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: lisinopril / hydralazine and derivatives attending: chief complaint: menorrhagia, symptomatic anemia (blood loss) major surgical or invasive procedure: endometrial biopsy history of present illness: 43f g1p1 with history of irregular menses, ckd on pertoneal dialysis p/w menorrhagia x 4 days. she reports bleeding has been increasing over the course of the last four days such that she has had to change her pad every half hour because it is soaked. she also reports passing baseball sized clots. she reports history of irregular menses which are typically heavy, but has not had any similarly heavy bleeding since her vaginal delivery 16 years ago. she reports symptoms of dizziness and l arm and face tingling, but denies any syncopal events. her last hct on was 28 per her dialysis clinic note. lmp . . in the ed initial vital signs were 97.7 80 150/69 16 100%. labs notable for hct 16, k of 6.4. ekg with sr at 88, na she was ordered for two units prbcs. pt refused kayexelate, insulin/dextrose. bleeding improved over several pelivic examinations. pelvic ultrasound showed thin endometrial stripe and clot near the cervix. obgyn, therefore, recommended observation, with potential surgical intervention if bleeding recurred. vital signs on transfer were: 98.6 hr 94 165/96 rr 24 100% ra. . . on the floor, patient reports continued blood loss, last pad just changed, soaked through in one hour. all other symtpoms described above now resolved, feels 100% improved. repeat hct 19. . review of systems: (+) per hpi, easy bruising since developing renal failure. (-) denies fever, chills, night sweats, recent weight loss or gain. denies headache, sinus tenderness, rhinorrhea or congestion. denies cough, shortness of breath, or wheezing. denies chest pain, chest pressure, palpitations, or weakness. denies nausea, vomiting, diarrhea, constipation, abdominal pain, or changes in bowel habits. denies dysuria, frequency, or urgency. denies arthralgias or myalgias. denies rashes or skin changes. past medical history: -gip1 - h/o tab - " ovarian cysts" - esrd with peritoneal dialysis, awaiting transplant - htn social history: immigrated from approx 20 years ago. denies alcohol, tobacco, or illicit drug use. lives at home with her husband and son. is a biologist, formerly worked at biotech firm, not currently employed. family history: sister who died from complications of a renal transplant, a mother who has severe chronic kidney disease, and a maternal grandfather who also had some form of glomerulonephritis. physical exam: admission exam: vitals: t:98.8 bp:176/100 p:117 r:13 o2: 100% general: alert, oriented, no acute distress heent: sclera anicteric, + conjunctival pallor, mmm, oropharynx clear neck: supple, jvp not elevated, no lad lungs: clear to auscultation bilaterally, few basilar rales, now ronchi cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding. pd catheter. gu: no foley, pad soaked with 3x3inch clot. visual and bimanual exam deferred given many recent exams today. ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema discharge exam: general: alert, oriented, no acute distress heent: sclera anicteric, + conjunctival pallor, mmm, oropharynx clear neck: supple, jvp not elevated, no lad lungs: clear to auscultation bilaterally cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding. pd catheter. ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema pertinent results: admission labs: 03:52pm blood wbc-4.7 rbc-1.83*# hgb-5.5*# hct-16.0*# mcv-87 mch-29.8 mchc-34.1 rdw-16.9* plt ct-145* 03:52pm blood neuts-85.5* lymphs-11.3* monos-1.8* eos-1.2 baso-0.2 03:52pm blood pt-11.8 ptt-20.3* inr(pt)-1.0 03:52pm blood glucose-127* urean-59* creat-13.5*# na-137 k-6.5* cl-98 hco3-27 angap-19 10:09pm blood calcium-6.6* phos-8.2* mg-2.0 other labs: 08:30am blood ret aut-1.2 08:30am blood caltibc-217* ferritn-131 trf-167* 08:30am blood albumin-3.2* calcium-6.9* phos-8.0* mg-2.0 iron-195* 03:52pm blood hcg-<5 08:32am blood type- ph-7.45 comment-green top 04:03pm blood hgb-5.3* calchct-16 08:32am blood freeca-0.84* discharge labs: 07:50am blood wbc-6.1 rbc-2.83* hgb-8.7* hct-24.3* mcv-86 mch-30.6 mchc-35.8* rdw-15.0 plt ct-79* 08:30am blood neuts-76.8* lymphs-15.5* monos-5.6 eos-2.0 baso-0.2 07:50am blood glucose-102* urean-50* creat-11.5* na-137 k-4.5 cl-99 hco3-28 angap-15 07:50am blood calcium-7.3* phos-7.4* mg-1.7 images: transvag u/s:1. no mass or polyp to explain the patient's bleeding. 