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: sulfa (sulfonamides) attending: chief complaint: s/p motor vehicle crash major surgical or invasive procedure: tracheosotmy & peg placement history of present illness: 76 yo female unrestrained driver, s/p high speed motor vehicle crash vs. tree. ? syncopal episode. gcs 14. she was taken to an area hospital where she was intubated for airway protection and then transferred to for further care. past medical history: 1. cad 2. hypercholesterolemia 3. depression 4. osteoporosis 5. dm type 2 6. anemia and leukopenia as above family history: noncontributory physical exam: upon admission to ed: bp 99/palp hr 56 vented o2 sat 100% t 100.6 rectal gen: intubated/sedated heent: perrl; open nasal fracture neck: cervical collar in place chest: bialt bs equal cor: brady abd: soft pelvis: stable pertinent results: 09:40pm urine blood-neg nitrite-neg protein-neg glucose-neg ketone-neg bilirubin-neg urobilngn-neg ph-7.0 leuk-neg 09:00pm glucose-104 lactate-1.3 na+-138 k+-4.4 cl--100 tco2-30 08:55pm urea n-21* creat-0.7 08:55pm ck(cpk)-390* amylase-186* 08:55pm ctropnt-<0.01 08:55pm ck-mb-14* mb indx-3.6 08:55pm asa-neg ethanol-neg acetmnphn-neg bnzodzpn-neg barbitrt-neg tricyclic-neg 08:55pm wbc-3.2* rbc-3.03* hgb-10.2* hct-30.4* mcv-100* mch-33.5* mchc-33.4 rdw-12.9 08:55pm plt count-202 08:55pm pt-13.3* ptt-27.9 inr(pt)-1.2* 08:55pm fibrinoge-321 ct c-spine w/o contrast reason: assess for c-spine injury medical condition: 76 year old woman s/p mvc reason for this examination: assess for c-spine injury contraindications for iv contrast: none. indication: 79-year-old woman with motor vehicle accident. c-spine ct without contrast: there is no comparison. cervical spine is visualized from the level of skull base to the level of c7-t1. the patient is intubated. there is no acute cervical spine fracture or subluxation. note is made of degenerative changes at multiple levels, centered at c5-6 and facet degeneration and left neural foraminal narrowing at c4-5 and c5-6. left upper rib fractures are noted at the first and second ribs. there is a left apical pneumothorax. fractures of the nasal septum and bilateral nasal bone fracture are not well seen on this study. please refer to facial bone ct for further evaluation. fluid levels are noted in the sphenoid sinuses with dense fluid noted likely blood. in addition blood is noted within the nasal cavity, nasopharynx, and iripharynx. an ett is in place. dense fluid likely representing blood is also noted i nthe left maxillary sinus. right thyroid nodules are noted. small hypodense areas and calcification noted in the left submandibular gland. impression: 1. no acute cervical spine fracture or subluxation. degenerative changes with neural foraminal narrowing as described. 2. hyperdense material (likely blood) in the nasal cavity, nasopharynx, oropharynx and sinuses as described. please refer to dedicated ct of the facial bones. 3. left upper rib fractures and left apical pneumothorax more completely assessed on subsequently performed chest ct. ct chest w/contrast; ct abdomen w/contrast reason: assess for injury field of view: 36 medical condition: 76 year old woman s/p mvc reason for this examination: assess for injury contraindications for iv contrast: none. indication: 46-year-old woman with motor vehicle accident, assess injury. technique: contiguous axial ct images of the chest, abdomen, and pelvis were obtained with administration of intravenous contrast . multiplanar reformation images are reconstructed. outside ct study was referenced. findings: there is small left pneumothorax along the apex and anterior base, with chest tube in place terminating in the apex. there has been decrease in size of pneumothorax compared to outside study. the patient is status post intubation. no evidence of mediastinal hematoma or pericardial or significant pleural effusion is noted. thoracic aorta is tortuous and calcified, however, no evidence of acute aortic injury. small mediastinal nodes are noted, however, no significant mediastinal or hilar lymphadenopathy is noted. tiny loculation of air is noted in the anterior mediastinum which may be related to the pneumothorax. bibasilar atelectasis is noted. there is a large calcified granuloma in the left lung base measuring 1 cm. in the right middle lobe, note is made of 4-mm noncalcified nodule. there is soft tissue contusion overlying the sternum along with a fracture involving the body of the