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: benadryl attending: chief complaint: fall major surgical or invasive procedure: colonoscopy history of present illness: 84 year-old right-handed man with a history of hypertension, long-standing diabetes, and atrial fibrillation (not on anti-coagulation or anti-platelet therapy due to a history of gastrointestinal bleeding), and chronic kidney disease (creatinine baseline ~) who presented earlier today after a fall with left hip pain; a code stroke was called at 8:13 pm, after concern for a right mca infarction on ct of the head. according to the patient's daughter, with whom i discussed the case over the phone, the patient was in his usual state of health until awakening this morning. at that time, he reported difficulty seeing multiple objects in the kitchen, including a kettle on the stove as well as a cup. he did not further describe the character of the vision loss. his daughter thought that this was unusual in a well-lit room, but attributed the difficulties from recently awakening, transitioning from the dark to light. he did not have any clear weakness, difficulty with speaking or comprehension. he has chronic tingling in his fingers related to diabetes, though no new sensory changes. at approximately 2 pm, he tripped over a cord as he walked from the kitchen, and fell forward. he was able to break his fall with his hands on a nearby table before landing on the floor of the study. there was no observed head trauma nor loss of consciousness. he reported pain in the left hip and was taken to for further evaluation. once at , the patient underwent a trauma evaluation for his fall. he was reporting pain and given 4 mg of morphine at 5:55 pm for his discomfort, then 50 mg bendadryl at 6:04 pm for subsequent itchiness. an attempt to perform ct scan was made around this time (~6 pm), but the patient was sent back as he was becoming increasingly confused and unable to sit still. he subsequently received 1 mg of lorazepam at 6:42 pm, then developed apneic periods for ~10-15 seconds at a time over a period of 20 minutes, by ed report. he received the ct of the head at 7:45 pm and a code stroke was called at 8:13 pm after a preliminary read of a right middle cerebral artery stroke. review of systems: unable to obtain at this time due to confusional state. past medical history: chronic systolic chf - echo with ef 25% hypertension dyslipidemia afib not on coumadin ckd iv, baseline 2.1-2.5, sees dr. anemia - likely mixed, ckd and iron deficiency, baseline 35-39 dm, on insulin, hgb a1c 9.2 gastritis - hematemesis . egd with antral erosions, small avm in duodenum - colonoscopy with single sessile 2 mm polyp of benign appearance in the proximal transverse colon (not removed bleeding risk) prior tobacco use osteoarthritis prostate cancer s/p prostatectomy urinary incontinence social history: widowed and lives with his daughter , who is his health care proxy. former , smoked 1-2 packs daily for ~40 years. previously drank one shot of whiskey daily. no known history of illicit drug use. family history: non-contributory physical exam: vitals: t 98.6 f bp 133/75 p 84 rr 14 sao2 100 ra general: thin, elderly gentleman - mildly deshevelved appearing. : nc/at, sclerae anicteric, mmm, no exudates in oropharynx lungs: clear to auscultation cv: irregularly irregular, no mmrg abdomen: soft, non-tender, non-distended ext: dry, no edema, pedal pulses appreciated an nihss could not be performed due to the patient's confusional state neurologic examination: mental status: alert and oriented to place and self. mildly dysarthric speech but fluent. follows commands. cranial nerves: fundi difficult to visualize bilaterally; inconsistent blink to threat on either side. pupils equally round and reactive to light, 3 to 2.5 mm bilaterally. eyes move to the left and right, but no gaze deviation. corneals intact bilaterally, and face appears grossly symmetric. tongue midline and palate elevated evenly. sensorimotor: normal bulk throughout, though tone is difficult to assess given active movement. no tremor. he had mild l pronator drift but full strength otherwise. reflexes: b t br pa pl right 2 2 2 2 0 left 2 2 2 2 0 left toe upgoing, right toe downgoing. coordination and gait: mild dysmetria with ftf more on l likely reflecting weakness. ambulatory with minimal assistance. pertinent results: 06:00am blood wbc-5.5 rbc-4.39* hgb-12.1* hct-37.6* mcv-86 mch-27.5 mchc-32.1 rdw-17.3* plt ct-163 06:00am blood pt-18.3* ptt-36.1* inr(pt)-1.7* 06:00am blood glucose-107* urean-32* creat-2.2* na-141 k-3.9 cl-102 hco3-26 angap-17 05:55pm blood ck-mb-notdone ctropnt-0.07* 07:45am blood ck-mb-notdone ctropnt-0.07* 06:00am blood calcium-9.4 phos-2.6* mg-2.0 05:55pm blood caltibc-399 ferritn-55 trf-307 07:45am blood %hba1c-9.7* 07:45am blood triglyc-49 hdl-52 chol/hd-2.0 ldlcalc-40 04:40am blood ammonia-73* 05:55pm blood tsh-1.5 05:20pm blood pep-polyclonal igg-1334 iga-385 igm-252* head ct : 1. acute infarct of the distal right mca (m3) distribution. regional sulcal effacement without midline shift. no intracranial hemorrhage at this time. 2. left frontal arachnoid cyst, unchanged. carotid us : no evidence of internal carotid artery stenosis in their extracranial portion. renal us : 1. no evidence of hydronephrosis. 