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: trazodone attending: chief complaint: chief complaint: ingestion/overdose reason for micu transfer: needed to be intubated in the ed major surgical or invasive procedure: intubation by ems on the way to the hospital history of present illness: 47f pmh depression w/ multiple prior sas, found unresponsive in bed at 1400 by husband. bottle of (carisoprodol, centrally acting muscle relaxant) found next to her. last seen normal at 1130 today. as per ems, rr of 4, gcs 3, intubated in field with etomidate and succinyl choline and sedated with midazolam. bp reportedly in the 80s in the field. husband denies known h/o illicit drug use or etoh abuse, but she has had 12 prior sas, at least one of which was with , which she has bought on the street. per husband, patient recently threatened suicide attempt, and was recently d/c from inpatient facility for depression. pt came into the ed sedated, intubated, and with emesis in her mouth and hair; she was having b/l myoclonic jerks. unclear if emesis occurred during intubation or prior. in the ed, vitals were temp 36, hr 88, bp 156/76, rr 14, 100% (never hypotensive). ett placement was verified (18g), and tube was advanced a little. og tube was placed and pill fragments were suctioned out. patient was seen by toxicology, who advised iv thymine and that myoclonic jerking was likely due to drug itself and not seizure. she got vecuronium for ct scan b/c of myoclonic jerking. cxr and head ct were unremarkable. she was sent up from ed on midazolam drip. on arrival to the micu, patient was intubated on ps, alert, and responding to commands. vitals were 98.3, 91, 118/74, 14, and 100% on ps. review of systems: (+) per hpi (-) not able to be completed with patient initially past medical history: - depression/anxiety with multiple prior suicide attempts (recent hospitalization at for ingestion and hospitalization and even more recent one ~2 wks ago elsewhere) - mao-i toxicity during which time she developed atn, acute liver injury, and mildly depressed lvef 55% - chronic etoh dependence; h/o alcoholism years ago, per husband - prescription drug abuse (abuse of ativan and in the past) - hypothyroidisim social history: - tobacco: no current tobacco use. - etoh: prior alcoholism history, husband reports she has not had problems with alcohol abuse in years. - illicit drugs: per husband, denies known history of illicit drug abuse. however has h/o prescription medication abuse, including benzodiazepines and . prior ob/gyn physician at , trained at hms for med school and for residency, now moving to a different career, has not practiced for 1 year. married with 2 kids, lives with husband at home. family history: patient is adopted physical exam: exam on admission to the micu vitals 98.3, 91, 118/74, 14, and 100% on ps vent general: alert, intubated, following commands heent: sclera anicteric, mmm, oropharynx clear, eomi, perrl neck: supple, jvp not elevated, no lad cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi abdomen: soft, non-tender, non-distended, bowel sounds present, no organomegaly gu: foley in place ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema neuro: clonus of b/l ankles psych: denies current suicidality . exam vitals: tcurrent: 37.1 ??????c (98.8 ??????f), hr: 89 (85 - 106) bpm, bp: 105/66(75) {84/45(53) - 122/87(95)} mmhg, rr: 12 (12 - 22) insp/min, spo2: 96%, heart rhythm: sr (sinus rhythm) general: alert, oriented x 3, following commands, remembers events of past 24 hours heent: sclera anicteric, mmm, oropharynx clear, eomi, perrl neck: supple, jvp not elevated, no lad cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi abdomen: soft, non-tender, non-distended, bowel sounds present, no organomegaly gu: no foley ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema neuro: no clonus of feet or hyperreflexia; nonfocal psych: denies current suicidality pertinent results: 03:30pm urine hours-random 03:30pm urine bnzodzpn-neg barbitrt-neg opiates-neg cocaine-neg amphetmn-pos mthdone-neg 03:30pm urine color-yellow appear-clear sp -1.017 03:30pm urine blood-neg nitrite-neg protein-tr glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-6.5 leuk-neg 03:30pm urine rbc-1 wbc-<1 bacteria-none yeast-none epi-<1 03:30pm urine mucous-rare 03:15pm po2-119* pco2-38 ph-7.39 total co2-24 base xs--1 03:15pm glucose-101 lactate-1.0 na+-139 k+-4.3 cl--109* tco2-22 03:15pm pt-9.5 ptt-26.1 inr(pt)-0.9 03:10pm glucose-104* urea n-13 creat-0.9 sodium-138 potassium-4.4 chloride-108 total co2-23 anion gap-11 03:10pm estgfr-using this 03:10pm alt(sgpt)-17 ast(sgot)-14 ck(cpk)-63 alk phos-49 tot bili-0.2 03:10pm lipase-23 03:10pm albumin-3.9 03:10pm asa-neg ethanol-neg acetmnphn-neg bnzodzpn-neg barbitrt-neg tricyclic-neg 03:10pm wbc-3.1* rbc-4.19* hgb-11.3* hct-35.3* mcv-84 mch-27.0 mchc-32.1 rdw-12.7 03:10pm neuts-54.0 lymphs-38.2 monos-5.1 eos-1.8 basos-0.9 03:10pm plt count-177 . ct head : findings: no acute intracranial hemorrhage, large vascular territory infarct, shift of midline structures, or mass effect is present. the ventricles and sulci are normal in size and configuration. the visible paranasal sinuses show mild ethmoidal mucosal sinus thickening. the mastoid air cells are well aerated. secretions are noted in the nasopharynx likely related to intubated status. impression: no acute intracranial process. . supine ap cxr : findings: endotracheal tube tip terminates 5.5 cm from the carina. orogastric tube tip courses below the diaphragm into the stomach, off the inferior borders of the film. the heart size is normal. the mediastinal and hilar contours are unremarkable. the pulmonary vascularity is