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: erythromycin / heparin agents / sulfa (sulfonamide antibiotics) attending: chief complaint: hip fracture major surgical or invasive procedure: left hip hemiarthroplasty endotracheal intubation and mechanical ventilation history of present illness: 59yom with a history of mitral valve prolapse, atrial fibrillation s/p maze and mitral valvuloplasty in at that was complicated by a right mca cva, rle dvt treated with coumadin presenting status post fall during transfer and fracture of his left hip. patient underwent arthroplasty of the left hip on . after the operation, he developed a new oxygen requirement and was on 4l nc for the past 2 days until he was found to have a hr of 140s on tele on at 1830 and an o2 sat of 71% on 4l nc. he was given 40mg iv lasix and 5mg iv lopressor, which was repeated when heart rates did not decrease with another 5mg iv lopressor. he diuresed 1 l of urine and his oxygen saturations increased to 100% on the non-rebreather. on arrival to the micu, o2 sats are 100% on non-rebreather and patient has a new fever of 101.2. patient denies chest pain, dyspnea, headache, or pleuritic pain. he is only aao x name, and is unclear where he is or why he is here. his family is very involved in his care and were involved with this history taking. past medical history: - : afib and went to were mitral valvuloplasty/l atrial maze and l atrial appendage resection were done. after this surgery on post-po day 1 he suffered a long-standing post-op seizure tonic clonic and found on imaging a r+ mca cva. --- pt reports that his vimpat is being de-escalated and that he hasn't had a seizure since his initial seizure. - : pseudoaneurysm from r common femoral artery (discovered after going to the hospital bc swelling of l+ ankle) and dvt in r+ lower extremity. - mitral valve prolapse - h/o dvt on coumadin - bilateral inguinal hernia repair - l+ knee arthroscopic surgery - h/o heparin-induced thrombocytopenia social history: lives in with his wife. 2 children that live in . orthodox. retired from financial management. denies tobacco, alcohol, illicits. family history: non-contributory physical exam: vitals: t: 101.2 bp:100/52 p:118 r:21 o2: 100% on non-rebreather general: alert, oriented only to person, no acute distress heent: sclera anicteric, mmm, oropharynx clear, eomi, perrl neck: supple, jvp not elevated, no lad cv: tachycardic, regular rhythm, normal s1 + s2, no murmurs, rubs, gallops lungs: clear to auscultation anteriorly, no wheezes, rales, ronchi, although upper airway sounds throughout. abdomen: soft, non-tender, non-distended, bowel sounds present, no organomegaly gu: foley ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema, teds and scds in place neuro: cnii-xii intact, 4+/5 strength upper/lower extremities on right, 3+ on left, grossly normal sensation, 2+ reflexes bilaterally, gait deferred discharge exam: pertinent results: 07:05pm glucose-115* urea n-12 creat-0.7 sodium-139 potassium-4.0 chloride-104 total co2-25 anion gap-14 07:05pm calcium-8.3* phosphate-3.9 magnesium-1.6 07:05pm wbc-21.8*# rbc-3.79* hgb-11.4* hct-34.0* mcv-90 mch-30.2 mchc-33.6 rdw-12.7 07:05pm plt count-223 07:05pm pt-12.8* ptt-27.5 inr(pt)-1.2* 12:48pm hct-36.6* 12:48pm hct-36.6* 11:50am glucose-87 urea n-12 creat-0.8 sodium-139 potassium-4.4 chloride-101 total co2-29 anion gap-13 11:50am estgfr-using this 11:50am wbc-10.8# rbc-4.34*# hgb-13.0*# hct-38.1*# mcv-88 mch-29.9 mchc-34.1 rdw-12.5 11:50am neuts-82.4* lymphs-13.6* monos-3.0 eos-0.9 basos-0.1 11:50am plt count-247 11:50am pt-11.3 ptt-30.0 inr(pt)-1.0 11:50am urine color-yellow appear-clear sp -1.004 11:50am urine blood-neg nitrite-neg protein-neg glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-7.5 leuk-neg path gross: the specimen is received fresh in a container labeled with the patient's name, ", ", the medical record number, and additionally labeled "left femoral head". it consists of a normally shaped femoral head without a portion of femoral neck that measures 5.5 x 4.5 x 4.5 cm. the articular surface is unremarkable. osteophytes are not present. the femoral neck margin is irregular. the specimen is cut along its length perpendicular to the articular cartilage. the cut surfaces reveal yellow-tan hemorrhagic cut surfaces. a fragment of femoral neck