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: penicillins attending: chief complaint: diabetic ketoacidosis major surgical or invasive procedure: none history of present illness: patient is a 60 year of female with longstanding h/o pancreatitis and pancreatic insufficiency who was transferred to for further care from (lgh). she presented to lgh for lethargy and fatigue. at the referring facility, she was found to have a blood glucose >900 and positive ketones. she was admitted, volume resuscitated and started on an insulin drip. she is was transferred for further care. past medical history: pmhx: htn, hypercholesterolemia, pvd, chronic pancreatitis with possible pseudocyst at pancreatic head . pshx: right lower extremity femoral-popliteal artery bypass(), basal cell carcinoma from the nose, endoscopic ultrasound ( and ) social history: former smoker 1 ppd prior to bypass graft. no etoh, no drugs. family history: non-contributory. no family h/o diabetes. physical exam: on admission: vs: 98.2 92sr 158/76 18 100%2lnc general: awake and alert cv: rrr lungs: cta bilaterally abdomen: soft, diffusely tender, no rebound/guarding, non-distended, hypoactive bowel sounds ext: warm, no edema pertinent results: on admission: 09:52pm type-art po2-114* pco2-20* ph-7.37 total co2-12* base xs--10 09:52pm lactate-1.1 09:52pm freeca-1.14 08:47pm glucose-105* urea n-20 creat-0.7 sodium-136 potassium-3.5 chloride-113* total co2-12* anion gap-15 08:47pm alt(sgpt)-13 ast(sgot)-21 alk phos-85 amylase-101* tot bili-0.2 08:47pm lipase-27 08:47pm albumin-3.5 calcium-8.2* phosphate-0.8*# magnesium-2.5 08:47pm wbc-33.3*# rbc-3.65* hgb-11.2* hct-31.6* mcv-87# mch-30.6 mchc-35.4* rdw-12.5 08:47pm plt count-233 08:47pm pt-12.3 ptt-20.5* inr(pt)-1.0 . imaging: ecg: probable ectopic atrial rhythm with borderline tachycardia but cannot exclude possible atrial tachycardia with 2:1 block. delayed r wave progression. modest st-t wave changes. findings are non-specific. since the previous tracing of sinus bradycardia has been replaced by rhythm as outlined and the qtc interval appears shorter but is difficult to measure. intervals axes: rate pr qrs qt/qtc p qrs t 98 120 80 344/410 -86 63 67 . ap chest: no evidence of acute cardiopulmonary disease or change from the study of . there has been placement of a left subclavian catheter that extends to the mid portion of the svc. no evidence of pneumothorax. . carotid series: findings: duplex evaluation was performed of bilateral carotid arteries. on the right there is mild heterogeneous plaque in the ica. on the left there is mild heterogeneous plaque seen in the ica. on the right systolic/end diastolic velocities of the ica proximal, mid and distal respectively are 104/29, 117/35, 112/35, cm/sec. cca peak systolic velocity is 108 cm/sec. eca peak systolic velocity is 113 cm/sec. the ica/cca ratio is 1.1. these findings are consistent with 40-59% stenosis. on the left systolic/end diastolic velocities of the ica proximal, mid and distal respectively are 86/25, 106/33, 121/34 cm/sec. cca peak systolic velocity is 125 cm/sec. eca peak systolic velocity is 123 cm/sec. the ica/cca ratio is .97. these findings are consistent with 40-59% stenosis. right vertebral antegrade artery flow. left vertebral antegrade artery flow. impression: right ica stenosis 40-59%. left ica stenosis 40-59%. . microbiology: mrsa screen: negative. urine cx: no growth. brief hospital course: : patient was transferred from evaluated and admitted to the sicu under the care of dr. general surgery service. patient is a 60 year old woman with chronic pancreatitis, pancreatic insufficiency, admitted with diabetic ketoacidosis. she was made npo, foley with aggressive fluid hydration, picc line already placed in left arm, iv dilaudid for pain, and placed on iv insulin drip. . : patient remained in sicu. nutrition consult was made. abg and labs were routinely monitored and electrolytes replaced appropriately. patient persisted on insulin drip and