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: shellfish / lisinopril / neosporin / sulfa(sulfonamide antibiotics) / ativan / glucophage / morphine / statins-hmg-coa reductase inhibitors / benadryl attending: chief complaint: hematochezia, chest pain, shortness of breath major surgical or invasive procedure: egd colonoscopy history of present illness: 66f with hx of copd, htn, and dm who presents with with 3 days of dark stools. she noticed red blood in her toilet today. over the past week she has had intermittent chest pain and shortness of breath. chest pain is substernal and radiates to jaw, associated with sob, and is exertional. no abdominal pain. nausea, no vomting. she went to osh ( ), where hct was found to be 13.3 (baseline 34), trop i 0.31 (thought to be due to demand ischemia). vitals at osh were reportedly stable with hr 95 and bp 105/43. she was transfused 3 units prbcs, given 2 l ns, protonix, and levaquin (for unclear reasons). they consulted cards, surgery, and finally, gi, who wanted the patient transferred to for for further management. she states that for the past 3 days, she has noticed loose, dark stools mixed with brbpr that comes out in a "gush" before her bm. she thought this was secondary to hemorrhoids, and therefore didn't immediately present for care. however, given exertional chest pain in a bandlike distribution across her chest, assoc w/ nausea/sob in addition to extreme fatigue and lightheadedness, she went to osh ed. very occassional sharp pains in stomach over past month when taking ice cubes. otherewise none. some fatigue and muscle pain over past 3 days. some loss of appetite past 3 days. she has never had an endoscopic procedure in the past, including colonoscopy. she denies any history of melena or brbpr. she does have lactose intolerance and ibs, so her bowel habits are variable, but states that she is currently having frequent stools. she notes recent "heartburn" symptoms for the past days as well, for which she has been taking tums prn. also of note, she takes ibuprofen 600mg 1-2 times per day x several months for lbp. in the ed, initial vitals were: 98.6 91 97/54 20 100% on ra. ng lavage showed a scant amount of red blood that cleared quickly, and the patient reportedly had a small amount of brbpr. gi and cardiology were consulted, large-bore iv access x 3 obtained, and blood was sent for crossmatch. hct was 23.3. gi recommended admitting to micu, 2 additional units of prbcs to be given in ed, egd/colonoscopy in the morning, and cta and call fellow if hemodynamically unstable overnight. vitals stable here. bp 120s/53. no fluids or red cells given in the ed. on arrival to the micu, patient feels well and has no pain. past medical history: chronic obstructive pulmonary disease htn osteoporosis, treated with yearly reclast spinal stenosis djd diabetes mellitus with recent hga1c 6.4% social history: retired legal secretary. lives w/ grandson and sister is upstairs in two story house. previous tobacco (quit 17 yrs ago, previously smoking 1 ppd x 34 yrs), drinks one glass of wine every 3-4 months, denies drugs. family history: no gi malignancies or ibd. gm with breast ca that metastasized to colon. physical exam: admission: vitals: t: 100.2 bp: p: r: 18 o2: general: alert, oriented, no acute distress, lying in bed. + pallor heent: sclera anicteric, mmm, oropharynx clear, eomi, perrl neck: supple, jvp not elevated, no lad cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi abdomen: soft, non-tender, non-distended, bowel sounds present, no organomegaly rectal: brbpr mixed in with stool, +external hemorrhoids gu: no foley ext: no edema, +pallor, cap refill; access: 3 18g pivs neuro: cnii-xii intact, 5/5 strength upper/lower extremities, grossly normal sensation, 2+ reflexes bilaterally, gait deferred, finger-to-nose intact discharge afebrile, hypertensive to the 140s systolic, not tachycardic, no oxygen requirement general: alert, oriented, no acute distress, heent: sclera anicteric, mmm, oropharynx clear, eomi, perrl neck: supple, jvp not elevated, no lad cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi abdomen: soft, non-tender, non-distended, bowel sounds present, no organomegaly gu: no foley ext: no edema, 2+ pulses neuro: cnii-xii intact, 5/5 strength upper/lower extremities, grossly normal sensation, 2+ reflexes bilaterally, gait deferred, finger-to-nose intact pertinent results: admission labs 01:13pm blood wbc-11.3* rbc-3.04* hgb-7.6* hct-23.3* mcv-77* mch-25.1* mchc-32.7 