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: imuran / remicade attending: chief complaint: transfered from osh for brbpr major surgical or invasive procedure: colonoscopy history of present illness: 47 yo f with breast cancer (in remission on herceptin), crohn's disease, pe/dvt, factor v leiden, who presented to with cc: of blood per rectum. per osh admission note, pt reports 4 weeks of inc abd cramping c/w crohn's flare. gi doctor with some mild improvement. she had 4 bloody bms at home preceeded by tenesumus and then came to osh ed for eval. . in ed, hd stable. six episodes of bloody stools, one with syncopal episode. exam notable for guiac positive stool on rectal exam. while at osh, recieved 2 u ffp for inr 3.5, with improvement ot 2.0. also recieved 2 u prbcs. was increased to 60 mg qd for crohn's flare. hct of 24. past medical history: 1. crohn's disease, followed by dr in , started w/ iritis per omr -failed imuran fevers -sulfasalizine did not help sxs; asacol/colazol with little relief -c-scope : internal hemorrhoids; ulceration, granularity, friability and erythema in the entire colon compatible with known crohn's colitis;abnormal mucosa in the cecum; normal ti, bx c/w diagnosis -seen in and was on asacol, , remicaid on hold while recieving chemo 2. pe/dvt -s/p filter placement 3. factor v leiden 4. breast cancer, stage ii, her-2 positive, er/pr negative dx -followed by dr w/ cytoxan, adriamycin, taxol -currently on herceptin 5. osteopenia steroids 6. h/o gib in (see omr) with syncope as presenting symptom 7. sleep apnea 8. h/o ovarian cysts social history: married, no etoh, smoking, works on a horse farm family history: significant for father having coronary artery disease and coronary artery bypass graft in his late 60s. he also had pulmonary embolism postoperative after gallbladder surgery. mother has breast cancer diagnosed in her late 70s. one sister with factor v leiden physical exam: pe: vs: 97.4 (af) hr 64 112/67 95-100% ra gen: pleasant lady, nad, drowsy s/p sedation for c-scope heent - perrl, extraocular motions intact, anicteric, mucous membranes moist, +conjunctival pallor neck: no jvd, no cervical lymphadenopathy chest: clear to auscultation bilaterally cvs: normal s1/s2, rrr, no murmurs, rubs, or gallops abd: soft, nontender, nondistended, with normoactive bowel sounds, horizontal scar across low abdomen, s/p breast reconsruction on r ext: 2+ dp pulses bilaterally, trace edema b/l pertinent results: 09:55pm blood wbc-16.0*# rbc-3.54* hgb-10.0* hct-28.9* mcv-82# mch-28.2# mchc-34.5 rdw-16.6* plt ct-338 05:20am blood wbc-11.1* rbc-3.80*# hgb-10.9*# hct-31.9*# mcv-84 mch-28.6 mchc-34.0 rdw-16.6* plt ct-430 09:55pm blood neuts-88* bands-5 lymphs-4* monos-3 eos-0 baso-0 atyps-0 metas-0 myelos-0 09:55pm blood hypochr-1+ anisocy-1+ poiklo-1+ macrocy-normal microcy-1+ polychr-occasional spheroc-1+ ovalocy-1+ 09:55pm blood pt-19.1* ptt-24.1 inr(pt)-1.8* 09:00pm blood pt-12.6 ptt-59.3* inr(pt)-1.1 08:45am blood pt-11.9 ptt-51.6* inr(pt)-1.0 09:55pm blood ret aut-2.0 09:55pm blood glucose-108* urean-14 creat-0.7 na-141 k-4.3 cl-105 hco3-28 angap-12 05:10am blood glucose-85 urean-25* creat-0.9 na-140 k-4.1 cl-102 hco3-30 angap-12 09:55pm blood alt-15 ast-11 ld(ldh)-156 alkphos-80 amylase-73 totbili-0.7 09:55pm blood lipase-35 09:55pm blood albumin-3.1* calcium-8.2* phos-4.8*# mg-2.3 iron-31 04:05am blood calcium-8.6 phos-4.0 mg-2.5 09:55pm blood caltibc-268 ferritn-127 trf-206 brief hospital course: ms. is a 47 yo lady with active crohn's disease, breast cancer in remission, factor v leiden with h/o pe/dvt, who was admitted to the icu from an osh with lgib in the setting of a crohn's flare. icu course: in the icu the pt was noted to be hemodynamically stable. she had bloody bowel movements while receiving bowel prep for a colonoscopy. her colonoscopy was performed and showed friable inflamed mucosa c/w crohn's dz. the patient was treated with iv steroids and asacol without antibiotic coverage. patient was then transferred to the medicine floor for further management. her