is also received in the container and measures 4.5 x 4.0 x 2.5 cm. it is cut perpendicular to the articular surface to reveal hemorrhagic bone marrow. tissue is not present. representative sections of the specimen are submitted for decalcification as follows: a= representative sections of femoral head, b = representative sections of femoral neck. ecg: sinus bradycardia. intraventricular conduction defect. left axis deviation, possibly due to left anterior fascicular block. diffuse non-specific st-t wave abnormalities. compared to tracing #1 the heart rate is decreased but there are no other significant changes. tracing #2 intervals axes rate pr qrs qt/qtc p qrs t 56 0 132 468/461 0 -57 85 hip xray: findings: single frontal view of the pelvis and three views of the left hip were obtained. a complete fracture of the left femoral neck is present with mild varus angulation. no dislocation is identified. vague lucencies of the left femoral shaft is suggestive of osteopenia. no radiopaque foreign bodies. impression: 1. left femoral neck fracture with mild varus angulation. 2. left femoral shaft lucencies suggestive of osteopenia in the setting of decreased weght bearing from prior stroke. cxr: findings: single portable view of the chest compared to previous exam from . the lungs are clear of focal consolidation or effusion. cardiomediastinal silhouette is within normal limits. median sternotomy wires are again noted. the osseous and soft tissue structures otherwise unremarkable. impression: no acute cardiopulmonary process. knee xray no prior studies for comparison. findings: three views of the left knee demonstrate no evidence of acute fracture, dislocation, joint effusion, or soft tissue foreign body. cpine xrays cervical spine, no prior studies for comparison. on the lateral view, all seven cervical vertebral bodies are visualized, but the superior aspect of t1 is obscured and cannot be assessed. prevertebral soft tissue structures are within normal limits. bone mineral density is apparently slightly decreased throughout. multilevel degenerative changes are present with small anterior osteophytes particularly at the c3 through c6 levels, as well as very minimal disc space narrowing. reversal of the normal cervical lordosis is evident at c4-c5. flexion and extension views demonstrate no evidence of instability. incidental note is made of an oval-shaped calcification posterior to the spinous processes of c4 and c5, which may represent ossification or calcification of the posterior longitudinal ligament. impression: 1. multilevel degenerative changes in the cervical spine as described. no acute fracture or dislocation identified, but ct of the cervical spine is much more sensitive than conventional radiographs for detecting traumatic abnormalities and would be suggested if there is persistent clinical suspicion for a cervical spine injury. 2. exam is limited by absence of an odontoid view and lack of visualization of c7-t1 disc space and top of t-1. ap cxr on impression: ap chest compared to : lungs are appreciably smaller and there is greater but symmetric opacification in the lower lungs. contributing to elevation of the diaphragm is a stomach severely distended with air and fluid. since there is also increased upper lobe vascular congestion, and new small left pleural effusion, appearance could be explained by either bibasilar pneumonia or a combination of atelectasis and edema. subsequent chest ct reported separately has findings of left lower lobe atelectasis, right lower lobe pneumonia and multifocal small regions of peribronchial opacification, probably bronchopneumonia. it shows vascular congestion but no pulmonary edema, and a stomach severely distended with air and fluid. ct chest: findings: the thyroid gland, aorta and major branches, heart and pericardium are unremarkable with the exception of changes of mitral valve annuloplasty. no pericardial effusion is seen. the esophagus is patulous and fluid filled. there is no axillary, hilar, or mediastinal adenopathy. gynecomastia is noted bilaterally. though this study is not tailored for subdiaphragmatic evaluation, imaged upper abdomen reveals distended stomach. the trachea and central airways are patent to the segmental level. the pulmonary arterial tree is well opacified without filling defect to suggest pulmonary embolism, though evaluation of the subsegmental vessels is limited due to respiratory motion. small bilateral pleural effusions are dependent and nonhemorrhagic. right greater than left basal opacities with milder opacification of the dependent segment of the right upper lobe and right middle lobe are concerning for multifocal pneumonia which likely includes the anterior subpleural opacities. osseous structures: there is no lytic or sclerotic bony lesion to suggest osseous malignancy. impression: 1. no pulmonary embolism or acute aortic pathology. 