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: r face and arm weakness major surgical or invasive procedure: iv tpa history of present illness: the patient is a 76 year old primarily-cantonese speaking man with vascular risk factors who was in his usual state of health until 8:30pm this evening. at that time, while watching tv he felt generally weak and unwell. he asked his wife to help his to the bathroom; he was too ??????weak?????? to make it there, and had an episode of urinary incontinence he then had the sensation of bilateral arm (particularly shoulder) weakness and heaviness. this sensation abated, and the patient noted r arm weakness; his wife called ems. on arrival, ems found fsg 161, bp 175/82, and an irregularly irregular pulse. they felt that the patient had r facial droop and r arm weakness. while in the ambulance, he was thought to develop dysarthria. he was brought to the ed and a stroke code was activated at 10:00pm. the neurology resident was at the bedside within minutes. she gave the patient an nihss of 3 (1 point each for r facial droop, r pronator drift, and rue dysmetria.) she also felt that the patient had a l tongue deviation. the patient??????s wife clarified that speech was at baseline (i.e. not newly dysarthric.) ekg revealed atrial fibrillation. sbp was noted to be 190 and the patient received 10mg iv labetolol. nihss at 10:30pm (by this author)= 3 loc ?????? 0 questions ?????? 0 commands ?????? 0 gaze ?????? 0 visual fields ?????? 0 facial paresis ?????? 1 strength ?????? 1 (right pronator drift) ataxia ?????? 0 sensory ?????? 0 language ?????? 0 dysarthria ?????? 1 neglect - 0 past medical history: prostate enlargement hypertension hypothyroidism (s/p thyroidectomy) gout (of note, there is no known history of atrial fibrillation) social history: patient is retired. he used to own and run a chinese restaurant. primarily cantonese speaking. used to smoke in the past. minimal etoh. family history: father died of an mi at age 76 physical exam: 166/66, 98 degrees, 76 (afib), 12, 98% ra 180lbs (approx) fundoscopic examination reveals no papilledema. there are no carotid bruits. heart is irregularly irregular. lungs are clear bilaterally. belly is soft and nontender. there is no peripheral edema. extremities are warm and pink with palpable pulses. mental status: the patient is awake and alert. he knows that he is in the hospital and that it is . there is normal naming and repetition. patient??????s wife says he describes the cookie jar properly in cantonese. patient follows multi-step commands properly. his speech is fluent. there is no neglect. cranial nerves: perrl. eomi. there is a mild r facial droop in an upper motor neuron pattern. facial sensation is intact to lt and pp. there is normal palate, gag, head turn, and shoulder shrug function. there is perhaps mild deviation of the tongue to the left on protrusion, but patient can move the tongue in all directions. hearing is normal to finger rub bilaterally. there is right pronator drift, with proximal and distal weakness of the right upper extremity. legs have full strength bilaterally. fine finger movements are perhaps slowed on the right. there is normal bulk and tone. there are trace ankle jerks, 1+ knee jerks, and 1+ biceps jerks bilaterally. patient withdraws to babinski testing bilaterally. there is intact sensation to lt, pp, vibration, and proprioception throughout except for early extinction to vibration in the toes. there is perhaps mild dysmetria on right fnf testing, but i suspect this may be due to weakness. heal-to-shin are normal. there is no truncal ataxia. gait testing was deferred. pertinent results: admission labs: 10:00pm pt-12.0 ptt-27.2 inr(pt)-1.0 plt count-191 wbc-7.1 rbc-6.18 hgb-13.1* hct-40.2 mcv-65* mch-21.1* mchc-32.5 rdw-16.3* tot prot-7.5 ck-mb-5 ck(cpk)-320* glucose-200* urea n-53* creat-2.1* sodium-136 potassium-3.7 chloride-99 total co2-24 anion gap-17 11:30pm urine rbc-0-2 wbc-0-2 bacteria-none yeast-none epi-<1 blood-sm nitrite-neg protein-tr glucose-100 ketone-neg bilirubin-neg urobilngn-neg ph-5.0 leuk-neg color-yellow appear-clear sp -1.012 ecg study date of 10:02:50 pm atrial fibrillation with rapid ventricular response. right bundle branch block. possible inferior myocardial infarction. age