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: no known allergies / adverse drug reactions attending: chief complaint: abdominal pain major surgical or invasive procedure: ercp ercp history of present illness: 86f w gallstone pancreatitis transferred from . pain started 1 week ago associated with n/v and decreased po intake since that time. pain sharp in epigastric region radiating to the back. emesis is recent po contents. no bowel movement in 4 days. denies fevers/chills, in stool, jaundice, darkening of urine or other complaints. past medical history: pmh: htn, insomnia, mitral regurg, osteoporosis, renal insufficiency, cataracts, dvt, spondylosis, hyperlipidemia, carpal tunnel psh: unknown back surgery, appendectomy, tah,bso social history: lives in , -tobacco, -etoh, -illict family history: unknown physical exam: physical examination upon admission: temp:97.6 hr:150 bp:172/95 resp:16 o(2)sat:98 constitutional: comfortable heent: pupils equal, round and reactive to light, extraocular muscles intact oropharynx within normal limits chest: clear to auscultation cardiovascular: regular rate and rhythm abdominal: mild tenderness to palpation right upper quadrant gu/flank: no costovertebral angle tenderness extr/back: no cyanosis, clubbing or edema neuro: speech fluent, neuro intact physical examination:upon discharge: vital signs: bp=108/56, hr=72, 18, room air 98% general: pale, sitting in chair, mild scleral icterus cv: ns1, s2, -s3, -s4 lungs: diminshed bs, crackles right base abdomen: soft, non-tender ext: cool, + dp bil, no pedal edema, bony lesions fingers, left fifth finger swollen, bony lesion, left foot, 2nd digit, adaptic dressing pertinent results: admission labs (from ): 22.7 > 38.6 < 410 145 104 91 --------------< 100 3.8 23 3 //11: ekg: atrial fibrillation. intraventricular conduction delay. no previous tracing available for comparison. tracing #1 : chest x-ray: impression: bibasilar atelectasis : ekg: sinus rhythm. possible old anterior myocardial infarction. compared to the previous tracing ectopy is resolved. : ercp: impression: peri-ampullary diverticula a moderate diffuse dilation was seen at the main duct with the cbd measuring 12 mm. there were at least 3 -4 round stones from 8 mm to 10 mm that were causing partial obstruction were seen. successful sphincterotomy successful plastic stent placement to bypass cbd stones. 06:15am wbc-10.7 rbc-2.19* hgb-7.2* hct-22.3* mcv-102* mch-33.1* mchc-32.5 rdw-19.7* plt ct-333 06:35am wbc-11.3* rbc-2.22* hgb-7.3* hct-22.7* mcv-102* mch-32.7* mchc-32.1 rdw-19.4* plt ct-347 05:50am wbc-13.1* rbc-2.35* hgb-7.6* hct-23.6* mcv-101* mch-32.4* mchc-32.2 rdw-18.2* plt ct-389 07:25am wbc-11.5* rbc-2.45* hgb-8.2* hct-24.5* mcv-100* mch-33.7* mchc-33.7 rdw-17.5* plt ct-387 07:00am wbc-12.3* rbc-2.52* hgb-8.1* hct-25.3* mcv-100* mch-32.0 mchc-31.9 rdw-16.7* plt ct-391 06:10am wbc-12.6* rbc-2.41* hgb-7.7* hct-23.8* mcv-99* mch-31.9 mchc-32.3 rdw-16.2* plt ct-371 09:55am wbc-17.2* rbc-2.77* hgb-8.9* hct-27.4* mcv-99* mch-32.0 mchc-32.4 rdw-15.8* plt ct-450* 06:15am wbc-10.7 rbc-2.19* hgb-7.2* hct-22.3* mcv-102* mch-33.1* mchc-32.5 rdw-19.7* plt ct-333 06:35am wbc-11.3* rbc-2.22* hgb-7.3* hct-22.7* mcv-102* mch-32.7* mchc-32.1 rdw-19.4* plt ct-347 05:50am wbc-13.1* rbc-2.35* hgb-7.6* hct-23.6* mcv-101* mch-32.4* mchc-32.2 rdw-18.2* plt ct-389 07:25am wbc-11.5* rbc-2.45* hgb-8.2* hct-24.5* mcv-100* mch-33.7* mchc-33.7 rdw-17.5* plt ct-387 07:00am wbc-12.3* rbc-2.52* hgb-8.1* hct-25.3* mcv-100* mch-32.0 mchc-31.9 rdw-16.7* plt ct-391 06:10am wbc-12.6* rbc-2.41* hgb-7.7* hct-23.8* mcv-99* mch-31.9 mchc-32.3 rdw-16.2* plt ct-371 09:55am wbc-17.2* rbc-2.77* hgb-8.9* hct-27.4* mcv-99* mch-32.0 mchc-32.4 rdw-15.8* plt ct-450* 06:45am