normal. there are mild bibasilar opacities likely reflecting atelectasis. there is no pleural effusion or pneumothorax though the extreme lung apices are excluded from the field of view. there are no acute osseous abnormalities. impression: endotracheal and orogastric tube tips in standard positions. patchy opacities in the lung bases likely reflective of atelectasis. . ekg : sinus tach @ 100, na, qrs 86, qtc 426, no ischemic changes brief hospital course: 47f w/ hx depression and multiple suicide attmepts presents after suicide attempt by ingestion of . . active diagnoses: # ingestion - pt had a sedative toxodrome with obtundation, likely . as per toxicology, " is considered a skeletal muscle relaxant but likely works by agonizing gaba...jerking motions are common s/p carisoprodol ingestions, likely due to myoclonic jerks. these should be self limiting...if jerking motions are not self-limiting upon paralysis wearing off, probably reasonable to rule out sz activity w/ eeg, though this would not likely be from a ingestion." asa, apap, etoh screens were negative. patient was able to be weaned from midazolam and extubated within an hour of arriving to the micu. when extubated, she reported that she had taken 15 (unknown strength) at around 2pm as a suicide attempt. she denies any other ingestion. she did not have spontaneous myoclonus in the micu, but initially had clonus when elicited on exam; this resolved within 12 hours. her initial ekg looks wnl (sinus), and there was no evidence of mao-i ingestion. repeat labs are wnl. especially given possible aspiration, the patient's respiratory status was monitored after intubation. no respiratory distress, fever, or elevated wbc. repeat ekg was reassuring. patient was given po thiamine. she complained of pleuritic chest pain and cough the morning after the ingestion, but her lungs were clear on exam, she was sat-ing well on room on air, and she was not tachypneic. cxr was wnl and showed no acute cardiopulmonary process. . # medical clearance for hospitalization - the patient was intubated and possibly aspirated, but we do not believe she currently has a pna (see above). if she develops fever or sob, she may need to be evaluated for pna, but right now she is medically cleared. she is eating, drinking, and is able to tolerate normal physical activity. . # hypothroidism (?) - chronic diagnosis. patient reports that she's on synthroid 50mcg at home, but husband and psychiatrist report that she is not as per psychiatry. she was given one dose of synthroid 50mcg the morning after her ingestion, as we did not know the patient was no longer on this medicaiton. she then developed tachycardia to 110. we initially thought this was related to volume depletion and/or anxiety, and she was given 1l lr. tsh level was sent before she was given the synthroid and is still pending. when we realized she is no longer on this medication, it was discontinued. . # suicidality/anxiety/depression - ingestion was suicide attempt. psychiatry was consulted and recommended inpatient hospitalization. the patient had a 1-to-1 sitter while in the micu. her home cymbalta, lorazepam, trazodone, ambien, and prazosin (for nightmares) were continued. her home dextroamphetamine was held. . # transitional issues - pending tsh study. unclear significance, given critical illness and intubation. recommend rechecking in 6 weeks. medications on admission: cymbalta 90 mg delayed lorazepam 1 mg tablet q6-8 hrs trazodone 150 mg qhs ambien cr 12.5 mg qhs prazosin 2mg qhs (for nightmares) dextroamphetamine -- unknown dose synthroid 50 mcg tablet qd ***patient's record lists an allergy to trazodone. but she does not have an allergy to trazodone, and, in fact, takes it currently. she does have an allergy to tranylcypromine --> malignant hyperthermia*** medications: 1. duloxetine 90 mg po daily 2. lorazepam 1 mg po q8h:prn anxiety hold for somnolence or rr<10 3. prazosin 2 mg po hs hold for somnolence or for sbp<100. 4. thiamine 100 mg po daily 5. trazodone 150 mg po hs hold for somnolence. 6. zolpidem tartrate 10 mg po hs please hold if patient is somnolent. disposition: extended care facility: hospital - diagnosis: primary: acute respiratory failure, suicide attempt, depression secondary: hypothyroidism. condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. instructions: dear dr. , it was our pleasure to care for you at . you were admitted for a medication overdose which caused you to become somnolent and require intubation and mechanical ventilation. we were able to successfully remove the tube and had you evaluated by the psychiatry team, who will assume your care. we made the following changes to your medication: *** stop taking dextroamphetamine. do not start taking this medication again unless prescribed by a psychiatrist or your pcp. *** start taking thiamine 100mg daily. do not stop taking this unless instructed by your pcp or psychiatrist to do so. there was a question as to if you were taking thyroid supplementation, although it appears that you were not, and we are not giving it to you. followup instructions: please follow up with the doctors at the facility. please make an appointment with your pcp within week of . please have your tsh tested within the next 6 weeks. procedure: continuous invasive mechanical ventilation for less than 96 consecutive hours diagnoses: unspecified acquired hypothyroidism dysthymic disorder acute respiratory failure suicide and self-inflicted poisoning by other specified drugs and medicinal substances myoclonus borderline personality disorder suicidal ideation poisoning by central nervous system muscle-tone depressants 

Answer: The patient is high likely exposed to