indeterminate. non-specific st-t wave changes. compared to the previous tracing of rapid atrial fibrillation and right bundle-branch block are new. intervals axes rate pr qrs qt/qtc p qrs t 109 0 158 372/457 0 -8 -5 cta head w&w/o c & recons study date of 10:07 pm impression: 1. acute intracranial hemorrhage. assessment for acute infarction is limited on the present study due to motion on the ctp study, with asymmetry in the mtt,in the temporo-occipital lobes, question real/artifactual. mri of the head, with diffusion-weighted imaging can be considered, for better assessment to exclude acute infarction. (pt.'s susequent mri shows an acute infarct in the left parietal lobe, which is not included on the ctp. 2. extensive atherosclerotic disease involving the aortic arch, arch vessels, common carotid artery bifurcations, proximal cervical internal carotid arteries, cavernous carotid segments, and distal vertebral arteries, with most significant involvement noted in the left proximal cervical internal carotid artery, with 50/60 percent luminal narrowing, with eccentric calcified/noncalcified plaques- intramural and a component of intraluminal location. 3. approximately 50% narrowing by european criteria is seen in the right proximal cervical internal carotid artery. however, this appears less than 50% by nascet criteria. no flow limitation distally. 4. diminutive caliber of the posterior cerebral arteries, with prominent posterior communicating artery on the left side. this may represent a variant appearance, however, any component of atherosclerotic disease associated is difficult to assess given the diminutive caliber. 5. multilevel degenerative changes in the cervical spine with moderate-to- severe spinal canal stenosis and neural foraminal narrowing most prominent at c5-c6 level, inadequately assessed on the present study. 6. lucent lesion in the right parietal bone, inadequately characterized. this can relate to part of the marrow. if there is concern for neoplastic etiology, bone scan can be considered. mr head w/o contrast study date of 2:36 pm impression: signal abnormality in the left posterior parietal lobe extending to the frontal lobe with blood products within. findings are suggestive of an acute infarction with hemorrhagic transformation. recommend correlation with unenhanced head ct. there is a cystic lesion in the right aspect of the sella, recommend correlation with dedicated imaging through the sella if clinically indicated. tte (complete) done at 10:05:52 am conclusions the left atrium is elongated. there is mild symmetric left ventricular hypertrophy. the left ventricular cavity size is normal. overall left ventricular systolic function is normal (lvef>55%). the ascending aorta is moderately dilated. the aortic valve leaflets are mildly thickened (?#). there is no aortic valve stenosis. mild to moderate (+) aortic regurgitation is seen. the aortic regurgitation jet is eccentric (so it is difficult to quantify). the mitral valve leaflets are mildly thickened. no mitral regurgitation is seen. there is no pericardial effusion. no cardiac source of embolus (other than history of atrial fibrillation) identified. ct head w/o contrast study date of 2:40 pm impression: unchanged left frontoparietal hemorrhage. no evidence for new hemorrhage or infarction. brief hospital course: mr. is a 76 yo m with history of htn with acute onset right-sided weakness and urinary incontinence. # right aca infarct: the patient presented as a code stroke. ct was without evidence of hemorrhage and ct perfusion was initially felt to be unremarkable. his nihss was 3 but despite the low score and negative ct given the progression of his symptoms, he received iv tpa and was admitted to the neuro icu for monitoring. an mri of the brain confirmed a left posterior parietal lobe stroke with mild hemorrhagic conversion seen on repeat ct head. the post-tpa protocol was followed and 24-hours post-infusion his home antihypertensives were reinstated. the patient was found to have atrial fibrillation. repeat ct scan showed stable hemorrhagic conversion. coumadin therapy was initiated upon discharge. # atrial fibrillation/pauses: the patient had no prior documented arrhythmia, however he was found to be in atrial fibrillation on arrival. he