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: doe, cough major surgical or invasive procedure: bronchoscopy chest tube mechanical ventilation port-a-cath placement history of present illness: 72yom with pmh tobacco use, copd, chf, presents c/o approx 6 weeks of gradually worsening dos and nonproductive cough, and stating that ct scan done recently at hospital outpt radiology showed "a large lymph node." he states that when doe became noticable 6 weeks ago he increased his lasix to triple dose for 3 days, lost 4 pounds, and felt his breathing was much improved. however, within the next week the doe returned and he increased his lasix dose again but this time without effect. he denies night sweats, weight loss, fevers, rash. he denies cp, productive cough, recent palpitations. he denies le edema, though states that even when "in chf" he never has le edema. baseline weight at home 190 lbs, on admission 202 lbs. ros: no headache, paraesthesias, weakness; no n/v/diarrhea, ros otherwise negative except as per hpi and moonlighter note. past medical history: chf, systolic copd nsvt hyperlipidemia htn gout arthritis icd placed for sustained vt focal penetrating aortic arch ulcer focal infra-renal aortic dissection social history: lives with wife, history positive for tobacco use but quit approx 20 years ago, no alcohol use, no drug use. family history: nc physical exam: t 98 hr 70 bp 121/80 rr 14 94%ra weight 201 lbs nad, breathing easily heent: vision, eomi neck supple no lad rrr nl s1s2 no mrg lungs with mild decreased bs at r base and crackles, no labored breathing abd soft, nt/nd, nabs le with 1+ edema, ue with 2+ edema in right arm, scattered healing papules pertinent results: cbc 07:30pm blood wbc-11.8*# rbc-4.12* hgb-12.1* hct-35.9* mcv-87 mch-29.5 mchc-33.8 rdw-15.5 plt ct-198 05:30am blood wbc-9.8 rbc-3.91* hgb-12.1* hct-34.9* mcv-89 mch-30.9 mchc-34.6 rdw-15.3 plt ct-204 02:19am blood wbc-56.5*# rbc-3.06* hgb-9.3* hct-28.0* mcv-92 mch-30.5 mchc-33.3 rdw-15.7* plt ct-204 11:04am blood wbc-49.6* rbc-2.88* hgb-8.8* hct-26.0* mcv-90 mch-30.6 mchc-33.9 rdw-15.4 plt ct-209 04:31pm blood wbc-31.3* rbc-2.83* hgb-8.6* hct-25.2* mcv-89 mch-30.3 mchc-34.0 rdw-15.6* plt ct-166 03:00am blood wbc-16.2* rbc-2.71* hgb-8.2* hct-24.3* mcv-90 mch-30.3 mchc-33.7 rdw-15.6* plt ct-134* 02:44pm blood wbc-9.8 rbc-2.52* hgb-7.6* hct-23.0* mcv-91 mch-30.2 mchc-33.1 rdw-15.7* plt ct-119* 02:49am blood wbc-8.2 rbc-2.51* hgb-7.4* hct-22.8* mcv-91 mch-29.7 mchc-32.7 rdw-15.5 plt ct-125* 08:18am blood wbc-10.4 rbc-2.48* hgb-7.4* hct-22.7* mcv-92 mch-29.9 mchc-32.7 rdw-15.4 plt ct-137* 04:20am blood wbc-27.2* rbc-3.14* hgb-9.5* hct-28.7* mcv-92 mch-30.4 mchc-33.2 rdw-15.3 plt ct-155 04:58am blood wbc-31.7* rbc-3.26* hgb-9.7* hct-29.9* mcv-92 mch-29.8 mchc-32.5 rdw-15.5 plt ct-144* 02:32am blood wbc-37.9* rbc-3.40* hgb-10.2* hct-29.1* mcv-86 mch-29.9 mchc-34.9 rdw-16.8* plt ct-115* 04:21pm blood wbc-50.6* rbc-3.45* hgb-10.3* hct-29.7* mcv-86 mch-29.8 mchc-34.5 rdw-16.6* plt ct-120* 12:00am blood wbc-54.9* rbc-3.07* hgb-9.2* hct-27.0* mcv-88 mch-29.9 mchc-34.1 rdw-16.5* plt ct-113* 12:00am blood wbc-57.0* rbc-3.68* hgb-10.7* hct-31.6* mcv-86 mch-29.1 mchc-33.8 rdw-16.0* plt ct-115* 12:00am blood wbc-0.9*# rbc-2.98* hgb-8.7* hct-25.8* mcv-87 mch-29.0 mchc-33.5 rdw-15.0 plt ct-60* 12:00am blood wbc-1.5*# rbc-3.44* hgb-9.8* hct-29.3* mcv-85 mch-28.4 mchc-33.3 rdw-14.7 plt ct-12* 12:00am blood wbc-4.1# rbc-3.40* hgb-9.8* hct-28.0* mcv-82 mch-28.7 mchc-34.8 rdw-14.8 plt ct-26* 12:01am blood wbc-2.6* rbc-3.13* hgb-9.0* hct-26.7* mcv-85 mch-28.8 mchc-33.8 rdw-15.1 plt ct-55* 12:00am blood wbc-2.4* rbc-3.66* hgb-10.5* hct-30.6* mcv-84 mch-28.7 mchc-34.3 rdw-15.2 plt ct-60* 12:00am blood wbc-2.2* rbc-3.63* hgb-10.3* hct-30.3* mcv-84 mch-28.5 mchc-34.1 rdw-15.1 plt ct-66* 07:30pm blood