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: no known allergies / adverse drug reactions attending: chief complaint: hemoptysis major surgical or invasive procedure: none history of present illness: this is a 36-year-old woman with a pmhx. significant for esrd (from hypertensive nephropathy) on hd (mwf) who is admitted from hospital with hemoptysis. according to patient and osh records, patient began experiencing hemoptysis the day prior to admission (once at 8am and then at 9pm); she went to hospital that night where she was evaluated and sent home. the following day she went to hd where she coughed up 30cc of rube-red blood in clots. she was sent to hospital where she had a cta, which showed pes in the lower lobe pulmonary artery branches bilaterally. the rv lv ratio was 1.01 and there was no septal bowing. ms. was subsequently transferred to for further evaluation. . at the ed, initial vitals were: hr 70, 98/54, 12, 100%ra. patient was guaic negative and she was started on a heparin. she was given vanc and levaquin for ggo on ct scan and question of hcap. after heparin drip was started, patient passed about 100cc of frank hemoptysis. however, she remained hemodynamically stable and maintained her airway. on admission to the micu, vitals were: 97.8, 68, 97/59, 97% on ra. past medical history: --htn --anemia --gerd --esrd on dialysis --secondary hyperparathyroidism social history: patient came from 1.5 years ago. she was not on hd there, but only started in the us. does not smoke cigarettes or drink etoh. she works at ' donuts. she is married and has an 11-year-old child. family history: no family history of kidney failure. no clotting or bleeding disorders. physical exam: vitals: 97.8, 68, 97/59, 97% on ra heent: eomi, mucous membranes dry chest: dullness at both bases, good air movement throughout cardiac: rrr, no mrg abdomen: +bs, soft, non-tender, non-distended extremties: no edema, erythema, or cords bilaterally neuro: alert and oriented x3 rectal: guaic negative pertinent results: 03:51am blood wbc-6.9 rbc-3.22* hgb-10.0* hct-31.0* mcv-96 mch-31.0 mchc-32.2 rdw-13.7 plt ct-158 08:11pm blood neuts-43.9* lymphs-45.0* monos-4.5 eos-5.8* baso-0.7 12:20pm blood pt-10.6 ptt-29.0 inr(pt)-1.0 03:51am blood glucose-85 urean-62* creat-10.0*# na-140 k-5.9* cl-108 hco3-22 angap-16 11:40pm blood alt-14 ast-10 ld(ldh)-106 alkphos-71 totbili-0.1 03:51am blood calcium-8.5 phos-4.9*# mg-3.1* 03:51am blood hcg-<5 08:30pm blood type- temp-36.7 po2-48* pco2-52* ph-7.38 caltco2-32* base xs-3 intubat-not intuba . 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%). right ventricular chamber size and free wall motion 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 appears structurally normal with trivial mitral regurgitation. there is no mitral valve prolapse. the estimated pulmonary artery systolic pressure is normal. there is no pericardial effusion. . impression: normal global and regional biventricular systolic function. normal estimated pulmonary pressures. . discharge labs 06:20am blood wbc-10.3 rbc-2.78* hgb-8.8* hct-27.2* mcv-98 mch-31.7 mchc-32.3 rdw-15.4 plt ct-311 06:45am blood neuts-58.9 lymphs-29.7 monos-4.8 eos-5.6* baso-0.9 06:20am blood pt-21.2* ptt-95.9* inr(pt)-2.0* 12:20pm blood at-100 protcfn-101 protsfn-106 12:20pm blood aca igg-6.2 aca igm-4.5 06:20am blood glucose-82 urean-54* creat-10.5*# na-139 k-5.0 cl-105 hco3-23 angap-16 11:40pm blood alt-14 ast-10 ld(ldh)-106 alkphos-71 totbili-0.1 03:11pm blood lipase-106* 06:20am blood calcium-9.5 phos-5.5* mg-2.8* 06:00am blood caltibc-212* ferritn-971* trf-163* 03:51am blood hcg-<5 12:20pm blood anca-negative b 12:20pm blood -negative 12:20pm blood anti-gbm-test 04:23am blood methylenetetrahydrofolate reductase (c677t)- brief hospital course: hospital course this is a 36-year-old woman with a pmhx significant for esrd on dialysis, htn, and anemia who is admitted to the micu with bilateral pes and hemoptysis. hospital course prolonged by repair of fistular prior to starting coumadin. fistula repair complicated by hematoma. the patient was ultimately discharged witha functioning fistula on coumadin for management of pulmonary emboli. . # hemoptysis: likely in the setting of bilateral pes. she was initially sent to the micu. there she remained hemodynamically stable. she was started on a heparin gtt for the pulmonary emboli, and hemoptysis resolved after 24 hours. . # bilateral pulmonary emboli: unclear etiology of hypercoagulable state however, there is no clear reversible risk factor. patient denies any long plane rides or periods of immobility, and she does not take birth control. patient denies any family history or personal history of blood clots. no known history of frequent miscarriages. bilateral upper and lower extremity ultrasound negative for clots. mrv pelvis showed no evidence of proximal clots. hypercoagulable studies showed were unrevealing for etiology (anca, , protein c and s, aca ig and igm, lupus anticoagulant, antithrombin, anti-gbm, methylenetetrahydrofolate). coumadin was not started immediately secondary to an effort to revise her prior fistula prior to initiation of coumadin. after successful revision of her left sided fistula, coumadin was started requiring several days of 7.5mg to maintain inr goal . her primary care physician was notified of the hospitalization, aware of initiation of coumadin and follow-up scheduled for initiation of coumadin