continued to be in atrial fibrillation on telemetry and was also noted to have occasional second pauses. a transthoracic echocardiogram demonstrated lvef>55%; there was no evidence of wall motion abnormality or cardiac source of clot. # glucose intolerance: the patient had an hgba1c of 6.4 on admission. he should be closely monitored for development of diabetes. # hyperlipidemia: the patient had an ldl of 123 in . baseline lfts were normal and the patient was started on simvastatin 20 mg daily. # hypothyroidism: levothyroxine treatment was continued. # hypertension: blood pressure remained slightly elevated (sbps 140's-150's). given his intermittent pauses on telemetry, no changes were made to the patient's home medications of nifedipine cr, valsartan, and quinapril. he may benefit from further outpatient cardiac evaluation. # renal failure, acute on chronic: the patient presented with acute renal failure with an admission creatinine of 2.1. this improved with hydration and was 1.6 at discharge. medications on admission: thyroxine 0.15mg finasteride 5mg qhs diovan 320mg qd nifedipine 90mg qd quinapril hcl 40mg metoprolol tartrate 50mg? colchicine 0.6mg discharge medications: 1. levothyroxine 75 mcg tablet sig: two (2) tablet po daily (daily). 2. finasteride 5 mg tablet sig: one (1) tablet po daily (daily). 3. metoprolol tartrate 50 mg tablet sig: one (1) tablet po bid (2 times a day). 4. quinapril 20 mg tablet sig: two (2) tablet po daily (daily). 5. aspirin 325 mg tablet sig: one (1) tablet po daily (daily): discontinue this medication once your inr is >2. 6. valsartan 160 mg tablet sig: two (2) tablet po daily (daily). 7. nifedipine 90 mg tablet sustained release sig: one (1) tablet sustained release po daily (daily). 8. simvastatin 20 mg tablet sig: one (1) tablet po at bedtime. :*30 tablet(s)* refills:*2* 9. coumadin 5 mg tablet sig: one (1) tablet po once a day: start on . please following dosing regimen as adjusted by your doctor. :*30 tablet(s)* refills:*2* discharge disposition: home with service facility: homecare discharge diagnosis: left aca infarct paroxsymal atriral fibrillation discharge condition: the patient was slightly hypertensive (sbps 140-150). his neurologic exam was notable for external rotation of the right leg with ambulation and mild weakness of the right hamstring. discharge instructions: you were admitted for evaluation of weakness. you were found to have a stroke and treated with a medication to dissolve blood clots. you were found to have an irregular heart rate called atrial fibrillation. this will require treatment with a blood thinner to help prevent strokes in the future. we have started you on 2 new medications. 1) simvastain 20mg daily(for cholesterol) 2) coumadin 5mg daily (for blood thinning and stroke prevention). this medication will require you to have blood tests and close follow up with your primary care doctor. you should start taking the medication on saturday. you will need to have your blood checked on tuesday. this can be done by going to your pcp's office between the hours of 2-4pm and telling them you need your inr checked. you should wait for the results of this study to determine what your next dose of coumadin should be. you will need to follow up with with your primary care doctor next week. you are also scheduled for follow up with the neurology clinic in . please call your doctor if you have any new symptoms including numbness, weakness, difficulty speaking, difficulty swallowing, chest pain, shortness of breath or any other symptom of concern. followup instructions: dr. tuesday 2pm-4pm for inr check. this is a walk in service, no appointment needed. pcp follow up: dr. thursday , 10am ( neurology follow up provider: , md phone: date/time: 1:30 procedure: injection or infusion of thrombolytic agent diagnoses: congestive heart failure, unspecified diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled acute kidney failure, unspecified unspecified acquired hypothyroidism hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified atrial fibrillation chronic kidney disease, unspecified other and unspecified hyperlipidemia chronic systolic heart failure cerebral artery occlusion, unspecified with cerebral infarction 

Answer: The patient is high likely exposed to