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: multifocal intraductal papillary mucinous neoplasia major surgical or invasive procedure: total pancreatectomy, splenectomy, open cholecystectomy, wedge liver biopsy history of present illness: this is a 64 year old female who was found to have multifocal intraductal papillary mucinous neoplasia found incidently during work-up for transverse colitis related to diverticulitis in . in , she developed mid-abdominal pain. she thought it was consistent with her previous diverticulitis. at that time, she went to and a ct of the abdomen and pelvis on showed transverse colitis. however, it also showed diffuse cystic replacement of the pancrease of uncertain etiology. she stayed in the hospital for iv antibiotics and the abdominal pain abated. it was recommended that the patient get an mrcp, however, she was unable to get that secondary to severe claustrophobia. she had an ercp done on which showed numerous areas of pancreatic ductal dilatation directly communicating with the pancreatic duct. it also showed that the pancreatic duct was enlarged and slightly irregular in contour. at that time, the differential diagnosis included an intraductal papillary mucinous neoplasm. past medical history: lap. tubal ligation, b/l knee replacements, carpal tunnel release, obesity, diverticulitis, hypertension, hypercholesterolemia. social history: she is a registered nurse. she quit smoking 15 years ago and drinks alcohol occasionally. family history: family history is not significant for any pancreatic or biliary disease. her mother did have breast cancer. her father nad with coronary disease and an aunt had cancer versus a polyp. physical exam: vs: bp 138/88 in the left arm, hr 88 and rr 12. gen: she looked her stated age, and was speaking in full sentences in no apparent distress. she appeared quite comfortable. heent exam: pupils are equal, round, and reactive to light. extraocular movements are intact. sclerae anicteric. oropharynx is clear without any exudate. neck: there is no lymphadenopathy or thyroid enlargement noted. cardiovascular: she had a regular rate and rhythm, s1, s2. no murmurs, rubs, or gallops. lungs: clear to auscultation bilaterally with good air entry. abdomen: notable for bowel sounds. it was soft, nontender, nondistended. there was no hepatosplenomegaly appreciated and we are unable to elicit any pain. pertinent results: 07:56am blood wbc-17.3* rbc-3.03* hgb-9.0* hct-26.9* mcv-89 mch-29.8 mchc-33.6 rdw-14.1 plt ct-477* 07:56am blood glucose-71 urean-12 creat-0.5 na-141 k-4.1 cl-104 hco3-31 angap-10 02:17am blood alt-200* ast-91* ld(ldh)-298* alkphos-62 amylase-12 totbili-0.4 02:17am blood lipase-41 02:17am blood albumin-3.0* calcium-8.6 phos-2.5* mg-2.1 . chest (portable ap) 6:33 am impression: ap chest compared to through : lung volumes remain low and atelectasis at the left base _____ a region of scarring is the only focal pulmonary abnormality clearly visible. ascending thoracic aorta is dilated but mildly tortuous. heart size is normal. there is no pleural effusion. in reviewing prior chest radiographs i note that the pre-operative study on may show a 1-cm wide pulmonary nodule projecting over the third left anterior interspace. alternatively this may be pleural thickening, more evident in the right hemithorax. evaluation with ct scanning would be needed, best obtained when lung volumes have improved and the patient has recovered from surgery. the findings were reported to the radiology department critical results co-ordinator for verified notification of dr. , at the time of dictation. brief hospital course: she went to the or on for: total pancreatectomy with splenectomy; open cholecystectomy; open liver wedge biopsy resp: she was admitted to the sicu for ventilation and hemodynamic support and monitoring after a prolonged 10 hour surgery. she was extubated on pod 2. she continued to require oxygen via nasal cannula. on pod 5, she was noted to have crackles on exam about half way up and was given lasix with good effect. she was seen by physical therapy and she was able to come off the o2 with ambulation and is, deep breathing. pain: she was started on an epidural and was having lots of pain issue and so a pca was also started. she was swithced to po meds once on a diet. gi/abd: she was npo with a ngt. she had jp drain in place draining serosangious fluid. the ngt was removed on pod 4. she was started on sips on pod 5. she was slowly advanced and was tolerating a regular, diabetic diet at time of discharge. her abdomen was soft, nontender. the drain was removed