wbc-17.0* rbc-2.91* hgb-9.2* hct-29.4* mcv-101* mch-31.7 mchc-31.3 rdw-15.2 plt ct-379 05:00am wbc-16.3* rbc-2.87* hgb-9.1* hct-29.2* mcv-102* mch-31.7 mchc-31.1 rdw-15.0 plt ct-386 03:20pm wbc-25.4*# rbc-3.33* hgb-10.5* hct-34.2* mcv-103* mch-31.7 mchc-30.8* rdw-14.9 plt ct-423 06:30am neuts-89* bands-1 lymphs-5* monos-2 eos-0 baso-1 atyps-0 metas-2* myelos-0 06:15am plt ct-333 06:15am plt ct-333 06:35am plt ct-347 06:15am glucose-93 urean-16 creat-1.1 na-140 k-3.9 cl-108 hco3-25 angap-11 06:35am glucose-78 urean-18 creat-1.1 na-141 k-4.2 cl-110* hco3-24 angap-11 05:50am glucose-75 urean-22* creat-1.1 na-140 k-3.9 cl-108 hco3-24 angap-12 07:25am glucose-74 urean-24* creat-1.3* na-138 k-3.9 cl-108 hco3-25 angap-9 06:10am glucose-78 urean-30* creat-1.5* na-140 k-3.5 cl-109* hco3-20* angap-15 06:40am glucose-86 urean-39* creat-2.2* na-141 k-3.9 cl-111* hco3-19* angap-15 06:30am glucose-81 urean-36* creat-2.0* na-143 k-4.0 cl-109* hco3-24 angap-14 06:45am glucose-75 urean-24* creat-1.1 na-145 k-3.9 cl-111* hco3-25 angap-13 06:15am alt-42* ast-40 alkphos-240* amylase-105* totbili-0.6 06:35am alt-49* ast-57* alkphos-263* amylase-107* totbili-0.7 05:50am alt-59* ast-53* ld(ldh)-278* alkphos-279* amylase-123* totbili-0.7 07:25am alt-71* ast-67* ld(ldh)-263* alkphos-283* totbili-0.6 07:00am alt-97* ast-119* alkphos-327* amylase-121* totbili-0.6 06:10am alt-101* ast-182* alkphos-253* amylase-111* totbili-0.8 04:00am alt-45* ast-45* alkphos-176* totbili-1.0 02:06am alt-42* ast-56* alkphos-148* amylase-260* totbili-0.8 09:46am alt-48* ast-48* alkphos-159* totbili-1.0 dirbili-0.6* indbili-0.4 06:35am lipase-48 05:50am lipase-88* 07:25am lipase-76* 07:00am lipase-90* 06:10am lipase-58 02:06am lipase-198* 09:46am lipase-76* 06:15am calcium-7.7* phos-2.9 mg-1.9 06:35am calcium-8.2* phos-3.5 mg-2.1 05:50am calcium-7.9* phos-2.9 mg-1.7 : x-ray hands: impression: severe multi-joint osteoarthritis. findings consistent with tophaceous gout. no comparison exams at this facility. : ultra-sound of the liver: 1. biliary sludge and seen within the gallbladder without any evidence of cholecystitis. the biliary stent is not visualized. : abdominal us: findings: single abdominal radiograph is obtained. a plastic stent is seen in the region of the common bile duct. the patient is status post surgical fusion of l1 through l5. a dual-lead nerve stimulator projects over the lower lumbar spine with leads coursing cranially. air is seen in small and large bowel. there is bilateral acetabular degenerative change. impression: plastic common bile duct stent seen in appropriate location. : ercp: bile duct was dilated to 15mm with multiple large stones. intrahepatic biliary ducts were normal. balloon shincteroplasty with a 12mm balloon. multiple small stones were extracted with balloon catheter. lithotripsy of larger stones was performed. about 80% of stones were removed. a 5cm by 10fr double pigtail plastic biliary stent was placed successfully. of note: diagnosis, assessment and recommendations: ms has a new diagnosis of anti-dantu alloantibody and warm and cold autoantibodies. dantu is a low frequency antigen and is a member of the mns group system. anti-dantu antibody has uncertain clinical significance. most abo compatible will be dantu-antigen negative and we will perform a full crossmatch. ms also has a diagnosis of warm and cold autoantibodies. these autoantibodies may or may not be associated with hemolysis and serologic results should be correlated with clinical findings. regardless of cinical significance, warm and cold autoantibodies may complicate bank testing. please contact the bank as soon as possible when transfusion is being considered. to faciliate future serologic testing, we will provide, when available, matched