rdw-19.2* plt ct-435 01:13pm blood neuts-81.2* lymphs-13.7* monos-2.7 eos-2.0 baso-0.4 01:13pm blood hypochr-3+ anisocy-1+ poiklo-2+ macrocy-1+ microcy-normal polychr-1+ ovalocy-1+ burr-1+ 01:13pm blood pt-11.2 ptt-25.3 inr(pt)-1.0 01:13pm blood glucose-115* urean-19 creat-0.8 na-134 k-3.6 cl-99 hco3-21* angap-18 01:13pm blood alt-24 ast-27 ck(cpk)-176 alkphos-46 totbili-0.6 01:13pm blood ck-mb-8 01:13pm blood albumin-3.7 01:18pm blood glucose-112* lactate-1.9 k-3.4 01:18pm blood hgb-7.8* calchct-23 01:13pm ctropnt-0.04* 01:13pm ck-mb-8 10:59pm ctropnt-0.11* discharge labs 07:15am blood wbc-6.3 rbc-4.16* hgb-10.9* hct-33.8* mcv-81* mch-26.1* mchc-32.2 rdw-19.1* plt ct-514* 07:15am blood glucose-96 urean-13 creat-0.9 na-141 k-4.5 cl-103 hco3-27 angap-16 07:15am blood calcium-9.4 phos-4.8* mg-2.0 cxr the lung volumes are normal. borderline size of the cardiac silhouette without pulmonary edema. the patient has received a nasogastric tube. the course of the tube is unremarkable, the tip of the tube projects over the middle parts of the stomach. no complications, notably no pneumothorax. no pleural effusions, no pneumonia. . ekg st depressions in v3-v6 . ct c/a/p 1. focal cecal wall thickening near the ileocecal valve, likely corresponding to primary lesion. local lymphadenopathy measures up to 10 x 7 mm. 2. small bilateral pleural effusions and bilateral lower lobe atelectasis versus consolidation. 3. multiple peripheral ground-glass nodules in the lungs may be of infectious origin although metastatic disease is not excluded. close interval followup is recommended. borderline mediastinal lymph nodes may also be re-evaluated at this time. 4. thyroid nodule in the left lobe should be correlated with prior imaging or further evaluated with routine thyroid ultrasound. 5. 8-mm focus of enhancement within segment 7 of the liver may represent an fnh or hemangioma. recommend continued attention on follow up. . endoscopy colonoscopy findings: protruding lesions a broad-based 5 cm mass with overlying exudate was found in the cecum. cold forceps biopsies were performed for histology. grade 1 internal hemorrhoids were noted. excavated lesions a single non-bleeding diverticulum was seen. impression: grade 1 internal hemorrhoids diverticulum in the colon mass in the cecum (biopsy) otherwise normal colonoscopy to cecum egd findings: esophagus: lumen: a partial, nonobstructing schatzki's ring was found. a small size hiatal hernia was seen. stomach: normal stomach. duodenum: normal duodenum. impression: small hiatal hernia schatzki's ring . pathology cecal mass biopsies: focal adenomatous mucosa with at least high grade dysplasia. no definitive invasive carcinoma is identified. additional levels examined. the biopsies may not be representative of the entire "mass" described. clinical correlation is needed. brief hospital course: 66f with pmh of copd and dm presented with gi bleed and chest pain, found to have hct of 13 out osh. active # gastroinstestinal bleed: the patient was admitted to the micu from outside hospital with a hct of 13. at that time she was hypotensive. she received 3 units of prbcs and ivns at the osh and was started on a protonix drip. upon transfer to she was transfused another 2 units prbcs. her hct was 31 and she remained hemodynamically stable. an egd was performed which was unremarkable for a cause of her gi bleed. she was prepped for colonoscopy and transfused another unit of prbcs to maintain her hct greater than 30. colonoscopy performed the next day revealed hemorrhoids and a 5cm mass in the cecum concerning for malignancy. surgery was consulted and she was discharged with scheduled resection of the mass on after being evaluated by cardiology, pulmonology, and anesthesia. her hct was stable at ~30 and she remained hemodynamically stable during the remainder of her stay with no evidence of gi bleed. # nstemi: the patient presented with chest pain and shortness of breath at the osh, which improved with transfusion of prbcs and ivns in addition, her troponin was elevated, and peaked at 0.16. her ekg demonstrated st depression in the lateral leads which improved with administration of prbcs, which were felt to be due to demand ischemia. her hct was maintained at > 28 in the setting of her troponin leak and symptoms. after egd and colonscopy, she was evaluated by cardiology prior to discharge for or planning. she was started on metoprolol that was uptitrated to 25 to a goal heart rate of 60. she was also