2. multifocla pneumonia with opacities in the lower lobes and left upper lobe. 3. patulous esophagus, correlate with symptoms of dysphagia and outpatient esophagram can be obtained if indicated. echo the left atrium and right atrium are normal in cavity size. left ventricular wall thickness, cavity size and regional/global systolic function are normal (lvef >55%). the estimated cardiac index is normal (>=2.5l/min/m2). right ventricular chamber size and free wall motion are normal. the diameters of aorta at the sinus, ascending and arch levels are normal. the aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic stenosis. trace aortic regurgitation is seen. the mitral valve leaflets are mildly thickened. the mitral valve leaflets are myxomatous. a mitral valve annuloplasty ring is present. the mitral annular ring appears well seated with normal gradient. mild (1+) mitral regurgitation is seen. there is moderate pulmonary artery systolic hypertension. there is no pericardial effusion. impression: well seated mitral annuloplasty ring with normal gradient and mild mitral regurgitation. pulmonary artery hypertension. normal biventricular cavity sizes with preserved global and regional biventricular systolic function. ap cxr findings: as compared to the previous radiograph, there is a substantial increase in extent and severity of the pre-existing multifocal pneumonia. these changes are evident at both lung bases. the lung apices are bilaterally spared from the pathologic process. unchanged borderline size of the cardiac silhouette. minimal fluid overload cannot be excluded. no larger pleural effusions. no pneumothorax. mild over distention of the stomach, unchanged normal alignment of the sternal wires. ecg sinus tachycardia. left anterior fascicular block. non-specific st-t wave abnormalities. compared to the previous tracing of the heart rate has increased, st-t wave abnormalities have improved. tracing #1 intervals axes rate pr qrs qt/qtc p qrs t 103 146 128 336/411 47 -45 78 ap cxr last of 3 for the day there is again seen diffuse air space opacities bilaterally, more confluent in the right lung and have increased slightly since the prior study. atelectasis at the left lung base is again seen. there are low lung volumes with poor inspiratory effort. there are no pneumothoraces. median sternotomy wires are present. ap cxr findings: a new left picc terminates approximately 1 cm beyond the cavoatrial junction. dense consolidation of the entire right lung as well as right-sided pleural effusion are unchanged. there is a persistent retrocardiac opacity as well as worsening consolidation of the left upper lobe when compared to the prior study from yesterday. there is improved aeration at the left costophrenic angle. there is no pneumothorax. heart size is top normal and unchanged. sternotomy cerclage wires are intact. impression: 1. new left picc should be withdrawn by 1.5 cm to ensure proper positioning in the lower svc. 2. multifocal pneumonia, slightly worse in the left upper lobe. bal bronchioalveolar lavage: negative for malignant cells. numerous neutrophils, bronchial cells, and pulmonary macrophages. no viral cytopathic changes or fungi seen. ap cxr chest, single ap portable view the patient is status post sternotomy. an et tube is present, tip in satisfactory position approximately 4.3 cm above the carina. a left-sided picc line is present, tip over distal svc. an ng tube is present, tip and side port beneath diaphragm, extending off film. there is diffuse alveolar opacity and air bronchograms throughout the right lung, with relative sparing of the right lung apex and minimal residual lucency at the right base. this has progressed compared with . possibility of an associated effusion cannot be excluded. there is