neuts-78.9* lymphs-14.1* monos-5.5 eos-1.4 baso-0.2 05:39am blood neuts-99* bands-0 lymphs-0 monos-0 eos-0 baso-0 atyps-0 metas-0 myelos-1* 02:50am blood neuts-94.6* lymphs-3.3* monos-2.0 eos-0 baso-0.1 12:00am blood neuts-85.0* bands-0 lymphs-6.8* monos-7.8 eos-0.4 baso-0.1 12:01am blood neuts-64 bands-15* lymphs-20 monos-1* eos-0 baso-0 atyps-0 metas-0 myelos-0 12:00am wbc 2.5* hb10.5* hct 31.6* plt 196 12:00am blood gran ct-760* 12:01am blood gran ct-140* 12:00am blood gran ct-140* 12:00am blood gran ct-890* 12:00am blood gran ct-3360 12:00am blood gran ct-1780* 12:00am blood gran ct-1500* 12:00am blood gran ct-2670* . chem 7 05:30am blood glucose-92 urean-23* creat-1.6* na-142 k-4.2 cl-102 hco3-31 angap-13 02:19am blood glucose-128* urean-33* creat-2.3* na-141 k-5.0 cl-109* hco3-20* angap-17 04:31pm blood glucose-171* urean-42* creat-2.7* na-140 k-5.0 cl-111* hco3-18* angap-16 03:00am blood glucose-180* urean-45* creat-2.5* na-142 k-4.6 cl-114* hco3-20* angap-13 03:09am blood glucose-138* urean-50* creat-1.9* na-146* k-4.5 cl-117* hco3-22 angap-12 01:50am blood glucose-122* urean-58* creat-1.7* na-148* k-4.2 cl-117* hco3-24 angap-11 02:49am blood glucose-135* urean-56* creat-1.5* na-148* k-4.4 cl-114* hco3-28 angap-10 05:14pm blood glucose-124* urean-55* creat-1.5* na-150* k-4.5 cl-114* hco3-30 angap-11 02:50am blood glucose-135* urean-57* creat-1.4* na-151* k-4.0 cl-112* hco3-31 angap-12 04:35am blood glucose-140* urean-53* creat-1.2 na-151* k-3.9 cl-109* hco3-32 angap-14 04:20am blood glucose-127* urean-52* creat-1.2 na-149* k-3.8 cl-110* hco3-33* angap-10 03:58am blood glucose-131* urean-60* creat-1.3* na-144 k-4.1 cl-104 hco3-29 angap-15 12:00am blood glucose-98 urean-49* creat-1.2 na-144 k-4.1 cl-109* hco3-28 angap-11 12:22am blood glucose-82 urean-37* creat-1.0 na-142 k-3.9 cl-107 hco3-28 angap-11 12:00am blood glucose-41* urean-34* creat-0.9 na-141 k-3.8 cl-106 hco3-28 angap-11 12:11pm blood creat-0.7 12:00am blood glucose-150* urean-24* creat-0.7 na-138 k-4.2 cl-107 hco3-27 angap-8 10:19pm blood glucose-83 urean-27* creat-1.0 na-138 k-4.0 cl-105 hco3-30 angap-7* 12:00am blood glucose-99 urean-26* creat-0.8 na-137 k-4.1 cl-105 hco3-27 angap-9 12:00am blood glucose-99 urean-27* creat-1.1 na-139 k-3.9 cl-100 hco3-34* angap-9 04:30pm blood urean-24* creat-1.0 na-137 k-4.3 cl-99 01:00pm blood glucose-118* urean-23* creat-1.0 na-138 k-4.1 cl-100 hco3-31 angap-11 01:00pm blood glucose-196* urean-48* creat-1.2 na-138 k-4.6 cl-101 hco3-31 angap-11 07:30pm blood calcium-9.5 phos-3.3 mg-2.4 05:30am blood calcium-9.4 phos-3.9 mg-2.4 uricacd-8.9* 01:50am blood calcium-9.4 phos-3.4 mg-3.0* 02:50am blood calcium-9.1 phos-3.4 mg-2.6 05:11pm blood calcium-9.2 phos-3.3 mg-2.8* 03:58am blood calcium-8.4 phos-4.5 mg-2.7* 01:37pm blood calcium-7.7* phos-2.4* mg-1.7 12:23pm blood calcium-7.6* phos-3.0 mg-2.1 12:00am blood calcium-7.5* phos-2.7 mg-2.0 12:00am blood albumin-2.6* calcium-7.9* phos-2.7 mg-2.0 01:00pm blood calcium-7.9* phos-2.6* mg-2.0 . misc 12:00am blood totprot-4.6* albumin-2.7* globuln-1.9* calcium-7.7* phos-2.6* mg-1.9 . cxr : 1. right superior mediastinal mass, likely anterior. recommend chest ct for better evaluation. 2. probable right lower lobe pneumonia. 3. new small right pleural effusion. . cxr : again, there has been apparent resolution of the right pneumothorax. however, an opacity projecting over the right mid lung remains, and is consistent with either aspiration or hemorrhage in the post-biopsy setting. this is approximately unchanged since the prior study. there is suggestion of developing right lower lobe atelectasis. there is unchanged position of a right pleural catheter, right subclavian line, and left chest dual-lead pacer. the endotracheal tube is unchanged in appearance. impression: continued right mid lung opacity consistent with