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: patient recorded as having no known allergies to drugs attending: chief complaint: vertigo, dysarthria, and right facial numbness described as pins and needles. major surgical or invasive procedure: none history of present illness: the patient is a 54 year old right handed woman with a history of hypertension, rle claudication s/p bypass grafts, squamous cell carcinoma of the vagina, and recent admission to neurology for complete right vertebral occlusion with bilateral posterior circulation infarcts for which she was restarted on her coumadin who now presents with vertigo, dysarthria, and right facial numbness described as pins and needles. she is accompanied today by her son, . the patient reports feeling well all weekend, and went to bed feeling well at 10:00 pm last night. at 6:30 am, she woke up and felt dizzy when she stood up, described as everything in the room was moving to the right. this lasted for 2 minutes, and ressolved after she sat down in bed. she has had recurrent dizziness with any movement. at the same time this morning she noticed dysarthria and difficulty getting her words out. she also noticed that her right face felt numb like pins and needles especially around her right eyes and mouth, which is still present. she then developed nausea. she continues to have unchanged bilateral blurry vision from the last admission (see below), which remains present with each eye closed individually. she denies headache, diplopia, dysphagia. she denies missing any doses of her coumadin and reports taking 6 mg daily at home, and had an outpatient inr check on friday (but is unsure of the result). on ros, in addition to above, she reports generalized weakness. she denies arm/leg numbness. she denies fevers/chills, cough/cold, diarrhea, or pain/burning on urination. the patient was admitted to the stroke service for unsteady gait (felt like she was lurching back and forth) and blurred vision in the setting of being off coumadin x3 days prior to a dental procedure (inr 1.1 on admission). a code stroke was called, and exam showed visual acuity 20/25 bilaterally, full strength, mild dysmetria on fnf on left. cta head/neck showed complete occlusion of the distal right vertebral artery, with abnormal increased mtt and decreased cerebral blood volume within the right occipital lobe concerning for posterior circulation event (equivocal mtt abnormalities in the cerebellum). mri/mra head showed multiple infarcts in bilateral posterior circulation territory in the setting of a very irregular distal right vertebral artery with a short segment of high-grade stenosis versus a short dissection. there appears to have been interval partial recanalization of the right vertebral artery compared to the cta. clot retrieval was discussed, but the risk outweighed the benefit. tte showed no pfo/asd. she was started on a heparin gtt and transitioned to coumadin. her inr was 2.2 at the time of discharge. past medical history: -vaginal cancer 10 years ago; s/p pelvic exeneration with neovagina and neobladder -hypertension -vasovagal episodes -s/p small bowel obstruction -s/p r ilio-akpop bpg w/vein (), stents placed -s/p left kidney surgery as a child, has left hydronephrosis -osteopenia -migraines- not in many years, no aura social history: married. works as a neuroscience nurse . has a history of tobacco use, 1ppd x 20 years. still smokes on occasion. social alcohol use. no drugs, no over the counter supplements. family history: hx of maternal hypertension. no history of cancer, stroke, clotting disorders. physical exam: physical examination: vs: temp 97.3, bp 150/90, hr 48, rr 18, sao2 99% on ra genl: awake, slightly drowsy, nausea heent: sclerae anicteric, no conjunctival injection, oropharynx clear cv: bradycardic but regular, nl s1, s2, iii/vi systolic murmur best at the llsb, no rubs or gallops chest: cta bilaterally anteriorly and laterally, no wheezes, rhonchi, rales abd: +bs, soft, ntnd abdomen neurologic examination: mental status: awake but slightly drowsy. oriented to person and place, but says date is (2 days off). attentive, says backwards. speech is fluent with normal repetition; naming intact. + dysarthria. intact. no right-left confusion. no evidence of neglect. cranial nerves: fundoscopic examination is difficult due to patient cooperation. pupils equally round and reactive to light, 4 to 2 mm