was closely monitored with sicu care. . : patient remained stable and her labs showed improvement. she was started on first day tpn and allowed a diabetic diet. the patient was then transferred to the floor in stable condition. on transfer from the sicu, the patient status was as follows: . neurologic: alert and oriented x 3, hydromorphone for pain. cardiovascular: htn controlled on beta blockade, home medications, hemodynamically stable. pulmonary: near complete respiratory compensation of metabolic acidosis. gastrointestinal/abdomen: chronic pancreatitis. nutrition: continued on continuous tpn and diabetic diet. started on creon. renal: foley in place, adequate urine output, electrolytes being repleted. hematology: hemodynamically stable; on sqh, plavix, aspirin. endocrine: insulin infusion discontinued, on lantus with improved glycemic control. diabetes team and nutrition following. id: trending wbc and fever curves, which were stable. . -: the patient remained stable on the floor. her finger sticks and labs were regularly monitored and corrected appropriately. clinic was active in monitoring and managing the patients insulin types and levels. nutrition was consulted for education instruction for which the patient received. physical therapy was consulted and deemed the patient safe for ambulation and home. her foley was discontinued on and she was advanced to full tpn with fats on . her tpn was then cycled, glycemic control followed closely, and insulin in the tpn and her insulin regimen was adjusted appropriately. her pain was well controlled with dilaudid po and she remained on prophylactic dvt and ulcer treatments. on hospital day , the patient had demonstrated proper understanding and control of her glucose levels, and it was deemed safe to discharge the patient home with services. tpn was cycled over 12 hours starting the evening of , and her insulin regimen was updated. . at the time of discharge, the patient's vitals signs were stable, and she was appropriately monitoring her fingerstick blood sugars and self-administering insulin as prescribed. tnp was cycled over 12 hours at goal, she was able to ambulate on her own, and her pain was controlled with po pain medications. she will return on for planned surgery. at the time of discharge, the patient was doing well, afebrile with stable vital signs. the patient received discharge teaching and follow-up instructions and verbalized understanding and was in agreement with the discharge plan. medications on admission: plavix 75 mg po daily hydrochlorothiazide 12.5 mg po daily zoloft 50 mg po daily folate 1 mg po daily moexipril 30 mg po daily zocor 20 mg po daily ambien 10 mg po qhs aspirin 81 mg po daily oxycontin p.r.n. pancrease 1-4 tabs qac discharge medications: 1. precision xtra test strip sig: one (1) strips in four times a day. disp:*100 strips* refills:*2* 2. lancets,ultra thin misc sig: one (1) lancet miscellaneous as directed. disp:*1 bag/box* refills:*2* 3. alcohol pads pads, medicated sig: one (1) pad topical as directed. disp:*1 box/bag* refills:*2* 4. insulin syringe-needle u-100 1 ml 30 x syringe sig: one (1) syringe miscellaneous as directed for insulin injection. disp:*1 bag/box* refills:*2* 5. moexipril 15 mg tablet sig: one (1) tablet po daily (daily). 6. aspirin 81 mg tablet, chewable sig: one (1) tablet, chewable po daily (daily): stop taking this medication on - one week before your surgery. 7. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily): stop taking this medication on - one week before your surgery. 8. simvastatin 20 mg tablet sig: one (1) tablet po once a day. 9. acetaminophen 325 mg tablet sig: 1-2 tablets po q6h (every 6 hours) as needed for fever or pain. 10. metoprolol tartrate 25 mg tablet sig: 0.5 tablet po bid (2 times a day). 11. zolpidem 5 mg tablet sig: 1-2 tablets po hs (at bedtime) as needed for insomnia. 