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: history of present illness: the patient is a 72-year-old white female with a history of colon cancer (status post resection 10 years ago) who was admitted to on with dyspnea, "almost black" diarrhea, bright red blood per rectum, a hematocrit of 23.3, and an inr of 3.8. the patient received 4 units of packed red blood cells. it appeared the patient's baseline hematocrit is in the low 30s. she has a history of b12 deficiency and thalassemia. the patient's dyspnea progressed over the past one to two weeks, and it was worse with exertion. this dyspnea was greater than her baseline dyspnea on exertion. she also had intermittent chest pain during this time which occurred at rest. the patient has a history of angina. the patient cannot lay flat at baseline secondary to shortness of breath. the patient received a gastrointestinal consultation and a cardiology consultation during that admission. a red blood cell scan showed a brisk bleed from the small bowel but could not pinpoint the area. the patient was ruled out for a myocardial infarction by cardiac enzymes and electrocardiogram. the patient denies fevers, chills, nausea, vomiting, or palpitations. the patient was on coumadin for atrial fibrillation and is being followed by her primary care physician for inr and coumadin adjustments. the patient is on home oxygen; about 2 liters to 3 liters via nasal cannula. upon admission, the patient's hematocrit went from 23.3 to 27.1 with one unit, and with two more units her hematocrit went to 26.9, and with one more unit her hematocrit went to 28. the patient was transferred to with a plan for an arteriogram. past medical history: 1. atrial stenosis; status post bovine aortic valve replacement in at . 2. atrial fibrillation (on coumadin). 3. coronary artery disease with a history of an inferior myocardial infarction and angina. 4. type 2 diabetes. 5. colon polyps that were malignant; status post resection. 6. chronic obstructive pulmonary disease. 7. pulmonary hypertension. 8. congestive heart failure. 9. b12 deficiency. 10. thalassemia. 11. chronic anemia. 12. dementia. 13. stress test in revealed an ejection fraction of 46% with no ischemic changes. an echocardiogram in revealed an ejection fraction of 55%. 14. a colonoscopy in was normal. medications on admission: (outpatient medications included) 1. zoloft. 2. aricept. 3. digoxin 0.25 mg by mouth once per day. 4. glyburide 5 mg by mouth twice per day. 5. spironolactone 50 mg by mouth once per day. 6. prednisone 20 mg by mouth once per day. 7. aspirin 81 mg by mouth once per day. 8. coumadin. 9. albuterol meter-dosed inhaler. 10. atrovent meter-dosed inhaler. 11. serevent meter-dosed inhaler. 12. singulair. 13. lasix 40 mg by mouth twice per day. 14. iron. allergies: no known drug allergies. social history: a 75-pack-year history of tobacco use; she quit 18 years ago. she denies alcohol. family history: family history of colon cancer, cervical cancer, and diabetes. physical examination on presentation: physical examination revealed her blood pressure was 130/50, her heart rate was 103, she was afebrile, and her oxygen saturation was in the 90s. in general, in no acute distress. she was sitting up in bed. head, eyes, ears, nose, and throat examination revealed pupils were equal, round, and reactive to light and accommodation. the mucous membranes were moist. the neck was supple. no jugular venous distention. cardiovascular examination revealed an irregularly irregular rhythm. first heart sound and second heart sound. a 2/6 systolic ejection murmur at the left upper sternal border and right upper sternal border. pulmonary examination revealed decreased breath sounds diffusely; posteriorly. no wheezes were noted. the abdomen was soft, nontender, and nondistended. positive bowel sounds. no hepatosplenomegaly. extremity examination revealed trace bilateral lower extremity edema to the ankles. pertinent laboratory values on presentation: the patient's laboratories on admission revealed her white blood cell count was 16.2 and her hematocrit was 30.2. her inr was 2, prothrombin time was 7.2, and partial thromboplastin time was 27.7. sodium was 137, potassium was 3.6, chloride was 94, bicarbonate was 31, blood urea nitrogen was 4, creatinine was 0.8, and her blood glucose was 192. calcium was 8.6, magnesium was 1.7, and phosphorous was 3.8. her creatine kinase and troponin levels from the outside hospital revealed a creatine kinase from 50 to 56 to 117. her troponin levels went from less than 0.01 and then again negative at less than 0.01. urinalysis was negative. pertinent radiology/imaging: a chest x-ray was normal. concise summary of hospital course by issue/system: 1. gastrointestinal bleed issues: the patient with a questionable history of melena but a positive history of bright red blood per rectum. a negative gastrointestinal lavage at the outside hospital but positive red blood cell scan. the patient received an upper endoscopy which showed normal mucosa to the third part of the duodenum. the patient had a colonoscopy which showed a few diverticula in the sigmoid colon. no source of bleeding. the patient received a small-bowel follow-through; the results of which are pending. the patient was placed on protonix. she had two large-bore intravenous lines placed. her aspirin and coumadin were held. the goal was to transfuse for a hematocrit of less than 30. the patient did not need any transfusions since her admission to . her hematocrit was stable since admission. gastroenterology was consulted. on discharge, her hematocrit was stable at 30.2 and her inr was 1. the patient was restarted on her coumadin but not her aspirin. the patient was to follow up with her primary care doctor. 