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: codeine / lipitor attending: chief complaint: # sob major surgical or invasive procedure: hemodialysis x4 history of present illness: 61f esrd s/p l arm hd fistula placement (), pending possible hd initiation (not anuric), admitted with increasing sob and ble edema x 3-4d. on the night of admission, pt had called ems after noting increasing sob while lying in bed. per report, pt's initial bp=226/94, with sao2 100/cpap. of note, pt had been recently admitted with rll mssa pna c/b mssa bacteremia. . ed course: # meds: nitroglycerin gtt, furosemide 100mg iv x 1, levofloxacin po x 1 dose # studies: cxr demonstrated edema and ?lll pna # clinical: weaned from cpap to 3l # consults: renal indicated no acute indication for hd. . ros on admission: (+) as above (-) dietary indiscretion, medication non-compliance, uop decline . ros on floor transfer: pt stated that she felt "good." (-) sob, abdominal pain, chest pain past medical history: # cv -cad s/p cath (): mild epicardial disease, collalateral flow to distal inferior wall, no intervention -htn -hyperlipidemia . # endo -dm2 --neuropathy --nephropathy --retinopathy . # gu -chronic kidney disease (stage iv) . # neuro -stroke -impaired memory s/p mva . # heme -anemia social history: # alcohol: never # tobacco: never # recreational drugs: never family history: # f, d70s: heart disease # siblings (two sisters): dm2 physical exam: pe on micu admission: . vs: t 97.1, bp 184/72, hr 85, r 21, sao2 98/3l gen: nad heent: perrla, eomi, sclera anicteric, op clear, mmm, no lad, no carotid bruits. 8-10 cm jvd. cv: regular, nl s1, s2, no m/r, +s4. pulm: crackles bilaterally, no r/w. abd: soft, nt, nd, + bs, no hsm. well healed midline gallston scar. ext: warm, 2+ dp/radial pulses bl, 1+ b le edema. l ue fistula +thrill. neuro: alert & oriented x 3, cn ii-xii grossly intact. strength symmetric @ triceps, biceps, delts, hip flexion, dorsoflexion, plantarflexion. sensation grossly intact. . pe on floor transfer: vs: tm 97, tc 97, hr 68-76, bp 139-163/47-74, r 13-21, spo2 98/ra-100/ra . gen: sleeping, nad heent: ncat, no lad, no jvd, cn ii-xii grossly intact cv: rrr, s1s2, no m/r/g noted chest: ctab abd: soft, ntnd, bs+, large pannus ext: no c/c/e neuro: nonfocal pertinent results: admission labs of note: . 04:50am glucose-351* urea n-60* creat-4.3* sodium-134 potassium-4.5 chloride-101 total co2-19* anion gap-19 04:56am lactate-1.0 09:11am ck-mb-5 ctropnt-0.03* 09:11am ck(cpk)-179* 11:15am %hba1c-8.5* 04:50am wbc-10.0 rbc-4.12* hgb-12.2 hct-37.4 mcv-91 mch-29.6 mchc-32.7 rdw-13.9 . ========================================= studies of note: . # chest (pa & lat) 1:31 pm 1. interval improvement of bilateral pleural effusions, now moderate to large on left and moderate on right. 2. interval progression of congestive heart failure. . # chest (portable ap) 4:26 am 1. probably large, layering bilateral pleural effusions with upper zone vascular redistribution suggestive of pulmonary edema. 2. dense opacification of the retrocardiac left lower lobe. while this could represent atelectasis in the context of pleural effusion, pneumonia cannot be excluded. . # ecg study date of 4:38:22 am sinus rhythm. within normal limits. compared to the previous tracing of no significant diagnostic change. . # chest (portable ap) 3:34 am impression: improving interstitial pulmonary edema with persistent bilateral pleural effusions. brief hospital course: 61f h/o esrd dm2 not yet on hd, presented with increased sob, ble edema, and hypertensive urgency chf. . # sob: pt's sob was considered likely either to pulmonary edema either esrd vs pna per cxr. after receiving one empirically dose of levofloxacin, pt was diuresed in the ed with furosemide 100mg iv, leading to uop 650cc and marked improvement of sob. levofloxacin was stopped and pt was continued on furosemide 100mg iv prn for a diuresis goal of 2l in the micu. upon transfer to the floor, pt had spo2=100/ra and continued to be monitored for respiratory status. pt was changed to furosemide po. after starting hd, pt was d/c'd without furosemide and had ambulatory sao2 = 97%. . # htn: pt reported baseline sbp=170s, but was found to have sbp=240s on admit. pt was therefore placed on a nitroglycerin gtt, with toprol xl increased to 300mg daily and amlodipine increased to 10mg po daily. as volume overload was considered the likely primary cause of pt's htn, pt was diuresed with furosemide iv with good effect. pt was also started on minoxidil 5 mg po daily for improved sbp control. upon transfer to the floor, pt had sbp=139-163, and continued to be monitored for bp control. after beginning hd, however, pt's bps normalized and she was discharged with only toprol xl 150mg daily. . # esrd: pt had esrd but had not been started on hd. renal was consulted and initially determined there was no acute indication for hd. pt was therefore continued on her home regimen of calcitriol and darbepoetin alfa. however, pt was noted to have persistent nausea and vomiting from uremia, and therefore was ultimately started on hd. pt was discharged with sevelamer 800mg tid with meals and nephrocaps 1 cap daily. . # dm2: on admission, pt did not know her home insulin regimen, and hba1c = 8.5%. the insulin regimen from pt's prior discharge summary was therefore applied, using insulin 70/30 29 units qam, 10 units qpm, and hiss. while on this previous fixed dose regimen, however, pt experienced one episode of hypoglycemia while on the floor, with bg to 40s. pt's insulin needs were therefore