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: shortness of breath major surgical or invasive procedure: cardiac catheterization microsuspension laryngoscopy with micro flap excision of left edema, awake fiberoptic intubation history of present illness: 47m with hx of hld, tobacco use, and occasional cocaine/crack use who presented to on with increasing shortness of breath concerning for cocaine-induced chest pain. he initially presented to the ed on with dyspnea and was treated with one dose of prednisone as well as albuterol inhalers and then discharged home. he states that his shortness of breath actually began approximately 1.5 months ago, which he attributed to smoking, and then it spontaneously resolved. he presented again the following day with severe dyspnea and initially required a 100% non-rebreather. his pulmonary exam revealed bilateral crackles and a chest x-ray revealed pulmonary edema. he received aspirin and nitroglycerin initially. his ekg was initially unremarkable. cardiac troponins were elevated to 0.43 later that day. cardiology was consulted and a tte was performed, the results of which were pending at the time of transfer. . he continued to have persistent stridor and a bronchoscopy was performed that revealed large papillomatous tumor originating predominantly from the left but also the right vocal cord, but, by report, the bronchoscope was able to be easily passed through the vocal cords. traces of blood were noted throughout the airway, which were suctioned. multiple bites were taken of the tumor and sent for pathology. a complete debulking was not performed out of concern for the recent nstemi though approximately 20% of the obstruction was removed from the posterior commissure. . given the complexity of the case and the absence adequate services, the decision was made to transfer the patient to for further management. vital signs at transfer were 97.8, 102, 143/93, 18, 96% on 2l nc. . on arrival to the micu, his vs were 98.2, 110, 149/92, 21, 96%ra. on further review, in addition to the details above, he related that he felt that he was having so much trouble breathing that he passed out at osh. he states that he occasionally uses crack and cocaine and last smoked crack approximately the day prior to his admission to . he currently denies chest pain, shortness of breath, abdominal pain, n/v/d, urinary symptoms, fevers, or chills. . review of systems: (+) per hpi, otherwise negative. past medical history: hypercholesterolemia chronic lower back pain cocaine abuse alcohol abuse tobacco abuse social history: he is single and has one 13 y/o child. he works as a printer. he has smoked one pack/day x 35 years. he drinks approximately beers/day, 6 days a week. he occasionally uses cocaine or crack. he uses marijuana as well. he denies any injectable drug use. he is currently in a custody battle with his ex-partner that has lasted several years. family history: his mother had an mi at the age of 69 and died in from lung cancer. she was a smoker. he does not know his father's history. he has two siblings who are alive and well. physical exam: admission physical exam: ======================== . vitals: 98.2, 110, 149/92, 21, 96%ra general: alert, oriented, no acute distress, hoarse, weak voice heent: sclera anicteric, mmm, oropharynx clear, eomi, perrl neck: supple, jvp not elevated, no lad cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops lungs: rales at bases bilaterally, otherwise clear abdomen: soft, obese, non-distended, bowel sounds present, no organomegaly, no tenderness to palpation, no rebound or guarding gu: no foley ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema neuro: cnii-xii intact, 5/5 strength upper/lower extremities, grossly normal sensation . discharge physical exam: ======================== . vs: 97.4 136/84 59 98%ra general: middle aged man in no acute distress resp: clear b/l with good inspiratory effort cv: normal s1 + s2, w/ no gallops, heaves, murmurs etc abd: soft, no ttp, no fluid, +ve bs neuro: grossly intact, aox3 pertinent results: admission labs: =============== . 