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: adhesive tape / furosemide / oxycodone attending: chief complaint: intracranial hemorrhage and right hip pain. major surgical or invasive procedure: : right craniotomy and resection of frontal lesion : prophylactic nailing, right femur. history of present illness: ms is a 72 yo woman with a recent diagnosis of met. melanoma transferred from an outside hospital with a rt frontal hemorrhage. pt presented to osh on with a 2 day h/o progressive lethargy. head ct w/o contrast revealed a 4x4 cm rt frontal ich. pt was on warfarin for a pe recently diagnosed and inr was 6.7. pt received ffp and vitamin k and had an ivc filter placed.she was also started on decadron and dilantin.her mental status improved significantly and repeat ct scan on shows no progression of bleed. on arrival, pt c/o hiccups and rt rib pain which she attributes to intractable hiccups. she has no headache/nausea/vision changes/muscle weakness or sensory changes. family reports that mental status back to baseline although she is fatigued and her speech is slower. pt continues to suffer from rt shoulder pain attributed turn rt rotator cuff as well as left hip pain and left shin pain.she denies fevers, chills, cough, sob, hemoptysis, abdominal pain, dysuria/frequency. all other ros is negative. past medical history: oncology history: 1.diagnosed with stage iiia melanoma in excisional biopsy showed invasive malignant melanoma with a depth of 2.1 mm, level iv, no ulceration and 2 mitoses per 10 high-powered fields. she then underwent a wide local excision with sentinel lymph node biopsy on and there was no residual melanoma identified. in the wide local excision specimen, there was a metastatic deposit in the sentinel lymph node. imaging showed no areas of metastatic disease. 2. presented to osh with acute sob and found to haev a pe, pulmonary nodules, and mult bone lesions on bone scan , ct guided biopsy of vertebral body lytic lesion was c/w metastatic melanoma. b-raf mutation status pending. . other pmh: 1. htn. 2. hyperlipidemia. 3. basal cell ca, s/p excision. 4. osteoarthritis, s/p bilateral knee replacements. 5. cholecystectomy, 6/. social history: she smoked briefly in high school and drinks alcohol rarely. she denies drug use. she is a widow and has 3 children. family history: father with possible prostate cancer. her mother had skin cancer of unknown type. physical exam: t 98.3 p 83 bp 158/82 rr 20 os sat 94% general: aaox3, no asd, +hicccups during interview. heent: pupils equal and reactive, sclerae non-icteric, o/p clear, mmm. neck: supple, no jvd, no thyromegaly. lymph nodes: no cervical, supraclavicular or axillary lad. cv: s1s2, reg rate and rhythm, no murmurs, rubs or gallops. resp: good air movement bilaterally, no rhonchi or wheezing. abd: soft, non-tender, non-distended, + bowel sounds. extr: no edema, good pedal pulses. derm: no rash. neuro: cranial nerves grossly intact, muscle strength 5/5 in all major muscle groups, sensation to light touch intact,knee reflexes symetrical , toes down going,no pronator drift. psych: appropriate and calm. pertinent results: admission labs: 05:45pm blood wbc-10.9 rbc-4.47 hgb-13.0 hct-36.9 mcv-83 mch-29.0 mchc-35.1* rdw-14.0 plt ct-244 05:45pm blood neuts-80.0* lymphs-13.5* monos-5.5 eos-0.6 baso-0.5 05:45pm blood pt-15.1* ptt-23.9 inr(pt)-1.3* 05:45pm blood glucose-118* urean-18 creat-0.6 na-142 k-3.8 cl-105 hco3-27 angap-14 05:45pm blood alt-11 ast-13 ld(ldh)-331* alkphos-103 totbili-0.4 05:45pm blood albumin-4.0 calcium-10.3 phos-2.1* mg-2.0 05:45pm blood phenyto-9.0* . mra brain- impression: although no vascular occlusion or abnormal vascular structures are seen. slight protuberance in the region of anterior communicating artery is seen which likely is due to a vascular loop. however, this area is not well evaluated due to motion artifacts. when the patient returns for gadolinium-enhanced image, a repeat study can be obtained for further confirmation. mri t spine- impression: bony abnormalities at the t6-7 and t10 levels, suspicious for bony metastasis. the examination is limited with only sagittal t2 images were obtained. consider repeat study with sedation if clinically indicated. ct torso- impression: 1. similar degree of bilateral pulmonary metastases. 2. probably similar appearance to metastatic involvement and vertebral body height loss of t6-t7 vertebral bodies, though direct comparison is not possible to the outside films provided. osseous destruction within the left hemisacrum, which is also probably similar compared with prior, though is incompletely imaged on the comparison study. 3. hypodensities within the liver and spleen are stable but highly suggestive of metastatic disease. ct femur- *** leni's- impression: dvt in the right common femoral vein. no left-sided dvt. head ct- 1. expected post-operative changes status post resection of right frontal hemorrhagic mass with some blood products in the surgical bed. mri would be more sensitive for a residual lesion. 