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: syncope major surgical or invasive procedure: upper endoscopy under conscious sedation history of present illness: 54 year old male with h/o gi bleed in secondary to esophagitis, who was in his usual state of health until he woke up the morning of admission feeling fatigued. he had a dark stool this morning. he went to shower, and syncopized in the shower. he remembers waking up lying in the bath tub. he spent most of the day resting in bed, but got up in the late afternoon to take his dog out. while walking outside he syncopized twice on the sidewalk. the patient hit his face, but did not hit any other part of his head. he had a final syncopal episode witnessed by his son while urinating, which caused him to present to the ed. of note, patient was previously on protonix, but ran out one month prior to admission. in the ed, initial vitals: t 98.7 hr 90 bp 118/68 rr 16 100% on ra. he was found to be guaiac negative. however on ng lavage, there was coffee grounds and bright red clots, that did not clear with 2l of saline. he received 2l iv fluids, 80mg iv protonix, and was started on a protonix gtt at 8mg/hour. ng tube was left in place. gi was consulted and plan to scope the patient overnight. vitals prior to transfer: hr 91 bp 107/61 rr 16 98%on ra. past medical history: gi bleed in esophagitis hiatal hernia grade 3 internal hemorrhoids htn hl osa detached retina in s/p bilateral cataract surgery intermittent back spasms depression social history: lives with his dog, works as a real-estate broker, has 2 kids, one at vanderbilt, pre-med. fairly active, golfs, no limitations to physical activity. no tobacco, but exposed to heavy tobacco as a child. rare etoh. family history: his mother died at the age of 61 of an mi. his father died at the age of 79 with sepsis. he had colitis at a late age. he has two sisters, one living at age 47 and one who died at the age of 54 of an mi and he has one living brother at the age of 58 who has had heart disease and bipolar disorder. physical exam: on admission: vitals: t: 97.4 bp: 112/66 p:88 r: 18 o2:96% on ra general: alert, oriented, no acute distress. ng tube in place. heent: sclera anicteric, mmm, oropharynx clear neck: supple, jvp not elevated, no lad lungs: clear to auscultation bilaterally, no wheezes, rales, ronchi cv: regular rate and rhythm, normal s1 + s2, no murmurs, rubs, gallops abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly gu: no foley ext: warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema pertinent results: hct 41.7 on admission lowest hct 31.5 on hct 37 on discharge . micro: none . images: colonoscopy polyp at 10cm in the rectum (biopsy) grade 3 internal hemorrhoids otherwise normal colonoscopy to cecum and distal 10 cm of ileum . egd medium hiatal hernia grade 3 esophagitis in the lower third of the esophagus erythema in the antrum . ekg: nsr @ 78bpm. nl axis. no st segment changes. . egd : erythema in the duodenum compatible with duodenitis medium hiatal hernia blood clots in the greater curve of the stomach body, not able to be flushed away grade c esophagitis salmon colored projections in the distal esophagus compatible with esophagitis, ? barrett's esophagus mass in the gastroesophageal junction otherwise normal egd to third part of the duodenum egd grade c esophagitis in the gastroesophageal junction ulcer noted at the ge junction with visible vessel and overlying clot. three clips deployed but unsuccessfully placed. 2cc of epinephrine injected and bicap applied. (thermal therapy) otherwise normal egd to second part of the duodenum brief hospital course: 54 yo m with prior gi bleed secondary to esophagitis who presents with syncope, ng lavage positive for bright red blood. . # upper gi bleed: the pt's initial egd showed esophagitis with a large clot at the ge junction. surgery was consulted but did not think esophagectomy would be indicated, except as a last resort in extreme circumstances; additionally, embolization would not be an option due to the limited blood supply of the distal esophagus. hct decreased to 31 from 41, although the pt remained hemodynamically stable throughout his entire course. he received a total 4 liters ivf as well as one unit of prbc. after , hct never dropped below 33, and was 37 on the day of discharge. repeat egd on showed grade c esophagitis in the gastroesophageal junction, ulcer at the ge junction with visible vessel and overlying clot. three clips deployed but unsuccessfully placed. 2cc of epinephrine injected and bicap applied. (thermal therapy). gastrin was checked and was still pending at the time of discharge (should be followed up as outpatient). h. pylori antibodies were negative. he was started on a ppi , and should remain on protonix 40mg as an outpatient. aspirin (for primary prevention) was held on discharge. he has follow up with dr. in and will have repeat egd in . . # htn: his home lisinopril, norvasc, and hctz were held in the setting of gi bleed. they were not restarted on discharge because systolic bp's were ranging in 110's to 120 while on the floors (). he was given a prescription for home bp cuff and was instructed to check bp daily, and report any bp>160/100 to his pcp, he will call to make an appointment next week. his pcp was and instructed of this plan. . # hl: continue simvastatin per outpatient regimen. . # depression: continued celexa. . # communication: patient. . # code: full (discussed with patient) medications on admission: 1. lisinopril 40 mg p.o. daily. 2. simvastatin 40 mg p.o. daily. 3. norvasc 5 mg p.o. daily. 4. protonix 40 mg p.o. daily. 5. hctz 12.5mg po daily. 6. celexa 60mg po daily. 7. aspirin 81mg po daily discharge medications: 1. atorvastatin 10 mg tablet sig: one (1) tablet po daily (daily). 2. citalopram 20 mg tablet sig: three (3) tablet po daily (daily). 3. protonix 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po twice a day. disp:*60 tablet, delayed release (e.c.)(s)* refills:*2* 4. blood pressure cuff please provide patient with blood pressure cuff. discharge disposition: home discharge diagnosis: primary: 1) upper gi bleed, 2) esophagitis, 3) ulcer . secondary: 1) hypertension discharge condition: at discharge, the patient was hemodynamically stable, with bp 116/75 and hr 74. his mental status was clear, coherant, alert and interactive, and was able to ambulate independently as well as do all his own adls. discharge instructions: you were admitted to medical center for syncope. you had bleeding from the bottom of your esophagus. you underwent upper endoscopy (the scope of your esophagus, stomach and duodenum), which showed inflammation of the bottom of your esophagus and of your duodenum, as well as an ulcer. you will need to follow up with dr. for a repeat endoscopy in weeks. you will also need to start taking protonix twice a day everyday. never miss a dose because you are at risk for having another episode of bleeding. take your blood pressure daily. we spoke with your pcp, . , about how your medications were stopped on this admission, and he wants you to follow up with him next week. call his office if you are having blood pressures over 160/100 stop the following medicines: 1. aspirin 2. lisinopril 3. norvasc 4. hctz start 1. protonix 40mg twice a day never take any aspirin, motrin/ibuprofen, or nsaids. followup instructions: please follow up with dr. ( for followup on at 8:20 and for endoscopy scheduled for at 7am in the building on the of . please follow up with your pcp, . next week. check your blood pressure daily and report any blood pressures over 160/100 to him immediately. procedure: other endoscopy of small intestine endoscopic excision or destruction of lesion or tissue of esophagus diagnoses: obstructive sleep apnea (adult)(pediatric) unspecified essential hypertension acute posthemorrhagic anemia depressive disorder, not elsewhere classified diaphragmatic hernia without mention of obstruction or gangrene other and unspecified hyperlipidemia hypotension, unspecified syncope and collapse fall from other slipping, tripping, or stumbling tachycardia, unspecified internal hemorrhoids without mention of complication ulcer of esophagus with bleeding 

Answer: The patient is high likely exposed to