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: brbpr major surgical or invasive procedure: colonoscopy x2 (. ) egd () angiogram with embolization 4th branch of the mesenteric artery () right ij cordis placement history of present illness: 80 y/o with pmh sig for cad s/p 1 vessel cabg, ef 15%, chf s/p icd, recent admit for gib for gib requiring 1 u prbc. during this admission, he an egd/colonoscopy off of coumadin but was restarted asa/plavix/coumadin on following procedure. the egd showed at that time showed mild gastritis and the colonoscopy showed 3 sessile nonbleeding polyps in ascending colon s/p hot snare single piece polypectomies (path showed adenoma) . pt presented to the ed on after two episodes of brbpr: one at approximatley 12:45 am, and another one after the patient presented to the ed. pt denied any n/v/diarrhea/melena/hematemesis/ cp/sob/f/c/ns or abdominal pain. . in ed, found to have initial hct of 35.4; inr 1.7, pt was initially hd stable but then dropped his sbp to 70s-->repeat hct was 28. pt was given a 250 cc ns bolus, along with 1 u prbc, 1 mg glucagon, protonix 40 mg iv. ngt lavage was normal (+bilious return). the gi service was consulted ddx at that time included polypectomy site bleed vs. sb bleed vs. brisk ugib?- most likely from polypectomy. initially hemodynamically stable, but became hypotensive to bp 70's at 4 am, hct drop to 28. improved w/ ivf bolus 500 cc to bp 130's, then trended down again to bp 90's. he was transferred to the icu for further managment past medical history: past medical history: 1. coronary artery disease s/p cabg (svg-lad known to be occluded) s/p lcx stent in ; d1 stent (des) placed 2. chf (ef 20%) with icd placed in , on coumadin for ?apical thrombus 3. prostate cancer with stable psa, followed by heme-onc 4. right complex renal mass followed by serial us; most recent renal us on showing complex cystic mass in right kidney, unchanged; cannot exclude neoplasm. 5. gallstones 6. cri 7. gout 8. htn 9. melena: , egd showed mild gastritis, showed 3 sessile nonbleeding polyps in ascending colon s/p hot snare single piece polypectomies, path showed adenoma. social history: denies t/a/d. lives with wife, has 3 children. former meatpacker, retired 22 yrs ago. family history: father died at age 42 from embolism. no history of early cad, sudden cardiac death. no dm physical exam: pe vs: 97.5 55 112/58 14 96% ra gen laying in bed, non-toxic appearing, pleasant comfortable eldery gentleman heent ncat, mild dry mm neck: supple, jvp flat chest: ctab without rales/wheezes cvs: rrr, no mrg appreciated abd soft, nabs, nd, slight rlq discomfort extrem: trace edema neuro: a&ox3, grossly intact . pertinent results: wbc rbc hgb hct mcv mch mchc rdw plt ct 09:11am 8.2 3.95* 12.4* 36.1* 91 31.4 34.3 15.9* 212 06:25am 9.4 4.02* 12.7* 35.5* 88 31.7 35.9* 15.8* 165 09:00pm 33.5* 03:15pm 34.9* 09:35am 34.9* 06:30am 7.1 3.46* 11.1* 30.0* 87 32.0 36.9* 15.9* 136* 09:00pm 32.7* 04:16pm 34.9* 06:33am 8.2 3.79* 11.8* 33.2* 88 31.1 35.5* 16.0* 156 07:45pm 35.0* 04:02am 9.6 3.68* 11.6* 32.3* 88 31.6 36.1* 15.8* 124* 11:04pm 31.8* 06:10pm 32.8* 01:13pm 31.7* 04:16am 8.1 3.29* 10.2* 28.6* 87 31.0 35.8* 16.1* 115* 11:49pm 30.7* 07:00pm 32.8* 03:05pm 33.6* 11:15am 11.9* 12.0* 33.2* 86 31.2 36.2* 15.6* 105* 07:00am 10.2* 29.9* 04:16am 9.7 3.22* 9.5* 27.0* 84 29.5 35.2* 16.5* 128* 11:46pm 11.0* 29.9* 07:44pm 11.2* 31.0* 01:49am hgb-11.3* calchct-34 01:53am wbc-8.6 rbc-3.66* hgb-11.4* hct-35.4* mcv-97 mch-31.1 mchc-32.2 rdw-14.9 03:46am hgb-9.2* calchct-28 09:00am hct-26.7* 01:30pm hct-26.1* 05:36pm hct-24.3* 09:59pm hct-26.5* 01:53am pt-15.8* ptt-27.7 inr(pt)-1.7 01:53am glucose-118* urea n-39* creat-1.6* sodium-140 potassium-4.5 chloride-104 total co2-26 anion gap-15 09:00am glucose-128* urea n-39* creat-1.3* sodium-139 potassium-4.7 chloride-107 total co2-23 anion gap-14 colonoscopy findings: contents: clotted blood was seen in the rectum and sigmoid colon. stool was found in the rectum and sigmoid colon. impression: blood in the rectum and sigmoid colon stool in the rectum and sigmoid colon otherwise normal colonoscopy to distal sigmoid colon recommendations: bleeding scan, if positive angiogram by ir. if bleeding scan negative and unable to do ir, continue golytely prep and will re-attempt colonoscopy.transfusion support. embolization procedure/findings: impression: super selective superior mesenteric arteriogram demonstrating extravasation of the contrast at the region of the ascending colon, which was embolized with four microcoils. no extravasation of the contrast noted at the end of the procedure colonoscopy findings: excavated lesions a single circular non-bleeding 8 mm ulcer was found in the proximal ascending colon. 