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: retroperitoneal bleed major surgical or invasive procedure: none history of present illness: mr. is a 70 year gentleman with copd admitted to for new onset heart failure and atrial fibrillation. the patient was started on digoxin, lasix, spironolactone & enalapril dose increased. during this course of treatment he developed acute renal failure with creatinine of 1.6 peaking at 2.8, but responding well to fluids. for his atrial fibrillation he was started on a heparin bridge to warfarin. he developed a left-thigh & retroperitoneal hematoma on accompanied by labile hypertension and hypotension to the 80s with a hematocrit drop from 30 to 20. he was given ffp, vitamin k and tranfused with all anti-coagulants held. for his copd he was started on a prednisone taper. . on admission the patient is conversant and complains on of cough productive of sputum and left sided groin pain. he denies dyspnea greater than baseline, chest pain, syncope, lightheadedness, abdominal pain. he denies dark or bloody stools, anorexia, nausea, vomiting, diarrhea. past medical history: chronic obstructive pulmonary disease hypertension obstructive sleep apnea not using bipap hypercholesterolemia benign prostatic hypertrophy gastroesophageal reflux disease social history: lives with his wife and is independent in adls. 35pk year tobacco hx, quit 25 years ago. 5 drinks daily, last drink 7 days prior to admission. denies illicit drug use family history: mother: rheumatic disease physical exam: vs: 99.2, 88 (afib), 144/61, 21, 95% on ra gen: obese man, talkative in nad neck: jvp 7cm cards: irreg. irreg. grade ii/vi systolic murmur best at rusb. pulm: diffuse rhonchi. no wheezes or crackles. abd: normoactive bowel sounds, soft, mildly distended v. obese, nontender back: no flank echymoses thigh: l anterior thigh with fading ecchymoses, r posterior thigh with fading ecchymoses. ext: 2+ dp, no edema pertinent results: 06:20am blood wbc-8.1 rbc-3.38* hgb-10.7* hct-32.1* mcv-93 mch-31.7 mchc-34.2 rdw-14.2 plt ct-129* 07:15pm blood hct-27.1* 09:16pm blood neuts-87.4* lymphs-7.5* monos-4.8 eos-0.1 baso-0.2 07:15pm blood pt-12.7 ptt-24.1 inr(pt)-1.1 06:20am blood plt ct-129* 06:20am blood glucose-110* urean-23* creat-1.2 na-141 k-4.5 cl-102 hco3-32 angap-12 09:16pm blood glucose-127* urean-43* creat-1.8* na-140 k-4.5 cl-103 hco3-31 angap-11 06:20am blood alt-39 ast-30 alkphos-48 totbili-1.1 dirbili-0.3 indbili-0.8 09:16pm blood alt-23 ast-18 ck(cpk)-286* alkphos-37* totbili-0.4 09:16pm blood ck-mb-3 ctropnt-<0.01 03:36am blood ctropnt-0.01 09:16pm blood wbc-7.5 rbc-2.45* hgb-8.0* hct-22.9* mcv-93 mch-32.6* mchc-34.9 rdw-13.7 plt ct-144* 03:36am blood wbc-7.6 rbc-2.44* hgb-8.1* hct-22.4* mcv-92 mch-33.3* mchc-36.3* rdw-14.2 plt ct-134* 06:20am blood albumin-3.9 calcium-9.5 phos-3.4 mg-2.2 iron-116 06:20am blood caltibc-346 vitb12-356 folate-10.5 ferritn-169 trf-266 03:36am blood tsh-1.0 brief hospital course: a 70 year old gentleman transferred from with a rp hematoma, arf and new onset chf & atrial fibrillation. 1) retroperitoneal bleed/hematoma: the patient was transfused a total of 3 units of prbcs while in the micu with an appropriate increase in hct. no further transfusions were required. hct's were checked every four hours. the patient did not require embolization to stabilize the bleeding. antihypertensives and anticoagulants held. 2) acute renal failure: most likely pre-renal azotemia from blood loss and aggressive diuresis at . improved with fluid and blood administration. 3) copd: continued spiriva & atrovent prn. administered flu vaccine & pneumovax. recomended outpatient pulmonary referal and pfts. 4) atrial fibrillation: likely related to atrial stretch. echo with dilated atrium. unlikely ischemia given negative cardiac enzymes. tsh normal and b1 pnd on discharge. cardiology consulted, did not recommend cardioversion considering increased risk of thrombosis following cardioversion and unable to anticoagulate currently. chads score of 2. warfarin was stopped given bleeding. would consider anticoagulation in the future. 