to the patient for major rh and antigens. approximately 63% of abo compatible will be e and k negative. brief hospital course: the patient was admitted to the acs service with nausea, back pain, and vomitting. upon admission was made npo, given intravenous fluids, and had work done which showed an elevated lipase and white cell count. imaging studies of the abdomen showed common bile duct stone. prior to her arrival to the hospital, she had an episode of atrial fibrillation which resolved with intravenous metoprolol. because of the new onset of atrial fibrillaton, she was admitted to the intensive care unit for monitoring. she underwent an ercp on where she had a sphincterotomy and placement of a stent. she did develop confusion and delirium post-procedure. she was placed on unasyn as coverage for her cholangitis. her foley catheter was discontinued on hd #4 and she has been voiding without difficulty. she did have another episode of atrial fibrillation prior to her transfer to the floor on , this resovled with intravenous metoprolol. her atrial fibrillation did resolve with medication. she was started on clear liquids on hd#5 with advancement to a regular diet. she has been evaluated by physical therapy and recommendations have been made for rehabilitation related to her deconditioning. she has resumed her pre-hospital medications. of note, she did develop a swollen 5th left finger. she did have anx-ray taken of her hands which did show osteo-arthitis and lesions suggestive of tophaceous gout. was consulted and recommendations were made for her management with subsequent follow-up. during the course of her hospitalization, she did have an elevation in her creatinine up to 2-2.2 and her medications were reviewed as a potential source. she did require additional intravenous fluids for additional hydration. in order to monitor her urine output, her foley catheter was re-insterted. on hod #8, she reported flank pain and was found to have a worsening of her liver function tests and a elevation in her white cell count. gi was consulted and recommended a repeat ercp. on hod # 12 she underwent an ercp which showed multiple large stones and a biliary stent was placed. over the last few days, her liver function tests have improved and her white cell count has normalized. her foley catheter was discontinued on hod #12. she did have difficulty voiding and it was replaced. a urine culture did show yeast and she was started on a 4 day course of fluconazole. her vital signs are stable and she is afebrile. her hematocrit is 22.3 and her creatinine has decreased to 1.1. her appetite is diminished and she continues to need encourageement to eat. she has been out of bed. because of her difficulty voiding, her foley catheter will remain in place. she is preparing for discharge to a rehabilitation facility with subsequent follow-up with her primary care provider, , gi, and with the acute care service. of note: her hctz, k-lor, and atacand have not been resumed related to her gout occurrence and normalized pressure. she does need to have a follow-up appointment with her primary care provider. t&c sent to red cross (very reactive). if needs will have to have emergency release and will be high risk for hemolysis. medications on admission: atenolol 75mg , klor-10 daily, lansoprazole 30mg qd, vitamin d 400u daily, atacand 16mg , folic acid 1mg daily, felodipine er 5mg daily, asa 325mg daily, hctz 25mg daily, lipitor 10mg daily, ambien 10mg daily discharge medications: 1. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). 2. ipratropium bromide 0.02 % solution sig: one (1) nebulizer inhalation q6h (every 6 hours) as needed for wheezing. 3. atenolol 25 mg tablet sig: three (3) tablet po bid (2 times a day): hold for pressure <110, hr <60. 