3 cc.epinephrine 1/ hemostasis with success. -cap electrocautery was applied for hemostasis successfully. 3 1 cc. ink injections were applied for tattooing with success. other the area of the ulcer was about 3 cm from the ileocecal valve. the scope visualized this area for 20 minutes and there was no bleeding. clots of blood were seen throughout the colon all areas were washed and there was no active bleeding impression: ulcer in the proximal ascending colon clots of blood were seen throughout the colon all areas were washed and there was no active bleeding the area of the ulcer was about 3 cm from the ileocecal valve. the scope visualized this area for 20 minutes and there was no bleeding. recommendations: patient should continue to be observed in icu with frequent hcts. if rebleeds will discuss with surgeons utility of repeat endoscopy versus surgery. egd findings: esophagus: normal esophagus. stomach: contents: bilious fluid was seen in the stomach body. duodenum: flat lesions a single, non-bleeding localized 1 mm red spot was noted in the transverse duodenum. mono-polar cautery unit was applied for hemostasis successfully. protruding lesions a single, very small benign appearing ,non-bleeding polyp was found in the duodenum. impression: 1 mm spot in the transverse duodenum polyp in the duodenum fluids in stomach brief hospital course: 80 y/o with pmh sig for cad s/p 1 vessel cabg, ef 15%, recent admit for gib for gib requiring 1 u prbc. during this admission, he an egd/colonoscopy off of coumadin but restarted asa/plavix/coumadin following procedure. the egd showed mild gastritis and the colonoscopy showed 3 sessile nonbleeding polyps in ascending colon s/p hot snare single piece polypectomies (path showed adenoma) . pt presented on with two episodes of brbpr: one at approximatley 12:45 am, and another one after the patient presented to the ed. pt denied any n/v/diarrhea/melena/hematemesis/ cp/sob/f/c/ns or abdominal pain. 1) gi bleed: in ed, found to have initial hct of 35.4; inr 1.7, pt was initially hd stable but then dropped his sbp to 70s-->repeat hct was 28. pt was given a 250 cc ns bolus, along with 1 u prbc, 1 mg glucagon, protonix 40 mg iv. ngt lavage was normal (+bilious return). ddx at that time included polypectomy site bleed vs. sb bleed vs. brisk ugib?- most likely from polypectomy. initially hemodynamically stable, but became hypotensive to bp 70's at 4 am, hct drop to 28. improved w/ ivf bolus 500 cc to bp 130's, then trended down again to bp 90's. pt was admitted to icu at 6 am and was hemodynamically stable w/ bp 110's s/p 1u rbc and 1u ffp. he got 2nd u rbc and 2nd u ffp. on , pt had a colonoscopy that was unsucessful too much bleeding. he went for tagged rbc scan which localized bleeding to the ruq. he then went to angiography where the 4th branch of sma was embolized. his hct was montired closely after this . his hct trended downward with rebleeding occuring on , ddavp given . a repeat colonoscpy was done at that time and an 8mm nonbleeding ulcer ~3cm from ileocecal valve was bicapped, injected with epi and dye. no active bleeding was noted at the time of scope. surgery was consulted during his micu stay for possiblity of colectomy if ongoing bleeding was an issue. since colonoscopy, his hct and hemodynamics remained stable. pt remained without any complaints except for vague rlq discomfort. he notes no nausea , vomiting, diarrhea, chest pain or other symptoms. his last transfusion was at 8am on . in total, he has required 20 units of prbc transfusion since admission on . the polypectomy site remained the most likely source of bleed. ppt hematocrit was followed hct closely. at least and then finally to q24 hours in the last 2 days of his hospital stay. an egd was done on 10/ 19 which did not reveal any additional bleeding source. the team including the medical attending, dr. his cardiologist, and the gi attending agreed on restarting plavix without a loading dose but to continue to hold coumadin and aspirin. pt was continued on protonix 40 mg po bid. while on plavix, his hct continued to be stable and even rose slightly. he remains hd stable. he continued to have large bore iv access. he was discharged with a plan for follow-up in 2 days for hematocrit check and re-evaluation by his cardiologist who will decide on the timing of restart of aspirin and whether coumadin should be restarted. 