11:29am blood wbc-25.8* rbc-4.44* hgb-13.3* hct-41.7 mcv-94 mch-29.9 mchc-31.9 rdw-13.6 plt ct-230 11:29am blood neuts-94.0* lymphs-3.3* monos-2.2 eos-0.4 baso-0.1 11:29am blood pt-10.4 ptt-37.0* inr(pt)-1.0 11:29am blood glucose-171* urean-14 creat-0.7 na-139 k-4.4 cl-104 hco3-26 angap-13 11:29am blood alt-30 ast-21 ld(ldh)-215 ck(cpk)-85 alkphos-62 totbili-0.2 11:29am blood lipase-43 11:29am blood albumin-4.0 calcium-9.0 phos-2.5* mg-2.5 . micro/path: =========== . mrsa screen: pending left vocal fold lesion pathology: pending . imaging/studies: ================ . portable cxr : findings: single ap portable view of the chest is provided. the cardiac, mediastinal silhouette and hilar contours are unremarkable. no large pleural effusions are seen. there are no focal opacities or consolidations. there is mild suggestion of cephalization of the pulmonary vasculature consistent with mild vascular congestion. . cardiac cath: comments: 1. selective coronary angiography of this right dominant system revealed 1 vessel coronary artery disease. the lm and rca were free of angiographically apparent disease. the lad had 50-60% mid stenosis. the lcx had 40% mid stenosis. 2. limited resting hemodynamics revealed normal left sided filling pressures with an lvedp of 14mmhg. there was normal systemic arterial pressure of 130/91mmhg. final diagnosis: 1. moderate mid-lad lesion best suited for continued medical therapy. 2. continue aspirin, statin, calcium channel blocker. . discharge labs: =============== 05:20am blood wbc-12.0* rbc-4.68 hgb-13.6* hct-43.3 mcv-93 mch-29.0 mchc-31.4 rdw-13.3 plt ct-218 07:00am blood pt-10.5 ptt-23.6* inr(pt)-1.0 05:20am blood glucose-119* urean-18 creat-0.8 na-141 k-3.8 cl-104 hco3-28 angap-13 05:20am blood calcium-8.4 phos-4.2 mg-2.2 brief hospital course: summary: 47 year old man with h/o cocaine abuse and a current smoker admitted for laryngeal mass leading to stridor and coronary vasospasm secondary to cocaine use. . # laryngeal mass s/p excision: patient presented on transfer from osh to micu with stable vital signs, hoarse voice, and inspiratory stridor. given pt's drinking and smoking history there was concern for new squamous cancer of the vocal cords. patient was evaluated urgently by ent and taken to the or for left vocal fold lesion excision. clinical impression of ent team was ??????s edema likely from etoh, tobacco, and yelling loudly during sporting events. pathology pending from and at time of discharge. he was evaluated the following morning by laryngoscopy at bedside which showed patent airway. he received 24 hours of steroids and was transferred to the floor. on the floor, the patient's breathing was much improved. he was evaluated by ent who felt a repeat procedure in the clinic 1-2 weeks after discharge was warranted to perform a similar procedure on the opposite vocal cord. . # coronary vasospasm: lead to dynamic twi's on i, ii, v4-v6 with tte at osh showing distal apical, septal, and anterior wall hypokinesis with preserved ef >55%. troponin trend at osh and 0.01, 0.43, 0.27, 0.07, and 0.03 with normal ckmb. patient remained chest pain free during his stay. he had a cardiac catheterization showing moderate mid-lad disease, making cad the unlikely etiology of his chest pain. his elevated troponin levels with flat ck-mb suggest demand ischemia in setting of cocaine use. pci was not done. the patient was started on lisinopril for blood pressure control, low-dose statin for hyperlipidemia, and nifedipine for vasospasm as well as 81mg asa daily for prophylaxis. he was not started on a beta-blocker given his recent cocaine. he may benefit from repeat tte on future outpatient visits. . # substance abuse: patient with active cocaine use, alcohol use, and tobacco abuse. social work was consulted, and the patient was counseled about abstaining from these substances. . # lower back pain: chronic. the patient was using a friend's gabapentin for relief. the patient was encouraged not to take medications not prescribed to him, and he was given a short course of gabapentin with instructions to follow-up with his primary doctor. . # hyperlipidemia: not on medications as an outpatient. was started on low dose simvastatin, with instructions to follow-up with primary care physician. . transitional issues: -f/u final pathology of vocal cord lesion. -needs f/u of chemistry panel post lisinopril initiation. -further smoking cessation and cocaine cessation counseling should be reinforced. -statin may need titration. -consider repeat outpatient tte. medications on admission: gabapentin 800mg tid (not prescribed to him; he takes a friend's supply) discharge medications: 1. oxycodone 5 mg tablet sig: one (1) tablet po every six (6) hours as needed for pain. 2. lisinopril 5 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 3. nifedipine 30 mg tablet extended release sig: one (1) tablet extended release po daily (daily). disp:*30 tablet extended release(s)* refills:*0* 4. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily). disp:*30 tablet, chewable(s)* refills:*0* 5. outpatient lab work please obtain a basic chemistry panel including potassium, bun and creatinine and have the results sent to dr. , r. within 1 week of discharge 6. nicotine 21 mg/24 hr patch 24 hr sig: one (1) transdermal once a day. disp:*30 patches* refills:*0* 7. simvastatin 10 mg tablet sig: one (1) tablet po once a day. disp:*30 tablet(s)* refills:*0* 8. neurontin 300 mg capsule sig: one (1) capsule po three times a day for 10 days. disp:*30 capsule(s)* refills:*0* discharge disposition: home discharge diagnosis: coronary vasospam leading to coronary demand ischemia laryngeal mass causing stridor, biopsy results pending tobacco abuse chronic lower back pain discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you were admitted for chest pain and shortness of breath. you had a procedure to look at the arteries around your heart, which did not reveal a direct cause for your chest pain. the most likely cause of your chest pain was related to cocaine, which can cause vasospasm (clamping down of the arteries around your heart). it will be very important for you to stop using cocaine to prevent further damage to your heart. you also had a procedure for the throat and breathing problems you' been having. this was most likely related to swelling of the area around your vocal chords, but the final results of the biopsy are pending, and it will be very important for you to follow-up with the ent doctors (ear, nose and throat - the team that did your procedure). ***you will need to follow-up in weeks in the ent office. the doctors would to perform another procedure, which can be done without putting you to sleep, and can be a same day office procedure. if you do not follow-up within 1-2 weeks, your symptoms could progress to the point where you would need emergency surgery*** it is also imperative that you stop smoking. continuing to smoke will increase your risk for future heart attacks, strokes, and many other severe health complications. it will be very important for you to follow-up at the appointments listed below. we are also starting you on several new medications. please note the following medication changes: -please start aspirin 81mg daily -please start lisinopril 5mg daily, a medicine to reduce blood pressure -please start nifedipine daily, a medicine to reduce blood pressure and prevent vasospasm - start simvastatin 10mg daily, to lower your cholesterol - start a nicotine patch daily to help you stop smoking we have also provided a prescription for a short course of neurontin. it is very important that you only take medications that have been prescribed to you. you should discuss whether to continue this medication with your primary care doctor. please have bloodwork checked on with results sent to dr. . your bloodwork needs to be checked because we are starting you on lisinopril, which can affect your kidneys and electrolytes. please also be sure that your pcp follows up the results of your biopsy. followup instructions: ***please call dr. (ent) office at to schedule a follow-up appointment within 1-2 weeks of discharge*** name: ,md specialty: primary care when: at 2:30pm address: , , phone: department: cardiac services when: thursday at 10:00 am with: , m.d. phone: building: sc clinical ctr campus: east best parking: garage md procedure: coronary arteriography using two catheters left heart cardiac catheterization laryngoscopy and other tracheoscopy other excision or destruction of lesion or tissue of larynx diagnoses: other chronic pain coronary atherosclerosis of native coronary artery tobacco use disorder asthma, unspecified type, unspecified alcohol abuse, unspecified cocaine abuse, unspecified other and unspecified hyperlipidemia anxiety state, unspecified lumbago cannabis abuse, unspecified other acute and subacute forms of ischemic heart disease, other polyp of vocal cord or larynx family history of malignant neoplasm of trachea, bronchus, and lung edema of larynx prinzmetal angina 

Answer: The patient is high likely exposed to