clinic. . # esrd on hd: as per dialysis center, patient is on hd because of hypertensive nephropathy, however ultimate etiology unclear. she is dialyzed mwf. however, she is not all that hypertensive, and tte shows no evidence of hypertensive changes, calling that diagnosis into question. a work-up as part of her hypercoagulability work-up as outlined above was initiated. a biopsy was not pursued given duration on hd. her phosphorous was persistently elevated on calcium high normal. calcitriol was discontinued and sevelamer was started. nephrocaps were continued. . # fistula repair: given hospitalization and initiation of hd, repair of her clotted, non functioning fistula was performed. transplant surgery was consulted, venous mapping was performed and a synthetic graft was placed at the site of her prior fistula. fistula repair was complicated by evolution of a hematoma at the repair site. several ccs of blood were aspirated and her pain was controlled with tylenol and oxycodone. no prescription pain medications were required at the time of discharge. . # hypertension: held lisinopril in setting of bleed. she continued to be hypotensive throughout her hospitalization with blood pressures in the 90-100s. lisinopril was held on discharge to be restarted in the outpatient setting as tolerated. . # anemia: iron studies confirmed anemia of chronic disease. ferrous sulfate was discontinued. . transitional issues - inr check on the monday following admission, with pcp of labs. pcp office aware of inr check- she will have lab draw at the office. - start coumadin and sevelamer, discontinue ferrous sulfate, lisinopril and calcitriol - follow-up primary care for initiation of - follow-up transplant surgery for fistula - code: full medications on admission: --vitamin d --ferrous sulfate 1 tab daily --senna --bcomplex vitamins --calcitriol --colace --lisinopril 20mg qd discharge medications: 1. outpatient lab work please check inr on and fax these results to dr. at fax# (phone # ) 2. coumadin 2.5 mg tablet sig: two (2) tablet po once a day. disp:*60 tablet(s)* refills:*2* 3. cholecalciferol (vitamin d3) 400 unit tablet sig: two (2) tablet po daily (daily). 4. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 5. b complex-vitamin c-folic acid 1 mg capsule sig: one (1) cap po daily (daily). 6. colace 100 mg capsule sig: one (1) capsule po once a day as needed for constipation. 7. sevelamer carbonate 800 mg tablet sig: four (4) tablet po tid w/meals (3 times a day with meals). disp:*360 tablet(s)* refills:*2* discharge disposition: home discharge diagnosis: 1. pulmonary embolism 2. end stage renal disease discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you were admitted for coughing up blood and were found to have blood clots in your lungs (pulmonary embolisms). it is unclear why you developed these blood clots developed. your primary care physician may consider formal evaluation to better understand why this occurred. typically when people develop deep vein thrombosis (blood clots in larger veins) or pulmonary embolisms, they require at least 3-6 months of anticoagulation with a blood thinner as treatment. you were started on a blood thinner called heparin that was through your iv. a pill form of anticoagulation (coumadin) was also started which takes longer to have effect. while awaiting for the coumadin to work, you were continued on heparin. while hospitalized our surgeons were able to fix your fistula. . you will need careful monitoring of your blood while on coumadin for the next 3-6 months. your primary care physician is aware of your hospitalization and will manage your coumadin. . the following medication changes were made: 1. start coumadin 5mg daily 2. start sevelamer three times a day with meals 3. discontiue lisinopril unless otherwise indicated 4. discontinue ferrous sulfate unless otherwise indicated 5. discontinue calcitriol unless otherwise indicated you will need to have your blood drawn on monday to assess your inr to see if your coumadin is therapeutic. please go to your primary care physicians office to have this blood drawn. they are expecting you. you have a primary care visit scheduled wednesday after dialysis. followup instructions: department: primary care when: wednesday at 3:30 pm with: location: , department: family medicine phone . department: transplant center date/time: 2:15 with: , md building: lm campus: west best parking: garage procedure: hemodialysis arteriography of other specified sites revision of arteriovenous shunt for renal dialysis aspiration of skin and subcutaneous tissue diagnoses: hyperpotassemia anemia in chronic kidney disease end stage renal disease hypotension, unspecified surgical operation with anastomosis, bypass, or graft, with natural or artificial tissues used as implant causing abnormal patient reaction, or later complication, without mention of misadventure at time of operation long-term (current) use of anticoagulants secondary hyperparathyroidism (of renal origin) primary hypercoagulable state seroma complicating a procedure other pulmonary embolism and infarction hypertensive chronic kidney disease, benign, with chronic kidney disease stage v or end stage renal disease other complications due to renal dialysis device, implant, and graft arterial embolism and thrombosis of upper extremity encounter for therapeutic drug monitoring 

Answer: The patient is high likely exposed to