on pod 8, and the staples were d/c'd with steri strips in place. she was seen by dr. for pancreatic insufficiency and he recommended creon20 caps with large meals and caps with smaller meals. post-op diabetes: she was started on an insulin gtt following surgery. she continued on this and had tight control in the low 100's. on pod 5, the insulin gtt was stopped and she was started on lantus and a humalog sliding scale. was following along and adjusted her insulin requirements. medications on admission: quinine, synthroid 131, aspirin, lisinopril 20, hydrochlorothiazide 25, wellbutrin discharge medications: 1. creon 20 66,400-20,000- 75,000 unit capsule, delayed release(e.c.) sig: six (6) capsule, delayed release(e.c.) po four times a day: take caps with large meals; caps with smaller meals. disp:*720 capsule, delayed release(e.c.)(s)* refills:*2* 2. insulin glargine 100 unit/ml solution sig: twenty two (22) units subcutaneous at bedtime. disp:*qs * refills:*2* 3. humalog 100 unit/ml solution sig: sliding scale subcutaneous three times a day: see sliding scale. disp:*qs * refills:*2* 4. blood glucose testing strips sig: one (1) four times a day. disp:*120 * refills:*2* 5. lancets misc sig: one (1) miscellaneous four times a day. disp:*120 * refills:*2* 6. insulin syringe 0.5cc/28g syringe sig: one (1) miscellaneous four times a day. disp:*120 * refills:*2* 7. cipro 500 mg tablet sig: one (1) tablet po twice a day for 3 days. disp:*6 tablet(s)* refills:*0* 8. hydrochlorothiazide 25 mg tablet sig: one (1) tablet po daily (daily). 9. lisinopril 5 mg tablet sig: one (1) tablet po daily (daily). 10. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). disp:*30 tablet, delayed release (e.c.)(s)* refills:*0* 11. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). disp:*60 tablet(s)* refills:*2* 12. bupropion 100 mg tablet sustained release sig: two (2) tablet sustained release po qam (once a day (in the morning)). 13. levothyroxine 125 mcg tablet sig: one (1) tablet po daily (daily). 14. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). disp:*60 capsule(s)* refills:*2* 15. oxycodone-acetaminophen 5-325 mg tablet sig: 1-2 tablets po every six (6) hours as needed. disp:*35 tablet(s)* refills:*0* discharge disposition: home discharge diagnosis: multifocal intraductal papillary mucinous neoplasia post-op diabetes discharge condition: good blood sugars well controlled with insulin pain controlled discharge instructions: please call your doctor or return to the er for any of the following: * you experience new chest pain, pressure, squeezing or tightness. * new or worsening cough or wheezing. * if you are vomitting and cannot keep in fluids or your medications. * you are getting dehydrated due to continued vomitting, diarrhea or other reasons. signs of dehydration include dry mouth, rapid heartbeat or feeling dizzy or faint when standing. * you see blood or dark/black material when you vomit or have a bowel movement. * your skin, or the whites of your eyes become yellow. * your pain is not improving within 8-12 hours or not gone within 24 hours. call or return immediately if your pain is getting worse or is changing location or moving to your chest or back. * you have shaking chills, or a fever greater than 101.5 (f) degrees or 38(c) degrees. * any serious change in your symptoms, or any new symptoms that concern you. * please resume all regular home medications and take any new meds as ordered. * continue to monitor your blood sugars and take your insulin as ordered. * continue to amubulate several times per day. * followup instructions: please follow-up with dr. in weeks. call ( to schedule an appointment. please follow-up with dr. in 2 months. call ( to schedule an appointment. procedure: cholecystectomy total splenectomy small-to-small intestinal anastomosis total pancreatectomy insertion of catheter into spinal canal for infusion of therapeutic or palliative substances systemic to pulmonary artery shunt open biopsy of liver anastomosis of hepatic duct to gastrointestinal tract diagnoses: pure hypercholesterolemia urinary tract infection, site not specified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled unspecified acquired hypothyroidism personal history of tobacco use pulmonary collapse hypoxemia obesity, unspecified chronic pancreatitis knee joint replacement diverticulosis of colon (without mention of hemorrhage) other chronic nonalcoholic liver disease chronic cholecystitis other acute postoperative pain carcinoma in situ of other and unspecified digestive organs 

Answer: The patient is high likely exposed to