also prominent focal interstitial and alveolar opacity in the left upper zone, which appears more confluent than on the earlier film. there is increased retrocardiac density, with obscuration of the left hemidiaphragm, unchanged. the small left effusion is slightly more prominent on this exam. there is relative lucency at the left lung apex. however, i doubt this represents a pneumothorax. impression: interstitial and alveolar opacities in both lungs, progressed compared with at 12:09 p.m. differential diagnosis includes multifocal pneumonic infiltrates, ards and chf. chest: imaged portions of the thyroid gland appear within normal limits. there is a left upper extremity picc line with its tip terminating in the svc. the patient is status post endotracheal intubation with the tip of the et tube lying approximately 4.9 cm above the carina. an ng tube is seen with its tip terminating in the stomach. there is no axillary, mediastinal, or hilar lymphadenopathy. the cardiac appear grossly within normal limits. there are no filling defects within the central pulmonary arterial tree. the patient is status post median sternotomy and mitral valve replacement. there are large bilateral pleural effusions with adjacent compressive atelectasis, right greater than left. patchy pulmonary opacities are noted in the remainder of the inflated upper lobes with hint of appearance of crazy pavement (series 2, image 13) in the left upper lobe and also within the right upper lobe (series 2, image 17) suggestive of pulmonary edema. there is no pneumothorax. additional scattered regions of ground-glass opacification are also seen scattered within the lungs, for example, on series 2, image 35, suggestive of edema. findings in the abdomen and pelvis: in the liver, there are two focal hypodensities seen centrally (series 2, image 56), which are less than a centimeter in size and are not well characterized on the current examination. there is no intra- or extra-hepatic biliary ductal dilatation. the portal vein is patent. the spleen is within normal limits in size. the adrenal glands, pancreas, and kidneys appear unremarkable. there is no mesenteric or retroperitoneal lymphadenopathy. there is minimal quantity of perihepatic fluid as well as a small quantity of fluid tracking into the right paracolic gutter. the gallbladder is distended and there is a small quantity of pericholecystic fluid (2, 82). minimal periportal edema is seen in the liver. there is a small quantity of fluid in the dependent pelvis (2, 108). the urinary bladder demonstrates no obvious abnormalities. a foley catheter is seen in place. no obvious abnormalities are seen in the colon. the stomach is slightly decompressed with ng tube in place, limiting evaluation. small bowel appears within normal limits. there is subcutaneous soft tissue edema, most predominantly noted in the gluteal region as well as in the upper thighs. there are flame-shaped opacities involving the retroareolar regions suggestive of gynecomastia. left hip replacement arthroplasty is seen. there are no suspicious osteolytic or osteoblastic lesions seen to suggest tumor. surgical staples are seen in the left gluteal region. impression: large bilateral pleural effusions with adjacent compressive atelectasis. crazy pavement changes in the lungs suggestive of mild pulmonary edema. additional multifocal regions of atelectasis and consolidation, underlying pneumonia is not excluded. no intra-abdominal abscess. distended gallbladder with small amount of pericholecystic fluid. findings are nonspecific. if there is clinical concern for acute cholecystitis, this can be further evaluated with right upper quadrant son. minimal quantity of perihepatic and pelvic fluid, which could be related to third spacing. additional diffuse regions of subcutaneous soft tissue edema in the pelvic girdle. cxr indication: pneumonia, questionable et tube placement. comparison: . findings: as compared to the previous radiograph, the monitoring and support devices are constant. the tip of the endotracheal tube projects 4.9 cm above the carina. the parenchymal opacity at the left lung apex is minimally decreasing in extent. the extensive right-sided opacity is unchanged. moderate cardiomegaly with borderline size of the cardiac silhouette and unchanged minimal blunting of the left costophrenic