calculated after placing her only on humalog sliding scale, and pt was discharged on nph 10 units at breakfast and nph 6 units at dinner. . # cad: pt ruled out for mi, with negative ce x3 and ekg demonstrating no acute changes. pt was continued on her home regimen of asa. toprol xl was increased from her original home regimen of 200mg daily to 300mg daily, with improved sbp control. after beginning hd, pt was discharged on a reduced dose of toprol xl 150mg daily. . # lfts: to be screened for outpatient hd placement, laboratories were drawn to assess lfts and hepatitis serologies. pt was negative for hbv and hcv infection, but alt and alk phos were found to be slightly elevated. this could be due to congestive hepatopathy. pt was informed that it may be useful to follow up on these lfts (if they persist to be abnormal) by liver ultrasound as an outpatient. # full code medications on admission: # amlodipine 10mg po daily # calcitriol 0.25mg qod/ 0.50mg qod # toprol xl 200mg po daily # insulin: pt did not know regimen # asa 325mg po qdaily # darbepoetin alfa 25mcg/0.42ml syringe, 1 injection daily # tums # mvi discharge medications: 1. aspirin 325 mg tablet sig: one (1) tablet po daily (daily). disp:*60 tablet(s)* refills:*2* 2. humalog insulin sliding scale 121-160mg/dl: breakfast 2 units; lunch 2 units; dinner 2 units; bedtime 2 units 161-200mg/dl: breakfast 4 units; lunch 4 units; dinner 4 units; bedtime 4 units 201-240mg/dl: breakfast 6 units; lunch 6 units; dinner 6 units; bedtime 6 units 241-280mg/dl: breakfast 8 units; lunch 8 units; dinner 8 units; bedtime 8 units 281-320mg/dl: breakfast 10 units; lunch 10 units; dinner 10 units; bedtime 10 units 321-360mg/dl: breakfast 12 units; lunch 12 units; dinner 12 units; bedtime 12 units 361-400mg/dl: breakfast 14 units; lunch 14 units; dinner 14 units; bedtime 14 units >400mg/dl: call your primary care doctor and go to the emergency . outpatient lab work please check chem 10 on , , and fax to dr. office at fax 4. b complex-vitamin c-folic acid 1 mg capsule sig: one (1) cap po daily (daily). disp:*30 cap(s)* refills:*2* 5. sevelamer 800 mg tablet sig: one (1) tablet po tid w/meals (3 times a day with meals). disp:*90 tablet(s)* refills:*2* 6. metoprolol succinate 100 mg tablet sustained release 24 hr sig: 1.5 tablet sustained release 24 hrs po daily (daily). disp:*45 tablet sustained release 24 hr(s)* refills:*2* 7. docusate sodium 100 mg capsule sig: two (2) capsule po bid (2 times a day) as needed for constipation. 8. senna 8.6 mg tablet sig: 1-2 tablets po bid (2 times a day) as needed for constipation. 9. insulin nph & regular human 100 unit/ml (70-30) suspension sig: one (1) bottle subcutaneous as directed: please inject 10 units at breakfast and 6 units at dinner time. . disp:*1 bottle* refills:*2* discharge disposition: home with service facility: homecare discharge diagnosis: primary diagnosis # congestive heart failure pulmonary hypertension # hypertensive, malignant # diabetes mellitus type 2, with complications uncontrolled. # chronic kidney disease stage 5 # initiation of hemodialysis . secondary diagnosis # hyperlipidemia # coronary artery disease discharge condition: stable discharge instructions: you came to the hospital because you were short of breath. we found that you had too much fluid in your body, you had very high blood sugars and you had a very high blood pressure. we gave you medications to make you urinate, we gave you blood pressure medications, and we gave you insulin. . we ***changed*** your medications: . this is the new insulin you should take: # for your blood sugar: ---insulin 70/30 10 units when you are eating breakfast ---insulin 70/30 6 units when you are eating dinner ---write down your sugars every four hours. bring this to your appointment with dr. office on monday! -please follow the insulin sliding scale attached . # for your kidney ---nephrocaps 1 capsule daily ---sevelamer 800 mg three times daily with meals . for your blood pressure: -toprol xl 150mg daily you should no longer take the amlodipine that you were taking before you came into the hospital. please take the rest of your medications as usual until you see your primary care doctor. . you have several follow-up appointments. see below. . if you have fevers, chills, nausea, vomiting, chest pain, or shortness of breath, call your primary care doctor immediately and go to the emergency room. followup instructions: you have the following appointments: . your kidney (nurse is part of dr. nephrology team): this is very important! provider: , rn phone: date/time: 5:00 . provider: , m.d. phone: date/time: 10:00 . provider: , m.d. phone: date/time: 11:00 procedure: hemodialysis diagnoses: hypertensive chronic kidney disease, malignant, with chronic kidney disease stage v or end stage renal disease chronic kidney disease, stage v anemia in chronic kidney disease congestive heart failure, unspecified acute kidney failure, unspecified other chronic pulmonary heart diseases diabetes with neurological manifestations, type ii or unspecified type, not stated as uncontrolled polyneuropathy in diabetes other and unspecified hyperlipidemia diabetes with other specified manifestations, type ii or unspecified type, not stated as uncontrolled long-term (current) use of insulin diabetes with renal manifestations, type ii or unspecified type, not stated as uncontrolled diabetes with ophthalmic manifestations, type ii or unspecified type, not stated as uncontrolled background diabetic retinopathy 

Answer: The patient is high likely exposed to