2. free fluid likely reflecting peritoneal dialysis brief hospital course: 43 year old female with history of irregular menses, esrd on peritoneal dialysis who presents with 4 days of menorrhagia. # anemia: pt had hct of 16 in ed in setting on ongoing vaginal bleeding. over hospital course received a total of 5 units prbcs and 1 unit ffp. refused platelets despite comorbid thrombocytopenia. anemia thought to be multifactorial, with acute on chronic etiologies. acutely, pt had menorrhagia thought to be secondary to anovulatory cycles. chronically, pt has anemia of chronic disease from reduced epo production in setting of chronic renal failure. anemia stabilized after prbc transfusions and gyn intervention to stop vaginal bleeding with depo provera. she was also started on epo and iron supplementation. she will follow up with renal and gyn as an outpatient. # menorrhagia: pt's vaginal bleeding is most consistent with anovulatory bleeding, of which she has a history thought to be ckd. pelvic ultrasound revealed thin endometrial stripe and no other obvious source of bleeding such as fibroids or cysts. gyn was consulted and recommended starting depo provera 10mg po bid for 2 weeks plus iron supplementation. pt was begun on this after which bleeding stopped and hct stabilized. she had an endometrial biopsy on to rule out malignancy and results were pending at the time of discharge. given the improvement in bleeding with medical intervention, gyn did not recommend operative management at this time. she will follow up with gyn within 1 month. # chronic kidney disease: pt does 4 overnight exchanges of 2l over 2 hrs of 1.5 % dextrose solution with cycler at home. pt was hyperkalemic on arrival with k 6.4, improved to 6.0 without intervention. on ekg, she had peaked t-waves in v3 on admission but these findings were similar to previous ekg in and were not diffuse. she refused interventions such as kayexelate and insulin/dextrose. she resumed her usual peritoneal hd while in house, and electrolytes were repleted as indicated. repeat ekg remained stable. she will follow up with renal as an outpatient. # hypertension: antihypertensives were initially held due to ongoing blood loss. on hospital day 2 these were restarted because bp remained stable and was elevated. sbp as high as 190s during admission, but pt refused to take some of her anti-hypertensives and sometimes only took a fraction of the dose provided. pt states "when she takes" her meds her bp is good, however, during hospitalization she was frequently non-compliant. recommend outpatient follow up with pcp and education on importance of medication compliance, especially in a patient who is hoping for a transplant. transitional issues: 1. medication education re: anti-hypertensives 2. follow up with gynecology re: dysfunctional uterine bleeding and endometrial biopsy results 3. follow up with renal re: peritoneal dialysis and electrolyte repletion medications on admission: amlodipine 5 mg daily ergocalciferol 50,000 unit qweek x 10 weeks labetalol 300mg calcium carbonate 200 mg discharge medications: 1. amlodipine 5 mg tablet sig: one (1) tablet po daily (daily). 2. labetalol 100 mg tablet sig: three (3) tablet po bid (2 times a day). 3. calcium carbonate 200 mg calcium (500 mg) tablet, chewable sig: one (1) tablet, chewable po twice a day. 4. medroxyprogesterone 10 mg tablet sig: one (1) tablet po bid (2 times a day) for 2 weeks. disp:*28 tablet(s)* refills:*0* 5. ferrous sulfate 325 mg (65 mg iron) tablet sig: one (1) tablet po twice a day. 6. ergocalciferol (vitamin d2) 50,000 unit capsule sig: one (1) capsule po once a week for 10 weeks. discharge disposition: home discharge diagnosis: primary diagnosis: menorrhagia secondary diagnoses: end stage renal disease discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: dear ms. , it was a pleasure taking care of you at . you were admitted for vaginal bleeding. you required several blood transfusions to keep your blood counts up but the bleeding has since decreased significantly. you also had an endometrial biopsy to evaluate what caused the bleeding. you will be contact with the results of the biopsy. while you were here, you were continued on peritoneal dialysis. please make the following changes to your medications: 1. please take provera 10mg for 14 days total. 1. please take ferrous sulfate 325mg by mouth twice a day for iron supplementation. please continue all other medications as prescribed. weigh yourself every morning, md if weight goes up more than 3 lbs. followup instructions: please make an appointment with ob/gyn within 1 month. you can contact any of the following physicians: dr. , dr. , dr , dr you have the following appointments already booked with : department: transplant center when: monday at 2:20 pm with: , md building: lm campus: west best parking: garage md procedure: closed biopsy of uterus diagnoses: thrombocytopenia, unspecified hypocalcemia end stage renal disease acute posthemorrhagic anemia hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage v or end stage renal disease excessive or frequent menstruation 

Answer: The patient is high likely exposed to