly dilated. the aortic valve leaflets (3) are mildly thickened. there is a minimally increased gradient consistent with minimal aortic valve stenosis. mild (1+) aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. there is no mitral valve prolapse. trivial mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. there is no pericardial effusion. impression: no cardiac source of embolism seen. normal global and regional biventricular systolic function. calcified aortic and mitral valves. mild aortic regurgitation. routine eeg brief hospital course: the patient is an 86 year old man with a history of cad (s/p cabg x 5 , stent x 3 stents and with re-instent thrombosis), hl, pernicious anemia, trigeminal neuralgia and a recent tia 3 weeks ago who presented with headache and confusion. he was last seen well at 1600 and subsequently was described by his wife as having difficulty following commands and speaking. a code stroke was called at 1731 and the decision was made to give him tpa which was infused was 1830. his nihss was 10 for the resident evaluation and then 9 for the fellow evaluation. the patient was observed to have a lateral tongue laceration as well which suggested the possibility of seizure for which the patient received lorazepam 1 mg. following tpa infusion, the patient was admitted to the neuro-icu where he remained hemodynamically stable, his neurological examination remained stable and had no bleeding diatheses. overnight, his examination improved such that he regained orientation and fluent speech. his blood pressure, initially sbp 200s, autoregulated down to the 130s-160s without intervention. his mri revealed a small left frontal stroke without any major vascular stenoses. the following morning, he was transferred to the neurology floor of the on 11 where he continued to do well. he and his family were educated about the mechanism of stroke and the therapy that he had received. a follow up ct scan showed no intracranial abnormalities, and other than some oozing at his piv site, there were no notable physical examination findings. he was discharged to home with follow up as noted below. we added a baby aspirin and fish oil to his medication regimen. of note, his prior tia was evaluated at and he was reported to have aphasia and possibly hemibody weakness; his mr studies were reportedly negative. he reported having some myalgias followed by leg muscle weakness as well which resolved around the time his statin was discontinued, though he has been taking simvastatin for at least 3-4 years with normal cks and lfts. medications on admission: medications - prescription clopidogrel - 75 mg tablet - 1 tablet(s) by mouth daily (daily) m-vit - 27-1mg tablet - take one by mouth every day for prevention nitroglycerin - 0.4 mg tablet, sublingual - 1 tablet(s) sublingually as directed as needed for chest pain can repeat every 5minutes three times, call 911 if chest pain not resolved medications - otc aspirin - (prescribed by other provider; dose adjustment - no new rx) - 81 mg tablet, delayed release (e.c.) - 1 tablet(s) by mouth once a day cyanocobalamin (vitamin b-12) - (prescribed by other provider) - 1,000 mcg tablet - one tablet(s) by mouth twice a day flaxseed oil - 1000mg capsule - take one by mouth twice a day for triglycerides glucosamine-chondroitin - (prescribed by other provider) - dosage uncertain discharge medications: 1. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). 2. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). 3. simvastatin 40 mg tablet sig: one (1) tablet po qhs (once a day (at bedtime)). disp:*60 tablet(s)* refills:*1* 4. fish oil 1,000 mg capsule sig: one (1) capsule po once a day. disp:*60 capsule(s)* refills:*1* 5. nitroglycerin 0.4 mg tablet, sublingual sig: one (1) sublingual every five minutes for a maximum of three as needed for chest pain. discharge disposition: home with service facility: homecare discharge diagnosis: ischemic stroke coronary artery disease hyperlipidemia/hypercholesterolemia discharge condition: discharge condition: stable mental status: alert, awake and oriented x 3 ambulatory status: ambulatory without support. discharge instructions: you were admitted to the neurology wards at the for an "ischemic stroke" caused by a blockage to one of your arteries in the brain. you received iv tpa (an intravenous clot busting drug) which helped improved your symptoms. you were monitored briefly in the icu and you were subsequently transferred to the floor wards. - it is important that you continue to take your medications as prescribed and follow up with your appointments as noted below. - we measured your cholesterol which showed us that your bad cholesterol (ldl) is still high (142). we have increased your statin dose to 40mg daily. cholest triglyc hdl chol/hd ldlcalc 205* 151*1 33 6.2 142* - please come to an er if you experience any concerning symptom such as difficulty speaking, blurry/double vision, loss of consciousness, problems with weakness or numbness or difficulty swallowing or breathing. your discharge medications include clopidogrel - 75 mg tablet - 1 tablet(s) by mouth daily (daily) m-vit - 27-1mg tablet - take one by mouth every day for nitroglycerin - 0.4 mg tablet, sublingual - 1 tablet(s) sublingually as directed as needed for chest pain can repeat every 5minutes three times, call 911 if chest pain not resolved aspirin - (prescribed by other provider; dose adjustment - no new rx) - 81 mg tablet, delayed release (e.c.) - 1 tablet(s) by mouth once a day cyanocobalamin (vitamin b-12) - (prescribed by other provider) - 1,000 mcg tablet - one tablet(s) by mouth twice a day flaxseed oil - 1000mg capsule - take one by mouth twice a day for triglycerides new medications simvastatin 40mg - take one by mouth every night before going to bed fish oil - 1000mg - take one by mouth daily for cholesterol followup instructions: provider , md phone: date/time: 1:50 provider / phone: date/time: 1:15 provider , .d. phone: date/time: 2:00 md, procedure: injection or infusion of thrombolytic agent diagnoses: pure hypercholesterolemia coronary atherosclerosis of unspecified type of vessel, native or graft aortocoronary bypass status percutaneous transluminal coronary angioplasty status other and unspecified hyperlipidemia cerebral artery occlusion, unspecified with cerebral infarction aphasia 

Answer: The patient is high likely exposed to