5) congestive heart failure: unclear etiology but likely longstanding given atrial enlargement. etiologies may include htn or even restrictive process in setting of etoh use. held beta blockade while patient hemodynamically unstable. discharged on toprol xl with cardiology f/u. discontinued ccb. medications on admission: terazosin 5 mg po qday enalapril 10mg po qday cartia xt 120mg po qday atenolol 25mg po qday simvastatin 20mg po qday omeprazole 20mg po qday cholestyramine 2 scoops daily asa 81mg po qday spriva advair mvi discharge medications: 1. terazosin 5 mg capsule sig: one (1) capsule po once a day. 2. simvastatin 20 mg tablet sig: one (1) tablet po once a day. 3. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po once a day. 4. cholestyramine light oral 5. aspirin 81 mg tablet sig: one (1) tablet po once a day. 6. spiriva with handihaler 18 mcg capsule, w/inhalation device sig: one (1) inhalation once a day. 7. advair diskus 250-50 mcg/dose disk with device sig: one (1) inhalation twice a day. 8. toprol xl 50 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po once a day. disp:*30 tablet sustained release 24 hr(s)* refills:*2* 9. enalapril maleate 5 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*2* 10. multivitamin tablet sig: one (1) tablet po once a day. 11. albuterol 90 mcg/actuation aerosol sig: one (1) inhalation every 4-6 hours as needed for shortness of breath or wheezing. disp:*1 1* refills:*3* discharge disposition: home discharge diagnosis: retro peritoneal hematoma acute on chronic diastolic congestive heart failure atrial fibrilation discharge condition: good discharge instructions: you were transfered from with bleeding in the back of your belly which was atributed to blood thining medications. we gave you blood products to reverse the thinning properties of your blood. also at you were noted to have congestive heart failure and atrial fibrilation. we gave you medication to help control heart rate (metoprolol). excess fluid from was removed your body with water pills. we are not prescribing any water pills at this time as you did not have edema (swelling) of your extremities when we examined you. please discuss the need for water pills with your regular doctor/cardiologist. it is very important that you maintain a less than 2gm of salt diet daily to prevent a reaccumulation of fluid. please weigh yourself daily and call your primary care physician if you gain more than 3 pounds. . you should discuss with your regular doctor the need for blood thining medication to prevent clots forming in your heart (in the seting of atrial fibrilation). at this point we are not giving you coumadin because of the risk for bleeding. you should start taking aspirin 81mg daily for stroke prevention with atrial fibrillation. . you need to follow up with a pulmonary doctor to have pulmonary function tests and with a cardiologist in order to help determine a long term medication regimen for you congestive heart failure. you should continue the medications toprol xl and enalapril to treat your heart failure. you should also discuss referral to rehab with your primary care physician. have been given a list of phone numbers for further information. we made the following chages in your medicaiton regimen. we added albuterol which you should take in addition to spiriva and advair. also we added metoprolol instead of atenolol for your atrial fibrilation. . also your blood count was noted to be low and you may need outpatient work up for anemia with your regular doctor. please call your regular doctor or return to the ed if you have shortness of breath, chest pain, lightheadedness, swelling of extermities or any other symptoms that concern you. followup instructions: please follow up with your primary care physician . : at 12:00 noon . please follow up with dr. in cardiology on at 3:00pm in the building on the . provider: , md phone: date/time: 3:00 . please maintain your scheduled follow up listed below: provider: , md phone: date/time: 1:30 provider: , md phone: date/time: 9:00 provider: . / dr. phone: date/time: 4:00 provider: ,interpret w/lab no check-in intepretation billing date/time: 4:00 provider: function lab phone: date/time: 3:40 md, procedure: transfusion of packed cells diagnoses: obstructive sleep apnea (adult)(pediatric) esophageal reflux tobacco use disorder congestive heart failure, unspecified unspecified essential hypertension acute kidney failure, unspecified chronic airway obstruction, not elsewhere classified atrial fibrillation acute on chronic diastolic heart failure hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (luts) hemoperitoneum (nontraumatic) 

Answer: The patient is high likely exposed to