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: ugib major surgical or invasive procedure: egd x 2 colonoscopy central line placement history of present illness: the patient is a 76y/o f with a pmh of htn, dm, chf with ef 25-30%, mesenteric vein thrombosis (on coumadin), ulcerative colitis and recent c. diff colitis admitted with coffee ground emesis. the patient was sent to er from her nursing home with reports of a 1 day history of coffee ground emesis. at , she was noted to have melanotic stools on exam. ng lavage with 600cc of coffee grounds. bp noted to be 93/54 pretransfusion with hr 103. hct 24.2. inr found to be 4.5. she was given 1u prbc, 2u ffp and vitamin k 10mg. repeat bp 158/69, hr 103. she was sent to for further evaluation. on arrival to the ed, she was noted to have minimal output from her ng tube. vitals: t 97.8, hr 115, bp 115/75, rr 18, o2 100% on ra. hct 25. she was given ciprofloxacin 400mg iv. 1l ns. pantoprazole gtt was started. 1u prbc ordered but not given prior to transfer to micu. on arrival to the micu, the patient is alert, oriented only to self. she is unable to relate the details of her history of bleeding. past medical history: diverticulitis, status post sigmoid resection in of with a diverting colostomy which was reversed in . mesenteric vein thrombosis diabetes mellitus htn hyperlipidemia cardiomyopathy - ef 25-30% mesenteric thrombosis - on coumadin gi bleeds in past dementia anxiety ulcerative colitis social history: lives in , most recently in nursing home. no known history of tobacco or etoh family history: unknown physical exam: tc: hr:101 bp:175/69 rr:16 100% sp02 nc alert, oriented to person, disoriented to place and time follows commands, heent: perrla, no jvd, mmm, anicteric, og tube in place. cvs: rrr, s1s2 clear, no m/r/g resp: mild inspiratory crackles abd: +ve bs, soft, non tender, obese ext: 1+ pitting edema pertinent results: 12:00am urine color-yellow appear-clear sp -1.016 12:00am urine blood-neg nitrite-neg protein-neg glucose-neg ketone-15 bilirubin-neg urobilngn-neg ph-5.0 leuk-tr 12:00am urine rbc-0 wbc-0-2 bacteria-none yeast-none epi-<1 11:00pm glucose-113* urea n-49* creat-0.9 sodium-136 potassium-4.5 chloride-97 total co2-18* anion gap-26* 11:00pm estgfr-using this 11:00pm ck(cpk)-177* 11:00pm ck-mb-7 ctropnt-0.03* 11:00pm magnesium-1.9 11:00pm wbc-11.8*# rbc-2.72*# hgb-8.4* hct-25.3* mcv-93# mch-31.0# mchc-33.3 rdw-16.6* 11:00pm neuts-88* bands-0 lymphs-6* monos-4 eos-0 basos-0 atyps-0 metas-2* myelos-0 nuc rbcs-3* 11:00pm hypochrom-normal anisocyt-normal poikilocy-normal macrocyt-occasional microcyt-normal polychrom-normal 11:00pm plt smr-normal plt count-365 11:00pm pt-19.8* ptt-20.5* inr(pt)-1.8* egd: medium hiatal hernia granularity, friability, erythema and nodularity in the lower third of the esophagus compatible with erosive esophagitis (biopsy) normal mucosa in the stomach (biopsy) otherwise normal egd to third part of the duodenum colonoscopy: a single sessile 20 mm non-bleeding polyp was found in the ascending colon. cold forceps biopsies were performed for histology. a single sessile 3 mm non-bleeding polyp of benign appearance was found in the ascending colon. otherwise normal colonoscopy to cecum brief hospital course: 76 y/o female with htn, dm, chf with ef 25-30%, mesenteric vein thrombosis (on coumadin), ulcerative colitis and recent c. diff colitis presenting with melanotic stools, coffee ground emesis in setting of coagulopathy with inr 4.5 on admission. #1 gi bleed: pt hemodynamically stable with hct of 24.2 on admission after 1 unit rbc at outside hospital. received ffp in hospital with reversal inr to 1.8 and placed on iv pantoprazole . initially the patient was observed in the icu. a central line was placed for access and blood draws due to poor peripheral access. serial hematocrits were followed and showed no evidence of active bleeding. an egd performed on showed increased granularity, friability, erythema and congestion in the lower third of the esophagus from 25cm to 35cm but no evidence active bleeding. the patient was transferred to the regular medical floor where she was observed for any further bleeding. colonoscopy performed on revealed a