sinus, potentially reflecting a small pleural effusion. no evidence of pneumothorax. brief hospital course: 59 y/o m with a history of mitral valve prolapse, atrial fibrillation s/p maze and mitral valvuloplasty in that was complicated by a right mca cva and a rle dvt presented status post fall and fracture of his left hip on . his hip was repaired with a l hemiarthroplasty on , and in the post-operative setting, he had persistent high oxygen requirements. he progressed to respiratory failure secondary to multifocal pneumonia and pulmonary edema, requiring re-intubation and transfer to the micu. he was treated with a 10 day course of antibiotics and aggressive diuresis, as well as vasopressors until he improved. he was extubated and gradually weaned off oxygen. once medically stable, pt advised further inpatient physical therapy in subacute rehab. active problems: # respiratory failure: multifocal pna (aspiration?) and pulmonary edema. following extubation from his orthopedic procedure, patient was maintained on 5l nasal canula on the floor. the evening of , he developed respiratory distress, not responsive to lasix. patient was then transferred to the micu, meeting sirs criteria by rr, temperature, and heart rate. pt was evaluated for a pe; cta showed no evidence of pe, but did show a multifocal pna. he was placed on broad-spectrum antibiotics (including vancomycin, and, at different points, cefepime, levofloxacin, and meropenem). blood, urine, and sputum cultures did not grow out any organism. the patient also developed hypotension and was volume-recusitated aggressively. his tachypnea increased, and he became hypoxic on bipap and required intubation on . cultures from bronchoscopy following intubation were unremarkable, and visual inspection of the airways did not demonstate purulence. further imaging with chest ct showed large bilateral pulmonary effusions, multifocal pna, and pulmonary edema. he received a 10-day course of antibiotics for vap coverage. as his pneumonia improved, concern lingered for pulmonary edema. he was started on lasix drip for diuresis, and was extubated on . by , he was was able to oxygenate well on 2l by nc. by he was stable on room air. . # hip fracture: his hip was repaired with a l hemiarthroplasty on . orthopedic surgery followed the patient throughout his stay in the micu. his surgical wound healed well, and staples were removed on , there was no concern for infection. physical therapy began working with the patient when he was weaned off sedation prior to being extubated. they continued working with him during the remainder of his hospitalization and recommended subacute rehab after discharge. . # pain control: patient had post-operative pain in his left thigh and hip. before and during intubation and after extubation, the patient had pleuritic chest pain as well. at different points during his hospitalization, his pain was controlled with morphine, fentanyl, ibuprofen, iv tylenol, and/or lidocaine patch. he will be discharged on tylenol and morphine prn. . # fever/thrombocytosis: likely reactive to pneumonia versus drug reaction. the patient continued to spike fevers during his micu stay. initially the fever was c/w pna and sepsis. however, even as his pna resolved, he continued to spike fevers. he also developed a thrombocytosis to the 900s. the fever and thrombocytosis are thought to be due to systemic inflammation in the setting of resolving pna. his platelets were down-trending by day of discharge. he has been afebrile for several days. . # persistent sinus tachycardia in the micu: this tachycardia was likely due to hypovolemia versus sepsis versus hypoxia. the patient's home metoprolol was held in the setting of hypotension. troponins were sent and were negative. when the patient was extubated and his tachycardia resolved, he was restarted on metoprolol, and switched to metoprolol 75mg xl daily the day of discharge. however his dose was held on discharge due to his sbp in the ~90s. . # hypotension: in the setting of sirs and multifocal pna. he required norepinephrine drip, but this was discontinued in the micu when his bp improved with maps in the 70s. he was normotensive on transfer to the floor and his metoprolol was held with his sbp in the ~90s. . # nausea/gerd: likely mutifactorial, with components of gerd, clinical