2. cad s/p cabg: restarted plavix several days prior to discharge. pt's aspiring and coumadin were held throughout his hospital stay. they will continue to be held until his cardiologist, gastroenterologist, and pcp agree that it is safe to continue these medications given his bleeding risk. his anti-htn agents were held since admission. half dose of his ace inhibitor was restarted. his carvedilol was restarted as well at 3.125 mg . pump: anti-htn agenets were on hold including ace, bb, amlodipine, nitrates. pt did not have persistent htn or significant signs of chf. his carvdelilol and ace inhibitor were restarted after he remained hemodynamically stable with stable hct for several days. rhythm: pt continued low dose amiodiarone for hx vt, his icd was in place. he was monitored on telemetry for vt and gi bleed concerns 3. gout: restarted allopurinol given increased risk for this with gi bleed . 4. acute renal failure: pt presented with elevated cr to 1.6 from baseline 1.0-1.2. this was likely due to prerenal state given his dramatic bleeding on presentation. this improved to baseline with iv fluids and transfusion support . 5. ppx: ppi, pneumoboots . 6. fen: pt was advance to full liquids and then to full diet in the day prior to discharge. magnesium and potassium were repleted aggressively given his hx cad and vt. 7. code: full code 8. pt consult - pt was cleared for home dischare medications on admission: allopurinol 300 mg qd finasteride 5 mg qd amiodarone 400 mg qd amlodipine 5 mg qd quinapril 20 mg imdur 30 mg qd lipitor 30 mg qd coreg 3.125 mg aldactone 25 mg qd protonix 40 mg asa 325 mg qd plavix 75 mg qd coumadin discharge medications: 1. atorvastatin 20 mg tablet sig: 1.5 tablets po daily (daily). 2. acetaminophen 325 mg tablet sig: 1-2 tablets po q4-6h (every 4 to 6 hours) as needed. 3. amiodarone 200 mg tablet sig: one (1) tablet po daily (daily). disp:*30 tablet(s)* refills:*0* 4. 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* 5. allopurinol 300 mg tablet sig: one (1) tablet po daily (daily). 6. clopidogrel 75 mg tablet sig: one (1) tablet po daily (daily). 7. carvedilol 3.125 mg tablet sig: one (1) tablet po bid (2 times a day). 8. quinapril 10 mg tablet sig: one (1) tablet po twice a day: please see your doctor before going up to your previous dose. 9. finasteride 5 mg tablet sig: one (1) tablet po once a day: as previously prescribed. discharge disposition: home discharge diagnosis: gi bleed (requiring 20unit prbc transfusion) blood loss anemia renal failure discharge condition: afebrile, hemodynamically stable, tolerating full diet, ambulating without difficulty (cleared by pt) hematocrit stable for over 4 days discharge instructions: weigh yourself every morning, md if weight > 3 lbs. adhere to 2 gm sodium diet and fluid restriction: 1.5 liters ******please do not take aspirin or coumadin unless instructed by your doctors to . please do not take aldactone, imdur or amlodopine until instructed to do so by your primary physician or your cardiologist. please note that your quinapril is at half the regular dose currently (10mg twice each day) please be in contact with your primary physician and your cardiologist in the next week and be sure to schedule appointments with both of them. please return to the emergency department immediately if you have any signs of bleeding including red blood with stools, maroon or black stools, lightheadedness, weakness, chest pain, shortness of breath or any other worrisome symptoms followup instructions: please contact dr. on monday morning for an appointment early next week. please be sure to keep your appointment with dr. , your cardiologist, on monday . please be sure to have your blood level (hematocrit) checked at that time as well as your chemistries. please be sure to discuss the restart of your heart and blood pressure medications (aldactone, amlodipine, imdur) with dr. . please discuss with your doctors when if your should restart aspirin. please discuss with your doctors when if you should restart coumadin. please contact dr. , your gastroenterologist, for his next available appointment to discuss your recent bleeding. provider: scan phone: date/time: 10:30 provider: , md phone: date/time: 10:30 md procedure: venous catheterization, not elsewhere classified other endoscopy of small intestine arteriography of other intra-abdominal arteries flexible sigmoidoscopy other endovascular procedures on other vessels endoscopic destruction of other lesion or tissue of large intestine transfusion of packed cells transfusion of other serum transfusion of platelets diagnoses: congestive heart failure, unspecified unspecified essential hypertension acute posthemorrhagic anemia acute kidney failure, unspecified gout, unspecified atrial fibrillation aortocoronary bypass status percutaneous transluminal coronary angioplasty status malignant neoplasm of prostate automatic implantable cardiac defibrillator in situ angiodysplasia of intestine with hemorrhage hypovolemia other and unspecified coagulation defects ulceration of intestine 

Answer: The patient is high likely exposed to