4. lipitor 10 mg tablet sig: one (1) tablet po once a day. 5. folic acid 1 mg tablet sig: one (1) tablet po once a day. 6. felodipine 5 mg tablet extended release 24 hr sig: one (1) tablet extended release 24 hr po once a day: hold for pressure <110, hr <60. 7. ambien 10 mg tablet sig: one (1) tablet po at bedtime. 8. docusate sodium 100 mg capsule sig: one (1) capsule po bid (2 times a day): hold for diarrhea. 9. heparin (porcine) 5,000 unit/ml solution sig: one (1) cc injection tid (3 times a day). 10. aspirin 325 mg tablet sig: one (1) tablet po once a day. 11. fluconazole 100 mg tablet sig: one (1) tablet po q24h (every 24 hours) for 4 days. 12. naproxen 250 mg tablet sig: one (1) tablet po every eight (8) hours: as needed for gout pain. discharge disposition: extended care facility: at village - discharge diagnosis: gallstone pancreatitis atrial fibrillation gout discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - requires assistance or aid (walker or cane). discharge instructions: you were admitted to the hospital with upper abdomimal pain. you were found to have a gallstone in the common bile duct. you underwent ercp where you had a sphincterotomy and a stent placed in the common bile duct. despite this, you continued to have elevated liver function tests and went for another ercp in which you had multiple stones removed from the bile duct and placment of a stent. your liver function tests have improved. you are now preparing for discharge home with the following instructions: please call your doctor or nurse practitioner or return to the emergency department for any of the following: *you experience new chest pain, pressure, squeezing or tightness. *new or worsening cough, shortness of breath, or wheeze. *if you are vomiting and cannot keep down fluids or your medications. *you are getting dehydrated due to continued vomiting, diarrhea, or other reasons. signs of dehydration include dry mouth, rapid heartbeat, or feeling dizzy or faint when standing. *you see or dark/black material when you vomit or have a bowel movement. *you experience burning when you urinate, have in your urine, or experience a discharge. *your pain in not improving within 8-12 hours or is not gone within 24 hours. call or return immediately if your pain is getting worse or changes location or moving to your chest or back. *you have shaking chills, or fever greater than 101.5 degrees fahrenheit or 38 degrees celsius. *any change in your symptoms, or any new symptoms that concern you. 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 followup instructions: please follow up with the acute care service in 2 weeks. you can schedule this appointment by calling # please follow up with dr. about repeat ercp in weeks. you can schedule this appointment by callling # please follow up with your primary care provider, . , in 1 week to discuss the new onset of atrial fibrillation. the telephone number is # procedure: endoscopic removal of stone(s) from biliary tract endoscopic sphincterotomy and papillotomy endoscopic dilation of ampulla and biliary duct endoscopic insertion of stent (tube) into bile duct replacement of stent (tube) in biliary or pancreatic duct pancreatic sphincteroplasty diagnoses: mitral valve disorders unspecified essential hypertension candidiasis of other urogenital sites atrial fibrillation other and unspecified hyperlipidemia osteoporosis, unspecified osteoarthrosis, unspecified whether generalized or localized, site unspecified retention of urine, unspecified cholangitis acute pancreatitis calculus of bile duct without mention of cholecystitis, with obstruction chronic gouty arthropathy with tophus (tophi) 

Answer: The patient is high likely exposed to