aspiration or hemorrhage. right lower lobe opacity likely representative of developing atelectasis. ct chest; 1. right-sided central tumor with associated large conglomerate lymph node masses in the right superior mediastinum and right hilar/subcarinal regions, as described. there is compression of the airways as described, with associated post-obstructive atelectasis in the right middle lobe. findings most likely represent either a primary lung cancer with associated lymphadenopathy or lymphoma. findings very unlikely represent atypical appearance of sarcoid, given the unilaterality of the finding as well as associated effusion. lesion would be amenable to tissue sampling via bronchoscopy. 2. new moderate right-sided pleural effusion. 3. new 2- to 3-mm pulmonary nodule in the right middle lobe, concerning for possible metastatic disease. 4. new moderate pericardial effusion. 5. unchanged nodule in the left lower lobe. . ct head: normal contrast-enhanced head ct with no evidence of metastasis. . ct of the chest: there is a right-sided aicd with its lead in the right ventricle. when compared with the prior study, there have been interval placements of endotracheal tube, nasogastric tube, and a right internal jugular central line that are seen in satisfactory position. there is also a new right-sided chest tube, which is seen in the right posteromedial right hemithorax. there is a rounded, heterogeneous 6.6 x 7.7 x 12 cm collection in the right posterior medial hemithorax adjacent to the chest tube, which is consistent with a hematoma. additionally, there has been interval development of a moderate- sized pneumothorax, which is predominantly seen anteriorly. there is also a new diffuse infiltrate involving the posterior aspect of the right upper lobe, right middle lobe and portion of the right lower lobe, which likely reflects pneumonia, possibly aspiration related. the previously seen right pleural effusion has nearly resolved. there is; however, a small new left pleural effusion demonstrating simple fluid density with associated airspace disease. the previously noted 1.6-cm rounded nodule in the left lower lobe is now obscured by pleural fluid and atelectasis. the previously seen 2-3 mm nodule in the right middle lobe, is also not seen, likely due to a new infiltrate in this region. the lungs demonstrate diffuse severe emphysematous changes. the aorta and pulmonary arteries are normal in caliber. as before, note is made of extensive, bulky mediastinal and hilar confluent masses/lymphadenopathy, exact dimensions of which are difficult to measure due to poorly-defined margins and confluent nature of the process. the right hilar mass/lymphadenopathy measures 5 x 7 x 8 cm and as before, causes obstruction of the right middle lobe bronchus and some of the right lower lobe bronchi. there is also mild mass effect on the anterior aspect of the right upper lobe bronchus. there are also large, bulky and anterior mediastinal/right paratracheal masses/adenopathy that measures 9.6 x 9 x 6.2 cm. this surrounds and narrows the brachiocephalic veins and superior vena cava which remain patent; however. the hilar mass also causes mild narrowing of the distal portion of the right pulmonary artery and right pulmonary veins. there is a large subcarinal mass/lymphadenopathy appears to be contiguous with the right hilar mass and measures at least 4 x 4 cm. the previously seen pericardial effusion has decreased in size and now a small residual pericardial effusion is seen. coronary artery calcifications are noted. heart is borderline in size. no axillary lymphadenopathy is identified. the largest axillary lymph node is seen on the left and measures approximately 0.7 x 0.9 cm. there is a small lymph node in the ap window region that measures 0.7 cm in short axis and 1.3 cm in long