bilaterally. visual fields are full to confrontation. extraocular movements intact bilaterally with left beating nystagmus at upgaze and bilateral end-gaze nystagmus. sensation intact to pinprick v1-v3, but has decreased sensation to light touch at right v2 (80% of the left). facial movement symmetric but ? slight left ptosis. hearing intact to finger rub bilaterally. palate elevation symmetric. sternocleidomastoid and trapezius full strength bilaterally. tongue midline, movements intact. motor: normal tone bilaterally in ue and le. no observed myoclonus, asterixis, or tremor. no pronator drift, but ataxic left hand when extended. tri we fe ff ip h q df pf te r 5 5 5- 5 5 5 5 5 5 5 5 5 l 4+ 5- 5- 5 5 5 5 5 5 5 5 5 sensation: intact to pinprick and position sense throughout. no extinction to dss. reflexes: 3+ and symmetric in biceps, triceps, knees. 2+ and symmetric in brachioradialis and ankles. toe upgoing on the left, downgoing on the right. coordination: ataxic with left>right finger-nose-finger, and left finger-to-nose. slowed fine finger movements bilaterally, and normal. has rebound of left arm when bilateral arms are extended. pertinent results: mr head w/o contrast study date of 11:12 am multiple new infarcts, extensively involving the brainstem as described above, with near total loss of flow signal within the intracranial arteries of the posterior circulation. mr head w/o contrast study date of 12:19 pm 1. two new tiny foci of infarction in the right cerebellum. 2. multiple subacute evolving infarcts in bilateral posterior circulation territory. 3. lack of flow in the right vertebral artery is better characterized on cta. brief hospital course: the patient is a 54 year old right handed woman with a history of hypertension, rle claudication s/p bypass grafts, squamous cell carcinoma of the vagina, and recent admission to neurology for complete right vertebral occlusion with bilateral posterior circulation infarcts for which she was restarted on her coumadin who now presents with vertigo, dysarthria, and right facial numbness described as pins and needles. she reports not missing any doses of her coumadin, but her inr is 1.3 on admission. her exam is significant for nausea, dysarthria, decreased light touch in right v2 (normal pinprick), slight weakness of left deltoid and triceps, and ataxia of the left>right arm with overshoot on the left. her toe is upgoing on the left and there is ? of left ptosis. the concern was that she is continuing to shower emboli from her right vertebral artery, possibly now causing a lateral medullary syndrome. she was then admitted for heparin gtt to make inr therapeutic. patient continued to decline and was found to have multiple new infarcts, extensively involving the brainstem, with near total loss of flow signal within the intracranial arteries of the posterior circulation. pt became unresponsive with non purposeful eye movements. she had deep agonal breaths. she had a heavy phlegmy cough but was not moving any secretions. palliative care was consulted and the family opted for this approach. pt was given iv morphine and a scopolamine patch was applied. patient then expired. exact time on death note. medications on admission: warfarin 6 mg daily -lisinopril 40 mg daily - 100 mg daily -cardizem 240 mg qhs discharge medications: none discharge disposition: expired discharge diagnosis: bilateral brainstem strokes. discharge condition: expired discharge instructions: patient was found to have multiple new infarcts, extensively involving the brainstem, with near total loss of flow signal within the intracranial arteries of the posterior circulation. followup instructions: expired md, procedure: venous catheterization, not elsewhere classified enteral infusion of concentrated nutritional substances diagnoses: abnormal coagulation profile urinary tract infection, site not specified unspecified essential hypertension atherosclerosis of native arteries of the extremities with intermittent claudication hypopotassemia cerebral edema primary hypercoagulable state hyperosmolality and/or hypernatremia attention to other artificial opening of urinary tract personal history of malignant neoplasm of other female genital organs occlusion and stenosis of vertebral artery with cerebral infarction occlusion and stenosis of other specified precerebral artery with cerebral infarction 

Answer: The patient is high likely exposed to