hospital course by problem is summarized below. . # crohn's flare. patient was followed by the gi team throughout her stay. she continued to have small bloody bms likely secondary to her active disease and due to her need for ongoing anticoagulation (see below). the main challenge with controlling her disease was this need for anticoagulation. she was treated with iv steroids and then a taper. she was continued on asacol. she is to follow up with gi as an outpatient for ongoing management. upon discharge she was hemodynamically stable for several days, tolerating pos and not having bloody bowel movements. . # h/o pe/dvt with factor v leiden. patient is on coumadin as an outpatient. on admission her inr was supratherapeutic likely exacerbating her gi bleed. patient was treated with ffp in the ed for an inr of 3.5. anticoagulants were thus held in the setting of her active bleed. after her colonoscopy and once she was not actively bleeding, a heparin gtt was started for short term anticoagulation since it was felt that her risk of thrombosis was high with her underlying disease. initially her ptt was difficult to control and required frequent adjustments to her sliding scale however this later stabilized within the therapeutic range. upon discharge, she was restarted on coumadin with a lovenox bridge. the patient has close follow up with hematology. . # breast ca s/p mastectomy w/reconstruction. no active issues. . # nutrition. patient was initially npo and then her diet was advanced slowly which she tolerated well without nausea, vomiting or worsening diarrhea. . # prophylaxis: ppi, anticoagulation as above, ambulation. . patient remained a full code. medications on admission: herpceptin q 3 wks coumadin 4 mg qd 40 mg qd aasacol 1200 mg tid discharge medications: 1. enoxaparin 80 mg/0.8 ml syringe sig: one (1) subcutaneous q12h (every 12 hours): as directed by your hematologist. disp:*qs qs* refills:*2* 2. pantoprazole 40 mg tablet, delayed release (e.c.) sig: one (1) tablet, delayed release (e.c.) po q24h (every 24 hours). disp:*30 tablet, delayed release (e.c.)(s)* refills:*2* 3. mesalamine 400 mg tablet, delayed release (e.c.) sig: three (3) tablet, delayed release (e.c.) po tid (3 times a day). disp:*270 tablet, delayed release (e.c.)(s)* refills:*2* 4. 20 mg tablet sig: three (3) tablet po daily (daily): please continue until tappered by your gastroenterologist. disp:*90 tablet(s)* refills:*0* 5. herceptin 440 mg recon soln sig: per your oncologist intravenous per your oncologist. disp:*0 0* refills:*0* 6. cholecalciferol (vitamin d3) 400 unit tablet sig: two (2) tablet po daily (daily). disp:*60 tablet(s)* refills:*2* 7. tums 500 mg tablet, chewable sig: one (1) tablet, chewable po twice a day. disp:*60 tablet, chewable(s)* refills:*2* 8. coumadin 5 mg tablet sig: one (1) tablet po once a day: as directed by your hematologist. disp:*30 tablet(s)* refills:*2* discharge disposition: home discharge diagnosis: 1. lower gi bleed 2. crohn's disease 3. factor v leiden with h/o pe/dvt 4. h/o breast cancer discharge condition: good - no further blood per rectum, afebrile, no abdominal pain, hct stable discharge instructions: please take all of your medications as directed. please make sure you have your inr checked in 2 days and report the results to the pcp. please return to the hospital with any bleeding, black stool, fevers, chills, abdominal pain or any other complaints. followup instructions: you have the following appointments scheduled: 1. provider: , gi (sb) date/time: 1:50 2. provider: dx rm2 radiology phone: date/time: 1:00 3. provider: , md phone: date/time: 2:15 please follow up with your hematologist within 1 week. procedure: colonoscopy transfusion of packed cells diagnoses: long-term (current) use of steroids acute posthemorrhagic anemia personal history of malignant neoplasm of breast regional enteritis of unspecified site long-term (current) use of anticoagulants primary hypercoagulable state disorder of bone and cartilage, unspecified 

Answer: The patient is high likely exposed to