single sessile 20 mm non-bleeding polyp in the ascending colon which was biopsied. polypectomy was deferred to outpatient setting secondary to recent active gi bleed. a repeat egd was also performed for biopsy of erosive gastritis. the patient was discharged on pantoprazole twice daily with instructions to follow up with dr. for polypectomy. #2 anticoagulation for history of mesenteric vein thrombosis in : patient presented with acute gi bleed in the setting of a supratherapeutic inr. as outlined above, the patient's anticoagulation was reversed using ffp and vitamin k and coumadin was held for the duration of her hospitalization. upon discharge the patient was not restarted on her coumadin as her colonic polyp was felt to be a significant risk for chronic gastrointestinal bleed. the decision whether to continue longterm anticoagulation is deferred to the patient's primary care physician, . . patients' with ibd are at 3x higher risk for developping pulmonary embolism/ deep venous thrombosis compared to the normal population. most associated thromboembolic events occur within the portal, mesenteric and retinal veins. 80% of patient's who present with newly diagnosed thromboses have active ibd at the time of diagnosis. #3 heart failure: systolic (ef55%): the patient presented with mild symptoms of volume overload consistent with chf exaccerbation post transfusion. during her hospitalization, volume status was monitored clinically and she was diuresed as needed with lasix. upon discharge, patient was euvolemic with no crackles in her lungs and only mild edema in extremities. she was discharged on her home dose of lasix. #4 htn: in the setting of an acute bleed, the patient's home blood pressure medications were held. subsequently, the patient was hypertensive with systolic blood pressure in the 170s. she remained asymptomatic with no symptoms of end organ ischemia. once hemodynamic stability was confirmed, home antihypertensive regimen (lisinopril, norvasc, metoprolol, lasix) was resumed and the patient remained normotensive. #5 ulcerative colitis: patient has history of ulcerative colitis. she was maintained on her home dose of azathioprine and asacol and had no evidence of active disease as confirmed by colonoscopy report. #6 clostridium difficile: prior to admission, the patient had been started on flagyl on for clostridium difficile. this regimen was continued and patient was discharged with instructions to complete the entire 14 day course. as per colonoscopy report, the patient did not have severe disease and no psuedomembranous colitis or evidence of toxic megacolone was visible. #7 dm: patient's home dose of glimeprimide was held throughout hospital course. despite instituting sliding scale insulin, the patient was hyperglycemic with average glucose ranging 200-220 throughout her hospital stay. upon discharge, home medical management was reinstituted. #8 dementia: at mental baseline, the patient was alert and oriented to person only. this was stable throughout her hospital stay. patient was maintained on her rivastigmine and antidepressive. #9 reflux disease: on omeprazole at home. started on pantoprazole in setting of gib. also started of sulfacrate twice daily. #10 fen: patient's electrolytes were monitored daily and replaced as needed. note: patient frequently required potassium replacement: supplementation may need to be provided on a daily basis esp as patient is on lasix status: full code communication: son medications on admission: tylenol 650mg po q4 prn albuterol 2puff inh qid amlodipine 2.5mg daily azathioprine 100mg daily calcitonin 1 spray daily colace 200mg calcium carbonate 1 tab cymbalta 20mg daily ferrous sulfate 325mg daily folic acid 1 mg daily lasix 20mg daily gabapentin 300mg tid glimepiride 1mg daily insulin lispro ss latanoprost 0.005% solution 1 drop op qhs lidoderm patch 1 top daily lisinopril 20mg loperamide 2 mg q6 prn magnesium oxide 500mg daily megestrol acetate 400mg daily metoprolol tartate 25mg flagyl 500mg tid (started ) mom 30ml prn mvi daily omeprazole 20mg daily percocet 1 tab q8 prn prednisone 10 mg daily rivastigmine 6mg coumadin 3mg daily vitamin d 50000u q 2 weeks discharge medications: 1. albuterol sulfate 90 mcg/actuation hfa aerosol inhaler sig: two (2) puff inhalation q6h (every 6 hours) as needed for sob. 2. duloxetine 20 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po daily (daily). 