axis. no left hilar adenopathy is seen. there are diffuse severe emphysematous changes in both lungs. heavy atherosclerotic calcifications with areas of eccentric plaque are seen in the thoracic aorta. coronary artery calcifications are present. ct of the abdomen: the liver is normal in size and contour. there is no intrahepatic or extrahepatic biliary dilatation. no suspicious focal liver lesions are seen. a 3-mm calcified gallstone is seen within the gallbladder. the pancreas and spleen are within normal limits. the right adrenal gland is unremarkable. the left adrenal gland is thickened. however, this appearance is unchanged since the prior ct from . the kidneys enhance symmetrically. there is no hydronephrosis. multiple small para-aortic lymph nodes are seen, which measure less than 1 cm in short axis and do not meet ct criteria for malignancy. there are heavy atherosclerotic calcifications within the abdominal aorta. there is no abdominal aortic aneurysm and the abdominal aorta measures approximately 2.1 cm in maximum diameter. there are also prominent porta hepatis lymph nodes abutting the inferior vena cava. there is no ascites. small and large bowel are normal in caliber. ct of the pelvis: the urinary bladder contains a foley catheter and is grossly unremarkable. there is trace amount of free pelvic fluid. prostate gland is not enlarged and measures 3.1 x 3.9 cm. no pelvic masses or adenopathy is identified. there is a right femoral arterial line in place, with its tip in the right external iliac artery. there is a dissection flap in the infrarenal abdominal aorta that originates to 30-cm distal to the left renal artery origin and extends to the level of the iliac bifurcation. the common iliac, external iliac and internal iliac arteries are grossly patent. bone windows: no focal suspicious lytic or sclerotic lesions are identified. however, the osseous structures in the pelvis have a somewhat mottled, heterogeneous appearance. a bone scan may be more sensitive in detection of subtle metastatic lesions. there are multilevel degenerative changes in the thoracolumbar spine. impression: 1. right hilar mass with bulky confluent mediastinal adenopathy, resulting in compression of the bronchi and vascular structures on the right. no axillary or left hilar lymphadenopathy. 2. interval placement of a right-sided chest tube, which is seen with its tip in the posterior right hemithorax medially. new hematoma in the right posterior hemithorax, adjacent to the chest tube. 3. extensive new right-sided airspace disease involving upper and lower lobes, probably reflects pneumonia. 4. interval improvement in pericardial effusion. 5. previously identified right middle and left lower lobe nodules are not seen on the current study due to interval development of a small left pleural effusion and the right-sided airspace disease. 6. borderline enlarged porta hepatis lymph nodes measuring 1.0 x 2.5 cm. no other pathologically enlarged lymph nodes or metastatic lesions are identified. 7. nodular appearance of the left adrenal gland, stable since . 8. heterogenous appearance of the osseous structures in the pelvis. further evaluation with a bone scan may be helpful with subtle underlying metastatic lesions. 9. moderate-sized right pneumothorax, predominantly anterior. . ct orbits:in the orbits, the eye globes demonstrate possible surgical changes, the density and configuration as well as the size of the optic nerves appear within normal limits. there is no evidence of intra- or extra- conal lesions. the orbital fat is preserved. the extraocular orbital muscles appear within normal limits. normal enhancement is identified in the major vascular structures. atherosclerotic changes are noted in the carotid siphons. the intracranial structures demonstrates no evidence of