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: melena major surgical or invasive procedure: esophagogastroduodenoscopy (egd) transfusion of 4 units packed red blood cells history of present illness: 65 year old female with a pmh significant for htn and a r hip hemiarthroplasty in admitted on with melena that was associated with nausea and fatigue. the patient reports that she has been using 1200-2400 mg ibuprofen daily for the past month s/p surgery, and that the day of admission she noted at home that her bp was 80/50, with a hct of 20. in the micu, the patient received a total of 4 units prbc, and an upper endoscopy that demonstrated a 10mm non-bleeding ulcer in the pre-pyloric region. the patient was then transferred to medicine for further management. past medical history: right hip hemiarthroplasty () osteoarthritis righ knee hypertension hyperlipidemia lvh, obstructive cm (ef >65%) osteopenia social history: 1 ppd x 40 years 2 glasses of wine nightly denies ivdu retired school administrator family history: father died of mi at age 61. mother died of lymphoma at age 78. brother: cad. physical exam: vs: 99.0 (tm 99.9), 126/70 (126-146/62-78), 86-97, 94-95%ra 8h i/o: none / 1350 last 8h shift on : + cc urine (missed hat) gen: sitting in bed, nad heent: perrl, eomi, mmm, oropharynx clear without erythema or exudates, neck supple w/no jvd, sclerae anicteric cv: rrr, nl s1+s2, iii/vi holosystolic murmur heard best at lusb pulm: ctab abd: soft, nt/nd, +bs, no rebound or guarding, no hsm ext: warm, well perfused, no c/c/e, 2+ dp/pt pulses bilaterally neuro: cn ii-xii grossly intact with no focal deficits. strength throughout. gait not observed. pertinent results: admission cbc: 05:00pm blood wbc-12.7* rbc-2.00*# hgb-6.1*# hct-18.7*# mcv-93 mch-30.4 mchc-32.5 rdw-17.6* plt ct-346 . discharge cbc: 08:15am blood wbc-9.1 rbc-3.26* hgb-9.5* hct-27.9* mcv-86 mch-29.1 mchc-34.0 rdw-20.2* plt ct-279 . 05:00pm blood neuts-76.0* lymphs-19.7 monos-3.3 eos-0.5 baso-0.4 08:15am blood glucose-103* urean-9 creat-0.5 na-141 k-3.6 cl-108 hco3-24 angap-13 helicobacter pylori antibody test (final ): positive by eia.(reference range-negative). egd report impression: ulcer in the pre-pyloric region otherwise normal egd to third part of the duodenum. brief hospital course: # melena: likely secondary to pre-pyloric ulcer, although not found to have active bleeding. patient has history of chronic nsaid use since r hip arthroplasty in (ibuprofen and aspirin), along with regular tobacco and occasional alcohol use. given hct of 18 and hypotension on presentation she was admitted to the icu for monitoring. patient did well overnight and received a total of 4 u prbc and 3 l ivf. she underwent egd in the icu on showing a 10mm shallow, clean based antral ulcer without active bleeding. no interventions were made. she was continued on iv ppi and transferred to medicine floor where she remained hemodynamically stable and with stable hematocrit. h. pylori antibody came back positive on the day after discharge; patient, pcp (dr. , and gi fellow (dr. alert and pcp will start patient on therapy. . # pain control: r knee osteoarthritis pain managed with acetaminophen. . # hypertension: was initially hypotensive secondary to gi bleed. normotensive s/p ivfs and 4 units prbcs. lisinopril was held during admission. . # hyperlipidemia: continued home simvastatin. . #ppx: pneumatic boots . #code status: full code medications on admission: lisinopril 10 mg daily simvastatin 20 mg daily mvi caltrate 600 aspirin 81 mg one po once a day. ibuprofen 1200-1400 mg /day discharge medications: 1. simvastatin 10 mg tablet sig: two (2) tablet po daily (daily). 2. multivitamin tablet sig: one (1) tablet po daily (daily). 3. calcium carbonate 500 mg tablet, chewable sig: one (1) tablet, chewable po tid (3 times a day). 4. cholecalciferol (vitamin d3) 400 unit tablet sig: two (2) tablet po daily (daily). 5. lisinopril 10 mg tablet sig: one (1) tablet po daily (daily). 6. omeprazole 40 mg capsule, delayed release(e.c.) sig: one (1) capsule, delayed release(e.c.) po twice a day. disp:*60 capsule, delayed release(e.c.)(s)* refills:*2* 7. outpatient lab work lab work to be checked on tues, : -complete blood count (cbc) results to be faxed to dr. at (. discharge disposition: home discharge diagnosis: primary diagnoses: pre-pyloric ulcer anemia 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: 1. you were admitted to the hospital for further evaluation of your dark, bloody stools, fatigue and nausea. you were found to have low blood counts, also known as anemia. we treated you with iv fluids and you were transfused 4 units of blood in the icu. 2. you had a procedure, known as an egd, which showed a 1 cm ulcer in your stomach. this was likely caused by excessive nsaid (non-steroidal anti-inflammatory drugs, such as ibuprofen) use. you will need to have a repeat egd in 6 weeks and follow up with the gi doctors. you should also have a colonoscopy at that time. 3. we ordered an h. pylori blood test; the results were pending at the time of discharge. we will call your with these results, or you can follow them up with your pcp. it is positive, you will need treatment. 4. you were started on a new medication: omeprazole 40mg twice daily by mouth. you did not receive your lisinopril in the hospital; you should restart it when you go home (take 5mg the first day, then 10mg daily after that). you should continue to take your other home medications as prescribed except for the following: - stop taking aspirin. please talk to your pcp about when to re-start it. - do not take any nsaids for pain (ex. advil, ibuprofen, aleve, motrin, naprosyn, naproxen, toradol, etc.). you can take tylenol or acetaminophen for pain. 5. you should have blood work (cbc) checked on tues, and faxed to dr. at (. please follow up with your pcp 1 week. followup instructions: **you will be contact by the clinic on tuesday, to schedule an outpatient egd and colonoscopy. if you have not heard from them by the end of the week, please call (.** **please schedule a follow up appointment with your pcp 1 week to follow up your lab work.** department: orthopedics when: thursday at 1:15 pm with: , md building: campus: east best parking: garage procedure: other endoscopy of small intestine diagnoses: pure hypercholesterolemia tobacco use disorder mitral valve disorders unspecified essential hypertension acute posthemorrhagic anemia other shock without mention of trauma osteoporosis, unspecified family history of ischemic heart disease chronic or unspecified gastric ulcer with hemorrhage, without mention of obstruction disorder of bone and cartilage, unspecified unspecified analgesic and antipyretic causing adverse effects in therapeutic use osteoarthrosis, localized, not specified whether primary or secondary, lower leg 

Answer: The patient is high likely exposed to