2. cardiovascular issues: (a) coronary artery disease: the patient with a history of myocardial infarction. aspirin was held given the gastrointestinal bleed. the electrocardiogram did not show any st-t wave abnormalities. the patient was ruled out for a myocardial infarction by enzymes at the outside hospital. the patient with recent chest pain and would recommend a stress test as an outpatient. the patient was started on a beta blocker and an ace inhibitor. (b) pump: the patient has an ejection fraction of 46% on last echocardiogram. the patient was evaluated for overload. there were no signs of congestive heart failure. (c) blood pressure: the patient with a history of hypertension. her blood pressures were kept under control with diuretics and beta blocker. (d) rhythm: the patient was continued on her digoxin for her atrial fibrillation. her rate was controlled with a goal of less than 100 with beta blocker. 3. diabetes issues: initially, the patient's glyburide was held and the patient was on an insulin sliding-scale. after the patient started eating her glyburide was restarted. there were no other diabetic issues. 4. chronic obstructive pulmonary disease issues: chronic obstructive pulmonary disease appeared to be stable. the patient was continued on her home nebulizer treatments. the patient is on an outpatient prednisone taper. she came in on a prednisone dose of 20 mg. we tapered this down to 15 mg. today is the fourth day at the dose of 15 mg. the patient was to follow up with her outpatient physician for continued slow taper. 5. increased white blood cell count issues: the patient was admitted with an increased white blood cell count. this could possibly be due to steroid use. a chest x-ray was negative. urinalysis was negative. it appeared to be trending down. at the time of discharge, her white blood cell count was 9.3. she was afebrile. 6. fluids/electrolytes/nutrition issues: the patient was placed on a low saturated fat, low cholesterol, low fat, diabetic, high fiber, no added salt diet. electrolytes were repleted as needed. 7. prophylaxis issues: the patient was not given subcutaneous heparin secondary to gastrointestinal bleed. the patient was placed on protonix and pneumatic boots. 8. code status: the patient was full code. 9. health care proxy issues: daughter and granddaughter are her health care proxies. 10. therapeutic inr issues: the outside hospital did not give vitamin k. they just watched and allowed her inr decrease. there was a question about mechanical valve; however, on admission to , we determined that her valve was bovine. her inr slowly drifted down and was 1 on discharge. coumadin was restarted, and the patient was to follow up with her primary medical doctor. 11. disposition issues: the patient was to be discharged to home. the patient has an extensive support system with her family. discharge instructions/followup: 1. the patient was instructed to follow up with her primary medical doctor within the next couple of days. i spoke with her primary medical doctor, and he wants the patient to call and make an appointment. 2. her primary medical doctor to monitor her coumadin dose and inr levels and will adjust medications as needed. condition at discharge: condition on discharge was good. discharge status: discharge status was to home. discharge diagnoses: 1. upper gastrointestinal bleed. 2. atrial stenosis. 3. atrial fibrillation. 4. coronary artery disease. 5. diabetes. 6. history of colon cancer. 7. chronic obstructive pulmonary disease. 8. pulmonary hypertension. 9. congestive heart failure. 10. thalassemia. 11. anemia. 12. dementia. 13. history of b12 deficiency. medications on discharge: 1. glyburide 5 mg by mouth twice per day. 2. albumin nebulizers 1 to 2 puffs inhaled q.6h. as needed. 3. salmeterol 1 puff inhaled q.12h. 4. ipratropium inhaler 2 puffs inhaled four times per day as needed. 5. furosemide 40 mg by mouth twice per day. 6. spironolactone 50 mg by mouth once per day. 7. digoxin 250 mcg by mouth once per day 8. sertraline 25 mg by mouth once per day. 9. montelukast 10 mg by mouth once per day 10. coumadin 5 mg by mouth once per day. 11. metoprolol 25 mg by mouth three times per day. 12. prednisone 15 mg by mouth once per day. 13. captopril. 14. pantoprazole. , m.d. dictated by: medquist36 procedure: other endoscopy of small intestine colonoscopy diagnoses: congestive heart failure, unspecified acute posthemorrhagic anemia chronic airway obstruction, not elsewhere classified atrial fibrillation blood in stool anticoagulants causing adverse effects in therapeutic use heart valve replaced by transplant hemorrhage of gastrointestinal tract, unspecified 

Answer: The patient is high likely exposed to