2. small amount of ascites. mri head : 1. right mca, superior division, acute infarct. 2. chronic small vessel ischemic disease. 3. no evidence of intracranial hemorrhage. echocardiogram : the left atrium is elongated. the estimated right atrial pressure is 10-20mmhg.there is moderate symmetric left ventricular hypertrophy with normal cavity size and severe global hypokinesis (lvef = 20-25 %). no masses or thrombi are seen in the left ventricle. the right ventricular cavity is mildly dilated with moderate global free wall hypokinesis. the ascending and descending thoracic aorta are mildly dilated. the aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. trace aortic regurgitation is seen. the mitral valve leaflets are structurally normal. mild (1+) mitral regurgitation is seen. the tricuspid valve leaflets are mildly thickened. there is mild pulmonary artery systolic hypertension. there is a trivial/physiologic pericardial effusion. compared with the prior study (images reviewed) of , left ventricular systolic function is less vigorous. in the absence of a history of marked hypertension, the findings are suggestive of an infiltrative process (e.g., amyloid, fabry's etc.) brief hospital course: 84 year-old right-handed man with a history of hypertension, long-standing diabetes, and atrial fibrillation (not on anti-coagulation or anti-platelet therapy due to a history of gastrointestinal bleeding), presented to ed after a fall and left hip pain. code stroke was called after a head ct concerning for r mca infarct and his examination was limited, given an acute confusional state with left upgoing toe is the only clear localizing finding at the time. he was out of the window for intervention and vessel imaging and contrast studies were risky given his degree of renal failure. patient was admitted to neurology service and he underwent pelvis study to rule out hip fracture and renal us to rule out renal obstruction. his left lower back pain most likely spasm s/p fall since he responded very well to small dose valium and analgesics. although, he initially was quite confused, he improved significantly with near full strength on his left side except for mild left facial, left pronator drift and some dysarthria. he was evaluted per pt/ot who recommended home pt/ot and vna services plus speech recommended regular diet if he has his dentures. given that patient has afib and this is most likely cardioembolic stroke given the risk factors, gi was consulted about his hx of gastritis and possible duodenal avm. gi recommended colonoscopy for risk stratification - bowel prep was extremely difficult. he has hx of several failed colonoscopies in the past due to poor prep. after several days of clear diet and several rounds of golytely, he underwent colonoscopy on which showed a few polyps but no contra-indication for anticoagulation hence he was started on coumadin with bridging ( to be stopped once inr therapeutic between 2~3). his inr will be followed up per dr. , pcp. also, given his chf hx and afib, cardiology was also consulted who recommended changing coreg to metoprolol since it is less hypotensive and he was instructed to restart low dose acei per pcp as outpatient. he had repeat echocardiogram that showed even more reduced ef of 20~25% and signs of infiltrative disease hence spep and upep were checked that appeared within normal range. he will be following up with dr. at the heart failure clinic. patient was discharged home with home pt/ot and vna services plus follow-up appointments with his healthcare providers including dr. for neurology. medications on admission: -lipitor 10 mg daily -calcitriol 0.25 mcg daily -colchicine 0.6 mg tablet daily -aranesp 40 mcg/0.4 ml syringe sq weekly -fluticasone 50 mcg spray, 1 puff each nostril daily -lasix 120 mg -insulin aspart: take 8 units when blood sugar over 150 before supper once a day -insulin detemir: take 50 units sc once a day at supper -metalozone 2.5 mg daily in am if weight 165 and over as needed for for swelling -nitroglycerin 0.1 mg/hour patch 24 hr apply at night, remove in once daily in am -protonix 40 mg daily -potassium chloride 20 meq daily -diovan 40 mg daily -acetaminophen 325 mg tid as needed for fever, pain -ferrous sulfate 325 mg -artificial tears one drop qid, bilaterally -senna/colace , as needed for constipation discharge medications: 1. outpatient lab work please draw an inr this every monday, wednesday and until told otherwise per dr. . fax results to health ctr, , , phone: ( 2. atorvastatin 10 mg tablet sig: one (1) tablet po daily (daily). 