then started on asa 81 and pravastatin. her losartan was held while uptitrating metoprolol and then restarted prior to discharge. she will need cardiology evaluation after surgery with stress testing and possible catheterization is performed. chronic # htn: pt's home medications hctz and losartan were held initially. losartan was restarted prior to discharge and the patient was instructed to restart her hctz only after consulting with her pcp for blood pressure check. # copd: the pt was on albuterol nebs and advair while in hospital. she was instructed to restart her home nebs on discharge. she underwent pre-operative pulmonary evaluation prior to discharge. # osteoporosis: on yearly reclast. she was continued on her calcium and vitamin d supplementation. # dm: the patient was placed on an insulin sliding scale while in the hospital. transitional # f/u pulmonary nodules # f/u thyroid nodule # cardiology to cath after surgery medications on admission: hydrochlorothiazide 37.5mg daily losartan 25mg daily spiriva neb 1x daily brovana neb 2x daily pulmicort neb 1x daily albuterol neb prn reclast once yearly ca/vit d daily ibuprofen 600mg 1-2x/day trichromium/cinnamon daily for dm discharge medications: 1. brovana *nf* (arformoterol) 15 mcg/2 ml inhalation 2. cal-citrate *nf* (calcium citrate-vitamin d2) 250-100 mg-unit oral daily 3. losartan potassium 25 mg po daily 4. pulmicort *nf* (budesonide) 0.5 mg/2 ml inhalation daily 5. reclast *nf* (zoledronic acid-mannitol&water) 5 mg/100 ml injection yearly 6. tiotropium bromide 1 cap ih daily 7. aspirin 81 mg po daily rx *aspirin 81 mg 1 tablet(s) by mouth daily disp #*30 tablet refills:*0 8. metoprolol tartrate 25 mg po bid rx *metoprolol tartrate 25 mg 1 tablet(s) by mouth twice a day disp #*60 tablet refills:*0 9. pravastatin 20 mg po daily rx *pravastatin 20 mg 1 tablet(s) by mouth daily disp #*30 tablet refills:*0 10. albuterol 0.083% neb soln 1 neb ih q6h:prn wheezing, shortness of breath discharge disposition: home discharge diagnosis: primary: lower gastrointestinal bleed, colon neoplasm secondary: type ii diabetes, hypertension, demand ischemia, discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: dear ms , it was a pleasure caring for you during your recent admission to . you were admitted because of bleed from your gastrointestinal tract. you had become quite symptomatic from this, as evidenced by your worsened shortness of breath. we believe that your low blood counts caused some strain on your heart. you were given several units of red blood cells to improve your symptoms. a colonoscopy and esophagogastroduodenoscopy (egd) were performed. egd showed no cause for your bleeding. however, the colonoscopy showed a 5 centimeter mass in the right side of your colon as well as hemorrhoids, both of which were likely to have contributed to your bleeding. it is felt that resection of this mass would be an appropriate means of treatment. we still do not have the pathology results from the biopsy taken from the colon mass. however, these will be followed up in the outpatient setting with gastroenterology and colorectal surgery. plans for your future management will be made at that time. because of the strain caused on your heart, you will also be started on three new medications, a statin for your cholesterol, aspirin, and metoprolol to control your heart rate. all of your other medications should remain the same. followup instructions: name:, g. address: , , phone: fax: md procedure: other endoscopy of small intestine closed [endoscopic] biopsy of large intestine other irrigation of (naso-)gastric tube diagnoses: subendocardial infarction, initial episode of care unspecified essential hypertension acute posthemorrhagic anemia diabetes mellitus without mention of complication, type ii or unspecified type, not stated as uncontrolled chronic airway obstruction, not elsewhere classified personal history of tobacco use diaphragmatic hernia without mention of obstruction or gangrene osteoporosis, unspecified osteoarthrosis, unspecified whether generalized or localized, site unspecified other diseases of lung, not elsewhere classified malignant neoplasm of cecum hemorrhage of gastrointestinal tract, unspecified spinal stenosis, unspecified region leukocytosis, unspecified stricture and stenosis of esophagus intestinal disaccharidase deficiencies and disaccharide malabsorption internal hemorrhoids without mention of complication 

Answer: The patient is high likely exposed to