sternum. a small stepoff is best seen on sagittal reformatted image 39. a small amount of retrosternal hematoma is noted. there are multiple rib fractures involving right first, third through seventh anteriorly and left first through third. abdomen: there is no evidence of free air, free fluid, fluid collection, or bowel dilatation or significant lymphadenopathy in the abdomen. the liver is unremarkable without evidence of intrahepatic ductal dilatation or focal liver lesion. gallbladder is unremarkable. spleen, pancreas, adrenal glands and the visualized portion of large and small intestines are within normal limits. right kidney is unremarkable. there is a large exophytic left lower pole simple renal cyst measuring 13 cm. there is no hydronephrosis. atherosclerotic disease of the aorta is noted. there is soft tissue stranding overlying the left hemipelvis. pelvis: the visualized portion of large and small intestines are within normal limits. uterus and ovaries appear normal. there is no ascites or pelvic lymphadenopathy. the uterus is unremarkable. foley catheter and contrast is noted in the urinary bladder. marked degenerative changes of pubic symphysis and thoracolumbar spine is noted. there is no compression deformity of the thoracolumbar spine. impression: 1. bilateral rib fractures, sternal fracture with retrosternal hematoma. 2. small left sided pneumothorax, with chest tube in place. 3. incidentally noted large exophytic left renal cyst. 4. 4-mm noncalcified right middle lobe nodule, if the patient is at low risk for lung cancer, no followup is needed. if the patient is at high risk for lung cancer, one-year followup is recommended. chest (portable ap) reason: post trach cxr medical condition: 76 year old woman with trauma, intubated for respiratory failure. s/p trach reason for this examination: post trach cxr type of examination: chest ap portable single view. indication: history of trauma, intubated for respiratory failure. now status post tracheostomy. findings: ap single view of the chest has been obtained with the patient in sitting semi-upright position. analysis is performed in direct comparison with a similar study obtained one day earlier. during the interval, the patient has been extubated and a tracheostomy has been performed. a cannula is seen in place terminating approximately 1 cm below the lower clavicular border. there is no evidence of pneumothorax. the previously identified left subclavian approach central venous line is in unchanged position. heart size is unaltered. pulmonary vasculature shows slightly more marked perivascular haze and diffuse densities on the bases are again suggestive of moderate amount of bilateral pleural effusion and perhaps slightly more on the right than the left. no new parenchymal infiltrates are identified. impression: conversion from ett ventilation to tracheostomy. successful procedure without evidence of pneumothorax or other complications. otherwise, stable chest findings. cardiology report echo study date of measurements: left ventricle - ejection fraction: >= 55% (nl >=55%) aorta - ascending: *3.7 cm (nl <= 3.4 cm) interpretation: findings: left ventricle: suboptimal technical quality, a focal lv wall motion abnormality cannot be fully excluded. overall normal lvef (>55%). right ventricle: normal rv chamber size and free wall motion. aorta: mildly dilated ascending aorta. mitral valve: mildly thickened mitral valve leaflets. mild mitral annular calcification. no mr. pericardium: no pericardial effusion. general comments: suboptimal image quality - bandages, defibrillator pads or electrodes. suboptimal image quality as the patient was difficult to position. suboptimal image quality - ventilator. conclusions: severely technically limited study. due to suboptimal quality, a focal wall motion abnormality cannot be fully excluded. overall left ventricular systolic function is probably normal (lvef>55%). right ventricular chamber size and free wall motion are probably normal. the ascending aorta is mildly dilated. the mitral valve leaflets are mildly thickened. no mitral regurgitation is seen. there is no pericardial effusion. cannot reliably assess for presence/absence of left ventricular outflow tract gradient or aortic stenosis due to suboptimal acoustic windows. if clinically indicated, a tee would better assess cardiac structure and for valvular disease. brief hospital course: she was admitted to the trauma service. plastic surgery was consulted