3. calcitriol 0.25 mcg capsule sig: one (1) capsule po daily (daily). 4. colchicine 0.6 mg tablet sig: one (1) tablet po daily (daily). 5. fluticasone 50 mcg/actuation spray, suspension sig: one (1) spray nasal daily (daily). 6. nitroglycerin 0.1 mg/hr patch 24 hr sig: one (1) patch 24 hr transdermal q24h (every 24 hours). 7. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day). :*60 capsule(s)* refills:*2* 8. aspirin 325 mg tablet sig: one (1) tablet po daily (daily): please stop once inr therapeutic (2~3). :*30 tablet(s)* refills:*2* 9. epoetin alfa 3,000 unit/ml solution sig: one (1) injection qmowefr (monday -wednesday-). 10. senna 8.6 mg tablet sig: one (1) tablet po bid (2 times a day). :*60 tablet(s)* refills:*2* 11. metoprolol succinate 25 mg tablet sustained release 24 hr sig: one (1) tablet sustained release 24 hr po daily (daily) as needed for hold if sbp < 100 or hr < 55. :*30 tablet sustained release 24 hr(s)* refills:*0* 12. insulin glargine 100 unit/ml cartridge sig: one (1) subcutaneous at bedtime: please take 25 units at bedtime. :*8 cartridge* refills:*2* 13. coumadin 2.5 mg tablet sig: one (1) tablet po once a day: please adjust the dose per dr. with goal inr 2~3 and please take coumadin between 4~6pm every day. you will need frequent inr checks while on coumadin. :*30 tablet(s)* refills:*2* discharge disposition: home with service facility: vna discharge diagnosis: primary diagnoses: right middle cerebral artery cardioembolic stroke uncontrolled diabetes mellitus (a1c 9.7) systolic congestive heart failure (ef 20-25%) left lower back strain secondary diagnoses: atrial fibrillation chronic renal insufficiency mildly elevated ammonia hypertension anemia, secondary to iron deficiency and chronic kidney disease discharge condition: mild left sided neglect with mild left facial droop discharge instructions: you were admitted with a right middle cerebral artery territory stroke that was likely cardioembolic. on echocardiogram, you were found to be in worsened congestive heart failure (ef 20-25%) and were seen by cardiology who recommended that you follow-up in heart failure clinic as an outpatient. because of atrial fibrillation, stroke and heart failutre, you were started on a blood thinning medication called warfarin which will need close blood checks after undergoing colonoscopy to assess for gastro-intestinal bleeding risk. you have been evaluated and treated per occupational and physical therapy during this admission who recommend discharge to home under the care of your daughter with home pt/ot and vna services. you will need to follow-up with your primary care physician this coming tuesday, at 12:15pm where he will check your inr (goal ) and adjust your warfarin dose accordingly. you will likely need your inr blood level checked at least twice or thrice weekly until your pcp instructs you otherwise. please take medications as prescribed. please keep follow-up appointments with all your health care providers. given your heart failure and low ejection fraction, please weigh yourself every morning, md if weight > 3 lbs. also please adhere to 2 gm sodium diet and fluid restriction: 1.5 liters please call your pcp 911 if you have new weakness/numbness, visual problems including transient blindness and/or speech problems including slurring of speech. followup instructions: provider: , md phone: date/time: 3:00 pm provider: , : date/time: 9:30 provider: , m.d. phone: date/time: 2:00 (neurology) 2:30 pm clinical center (cardiology - heart failure clinic) 1:00 pm md, procedure: other endoscopy of small intestine colonoscopy diagnoses: anemia in chronic kidney disease congestive heart failure, unspecified chronic kidney disease, stage iv (severe) hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage i through stage iv, or unspecified atrial fibrillation personal history of malignant neoplasm of breast other and unspecified hyperlipidemia long-term (current) use of insulin chronic systolic heart failure other encephalopathy diabetes mellitus without mention of complication, type ii or unspecified type, uncontrolled cerebral embolism with cerebral infarction benign neoplasm of colon fall from other slipping, tripping, or stumbling unspecified gastritis and gastroduodenitis, without mention of hemorrhage facial weakness cerebral cysts sprain of unspecified site of sacroiliac region 

Answer: The patient is high likely exposed to