illness, and not taking pos for several days. patient with history of gerd. pt was initially on iv protonix, then was switched to po ppi. he was treated with zofran, calcium carbonate, aluminum-magnesium hydrox, and simethicone. on cta of the chest, patulous esophagus was also seen (see transitional issues below), which may have also contributed to his difficulty taking pos. his symptoms had resolved by day of discharge. . # rash: over back, consistent with heat-induced follicullitis. first noted and resolved in the micu. . # altered mental status: on arrival to micu, question hypoxia precipitating versus history of previous stroke. per family, patient was initially off baseline, but improved with oxygen saturations, although patient still having episodes of confusion prior to intubation. he was treated with quetiapine, and his mental status improved while he weaned off sedation when he was intubated and then improved further after extubation. on transfer to the medical floor he was stable and remained oriented. . # dropping hct: hct dropped from 28 on to 22 on without a source of bleeding. this may have been dilutional, but the patient was transfused with 1 unit prbcs on . from that point, his hct has been increasing. . chronic problems: # history of dvt: pt has a hx of dvt and was treated previously with coumadin. this was held during his hospitalization. due to his history of being hit antibody +, he was not treated with unfractionated heparin. he was treated with aspirin 81 mg po/ng daily and fondaparinux sodium 2.5 mg sc daily. . # bph: on flomax at home. this was initially held, but was restarted on the patient's foley was removed on and he maintained urine output on discontinuation of the foley. . # history of stroke and seizures: the patient remained clinically stable on his home lacosamide 50 mg po/ng daily, pravastatin 20 mg po hs, and aspirin 81 mg po/ng daily. . # history of seasonal allergies: inactive during this hospitalization. home medications were initially held, but were restarted on discharge. . # history of depression: the patient remained clinically stable. his home duloxetine 60 mg po daily was held initially but restarted on . . # skin conditions: pt on several home medications that were continued, including hydrocortisone cream 0.5% 1 appl tp tid:prn intching, ketoconazole 2% 1 appl tp daily, and triamcinolone acetonide 0.1% cream 1 appl tp to scalp as needed. . transitional issues: # the patient responds well to diuresis with iv furosemide 20mg if there are signs of fluid overload. # the patient's metoprolol 25mg tid was consolidated to metoprolol succinate 75 once a day, but his sbp has been in the high 90s towards the end of his hospital stay, so antihypertensives had been held. # patulous esophagus seen on cta chest : outpatient esophagram can be obtained if indicated # the patient will need rehab for his left hip surgery. medications on admission: -lacosamide (vimpat) 100 mg oral tablet tab daily -fluticasone 50 mcg/actuation nasal spray, suspension use 2 sprays in each nostril once daily -tamsulosin (flomax) 0.4 mg oral capsule, ext release 24 hr 1 tablet daily 30 minutes after breakfast -nystatin (mycostatin) 100,000 unit/g topical powder use -duloxetine (cymbalta) 60 mg oral capsule, delayed release(e.c.) 1 tab qd -fluocinonide 0.05 % topical solution apply twice daily as directed -fexofenadine () 180 mg oral tablet take 1 tablet daily as needed. available over the counter. -pravastatin (pravachol) 20 mg oral tablet 1 tablet in the evening -metoprolol tartrate 25 mg oral tablet 3 tablets daily total 75mg -ketoconazole (nizoral) 2 % topical cream apply twice daily -ketoconazole (nizoral) 2 % topical shampoo shampoo 5 minutes 2 to 5 times per week or as directed -dantrolene (dantrium) 25 mg oral capsule as directed -triamcinolone acetonide 0.1 % topical lotion apply to the scalp as needed -lorazepam (ativan) 0.5 mg oral tablet tablet q 6hrs as need for anxiety -acetaminophen (tylenol extra strength) 500 mg oral tablet 2 tablets -docusate sodium (colace) 100 mg oral capsule once daily -sennosides (senna laxative oral) one tablet daily as needed for constipation -multivitamin oral once a day -aspirin 81 mg tab discharge medications: 1. acetaminophen 650 mg po q6h pain or fever patient may refuse 2. albuterol inhaler puff ih q6h:prn