given her open nasal fracture. the area was irrigated and sutured. a nasal splint was applied and eventually removed. she will require follow up within 1-2 weeks in plastic surgery clinic. acute pain service consulted for epidural catheter placement given her rib fractures. her pain was adequately controlled with this. the epidural was eventually removed on . she is receiving tylenol prn; was receiving fentanyl prn for pain in the trauma icu, but will be discharged on prn iv morphine. she should be changed to oral narcotics that can be given through her peg once pain better controlled while at rehab. hematology consulted for leukopenia; patient with a long standing history of this and anemia and has been followed by an outside hematologist (dr. ) for this. there was no evidence for leukemic or hematologic malignancy on smear; it was recommended that if her neutrophils and bands were <1000 she should be placed on neutropenic precautions. she will need to follow up with her hematologist once all of her acute issues are resolved. a tracheostomy and peg was placed; she is receiving tube feedings and is tolerating them without difficulties. physical therapy was consulted and have recommended acute rehab. she will need to follow up with her primary care doctor, dr. in the area, for a finding on her chest ct (see pertinent results). medications on admission: fosamax lexapro ritalin trazodone mirapax asa mvi glucosamine discharge medications: 1. heparin (porcine) 5,000 unit/ml solution sig: one (1) ml injection tid (3 times a day). 2. acetaminophen 325 mg tablet sig: two (2) tablet po q6h (every 6 hours) as needed. 3. docusate sodium 50 mg/5 ml liquid sig: ten (10) ml's po bid (2 times a day). 4. pramipexole 0.125 mg tablet sig: one (1) tablet po qhs (). 5. bisacodyl 10 mg suppository sig: one (1) suppository rectal hs (at bedtime) as needed for constipation. 6. escitalopram 10 mg tablet sig: one (1) tablet po daily (daily). 7. albuterol sulfate 0.083 % (0.83 mg/ml) solution sig: one (1) neb rx inhalation every four (4) hours as needed for shortness of breath or wheezing. 8. methadone 5 mg tablet sig: one (1) tablet po tid (3 times a day). 9. metoprolol tartrate 25 mg tablet sig: one (1) tablet po tid (3 times a day): hold for hr <60; sbp <110. 10. insulin regular human 100 unit/ml solution sig: one (1) dose injection asdir (as directed) as needed for per insulin sliding scale. 11. gabapentin 400 mg capsule sig: one (1) capsule po tid (3 times a day). 12. hydralazine 20 mg/ml solution sig: 0.5 ml injection q6h (every 6 hours) as needed for sbp>160. 13. morphine 1 mg/ml solution sig: 0.5-1 ml injection every four (4) hours as needed for pain. 14. heparin flush cvl (100 units/ml) 1 ml iv daily:prn 10ml ns followed by 1ml of 100 units/ml heparin (100 units heparin) each lumen qd and prn. inspect site every shift 15. lactulose 10 g/15 ml solution sig: fifteen (15) ml po once a day as needed for constipation. discharge disposition: extended care facility: - discharge diagnosis: s/p motor vaehicle crash sternal fracture multiple rib fractures: right 1, anteriorly & left degloving and nasal fracture left pneumonthorax discharge condition: stable followup instructions: follow up with dr. , trauma surgery in weeks. call for an appointment. follow up with plastic surgery clinic in weeks, call for an appointment. follow up with your outpatient hematologist after discharge from rehab. you will also need to follow up with your primary care doctor (dr. in ) for further work up of a nodule found on chest ct imaging at . you will need to call for an appointment. procedure: venous catheterization, not elsewhere classified continuous invasive mechanical ventilation for 96 consecutive hours or more insertion of endotracheal tube other bronchoscopy percutaneous [endoscopic] gastrostomy [peg] temporary tracheostomy transfusion of packed cells diagnoses: anemia, unspecified coronary atherosclerosis of native coronary artery diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled paroxysmal ventricular tachycardia myelodysplastic syndrome, unspecified closed fracture of sternum osteoporosis, unspecified other motor vehicle traffic accident involving collision on the highway injuring driver of motor vehicle other than motorcycle traumatic pneumothorax without mention of open wound into thorax flail chest street and highway accidents closed fracture of nasal bones closed fracture of seven ribs 

Answer: The patient is high likely exposed to