2. 3 mm hemorrhagic mass abutting the body of the left lateral ventricle, as seen previously. other small intracranial masses were better seen on the recent mri wbc rbc hgb hct mcv mch mchc rdw plt ct 06:05 13.4* 3.47* 9.9* 28.5* 82 28.6 34.8 14.7 163 05:20 15.6* 3.80* 10.7* 32.1* 84 28.2 33.4 15.1 175 16:05 20.7* 4.20 11.8* 35.9* 85 28.1 33.0 15.0 239 08:30 21.0* 4.22 12.1 34.6* 82 28.8 35.1* 14.5 237 04:17 21.9* 4.37 12.5 35.7* 82 28.5 34.9 14.8 264 source: line-aline 08:54 14.0* 4.55 12.9 37.6 83 28.3 34.2 14.0 252 07:21 13.2* 4.75 13.4 40.0 84 28.3 33.6 14.5 233 07:47 10.6 4.72 13.1 39.0 83 27.7 33.5 13.8 247 08:10 12.2* 4.57 12.8 37.8 83 28.0 33.9 13.9 267 17:45 10.9 4.47 13.0 36.9 83 29.0 35.1* 14.0 244 glucose urean creat na k cl hco3 angap 06:05 157*1 26* 0.7 137 4.0 103 26 12 05:20 146*1 28* 0.6 140 4.1 106 26 12 08:30 164*1 20 0.7 142 4.1 106 25 15 19:25 212*1 21* 0.8 136 3.6 102 21* 17 source: line-aline 08:54 981 20 0.6 139 3.8 104 26 13 07:21 821 19 0.7 137 3.8 101 22 18 07:47 3.7 103 25 14 08:10 3.6 104 26 15 17:45 118*1 18 0.6 142 3.8 105 27 14 totprot albumin globuln calcium phos mg uricacd iron 06:05 9.8 2.1* 2.0 05:20 10.0 2.2* 2.1 08:30 10.2 3.4 2.1 19:25 9.7 3.6 1.9 source: line-aline 08:54 10.3 2.7 2.0 07:21 10.5* 2.9 2.1 07:47 10.2 2.8 1.9 08:10 4.1 9.7 2.5* 1.9 17:45 4.0 10.3 2.1* 2.0 neuropsychiatric phenyto 17:45 9.0* blood gas blood gases type temp rates tidal v peep fio2 o2 flow po2 pco2 ph caltco2 base xs 17:12 art 123* 32* 7.43 22 -1 whole blood, miscellaneous chemistry glucose lactate na k cl 17:12 149* 0.8 128* 3.2* 100 hemogloblin fractions ( cooximetry) hgb calchct 17:12 10.9* 33 calcium freeca 17:12 1.20 brief hospital course: 72 yo woman with recent diagnosis of metastatic melanoma with lung and bone mets and recent diagnosis of pe on anticoagulation presented to osh with an right frontal intracranial hemorrhage and right pathological hip fracture admitted to the hem/onc service on . #. ich: -neurosurgery consulted and appreciate assistance. they feel that since pt 3 days from diagnosis of bleed and stable both clinically and imaging that pt can be on the oncology floor. -neuro checks q 4hrs. -decadron 4 tid. -keppra 500 mg x2 days and then increase to 1000 mg . -mri of brain tonight. - inr goal 1.3 or below. -systolic blood pressure to maintain below 140. . #met melanoma: results of b-raf mutation status pending. -will need x-rays of bilateral femurs to asses stability/risk of fracture as well as likely mri of spine to better evaluate spinal mets. . #pe: pt had an ivc filter placed at outside hospital. . #htn: pt was on toprol xl 100 mg at home. dose was deceased to 25 mg at osh d/t bradycardia. -start metoprolol 25 mg po bid and will monitor pulse and bp closely. -cont losartan 80 mg. . #hypercalcemia: mild hypercalcemia at osh. -d/c calcium and vit. -will need bisphosphonates in the future for bone mets. . #pain:will minimize narcotics given ich and need to asses neurological status. -scheduled tylenol. -low dose iv morphine ( 0.5 mg iv q hrs prn) -lidocaine patch . fen: regular, iss ( given decadron), replete phos. dvt prophylaxis: s/p ivc filter, no heparin. lines :pic placed with the assistance of anesthesia. pt with poor peripheral veins and likely will need a picc line placed. full code on the patient was transferred to the neurosurgery service. she underwent a right frontal craniotomy and resection of the frontal brain lesion. she was extubated and transferred to the icu. post op head ct revealed post operative changes and pneumocephalus therefore she was placed on a non-rebreather. on she was started on levetiracetam. on she was neurologically stable therefore her neuro checks were changed to q and sbp was liberalized to 160. orthopedic's had previously been consulted and they recommend surgical fixation for her pathological hip fractures. on she underwent open reduction internal fixation of the right hip without complication. she was transferred to the orthopedic service post operatively. she was started on lovenox for dvt prophylaxis. a lower extremity us on showed no evidence of dvt. the patient is being discharge to rehab in stable condition. medications on admission: meds on transfer toprol 25 mg daily phenytoin 100 mg tid valsartan 80 mg daily tylenol #3 q4hrs prn zofran prn lipitor 20 mg daily calcium and vit d discharge medications: 1. metoclopramide 10 mg tablet sig: one (1) tablet po q8h (every 8 hours) as needed for hiccups. 2. lidocaine 5 %(700 mg/patch) adhesive patch, medicated sig: one (1) adhesive patch, medicated topical daily (daily). 3. omeprazole 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily). 4. valsartan 160 mg tablet sig: one (1) tablet po daily (daily). 5. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day) as needed for constipation. 6. levetiracetam 500 mg tablet sig: two (2) tablet po bid (2 times a day). 7. metoprolol tartrate 50 mg tablet sig: one (1) tablet po tid (3 times a day). 8. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for pain. 9. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). 10. acetaminophen-codeine 300-30 mg tablet sig: one (1) tablet po q4h (every 4 hours) as needed for pain. 11. enoxaparin 40 mg/0.4 ml syringe sig: one (1) syringe subcutaneous qpm (once a day (in the evening)) for 1 weeks: end date . start coumadin when lovenox is discontinued. 12. dexamethasone sodium phosphate 4 mg/ml solution sig: one (1) injection injection q6h (every 6 hours). 13. coumadin 2.5 mg tablet sig: one (1) tablet po once a day: adjust daily according to inr. goal inr . start date . discontinue lovenox once coumadin started. 14. outpatient lab work daily pt/inr for coumadin dosing to start . target inr . discharge disposition: extended care facility: discharge diagnosis: right frontal brain mass right hip fracture discharge condition: mental status: confused - sometimes. level of consciousness: alert and interactive. activity status: ambulatory - requires assistance or aid (walker or cane). discharge instructions: general instructions/information ****** do not start coumadin therapy until 7 days after your neurosurgical procedure on ********* ?????? have a friend/family member check your incision daily for signs of infection. ?????? take your pain medicine as prescribed. ?????? exercise should be limited to walking; no lifting, straining, or excessive bending. ?????? you may wash your hair only after 5 days. your wound closure uses dissolvable sutures, you must keep that area dry for 5 days. ?????? you may shower before this time using a shower cap to cover your head. ?????? increase your intake of fluids and fiber, as narcotic pain medicine can cause constipation. we generally recommend taking an over the counter stool softener, such as docusate (colace) while taking narcotic pain medication. ?????? unless directed by your doctor, do not take any anti-inflammatory medicines such as motrin, aspirin, advil, and ibuprofen etc. ?????? you have been discharged on keppra (levetiracetam), you will not require blood work monitoring. continue to take keppra as prescribed. ?????? you are being sent home on steroid medication, make sure you are taking a medication to protect your stomach (prilosec, protonix, or pepcid), as these medications can cause stomach irritation. make sure to take your steroid medication with meals, or a glass of milk. ?????? clearance to drive and return to work will be addressed at your post-operative office visit. ?????? make sure to continue to use your incentive spirometer while at home. call your surgeon immediately if you experience any of the following ?????? new onset of tremors or seizures. ?????? any confusion or change in mental status. ?????? any numbness, tingling, weakness in your extremities. ?????? pain or headache that is continually increasing, or not relieved by pain medication. ?????? any signs of infection at the wound site: increasing redness, increased swelling, increased tenderness, or drainage. ?????? fever greater than or equal to 101?????? f. physical therapy: activity: activity: activity as tolerated right lower extremity: full weight bearing left lower extremity: full weight bearing encourage turn, cough and deep breathe q2h when awake treatments frequency: remove staples 14 days from date of surgery from right hip. followup instructions: follow-up appointment instructions ??????please return to the neurosurgery office in days (from your date of surgery) for a wound check. this appointment can be made with the nurse practitioner. please make this appointment by calling . if you live quite a distance from our office, please make arrangements for the same, with your pcp. ??????you have an appointment in the brain clinic on at 2 pm. the brain clinic is located on the of , in the building, . their phone number is . please call if you need to change your appointment, or require additional directions. please call the orthopedic department at to schedule a follow up appointment with , np. procedure: other operations on extraocular muscles and tendons other excision or destruction of lesion or tissue of brain other repair of cerebral meninges internal fixation of bone without fracture reduction, femur diagnoses: abnormal coagulation profile pure hypercholesterolemia malignant neoplasm of liver, secondary unspecified essential hypertension asthma, unspecified type, unspecified personal history of tobacco use intracerebral hemorrhage secondary malignant neoplasm of brain and spinal cord long-term (current) use of anticoagulants personal history of venous thrombosis and embolism other postprocedural status secondary malignant neoplasm of lung acute venous embolism and thrombosis of deep vessels of proximal lower extremity knee joint replacement personal history of malignant melanoma of skin secondary malignant neoplasm of bone and bone marrow leukocytosis, unspecified hypercalcemia hiccough other specified prophylactic or treatment measure 

Answer: The patient is high likely exposed to