12. lipase-protease-amylase 12,000-38,000 -60,000 unit capsule, delayed release(e.c.) sig: two (2) cap po tid w/meals (3 times a day with meals). disp:*180 cap(s)* refills:*2* 13. folic acid 1 mg tablet sig: one (1) tablet po once a day. 14. famotidine 20 mg tablet sig: one (1) tablet po q12h (every 12 hours). disp:*60 tablet(s)* refills:*2* 15. precision xtra monitor misc sig: one (1) kit miscellaneous as directed. disp:*1 kit* refills:*0* 16. dextrose 40 % gel sig: one (1) single-dose tube po administer as directed for a blood sugar less than 60 or if experiencing symptoms of hypoglycemia. disp:*1 box (3 single-dose tubes)* refills:*2* 17. hydromorphone 4 mg tablet sig: one (1) tablet po q3-4hours: prn as needed for pain. disp:*70 tablet(s)* refills:*0* 18. nicotine 14 mg/24 hr patch 24 hr sig: one (1) patch 24 hr transdermal daily (daily). disp:*14 patch 24 hr(s)* refills:*2* 19. insulin lispro 100 unit/ml solution sig: 2-14 units subcutaneous as directed per humalog insulin sliding scale. disp:*1 vial* refills:*2* 20. lantus 100 unit/ml solution sig: fifteen (15) units subcutaneous at bedtime. disp:*1 vial* refills:*2* 21. multivitamin tablet sig: one (1) tablet po once a day: recommend that you purchase a multi-vitamin of your choice. discharge disposition: home with service facility: , discharge diagnosis: 1. diabetic ketoacidosis 2. type ii dm 3. chronic pancreatitis discharge condition: mental status:clear and coherent level of consciousness:alert and interactive activity status:ambulatory - independent discharge instructions: given your low blood pressures during this hospital admission, we have stopped your moexipril and hydrochlorothiazide for hypertension. you should have dr. (pcp) evaluate whether you still require these medications in the future after your surgery. please stop taking the aspirin and plavix on , one week before your surgery. also, please do not take any nsdais (motrin, ibuprofen, aleve, naprosyn, etc) one week before your surgery date. otherwise, please resume all regular home medications, unless specifically advised not to take a particular medication. also, please take any new medications as prescribed. please get plenty of rest, continue to ambulate several times per day, and drink adequate amounts of fluids. avoid lifting weights greater than lbs until you follow-up with your surgeon, who will instruct you further regarding activity restrictions. avoid driving or operating heavy machinery while taking pain medications. please follow-up with your surgeon and primary care provider (pcp) as advised. . picc line: *please monitor the site regularly, and your md, nurse practitioner, or nurse if you notice redness, swelling, tenderness or pain, drainage or bleeding at the insertion site. * your md to the emergency room immediately if the picc line tubing becomes damaged or punctured, or if the line is pulled out partially or completely. do not use the picc line in these circumstances.please keep the dressing clean and dry. contact your nurse if the dressing comes undone or is significantly soiled for further instructions. followup instructions: your surgery has been scheduled for wednesday, . you will be contact by dr. office with the pre-operative instructions and instructions regarding the time and location to return to the hospital. please call ( if you have any questions. . please call ( to arrange a follow-up appointment with dr. (pcp) in weeks (2-3 weeks after up-and-coming surgery). . other appointments: provider: lab phone: date/time: 9:30 provider: , md phone: date/time: 10:10 procedure: parenteral infusion of concentrated nutritional substances diagnoses: anemia, unspecified tobacco use disorder peripheral vascular disease, unspecified alcohol abuse, unspecified personal history of other malignant neoplasm of skin loss of weight long-term (current) use of insulin chronic pancreatitis other specified diseases of pancreas cyst and pseudocyst of pancreas diabetes with ketoacidosis, type ii or unspecified type, uncontrolled body mass index less than 19, adult 

Answer: The patient is high likely exposed to