intra- or extra-axial hemorrhage, mass, mass effect or shift of normally midline structures. the images of the temporal bones are unremarkable with normal pneumatization on the mastoid air cells. the ossicles and middle ear appear within normal limits. small amount of cerumen is identified on the left external auditory canal. the paranasal sinuses demonstrate normal pneumatization with nasal septum deviation and s-shaped configuration. mild bilateral degenerative changes are identified on the temporomandibular joint consistent with osteopenia, however, the glenoid cavities appear within normal limits. impression: there is no evidence of abnormal enhancement, the optic nerves as well as the orbital structures appear within normal limits. bilateral atherosclerotic calcifications are visualized in the carotid siphons as described above. possible post-surgical changes are visualized in the eye globes, please correlate clinically. . ct chest : marked enlarged right pleural effusion with associated new right middle lobe and right lower lobe collapse. there has been interval decrease in size in large right perihilar mass and mediastinal lymphadenopathy. complete obstruction of the right middle lobe bronchus, partial obstruction of the right lower lobe superior segment bronchus is stable. left lower lobe lung nodule is slightly decreased in size. new mild cardiomegaly with interval mild decrease in size in pericardial effusion. resolved left pleural effusion. stable right lower lobe hematoma. . pleural fluid: wbc, pleural 1000* #/ul 0 - 0 rbc, pleural * #/ul 0 - 0 polys 83* % 0 - 0 lymphocytes 12* % 0 - 0 monos 1* % 0 - 0 macrophages 4* % 0 - 0 total protein 2.2 glucose 103 ldh 845 amylase 76 albumin 1.4 ph 5.5 brief hospital course: 72-year-old man with copd, chf, presented with 6 weeks of doe, cough. . # lung cancer: admission ct scan showed a mediastinal mass and right pleural effusion. a thoracentesis was performed and the cytology was negative for malignancy. the patient underwent a bronchoscopy that revealed a necrotic mass with biopsy revealing small-cell carcinoma. his post-bronchoscopy course was complicated by ptx and respiratory failure as described below. the patient had chemotherapy with carboplatin and etoposide (cycle 1) and underwent xrt. he developed neutropenia and required neupogen. his wbc did not recover and remained low at 2.0, but not neutropenic. he received a second cycle of carboplatin and etoposide with reduced dose. he should receive neupogen for 10 days, 1st dose . he will need daily cbc and absolute neutrophil count check. his wbc is 2.4, ancis 2190 on . he will need daily xrt. he should follow up with his oncologist dr. . . # respiratory failure: during the bronchoscopy there was some oozing of blood. after the procedure the patient felt dyspneic and dropped his o2 saturation despite being on a nrb. he was intubated. cxr showed a right-sided pneumothorax. chest tube was placed, and he was transferred to the icu. his antibiotic coverage, which had been levofloxacin initially, was changed to vanc/unasyn. he was also found to be bronchospastic and treated for copd exacerbation with steroid taper. he was then switched to fluticasone, albuterol and ipratropium nebs. fluticasone was discontinued when he became less bronchospastic. albuterol was discontinued when he had svt to 150's. ipratropium was continued. he was also diuresed as he was 10l positive with ef of 20%. he was successfully extubated on and transferred to omed. the patient required supplemental o2 via nasal cannulae to maintain adequate saturation. his oxygenation improved with diuresis. however, he developed an increasing, large right pleural effusion. with the increase in effusion, he became more sob with worsening hypoxia. he received a thoracenteisis with improvement, exudative