3. gabapentin 300 mg capsule sig: one (1) capsule po tid (3 times a day). 4. latanoprost 0.005 % drops sig: one (1) drop ophthalmic hs (at bedtime). 5. lidocaine 5 %(700 mg/patch) adhesive patch, medicated sig: one (1) adhesive patch, medicated topical daily (daily). 6. rivastigmine 3 mg capsule sig: two (2) capsule po bid (2 times a day). 7. azathioprine 50 mg tablet sig: two (2) tablet po daily (daily). 8. metoprolol tartrate 25 mg tablet sig: one (1) tablet po bid (2 times a day). 9. captopril 25 mg tablet sig: one (1) tablet po tid (3 times a day). 10. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q12h (every 12 hours). disp:*60 tablet, delayed release (e.c.)(s)* refills:*2* 11. prednisone 10 mg tablet sig: one (1) tablet po daily (daily): take with meal. 12. sucralfate 1 gram tablet sig: two (2) tablet po bid (2 times a day). disp:*120 tablet(s)* refills:*2* 13. furosemide 20 mg tablet sig: one (1) tablet po daily (daily). 14. flagyl 500 mg tablet sig: one (1) tablet po twice a day for 5 days. 15. norvasc 2.5 mg tablet sig: one (1) tablet po once a day. 16. lisinopril 20 mg tablet sig: one (1) tablet po twice a day. 17. outpatient lab work pleave have hct rechecked in 1 week discharge disposition: extended care facility: & rehab center - discharge diagnosis: acute anemia erosive gastritis colonic polyp discharge condition: alert and oriented x 1, at baseline per family members hemodynamically stable with stable hematocrit at 28 for 24 hours stools are fecal occult blood negative discharge instructions: you were admitted with bleeding from your gastrointestinal tract. you have received blood transfusions and have had 2 endoscopies and a colonoscopy with the gastroenterology team. you were found to have several causes for your bleeding, both irritation in your esophagus and a polyp in your colon. because of this bleeding, your coumadin has been held, please discuss whether or not to restart your coumadin with your primary care physician. have your primary care physician recheck your hematocrit in one week. you will need to follow up as indicated below with your gastroenterologist dr. for treatment of your colon polyp. please make the following changes to your medication regimen: 1. please change omeprazole 20 mg by mouth daily to omeprazole 40 mg by mouth twice daily to help prevent acid secretion in your stomach 2. please start taking sulfacrate by mouth twice daily to help protect the lining in your stomach 3. please stop taking your coumadin until further notification by your primary care physician followup instructions: you should be following up with your gastroenterologist dr. within 1 months time for a repeat colonoscopy and removal of your polyp to minimize your risk of further bleeding. his office will be contacting you or your son regarding scheduling this. if you do not hear from them within 1 week, the number at the clinic is please follow up with your primary care physician . after hospital discharge. you have an appointment on at 2:00pm. please call if you have questions or need to reschedule. . md procedure: venous catheterization, not elsewhere classified other endoscopy of small intestine esophagogastroduodenoscopy [egd] with closed biopsy closed [endoscopic] biopsy of large intestine diagnoses: other primary cardiomyopathies esophageal reflux congestive heart failure, unspecified unspecified essential hypertension acute posthemorrhagic anemia other persistent mental disorders due to conditions classified elsewhere hypopotassemia anxiety state, unspecified long-term (current) use of insulin blood in stool intestinal infection due to clostridium difficile diabetes mellitus without mention of complication, type ii or unspecified type, uncontrolled anticoagulants causing adverse effects in therapeutic use hematemesis ulcerative colitis, unspecified acute on chronic systolic heart failure benign neoplasm of colon disorders of magnesium metabolism other esophagitis 

Answer: The patient is high likely exposed to