sob, wheezing 3. aspirin 81 mg po daily 4. bisacodyl 10 mg po/pr daily:prn constipation 5. calcium carbonate 500 mg po bid calcium supplement please do not administer within 2 hours of cipro doses 6. docusate sodium 100 mg po bid 7. duloxetine 60 mg po daily 8. fluticasone propionate nasal 2 spry nu daily 9. fondaparinux sodium 2.5 mg sc daily 10. hydrocortisone cream 0.5% 1 appl tp tid:prn intching 11. ketoconazole 2% 1 appl tp daily 12. lacosamide 50 mg po daily 13. lidocaine 5% patch 1 ptch td daily 14. miconazole powder 2% 1 appl tp 15. morphine sulfate ir 7.5 mg po q6h:prn pain 16. multivitamins 1 tab po daily 17. omeprazole 40 mg po daily 18. ondansetron 4 mg iv q6h:prn nausea 19. pravastatin 20 mg po hs 20. prochlorperazine 10 mg po q6h:prn nausea caution oversedation 21. quetiapine fumarate 25 mg po tid:prn agitation 22. senna 1 tab po bid 23. simethicone 40-80 mg po qid:prn abdominal discomfort 24. sodium chloride 0.9% flush 3 ml iv q8h:prn line flush peripheral line: flush with 3 ml normal saline every 8 hours and prn. 25. tamsulosin 0.4 mg po daily 26. triamcinolone acetonide 0.1% cream 1 appl tp to scalp as needed 27. vitamin d 800 unit po daily 28. metoprolol succinate xl 75 mg po daily hold if sbp<100, hr<60 discharge disposition: extended care facility: nursing & therapy center - ( center for rehabilitation and sub-acute care) discharge diagnosis: primary: left hip fracture, respiratory failure, pneumonia, pulmonary edema secondary: depression, congestive heart failure, hypertension discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: out of bed with assistance to chair or wheelchair. discharge instructions: dear mr. , it was a pleasure caring for you at . you were admitted because you had a broken hip which required surgery. your recovery was complicated by pneumonia, pulmonary edema (fluid in your lungs), and respiratory failure, which required that we insert a breathing tube and provide mechanical ventilations in the medical icu. we also treated you with oxygen, antibiotics for the pneumonia and diuretic medications, which remove fluid from your body. we also gave you medications to maintain your blood pressure. . you responded to treatment well, except for some confusion known at icu delirium. once you improved, we transferred you to the general medicine floor and monitored you for several more days until your oxygen was stopped completely. please note the following changes in your medications: you should start fondaparinux to prevent blood clots, as managed by your orthopedic surgeon. you should change metoprolol to metoprolol 75mg xl once a day for high blood pressure. you should start the skin ointments and powders for your rashes, as needed, for 1-2 weeks until they resolve. you may start acetaminophen and morphine for pain control, as needed. you may continue the rest of your medications as previously prescribed. followup instructions: *please schedule a pcp appointment on discharge from your rehab facility. *please schedule an appointment with a dermatologist if your skin rashes do not resolve in weeks. orthopedic surgery followup: department: orthopedics when: thursday at 10:20 am with: ortho xray (scc 2) building: sc clinical ctr campus: east best parking: garage department: orthopedics when: thursday at 10:40 am with: , np building: campus: east best parking: garage procedure: continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube enteral infusion of concentrated nutritional substances partial hip replacement closed [endoscopic] biopsy of bronchus diagnoses: pneumonia, organism unspecified esophageal reflux unspecified pleural effusion congestive heart failure, unspecified acute posthemorrhagic anemia unspecified septicemia severe sepsis atrial fibrillation unspecified fall depressive disorder, not elsewhere classified hypertrophy (benign) of prostate without urinary obstruction and other lower urinary tract symptom (luts) acute respiratory failure alkalosis late effects of cerebrovascular disease, hemiplegia affecting unspecified side personal history of venous thrombosis and embolism other alteration of consciousness closed fracture of unspecified part of neck of femur acute edema of lung, unspecified other specified diseases of hair and hair follicles essential thrombocythemia 

Answer: The patient is high likely exposed to