effusion on labs. he was then further diuresed wit lasix 60 mg iv bid and was able to come off of 02. his extremety edema also markedly improved. his creatinine bumped and he was changed to lasix 80mg po bid on . he will need his creatinine followed every other day. he should be switched back to his home dose of lasix 80mg daily when his edema has resolved. as he has underlying copd, his goal sao2 is 90-93%. he was sat'ing 94% ra on discharge. . # hypotension: pt had transient hypotension following propofol, which improved with dc of propofol and boluses of fluid. he then became hypotensive to 60/40 evening of with three pressors, levophed, neo, and vasopressin. a sig. component was felt to be due to autpeep and pt improved after being disconnected from the ventilator. there was also concern for pericardial tamponade as he has known pericardial effusion from echo on . cardiology was consulted and repeat echo on showed no sig effusion but noted that echocardiographic signs of tamponade may be absent in the presence of elevated right sided pressures. there was also a concern of sepsis and pt was continued on vanc/unasyn for pna/aspiration. he was also started on stress dose steroids and fludracort for possible adrenal insufficiency from possible mets. pt was weaned off of pressors within 72 hours and then became hypertensive. stress dose steroids were tapered and fludrocort was discontinued. as his bp improved, his home heart failure regimen was restarted. nifedipine was discontinued to all room for medications for diuresis and heart rate control. . # visual loss: after extubation, the patient noted that his vision was impaired. head ct negative for stroke. ct of orbits negative. opthalmology was consulted. he had visual field tested in clinic which showed severely impaired vision. he was diagnosed with retrobulbar ischemia that likely occured during hypotension and hypoxia. he is to follow up in clinic. he received ot. . # acute on chronic renal failure: pt has a basline cr of 1.0. his creatinine peaked at 2.7, likely hypotension/atn. this improved to baseline with ivf resuscitation during his hypotensive episodes. his creatinine crept up to 1.2 with diureses and his lasix was cut back. . # acute on chronic systolic chf: prior to admission, pt was noted to have 10 lb weight gain. in the icu, he was positive 10 l for stay. he had significant peripheral edema. digoxin was held with his renal failure. once his blood pressure recovered, he was restarted on his home digoxin, metoprolol, which was titrated up, and diuresed. his peripheral edema improved. asa was initially held for biopsy and then for bloody secretions after bronchoscopy. . # htn: pt was well controlled on home regimen. this regimen was held when he become hypotensive. as his bp recovered, he was restarted on metoprolol, ca blocker added for hr control, see below. his bp remained low around sbp 100. . # h/o svt/vt: pt has an icd placed in 07. on the omed service, he developed multiple forms of svt wit hr to 130-150 - sinus tachycardia and occ afib. he was hemodynamically stable. he was restarted on metoprolol and titrated up to 100mg tid. diltiazem was added for rate control. digoxin was also started; dig level 0.4, digoxin dose increased. his hr improved to 80-90. he also has occ nsvt, approx 2 episodes a day, usually assymptomatic, hd stable. once his pleural effusion was tapped and he was diuresed, his heart rate improved. he was maintained on metoprolol 100 tid and digoxin 250mcg with hr in 90's at discharge. ekg showing nsr with occ pvc's. medications on admission: aspirin 81 mg qd, carvedilol 3.125 mg b.i.d., procardia xl 60 mg qd, zocor 40 mg qd, allopurinol 100 mg qd, digoxin 0.125 mg qd, lasix 80 mg a day, and combivent two puffs up to four times daily discharge medications: 1. simvastatin 40 mg tablet sig: one (1) tablet po daily (daily). 2. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for pain. 3. artificial tear with lanolin 0.1-0.1 % ointment sig: one (1) appl ophthalmic prn (as needed). 4. docusate sodium 50 mg/5 ml liquid sig: five (5) ml po bid (2 times a day) as needed for constipation. 5. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 6. prochlorperazine maleate 10 mg tablet sig: one (1) tablet po q4-6h () as needed for nausea. 7. lorazepam 0.5 mg tablet sig: 1-2 tablets po q8h (every 8 hours) as needed for anxiety. 8. ipratropium bromide 0.02 % solution sig: one (1) neb inhalation q6h (every 6 hours). 9. metoprolol tartrate 50 mg tablet sig: two (2) tablet po tid (3 times a day). 10. zolpidem 5 mg tablet sig: one (1) tablet po hs (at bedtime) as needed for insomnia. 11. digoxin 250 mcg tablet sig: one (1) tablet po daily (daily). 12. lisinopril 20 mg tablet sig: one (1) tablet po daily (daily). 13. carvedilol 3.125 mg tablet sig: one (1) tablet po bid (2 times a day). 14. oxycodone 5 mg tablet sig: two (2) tablet po q3h (every 3 hours) as needed for pain. 15. filgrastim 480 mcg/1.6 ml solution sig: one (1) tablet injection q24h (every 24 hours) for 10 days. 16. lasix 80 mg tablet sig: one (1) tablet po twice a day. discharge disposition: extended care facility: & rehab center - discharge diagnosis: primary: small cell lung cancer secondary: pneumothorax vision impairment acute renal failure congestive heart failure supraventricular tachycardia non-sustained ventricular tachycardia discharge condition: improved discharge instructions: you were admitted for a bronchoscopy. you subsequently had a pneumothorax and respiratory failure, which have now resolved. you also suffered from vision loss that is thought to be due to injury to the eye nerves secaondary to decreased oxygen. you were also diagnosed with small cell lung cancer and received two rounds of chemotherapy and radiation. you will need to continue with chemotherapy and radiation. . if you have worsening shortness of breath or fever, you should go to the emergency room followup instructions: you will need to have cbc and absolute neutrophil count checked daily for one week . you will need chem 7 checked every other day to monitor your renal function. . radiation oncology appointments mon-fri 2:45pm on 4 until . . provider: , md phone: date/time: 9:00 . provider: . (neuro-opthalmology) 1:30 in clinic and 2:00 for visual field testing . provider: (pulmonology) 7:30 pft's; 8:oo am with dr. . provider: , md phone: date/time: 3:00 provider: phone: date/time: 9:00 . provider: , m.d. phone: date/time: 2:00 md procedure: insertion of intercostal catheter for drainage venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube enteral infusion of concentrated nutritional substances thoracentesis arterial catheterization closed endoscopic biopsy of lung transfusion of packed cells insertion of totally implantable vascular access device [vad] injection or infusion of cancer chemotherapeutic substance transfusion of platelets teleradiotherapy using photons diagnoses: other iatrogenic hypotension unspecified pleural effusion congestive heart failure, unspecified acute kidney failure, unspecified chronic airway obstruction, not elsewhere classified hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified hematoma complicating a procedure chronic kidney disease, unspecified paroxysmal ventricular tachycardia other and unspecified hyperlipidemia other specified cardiac dysrhythmias pneumonitis due to inhalation of food or vomitus iatrogenic pneumothorax malignant neoplasm of other parts of bronchus or lung acute on chronic systolic heart failure other specified diseases of pericardium shock, unspecified other optic neuritis 

Answer: The patient is high likely exposed to